Contents

ACKNOWLEDGMENTS

FOREWORD

INTRODUCTION

CHAPTER 1: Coffee and Caffeine: A Dose of Reality

CHAPTER 2: Are You Addicited?

CHAPTER 3: Caffeine and Your Body

CHAPTER 4: Caffeine and Your Mind

CHAPTER 5: Specific Health Disorders: The Caffeine Connection

CHAPTER 6: Caffeine and Women’s Health

CHAPTER 7: Politics and Pushers

CHAPTER 8: The Hard Truth about Soft Drinks

CHAPTER 9: Options and Alternatives

CHAPTER 10: Off the Bean and On to Vitality Off the Bean

Conclusion

APPENDIX A
APPENDIX B
APPENDIX C

DON’T LET YOUR MORNING PICK-ME-UP TEAR YOU DOWN

• Caffeine can’t provide energy, only chemical stimulation, an induced

emergency state that can lead to irritability, mood swings, and panic attacks.

• Caffeine’s ultimate mood effect can be letdown, which can lead to

depression and chronic fatigue.

• Caffeine gives the illusion of heightened alertness by dilating pupils,

quickening heart rate, and raising blood pressure. In fact, caffeine does not
increase overall mental activity.
 FOREWORD

As a physician, I prescribe drugs with great care, because all drugs have
effects and side effects. In addition, some can create a state of dependence.
Clearly, caffeine is such a drug, and I find that very few people are aware of
its side effects and dangers. In fact, most people do not even know how much
caffeine they are consuming, and what concerns me is that this information is
purposely withheld from consumers.

Caffeine is clearly addictive, completely unregulated, and its presence in our

foods and beverages is often hidden! Almost daily I see a patient whose
symptoms are made worse by the consumption of caffeine. The drug
contributes to palpitations, panic attacks, hypoglycemia, gastritis, fatigue,
insomnia, and PMS, to name a few. Some people are so sensitive to caffeine
that they don’t realize a fruit drink with hidden caffeine can cause their
symptoms.

Although I know a few people who use caffeine prudently, most people I meet
report drinking what you will discover are dangerous amounts of caffeine.
Perhaps an occasional cup is safe, but by the time you realize that you can’t
make it through the day without caffeine, you’re in trouble. Coffee, tea, soft
drinks, caffeine-spiked beverages, and the other hidden forms of caffeine are
promoted as harmless, energizing treats. I consider this deceptive and false
advertising. And what concerns me most is the dramatically increasing use of
caffeine by children, accompanied of course by large amounts of sugar or
artificial sweeteners, which add to beverages’ deleterious and addictive
effects.

I find Caffeine Blues to be an extraordinary and important book. Knowledge is

power, and this book will empower you to regain and protect your health.
Finally, you have in your hands all the information you need to make an
informed choice regarding caffeine use. Everyone needs to know the short-
and long-term effects of caffeine. Everyone, including doctors, needs to
become more aware of caffeine’s role in cardiovascular disease, anxiety,
depression, gastrointestinal disorders, and women’s health. I’ve looked
forward to this exposé for years, and I’m pleased that it is so well documented
and readable.

I recommend it to my patients and keep a copy in the waiting room. I’ve

known and learned from Stephen Cherniske for many years. His in-depth
knowledge, experience, and scientific research on numerous topics in health
and nutrition make him a natural to tell this shocking and critical story. I
encourage you to trust his information and insight, as I do. Caffeine Blues will
make my job a great deal easier. I suggest that you take the book seriously,
and discover the truth that’s been hidden from you for far too long.
This book not only blows the whistle on the caffeine industry, but it also
provides you with a proven strategy to kick the habit without suffering through
weeks of withdrawal. For many of my patients, kicking caffeine has been an
important step on the road to optimum health. Enjoy the journey.

Jesse Lynn Hanley, M.D.

INTRODUCTION

“Coffee?” she intoned. “Thank you,” I replied, taking a cup from the hostess in
the airport lounge. I was waiting for an early-morning flight to Anchorage to
give a weekend seminar on clinical nutrition. The flight was delayed, so I had
another cup as I read the newspaper. I didn’t notice when she refilled my cup.
When we finally boarded, a flight attendant had a cup of coffee in my hand
before I had my seat belt fastened.

Breakfast was served twenty minutes later, along with another cup of coffee.
Looking back, it seems extraordinary how all this took place, but at the time it
appeared perfectly normal. The entire five-hour flight was punctuated with
“Coffee?” “Cream and sugar?” “Can I warm that up for you?” “Coffee, sir?”
Here I must tell you that I love coffee, and at that time was in the habit of
drinking two cups every day. I also love to fly, because there are no clients, no
charts, and, until recently, no phone. It’s usually one of the most relaxing
times of my busy schedule. But this flight was a nightmare. I felt anxious.
Instead of “zoning out,” thoughts raced through my mind with surprising
intensity.

I felt flushed and heated; I loosened my tie but could not get comfortable.
Finally, lunch was served, which provided a brief diversion—and another cup
of coffee. By midflight, I was nearly panicked. For the first time in my life, I felt
claustrophobic and fearful. I tried to figure out what was wrong, but I couldn’t
put my finger on it. I tried to organize my lecture notes, but couldn’t
concentrate. “Coffee?” the stewardess chimed. “Do you need a refill, sir?” I
looked at my watch every fifteen minutes as the time dragged on. Finally, the
Anchorage area came into view.

But as we approached the airport, the captain announced that weather

conditions would delay our landing. Thirty minutes later, we were still circling
the airport, and I did something I’d never done before: I yelled at the flight
attendant. “When the hell are you going to land this plane?” I snapped.
Slightly taken aback, she placed a hand on my shoulder and answered as if
she were speaking to a three-year-old. I felt like an idiot. “I’m really not feeling
myself,” I muttered. Flying north for these seminars is usually not a problem.
I gain an hour from Pacific Standard Time, and normally arrive for my
presentation refreshed and well prepared. This time was different. Nothing
seemed to go right. The hotel van was crowded. The university had neglected
to reserve a room near the lecture hall. A box holding my slides had opened
inside my suitcase, and it took me over an hour to put them back in order. I
walked up to the speaker’s podium feeling frazzled and disconnected, and my
lecture proved to be just as bad.

For the first time in my professional career, I had lapses of memory and
omitted important information. A number of slides were upside down. The
usual flow of my presentation was completely gone. I consoled myself with
the thought that I would do better the following day. Walking to the elevator, I
was approached by a student who had taken a number of my previous
classes. “Are you all right?” he asked. “You look terrible.” Back in my room, I
had to admit he was right. Instead of my usual healthy glow, there were dark
circles under my eyes and deeply etched wrinkles.

