Caffeine has become an ubiquitous drug. Used originally in most cultures for ceremony or some daily stimulation, it has become a regular, overused energy stimulant in the Western world, with the United States leading in coffee and caffeine use. Coffee, brewed from the ground-up coffee bean (Coffea arabica), is the major vehicle for caffeine consumption. In this country, more than a half billion cups are drunk daily, with most consumers drinking two or more cups, and more than ten pounds of coffee per person are consumed yearly. This food/drug mixture, often along with sugar and/or milk, is one of the most freely marketed substances in the world. There are several basic areas of concern about this substance. I believe that a major one, possibly even more important than the caffeine itself, is the toxic chemicals used in the many stages of growing and marketing coffee. The easily rancified oils and the irritating acids contained in the beans offer further hazards. People trying to cut down by drinking decaf could even be exposed to dangerous chemicals unless they are drinking coffee prepared by the water process or Swiss process, which uses steam distillation to remove the caffeine. Otherwise, agents such as TCE (trichlorethylene) or methylene chloride used in the chemical processing may be contained as residues in the decaf coffee. More coffee-drinking concerns have arisen over the last decades as pesticide use and chemical processing have generally increased, though fortunately our coffee consumption has lessened over the last 40 years. In 1946, at the peak of use, yearly consumption was 20 pounds per person; since most children and some adults were not consuming any, many people were consuming a lot more than the 1,000-cup-a-year average. In 1979, estimated consumption was down to around 9 pounds per year, or about two cups per day per person. It has gone up slightly since then, here and in many other countries of the world, where it is also consumed in large quantities. Another problem is caffeine’s widespread use in so many products, such as soft drinks and many over-the-counter (OTC) drugs. All products containing caffeine should carry a warning saying something like, “Caffeine can be hazardous to your health. Regular use may be addicting and injurious.” The problem here is less with the drug itself and more with the amounts consumed and the constant stimulation on which people depend many times daily. One big area of concern here is with children and teenagers, who may consume large amounts of caffeine in soft drinks. Cola naturally contains caffeine, yet many soft drinks have even more added. The caffeine creates an addiction to the drink. Another concern is that caffeine addiction often occurs along with other substance abuses, nicotine and sugar most commonly. Caffeine, like sugar, overstimulates the adrenals and then weakens them with persistent or chronic use. First, sugar stimulates and weakens the adrenals, which creates fatigue. Then we use caffeine to keep us aware and awake, further depleting our adrenals, to which many respond by drinking more caffeine with sugar. In addition, people who overuse caffeine tend to need more tranquilizers and sleeping pills to help them relax or sleep. Caffeine can be a lifetime drug for many. We begin with hot chocolate or chocolate bars, which contain some caffeine, move into colas or other soft drinks with caffeine, and then add coffee and tea. Many adults use caffeine daily, but this is slowly changing with education and experience revealing the long-range problems resulting from caffeine abuse. Caffeine, one of the class of methylxanthine chemicals/drugs, is present in coffee and many other drinks and products. Another of the xanthines, theophylline, is found in black teas; it is also commonly used in medicine to aid in breathing. Theobromine, the third xanthine derivative, is found in cocoa. Methylxanthines are found in many other plants, including the kola nut originally used to make cola drinks. Physiologically, caffeine is a central nervous system (CNS) stimulant. A dosage of 50-100 mg., the amount in one cup of coffee, will produce an apparent temporary increase in mental clarity and energy level while reducing drowsiness. For many users, it specifically improves muscular-coordinated work activity, such as typing. Through its CNS stimulation, caffeine increases brain activity, but it also stimulates the cardiovascular system, raising blood pressure and heart rate. It generally speeds up our body, increasing the basal metabolic rate (BMR), which can help burn more calories. Initially, caffeine may