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The adrenals produce it in abundance during youth, helping to create the energy, optimism, sex drive, and high level of immunity we enjoy in our twenties.
DHEA is the precursor to other essential sex and youth hormones such as testosterone and estrogen. At about age twenty-five, DHEA levels start to drop, and this decline continues until at age seventy, most people are only producing about 15 percent of prime peak. The effects of low DHEA are unfortunate and farreaching: decreased energy, decreased immune competence, and immune dysregulation contributing to autoimmune disease. Low DHEA obviously contributes to decreased sex drive, as well as reduced ability to repair and rebuild tissues.
Since such effects normally accompany aging, researchers thought the decline in DHEA production was just one of the inevitable effects of growing old. As it turns out, however, decreased DHEA production is also a cause of the aging process. In fact, some experts believe that declining production of DHEA is not inevitable at all, but simply reflects the declining health of the adrenal glands. Today, endocrinologists are using the term adrenopause to describe this phenomenon, and a growing number of health professionals (including myself) believe that much of the degeneration associated with aging can be avoided by maintaining high levels of DHEA. That, of course, is going to be terribly difficult if you’re drinking a lot of coffee— since caffeine elevates cortisol, which leads to DHEA deficiency.
WHAT CAUSES ADRENOPAUSE?
Again, it’s tempting simply to ascribe it to the aging process, but facts do not
Again, it’s tempting simply to ascribe it to the aging process, but facts do not support that position. Looking at a population of sixty-year-olds, you’ll find some with DHEA blood levels of 200 nanograms per deciliter and others with three times that amount. There are numerous factors that contribute to the spread, but mainly it reflects the differing ability of human beings to withstand the effects of stress.
Research is revealing that cortisol and DHEA, both produced in the adrenal cortex, hold an inverse relationship. As serum cortisol increases, DHEA levels fall. It may be that stress and caffeine create such a high need for cortisol that the exhausted adrenals simply cannot maintain production of DHEA at optimal levels. This results in the double whammy of degeneration: elevated cortisol and DHEA deficiency.
The importance of DHEA in maintaining peak immunity is clearly illustrated in the progression of HIV infection to full-blown AIDS. In this case, deterioration is marked by declining levels of an important immune cell known as the T helper (medical term: CD4 cell). Researchers have found a striking correlation between blood levels of DHEA and CD4 counts of AIDS patients.22
The investigators in one study stated, “There is a relationship between the circulating sex hormone levels, particularly DHEA, and the progression of immune depression in HIV, whatever the risk factor.” A 1996 editorial in the Journal of Laboratory and Clinical Medicine suggests that serum DHEA be used as a marker for progression of HIV,23 and at least one clinical trial has found DHEA supplementation to be effective in reducing the amount of HIV
virus in the body.24
The important point for this discussion is that cortisol has been found to accelerate HIV infection, while DHEA slows the virus down. There appears to be a “tug-of-war” in the bodies of HIV-positive individuals between these two adrenal hormones. To the degree that cortisol wins, the disease progresses. We would all do well to remember that this scenario is certainly not limited to AIDS, but most likely plays a role in every disease we suffer.
Critical Point #8: Your Stress Threshold
Life is an unpredictable mix of pleasant and unpleasant events. Unpleasant events can be divided into two categories: not getting what you want, and getting what you don’t want. Either can create stress, but not necessarily dis tress, which suppresses immunity and increases risk for disease. The determining factor is the individual’s emotional response to the event. Two people, for example, can
individual’s emotional response to the event. Two people, for example, can experience the same stressful situation (traffic ticket, final exam, fight with spouse), but one of them is mildly annoyed while the other “flies off the handle”
into distress. Psychologists look at this response as part of the Type A/Type B
personality picture, but they have failed to look at the caffeine factor.
