Advance Magazine for Physical Therapists and PT Assistants
Vol. 19 •Issue 6
• Page 38
All the Buzz- Is caffeine bad for your health, or is the news just a hoax?
A day rarely passes in the clinic where I work that I don't see a person (patient and/or coworker) drinking a caffeinated beverage. Caffeine, from the French term for coffee, café, is a xanthine alkaloid compound (in same class as morphine, nicotine and cocaine) that acts as a psychoactive stimulant and diuretic in humans.
The main difference between caffeine and other psychoactive drugs is that caffeine is considered legal and is unregulated in many places around the world. However, legal doesn't necessarily mean safe.
Although the U.S. Food and Drug Administration lists caffeine as a "multiple-purpose generally recognized as a safe food substance," its safety should be questioned. The DSM IV (Diagnostic and Statistical Manual of Mental Disorders) lists caffeine-related disorders, such as "caffeine-induced sleep disorder (F15.8)."
A large percentage of today's pharmaceutical drugs contain caffeine as one of their "active ingredients." The fact that there are negative withdrawal symptoms alone should be a clue to its questionable safety.
Caffeine is found in varying quantities in more than 60 plants, including coffee, tea, kola nut, cacao (chocolate) and many others.
Caffeine is called guaranine when found in guarana, mateine when found in mate, and theine when found in tea. Caffeine acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants.
As mentioned previously, in humans, caffeine is a central nervous system stimulant. Many people believe caffeine gives them energy. However, the reality is that it does the exact opposite. The stimulation effect that is provided by caffeine will always be followed by a period of depression.
Caffeine forces the liver to release glucose into the blood stream. This produces a temporary blood sugar high that is often followed by a blood sugar low when the body reacts by producing insulin to store the excess sugar as fat.
Dr. Herbert Shelton clearly explained the delusion of stimulation in his book, Orthobionomics: Hygienic System. "Whenever any irritating substance or influence is brought to bear upon the living organism, this occasions vital resistance and excitation manifested by increased and impaired action, which always necessarily diminishes the power of action and does so in precisely the degree to which it accelerates action; the increased action is caused by the extra expenditure of vital power called out, not supplied, by the compulsory process, and therefore the available supply of power is diminished by this amount. Under all circumstances, vitality or energy of any character whatever is invariably manifested or noticed by us, as energy, in its expenditure, never in its accumulation."2
Stephen Cherniske is a scientist who spent 10 years of his life researching the effects of caffeine on the body and compiled them in a shocking document called Caffeine Blues.3
The book states, "Caffeine can't provide energy, only chemical stimulation and an induced emergency state that can lead to irritability, mood swings and panic attacks. Caffeine's ultimate mood effect can be letdown, which can lead to depression and chronic fatigue. Caffeine gives the illusion of heightened alertness by dilating pupils, quickening heart rate and raising blood pressure. In fact, caffeine does not increase overall mental activity."
Consumers Should Beware
"Caffeine exaggerates the stress response," said James D. Lane, PhD, professor of medical psychology at Duke University Medical Center in Durham, NC, and a long-time caffeine researcher.
"At the cellular level, caffeine locks the receptor normally used by adenosine, a brain modulator that provides feedback to avoid over-stimulation of nerve cells. If adenosine is locked up, nothing keeps the nervous system from getting too excited at a cellular level."
"Hidden" caffeine is a growing danger, say scientists at the Center for Science in the Public Interest (CSPI), a nonprofit health advocacy organization. In 1997, the CSPI petitioned the FDA to label the caffeine content of foods, noting that the amount of caffeine varies widely among food products.
Even decaf coffee may contain caffeine, according to a University of Florida study published in an issue of the Journal of Analytical Toxicology. Nearly all decaf contains some caffeine, the researchers reported, so that if someone drinks five to 10 cups of decaf coffee a day, their caffeine intake could equal that in a cup or two of regular coffee.4
Caffeine's Effects on the Body
The following health problems can be exacerbated by caffeine:
Cardiovascular problems. Caffeine increases heart rate, elevates blood pressure and can contribute to the development of heart disease. Both decaf and regular coffee increase cholesterol and homocysteine—the biochemical that science has linked to increased risk for heart attack.
Caffeine is also linked to coronary vasospasms, the cause for 20 percent of all fatal heart attacks which kill otherwise perfectly healthy people.
Anxiety and stress. Caffeine stimulates the excretion of stress hormones that can produce increased levels of anxiety, irritability, muscular tension and pain, indigestion, insomnia and decreased immunity. Increased levels of stress from caffeine can impair the ability to make healthy responses to the normal daily stresses that people are subjected to in their lives.
Blood sugar swings. Patients with diabetes and hypoglycemia should avoid caffeine because it stimulates a temporary surge in blood sugar, which is then followed by an overproduction of insulin that causes a blood sugar crash within hours. If you are trying to lose weight, this rollercoaster will actually cause weight gain, since insulin's message to the body is to store excess sugar as fat and appetite increases once blood sugar is low. Increased cortisol levels induced by caffeine can lead to the increased deposition of more abdominal fat as well.
Gastrointestinal problems. Many people experience a burning sensation in their stomach after drinking coffee because caffeine increases the secretion of hydrochloric acid, leading to an increased risk for ulcers.
