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Energy-boosting supplements: Do these drugstore staples deliver?

MDlinx Jun 05, 2024

The elusive promise of energy in a bottle is a tempting proposition that appeals to a wide audience. Students, athletes, parents, shift workers, and busy retirees may be tempted by the allure of energy supplements. 

 

Caffeine is an old standby, but here are some other common energy supplements your patients may be buying at the drugstore—and if research suggests they’re worth the money.

 

Guarana

 

Guarana (Paullinia cupana) is a native plant from the Amazon. It’s a popular ingredient in energy-boosting supplements, and indigenous groups have used it in natural medicine for hundreds of years.

Hack B, Penna EM, Talik T, et al. Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis. Nutrients. 2023; 15(2):434. doi:10.3390/nu15020434.

 

A 2023 systematic review and meta-analysis determined, “Acute guarana ingestion appears to have a small effect on response time indicating faster performance during a variety of cognitive tasks without affecting accuracy.”

Hack B, Penna EM, Talik T, et al. Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis. Nutrients. 2023; 15(2):434. doi:10.3390/nu15020434.

 

Pure guarana is a highly concentrated source of caffeine. Compared to espresso, which is around 0.21% caffeine, guarana can be as high as 5.30% caffeine. Although there is a question of whether or not guarana’s effects are simply due to its caffeine content or its other bioactive compounds, published data are currently limited. 

Comparison studies with guarana and caffeine either show mixed results or similar effects.

Hack B, Penna EM, Talik T, et al. Effect of Guarana (Paullinia cupana) on Cognitive Performance: A Systematic Review and Meta-Analysis. Nutrients. 2023; 15(2):434. doi:10.3390/nu15020434.

Nonetheless, guarana has proven short-term stimulant properties, but it’s not ideal for caffeine-sensitive patients.

 

 

B vitamins

 

B vitamins play critical roles in energy metabolism and oxygen transport. Their ability to impact brain and muscle function (along with the generally high safety profile of water-soluble B vitamins) has led to them becoming an almost ubiquitous component of energy drinks and supplements.

Individual B vitamin deficiencies cause energy-zapping symptoms such as muscle weakness, fatigue, insomnia, apathy, and shortness of breath. 

 

While most health authorities say supplementation without a deficiency isn’t worthwhile, several studies suggest that subclinical deficiencies (or insufficiencies) are widespread and produce cognitive and physical symptoms that would benefit from a B vitamin boost.

Tardy AL, Pouteau E, Marquez D, et al. Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence. Nutrients. 2020;12(1):228. Published 2020 Jan 16. doi:10.3390/nu12010228.

 

Consider the following:

  • A meta-analysis reported that in 11 out of 18 trials, combination B vitamin supplements positively impacted participants’ moods. 

  • A placebo-controlled study on ultramarathon runners found supplementing with riboflavin (vitamin B2) before and during the race reduced subsequent muscle fatigue.

  • Young athletes given a high dose of thiamine (vitamin B1) for 3 days had lower subjective fatigue scores from cycling exercises.

Certain populations with vitamin deficiencies, including those with chronic alcohol consumption or poor diets, may be more susceptible to the positive impact of B vitamin supplements. 

 

Overall, B vitamin supplements pose little risk and moderate potential benefits for most patients who want more energy, particularly if the doses aren’t excessively over recommended intakes.

 

Ginseng

 

Ginseng is found in more than 30% of the top-selling energy drinks and shots.

Jagim AR, Harty PS, Tinsley GM, et al. International society of sports nutrition position stand: energy drinks and energy shots. J Int Soc Sports Nutr. 2023;20(1):2171314. doi:10.1080/15502783.2023.2171314.

Its stimulating reputation links back to ancient Chinese medicine, as it is said to increase stamina and vitality.

 

Research suggests that Panax ginseng and Panax quinquefolius (American ginseng) effectively reduce fatigue when dosed around 80 mg to 2,000 mg per day. Ginseng itself is unlikely to cause dangerous side effects, but physicians should be aware it may interact with alcohol, warfarin, and phenelzine.

 

The potential to mask health concerns

 

Perhaps the bigger hazard of energy supplements isn’t what they may do, but what they may hide.

A wide range of conditions, such as sleep apnea, depression, liver problems, anemia, diabetes, autoimmune diseases, and medication side effects, may cause fatigue that should not be treated with supplements alone.

Fatigue. Mayo Clinic. February 11, 2023.

 

Exploring the reasons for your patients’ lack of energy can help uncover underlying health and lifestyle issues that warrant medical attention. 

 

What this means for you

Generally, energy-boosting supplements have limited evidence of efficacy or owe their effects to caffeine. Ultimately, healthcare providers have a responsibility to inform patients about the potential dangers of energy supplements, particularly given the fact that they often contain an array of ingredients in unverified amounts. Instead, steer your tired patients toward regular exercise, proper hydration, sufficient sleep, and medical testing when appropriate.

 

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