Thursday, August 23, 2007

Blaming It All on Red Bull

In case you haven't seen it, there's been a report of aborted sudden death circulating about in the press and blog-o-sphere about a guy who drank too many Red Bulls, and had a cardiac arrest.

Everyone wants to blame Red Bull.

But was Red Bull to blame?

Here's how the press painted the episode:
Mr Penbross, a concreter, regularly had four Red Bull drinks a day.

"With the work I do I don't have a lot of time to eat," he said. "I have a couple of Red Bulls in the morning and it carries me through."

Last Sunday he was competing in a motocross event near Port Macquarie when he consumed eight Red Bulls over five hours.

"It was to get a bit of a buzz and keep down my reaction time," he said. "You have got to get off [the mark] and around the first corner first."

After his event, Mr Penbross, from Bonny Hills, noticed his heart racing. He collapsed soon after.

He was taken to Port Macquarie Hospital before being flown to Newcastle.
For the record, Redbull contains the about same amount of caffeine as a cup of coffee:
A 7 oz cup of coffee has the following caffeine (mg) amounts, according to Bunker and McWilliams in J. Am. Diet. 74:28-32, 1979:

Drip 115-175
Espresso 100mg of caffeine
1 serving (1.5-2oz)

Brewed 80-135
Instant 65-100
Sure, too much caffeine can cause the heart to race. And some studies have suggested it raises blood pressure, but at least one long term study did not substantiate this effect. And over five hours, about half of his caffeine had metabolized, provided he had a normal liver. Most reported deaths from caffeine overdose (usually from pills) have occurred with 50-100 times the amount of caffeine as this man ingested.

So was caffeine really the CAUSE? Of was it a mere bystander? We will probably never know.

But I was also intrigued by the part of the article that mentioned what his cardiologist had said:
He said Mr Penbross had no other risk factors apart from smoking and had told him he previously experienced chest pain at times when his intake of the drinks was high.
Now I never saw this dude, but given this story, one wonders about previously undiagnosed coronary disease as the cause of his cardiac arrest. Oh, sure, the Red Bull might have increased the heart's requirement for oxygen if his rate or blood pressure increased, but the lack of delivery of oxygen around an area of fixed obstruction from a plaque is more likely what made a young man's heart fibrillate and develop full cardiac arrest.

I wonder: did anyone suggest this man stop smoking?



rlbates said...

Good comments.

beachbirdie said...

Some good thoughts.

I might add one more. Even though this individual is male, did anyone check his thyroid?

I was never able to get my heart rhythms to settle until I got on thyroid medication. Even though they probably don't address this in medical school during the 5 minutes devoted to thyroid, it can affect the heart. I have Hashimoto's thyroiditis and had many episodes of tachycardia, PVCs and other uncomfortable cardiac stuff. Went through a lot of expensive cardiac tests.

Fixing the thyroid levels (suppressed TSH, mid-range or highter Free T3 AND Free T4) fixed the cardiac. Simple as that.

Anonymous said...

The caffeine is only part of the equation... Red Bull also contains sodium citrate.

The temporarily raised blood pressure can be exacerbated by the sodium citrate. Especially after eight red bulls over an extended period of time.

btw.. the side effects of sodium citrate are....

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; hives);
wheezing or shortness of breath;
an unusually slow or irregular heartbeat;
swelling of the feet and lower legs;
leg pain or cramping;
sudden weight gain (more than 2 pounds in one day or 5 pounds in one week);
chest (heart) pain;
tremor or muscle twitching
severe diarrhea or stomach pain

So that explains the racing heart.
Next time you drink a red bull.. sit for a bit.. stand up and notice your swollen legs.

DrWes said...

Anony 1:13AM:

Sorry, at least one study from a reputable peer-reviewed journal disputes your claims of elevations of blood pressure with sodium citrate.

And regarding all of those side effects, did I miss something in the article? Those were never mentioned.

Celestor said...

I was drinking those in a daily basis... today i'm feeling like my heart would explode or even stop. Even tho I only drink 1 can (250ml i think) per day... after 2 months and a half, I start having pain in my upper chest...

It's very bad for health, WAY worse than coke.

You can still use some, once or twice a week, I think the effects are great (except for my current pain)...

I have'nt seen any text saying that you shouldnt drink those each day. I wonder if I could sue them for messing with people health. Easy money

Anonymous said...

The comment on Sodium Citrate fit closely with what happened to my 16 year old daughter last week. After drinking her first red bull ever she experienced a rash on her left hand followed by a feeling of disorientation, then a slight cough, wheezing and then anaphylaxis.

I don't know about the study Dr. Wes refers to and my daughter may be extremely sensitive, but the reactions fit closely with those predicted for Sodium Citrate.

We are, obviously following up with the best Immunologist we can find.