The Food and Drug Administration has significant jurisdiction over prescription drugs, but little over beverages, unless the potential for harm has been demonstrated. In the middle are dietary supplements, whose manufacturer is supposed to alert the FDA when there is a side effect that could be linked to them.

In the news are popular energy drinks 5-Hour Energy, Monster Energy, and Rockstar Energy, which are listed as dietary supplements. The FDA is disclosing to the public reports of possible side effects. 5-Hour Energy has been possibly linked to 13 deaths over the past four years and injuries including heart attacks and seizures. While there is no proof that energy drinks caused these problems, there is reason to be concerned. According to the Substance Abuse and Mental Health Services Administration, more than 13,000 emergency room visits in 2009 were associated with energy drinks alone.

The biggest problem is a lack of consistency. Red Bull, Full Throttle and other energy drinks are listed as beverages, not dietary supplements, so potential side effects are not reported to the FDA.

I am concerned about people who may have underlying undiagnosed heart disease or other conditions that could be provoked by these drinks. In most cases they are safe, but not all. Caffeine is an active chemical that can cause a rise in heart rate, blood pressure, dizziness, and is not always well tolerated.

The physician should be in the loop when you take any stimulant, including an energy drink, but he or she often doesn’t know until it’s too late.

Marc Siegel, MD, is an internist and professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear