by Melissa Rimac
Coffee was once believed to be a means by which to
achieve religious ecstasy. Although most of us don’t use coffee
to try to communicate with the divine, many people assume an identity
akin to savage snarling beasts if there is a delay in their ‘fix’
for the day, and wouldn’t be caught without it in the house. Caffeine
is unique among psychoactive substances in that even the healthiest
of us can be hooked to the extent that we feel that, without that heady
‘buzz’, we can’t launch ourselves into the day.
Caffeine is a socially acceptable and invisible drug which produces
feelings of alertness, energy and motivation and has people reaching
for more in times of stress.
Although many researchers concur that small doses of caffeine will have
little or no negative impact upon the health of most people, the picture
changes when the amounts of caffeine consumed rise. A cup of brewed
coffee will typically give you about 100 mg of caffeine, while a cup
of tea has between 40 and 45 mg. A can of Coca-Cola has 45 mg and chocolate
has 8 mg (although it has other chemicals which react with the caffeine
to give you a bigger buzz than you would expect from this amount of
caffeine). (7) A less predictable source is the plethora of pharmaceuticals
such as headache preparations and slimming pills which contain caffeine.
Coffee has become almost synonymous with caffeine and much of the research
about the effects of caffeine have focussed on coffee. Although coffee
consumption has been falling steadily, the rate of caffeine consumption
in Australia has tripled since 1962. We now get our caffeine from a
much wider range of products - for example, the consumption of caffeine-containing
soft drinks in this time has doubled. This is of concern because people
are acquiring a taste for caffeine at a younger age.
A Potent Chemical *****tail!
Not long after that first aromatic sip, caffeine starts to weave a tangled
web of intrigue and deception in just about every organ in the body.
Caffeine easily crosses cell membranes and is rapidly distributed to
all the body’s tissues.
In no time at all the caffeine in coffee triggers the release of norepinephrine
into the brain. This is the brain’s own natural feel-good chemical.
It quickens respiration, strengthens pulse, raises blood pressure, stimulates
the kidneys, temporarily relieves fatigue and depression while stimulating
the functions of the brain.
But the sly hand of deception is at work here, starting with caffeine’s
bi-phasic nature its effects at low doses are very different to its
effects at high doses. While it may initially act as a stimulant, in
larger doses it actually depresses the central nervous system. Caffeine
interferes with the activity of other molecular regulators in the brain,
setting off a chemical chain of events which inhibits nerve firing.
Caffeine further tricks your brain by interfering with the adenosine
receptors - which constitute a kind of neurological thermostat with
a crucial role in regulating the overall arousal levels of the brain
and preventing the neurotransmitters from being overloaded with messages.
This is why too much caffeine can produce an effect which mimics ‘speeding’
or a panic attack, leaving people feeling jittery and in a heightened
nervous state.
Regular tampering with your adenosines makes the brain need the stimulation
of caffeine in order to feel normal. Frequent caffeine users end up
having an oversupply of adenosine receptors. Feelings of lethargy and
drowsiness are the body’s way of retaliating for having its adenosines
immobilised. When caffeine helps to alleviate these symptoms it’s
actually bringing you back to normal speed! So while it may feel as
if caffeine is giving you an energy boost your body is actually adopting
a continuous pattern of catch-up. Caffeine is quite remarkable for the
range of reactions which it produces, and people metabolise caffeine
at vastly different rates. This is believed to be related to the number
and distribution of adenosine receptors. A person with an increased
number literally has more targets for the caffeine to hit and is likely
to be very sensitive to its effects.
Effects on Moods and Emotions
Norepinephrine is a neurotransmitter which plays a critical role in
regulating mood and behaviour and is believed to also be associated
with memory. Low levels of noradrenaline are associated with depression
and mood swings, while increased levels tend to lift depression and
improve moods.
Stress causes the body’s reserves of norepinephrine - the brain’s
own anti-depressant neurotransmitter - to become depleted. Paradoxically,
most people increase caffeine intake in times of stress - just when
it is going to further accentuate the stress symptoms.
