Health Canada has received 86 reports of adverse reactions to energy drinks, at a time when U.S. regulators are investigating 13 deaths possibly related to energy "shots" in that country.
The U.S. Food and Drug Administration has received 92 reports that cite illnesses, hospitalizations and deaths after people consumed 5-Hour Energy.
"There are two 5-Hour Energy products that are permitted for sale in Canada," Sean Upton, senior media relations officer for Health Canada, said in an email to CBC News. "They are 5-hour Energy Extra Strength (en-140564) and 5-hour Energy Regular Strength (EN-140566)."
Both products need to be labelled with information including each medicinal ingredient, he added.
Health Canada's database of adverse reactions started in 1965 but the energy products have only been on the market in recent years.
Doctors in Nova Scotia are recommending a ban on the sale of energy drinks to anyone under age 19.
Earlier, the FDA also received reports that cited the highly caffeinated Monster Energy Drink in five deaths and one non-fatal heart attack.
No deaths linked to products
Health Canada recommends adults have no more than 400 mg of caffeine per day, equal to roughly two of the 5-Hour Energy drinks.
"If someone is thinking about taking one of these products, they should consult with their health-care provider to ensure that there are no underlying or undiagnosed medical conditions that could worsen as a result of using them," FDA spokeswoman Shelly Burgess said.
Elaine Lutz, spokeswoman for Michigan-based Living Essentials, LLC, advises consumers to drink no more than two bottles of 5-Hour Energy shots a day, spaced several hours apart, and for new consumers to drink half a bottle to start.
Lutz said in a statement that the company is not aware of any deaths proven to have been caused by their product.
Last month, Monster Energy said in a statement that it stands by its products.
Risk: Caffeine Overload
Many energy drinks and other products feature very large amounts of caffeine -- approximately three times the amount found in a regular cup of coffee -- often along with other stimulants. The problem with consuming large amounts of caffeine is two-fold, explains K. Steven Whiting, Ph.D., of Phoenix Nutritionals in San Diego and author of "Healthy Living Made Easy". One, it targets the central nervous system directly. Two, it can lead to dehydration and loss of water-soluble nutrients that have a calming effect on the central nervous system. This combined effect can cause agitation and sleep problems and potentially lead to the development of long-term anxiety issues.
Risk: Too Many 'Energy-Boosting' Ingredients
Caffeine may not be the only stimulant in your energy drink. Many of these products contain similar ingredients, from various forms of caffeine to guarana, acai berry, taurine, ginseng, arnitine, creatine, inositol and ginkgo biloba -- all of which have stimulating effects. "Taurine has been shown to improve athletic performance so this may be the reason why it is added to many of these drinks -- and mixing taurine with caffeine may increase mental performance, but this research remains inconclusive," says Amy Shapiro, R.D., C.D.N., of Real Nutrition in New York City.
Risk: Sugar Overload
Other dangers of energy drinks can be traced to the fact that they're also loaded with sugar, a particular health risk for children and people at risk for diabetes. Even for non-diabetics, all the sugar causes a crash a few hours later, leaving the drinker more exhausted than before they had the drink. Keep in mind that while sugar-free energy drinks may be a better option, sugar-free versions of Red Bull, Amp, Rockstar, NOS and Crunk still carry serious risks because of their high caffeine content and artificial ingredients, including artificial sweeteners like aspartame.
Beware of Energy Drinks for Kids
With endorsements from cartoon characters and famous athletes, many energy drinks are marketed directly to kids and teens. "Young people really need to be careful with these energy products because their central nervous system is not full developed and [the drinks] can lead to longer-term health problems," Whiting warns. Talk to your child's doctor about whether any amount of caffeine is acceptable, and make sure your teen knows the possible dangers of drinking these products. <br><br> In the lawsuit against Monster, Fournier's mother says that the caffeine in energy drinks should be regulated, particularly because the drinks are heavily marketed to teens and children.
Do Not Mix: Energy Drinks And Alcohol
Some energy drinks not only contain high amounts of caffeine and sugar but also high amounts of alcohol and have been associated with serious side effects, including death. Some states, including New York, have banned drinks that combine alcohol and caffeine, but many people continue to mix them through Red Bull-vodka cocktails, among others. "The combination of alcohol and caffeine may lead to adverse effects, as the presence of caffeine increases the absorption of alcohol, which can increase intoxication," Shapiro says. Although many people may think that the caffeine in these drinks can prevent the drowsiness associated with drinking alcohol, it cannot prevent the effects that alcohol has on the brain.
The Problem With Energy Shots
Energy shots, including 5-Hour Energy and 6-Hour Energy, provide a burst of energy to help you get through the day and typically do not contain large amounts of sugar, but the amount of caffeine they contain is unclear. "The problem with these energy products is no one really knows how much is too much," says Whiting. "The manufacturers have not done any studies to determine the appropriate amount, as caffeine is an uncontrolled substance. They don't put any warnings or precautions on these products either."
Energy Strips Caution
Energy strips, including LeBron James's Caffeine Strips, are packaged like breath strips and are marketed to teens and tweens. They have the same dangers as energy drinks. "Energy strips are likely absorbed much quicker than other energy products as they are absorbed directly into the bloodstream through the tongue," Shapiro explains.
The Dangers Of Caffeine Pills
Caffeine or energy pills carry a greater risk for adverse effects when used in combination with other energy products. "The problem is that many people probably use more than one form of these products to stay awake," Whiting says. "They take an energy or caffeine pill in the morning, have a cup of coffee, and in the middle of the afternoon have an energy drink -- it can be very harmful to have this excess of caffeine."