Caffeine Blues_ Wake Up to the Hidden Dangers of America's #1 Drug ( PDFDrive )
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THE CALCIUM CONNECTION
To understand just how caffeine produces muscle tension, you need to know that the drug disrupts calcium ion flow through what are known as calcium-release channels. Smooth muscle lacks these caffeine-sensitive calcium-release channels, so there is no contraction.132 Skeletal muscle, however, is rich in calcium-release channels, and thus caffeine can cause contraction or spasm.133 In fact, the sensitivity of muscle tissue to caffeine has been used by veterinarians to predict muscle damage from strenuous running.
A procedure called the caffeine contracture test measures the degree to which a muscle contracts in response to caffeine. Horses whose muscles contract severely in response to caffeine will be very likely to incur damage from strenuous running.134 A syndrome of muscle pain after exertion has also been identified in humans, and once again, the marker appears to be increased sensitivity to caffeine.135
THE ULTIMATE TEST
Of course, the best way to evaluate the relationship of caffeine to your muscle pain is to get off the drug and see how you feel. Many people have been amazed when an unlooked-for benefit from quitting caffeine was relief from pain caused by neck, back, and shoulder tension. But remember, if you’re suffering from chronic pain, going cold turkey off caffeine is likely to make your condition worse before it gets better. Therefore I urge you to employ the Off the Bean strategy presented in Chapter 10. That will minimize withdrawal symptoms and ease you into a different life—one in which you are free of the background stress and tension created by caffeine.
Headache
Forty-five million Americans suffer from chronic headache. Seventeen million are migraine sufferers. The relationship of caffeine to headache is confusing, not because the data is inconclusive, but because for half a century, a major cause of headache has been promoted as the cure. Caffeine is a common trigger for migraine and other types of headache.136 There is no mystery here. As we’ve seen, caffeine increases tension in the jaw, shoulders, back, and neck. It has a powerful vasoconstrictive effect in the brain. As little as 250 milligrams of caffeine has been shown to decrease total brain cerebral blood flow by 30
percent.137 New research also shows that headache sufferers commonly have low magnesium levels (measured as serum ionized magnesium),138 and we have already learned that caffeine depletes the body of this essential mineral. Now consider the following common scenario.
The person with a headache doesn’t know that it was caused or triggered by caffeine, so he or she looks for a painkiller (analgesic). Studies show that in 95
percent of cases, the analgesic drug contains caffeine.139 Such painkillers work, especially if the headache was caused by ****caffeine withdrawal, but the caffeine ultimately triggers another headache. Ultimately, the hapless sufferer becomes dependent on the painkiller for even a modicum of relief, but the headaches increase in frequency and intensity. This may go on for many years, creating a cycle of pain and depression that destroys the quality of life.140
And the cycle is not uncommon. Very often the patient’s doctor is the one to recommend a caffeine analgesic. And often it is the same doctor who must ultimately admit the patient to a hospital for analgesic abuse detox. The standard analgesic detox program looks like this:141
1. Withdrawal of caffeinecontaining analgesics
2. Treatment of the withdrawal headache (which may last one to two weeks)
3. Therapy to reduce migraine triggers, including avoidance of caffeine What’s wrong with this picture? Is it not crystal clear that if someone had told the headache sufferer to avoid caffeine in the first place, a decade or more of pain and suffering, addiction, and depression could have been avoided?
WITHDRAWAL
AND BEYOND
A caffeine deprivation (withdrawal) headache results from the normal opening (dilation) of blood vessels that are constricted by caffeine. In other words, habitual caffeine intake keeps blood vessels in the brain constricted. When caffeine is not consumed, these blood vessels return to their normal blood-flow potential, and it is this increased circulation in the brain that causes the throbbing agony of caffeine withdrawal headache. In studies where caffeine is withheld or simply delayed, headaches result from habitual ingestion of as little as 100
milligrams (one cup of coffee or two cola beverages) per day.142, 143
Ultimately, of course, the brain becomes accustomed to normal blood flow and the headache subsides. In Chapter 10, I will explain how to decrease or eliminate caffeine without suffering so much as a single headache. But the point to keep in mind is that habitual caffeine users are disrupting normal and essential blood flow to the brain. This is not a good thing, even if the body does get used to such abuse.
