Who Is at Risk of Caffeine Intoxication?

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While caffeine — usually in a cup of coffee or two — is a regular part of most people’s daily routine, at high levels of consumption it can have toxic effects, known as “caffeine intoxication,” experts said.

A safe amount of caffeine for the average person tops out at roughly 400 mg per day — about 4 to 5 cups of coffee, according to the FDA. However, the toxic effects of caffeine kick in with rapid consumption of about 1,200 mg — about 12 cups of coffee.

Guy Mintz, MD, of Northwell Health Sandra Atlas Bass Heart Hospital in Manhasset, New York, told MedPage Today that caffeine intoxication has a range of symptoms, from jitteriness, elevated heart rate, and increased in blood pressure, all the way up to palpitations, nausea, or vomiting, and even seizures.

“Caffeine intake of 400 mg or less per day is deemed safe and acceptable,” Mintz said. “Once you start to get above 400, people can have various side effects, which would include all of these things, [and] … potential seizure.”

Mintz noted that every individual will have a different tolerance level, and that adolescents are especially susceptible to the risks of caffeine intoxication because they likely have a lower tolerance threshold for overall caffeine consumption. He recommended that younger caffeine drinkers should consume no more than 200 mg per day.

Still, most people don’t realize that they may be consuming more than the recommended amount of caffeine each day.

While people say they limit their intake to a few cups of morning or afternoon coffee, “It’s not just about coffee,” Mintz said. People unknowingly consume caffeine from other sources, such as energy drinks. “It all adds up.”

Other sources of caffeine include that cup of tea at dinnertime or a Red Bull to stave off the mid-afternoon lull, he said. All of those sources of caffeine can accumulate in a person’s system leading to potential intoxication. In fact, he noted that caffeine from a single drink can stay in a person’s system for up to 9 hours.

In addition, these other kinds of drinks frequently contain far more caffeine than a typical cup of coffee, he warned.

Recently, drinks with high levels of caffeine have even been cited in wrongful death lawsuits brought by people with preexisting conditions, such as long QT syndrome type 1, that made them more susceptible to caffeine’s adverse effects. Some research exists backing up these claims that caffeine can lead to death.

Adding to the risk of caffeine intoxication, many people tend to consume caffeinated drinks almost every day, which can lead to chronic intoxication, according to Nicole Clark, MD, a neurologist at St. Peter’s Health in Helena, Montana.

“If you have chronic intoxication you can become very dependent, just like on any other chemical, and that causes its own set of problems,” Clark told MedPage Today.

People tend to feel the side effects of caffeine withdrawal — headaches, excessive tiredness, and even feelings of depression — after missing just one day of their normal caffeine intake.

Both Clark and Mintz recommended that physicians discuss the risk of caffeine intoxication with their patients, similar to questions regarding alcohol consumption, during annual wellness check-ups.

While caffeine tolerance will be unique to each individual, Mintz said, the risk of intoxication exists for everyone.

“It’s unclear [at] what level someone will progress to extreme toxicity, where you’re at increased risk of seizure activity,” Mintz said, “but along the way there’s a lot of side effects.”

Michael DePeau-Wilson is a reporter on MedPage Today’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news. Follow

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