lower blood sugar, leading to increased hunger or craving for sweets. After the adrenal stimulation, the blood sugar rises again. Caffeine also increases the respiratory rate, and for people with tight airways, it opens the breathing passages, as do the other xanthine drugs. Caffeine is also a diuretic and a mild laxative, an effect that many coffee drinkers appreciate. The amount needed to produce the wake-up and stimulation effect increases with regular use, as is typical of addictive drugs. Larger and more frequent doses are needed for the same effect, and symptoms can develop if we do not get our “fix.” Eventually, we need the drug to function; without it, fatigue and drowsiness occur. So caffeine is a natural stimulant with both physical and psychological addiction potential and with withdrawal symptoms similar to the symptoms of its abuse. A nutritional concern of most caffeine products is that they do not contain any of the nutrients (coffee and tea have a little manganese and copper) needed to support the increased activity that they cause. Also, the diuretic effect of caffeine leads to the urinary loss of many nutrients. There are many possible symptoms and signs of caffeine intoxication and abuse. People who are already overstimulated, busy types (adrenal or fiery types) do not necessarily like the effects of caffeine. I have never been inclined to drink coffee because of both the taste and the effects, yet I understand that many people thoroughly enjoy the experience. The key to its use is moderation and avoiding addiction (even daily use can be considered as addiction). Allergy-type addiction is also fairly common, especially with coffee, but also with tea, chocolate, and cola. With allergy, withdrawal from the substance may lead to even worse symptoms. Overall, addiction to caffeine is not as bad as addiction to most other drugs, but it is a problem for many. Completely stopping its use or tapering it off over time before stopping may produce several symptoms. Usually, the slower the tapering, the easier the withdrawal. After withdrawal and detox from caffeine, it is possible that it can still be used in moderation, but for many people, it can easily become a habit and addiction again. We cannot really know the severity of our addiction until we get off caffeine. —————————————————————————————————————– Signs and Symptoms of Caffeine Intoxication or Abuse nervousness headache increased heart rate anxiety upset stomach irregular heartbeat irritability GI irritation elevated blood pressure agitation heartburn increased cholesterol tremors diarrhea nutritional deficiencies insomnia fatigue poor concentration depression dizziness bed wetting Caffeine Withdrawal Symptoms headache constipation runny nose craving anxiety nausea irritability nervousness vomiting insomnia shakiness cramps fatigue dizziness ringing in the ears depression drowsiness feeling hot and cold apathy inability to concentrate tachycardia —————————————————————————————————————– The most common withdrawal symptom is a throbbing and/or pressure headache, usually located at the temples but occasionally at the back of the head or around the eyes. A vague muscular headache often follows. Of course, caffeine cures the symptom; but this is not the answer. Dietary guidelines and supplements may help with this and other withdrawal problems. Let us now look at the wide range of uses of caffeine in the food and drug industries. Caffeine and caffeinelike xanthines are contained in coffee, many teas, cola, and chocolate. Of the teas, all “black” teas or common teas contain theophylline and theobromine, as do some “green” teas. Both contain less caffeine than coffee. These teas and coffee also contain tannic acid, which is a mild irritant to the gastrointestinal mucosa, and may further bind and reduce absorption of minerals, such as manganese, zinc, and copper. Most herbs do not contain caffeine, although mat nd guarana are fairly high in caffeine. The kola nut and the cocoa bean also contain caffeine. All of these are natural products that have been used as stimulants throughout history; today, caffeine and its related stimulating xanthines are used in many artificial products, including soft drinks such as Coca-Cola, Pepsi Cola, Mountain Dew, Dr. Pepper, and Jolt, plus many chocolate bars. (Some of the soft drink companies are now making caffeine-free drinks.) Caffeine-Containing Food Products yerba mat uarana root kola nut cocoa/chocolate some soft drinks tea coffee —————————————————————————————————————– Both extracted and synthesized caffeine may be added to other products. Many common