Can too much caffeine lead to death?

It was late in 2023 that news of a college student’s death due to drinking a highly caffeinated lemonade at a Panera Bread location had parents in a panic. Wondering the if the same could happen to their own children, teens or young adults, they were asking how much caffeine is too much.

“At the time of this young woman’s death, it was reported that a 30-ounce serving of Panera’s ‘Charged Lemonade’ had 390 milligrams of caffeine,” says Dr. Abisola Olulade, a board-certified family medicine doctor with Sharp Rees-Stealy Medical Group. “While that number has since been revised on the company’s website, 390 milligrams is just 10 milligrams less than the maximum daily recommended amount for healthy adults. And this drink was offered as a single serving with the possibility of free refills.”

In comparison, an 8-ounce cup of coffee usually has 80 to 100 milligrams of caffeine, an 8-ounce cup of black tea has about 50 milligrams, and a can of cola has 30 to 40 milligrams. An energy drink, such as Red Bull, has about 80 milligrams of caffeine, though some can have two to three times that amount.

The Food and Drug Administration (FDA) reports 400 milligrams of caffeine a day is safe for most healthy adults but discourages the consumption of caffeine by children and adolescents. Pregnant people, breastfeeding people or people with underlying conditions should discuss whether any amount of caffeine is safe with their doctors.

The college student, age 21 when she collapsed after drinking the Charged Lemonade, had a preexisting irregular heart rhythm. Her family says she avoided caffeine and was not aware the drink had elevated levels of the stimulant, as lemonade is usually caffeine-free. Panera now displays signs warning the drink contains caffeine.

Some health effects of caffeine are concerning

Caffeine is fundamentally a drug, says Dr. Olulade. It affects several systems within the body and can lead to a variety of health problems, regardless of whether someone has preexisting health concerns or not.

Signs of caffeine overuse include:

• Restlessness and shakiness

• Insomnia

• Headaches

• Dizziness

• Fast heart rate

• Increased blood pressure

• Upset stomach and nausea

• Dehydration

• Anxiety

• Caffeine dependency

The young woman whose tragic story was shared worldwide through news stories and social media posts went into cardiac arrest after drinking Panera’s Charged Lemonade. She was taken to a hospital and treated but had a second cardiac arrest soon after and died.

“While death from caffeine use is very rare, we’re seeing that it can happen,” Dr. Olulade says. “This tends to occur when taken in concentrated from, such as pills and powders, and has been seen in very young people and athletes, who may combine excess caffeine use with exercise.”

Awareness and good decision-making help reduce risks

Dr. Olulade recommends that parents not only talk to their children about the dangers of caffeine but also regulate their own use. “We need to be careful about the things we’re consuming,” she says. “Moderation is key, especially when it comes to caffeine.”

Dr. Olulade also notes that while overuse of caffeine can be dangerous, some use can have benefits for healthy adults. In small doses, caffeine can improve focus, mood and energy levels. What’s more, the American Heart Association reports that people who regularly drink appropriate amounts of coffee, the most common caffeinated drink chosen by Americans, may be less likely to develop chronic illnesses, including heart disease, diabetes, Parkinson's disease and some cancers.

“Caffeine affects people differently,” says Dr. Olulade. “What works for one person may be too much for another based on the medications they’re taking, how much they weigh and how fast their body metabolizes it.”

Awareness of what you’re consuming — and what your children are consuming — is important, Dr. Olulade says. And as with any health-related matter, she recommends talking with your doctor if you’re concerned about your caffeine intake or its effects.

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