And the caffeine-headache connection goes well beyond withdrawal.
Caffeine itself contributes to headache even when it is consumed moderately and consistently.144, 145 One landmark study demonstrated significantly increased risk for headache at caffeine intakes of 250 milligrams per day.146 Yet I continue to come across reports in the medical literature and popular press that caffeine is a cure for headache. Perhaps the most bizarre is a recent article in the Medical Tribune advising people who wake up with headaches to have a cup of coffee before they go to bed.147
Today, the most popular herb sold in America is Gink-go biloba. Ginkgo has been shown to enhance peripheral blood flow, especially in the brain, and thus may be helpful in the prevention and treatment of Alzheimer’s disease and some types of vascular disorders.148, 149 But clinicians are starting to report that some people taking ginkgo are experiencing headaches. Do you see why? Ginkgo dilates the same peripheral blood vessels in the brain that caffeine constricts.
Thus habitual caffeine users are taking ginkgo and giving themselves withdrawal headaches: the worst of both worlds.
STUMBLING
INTO ADDICTION
Here’s a classic example of how caffeine addiction and the commensurate headache can insidiously sneak into a person’s life. At sixteen years of age,
headache can insidiously sneak into a person’s life. At sixteen years of age, Caroline was attending a boarding school and came down with mononucleosis.
Sent home for a month to recover, she began drinking coffee for the first time in her life simply as a way to cope with the profound fatigue.
Upon returning to school, where students were not allowed to drink coffee, Caroline began to experience blinding, almost incapacitating headaches in the midafternoon. She was given Excedrin, two of which delivered a whopping 130
milligrams of caffeine to her 100-pound body. The analgesic relieved her headache but also kept her awake until 3 A.M. As a result of disturbed sleep and endocrine stress, full recovery from her illness, which is normally accomplished in four to six weeks, took Caroline more than three years. What’s more, she became addicted to painkillers and was not free of headaches until, as an adult, she eliminated all sources of caffeine in her diet.
>THE OPERATION WAS A SUCCESS, BUT THE PATIENT IS
ADDICTED
Post-surgery headache has been noted in the medical literature for decades, and was until recently attributed to a side effect of anesthesia. Then, a few years ago, someone made the observation that people who abstain from caffeine do not experience such headaches. Ultimately, it was found that the “postoperative headache” was in fact a caffeine withdrawal headache, since surgical patients are not allowed to drink before their operation.150
Sensible solution: Get off caffeine. Preposterous solution: Put caffeine in the patient’s intravenous drip. Action taken: The preposterous solution, of course!
I’m not making this up. It’s called prophylactic (preventive) intravenous administration of caffeine, and it’s currently being recommended for habitual coffee drinkers who are undergoing surgery.151
A New View on Caffeine Withdrawal
“Although the phenomenon of caffeine withdrawal has been described previously, the present report documents that the incidence of caffeine withdrawal
is higher (100 percent of subjects), the daily dose level at which withdrawal occurs is lower (roughly equivalent to the amount of caffeine in a single cup of strong brewed coffee or three cans of caffeinated soft drink), and the range of symptoms experienced is broader (including headache, fatigue and other dysphoric mood changes, muscle pain/stiffness, flu-like feelings,
other dysphoric mood changes, muscle pain/stiffness, flu-like feelings, nausea/vomiting and craving for caffeine) than heretofore recognized.”
Source: R. R. Griffiths, S. M. Evans, S. J. Heishman et al., “Lowdose Caffeine Physical Dependence in Humans,” Journal of Pharmacology and Experimental Therapeutics December
1990;255(3):l 123-32.