I felt old. Still, I reasoned, after a good night’s sleep, I’d be back to my
energetic, positive self. Instead, I tossed and turned for hours until it hit me:
insomnia. How many cups of coffee had I had that day? I couldn’t remember,
but it had to be at least six, maybe more. Strange as it may sound, I was
relieved that I finally had an explanation for my terrible experience. Firmly
resolved to quit coffee, I fell asleep around 2 A.M. I arose four hours later,
feeling like I’d been hit by a bus. The first lecture began at 8 A.M., and I
wanted to prepare well to make up for the previous day.

A cold shower served to rouse my tired body, and I managed to arrive at the
lecture hall looking half decent. I carefully avoided the coffee urns that dotted
the back and side aisles of the auditorium and, with a pitcher of water by my
side, began the morning topic. By 10 A.M., I had a splitting headache. I
announced a thirty-minute break and retreated to my room. Ice did nothing.
Aspirin did nothing. My hands were shaking. I felt nauseous and was
suddenly afraid that if I blew the second day, student evaluations would be
dismal.

A single thought pounded in my head: “Have a cup of coffee. There’s too

much at stake.” One large cup of coffee later, the headache was gone. Within
an hour, I was a new man, pain free and alert. It was hard for me to admit that
I was addicted to coffee, but the hell I had been through the day before was
clearly a drug overdose, and the worse hell I had faced that morning was
clearly a drug withdrawal. Quite simply, I was feeling better because I had my
fix. This realization was frightening and unacceptable to me, so I decided then
and there to kick the caffeine habit. I also left the conference resolved to
research carefully the effects of caffeine. During six years of college, I had
been told only that caffeine was a mild stimulant and its association with
health disorders was unproven. I was also told that caffeine is not addictive.
Since I knew from my own painful experience that the opposite was true, I
reasoned that perhaps I had been snowed on the whole topic.

What I quickly learned was that everyone has been snowed—researchers,

doctors, journalists, and especially the public. The deception has been well
coordinated by an industry whose goal is quite simple: to get as much
caffeine into your body as possible. If the caffeine industry can accomplish
that, they have you as a customer for life. They know caffeine saps your
natural sense of vitality, leaving you dependent on their products to get
through the day. They know that you actually crave their products and, more
importantly, that you suffer when you don’t consume them. It’s a marketing
dream, and it’s legal.

No wonder more and more companies are jumping on the caffeine

bandwagon, churning out products from specialized coffees and teas to
“herbal” caffeinated energy pills, caffeine-laced fruit beverages,
“supercharged” soft drinks, caffeinated beer, and even caffeinated bottled
water.

A Clear and Present Danger

Cardiologists report that caffeine raises blood pressure. Endocrinologists

acknowledge that it contributes to adrenal exhaustion. Neurologists document
changes in brain biochemistry. Researchers identify correlations between
caffeine intake and certain types of cancer.

Internists say that coffee (even decaf) increases ulcer risk, and gynecologists
say that caffeine intake contributes to hormone imbalance and a long list of
health disorders in women. Why aren’t health warnings required on coffee
cans? Why, in the face of this mountain of data, are physicians not warning
their patients? Because there is no comprehensive view of the problem.
Everyone is looking at their own little piece of the puzzle. In 1993, a study
published in the Journal of the American Medical Association found that
regular drip coffee (the kind most people drink) raises blood cholesterol
levels.

Nevertheless, the authors conclude that the increased risk to heart disease is
small. Apparently, they’re not talking to their colleagues who have found that
caffeine also raises blood pressure, increases homocysteine (a biochemical
that damages artery walls), promotes arrhythmias, and constricts blood
vessels leading to the heart. Viewed together, these effects present a clear
picture of caffeine’s contribution to the nation’s leading cause of death.

But in countless newspaper articles, the issue is presented in pieces, and the
truth is diluted by “experts” who are unwilling to take a stand and instead
qualify their findings by saying, “There’s not enough evidence.”

Caffeine Myths Debunked

In the pages of Caffeine Blues, I present the full scope of caffeine’s effects on
physical, mental, and emotional well-being, and debunk the following popular
misconceptions about caffeine:

1- Caffeine gives you energy. Wrong. Caffeine does not provide energy—
only chemical stimulation. The perceived “energy” comes from the body’s
struggle to adapt to increased blood levels of stress hormones. In most
cases, this induced emergency state leads to well-defined side effects
collectively known as caffeinism. Ironically, caffeinism is characterized by
fatigue.

2- Caffeine gives you a “lift.” Wrong. Using coffee for mood enhancement is
a short-term blessing and a long-term curse. While the initial adrenal
stimulation may provide a transient antifatigue “lift,” caffeine’s ultimate mood
effect is a letdown, either subtle or profound. Advertisers and coffee
“institutes” have kept this side of caffeine from public view. In Chapter 4, you’ll
find clear and unequivocal evidence of caffeine’s role in depression and
anxiety. What’s more, caffeine is positively linked to panic attacks, a
psychiatric disorder affecting an estimated 5 million Americans.

3- Caffeine sharpens your mind. Wrong. While caffeine users may feel more
alert, the experience is simply one of increased sensory and motor activity
(dilated pupils, increased heart rate, and higher blood pressure). The quality
of thought and recall is improved no more than the quality of music is
improved when played at a higher volume or speed. In Chapter 4, you will
find a convincing argument, backed by clinical research, that caffeine actually
decreases overall mental acuity.

The Dark Side of Caffeine

There are plenty of people who don’t want you to know the truth about
caffeine. If it were just a matter of “coffee jitters,” it wouldn’t be such an issue.
But as you will see, the effects of caffeine are far-reaching and can be quite
serious. Importantly, women are at higher risk than men, and children are the
most vulnerable to caffeine because of their limited ability to detoxify the drug.
Caffeine stays in a child’s brain and bloodstream much longer than an adult’s,
and subsequent doses produce a cumulative increase in stress and addiction.
Is it any wonder that soft drinks, to which manufacturers add caffeine, have
become the most widely consumed beverages in America?.
The truth is, Americans of all ages are addicted to the caffeine in soft drinks!
It’s a fact that young children consume alarming amounts of caffeine, entering
the cycle of dependency and nervous system dysfunction early in life. One
study identified peak consumption periods at three, thirteen, and seventeen.
These children are set up for a lifetime addiction with serious health
consequences. In the following chapters, we’ll explore caffeine’s connection
to hyperactivity, learning and behavior disorders, fatigue, cancer, heart
disease, ulcers, headache, allergy, PMS, birth defects, and more.

