The Truth about Caffeine

Publisher’s Comment: This book is not intended as a substitute for medical advice from physicians. The purpose of this book is to educate. It is sold with the understanding that the publisher and author shall neither be liable nor responsible for any injury caused or alleged to be caused by the information contained in this book. The reader should consult a qualified health care provider regarding his or her health. The contents of this book should not be construed as medical advice. If you do not wish to be bound by the above, you may return this book to the publisher for a full refund.

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Copyright 2015, 2009, 2006 by Marina Kushner All rights reserved

Printed in the United States of America Library of Congress Control Number: 2008912120

Includes bibliographical references and index ISBN 978-1-63227-025-2

Cover design by Waz Wu

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TABLE OF CONTENTS

Chapter 1: Kicking the Caffeine Habit

Chapter 2: The Chemistry of the Enemy

Chapter 3: Why Women Should Avoid Caffeine

Chapter 4: Caffeine and the Central Nervous System

Chapter 5: Caffeine, Coffee, and the Heart

Chapter 6: Do You Have the Stomach for Coffee?

Chapter 7: Caffeine, Coffee, and Cancer

Chapter 8: Double Trouble: Kids and Caffeine

Chapter 9: Are You Hooked on Caffeine?

Chapter 10: Breaking Free from Caffeine

Endnotes

Caffeine Bibliography

Resources

About the Author

ACKNOWLEDGEMENTS

First and foremost, I would like to thank my husband for his painstaking and thorough criticisms of this book. Without his support, talent, and cooperation, this book would not have been possible.

I would like to thank Columbia University professor Toubia for granting me the opportunity to work with his highly gifted and talented students.

Special thanks go to my editor Patricia Ahearn, to Waz Wu for the brilliant front cover design, to Antoinette of Addesign-graphics.com for the superb book layout, and to Daudesign.com for the excellent back cover.

~ FOREWORD ~

Caffeine has become such an integral part of our lifestyle that we don’t even realize the effects it has on our bodies. Much of our daily nutrition consists of products containing caffeine, e.g., tea, coffee, soft drinks, chocolates, and various other foods.

As a physician, my primary concern is the effect it has on our health. Hypertension (HTN) is one the most common problems seen in Internal Medicine, thus my practice. There is a myth that caffeine should help decrease blood pressure through vasodilatation, but the fact that is missed is that caffeine-induced medullary stimulation can increase catecholamines and thus offset the effect. In my experience, it usually increases the pressure, and as I always tell my patients, HTN is a silent killer and an issue that needs to be addressed right away.

Caffeine is also one of the common culprits in Gastro-esophageal Reflux Disease (GERD), which is addressed in the book. GERD is usually due to incompetence of the lower esophageal sphincter. There are several etiologies of GERD, and caffeine can play a role. It is a disorder that presents with heartburn, with or without regurgitation, or just a feeling of abdominal discomfort. People who ingest high levels of caffeine end up with symptoms of GERD and need to be treated with medication. Depending on the severity, patients may develop various complications.

Caffeine does have a therapeutic role in disorders such as headaches and is commonly used in various drug preparations. However, these drugs should be taken carefully, as an overdose can be fatal.

In adults, ingestion of 1,000 mg or more of caffeine can result in symptoms such as nausea, vomiting, diarrhea, tremors, increased heart rate, and rarely death. An increase in heart rate and elevated blood pressure can increase urine output, thus causing dehydration and decreased potassium. Potassium is one of the key electrolytes in our bodies, and if deficiencies are not corrected, can cause arrhythmia and death. Caffeine toxicity is very rare, but deaths have been reported. The estimated lethal dose of caffeine in an untreated adult is from 5 to 10 g, [12] [50], and in children 78 mg/kg has caused serious symptoms.¹

In my practice, I have seen the effects of caffeine on our health and the above are just a few examples. I am also a mother and the effects it has on our children are not missed by anyone. A key fact here is to be aware of the half-life of caffeine in different age groups. Half-life is an indication of the time that it takes any product to be eliminated from the body.

TABLE 36-2

Elimination Half-Life of Caffeine in Different Age Groups²

The following table sets forth the numbers:

As a mother, I have seen the excitability, agitation, and nervousness it causes in a child. Some things cannot be avoided, since kids are going to be kids and will want chocolate, but products like soft drinks can definitely be consumed in caffeine-free form.

