The science behind the most popular drug
I love coffee. The taste of a hot or iced coffee in the morning is sometimes what I look forward to the night before. Some people may relate to the craving the feeling of a fresh start to their day. As a woman in my early 20’s I can say that caffeine culture is all around me. It’s difficult to deny myself that grande iced macchiato! In a world where busy schedules and demanding lifestyles are the norm, many turn to caffeine as a go-to solution to stay alert and energized; either in the form of coffee, tea, energy drinks, or supplements. Caffeine is the most widely consumed psychoactive substance. However, as a medical professional I have to be honest with myself and those around me about the benefits, side effects, and long-term conditions that may result from chronic caffeine consumption. In this blog post I will discuss advantages, disadvantages, and alternatives to caffeine based on scientific research.
Advantages
- Increased Alertness and Improved Focus
It is no secret that caffeine is popular because it wakes you up. It is renowned for its ability to enhance mental alertness and concentration. This can be very helpful while studying or test-taking for some people. Caffeine is an adenosine-receptor antagonist. Truthfully, it promotes wakefulness by antagonizing (blocking) all types of adenosine receptors— which are responsible for causing the feeling of sleepiness through its effects on neurons and glial cells of all brain areas (Ribeiro & Stabastião, 2010). Caffeine essentially bumps off all the adenosine off of these receptors, resulting in wakefulness. This prevents the onset of drowsiness and promotes a more focused state of mind.
- Enhanced Physical Performance
Athletes and fitness enthusiasts alike often turn to caffeine (pre-workout supplements) for its ability to boost physical performance. Caffeine stimulates the release of adrenaline, increasing the heart rate and providing an extra burst of energy. In one double-blind study (neither the participants nor researchers knew who was given caffeine until after the experiment), it was identified that caffeine increased the average power output and average bar velocity during an explosive bench press throw in 12 male athlete participants (Abalo, 2021). This can be particularly beneficial during endurance activities!
- Mood Elevation and Reduced Depression Risk
Caffeine has been linked to the release of neurotransmitters like dopamine and serotonin, contributing to a sense of euphoria, improved mood, and a lower incidence of depression. This may suggest that low to moderate caffeine consumption could potentially act as a natural mood enhancer. However, research suggests that it really does depend on the person consuming it. Many genetic traits significantly influence the neurocognitive effects of caffeine (Fuller et al., 2021). Additionally, Fuller et al. (2021) mention that “an individual’s [baseline] mental and physical energy and fatigue… may play a role in how individuals respond acutely to caffeine” (sect. 4.4).
- Antioxidant Properties
Coffee, one of the most popular sources of caffeine, contains significant amounts of antioxidants. These compounds help neutralize free radicals in the body, which potentially play a role in reducing certain disease risks. Açıkalın and Şanlıer (2021) mention that it was found in recent years that these coffee compounds stimulate the immune system due to their anti-inflammatory and antioxidant effects. These positive effects on the immune system “stem from caffeine, chlorogenic acids, kahweol, cafestol, and similar compounds” (Açıkalın & Şanlıer, 2021, para. 3).
Disadvantages
- Insomnia/Disrupted Sleep Quality
One of the most common side effects of caffeine is its impact on sleep. Consuming caffeine, especially later in the day, can interfere with the ability to fall asleep and stay asleep, resulting in restless nights. By inhibiting adenosine’s action on the body, caffeine disrupts the natural sleep-inducing process. This can result in lower quality sleep. Rapid Eye Movement (REM) sleep is a crucial phase of the sleep cycle associated with dreaming and cognitive restoration. Caffeine has been found to reduce the amount of REM sleep, potentially impacting the restorative aspects of the sleep cycle (Weibel et al., 2021). This is extremely concerning considering how important it is to get restful and sufficient sleep. While caffeine is proven to have performance benefits, sleep deprivation brings the major risk of performance deficits (O’Callaghan et al., 2018). O’Callaghan et al. (2018) assert “If caffeine consumption is not wisely regulated during the first daytime, sleep deprivation will ensue, and performance deficits will be experienced during the subsequent daytime” (para. 7). Chronic usage may produce significant, compounding negative effects over a long period of time.
