Caffeine and Your Health
October 25th, 2012There has been a lot of buzz in the media recently regarding caffeinated drinks and so-called “energy” drinks and safety. Caffeine is a stimulant drug and causes our bodies to release hormones such as epinephrine, known as the “fight or flight hormone” in our bodies. On one hand, it can be used to fight fatigue due to a lack of sleep or jet lag and can be used to treat migraines. However, in high doses or people whom are more sensitive to the drug, it can cause the heart to beat faster (tachycardia), anxiety, hand tremors, nausea, esophageal reflux (GERD) and insomnia. At very high doses, caffeine can lead to fatal arrythmias (abnormal heart beats).
While the occasional cup of coffee does not have deleterious effects, we must make sure we are not taking in extra caffeine for the wrong reasons. For example, people who have daytime sleepiness from chronic sleep deprivation could be using caffeine to mask underlying medical problems. They should have a complete work-up with their physician for sleep apnea or thyroid disorders. I always address caffeine intake with all my patients, and if I hear someone is drinking 5 vente coffees from Starbuck’s each day that is certainly a red flag for me to inquire more about the person’s overall health.
Another issue is the effect of caffeine on sleep. Caffeine will certainly affect the quality of sleep and the ability to fall asleep. This can lead to a vicious cycle where one night of insomnia, leads to an energy drink to stay awake in the morning, which again causes restless sleep, and more caffeinated beverages the following day. Over time, caffeine dependence can develop and along those lines, caffeine withdrawal.
I once had a patient who complained of severe headaches and fatigue that started abruptly two weeks prior. It turned out that the local coffee place where he would normally go for his twice daily espresso drinks went out of business around that time, and he wasn’t able to walk to the coffee place a few blocks away. After he started back on coffee and a short course of tylenol, his headaches went away.
Coffee and tea used to be the only sources of caffeine. However, the typical market is now full of all types of caffeinated foods. Energy drinks, sodas, and guarana juice are aggressively marketed to teenagers with brightly colored packaging. The trend towards bitter or dark chocolate is another hidden source of caffeine. I recall a patient who said he couldn’t sleep and denied any caffeine use, “I don’t touch coffee or tea because I know it will keep me up at night.” However, when I questioned him further, he talked about how he recently got into the habit of having 2 pieces of dark chocolate before bedtime. The 30 milligrams of caffeine per piece (about the same as a cup of coffee) was certainly the cause of his sleeplessness. After he stopped his nightly sweet ritual, his sleep immediately improved.
I would urge anyone with a history of heart condition, irregular heartbeat (such as atrial fibrillation), and teenagers from consuming caffeine. With the multitude of hormones stimulated by caffeine, it is also uncertain whether any of these imbalance can have an effect on a teenager’s growth and development. People react differently to caffeine and can have varying degrees of tolerance, so it is hard to say how much is too much. However, if it is affecting your life or how you feel in the day, it is best to cut back. As with all things moderation is the key.
