A Man Dryscooped 35000 Milligrams Of Caffeine. This Is What Happened To His Organs.
ET is a 37 year old man, presenting to the emergency room, agitated, confused,
and complaining of a massive headache. Paramedics tell the admitting nurse
that they saw him have a seizure in the ambulance. When it was finished,
they noticed that his heart was beating erratically.
ET was devoted to his gym lifestyle. In his early 20s, in college, he knew that that
age was the prime time in his entire life to build not only a solid base of muscle,
but also a solid foundation of discipline. He ate clean, he didn’t party, he slept well
and consistently put in his hours to become as strong as he could be. And it paid off,
even though he knew he wouldn’t be able to keep up to be as strong later in life as he was in college
ET never really bought into the hype of supplements. He knew consistency
in 1)eating well, and 2) training well were always the most important. But when he did
take supplements, he’d save money by buying raw ingredients, and creating his own mix.
One day while transferring ingredients from the wholesaler’s bags to his own containers,
ET mislabeled the caffeine powder for branch chain amino acids. As he mixed his custom supplement
blend, he thought something was different. Usually the amino acids had a particular texture and
didn’t clump up in to chunks, like how powdered caffeine does. Even though it looked and felt a
little different, he thought maybe the factory used a different way to manufacture things,
maybe it was a different batch. He wasn’t really paying that much attention this time around.
Everything was white powder and it was just hard to tell a difference. As the mixture was ready,
ET had no idea of the sheer amount of caffeine powder in this particular mix. That just a
single scoop alone, contained a lethal dose of caffeine, as he placed the container on his shelf.
The next day, ET prepared his peri workout supplement,
something to drink and keep him hyped during his training session,
but he was completely oblivious to the fact that he was about to consume a lethal dose of caffeine.
In the middle of one of his sets, he decided he would dry scoop it,
as he popped the powder in to his mouth and washed it down with some
drink. As he started swallowing, he noticed it tasted really funny,
kinda bitter with a peculiar after taste. Maybe the factory really changed those amino acids.
Immediately after swallowing 35000 milligrams of caffeine, ET noticed something weird. He wasn’t
sure what was wrong with the taste. He thought the workout was a little weird while he was doing it,
so maybe he just tweaked something, he thought. As the minutes passed,
ET started feeling like he was getting hit by a slow moving train. He felt his stomach was
burning, but his heart was starting to beat faster and faster. He started feeling dizzy,
as it felt like an animal was chewing its way out of his stomach. He felt an overwhelming
sense of doom as he started hyperventilating. Unknowingly, ET’s pupils start to dilate as his
vision starts to blur. He stumbled around and in the shuffle, he felt a tingle through his
cheeks as liquid gushed out under his tongue, and he heaved into the toilet.
At home now, ET laid down on the floor. He could feel a massive pain in his chest. He
called for 911 because he was in such a horrible panic. In the ambulance now,
ET he finally has his first seizure as he’s brought to the emergency room where we are now.
Clearly, all of ET’s problems are because of the 35000 milligrams of caffeine he accidentally
consumed in his home-mixed workout supplement, but ET doesn’t know what he really consumed, he just
knew all of this started after he drank that mix. And doctors also have no idea what happened, but
they noticed that his body temperature was high, and a blood test finds that ET has hyperglycemia.
Hyper meaning high. Glyc from Ancient Greek origin of the word glucose referring to sugar.
And -emia meaning presence in blood. High sugar presence in blood. If ET’s heart rate
is high, if his heart rhythm is erratic, if he’s shaking and he just had a seizure,
then you could reasonably guess that maybe he’s hopped up on a chemical stimulant. His
hyperglycemia was from the stimulant triggering a chemical message to the body that it’s time
to “fight or flight,” cueing the body to immediately mobilize glucose stores from his
body in an effort to supply cells and muscle with energy in order to perform that fight or flight.
