The elusive promise of energy in a bottle is an attractive proposition that draws a wide range of people: students, athletes, parents, shift workers and busy retirees may all be drawn to the allure of energy supplements.
Caffeine is an old favorite, but there are several other common energy supplements that patients may have purchased at the drug store that may also have value in some cases.
Guarana
Guarana (Paulinia Cupana) is a plant native to the Amazon. It’s a popular ingredient in energy-boosting supplements and has been used by indigenous peoples as a natural remedy for hundreds of years.[]
A 2023 systematic review and meta-analysis determined that “acute guarana supplementation appears to have a modest effect on reaction time and improves performance on a range of cognitive tasks without affecting accuracy.”[]
Pure guarana is a highly concentrated source of caffeine: 5.30% caffeine compared to approximately 0.21% in espresso. There is a question as to whether the effects of guarana are solely due to its caffeine content or to other bioactive compounds, but currently published data is limited.
Comparative studies of guarana and caffeine have shown mixed results or similar effects.[] However, guarana has been shown to have short-term stimulant effects and may not be ideal for patients who are sensitive to caffeine.
Vitamin B
B vitamins play a key role in energy metabolism and oxygen transport. Their ability to affect brain and muscle function (water-soluble B vitamins are generally safe) has led to them being used as nearly every ingredient in energy drinks and supplements.
Deficiencies of individual B vitamins can cause energy-sapping symptoms, such as muscle weakness, fatigue, insomnia, lethargy, and shortness of breath.
Although most health authorities say there’s no point in taking supplements if there’s no deficiency, some studies suggest that subclinical deficiency (or insufficiency) is widespread and causes cognitive and physical symptoms that improve with vitamin B supplementation.[]
Consider the following:
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A meta-analysis found that 11 of 18 trials reported that a combination of B vitamin supplements had a positive effect on participants’ mood.
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A placebo-controlled study in ultramarathon runners found that supplementing with riboflavin (vitamin B2) before and during the race reduced muscle fatigue after the race.
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Young athletes given high doses of thiamine (vitamin B1) for three days experienced reduced subjective fatigue scores during cycling exercise.
Certain populations with vitamin deficiencies, such as chronic alcohol use or unhealthy dietary habits, may be more susceptible to the positive effects of vitamin B supplements.
Overall, vitamin B supplements offer little risk and moderate potential benefit for most patients seeking more energy, especially as long as recommended intakes are not excessively exceeded.
carrot
Ginseng is used in over 30% of the top selling energy drinks and energy shots.[] Its stimulating reputation dates back to ancient Chinese medicine, where it is said to increase stamina and vitality.
Research suggests Korean ginseng and Panax ginseng (American ginseng) effectively reduces fatigue when taken at approximately 80-2,000 mg per day. Although ginseng itself is unlikely to cause dangerous side effects, doctors should be aware that it may interact with alcohol, warfarin, and phenelzine.
May hide health concerns
Perhaps the greater danger of energy supplements is not what they do, but what they hide.
A variety of conditions can cause fatigue and cannot be treated with supplements alone, including sleep apnea, depression, liver problems, anemia, diabetes, autoimmune diseases, and medication side effects.[]
By exploring the causes of a patient’s lack of energy, we can uncover underlying health and lifestyle issues that may require medical treatment.
What this means for you
In general, evidence for the effectiveness of energy-boosting supplements is limited or their effects are due to caffeine. After all, energy supplements often contain a variety of ingredients in untested amounts, and healthcare professionals have a responsibility to inform their patients of their potential dangers. Instead, they should encourage tired patients to exercise regularly, drink adequate fluids, get enough sleep, and get medical testing when appropriate.
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