The author of this book has done a very good job in terms of researching the topic and providing readers with valuable material for making informed decisions. This book is a good source of knowledge. It provides a thoughtful insight into an issue that is experienced in the daily life of many and yet seldom discussed.

NAVLEEN KAUR, M.D.

Foreword References:

1 Kanfer, I., Dowse, R., Vusumuzi, V. Pharmacokinetics of oral decongestants. Pharmacotherapy 1993; 13:116s.

2 Ford: Clinical toxicology, 1st edition, 2001, p. 321.

Chapter One

Kicking the Caffeine Habit

Millions of people are addicted to caffeine. They need their caffeine just as smokers need their dose of nicotine. The symptoms of caffeine withdrawal can be just as painful and even longer lasting than those experienced by the most chronic alcoholics. And just like the other junkies, dependence on caffeine and its ubiquitous delivery systems – coffee, tea, cola, energy drinks, and pills – strips caffeine addicts of their freedom. They give up their minds, their bodies, and sometimes even their lives to their debilitating drug of choice: caffeine.

The Double-Barreled Threat

It must be understood at the very outset that we are talking about two separate but related chemical compounds – coffee and caffeine, which both together and individually pose a grave threat to people habitually consuming them, indiscriminately and in excess.

The addictive substance that we are talking about is not just caffeine that occurs naturally in coffee, tea, cacao, and chocolate, but one that is also widely used as an additive in beverages, foods, and medicines. We are also talking about all types of coffee. The range of illnesses caused by caffeine and by coffee differs significantly. The unholy combination of caffeine and coffee pose a major threat in a society where their consumption to excess is not merely encouraged but actively promoted.

Similarly, it could be argued that some drugs cause more deaths and more obvious diseases, both mental and physical, than caffeine does. However, caffeine is the number one enemy of public’s health because people use caffeine more than any other drug. No drug is as widely present in foods and beverages as caffeine. More people are addicted to caffeine than to any other drug. According to the British Journal of Addiction, one out of every ten individuals poisoned by caffeine.¹

Caffeine is added, not only to many over-the-counter medications, such those which are created to help with headaches, allergies, colds, sinus problems, and stay-awake remedies, but also, to foods such as baked goods, frozen dairy products, soft candy, gelatins, and puddings. Caffeine is supposedly used to flavor these foods. However, the flavoring claim seems doubtful because in its pure form, caffeine is an odorless, mildly bitter chemical. There are stronger flavoring agents available. The real reason for using caffeine is its addictive nature, and thus, it is added everywhere, in the foods we eat and in the beverages we drink. More than 2,000,000 pounds of caffeine are purged from coffee annually – caffeine that is used to adulterate our food, beverages, and medicines.

We are served caffeinated products in homes, schools, places of worship, restaurants, hospitals, and mental institutions. Psychiatric patients, children, and seniors in retirement homes are regularly administered mind-altering doses of caffeine. Its presence is virtually inescapable. Never before have people been exposed to so many different sources of caffeine. Nor has it ever been more important to rid our systems of this noxious, poisonous, and debilitating drug.

Millions of people consume mind-boggling doses of caffeine every day. No other addiction as prevalent as caffeine addiction; yet we profess to know so little about it. Lastly, there is no other addiction that has been the object of so few discussions. This spirited polemic may serve as an important one.

What Doctors Tell Us

Ask any doctor about how much coffee you can safely drink, and the answer will be, an eight-ounce cup or two per day. Medical authorities and researchers are almost universal in their agreement that drinking any more than a couple of eight-ounce cups of coffee per day is asking for medical problems. However, moderation, as we all know, means nothing when it comes to addictive substances. Moderation is the exception, rather than the rule, for most caffeine consumers.

According to the figures provided by the National Coffee Association of the U.S.A. Inc., the average American coffee consumer drinks 3.56 cups per day. In some sections of the country, coffee drinkers consume more than four cups per day. In other words, Americans consume, on the average, anywhere from 1.5 to 4 times more than doctors and clinicians say is safe. And remember, that is the average. Millions of Americans drink a great deal more than the average.

Researchers often find that coffee consumers drink from 10 to 20 cups of coffee per day. Many professional researchers confirm what informal surveys often reveal: millions of people are addicted to caffeine. A government study shows that at least 68,240,000 Americans drink 3 cups of coffee or more every day. At least 30 million drink 5 or more cups per day. Some 21 million drink 6 or more cups of coffee per day.

