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May 13 2022
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With coffee shops popping up on every street corner, the debate over coffee’s health benefits rages on. While some studies pronounce coffee’s extraordinary benefits in reducing the risk of cardiovascular disease, Type 2 diabetes, and Parkinson’s Disease, as well as associating high coffee consumption with an 8-15% reduction in risk of death, others warn of coffee’s detriment. We’ve even seen the World Health organization and the Dietary Guidelines Advisory Committee change their tune from coffee being harmful to coffee being a health food, going so far as recommending 3-5 cups per day for a healthy lifestyle.
Although the coffee lovers will defend this dark elixir to the end, science is helping shed some light on the pros and cons of drinking coffee.
While coffee as a whole is replete with beneficial antioxidants, caffeine is the active ingredient at the center of this debate. Generally accepted as a psychoactive substance, caffeine addiction, intoxication and withdrawal are defined and discussed in the Diagnostic and Statistical Manual of Mental Disorders (5th edition), otherwise known as DSM-V. It’s surprisingly easy and common for someone to overdose on caffeine, says the DSM-V. This can occur by simply consuming 250 mg of caffeine, and experiencing five or more symptoms, such as “restlessness, nervousness, excitement, insomnia, flushed face, diuresis, gastrointestinal disturbance, muscle twitching, rambling flow of thought and speech, tachycardia or cardiac arrhythmia, periods of high energy, or psychomotor agitation.”
Apart from the obvious laundry list of DSM-V symptoms, there are other reasons one would want to minimize or abstain from caffeine, or “avoid caffeine intoxication”. Caffeine has adverse effects on people with anxiety, hypertension, adrenal fatigue, and GERD. Its consumption exacerbates symptoms of circulation disorders such as Raynaud’s Phenomenon. We also can’t ignore that healthcare practitioners regularly suggest eliminating caffeine during a structured detoxification program to give the liver a rest.
But avoiding caffeine is easier said than done. The typical amount of caffeine found in an average coffee house beverage easily exceeds the amount indicated for overdose. For example, a 20-ounce Blonde Roast coffee from Starbucks is about 475 mg. The same size of a Dunkin Donuts coffee with turbo shot is nearly 400 mg and a 16-ounce light-roast from Panera Bread is 300 mg. Even if we avoid coffee altogether, caffeine is found in teas, soda and chocolate. As a result, many of us are walking around overdosing on caffeine. According to a review, nearly 90% of Americans consume well over 250 mg caffeine per day.
While the debate continues, an important consideration needs to be that “one size does not fit all” when it comes to caffeine. Personalized medicine is gaining popularity for a reason. While some people get the jitters from caffeine, not everyone experiences the same symptoms required to establish a diagnosis of overdose. The reason is that the liver’s ability to metabolize caffeine will vary from person to person. Concentrations of CYP450 enzymes required for phase I liver detoxification make some people “fast-clearers” of caffeine (those who can have a double espresso and drift dreamily to bed within the hour) and others slow-to-impossible clearers (tweaked out, nervous wrecks when given the slightest sip of hot chocolate).
Arguably, caffeine’s effects can be leveraged to treat symptoms of headaches or asthma, provide attention and focus, and energize muscles in a training athlete. However, caffeine’s addictive quality, and its potential to tax the liver and nervous system, cannot be ignored.
When faced with a reason to reduce or eliminate caffeine from the diet, traditional users are challenged by withdrawal symptoms (e.g. headache, agitation, muscle strain, anxiety) and changing psycho-social behaviors (e.g. social coffee-culture or afternoon chocolate pick-me-up).
If you’re on “Team Detox from Coffee”, here are some tips that may help:
Chronic caffeine intake can deplete magnesium, resulting in muscle tension and headaches. Restoring healthy magnesium levels tends to relieve these symptoms. L-theanine is believed to have a calming effect. One study from 2012 showed that L-theanine reduced anxiety and inhibited increases in blood pressure in study participants who were faced with stressful tasks on a computer. L-DOPA, or Dopamine, is called the “happy compound,” responsible for regulating the pleasure and reward centers of the brain, the same areas stimulated by addictive substances like caffeine and sugar. A recent double blind, randomized controlled crossover trial compared the pharmaceutical levodopa (used to treat Parkinson’s patients) to Mucuna pruriens, a natural source of L-Dopa, and found them similar in clinical efficacy, with Mucuna pruriens being more tolerable.
The right answer for whether to drink coffee or not is as personal as a Starbucks custom coffee order. If you want to kick the caffeine habit, however, here’s a simple, no-nonsense approach to easing off of caffeine:
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