ET appears to be experiencing sympathomimetic toxidrome. Toxidrome, a combination of the words
syndrome, referring to a group of symptoms happening simultaneously, and toxin being a
poison. Sympatho referring to the sympathetic nervous system, the one responsible for fight
or flight response as opposed to rest and digest and mimetic meaning an imitation of.
ET has symptoms happening together, that’s imitating a response that would
be elicited by a natural function of one part of the nervous system,
caused by a massive ingestion of a toxin, unknown to ET and the medical team,
but known to us as 35000 milligrams of caffeine, almost 90 times the daily recommended limit.
As the medical team reads the results of ET’s blood test they find that he has hypokalemia.
Hypo- meaning low. Kali referring to potassium, or more formally Kalium as shown by its symbol on the
period table of elements. Low potassium presence in blood. But what does this mean? Potassium,
like sodium above it on the periodic table, is an electrolyte that signals to cells to do, or
to stop doing things. Sodium is primarily outside of cells, and potassium is primarily inside cells.
Moving in and out and being present or absent are how these electrolytes send their messages.
One place that relies heavily on these signals is muscle tissue. The nerves signal for a
contraction by sending neurotransmitters. Sodium enters the muscles to signal for a contraction.
Calcium enters, telling the muscle to commit to a contraction. And potassium signals relaxation. Too
much potassium means the muscles relax for a long time, and too little means the muscles wont stop
contracting, bringing us back to hypokalemia. If there’s low potassium presence in blood,
and too little potassium means that the muscles wont stop contracting,
then it could make sense why ET is so jittery and why he’s shaking. The heart is a muscle too
and if it can’t relax properly, then this could explain why ET’s heart is beating so erratically.
And as the medical team gets ready to admit ET into the hospital, his heart rhythm is so fast
and so erratic, that his heart suddenly stops beating. Doctors scramble to resuscitate ET.
We know that ET accidentally consumed a lethal dose of caffeine. Hyperglycemia could be a
result of that “fight or flight” response and hypokalemia could have caused his twitching
muscles and his cardiac arrest, but why did these happen? Well, caffeine is found in nature in
cocoa beans and tea leaves. The interesting thing about caffeine’s chemical structure,
is that it’s similar in shape to something else that’s produced and used everywhere inside humans,
called adenosine. Our DNA is made of it. You might recognize it through the chemical manufactured
by our mitochondria and used by our cells for energy, ATP, Adenosine Triphosphate. In the body,
certain chemicals fit inside spaces on the cell surface, or maybe it’ll fit into something inside
the cell. Binding into these spaces tells the cells to do, or to stop doing things. So,
a chemical needs the physical shape to fit in. It’s kind of like a square peg,
that should fit in a square hole. And this is where all the problems with caffeine poisoning
happen. In a brief moment, ET tells doctors that all of this started happening after he
swallowed some supplements post-workout. It was OK that he created his own mix because
he knew exactly which ingredients to list, and this tells the medical team everything
they need to know, because caffeine was the only ingredient capable of doing this.
In the brain, adenosine helps balance neurotransmitters, one of which helps
calm the brain preventing overexcitation. Because caffeine is shaped like adenosine,
it fits into those places in the brain instead of adenosine. At regular amounts you’d drink
in one coffee, it’s not a huge deal. But at lethal dose amounts, like in ET’s case,
it can cause such an extreme imbalance that electricity discharges everywhere in ET’s brain,
explaining his seizure. You can start to see why all of this is happening now.
In the heart, adenosine helps regulate pace maker cells. If caffeine is there, preventing adenosine
from performing its functioning, then those pace maker cells can’t be regulated anymore.
The heart starts to lose its normal pace, and it starts to beat erratically. But it doesnt
stop here. In the blood vessels, adenosine helps maintain how relaxed and constricted blood vessels
are. If a huge dose of caffeine is blocking it, then the blood vessels tense up and constrict,
increasing blood pressure and decreasing blood flow. This is a problem in the brain because
blood vessels there can be constricted, limiting blood flow during a time where over excitation
would cause the cells to need more oxygen for the increased activity, but that blood can’t
get there because of the vasoconstriction. But this is only the start of ET’s problems.