In addition, caffeine also lowers the levels of tyrosine, a substance
which is vital for the production of norepinephrine and is believed
to increase the effects of stress upon mind and body. Tyrosine also
regulates blood pressure and is very important for the healthy functioning
of the thyroid gland which regulates, among other things, weight gain,
metabolism and libido. (5)
Health Problems Physical
When caffeine consumption exceeds approximately 200 mg a day - about
2 cups - there’s cause for concern. Studies indicate that possible
problems include:
Increased nervous symptoms, such as increased anxiety, sometimes culminating
in panic attacks, insomnia (and other sleep disturbances and feelings
of lethargy), depression, irritated lining of the stomach, diarrhoea
and heartburn, aggravated heart and artery disorders.
One study, reported in the New England Journal of Medicine concluded
that, “Men who drank 5 or more cups a day had an estimated coronary
heart disease relative risk of 2.49 compared with non-coffee drinkers”
(2)
Other symptoms were:
Short-term blood pressures will rise. Blood cholesterol levels may rise.
Aggravation of irritable bowel syndrome. Increasing infections associated
with prostate infection. Shortness of breath and irregular heartbeat.
Headaches can be triggered by caffeine. Caffeine can interfere with
the body’s anti-inflammatory devices. Children who have high caffeine
intakes, in the form of chocolates and soft drinks, display higher levels
of hyperactivity and anxiety. (6)
Effects on Metabolism
Caffeine increases the basal metabolic rate and can produce hyperglycaemia.
It’s not accidental that caffeine is an ingredient in many slimming
preparations 500 mg of caffeine can increase the metabolic rate by between
10 and 25%.
Effects on Reproduction
High levels of caffeine will damage chromosomes. Even a moderate intake
can damage sperm. Intending fathers should limit their caffeine intake
to less than the equivalent of 4 cups of coffee a day.
Caffeine has been shown to speed up foetal activity.
Doses as low as 150 mg a day have been implicated in an increased rate
of spontaneous abortion.
High caffeine intake has been associated with difficulty in becoming
pregnant.
Irritability and sleeping problems have been observed in nursing infants
whose mothers are heavy caffeine users.
Linked with lower birth weights.
Effect on Women’s Health
Studies have linked caffeine to an increase in breast cysts in some
women. (4) Can exaggerate symptoms of PMT - even though, paradoxically,
most women tend to increase their intake of caffeine at the onset of
these symptoms. May also encourage fibrocystic breast disease in women.
Effect on Nutrient Absorption
This is where caffeine becomes insidious and nasty. It can produce dietary
deficiencies by preventing the absorption of some nutrients and increasing
the rate of excretion of others. Caffeine increases the urinary secretion
of phosphorus, potassium, magnesium and calcium. High doses of caffeine
speed up the metabolism so much that the body doesn’t get the chance
to fully utilise these nutrients.
Caffeine prevents calcium being properly absorbed. This effect becomes
pronounced when more than two cups of coffee are consumed. Eventually
calcium can be lost from the bones and excreted via the urine, decreasing
bone density and leading to osteoporosis.
Caffeine interferes with the absorption of iron. Coffee taken with or
within an hour after a meal has been found to reduce iron absorption
by 39%. (4) Coffee drunk an hour before a meal, however, didn’t
affect iron absorption. Tea has been shown to have a similar, though
less dramatic, effect.
Caffeine is believed to create inositol and biotin deficiencies, prevent
available iron from being properly utilised and cause many other vitamins
to be eliminated before they can be properly absorbed. (6)
Health Problems - Mental
While small doses of caffeine can enhance mental activity, increased
doses can produce disturbing symptoms. Larger doses are likely to give
rise to feelings of anxiety, restlessness, insomnia, headaches, tremors
and hyperaesthesia (abnormally increased sensitivity to stimuli) and
interfere with psychomotor functioning (mind-originated muscular activity).
The tendency of caffeine to engender feelings of depression becomes
magnified in some people.