Thus, the gravity of the problem is as enormous as it is shocking. Millions of people drink coffee in amounts that greatly exceed doctor-recommended levels. Millions of people drink coffee excessively because they are addicted to caffeine. Millions more abuse caffeine-containing beverages, thereby doubling, tripling, or even quadrupling their exposure to illness and disease. The mental and physical wounds caused by caffeine addiction are staggering, but as often happens, we learn too little, too late to prevent harm.

Innocent Beginnings

Coffee drinkers begin their precipitous descent from novices to addicts innocently enough. For most people, starting the day with a morning eye-opener of hardy black coffee is routine. This so-called ritual may be repeated once or, perhaps, twice during the day.

For hundreds of years, we have praised coffee’s ability to promote rapid and clear thinking, to improve intellectual efforts, and enhance mental acuity – all valued attributes in a society that worships success and achievement. How can something that seems so right be so wrong?

The answer is simple. Caffeine is a psychoactive drug, which is harmless only in small doses – 200–250 mg – and if not taken every day. Caffeine is an addictive stimulant; even small doses can cause daily dependence: such as difficulty to start the day without a dose. Small doses can also grow into large ones because the level of tolerance will gradually increase. We develop a tolerance to caffeine, as to any other drug, and increase our dosage because lower amounts no longer deliver the same effect. However, large doses of caffeine can be dangerous. Caffeine saturates all tissues and fluids in the body, can aggravate any preexisting illnesses and diseases, and can become the cause of new physical and mental disorders.

Large doses of caffeine can also cause altered conscious state, vomiting, abdominal pain, convulsions, heart arrhythmia, tachycardia, coma, and even death. According to a study conducted on laboratory rats, the direct cause of death is ventricular fibrillation (severe heart arrhythmia).² Myocardial infarction, hypotension, seizures, and electrolyte disturbances are contributing factors to mortality.

Caffeine is a deadly poison in excess of five grams. Although lethal caffeine overdoses are rare, its mild toxic effects, such as nervousness, restlessness, insomnia, and tremor, are very common and can manifest after taking 500 mg or more, depending on the level of tolerance and body weight. The larger the dose, the more severe the symptoms of overdose will be, which can cause seizures and cardiovascular disorders.

Average doses of caffeine consumption are 85 to 250 mg per day. An average cup of coffee contains approximately 120 milligrams of caffeine; specialty coffee may contain more.

The typical coffee consumer drinks a couple of cups each day without incidents. His habit usually begins in response to social or peer group pressure or as part of family socialization. The vast majority of coffee consumers who remain at low levels of a cup or two each day have only occasional complaints: a sleepless night here and there, an upset stomach once in a while, or a headache. They can also sometimes be impatient, irritable, or grumpy, but they never connect all these minor disturbances with their caffeine intake.

Those who consume more than two or three cups of coffee, more than 400–500 mg of caffeine, per day may experience restlessness, nervousness, chest pain, insomnia, diuresis, and gastrointestinal disturbance. Other pronounced symptoms of caffeine overdose can be flushed face, muscle twitching (especially eyelids), rambling flow of thought and speech, and psychomotor agitation.

Most doctors would agree that coffee consumption at levels of one or two eight-ounce cups a day poses no significant health hazard. However, millions of coffee drinkers, like millions of tobacco smokers and alcohol consumers, do not stop at just one or two. They go on and on, often with devastating results. Who knows the reason why? Who knows why some people can experiment with drugs and leave them behind while others continue to make them a major and debilitating part of their lives?

The answer may lie in the biochemistry of an individual. People with low serotonin levels have poor self-control and are prone to compulsive behaviors, which result in addictions, such as overeating, chain-smoking, abuse of alcohol, and excessive intake of caffeine and other drugs. Due to its addictive nature, caffeine makes them even more compulsive: cup after cup, after cup, they just do not stop drinking. This biochemical imbalance may occur if the serotonin neurotransmitter system lacks a sufficient amount of tryptophan, an essential amino acid.

Coffee: A Mild Legal Drug

People say that they enjoy the taste of coffee, and the agreeable taste is what keeps them coming back for more. Other coffee consumers rave about the great pick-me-up that coffee gives them, how it arouses their sleepy brains and spurs them into action in the morning. During the day, their mental acuity and alertness are heightened with more coffee. It is part of the coffee break ritual, the great social lubricant of any work-place. All this is agreeable. So why does one decide to quit? Obviously, the disadvantages of drinking coffee begin to outweigh the advantages.

Thus, people begin drinking coffee because they