Coffee, including decaf, reduces the pressure on the valve between the esophagus and the stomach so that the highly acidic contents of the stomach pass up to the esophagus. This can lead to heartburn and gastro-esophageal reflux disease. With our culture's high consumption of coffee, it's no wonder that one of the best selling over-the-counter drugs are so-called antacids.
Nutritional deficiencies. Caffeine inhibits the absorption of some nutrients and causes the urinary excretion of others, including but not limited to B-Vitamins, calcium, magnesium, potassium, iron and other trace minerals, as well as depleting pepsin in the stomach—the enzyme that breaks down proteins, which are all essential elements necessary for good health and healing.
Male health problems. Men can significantly reduce their risk for urinary and prostate problems, as well as improve sexual functioning, by making dietary changes that include eliminating coffee and caffeine.
Female health problems. Fibrocystic breast disease, PMS, osteoporosis, infertility problems, miscarriage, low-birth weight infants and menopausal problems such as hot flashes are all exacerbated by caffeine consumption. Women on birth control pills are particularly at risk since they have a decreased ability to detoxify caffeine.
Adrenal exhaustion and fatigue. Caffeine consumption leads to eventual adrenal exhaustion that can leave a person vulnerable to a variety of health disorders related to inflammation, autoimmunity, depression, fatigue and other mood imbalances.
Aging. Many people find in their 40s that they can no longer tolerate the same level of caffeine consumption as they could in their 20s and 30s. The production of DHEA, melatonin and other vital hormones start to decline, and caffeine speeds up that downhill drop.
Conversely, cortisol (a stress hormone) tends to increase in production as many people age, and caffeine can increase cortisol levels in the blood for up to 18 hours. Caffeine dehydrates the body and can contribute to the aging of the skin and vital organs. Caffeine has also been shown to inhibit DNA repair and slow the ability of the liver to detoxify the body.
Caffeine and sleep disturbance. There is a popular notion that drinking coffee before 3 p.m. won't disturb sleep. In fact, caffeine at any time of the day can cause sleep problems, especially if a person is under stress. Caffeine disturbs the most important phase of sleep (deep-sleep phase), which is when the body performs tissue repair and healing.
Caffeine can promote a vicious cycle: caffeine intake leads to decreased sleep quality, which leads to increased caffeine intake, which leads to decreased sleep quality, which leads to disease and fatigue, which leads to increased caffeine intake, and so on.
Caffeine and headaches. Millions of Americans suffer from chronic headaches linked to caffeine intake.2-12
What About Benefits?
Others say caffeine has positive benefits. For example, coffee drinking, some researchers say, may help prevent Type-2 diabetes, Parkinson's disease and liver disease, including liver cancer—and it doesn't appear to significantly increase heart disease risk or cancer. However, they warn, those with high blood pressure, as well as children, teens and the elderly, may be more vulnerable to caffeine's adverse effects—possibly including headaches, irritability, an inability to concentrate and stomachaches that appear within 12 to 24 hours after discontinuation of caffeine intake, peak at roughly 48 hours, and usually last from one to five days, representing the time required for the number of adenosine receptors in the brain to revert to "normal" levels.5-14
We shouldn't doubt there are some potential benefits of caffeine. However, is anyone asking the question, "At what cost?" Focusing on one potential benefit while ignoring many detriments is not a wise health approach, but it does appear to be a common one.
Everyone is Different
The precise amount of caffeine necessary to produce side-effects varies from person to person depending on body size and degree of tolerance. It takes less than an hour for caffeine to begin affecting the body and a mild dose wears off in three to four hours. However, the moderate caffeine consumer is a rare gem, because it's so addictive that most consumers eventually end up taking in quite a bit.
And the "average person" is a myth. This person, often described by scientists in their research papers when they statistically analyze caffeine consumption, often fails to exist. Not everyone reacts to a poison the same way, for example, not everyone can detoxify it at the same rate, and not everyone consumes the same dose. The same dose of caffeine will likely have different effects on different people. Therefore, recommending caffeine in "moderation" may be misleading because it doesn't have a concrete meaning. Moderation can only concern the healthy factors of life, not those that are damaging it.2-16
History is filled with cases where millions of people make choices that are not in their best interest. For example, there are herbs in China as well as medicines in the Western world that have been used medicinally for many years, and are still being used to treat various health problems. However, repeated use of these herbs and drugs over time can actually cause significant health problems. Epidemiological studies have estimated that this habit has caused premature death for millions of people.3,18-20
Therapists should always educate patients about weighing the risk-to-benefit ratio of any intervention. Since caffeine seems to have many more risks than it does benefits, it may not be a wise thing to consume, especially during the healing process. The body is already under stress when injured or ill; it does not need extra stress placed on it during these times.
We should always consider the following question as well: Could the same touted benefits of caffeine be received from other less invasive and healthier interventions? For example, rest/sleep, proper diet, sunshine, exercise, and stress management (nature's safer versions of caffeine) can provide the same benefits of caffeine, but without the negative side effects.
References available at www.advanceweb.com/pt or by request.
Samuel A. Mielcarski is an expert in the field of rehabilitation with more than a decade of experience. He is licensed as a physical therapist in Georgia and Florida. He currently practices physical therapy in the Atlanta, GA region. He can be reached at www.DrSamPT.com.