Studies have shown that people who suffer from panic disorders are more
sensitive to caffeine and that it produces exponential increases in
symptoms such as anxiety, nervousness, fear, nausea, palpitations, restlessness
and tremors. Increased anxiety may also be experienced as a result of
caffeine withdrawal. (4)
The American Psychiatric Association has identified a ‘Caffeine-Induced
Organic Mental Disorder’. This requires a dose of over 250 mg to
bring on symptoms as disturbing as muscle twitching, insomnia, psychomotor
agitation, extreme nervousness, episodes of inexhaustability and, in
some cases, delirium.
Caffeine Can React With...
Because caffeine and its chemical cousins are common ingredients in
a dizzying array of pharmaceutical drugs, any other caffeine ingested
may interact with the caffeine in the medicines to give a much bigger
jolt than you initially expected. These medications may slow the elimination
of caffeine from the body - so you stay ‘wired’ for a lot
longer.
Women who take the contraceptive pill need to be particularly cautious
about their caffeine intake and should try and moderate it. Pharmacologically,
caffeine is similar to theophylline, an ingredient in the pill, so once
again you may get more than you bargained for in that invigorating cup
of coffee. Studies have shown that the effects of caffeine in women
who take the pill are prolonged and possibly intensified. This could
lead to increased nervousness, insomnia and that wired, slightly out-of-control
feeling that can set in after too much caffeine.
Theophylline is also used in many asthma medications, so taking caffeine
with them equates to an ‘overdose’ which is likely to magnify
the problems caused by excessive caffeine intake.
Be wary of herbal preparations which claim to boost energy as many contain
caffeine-like substances which could interact with other medications.
A good example is guarana, a popular herbal ingredient found in many
‘natural’ products, especially those claiming to be diet aids
and stimulants. It’s not surprising that it’s sometimes marketed
as ‘Zoom’ - it contains up to or more than double the caffeine
content of coffee! It is therefore likely to react with other substances
to an even greater extent than the conventional sources of caffeine.
(3)
Caffeine can render many anti-inflammatory medications quite ineffective.
This can result in slower healing time and diminished pain-killing attributes
of the medication.
Caffeine Should Be Avoided Or Intake Cut by...
People who display noticeable heartbeat irregularities when caffeine
is consumed. Pregnant and lactating women and prospective fathers. Smokers
- they eliminate caffeine more quickly and end up consuming more caffeine.
People with cardiac disease. People who have a tendency to peptic ulcers
and gastrointestinal problems. People with hypertension and high cholesterol
levels. People who suffer from insomnia, depression, anxiety and chronic
fatigue syndrome. People in a high risk category for osteoporosis.
Caffeine Does Have Some Benefits
Some research indicates that caffeine isn’t all fire and brimstone
and that there are a few tangible health benefits for some people. Because
the bronchial tubes are dilated by caffeine, it’s an effective
emergency remedy for asthma attacks. Regular consumption has been shown
to reduce the symptoms of asthma and wheezing (but this should never
be used as a treatment for asthma!).
Another study found that as little as one cup of moderately strong coffee
could increase feelings of well-being, energy and motivation to work.
(2)
Caffeine has been shown to enhance the therapeutic action of some medications,
such as pain-killers containing acetaminophen, and is often used in
preference to increasing the dose of medication.
Certain types of headaches, especially those caused by cerebral vasodilation,
can be alleviated by caffeine.
Caffeine Dependence
In keeping with the body’s maintenance of a state of equilibrium,
attempts to ‘rev’ up the brain’s activity will be met
with a response which reduces that activity. This adaptation in the
case of caffeine takes the form of extra adenosine receptors being produced,
and this is how tolerance develops.
Many regular caffeine users are in the initial stages of caffeine withdrawal
by the time they wake up in the morning, so they are more likely to
feel tired, irritable and groggy than people who abstain from coffee.
This explains why getting caffeine into the bloodstream as soon as possible
is an essential morning ritual for many caffeine users.