OXYGEN, THE ESSENCE
OF LIFE
Whether or not you suffer from tension or migraine headaches, you have to ask yourself if you want to con sume a drug (caffeine) that clamps down the blood vessels of your brain and restricts oxygen delivery to billions of cells. In one more highly ironic twist of modern life, we now have oxygen bars springing up around the country, supposedly to rejuvenate patrons with a superoxygen hit.
But many of these same people have just visited the espresso bar, where they loaded up on caffeine, thus making the oxygen unavailable to their cells. Better to forget the oxygen, bar, stay off the caffeine, and enjoy the natural vitality that exercise, adequate rest, and good diet can provide. I predict you’ll have fewer headaches and more brain power to meet any challenge the day may bring.
Aging
You’re probably surprised to find aging in a section on health disorders. After all, every time the earth circles the sun, we’re all one year older. But while that fact is inexorable, the consequences of aging are neither inevitable nor immutable. We are learning that aging does not have to include degeneration and decrepitude. It is possible, for example, to place two sixty-year-old women side by side and have most people believe that one is the other’s daughter. Now mainstream medicine tends to focus on the older-looking individual because mainstream medicine is concerned primarily with the treatment of disease. On the other hand, I study the younger-looking one to see what can be learned regarding prevention and anti-aging strategies.
Over the years, this line of inquiry has paid rich dividends as research uncovers significant differences in the biochemical makeup of young-and oldlooking individu als. We have discovered differences in hormone levels and radically different levels of other important repair and rebuild biochemicals such as insulin-like growth factor-1 (IGF-1). Much of that data was reported in my book The DHEA Breakthrough (Ballantine, 1996), and while this is not the place for an exhaustive review, there are critical points that need to be addressed in relation to coffee and caffeine. In addition, new and extremely exciting data is being published every month that reveals the importance of hormone production to longevity.
WHAT IS AGING ANYWAY?
There are a variety of theories that seek to explain the breakdown of human systems leading to death. Over the years, they are either refined or disproved as more information becomes available. When I was in graduate school, the genetic theory prevailed, that being the concept that “death genes” (or perhaps, a single death gene) programmed tissues to self-destruct. But in more than twenty-five years, such a gene has not been found. On the contrary, researchers have been able to create conditions in which tissues live far longer than expected. The critical factors in aging appear to be the efficiency by which nutrients are delivered, toxins are removed, and repair processes are maintained.
Indispensable to all these life functions is water. Water is not only the
environment within which nutrient delivery, detox, and repair take place, it is an active and critically important participant in every chemical reaction that takes place in your body. One of the primary markers of aging, of course, is dehydration, and the loss of water from our tissues is accelerated by caffeine.152
That means more lines and wrinkles on die outside, and a loss of metabolic efficiency on the inside.
Caffeine has significant diuretic effects even in habitual users. Even though considerable attention has been placed on the nutrients that are lost in the urine, hardly anyone has looked at the effects of the water loss itself. This is particularly ironic because coffee, tea, and soft drinks are today more widely consumed than water, thus creating a vicious cycle of dehydration and diuresis.
What’s more, rehydration after exercise is actually impaired by drinking caffeinated beverages,153 and in yet another vicious cycle, dehydration appears to increase the toxicity of caffeine.154, 155 Therefore, the net effect of high caffeine use is accelerated aging, especially of the skin and kidneys.
CAFFEINE
AND DETOXIFICATION
Detoxification, or die ability of the body to break down and eliminate toxins and waste, is a biomarker of the aging process. We are used to thinking of the liver, kidneys, and skin as the major organs responsible for this essential function, but each is entirely dependent upon water to get the job done. Thus, any degree of dehydration can seriously impair the detox process, accelerate aging, and increase risk to illness and disease.
