Wise Words… 05-04-11

Caffeine
by Dr. Rebecca Wise

Present naturally in more than 60 different plants, caffeine comes to us compliments of the coffee bean, kola nut, tea leaf, and cacao pod, among others.

Caffeine is widely recognized as the most popular mood-altering drug in the world.

For anyone who wakes up and smells the coffee (or tea), its benefits are obvious: an increased sense of alertness, well-being, and sociability. For some, however, this drug can have a down side, too: increased irritability or anxiety, rapid heartbeat, excessive urination, or disrupted sleep—especially when consumed late or throughout the day, or in large quantities.1 Caffeine may also slightly increase your blood pressure or contribute to acid reflux, where stomach contents back up into your esophagus.

Caffeine can cause physical dependence, meaning it leads to withdrawal symptoms within 12 to 24 hours of discontinuing its use. This can happen if you regularly consume as little as 100 mg of caffeine a day—what’s found in a 5-ounce cup of coffee. Symptoms can be severe enough to interfere with your day-to-day functioning and can last for 2 to 9 days.

What are the symptoms of withdrawal? You may have experienced them when you forgot to pack the ground coffee for that five-day backpacking trip or when you had to go “cold turkey” right before a medical procedure or test. Headaches, fatigue, irritability, anxiety, flu-like symptoms, lack of concentration, all in all—not a whole lot of fun.

Does this mean you should give up your beloved cup o’ Joe? It depends. Certainly if symptoms are causing you discomfort, it might be time to gradually cut back.

Perhaps the first step you should take is to become more familiar with the many sources of caffeine. It’s not only found in coffee and tea, but also in many sodas and foods containing chocolate, such as cake, ice cream, yogurt, candy, and pudding. Did you know that even decaffeinated or so-called “caffeine-free” beverages contain small amounts of caffeine? And, certain noncola drinks, such as some orange or cream sodas and lemon-lime drinks do, as well.

Here’s a sample of the caffeine content in a few common beverages and foods:

• Coffee: (5 oz): 60–150 mg
• Tea: (5 oz): 40–80 mg
• Caffeinated soft drink (12 oz): 22–71 mg
• Coffee ice cream (6 oz): 8–85 mg
• Espresso (1 oz): 30–50 mg
• Coffee yogurt (8 oz): 45 mg
• Dark chocolate (1.5 oz): 5–35 mg

Check labels. Other products also contain caffeine. These include weight loss products, which contain 75–350 mg of caffeine. Prescription medications, such as Darvon, Cafergot, and Fiorinal, and over-the-counter (OTC) medications, such as Midol, Nodoz, and Vivarin, also do. Before taking products such as these, discuss any medical conditions you have with your doctor. Bring your doctor or me a list of your medications—some can interact poorly with caffeine.

Pain relievers, such as Excedrin, contain 64–130 mg of caffeine in just two tablets. Caffeine can help your body absorb the medication faster and make it more effective. But when combined with other foods high in caffeine, medications such as these can cause rebound headaches. If this is a problem for you, don’t stop taking the medication without first talking with you’re doctor

If you’re pregnant or breastfeeding, also discus how much to reduce your caffeine consumption. And, don’t hesitate to come to me with any questions you have about the relationship between caffeine and medications. I’m here to help.

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Wise Words…. is a weekly general medical information column from Dr Rebecca Wise. Dr. Wise has a master’s degree in education as well as her doctorate in pharmacy. She is an adjunct clinical professor at LECOM School of Pharmacy in Erie and a teacher at Great Lakes Institute of Technology. She is the owner/manager at Lakeside Health Mart Pharmacy in Edinboro and can be reached there by phone (814) 734-8500 or email pharmacist@EdinboroRx.com.

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