We now know that caffeine can lower the stress threshold (the point where stress becomes distress) in virtually anyone, whether they are Type A, Type B, or anything in between. And the amazing thing is that this “short-fuse”
phenomenon occurs either when blood levels of caffeine rise, or (in habitual coffee drinkers) when blood caffeine levels fall. One eye-opening study looked at behavioral changes that occur when habitual coffee drinkers were deprived of their morning coffee. Compared to controls, the coffee drinkers reacted to situational challenges with a far greater number of negative mood effects, including anger, violence, frustration, and depression.25
CAFFEINE VERSUS GABA
As I mentioned, the brain uses adenosine receptors to keep neuron firing within safe limits. Neurotransmitters comprise another very powerful control system.
Remember that excitatory neurotransmitters speed communication between neurons. The hormone norepinephrine is an excitatory neurotransmitter that is stimulated by the ingestion of caffeine.
The primary inhibitory neurotransmitter is known as GABA, or gamma aminobutyric acid. GABA has a unique ability to calm the mind without putting you to sleep. The researchers who discovered GABA took mice and taught them to find their way through a maze. Once this was accomplished, they stressed the mice by immobilizing them (mice hate that). Interestingly, the stressed mice could no longer find their way through the maze. But when GABA was injected into their brains, they waltzed right through. Seeing the obvious parallel between that experiment and the way most of us live, other researchers scurried to their labs to synthesize GABA for human consumption. This was accomplished in record time, and scant onths later, GABA appeared on the shelves of healthfood stores.
There are two reasons why I am telling you this story. First, it’s a good “nutrition detective” lesson. In the mice study, the GABA was injected directly into the brain. The healthfood store products are oral capsules. As it turns out, you cannot raise brain levels of GABA by eating it. The fragile molecule is completely digested in the stomach. So much for the idea of popping a few
completely digested in the stomach. So much for the idea of popping a few GABA capsules with your double espresso.
The second point is that the mice research revealed yet another reason to decrease your intake of coffee. Caffeine, it turns out, disrupts the normal metabolism of GABA.26 Here’s this wonderful brain biochemical that increases the “filter mechanism” of the brain, helps you to step back and see clearly even under stress, and caffeine screws it up. Thus, in the maze of life you never make it to the cheese.
GABA IN YOUR GUT
New research tells us that GABA is also produced in the intestinal tract, where it serves a similar purpose: calming anxiety and stress. Since caffeine disrupts the normal metabolism of GABA, investigators now believe they have found the smoking gun to implicate coffee with ulcers and irritable bowel syndrome.
What’s more, this anti-GABA action is powerfully amplified by other drugs, including commonly prescribed antibiotics. These medications interfere with the action of GABA and at the same time decrease the body’s ability to detoxify caffeine.27 This combination can produce anxiety, irritability, hyperactivity, and even epilepsy-like convulsions28—all the more reason to ask your physician if your medication has any interactions with caffeine.
RESEARCH CAPSULE
Habitual Caffeine Use Is No Protection
Coffee promoters are fond of claiming that the drug’s negative side effects somehow “wear off” as you develop a tolerance to caffeine, but research does not support that claim. In fact, major scientific reviews agree that, while the diuretic effect may decreas
e with habitual use, humans do not develop “tolerance” to the far more dangerous central nervous system effects.29–3031
Still, caffeine apologists can cite research where coffee drinkers were given caffeine and their blood pressure did not increase. But this is not a real-world experiment. In the real world, we are faced with numerous challenges as we go through the day. Some of these challenges are mental (like taking a final exam), some are emotional (dealing with a difficult relationship), and some are
emotional (dealing with a difficult relationship), and some are physical (sports and exercise). Research with real people shows conclusively that caffeine accelerates and magnifies the damage that we experience from stress. In fact, it is often the critical factor that pushes us over the stress threshold into distress, disease, and degeneration.
Here are three studies that debunk the idea that habitual coffee drinkers are somehow immune to caffeineinduced stress damage.
Note that all three are well-designed, placebo-controlled experiments.
1. In this study, healthy students were selected to evaluate the combined response to caffeine and a difficult laboratory task. All of the students were coffee drinkers. Some were habitual consumers and others were light consumers. On the test day, they were given a moderate dose of caffeine based on their weight. A 150-pound man, for example, was given 238 milligrams, or the equivalent of a mug of strong coffee.