Caffeine Is Literally a Pain in the Neck

You’ll learn that many of our physical experiences of tension and pain are
directly related to the level of stress hormones in our bodies—and that
caffeine acts as a pain trigger because it elevates blood levels of these
biochemicals. Susan M., for example, came to me as a last-ditch effort to help
with her neck and shoulder pain. She’d been to doctors, chiropractors, and
acupuncturists, but the pain was relentless. Susan listed four cups of coffee
per day on her diet diary, and I soon learned that her “cup” was a sixteen-
ounce mug.

She was thus consuming over 900 milligrams of caffeine per day from coffee
and, ironically, another 190 milligrams in her over-the-counter painkiller. Using
the Off the Bean program outlined in Chapter 10, she gradually reduced her
caffeine intake to almost zero. Three weeks later, she was pain free for the
first time in twenty years. This case is not an isolated incident. Over the
years, I have counseled hundreds of patients who could trace the beginnings
of their chronic pain to a time when they started drinking large amounts of
coffee. Often, it was during their college years, or when they started working
in an office. And usually there was the vicious cycle of coffee and stress.
Perhaps you have found yourself in a similar similar situation.

Unsafe at Any Speed?

Newspaper and magazine articles appear every week identifying some health
risk associated with caffeine. Invariably, however, they conclude with the
absurd statement that “moderate intake” is no problem. The fact is that no
scientist can tell you how much caffeine is safe for you to ingest because the
effects of caffeine differ significantly from person to person. A multitude of
individual differences enter the picture, including age, weight, sex, and
numerous biochemical, psychological, and emotional factors. What is
tolerable for one person may be excessive for another.

Moreover, what is tolerable caffeine intake at one point in your life may
actually cause health problems just a few years later. If this sounds strange,
remember that caffeine is a drug with cumulative effects over time. Also keep
in mind that of all of the thousands of research papers that have been
published on caffeine, none have concluded that caffeine is good for you.
Rather, the continuing debate in the popular and scientific press focuses
entirely on the degree to which caffeine is injurious. Caffeine Blues will help
you understand how your body works. With the right care, the human body is
designed to last 100 years or more, but most of us fall apart after age sixty
and die in our mid-seventies.

I have drawn upon thirty years of clinical and research experience and will
give you graphic case histories culled from thousands of client files. But in the
final analysis you are the only scientist who matters, and the only laboratory
you need is your body. Health risks are rarely self-evident. For a cigarette
smoker, the destruction of lung tissue occurs silently over many years—until
one day it’s too late.

Likewise, the first overt consequence of a high-fat diet is often a fatal heart
attack. As a society, we therefore make education about such health issues a
priority. We put warnings on cigarettes and encourage sensible eating. But I
would like to remind you of a sobering fact. Cigarette companies fought
successfully for years against warning labels, and only recently admitted that
nicotine is addictive.

The caffeine industry has refused even to disclose the amount of caffeine in
their products. Big business watches bottom-line profits, and addiction to any
substance means higher levels of consumption and more product sales. The
caffeine industry knows this better than anyone.

Caffeine Alternatives: There Is Hope

Caffeine Blues presents a credible and carefully researched argument

against the habitual consumption of caffeine, but, unlike other health
exposés, it will not leave you feeling helpless. This book will give you a new
view of life after caffeine as seen through the eyes of former coffeeholics. I
am keenly aware that coffee plays a major role in most people’s lives. Without
their morning “wake-up” cup and their midmorning and midafternoon jolts,
most of my clients were concerned that they would not be able to function
effectively. These concerns led to my next research project: finding safe and
effective alternatives to caffeine. I scrutinized botanical texts, ran hundreds of
Medline computer searches, and ultimately traveled to three continents
researching every legal substance purporting to have energy-enhancing
effects.

This research was a real eye-opener. There was a tremendous amount of

misinformation, especially concerning so-called herbal energizers. Most, like
guarana, kola nut, yerba maté, and ma huang (ephedra), turned out to be
nothing more than plant sources of caffeine and other stimulant drugs. Their
mode of action is exactly the same as coffee: stimulation of the central
nervous system resulting in adrenal stress. The fact that these stimulant
products are found in health-food stores and claim to be “all natural” is simply
part of the hype that fills the energy market. These “alternatives” to coffee are
thoroughly debunked in Chapter 7.

Let me state this clearly: A substance that purports to give you energy by
stimulating your nervous system isn’t giving you anything. It’s harming you!
Using stimulants is like whipping a horse. They work for a short time, but
prove disastrous when used repeatedly. My goal was to find substances that
would nourish the body, not stress the adrenals, substances that would
enhance the metabolic efficiency of the body in order to fulfill our inherent
potential for vitality and wellness. Eventually, I discovered a group of
substances with true energizing properties.

Just as a tune-up can enhance the efficiency of your car’s engine, this group
of vitamins, minerals, herbs, coenzymes, and organic acids can dramatically
improve your body’s production of energy. And I’m not just talking about
energy in the sense of strength, stamina, and endurance. Imagine every cell
in your body operating at a higher level of efficiency, including your immune
system, brain, and nervous system. This “tune-up” has already changed
countless lives, and you too can experience the exhilaration of peak vitality
and what I call high-level wellness.

It’s ironic that all the things you thought you could get from caffeine can in fact
be obtained only by getting off it. These breakthrough alternatives are
presented in detail and supported with abundant scientific and medical
references in Chapter 10. I’ll show you how to quit coffee by drinking
delicious, satisfying, healthful alternatives and rebuild your natural abundant
energy supply without harmful stimulants.

Beating the Caffeine Blues

Perhaps you’ve already thought about reducing your caffeine intake. But to
make that decision, you need accurate information, and the facts on coffee
have been slow in getting out. And you also need more than just information,
since facts alone are not enough to motivate change. Caffeine Blues is
designed to lead you through a discovery process that will increase your
health awareness. For some people, awareness begins when they add up
how much caffeine they consume every day.

Then they connect their caffeine intake to the tired feeling they have when
they wake up, or the roller-coaster mood and energy swings they experience
throughout the day. The challenge, of course, is to discover just how addicted
you are to caffeine, and how that addiction affects the quality of your life. I
suggest that you try kicking the habit for sixty days—the minimum amount of
time you’ll need to evaluate the benefits of a caffeine-free body and mind. For
some people, I know that’s asking a lot. But don’t Worry. Chapter 10 will give
you an effective, clinically proven, and pain-free method for reducing or
eliminating caffeine.

This step-by-step Off the Bean program will enable you to free yourself from
dependence on caffeine without the headaches, irritability, fatigue, and
depression normally associated with caffeine withdrawal. This program is not
theory or conjecture. Thousands of people have already taken this important
step, and are right now experiencing greater vitality, greater energy, and
better health than they ever felt when they were addicted to caffeine. You can
also enjoy these blessings if you really want them. The choice is up to you!