This brings us back to the idea of “fight or flight.” Caffeine, in the setting of overdose,
sets off a chemical cascade in the cells. As this signal amplifies itself, it ends
with the release of adrenaline in to the blood. Typically, when the body is in immediate stress,
adrenaline is released to activate that “fight or flight” response. Almost immediately, deposits of
sugar in the liver are released into the blood, so that muscles can use them for energy. The heart
immediately starts beating faster to supply blood to the rest of the body. But this brings us back
to the name, sympathomimetic toxidrome. If the fight or flight response is from the sympathetic
nervous system, but adrenaline is a hormone released into the blood from glands that are
above the kidneys which are not part of the nervous system, then it means there could be
another chemical released from the nervous system due to this fatal dose of caffeine. Noradrenaline
is that chemical, and it quickly spreads all throughout throughout ET’s nervous system,
sending extreme signals. It gets to his muscles, which now have an abundance of sugar to use for
energy because of hyperglycemia. The incessant signal from the brain and the nerves cause the
muscles to twitch. Because the muscles are so active now, they’re producing heat, explaining why
ET’s body temperature was so high. Because they’re so active they’re producing metabolic
wastes. The body needs to balance this waste out, so it takes potassium from the blood and shoves
it into the cells explaining his hypokalemia. But potassium is supposed to signal muscle relaxation,
and there isn’t enough of it in the blood to make that signal. And this is happening at a time when
adrenaline and noradrenaline and sending signals nonstop telling the muscles to contract, and
without that proper relax signal, the muscle of the heart starts beating more and more erratically
until suddenly, it isn’t beating anymore. The stopping of blood flow means oxygen can’t get to
ET’s muscles, during a time when their energy demand is high. The muscles and the brain start
to starve of oxygen and die. As the medical team keeps trying to resuscitate ET because
his heart keeps stopping, the dead muscle tissue can leak its contents and spill protein and iron
in the blood. When the heart starts circulating blood again, those dead muscle cell remnants
can collect in his kidneys, and they can start damaging the tubules causing permanent injury.
This is what happened to ET’s brain, his heart, his muscles, and his kidneys after drinking
35,000 milligrams of caffeine. Is there anything that can be done for ET? Maybe.
This brings us back to the chemical structure of caffeine. First, the molecule is small and
light. This could make it easy to handle. Second, caffeine is hydrophilic. Hydro meaning water,
and -philic meaning affinity for. This means that caffeine dissolves preferentially in water,
as opposed to oil, which doesnt mix well with water, so caffeine wouldn’t distribute widely into
fat tissue in the body. All of this meaning that caffeine is more likely to stay in the blood,
than hide inside the organs where it would be impossible to extract out, once it’s in. Because
of this, it could be possible to “clean” ET’s blood of caffeine. He’s hooked up to a dialysis
machine where his blood flow is diverted to a machine so that it can remove caffeine. The clean
blood is then sent back to his body for normal function. Because ET drank his caffeine recently,
it may not yet be too late, it might still be possible to decontaminate his stomach,
and prevent the caffeine from absorbing into his blood. Activated charcoal was given to
him in the hopes that the remaining caffeine in his stomach would stick to the surface of the
charcoal, not absorb into the blood to do its damage, and eventually pass out of his body.
Hours after the dialysis was started, ET no longer had any seizures and his heart rhythm
started to normalize. Hyperglycemia isn’t life threatening in this context, and it too started
to resolve soon after. Because his hypokalemia was a function of potassium shift into his cells,
his body didn’t actually lose potassium, so aggressively replacing it was not necessary,
an equilibrium was reestablished. Days later, ET was able to make a full recovery
as he returned home, and returned to his original affirmation, that supplements are a nice to have,
but food and consistent training are must haves for true gains in the gym.
Thanks for watching. Take care of yourself. And be well.