Caffeine administration more than doubled epinephrine and cortisol levels from baseline, and the magnitude of this increase was not different between the habitual and light coffee drinkers.
The study authors concluded that: “Caffeine can potentiate both cardiovascular and neuroendocrine stress reactivity, and the habitual use of caffeine is not necessarily associated with the development of tolerance to these effects.”
Source: J. D. Lane, R. A. Adoock, R. B. Williams et al., “Caffeine Effects on Cardiovascular and Neuroendocrine Responses to Acute Psychosocial Stress and Their Relationship to Level of Habitual Caffeine Consumption,” Psychosomatic Medicine, MayJune 1990;52(3):320-36.
2. Another study looked at the combination of caffeine and exercise. Again, the subjects were healthy young men with normal blood pressure. This time the dose of caffeine was even smaller, roughly the equiva lent of one mug of coffee.
We know that exercise by itself increases blood pressure, so measurements were taken twice: once on the day when caffeine was administered and once on the day when subjects received a placebo. Dangerous elevations of blood pressure were recorded more than twice as often on caffeine days as compared to placebo
more than twice as often on caffeine days as compared to placebo days. In addition, caffeine impaired circulation due to the constriction of blood vessels and elevated stress hormones.
Source: B. H. Sung, W. R. Lovallo, G. A. Pincomb et al., “Effects of Caffeine on Blood Pressure Response during Exercise in
Normotensive Healthy Young Men,” American Journal of
Cardiology, April 1, 1990;63(13):909-13.
3. In the third study, students were given either caffeine (the equivalent of one mug of coffee for a 150-pound person) or placebo during periods of low stress (no exams) or high stress (final exams). Over a period of eight days, heart rate and blood pressure were measured. As you would expect, the stress of exams increased blood pressure slightly. But when caffeine was added, blood pressure shot up in many of the subjects to the borderline hypertensive range. What’s more, caffeine increased blood cortisol and cholesterol levels.
Source: G. A. Pincomb, W. R. Lovallo, R. B. Passey et al.; “Caffeine Enhances the Physiological Response to Occupational Stress in Medical Students,” Health Psychology, 1987;6(2):101-12.
Because this is a real-world scenario, this study brings up an important point. In the real world, if a person were to go to the doctor with the symptoms created by exams and caffeine, he or she would likely be placed on blood pressure medication—which would be completely inappropriate and possibly dangerous. Do you think doctors routinely survey their patients to determine caffeine ingestion? Did your doctor ask you about caffeine at your last physical exam?
THE STRESS-FATIGUE-DISEASE CYCLE
It has been said that actions become habits and habits determine our lives. That is especially true when it comes to what we eat and drink. The problem with the caffeine habit is that it’s very hard to be moderate or even sensible. That’s because it sets up a cycle of alertness followed by fatigue. You might start with one cup in the morning, but most people find that they soon need a second cup at midmorning, and another caffeine hit (coffee or cola) in the afternoon. Over
midmorning, and another caffeine hit (coffee or cola) in the afternoon. Over time, adrenal weakness leads to deeper fatigue, more caffeine, and a spiral of increasing stress and decreasing health that can be devastating. The good news is that once you understand this cycle, you can break free. And only when you break free you can begin the task of repairing the damage.
Illustration 2
The Stress-Fatigue-Disease Cycle
Clinical evidence suggests that at a certain point, stress and caffeineinduced alterations of hormone and metabolic functions may not be reversable. The following case history will give you a glimpse of how far this downward spiral can go.
Linda A. was a moderate coffee drinker until she started a very demanding job right after college. Working long hours meant an additional mug of coffee around 3 P.M. that would keep her going until six or seven. But the quality of her sleep began to suffer and, unlike her rise-and-shine past, she found that she had to drag herself out of bed. She even had to move her alarm clock out of reach to prevent herself from hitting the snooze button and being late for work.
When she complained about this to her doctor, he told her that the afternoon coffee was not likely to be causing the insomnia and restlessness. He blamed it on the stress of her job.