A Word about Notes

In compiling this manuscript, I initially handed my editor over 700 footnotes.

“Take out these footnotes,” he said. “They make it look like a textbook”. I
protested. “I’m asking readers to consider a very controversial subject,” I
argued, “one that purports to show beyond the shadow of a doubt that most
everything they’ve heard about caffeine is wrong. How can I expect them to
believe me if I don’t provide legitimate scientific support?” I also wanted the
health-care community to pay attention to this material, and they would of
course require careful documentation.

So we compromised. The key controversial statements are referenced, and

notes are listed at the end of the book. This level of scientific integrity means
that you can share the book with your doctor without the fear of being labeled
a “health nut.” The research cited here can be found in any medical library.
You can skip the notes or use them for further study.
 CHAPTER 1

Coffee and Caffeine: A Dose of Reality

We have seen several well-marked cases of coffee excess. … The sufferer is

tremulous, and loses his self-command; he is subject to fits of agitation and
depression; he loses color and has a haggard appearance. The apatite falls
off, and symptoms of gastric catarrh may be manifested. The heart also
suffers; it palpitates, or it intermits. As with other such agents, a renewed
dose of the poison gives temporary relief, but at the cost of future misery. …
By miseries such as these, the best years of life may be spoilt.

—Sir T. Clifford Allbutt and Dr. Walter Ernest Dixon in A System of

Medicine, vol. II, London, 1909

Goatherds, Monks, and the Rest of Us

The origins of coffee are lost in legend, although the most popular tale traces
its discovery to a goatherd dwelling in Ethiopia. According to the story, the
goatherd watched his flock eat the bright red berries from a wild evergreen
bush—and was subsequently amazed to see the animals leap about with wild
abandon. He tried some of the berries himself, and soon he was leaping too.
By around the sixth century A.D., the plant had reached Arabia, where it was
used as a food and medicine. Coffee berries were either fermented to make
wine, or dried, crushed, mixed with fat, and eaten. It was not until the
thirteenth century that Arab monks made a revolutionary discovery: Roasted
coffee beans could be made into a drink. No more falling asleep at prayers!
The news spread from monastery to monastery, then hit the streets with the
worlds first coffeehouses. Everyone who tried coffee wanted more—and if
they were travelers, they wanted to take it home with them.

With lightning speed, coffee became a valuable trading commodity and

spread to the world at large: first to Turkey, then to Italy and France, and
finally to the rest of Europe by the mid-seventeenth century. The Arabs
maintained strict control of the coffee trade until smugglers from other
countries got hold of the seeds. The Dutch brought coffee to Java and
Ceylon, the French transported it to the West Indies, and a Brazilian obtained
coffee for his homeland. Today coffee is cultivated widely in regions between
the Tropics of Cancer and Capricorn: Central and South America, Java,
Sumatra, India, Arabia, equatorial Africa, Hawaii, Mexico, and the West
Indies.

Most American colonists drank tea, a caffeine-containing leaf from the

Camilia senensis bush, until the boycott against King George’s tea tax
climaxed with the Boston Tea Party in 1773. From that point forward, coffee
grew in popularity as America’s national drink. Americans are now the largest
consumers of coffee in the world, drinking over 420 million cups per day, or
about one-fifth of the world’s total annual supply. In America, coffee wins
hands down as the most popular substance containing caffeine, with soft
drinks, tea, and chocolate as runners-up.

From Plant to Percolator

The word coffee comes from the Arab word qahwah. The botanical name of
the original species discovered in Africa whose beans are grown around the
world today is Coffea arabica. There are three general groupings of coffee:
Brazils (all Coffea arabica grown in Brazil), Milds (all Coffea arabica grown
outside of Brazil), and Coffea robusta, a variety of coffee grown at lower
elevations and generally considered to be inferior in quality to Coffea arabica.

Robusta beans contain nearly twice the caffeine of arabica and are also more
acidic. Mass-marketed brands of coffee contain primarily robusta, whereas
specialty coffees tend to be made primarily from arabica beans. One reason
coffee spread so quickly around the globe is because it’s an exceptionally
hardy, self-pollinating plant. Though it’s usually referred to as a tree, coffee is
actually an evergreen shrub that, when cultivated, is pruned to a height of
twelve feet or less. An arabica tree produces only about one to two pounds of
coffee beans per year, so supplying worldwide demand requires an incredible
amount of space.

We’ll discuss the problems associated with coffee cultivation in Chapter 7.

Coffee berries—the fruit of the plant, which contains the beans—are usually
harvested by hand and undergo a lengthy processing procedure. Once
removed from the berries, the beans are fermented, washed, dried, hulled,
and peeled before they are roasted. After roasting, the beans are ground and
then they are ready to perk, brew, or drip into your favorite cup of Java.

A Cupa Cupa Cupa Cupa Chemicals

Caffeine has received a great deal of attention ever since it was identified as
the principle stimulant in coffee (1820). But it seems that every year, even
more noxious ingredients are isolated in coffee. In 1992, researchers found
another stimulant compound distinctly different from caffeine that may be
responsible for coffee’s gastrointestinal effects.1 To date, over 700 volatile
substances in coffee have been identified, including more than 200 acids and
an incredible array of alcohols, aromatic compounds, carbonyl compounds,
esters, hydrocarbons, heterocyclic compounds, and terpenoids.

Nonvolatile substances in coffee include caffeine and other purines,

glycosides, lipids, melanoidins, caffeic acid, and chlorogenic acid. And that’s
just the stuff that’s supposed to be there. Coffee often contains a raft of
pesticide residues and other contaminants such as nitrosamines, solvents,
and my co-toxins. These carry well-defined health risks, and some are
carcinogenic.2 Survival of the Bitterest Caffeine is produced by more than
eighty species of plants, and the reason may well be survival. As it turns out,
caffeine is a biological poison used by plants as a pesticide.

The caffeine gives seeds and leaves a bitter taste, which discourages their
consumption by insects and animals. If predators persist in eating a caffeine-
containing plant, the caffeine can cause central nervous system disruptions
and even lethal side effects. Most pests soon learn to leave the plant alone.
Which is not to say that coffee is impervious to insects. On the contrary, the
modern agricultural practice of growing coffee plants in dense plantations
fosters the development of insect infestations. Enormous amounts of
chemical pesticides and herbicides are then applied to control those
infestations. In fact, coffee is the most heavily sprayed food or beverage
commodity on the face of the earth. Caffeine: Romancing the Drug When
coffee was first brought to European cities in the seventeenth century, people
were repelled by its color and taste. They complained that it smelled and
looked like roofing tar. But after they experienced its stimulating effect, the
beverage was quickly proclaimed to be one of nature’s miracles. Historians
record this phenomenon without noticing the irony of what they are writing.