- Increased Heart Rate and Blood Pressure
While moderate caffeine consumption is generally considered safe for most people, excessive intake or caffeine sensitivity can contribute to these cardiovascular effects. Just like genetic traits play a role in the neurocognitive changes caffeine produces, they also determine the cardiovascular effects one may experience. Individuals vary in their sensitivity to caffeine—age, genetic predisposition, and overall health can influence how an individual responds to caffeine. Caffeine is known to enhance the activity of the Sinoatrial (SA) node, the heart’s natural pacemaker, leading to a faster heart rate. This may be noticeable shortly after consumption. A temporary increase in blood pressure may occur as a result of increased heart rate and the constriction of blood vessels. While this elevation in blood pressure is generally mild and usually passes for most individuals, those with pre-existing hypertension or cardiovascular conditions may experience more pronounced effects. It is recommended that these individuals consult with their physician to determine if caffeine is safe for consumption. Staying adequately hydrated can help mitigate some of the potential negative cardiovascular effects of caffeine. Additionally, maintaining a healthy lifestyle through regular exercise and a balanced diet contributes to overall cardiovascular health!
- Anxiety
While some people find that caffeine consumption enhances alertness and mood, excessive intake or sensitivity to caffeine may exacerbate symptoms of anxiety. This is especially true for individuals with pre-existing anxiety or panic disorders. In a series of 9 studies including 237 patients with panic disorder, 51.1% had a panic attack following caffeine, but NONE after a placebo (Klevebrant & Frick, 2022). Because caffeine stimulates the Central Nervous System (CNS) by the blocking adenosine receptors in the brain leading to increased dopamine and norepinephrine levels, heightened arousal and subsequent feelings of anxiety may occur.
As a teen, I would consume several energy drinks a day, which I would never recommend to anyone. I did not realize how it negatively impacted my mental health and worsened my anxiety until I quit consuming these drinks. Excessive intake of caffeine may lead to anxiogenic effects. These include increased heart rate, restlessness, and jitteriness, which can mimic the physical symptoms of anxiety. Also, the sleep disturbances caused by caffeine use, such as disrupted sleep patterns, can contribute to feelings of anxiety. Lack of quality sleep is closely linked to heightened stress levels and can exacerbate existing anxiety disorders. Individuals concerned about the impact on their mental health should consult with healthcare professionals who can provide personalized advice based on an individual’s health history and current symptoms.
For many individuals, moderate caffeine consumption may not lead to significant anxiety-related issues. Establishing a balance and being mindful of personal tolerance levels can help people enjoy the potential benefits of caffeine without experiencing adverse effects.
- Dependency, Tolerance, and Withdrawal Symptoms
Dependency is a common phenomenon that occurs with regular and prolonged consumption of caffeine-containing products. As the body becomes accustomed to the stimulating effects of caffeine, it may develop a reliance on this substance to maintain normal functioning. Over time, the brain adjusts to the changes caused by blocking of adenosine receptors, and regular caffeine drinkers may be required to consume higher doses to maintain a perceived state of normal functioning. This phenomenon is known as tolerance.
When people who are dependent on caffeine reduce or suddenly stop their intake, they may experience withdrawal symptoms including headaches, fatigue, irritability and mood changes, anxiety, difficulty concentrating, nausea, muscle aches, dizziness, and sleep disturbances. Ironically, withdrawal from caffeine can also lead to sleep disruptions. Withdrawal typically begins within 12-24 hours after the last caffeine intake and may peak within 48 hours. The symptoms can persist for several days to a week or more, depending on individual sensitivity, amount of caffeine previously consumed, and overall health. Again, there is individual variability in how people experience withdrawal symptoms. Some people may quit caffeine with minimal discomfort, while others find it very challenging.
To minimize withdrawal symptoms, individuals looking to cut back on caffeine are often advised to do so gradually. Gradual reduction allows the body to adjust more slowly, potentially minimizing the severity of withdrawal symptoms. Any time you are planning on quitting a substance, it is advised to do so under the direction of a physician who knows your medical history so you can do so safely. Additionally, staying hydrated, maintaining a healthy lifestyle, and support from friends, family, or healthcare professionals can be beneficial for people navigating caffeine withdrawal.
- Digestive Issues
While some people may find they tolerate caffeine well, others may experience digestive issues as a result of its stimulant properties. The increased stomach acid (gastric acid) production caused by caffeine consumption can lead to digestive discomfort, including sensations of heartburn or acid reflux. Those with pre-existing GI conditions such as Gastroesophageal Reflux Disease (GERD or acid reflux) or peptic ulcers, may be even more sensitive to these effects. Individuals with Irritable Bowel Syndrome (IBS) may also be more prone to experiencing negative GI effects. Caffeine’s stimulant properties can contribute to intestinal contractions, potentially leading to symptoms of abdominal pain, cramping, and changes in bowel habits.