pharmaceutical preparations contain caffeine for its stimulating effects to counteract sedating antihistamines or for its cerebral vasodilating effects to relieve vascular headaches. Cafergot is a prescription drug containing caffeine and is used for migraines; thus, caffeine can help reduce headaches or cause them, which is more common. —————————————————————————————————————– Caffeine Drugs Available Over the Counter Stimulants?NoDoz, Vivarin, Refresh?n Weight control?Dexatrim, Dietac Pain Relief?Excedrin, Anacin, Vanquish, Empirin Compound Menstrual pain relief?Midol, Premens, Aqua-Ban, Cope Cold remedies?Dristan, Sinarest —————————————————————————————————————– Some people run their bodies on caffeine and not on their basic life force and the natural energy of their hormones, such as adrenal and thyroid. Caffeine, although it is not seriously addicting, is very habit forming. It is not particularly good for athletes or anyone seriously interested in their health. Although it may improve muscular work and short-term performance in both physical and mental athletes, it creates depletion by its diuretic nutrients, and foods can help balance this. —————————————————————————————————————– Caffeine Levels* in Common Substances** Coffee and Other Amount of OTC Amount of Drinks/6 oz. cup Caffeine (mg.) Medicines Caffeine (mg.) Drip 120-150 NoDoz 100 Percolated 80-110 Vivarin 200 Instant 60-70 Dexatrim 200 Decaf 3-10 Dietac 200 Black tea 50-60 Cafergot 100 Green tea 30- Excedrin 65 Cocoa 10-30 Fiorinal 40 Chocolate milk 10-15 Anacin 30 Cocoa (dry, 1 oz.) 40-50 Vanquish 33 Chocolate (dry, 1 oz.) 5-10 Aqua-Ban 100 Midol 32 Soft drinks, per 12 oz. serving Colas 30-65 Mountain Dew 50 —————————————————————————————————————– *These caffeine levels and caffeine equivalents may depend on length of brewing time or amount of product used. **INFORMATION GATHERED AND INTEGRATED from at least six different sources. Negative Effects of Caffeine Most of the negative effects are not a concern with occasional caffeine use, such as a cup of coffee, tea, or cola a few times a week or even once daily. However, with regular use of over 100 mg. daily, many problems arise. A limit of one cup of coffee daily is suggested, along with a week off every few months just to assure us that we are not addicted and that we do not have appreciable symptoms from stopping or restarting. If we do, then we should stop totally. The risks discussed in the following list vary with the level of caffeine intake. A total of over 500 mg. daily could be a relatively high intake. The total includes coffee, tea, soft drinks, and drugs (that is, five cups of coffee a day or a few cups of coffee and a few caffeinated aspirins, as examples). Between 250 and 500 mg. might be classified as moderate intake, while under 250 mg. would be low. With chronic use, the risks of problems rise, and even lower amounts become more of a concern. For a long time, the popularity of caffeine has led people to resist the initial negative findings. Now the dangers are fairly clear, and it is hard to refute the evidence of the many difficulties generated by this addictive drug. Possible negative effects from caffeine use and abuse include the following: Common side effects of caffeine use include excess nervousness, irritability, insomnia, “restless legs,” dizziness, and subsequent fatigue. Headaches can also be very common, as is “heartburn.” Psychological symptoms of general anxiety or panic attacks may also occur. Hyperactivity and bed wetting may also develop in children who consume caffeine. An acid irritant to the gastrointestinal tract and liver, caffeine directly increases stomach hydrochloric acid production, so it is clearly bad for people with or prone to ulcers or gastritis. Regular coffee drinking thus also increases the likelihood of peptic ulcer disease. Decaffeinated coffee is also acidic, though it is less stimulating. Caffeine?s diuretic effect causes loss of potassium, magnesium, zinc and other minerals, and B vitamins, especially thiamine B1. Caffeine also washes out vitamin C. Therefore, all of these nutrients can be deficient unless they are obtained from foods in increased amounts or taken as supplements. Caffeine, and particularly coffee, reduces absorption of iron and calcium, especially when it is drunk around mealtime. These minerals are extremely important for women. Osteoporosis and anemia are thus more common with regular coffee use. Also in children and adolescents, caffeinated drinks interfere with these essential minerals needed for growth and health. Diarrhea can also occur with increased amounts of