Having a latte or energy drink before practice might sound harmless and just a normal part of being a busy teenager. But doctors are seeing the flip side: Teens sitting in the exam room describing a heart that feels like it’s fluttering, racing and skipping beats. Palpitations are one of the most common reasons kids end up in a pediatric cardiologist’s office. The culprit usually isn’t a heart condition but caffeine.
“Palpitations are one of the top five reasons kids come to see me, alongside murmurs, chest pain, and dizziness,” said Faustino G. Ramos, MD, a pediatric cardiologist at UT Physicians Pediatric Center – The Woodlands. “They are probably the biggest direct link to caffeine consumption, and caffeine is fuel for these premature beats.”
Dizziness is another common but sometimes difficult-to-pinpoint symptom. Ramos said cardiologists frequently see teens for dizziness, but these patients may also be evaluated by other specialists, including neurologists. Caffeine use is widespread among teens, and dizziness is common in this age group. Although the two can occur together, research has not established that caffeine directly causes dizziness.
“We advise across the board that if you’re having dizziness symptoms, you should not be drinking caffeine, period,” he said.
Ramos said caffeine can make the symptoms that bring teens to his office worse. Dehydration can compound the problem especially when teens aren’t drinking enough water.
It starts out innocent enough, Ramos said. Then it becomes a daily habit: an energy drink before football or cheer practice, before a game, or when teens need an extra push. Studies show almost one-third of teens ages 12 to 17 drink them regularly.
“There’s a lot of pressure for teens to use caffeine, whether it’s for studying, hanging out with friends, or as a coping mechanism with their academics, sports, and activities,” Ramos said. “They’re using it to stay up late to do homework. It’s a temporary fix, not a long-term solution.”
How much caffeine is in that drink?
Part of the problem is caffeine can be hiding in plain sight. In the United States, manufacturers must declare caffeine in the ingredient list, but caffeine amounts aren’t always listed on beverage labels.
Popular coffee drinks can include more than 300 milligrams of caffeine in a single serving compared to an average cup of coffee with 100 mg. Energy drinks marketed as a healthier alternative often contain around 200 mg. That can be far more caffeine than teens realize they’re consuming.
“Very, very small doses of caffeine can be helpful to train focus, but very small doses,” Ramos said. “An energy drink is probably 10 times more than what they actually need.”
His recommendation is simply no caffeine at all for children and teens. There’s no physiological need for it, he said.
“There’s plenty of data to show that it interferes with their sleep, which causes them to be sleepy and tired during the day,” Ramos said. “What’s the answer? More caffeine, which just perpetuates the cycle. It’s a vicious cycle that needs to be broken.”
Open conversations and early habits
Ramos encourages parents to stay vigilant and talk openly with children and teens about caffeine. He understands the challenge firsthand as a parent. For those with younger children, he said it’s best to avoid introducing caffeine in the first place. Building healthy habits early can make those choices easier to maintain as kids get older.
“There are a lot of people who have an underlying predisposition to develop an arrhythmia, and they’re not aware of it,” Ramos said. “The biggest misconception parents have is that it’s OK for teens to drink a coffee from Starbucks. We don’t realize the effects are there—we’re just not recognizing them.”