Caffeine is, after all, a psychoactive drug, and human beings tend to crave
substances that alter their state of mind—among them caffeine, morphine,
nicotine, and cocaine. Indeed, all of these alkaloids are chemically related
and, while they produce widely different effects, all are poisonous. Caffeine is
considered harmless simply because it is so widely used. Obviously, from a
scientific perspective, that is not valid reasoning. What’s more, if caffeine
were proposed today as a new food additive, the FDA would never approve it.

Any substance that causes such extreme reactions—heart palpitations,

anxiety, panic, insomnia, and even birth defects—would be treated by the
FDA as a new drug and denied status as a food additive. Yet amazingly, even
healthconscious people, many of whom try to minimize their use of additives,
preservatives, and drugs, consume high amounts of caffeine with no thought
to the consequences. My .goal in is to provide you with the facts you need to
make informed choices about your own caffeine consumption. Until now,
reliable information about caffeine has been unavailable, and there are some
intriguing reasons for that.

First of all, most people are generally unaware of the amount of caffeine they
are ingesting. Manufacturers can add caffeine to any food or beverage they
want without disclosing the amount. (More about that in Chapter 7.) Few
people know how much caffeine is in a cup of coffee or a can of soda, so they
have no way of evaluating the danger. Instead, they rely on what they hear
and read in the media, and that information is rarely accurate. In his landmark
review of caffeine and human health, R. M. Gilbert concludes: “If more were
known about caffeine’s effects, and if what is known were known more widely,
the damage done by caffeine might very well appear to be intolerable”.

Industry Feathers in the Academic Nest

The caffeine industry has generated a tremendous amount of propaganda

and disseminated it successfully throughout the scientific, medical, and public
arenas. But you won’t see SPONSORED BY THE CAFFEINE INDUSTRY
stamped across the top. This material is invariably published by foundations
and institutes with very academic-sounding names. But the fact is that many
of these august bodies are heavily influenced by the caffeine industry, and so
are the reports you read and hear.

The International Life Sciences Institute, for example, has been churning out
studies and information to government, academic, and public institutions for
decades. Few know that it is supported by the caffeine industry. In 1985, the
ILSI merged with the prestigious Nutrition Foundation, an organization whose
mission statement includes the acknowledgment that it is “created and
supported by leading companies in the food and allied industries.” Prominent
among the trustees of the combined ILSI/Nutrition Foundation are executives
from the Coca-Cola Company, PepsiCo, Hershey Foods, NutraSweet, and
Procter & Gamble.

A Case in Point

If you were curious about the dangers of caffeine, you would undoubtedly
come across a brochure entitled What You Should Know about Caffeine. You
would find this ubiquitous brochure on information racks in hospitals,
pharmacies, public health offices, or in your doctor’s office. It’s available
through the mail and on the Internet. What You Should Know about Caffeine
is published by the very official-sounding International Food Information
Council in Washington, D.C. The brochure does not list sponsors or disclose
an industry affiliation.

When I requested specific details of industry sponsorship, I received another

glossy color brochure that mentioned nothing about which organizations
supply the funds to disseminate all this information. After pressing the issue
through several phone calls, I finally received a list of IFIC “supporters,”
including Pepsi-Cola, Coca-Cola, M&M/Mars Candy, NutraSweet, Nestle,
Hershey Foods, Frito-Lay, Procter & Gamble, and the Arco Chemical
Company. Oddly enough, the IFIC “partners” also included the Association of
Women’s Health, Obstetric and Neonatal Nurses; the National Association of
Pediatric Nurses Associates and Practitioners; and the Children’s Advertising
Review Unit of the Council of Better Business Bureaus, Inc.

This strategy perfectly illustrates the approach of the caffeine industry:

aligning itself with professional health organizations and scientific
foundations. What better way to head off criticism that its products are
harming the American public?

Is the Information Accurate?

What You Should Know about Caffeine states: “Caffeine does not accumulate
in the bloodstream or body and is normally excreted within several hours
following consumption.” In fact, only about 1 percent of caffeine is excreted.
The remaining 99 percent must be detoxified by the liver, and the removal of
the resulting metabolites is a slow and difficult process. In Chapter 3, you will
learn that it can take up to twelve hours to detoxify a single cup of coffee. In
fact, the matter of accumulation has never been resolved. Evidence suggests
that it may take up to seven days to decaffeinate the blood of habitual coffee
drinkers.4 Plus, it can take three weeks or more for the body’s levels of stress
hormones to return to normal. If that’s not accumulation, what is?

All the News That Fits, We Print

Prominent on the first page of What You Should Know about Caffeine is a
colored box that states: “Research in relation to cardiovascular disease,
reproduction, behavior, birth defects, breast disease and cancer has identified
no significant health hazard from normal caffeine consumption.” When I
inquired as to exactly what “normal” consumption was, I was told 200 to 300
milligrams per day. As you will soon find out, most American adults ingest that
amount before noon.

What about ingestion of more than 300 milligrams of caffeine? The IFIC
doesn’t say a word about that, but in the following chapters you will learn
exactly how that much caffeine can damage and even destroy your health.
This information has been withheld from you because until now, the loudest
voices in the caffeine debate have been connected directly or indirectly to the
caffeine industry.

Digging Deeper

When I asked the IFIC for scientific support for their assertion that 300
milligrams of caffeine was perfectly safe, they sent me a report published in
Food and Chemical Toxicology. The authors of this report are both employees
of the Coca-Cola Company and members of the National Soft Drink
Association.5 As you might expect, the report downplays the effects of
caffeine in the American diet, using some interesting techniques.

When Is a Cup Not a Cup?

Answer: When it’s a “standard” five-ounce serving. For some reason, the
above authors state that a standard serving of coffee equals five fluid ounces.
That way they can list the caffeine content as eighty-five milligrams per cup.
(Most studies claim that a standard cup of coffee equals six fluid ounces, the
amount held by a teacup—which is still far less than almost anyone actually
drinks at one time).

Likewise the “standard” soft drink serving is listed as six ounces, when all
sodas come in twelve-ounce cans—and soft drink manufacturers are now
heavily pushing the twenty-ounce bottle. The caffeine content of soft drinks is
listed as eighteen milligrams per six-ounce serving. In reality, soft drinks
contain anywhere from forty-five to seventy-two milligrams per twelve-ounce
can.

“What Caffeine Problem”?

Caffeine consumption is also downplayed in the study cited above by using

per capita figures, which is simply the gross amount of caffeine consumed
divided by the total population. The problem, of course, is that not everyone
consumes caffeine in equal amounts. Per capita figures may be useful for a
discussion of economics, but not of health. If you are supposedly reviewing
the safety of a substance, it is absolutely critical to consider the individuals
most vulnerable to possible adverse effects.