As the months went on, however, she found that she could not function without two or three cups of coffee in the morning. She looked forward to a 10
A.M. cup at work, and usually had a cola beverage with lunch. Eventually, there was a steady stream of caffeine throughout her day; always a mug of coffee or a can of cola at her desk. She started getting headaches, and the only thing that seemed to help was a cup of coffee. She knew that she was, as she explained, “in trouble,” but she thought she could hold everything together until things in her
trouble,” but she thought she could hold everything together until things in her life “settled down.” Unfortunately, that never happened. Instead, she came home one night and her husband announced that he was leaving her.
He told her that her entire personality had changed since they met. She was no longer a fun-loving, easygoing woman, but an irritable, anxious, and unhappy person She became defensive, blaming the stress of her career. When he pointed out that their sex life was next to nonexistent, she blamed her headaches and the fact that her periods literally knocked her out of commission for ten days out of every month. She had never told him about the painful lumps in her breasts that made intimacy a less than pleasurable experience.
The stress of her broken marriage got her to seek help, but all she received was a prescription for a tranquilizer and an antidepressant. At the age of thirtythree, she started experiencing painful swollen joints, but was given only painkillers.
Linda came to my office with the diagnosis of rheumatoid arthritis, cystic breast disease, PMS, migraine, and depression. Her food and beverage survey revealed that she was ingesting over 1,000 milligrams of caffeine each day, and my suggestion that caffeine was causing many of her troubles was at first met with disbelief and alarm. After all, she was convinced that without caffeine she could not function. It was only after I showed her research proof associating caffeine with every one of her disorders that she agreed to start cutting back. It took Linda four months to get down to two cups of coffee per day, and at that point, she switched to tea.
After one year on my
Off the Bean program, including nutritional therapy to help repair her adrenals and nervous system, Linda was completely free of headaches. The painful lumps in her breasts disappeared, her mood swings evened out, her energy dramatically improved, and her PMS was a thing of the past. But three years later, she was still battling the arthritis. As her rheumatologist explained, something in her body just went “haywire,” causing her immune system to attack her joint tissue. Aside from steroid drugs and other powerful immune-suppressing agents, he offered no hope for relief.
I believe that Linda will one day be free of rheumatoid arthritis, but it may take years. For so long her body had been held in a perpetual state of near panic.
Stress hormones ravaged her immune system, destroyed muscle fibers, drove her DHEA levels down to those of a seventy-year-old, and left her adrenals exhausted and weak. The road back is not easy, but she has seen tremendous improvement.
By the way, Linda was using birth control pills when she first noticed that her sleep was disturbed. These drugs decrease the body’s ability to detoxify caffeine,
sleep was disturbed. These drugs decrease the body’s ability to detoxify caffeine, and as it turns out, that 3 P.M. mug of coffee was keeping caffeine coursing through her blood until 2 A.M. It was all downhill from there.
Critical Point #9: Your Sleep Cycle
Few people understand the importance or the function of sleep. We tend to think of sleep as “wasted time,” and that may be the reason why studies show that the vast majority of Americans don’t get enough sleep. Pressed as we are for time, we just assume that we can get by with less. Even doctors are largely unaware of the critical importance of sleep. They treat insomnia with drugs (many of which actually disturb sleep quality), but few physicians today bother to take a sleep history. Routine intake questionnaires rarely include a section on sleep habits.
But among researchers, sleep is an extremely hot topic. Entire journals are devoted to the subject, and sleep centers are opening in research facilities around the world. This explosion of interest has been fueled mainly by neurobiologists who are starting to unravel the complex way in which the brain directs the healing powers of the body. And one of the most startling discoveries has to do with what goes on while you sleep. When you begin to understand these mysteries, you’ll never look at a cup of coffee in quite the same way. That’s because sleep can be a youth-restoring, powerfully rejuvenating, deep healing experience—or, it can be merely a continuation of the day’s tension, conflict, and frustration. For most of us, the difference is a drug called caffeine The World Health Organization (WHO) in Geneva reports that more than 30 percent of people in industrialized countries experience episodes of sleeplessness, and about 12 percent of adults have chronic insomnia.