Excessive caffeine consumption fits in well with other ‘addictive’
types of behaviours. Researchers at the Johns Hopkins Medical Centre
were surprised to find that caffeine abuse tended to be clustered together
with other types of substance abuse. The majority of the people who
sought help for caffeine dependency had a previous history of substance
abuse. (1) For instance, people who smoke are much more likely to drink
coffee excessively.
Many studies have unveiled a pattern of people increasing their caffeine
consumption in times of stress. Ironically, this leads to a magnification
of the stress symptoms, which in turn can lead to drinking more coffee
or tea in order to relieve the symptoms, but actually only mask them.
People who try to give up caffeine often suffer withdrawal symptoms
such as headaches, fatigue, depression and drowsiness. They typically
feel much better when caffeine use resumes. This is why it is difficult
for many people to cut down on caffeine.
Treatment - Overcoming the Dependence
A wholistic health approach to any type of substance dependence involves
treating the mind and the body and determining what are the real issues
behind the excessive usage. The mind-body connection is very important
in the case of caffeine as there is usually an underlying psychological
stress which triggers dependency.
Caffeine dependence can be viewed as a barometer of the general health
of the body and mind. A person is much more likely to abuse a substance
such as caffeine when there are underlying physical, nutritional and/or
emotional imbalances. Often one facet of a body which is not at its
optimum of health triggers a vicious circle whereby minor problems lead
to increased caffeine use.
Dependence on psychoactive substances can mask deeper underlying problems
associated with motivation and attitudes to work, or can sometimes be
indicative of a deeper psychological or health malaise. It can be an
effective smokescreen for the need for more positive action including
lifestyle and health changes
In seeking to overcome the dependence, it is important to isolate the
real problem. Does caffeine really provide an energy and motivation
boost or is it being used to drown out problems such as stress, overwork
or lack of enthusiasm for work? Dependence on caffeine can allow us
to escape from confronting the real issue and devising long-term coping
strategies to deal with it.
People with nutritional deficiencies are much more likely to abuse substances,
including caffeine. Excessive caffeine use slots in with an unhealthy
lifestyle, characterised by unhealthy diet, lack of exercise and a lot
of stress. Substance dependency is more likely to develop when there
is nutritional imbalance. Nutritional support can help the body to weather
the storm of withdrawal symptoms. Some natural therapists advocate a
complete nutritional overhaul.
Because caffeine affects people differently, treatment programs need
to match the needs and psychological makeup of the individual. Some
people find it virtually impossible to go ‘cold turkey’, and
several doctors I have spoken to don’t recommend this at all .
Acupuncture can be very effective in dealing with the myriad of symptoms
which accompany caffeine withdrawal. The practitioner will seek to restore
balance and achieve a better functioning of the body in general. While
acupuncture cannot prevent addiction from developing, it can help maintain
the body in a state of equilibrium in times of stress, and possibly
avert the desire to increase caffeine consumption.
In Closing
Most research indicates that healthy people can consume up to 200 mg
of caffeine a day (about 2 cups of coffee) before they need to be concerned
about the effects on their health - although the best amount is almost
certainly zero.
There are still many unanswered questions about the effects of caffeine,
but in the meantime there are compelling reasons to limit caffeine consumption.
So if you do savour a cup of the aromatic brew, remember - more isn’t
always better!
References:
1. Baum, S: Buzz - The Science and Lore of Alcohol and Caffeine (Oxford
University Press, 1996).
2. Cooper, K: Advanced Nutritional Therapies (Thomas Neilson, 1996).
3. Graedon, T: The people’s Guide to Deadly Drug Reactions (St
Martins Press, 1995).
4. Wohlmuth, H: ‘Short Black - the Impact of Coffea Arabica’,
NHAA Conference paper.
5. Vayda, W: Mood Foods (Ulysses Press, 1995).
6. Kirshman, G and D: Nutrition Almanac (McGraw-Hill, 1996).
7. Partington, D: Pills: Poppers and Caffeine (Hodder Ltd, 1996).
Martine Negro - Acupuncture practitioner.
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