You’ll find, however, that none of the caffeine industry reports take that
approach. Instead, they constantly refer to “mean” values, “average” people,
and “normal” consumption. Remember the statistician who drowned trying to
wade across a lake with an average depth of three feet? You have to look at
reality, which is what you’re going to do in Chapter 2 when you calculate the
amount of caffeine you consume. For a scientist, the word average raises a
red flag because average figures are often useless.

Even worse, the use of averages is the easiest way to manipulate data. In the
coffee research reported in newspapers and magazines, you will invariably
see “average consumption figures.” But in a group of people with an average
consumption of three cups per day, you’ll find some people who drink no
coffee at all, some who drink one to three cups, and some who drink six to
ten cups a day. Now this might average out to three cups per person, but
what good is this information?.

The effects of caffeine are very much dose related, and, as you have
probably already guessed, the effects of one cup of coffee are quite different
from the effects of four or six. It is important to understand that the caffeine
industry’s “average” consumer does not exist. This mythical person, upon
whom all their conclusions are based, is neither male nor female, weighs
approximately 150 pounds, never experiences excessive stress, has perfectly
functioning adrenals and liver, does not use birth control pills or any other
caffeine-interacting drugs, consumes less than 300 milligrams of caffeine per
day, and eats a well-balanced diet including a variety of foods high in B
vitamins, calcium, magnesium, and zinc. Anyone who has a disorder that
would be aggravated by caffeine is either dropped from caffeine industry
studies or buried under the mountain of “mean” values.

The Search for Truth

For the past eight years, I have conducted a systematic review of the world
scientific literature on caffeine. This research has taken some real detective
work. It’s difficult to tell what’s really going on at first. After all, I drank coffee
for over twenty years, simply because I believed like everyone else that
coffee, and caffeine, had no adverse health effects. I was in for the surprise of
my life. The first thing I noticed was that much of the research on coffee was
imprecise.

The majority of researchers refer to the standard coffee cup as a six-ounce

serving, but most people drink from mugs, which contain twelve to fourteen
ounces or more. That’s not to mention convenience-store coffee cups, which
contain anywhere from twenty to thirty-two ounces. If you’re like most people,
you probably probably consume far more caffeine than you think you do.

Likewise, many reports on coffee failed to specify the brewing method. Six
ounces of drip-filtered coffee contain about 100 milligrams of caffeine, but the
same amount of percolated coffee gives you 120 milligrams, and European-
style boiled coffee packs in 160 milligrams of caffeine per cup. I began to see
that the caffeine issue is rarely taken seriously. Nearly every researcher starts
from the assumption that caffeine is okay. Why? Because, consciously or
subconsciously, they are influenced by the fact that they themselves depend
on coffee. I have visited the offices of hundreds of scientists, professors, and
clinicians. The coffee machine is as much a part of their environment as test
tubes and computers.

Likewise, the journalists who report health news to the public are usually
heavy coffee drinkers. I’m not saying that these people are dishonest, only
that information can be biased by the habits of those who make and break the
news.
 The Great Chain of Caffeine

It is also important to look at the chain of biochemical and behavioral events

that caffeine creates, not just the immediate effects. Scientists rigorously
adhere to this rule when looking at other drugs, but ignore it when studying
caffeine. This error is illustrated graphically by one study on the effects of
caffeine on schizophrenic patients, where regular coffee was replaced with
decaf.6 The researchers postulated that if caffeine produces detrimental
psychoactive effects, the patients should improve when decaf is used instead
of regular coffee.

They made the switch, the patients did not improve, and so the researchers
concluded that caffeine has no effect on psychiatric patients. What’s wrong
with this conclusion? The study ignored the chain of events that result from
caffeine withdrawal. Here a group of hospitalized schizophrenic patients, who
are used to drinking three to eight cups of coffee a day, are switched to decaf
without their knowledge. These people are going to have serious withdrawal
reactions, including disorientation, irritability, anxiety, and depression.
Obviously, they will not show signs of improvement. How could they? Most of
them probably had splitting headaches from caffeine withdrawal!

Yet the research was published and is frequently used to support the
erroneous view that caffeine produces no negative psychoactive effects. It
gets worse. These same researchers introduced decaf a second time and did
see behavioral improvements. Did they recognize the likelihood of a
decreased withdrawal reaction? No way—instead, they stated that these
improvements were probably a result of coincidence.

A Matter of Interpretation

I must say right away that I also found investigators who did an excellent job
at analyzing the behavioral effects of caffeine ingestion by schizophrenics.
One extremely well-designed study documented significant increases in
thought disorder and psychosis after caffeine administration. The
investigators also found that caffeine increased blood pressure and stress
hormone levels in the patient group.7 This is important information for anyone
involved in psychiatric care, but how the issue of caffeine and mental health is
resolved depends upon which study is read and how the reader wishes to
interpret the information.

When I brought the latter study to the attention of a leading psychologist, he

acknowledged that caffeine can cause significant increases in stress
hormone levels but concluded, “A cup of coffee is no more stressful than
watching a suspense thriller on TV”. Can you see the profound error of this
response? It looks blindly at the short-term consequences of caffeine use and
ignores the real issue, which is the effects of long-term use. After all, what
psychologist would condone the viewing of five suspense thrillers every day,
year after year? Yet that analogy accurately describes the body’s hormonal
response to regular caffeine consumption.

More Flawed Research: Caffeine and Hypertension

Another common mistake in caffeine research has to do with the relationship

of caffeine to hypertension (high blood pressure). I found numerous studies in
which hypertensive patients were taken off coffee. After a week or two, when
blood pressure did not drop, investigators concluded that caffeine has no
significant effect on blood pressure. This is absurd because it may take three
weeks or more after withdrawal from caffeine before stress hormones return
to normal. Evaluating blood pressure over the first one or two weeks is
meaningless.

What’s Real for You? If you look at the way real people consume coffee and
soft drinks, you find, first of all, that most consume a great deal more than
300 milligrams of caffeine per day. There have been studies that measure the
caffeine content of beverages as people actually consume them. One such
study, published in Food and Chemical Toxicology, found that the caffeine
content of a six-ounce cup of drip, filtered coffee (the type most people drink)
ranged from 37 to 148 milligrams.8 A survey conducted by the Addiction
Research Foundation found that a “cup” of coffee, as defined by the individual
drinker, could contain as much as 333 milligrams of caffeine.

