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Too revved up

Pre-workout supplements can have negative cardiac side effects.

Article Author: Johnny Woodhouse

Article Date:

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Many people consume protein shakes, energy bars or sports drinks to help boost their workout performance. But those who want to hit their training targets even faster have turned to a wide range of liquid, powder, or encapsulated pre-workout supplements to do the trick. These products contain a variety of ingredients, including amino acids, B vitamins, caffeine and artificial sweeteners.

Research on the effectiveness of “pre-workout” is very limited, but some studies suggest certain ingredients, like the popular muscle-building substance creatine, have been shown to support athletic performance.

But like many dietary products, pre-workout supplements are not closely regulated by the Food and Drug Administration (FDA).

In other words, buyer beware.

Pre-workout problems?

Alejandro Pena Jr., MD, a cardiologist with Baptist Heart Specialists and former certified personal trainer, said it is very important to look at the full ingredient list on any health supplement prior to taking it.

“Since these formulas are not regulated by the FDA, the manufacturers do not need to follow any federally approved guidelines on safe dosing or content,” he said. “Most pre-workout mixes are known to contain more than 200 milligrams of caffeine, the equivalent of two cups of coffee, which can improve energy levels but also increase the risk of high blood pressure, arrhythmias, and potentially a heart attack in patients with severe coronary disease.”

Caffeine is a vasoconstrictor, meaning it makes blood vessels smaller and reduces flow to the muscles. It’s also a diuretic, which increases urination, leading to dehydration.

The scoop on dry-scooping

A new take on pre-workout is causing more alarm. “Dry-scooping,” consuming heavily caffeinated pre-workout powder in its undiluted form as a means of enhancing its effects, can have dangerous consequences.

Not only does it present a choking risk, but health experts warn dry-scooping pre-workout supplements, which contain citric acid, can damage your teeth, causing tooth sensitivity and even pain.

“Additionally, many of the pre-workout mixes contain compounds or herbs similar to ephedrine, a central nervous system stimulant used to treat breathing problems that is even more powerful than caffeine,” Dr. Pena added. “This could create an even higher risk of negative cardiac side effects.”

“Use caution with any pre-workout supplement, especially those containing excess caffeine or ephedrine compounds,” said Dr. Pena.

“Ideally, you would want more blood flow and hydration to feed your muscles, so caffeine isn't the best choice. B-complex vitamins and drinks with electrolytes, like Gatorade, mixed with water are more helpful.”

Safer supplements

Products made from natural ingredients like green tea and beets are much safer alternatives. For those who still want to experiment with pre-workout supplements, it’s important to work up to the full dose, especially if it contains any sort of stimulant.

The type of exercise you do is just as important, Dr. Pena added. For example, lifting very heavy weights, even with proper breathing techniques, can cause spikes in blood pressure which, over time, increase your risk for negative cardiovascular events.

When in doubt, consult your doctor or a certified personal trainer when it comes to safe exercise practices.


The comprehensive wellness and prevention programs at Baptist Heart Specialists help patients maximize their heart-healthy lifestyle. To request an appointment, call 904.720.0799.

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