caffeine, which relaxes the smooth muscle in the colon. The laxative effect of caffeine can also create a dependency. A number of negative cardiovascular effects are caused by caffeine. First, it raises the blood pressure. Hypertension is a risk factor in atherosclerosis and heart disease. Caffeine increases cholesterol and triglyceride blood levels, also risk factors in cardiovascular disease. Heart rhythm disturbances, arrhythmias, though usually of a mild type, occur with caffeine; these include a generally increased heart rate (tachycardia) and excitability of the heart nerve conduction system, leading to both palpitations and extra beats. Caffeine also increases norepinephrine secretion, which causes some vasoconstriction?that is, restricted blood flow. Although caffeine may have a mild direct vasodilating effect in the heart and body (vasoconstricting in the brain), the adrenal stimulation may override this. Research reports regarding caffeine?s role in increasing the risk of heart attacks are mixed; however, it seems reasonable with the cardiovascular stimulation of caffeine to assume that drinking four to five cups of coffee per day does increase the incidence of myocardial infarctions. Overall, caffeine clearly increases risk of cardiovascular disease. Fibrocystic breast disease (FBD) may also be a consequence of caffeine use. Although results of various studies seem to be contradictory as to whether caffeine is a cause of FBD, it is clear that some women are more sensitive to caffeine use and that they experience an increase in size and number of cysts with increased use and a reduction of the disease when they stop using caffeine. Birth defects have been noted with higher levels of caffeine use during pregnancy. Spontaneous abortions are also more frequent with coffee drinking early in pregnancy. It is clear that caffeine crosses the placenta and affects the fetus, but whether it is the caffeine itself or other chemicals in coffee which have a mutagenic effect is not clear. It is wise to limit or completely avoid the use of caffeine during pregnancy. Caffeine also gets into breast milk, so it is also wise to limit its use during the nursing period to prevent having a jittery baby. The incidence of certain cancers is increased with caffeine use. Bladder cancer may result, probably also from a nicotine and caffeine combination along with the mild dehydration that occurs from the result of using these two drugs. Ovarian cancer is increased in women with an association of long-term coffee intake. Pancreatic cancer, which is very deadly, has also been in question as occurring more frequently with increased coffee use (more than three cups per day). Whether this is caused by the caffeine or by the chemicals used in coffee that concentrate in its oils is not clear. Recent research has cast some doubt on this relationship, however. Prostate enlargement and cancer may also be attributed to increased caffeine intake. Caffeine may also be correlated with kidney stones, possibly as a result of the diuretic and chemical effects. The fluoride mineral that is found in coffee and tea can also cause problems when consumed in excess. In addition, caffeine use may increase fevers, both by a mild direct effect and by counteracting the effect of aspirin. The adrenal exhaustion/stress/fatigue/hypoglycemia syndrome is tied to caffeine use as well. Caffeine has an overall effect of increasing blood sugar (especially when it is sweetened), as it stimulates the adrenals. Both stress and sugar use tend to pressure and weaken the adrenal function. Recovery from the resulting fatigue requires rest, stress reduction, and sugar avoidance, but caffeine can override this fatigue and restimulate the adrenals. This process can eventually lead to chronic fatigue, adrenal exhaustion, and subsequent inability to handle stress and sugar intake. Caffeine will then be of little help. What to do? Detox Anyone with regular caffeine intake should truly consider withdrawing from their habit until they can reach a state of occasional use and enjoyment. For caffeine detoxification, it is important to support ourselves nutritionally while we eliminate or reduce our intake. If we are clearly addicted to caffeine products or if we become pregnant, we should quit totally. Breaking the habit by tapering down or going “cold turkey” will be better handled with a good diet and adrenal support. An alkaline diet is helpful during detoxification. Fruits can be used as snacks; vegetable salads, soups, greens, seaweed, corn, some whole grains, sprouts, soy products, and some nuts and seeds are the