This conflicting data once again demonstrates that the idea of “normal”
caffeine consumption is meaningless. Some scientific studies suggest that a
170-pound man could successfully detoxify 300 milligrams of caffeine over
the course of a day without serious damage to his body. Theoretically, this
may be possible—but not if he is under any significant degree of stress.
Moreover, a 110-pound woman is almost certain to experience significant
adverse effects from that amount of caffeine. And for anyone under a great
deal of stress, even one cup may be enough to trigger the negative effects of
caffeine.

Obviously, caffeine intake needs to be evaluated on an individual basis. In the

chapters that follow, you will see that the effects and dangers of caffeine
depend upon a host of variables, including gender, weight, age, stress level,
general health, and medications. What’s more, caffeine may affect the same
person differently at different times. The only way to safeguard your health
and the well-being of your family is to inform yourself. A great place to start is
by taking the “” tests in the next chapter.
 CHAPTER 2

Are You Addicited? How Much Is Too Much?

In the old days, coffee was served in teacups that sit on saucers. That size
cup holds six ounces of beverage, which is considered the standard-size cup
by researchers and the coffee industry. However, when I ask patients how
much coffee they drink and they say, “Oh, no more than three cups a day,” I
invariably find that means three mugs a day at fourteen ounces apiece, or the
equivalent of seven cups of coffee. In most coffee shops, a “normal” cup of
coffee is fourteen ounces and a large cup is twenty ounces. Thus, one large
cup equals 3.3 cups of coffee. One of my clients told me that he only drank
one cup of coffee a day. It turned out to be one of those giant thirty-two-ounce
convenience-store mugs with the vented cover for drinking while you drive.

This man (and millions like him) consumed nearly 500 milligrams of caffeine
on his way to work on an empty stomach. No wonder there’s so much conflict
and tension at the office. By the time they get to work, these coffee-inhaling
employees are wired and ready to fly off the handle. There’s no doubt that the
damage done by caffeine is very much dose related. But it’s impossible to
make general, blanket statements about how much caffeine is okay and how
much is dangerous, since caffeine’s effects are different for each person.

Understanding the effects of your own caffeine ingestion requires self-

knowledge and experimentation. As you reflect on the material presented
here, most likely you will see yourself in one of the examples or case
histories. As you read, keep an open mind and consider the possibility that
how well you live, and even how long you live, depend to a significant degree
on the amount of caffeine you consume. This book provides the information
you need, but the rest is up to you.

Obviously, there are many factors affecting longevity and health, but none is
easier to modify than caffeine intake. In my clinical practice, I have counseled
more than 9,000 patients and kept careful records regarding their compliance
and level of success. Of all my recommendations—including weight loss,
dietary change, exercise, and stress management—no single factor matched
the impact of caffeine reduction. Again, it’s not that all those other things are
unimportant. On the contrary, I believe that exercise and a balanced diet are
critical to optimum health, and I’ve devoted my career to making those goals
obtainable. But the truth is, getting people to make significant changes in diet
or exercise is extremely difficult. Research shows that even with careful
supervision, compliance is well below 30 percent.

On the other hand, getting off caffeine (at least with my Off the Bean
program) is relatively easy, and the rewards are often immediate and
dramatic. Over 80 percent of the people who’ve tried the Off the Bean
program have stuck with it—and have experienced tremendous health
benefits as a result!

What Your Doctor Doesn’t Know Can Hurt You

Until now, people had no way of evaluating their caffeine intake and the harm
it can do. Remember that the initial stages of caffeine damage are often silent
—just like lung damage from smoking or cardiovascular disease from a high-
fat diet. Also be aware that the information you need about caffeine is not
likely to come from your doctor. Consider the guidelines given to physicians in
the medical literature. A typical example appeared in Postgraduate Medicine,
in which doctors were advised that caffeine can cause abnormal heart
rhythm.

The article, citing a report entitled “Caffeine and Arrhythmias: What Are the
Risks?” stated that “about 80% of American adults drink three to four cups of
coffee each day.” It then went on to explain that each cup contains between
60 and 150 milligrams of caffeine. The logical conclusion from this information
is that many American adults are consuming 500 to 600 milligrams of caffeine
from coffee per day. The bullet points of the article inform doctors that:

Point 1: “Consuming less than 300 mg of caffeine per day does not seem
likely to produce significant arrhythmias”.

Comment: We’ve already learned that most Americans consume more than
300 milligrams of caffeine per day from coffee alone (remember the six-ounce
cup?), not to mention additional caffeine from soft drinks, medications, and
other sources. And what exactly is significant arrhythmia? If your heart fails to
maintain normal beats, you are in mortal danger, period.

Point 2: “People with underlying heart disease probably should avoid

consuming more than 300 mg of caffeine per day since significant increases
in arrhythmias have been reported after consumption of higher amounts”.

Comment: Good advice, but (A) people with underlying heart disease often
do not know that they have heart disease; (B) people have no way of
following this advice since manufacturers are not required to list the amount
of caffeine in their products.

Do you see the folly of this approach? First of all, most people already
consume over 300 milligrams of caffeine per day. What’s more, the 300-
milligram level does not take into consideration the myriad factors that
influence how caffeine affects individual people. One person who consumes
300 milligrams of caffeine might only experience disturbed sleep, while
another person might experience severe anxiety, depression, or dramatically
increased risk for heart disease. Women are affected by caffeine far more
than men. Age, overall health, weight, and a host of other lifestyle factors also
enter the picture. How can you determine your own personal risk level? You
can start by figuring out your caffeine quotient—quotient—exactly how much
caffeine you presently consume, and how it is affecting your life.

Is Caffeine Hurting You?

If you are a regular caffeine user, chances are high that the drug is affecting
the quality of your life right now. You probably depend on the stimulating “lift”
to energize your body and clear your mind. Your total daily intake of caffeine
comes from a variety of sources—not just coffee, but also tea, cocoa, soft
drinks, medications, and chocolate. In fact, if you’re like most Americans, you
find it hard to get through the day without multiple hits of caffeine. You are
probably addicted. If you object to that statement, take a few minutes to
complete the following self-tests. You have nothing to lose. If caffeine’s not a
problem for you, great. But if it is, confronting the addiction is the only way to
do something about it. This book will help you evaluate the effects caffeine
has on your life and, most importantly, show you how to achieve far greater
levels of energy and vitality without the drug.