While caffeine contributes to dehydration, perhaps the most important point to remember (from Chapter 3) is that caffeine itself must be detoxified by the liver, and that is not an easy process. In fact, high doses of caffeine may impair liver function, creating yet another metabolic stress. After all, the liver is responsible for detoxifying not only caffeine, but the vast majority of foreign materials that we are exposed to through water, air, food, and the environment.
Most of these substances, collectively termed xenobiotics, are broken down by a group of enzymes known as the cytochrome P450 system (CP-450).
For years, scientists have used caffeine to evaluate stress on the CP-450
system. If a drug or therapy is toxic to the liver, that organ will take longer to detoxify a given quantity of caffeine.156 The converse may well be true.
Consider the liver function of an individual consuming large amounts of
caffeine. It stands to reason that the liver’s detoxification of other xenobiotics will be impaired. Evidence in support of this theory comes from research with anticancer (chemotherapy) drugs.
Remember that chemotherapy drugs are basically selective poisons that act chiefly upon rapidly dividing cells, such as those in a tumor. One of the problems encountered by oncologists is that these drugs become less effective over time. The body actually develops a tolerance or resistance to the drugs because the liver gets really good at detoxifying them.
Caffeine, however, has been shown to reduce the development of such tolerance, presumably by impairing the detox ability of the liver and inhibiting DNA repair.157 Now, lest you think this is a good thing, consider the big picture.
Caffeine is a drug that is consumed by millions of people, often in amounts of 500 to 1,000 milligrams per day. If it is impairing the ability of the body to detoxify xenobiotics, it is actually promoting disease (including certain types of cancer). The fact that it may have some benefit in enhancing the effectiveness of chemotherapy drugs is hardly cause for celebration.
HEREDITARY FACTORS
IN DETOXIFICATION
In looking carefully at the CP-450 system, researchers have uncovered an extremely interesting phenomenon. Some people, termed “slow acetylators,”
have rather sluggish detox activity, and this appears to be purely genetic. Slow acetylators will have impaired caffeine clearance, and their detoxification of other drugs will also be impaired. Studies show that slow acetylators experience more toxic effects after caffeine ingestion, and often have serious allergic-type reactions to a class of antibiotic drugs known as sulfon-amides.158, 159
It’s important to understand that you have no way of knowing if you are a slow acetylator, because such testing is not done on a routine basis. Research suggests, however, that the condition may be extremely common. In one study, slow acetylator status was identified in 55 percent
of the control group population.160 Once again, this underscores the folly of blanket statements concerning the safety of caffeine. Safe for whom? At what dose?
REPAIR
The ascending theory of aging at the moment is one of accumulated error.
Scientists marvel at the astounding ability of cells to repair and clone
Scientists marvel at the astounding ability of cells to repair and clone themselves, noting that our bodies are involved in a massive twenty-four-hour-aday regeneration process. But as cells continue to copy themselves, the chance of error increases. Error, of course, results in the production of an abnormal cell, and when a critical mass of abnormal cells is reached, the tissue malfunctions or dies, thus contributing to the degeneration of aging.
The question, of course, is, “What causes the error? Theoretically, every cell’s DNA is a perfect blueprint for the entire life, repair, and replication of that cell, and as long as the blueprint is faithfully followed, error should not occur.
But in biology, as in construction, mistakes happen. For example, what if the blueprint is damaged?
Imagine a construction office where someone spills coffee on the blueprint.
It’s quickly wiped off, but a part of the document is smudged. Construction must continue, so the general contractor guesses where the support beams are to be placed. As a result, eventually the building collapses.
Likewise, DNA can be damaged by an array of chemical and biological toxins. Collectively, these are called mutagens because they cause mutation.
Fortunately, your body also produces cells that fix DNA. As you might have guessed, however, this DNA repair becomes less efficient as we grow older, and caffeine appears to play a role in the decline. There are three aspects to this: 1. Caffeine is a known mutagen. That is, it can cause replication error, either by damaging the DNA blue print or disrupting communication of that information to other “builder” molecules like RNA.