Caffeine is known to have diuretic properties, which means it can increase urine production. While this is not directly related to digestive issues, it can contribute to dehydration if one does not adequately compensate by drinking enough water. Dehydration exacerbates many of the negative side effects of caffeine. Proper hydration is essential for overall digestive health. It is crucial to balance caffeine consumption with adequate water intake to prevent dehydration and support healthy digestion. Moderation is key to minimizing these potential issues. Being mindful of the timing of intake, especially for those with sensitivity, can help manage potential discomfort.
Alternatives
For those seeking alternatives to coffee, a variety of beverages offer a gentle pick-me-up without the negative, stimulating effects. While certain teas contain caffeine, they also contain L-theanine, which is a chemical that helps you stay alert longer in combination with caffeine. I enjoy drinking a matcha or chai latte, even though they both contain caffeine, as I find they do not make me feel overstimulated.
“A coffee buzz hits hard and fast, but tea might offer slower, more steady energy” (Coomer, 2023, para. 5).
If you are looking to completely cut out caffeine, herbal teas, such as peppermint, chamomile, or rooibos, provide a soothing and caffeine-free option that can enjoyed throughout the day. Decaffeinated versions of traditional teas and coffee maintain the familiar flavors without the stimulating properties. I personally love drinking a cup of coffee for the experience and taste, rather than the stimulating effects of caffeine. I also find that the taste of coffee itself wakes me up, so I often opt for caffeine-free options. Decaffeinated coffee and tea still maintain their antioxidant health benefits!
Hydration is key, and water infused with fruits, herbs, or cucumber can be a refreshing and satisfying beverage choice. For a burst of natural energy, consider consuming fresh fruit juices (without added sugar) and smoothies rich in vitamins and nutrients. There are a plethora of alternatives catering to different taste preferences that also provide a range of health benefits, making it easier to find a suitable option for everyone.
If you take medication it is essential to consult with your physician and pharmacist before consuming herbal teas or supplements to ensure no negative interactions exist.
Conclusion
Caffeine culture is dynamic, with both benefits and potential disadvantages or side effects. From heightened alertness and enhanced physical performance, to the risks of disrupted sleep and increased heart rate, understanding how caffeine affects our bodies is crucial. It is a balancing act that requires both mindfulness and moderation. While caffeine can be a valuable ally for productivity and mood elevation, it is necessary to be aware of your individual sensitivities and dependencies. The impact of caffeine on sleep, cardiovascular health, anxiety, and digestion underscores the need for a thoughtful approach to consumption. As we navigate the nuances of caffeine, considering alternatives like herbal teas, decaffeinated options, and natural energy sources allows us to tailor our choices to personal preferences and health goals (under provider supervision). In the end, a well-informed and balanced relationship with caffeine ensures that we can enjoy its perks while mitigating the risks, ultimately supporting our overall well-being. I encourage you to look at the role caffeine plays in your daily life, and what ways it affects you personally. I’m a firm believer in doing the things that make you happy, within moderation. As we savor our favorite caffeinated or caffeine-free beverages, let’s not forget that the key to a harmonious relationship with these elixirs lies in conscious choices, mindful consumption, and a genuine understanding of our bodies. Cheers to embracing the diverse world of beverages that cater to our needs, and here’s to a journey of well-being that finds balance in each sip!
References
Abalo, R. (2021). Coffee and caffeine consumption for human health. Nutrients, 13(9), 2918. https://doi.org/10.3390/nu13092918
Açıkalın, B., & Şanlıer, N. (2021). Coffee and its effects on the immune system. Trends in Food Science and Technology, 114, 625–632. https://doi.org/10.1016/j.tifs.2021.06.023
Coomer, S. H. (2023, September 25). Coffee vs. Tea: Which Drink Is Healthier? Forbes Health. https://www.forbes.com/health/nutrition/coffee-vs-tea/
Fuller, D. T., Smith, M. L., & Boolani, A. (2021). Trait energy and fatigue modify the effects of caffeine on mood, cognitive and Fine-Motor task performance: a Post-Hoc study. Nutrients, 13(2), 412. https://doi.org/10.3390/nu13020412
Klevebrant, L., & Frick, A. (2022). Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis. General Hospital Psychiatry, 74, 22–31. https://doi.org/10.1016/j.genhosppsych.2021.11.005
O’Callaghan, F. V., Muurlink, O., & Reid, N. (2018). Effects of caffeine on sleep quality and daytime functioning. Risk Management and Healthcare Policy, Volume 11, 263–271. https://doi.org/10.2147/rmhp.s156404
Ribeiro, J. A., & Sebastião, A. M. (2010). Caffeine and adenosine. Journal of Alzheimer’s Disease, 20(s1), S3–S15. https://doi.org/10.3233/jad-2010-1379
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