basis of this high-nutrient diet. A decrease in acid foods, such as meats, sugar (avoiding sugar may really help minimize caffeine withdrawal), and refined flours, and avoiding overuse of baked goods, even whole grain products, and nuts and seeds are good ideas. Drinking at least six to eight glasses of filtered water and sipping on some mineral waters can help replace the coffee habit. Often, some baking soda or, even better, potassium bicarbonate tablets, will help make us more alkaline and reduce withdrawal symptoms. Vitamin C supplementation also helps during withdrawal and supports the adrenals. As an antistress program, several grams or more of vitamin C can be taken over the course of the day, preferably in a buffered form, along with certain minerals such as potassium, calcium, magnesium, and zinc, all of which often need to be supplemented. B complex vitamins with extra pantothenic acid (250 mg. four times daily) along with 500 mg. of vitamin C every two hours can be helpful in withdrawal. With general coffee usage, we need to support the commonly depleted nutrients. These include thiamine (B1), riboflavin (B2), pyridoxine (B6), vitamin C, potassium, magnesium, and probably zinc, iron, calcium, and the trace minerals. Sometimes additional amino acids are helpful in balancing our energy level during use or withdrawal from caffeine. Water intake and additional fiber, even on top of a high-fiber diet, will help support the bowel function, which can slow down during caffeine withdrawal. For caffeine detoxification, it is definitely easier to detox over a week or two to avoid significant headaches and other symptoms, although some regular users can stop fairly easily without many problems. Drinking grain-coffee blends, diluted or smaller amounts of regular coffee, or decaffeinated coffee (only if it is water processed) is a good way to reduce caffeine intake. Some people can substitute tea, which has less caffeine, and taper off of that more easily. If headaches occur during detoxification, some mild pain relievers can be used for a few days, but not much longer. Increased water intake, vitamin C and mineral support, an alkaline diet, and white willow bark herb tablets, which contain a natural salicylate, may also ease withdrawal. As we move away from coffee and caffeine beverages, there are a number of herbal substitutes that can be both stimulating and refreshing. The roasted herbal roots, including barley, chicory, and dandelion, are most common. These grain “coffees,” such as Rombouts, Postum, Pero, Cafix, and Wilson?s Heritage, are becoming very popular among former coffee drinkers. Ginseng root tea is preferred by some. The Chinese herb ephedra is a stimulant like caffeine and can be used for transitions, though I do not recommend its regular intake as we still want our body?s natural energizing functions to work. Ephedra is found in a number of “natural” stimulant formulas. Herbal teas made from lemon grass, peppermint, ginger root, red clover, and comfrey can also be very energizing. —————————————————————————————————————– Herbal Caffeine Substitutes Roasted barley Rombouts Ginseng root Chicory root Rosataroma Ginger root Dandelion root Wilson?s Heritage Ephedra Postum Cafix Comfrey leaf Pero Miso broth Lemon grass Pioneer Duran Red clover Peppermint Comfrey leaf —————————————————————————————————————– Some authorities feel that if we are to drink a cup of coffee a day, we should do it in the mid to late afternoon, the most harmonious time. For the English, this is teatime. This best fits our body?s natural cycle, as it does not interfere with the usually “up,” high-adrenal morning hours, it mildly supports our relaxing time of the day while we may still have work to do, yet it is not too late interfere with sleep for most people. Those who are sensitive to caffeine?s effects may not relax or sleep well after using it; they should consider avoiding it totally or using it only rarely. The pleasures of coffee or tea drinking are related to our culture, taste preferences, and conditioning in terms of both social graces and work/life demands. All of these are developed, not inherent, and anything we learn, we can also unlearn or relearn. This is often what it takes to change our regular drinking of caffeinated beverages to more healthful practices regarding liquid refreshments and energy generation. The ranges for certain nutrients in the table above represent amounts that vary from the lower support levels to the higher amounts to be used during detoxification. The amounts shown are daily totals, usually taken two or three times during the day.