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Short-term Effects
Caffeine taken in beverage form begins to reach all tissues of the body within five minutes. Peak blood levels are reached in about 30 minutes. Half of a given dose of caffeine is metabolized in about four hours more rapidly in smokers and less rapidly in newborn infants, in women in late pregnancy, and in sufferers from liver disease. Normally, almost all ingested caffeine is metabolized. Less than 3%
appears unchanged in urine, and there is no day-to-day accumulation of the drug in the body. Short-term effects of a drug are those that appear soon after a single dose and disappear within hours. Ingestion of the amount of caffeine in one or two cups of coffee (75-150 mg) causes many mild physiological effects. General metabolism increases - expressed as an increase in activity or raised temperature, or both. The rate of breathing increases, as does urination and the levels of fatty acids in the blood and of gastric acid in the stomach. (However, at least one other component of coffee also increases gastric acid secretion. Therefore ulcer sufferers may not achieve relief by switching to decaffeinated coffee.) Caffeine use may increase blood pressure. Caffeine stimulates the brain and behavior. Use of 75-150 mg of caffeine elevates neural activity in many parts of the brain, postpones fatigue, and enhances performance at simple intellectual tasks and at physical work that involves endurance but not fine motor coordination. (Caffeine-caused tremor can reduce hand steadiness.) Caffeine's effects on complex intellectual tasks and on mood do not lend themselves to a simple summary. The effects depend on the personality of the user, on the immediate environment, on the user's knowing whether caffeine has been taken, and even on the time of day. The effects of caffeine on sleep are clear-cut: taken before bedtime, it usually delays sleep onset, shortens overall sleep time, and reduces the "depth" of sleep. After using caffeine, sleepers are more easily aroused, move more during sleep, and report a reduction in the quality of sleep. The effects of caffeine on dreaming are less clear. Larger doses of caffeine, especially when given to non-users, can produce headache, jitteriness, abnormally rapid heartbeat (tachycardia), convulsions, and even delirium. Near-fatal doses cause a crisis resembling the state of a diabetic without insulin, including high levels of blood sugar and the appearance of acetonelike substances in urine. The lowest known dose fatal to an adult has been 3,200 mg - administered intravenously by accident. The fatal oral dose is in excess of 5,000 mg - the equivalent of 40 strong cups of coffee taken in a very short space of time.
Long-term Effects
Long-term effects of a toxic nature do not appear evident when regular caffeine use is below about 650 mg a day - equivalent to about eight or nine average cups of coffee. Above this level, users may suffer from chronic insomnia, persistent anxiety and depression, and stomach ulcers. Caffeine use appears to be associated with irregular heartbeat and may raise cholesterol levels, but there is no firm evidence that caffeine causes heart disease. The evidence is also unclear concerning caffeine and cancer. Caffeine and some of its metabolites can cause changes in the cells of the body and in the way in which they reproduce themselves, and caffeine certainly enhances this kind of action by some known carcinogens. However, although caffeine is suspected as a cause of cancer, the evidence is contradictory and does not allow a clear conclusion. Some animal studies suggest that caffeine can have anti-cancer properties. For example, in rats it prevents breast cancer caused by diethylstilbestrol (the "morning after" pill). Caffeine certainly has the ability to cause a variety of reproductive effects in animals, including congenital abnormalities and reproductive failures, reduced fertility, prematurity, and low birth weight. What is unknown is whether these findings are relevant to the use of ordinary amounts of caffeine-containing beverages by pregnant women. Pregnant women have been advised to restrict caffeine intake by both Canadian and United States governments. Pregnant smokers should be especially wary.
Therapeutic uses
The most common medicinal use of caffeine is as a part of headache preparations and other pain relievers. Caffeine is added both for its specific ability to relieve headache, including that caused by caffeine withdrawal, and for its ability to help analgesics do their work better. The ability of caffeine to stimulate breathing is used in the treatment of apnea (cessation of breathing) in newborn babies, and as an antidote against the depression of breathing by overdoses of heroin and other opiate drugs. More controversial therapeutic uses of caffeine are these: to kill skin funguses; to improve sperm mobility; to enhance the toxic effects of chemicals used in cancer therapy; and to facilitate the production of seizures during electroconvulsive therapy. to ^ top
Copyright (c) 1980 Revised January 1991 Alcoholism and Drug Addiction Research Foundation, Toronto Canada To receive weird, irregular mailings fill out your emailaddress
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