First it was Monster Energy, and now the popular 5-Hour Energy shot has been cited in a report released earlier this month by the U.S. Food and Drug Administration linking it to 33 hospitalizations and 13 deaths.

Tamara Ward, a public affairs specialist for the FDA, said the organization is currently investigating reports of illness, injury or death of people who drank the energy shot. 5-Hour Energy, marketed as an energy shot and labeled as a dietary supplement, has been named in 92 patient reports.

“The FDA is a scientific public health agency and must carefully investigate and evaluate all possible causes before deciding whether the product actually caused the medical problem,” Ward said in a Nov. 16 press release.

The FDA continued by saying that though 5-Hour Energy is listed in many reports, that doesn’t necessarily mean that the energy drink is the only factor causing the sicknesses and deaths in each respective claim.

“If we find a relationship between consumption of the product and harm, (the) FDA will take appropriate action to reduce or eliminate the risk,” Ward said.

The FDA said that although it investigates each to the best of its ability, it may not be able to conclusively determine what caused each individual case.

“The agency continues to work with the complainants, medical professionals, state and local health authorities, and dietary supplement manufacturers and distributors, who are required by law to report any new medical information received within a year of the adverse event report,” Ward said.

5-Hour Energy did not respond to requests for comment as of press time.

The FDA said consumers who take energy shots or drinks as an alternative to sleep can be especially at risk.

Sarah Van Orman, the executive director of University Health Services at the University of Wisconsin-Madison, said she is very concerned about the growing market for energy drinks.

Van Orman said that in addition to the deaths listed in the report, there are nearly 13,000 emergency room visits a year relating to these drinks.

There are four main issues when it comes to energy drink consumption, she said.

First, Van Orman said that 5-hour Energy Drinks contain large amounts of caffeine concentrated in small volumes. When a person consumes several of the shots, he or she is quickly at the toxic level of caffeine.

“Acute caffeine toxicity can cause heart damage, seizures, nausea and vomiting, and in some cases cause a critical illness by causing overwhelming release of adrenaline-like hormones,” Van Orman said.

Van Orman said the second issue is that long-term daily use of energy drinks or supplements can cause kidney, heart and liver damage. It can also cause anxiety and other mental health problems along with physical dependance.

The third issue is that the other components of the drink can be potentially toxic, she said.

“The effect of high levels of some of these is not known, but for example, pyridoxine, a supplement found in many, is known to cause nerve damage at high doses,” Van Orman said.

Van Orman said the final issue is the effect of the drinks combined with alcoholic beverages.

“The caffeine in the drinks keeps people from feeling the sedating effects of alcohol, and they may not realize how intoxicated they are becoming,” Van Orman said. “There have been many cases of this leading to alcohol overdoses.”

Van Orman said she thinks these studies will eventually lead to the regulation of energy drinks, which she believes is crucial.

“Caffeine is a drug that has profound physiologic effects,” Van Orman said. “When consumed in the small quantities found in coffee, tea and soda, it is relatively safe. These newer energy drinks deliver the drug in very high doses that are well established to be toxic.”

Van Orman said one energy drink is equivalent to two cups of coffee, which is most likely fine. However, daily usage, the usage of several at once and combining the drink with alcohol can all be dangerous and lead to long term issues.

“If students are using them as a study aid, any short-term alertness will likely be outweighed by the negative effects of anxiousness and poor concentration and definitely not make up for sleep deprivation,” Van Orman said.

Daniel Bernard, a freshman in the College of Arts & Sciences, isn’t surprised by the findings.

“It isn’t something that you should be using in excess,” Bernard said. “It’s kind of like cigarettes: too many of them isn’t good.”