ackground: Red bull (RB) energy drinks became popular especially among young adults believing that they improve the
level of performance and giving them more energy.
Objectives: One of the organs most susceptible to the toxicity of red bull is the liver. Therefore, the goal of our study was to
assess the effects of RB ingestion on the livers of adult male albino rats as well as the consequences of its withdrawal.
Materials and Methods: Thirty six adult male albino rats were divided into 3 groups; control group, Red bull given group < br />(received red bull in a dose 1.5 ml/100g b.wt daily orally for 4 weeks) and withdrawal group (received red bull as in Red bull
group and left for 4 weeks without treatment). Specimens of the liver were taken from all groups and processed for the light,
electron microscopic and immunohistochemical study. Morphometric measurements and statistical analyses were done.
Results: Red bull given group displayed a significantly higher serum level of liver enzymes in comparison to the control group.
Loss of the typical liver architecture was noticed through histopathological analysis in the same group; most hepatocytes were
degenerated with pyknotic nuclei and cytoplasmic vacuolations.Lipid droplets infiltration was noticed between hepatocytes.
Leucocytic infiltration surrounding central vein and vessels of portal area with eosinophilic exudate within and between portal
area vessels were seen. The immunohistochemical results demonstrated a significant increase in alpha smooth muscle actin
(α-SMA) .The ultrastructural assessment confirmed these changes. However, cessation of RB intake showed improvement in
the liver histopathological and biochemical changes depicted previously.
Conclusion: Hepatocytes affected by ingestion of caffeinated energy drinks. But as seen by the withdrawal group's blood and
histopathology study results, these harmful effects were reversible.