Test I: Your Caffeine Intake

In the first column, enter the number of servings, then multiply to get your
total caffeine intake from each source. Figures given for coffee and tea are
based on a six-ounce serving. Remember that most coffee mugs or cups hold
twelve to fourteen ounces. A “large” coffee cup holds twenty ounces or more,
so be sure to calculate accordingly. Amounts of caffeine listed for each type of
beverage are averages; variations may occur from product to product.
The amount of caffeine in common medications may surprise you. However,
according to the FDA, nearly 1,000 prescription drugs and 2,000 over-the-
counter medications contain caffeine—anywhere from 30 to 200 milligrams
per tablet or capsule.
 YOUR CAFFEINE QUOTIENT

“Caffeinism” is a state of chronic toxicity resulting from excess caffeine

consumption. Caffeinism usually combines physical addiction with a wide
range of debilitating effects, most notably anxiety, irritability, mood swings,
sleep disturbance, depression, and fatigue. Use your “Total Daily Caffeine
Intake” from the previous page to determine if you are a victim of caffeinism.

• If your caffeine quotient is less than 100 milligrams per day, it is highly
unlikely that you are a caffeine addict.

• If your total is between 100 and 300 milligrams per day, you’re in the
“danger zone.” Disruption of sleep patterns begins at this level, and certain
heart disease risk factors may be increased.

• If your total is 300 to 600 milligrams per day, you are undoubtedly
experiencing some degree of mental and physical addiction to caffeine.
Research shows an almost 200 percent increase of risk for ulcers and
fibrocystic disease at this level.

• Intake of 600 to 900 milligrams per day indicates almost certain addiction. At
this level, your mood and energy levels are severely affected. Research
suggests that your risk of heart attack may be twice that of non-caffeine
users. If you are a pre-menopausal woman, your chance of maintaining
optimal iron levels is slim.

• At 900 milligrams or more per day, you’re a caffeine addict—hook, line, and
sinker. At this level of dependency, all heart disease risk factors are
significantly increased, as are the risks for stroke, psychological disorders,
and gastrointestinal disease. You may need medical help to kick the habit.

“Although infrequently diagnosed, caffeinism is thought to afflict as many as

one person in ten of the population”.

Source: Jack E. James and Keryn P. Stirling, “Caffeine: A Summary of Some

of the Known and Suspected Deleterious Effects of Habitual Use,” British
Journal of Addiction, 1983;78:251-58.

Test II: Caffeine’s Effects on Your Body

Do you experience any of the following on a recurrent or frequent basis?

If you have 6 to 7 “yes” answers, caffeine is a problem for you. Decreasing or
eliminating caffeine intake will significantly improve your health. If you have 8
to 10 “yes” answers, caffeine is a serious problem. Decreasing or eliminating
caffeine is an urgent need. If you have 12 or more “yes” answers, your
caffeine intake represents a critical health risk that may actually decrease
your life expectancy. Act now to take control of your life and health.

Dr. Fred Sheftell, director of the New England Center for Headache, states:
“It’s not unusual for us to find people who are taking 1,000 mg of caffeine or
more per day.” He notes that adverse side effects have been reported from as
little as 250 milligrams per day.

Test III: Caffeine’s Effects on Your Nervous System

Caffeine has been found to impair motor steadiness in neuropsychological

tests. Here is a simple way to evaluate this effect without expensive
laboratory procedures: Sitting up in a chair, extend your arm straight out in
front of you, locking the elbow, palm down. Look at the tips of your fingers. If
there is any noticeable trembling, chances are that caffeine has already
damaged your nervous system.

In Chapters 3 and 4, we will discuss how caffeine disrupts biochemical

message centers in the brain known as receptors. Human and animal data
suggest that dopamine and benzodiazepine receptors are involved in hand
tremor, and the condition is common in both habitual and casual coffee
drinkers. The good news is that this damage can be repaired, but not until
you get your caffeine intake under control. In Chapter 10, you’ll see that it’s
not as difficult as you might think.

Test IV: Caffeine’s Effects on Your Muscles

Muscle tension is hard to evaluate. Many times, we don’t even know we’re
tense until we get a headache, or someone places their hands on our
shoulders and we wince. Tension in the jaw muscles, however, is fairly easy
to measure.

1- Open your mouth as wide as you can, then close slowly. Do you hear
any popping or cracking? This is often a sign of problems with jaw alignment
known as temporomandibular joint dysfunction (TMJD). TMJD affects millions
of Americans, contributes to headache and a raft of other disorders, and is
positively associated with stress and caffeine intake. That’s because caffeine
and stress cause a tightening of the jaw muscles that contributes to
misalignment of the jaw on the skull. Teeth clenching and grinding (bruxism)
at night are also related to stress and caffeine.

2- Now open your mouth wide again, and this time try to insert your first
three fingers held vertically. (Or use a wine cork.) This is another simple test
to see if you are holding significant tension in your jaw muscles. Reduced jaw
mobility is a classic sign of chronic tension exacerbated by caffeine.

The Four Warning Signs of Caffeine Dependence

The most common response I hear from people who have eliminated caffeine
from their lives is their surprise at how much better they feel. I know what
you’re thinking: “How could they feel better? Every time I try to quit coffee I
feel like I’ve been hit by a truck.” That’s because caffeine is an addictive drug
with a very well-defined withdrawal syndrome. I’m not going to split hairs
about whether people are truly addicted or just dependent on the drug.

Studies have found conclusively that caffeine produces classic signs of

addiction. And you don’t have to consume huge amounts of coffee to become
addicted. In one recent study, the median daily intake of the caffeine-
dependent group was 357 milligrams, and 19 percent of them consumed less
than the U.S. daily average. Here is how the scientists conducting that study
made the diagnosis of caffeine dependence. See if it describes how you feel.

1. WITHDRAWAL

Reducing the dose or stopping the drug altogether produces well-defined

symptoms, which may include:

• Headache
 • Depression
• Profound fatigue
• Irritability
• Disorientation
• Increased muscle tension
• Nausea
• Vomiting

Ninety-four percent of the caffeine-dependent subjects experienced some of

these withdrawal symptoms.

2. DEPENDENCE

Researchers defined dependence as consuming the beverage “despite

knowledge of a persistent or recurrent physical or psychological problem that
is likely to have been caused or exacerbated by caffeine”. Ninety-four percent
of the caffeine-dependent subjects experienced this behavior.

3. INABILITY TO QUIT

This was defined as a “persistent desire or unsuccessful efforts to cut down

or control use”. Eighty-one percent of the caffeine-dependent group found
that they were unable to reduce or discontinue drinking caffeine-containing
beverages.

4. TOLERANCE

The body develops a tolerance for caffeine so that greater amounts are
required to produce the same level of stimulation. Seventy-five percent of the
caffeine-dependent group reported tolerance.

Source: E. C. Strain et al., “Caffeine Dependence Syndrome: Evidence from

Case Histories and Experimental Evaluations,” Journal of the American
Medical Association, 1994;272:1043-48.

Caffeinism: It Could Happen to You!

In over a decade of practice as a clinical nutritionist, I have seen firsthand,

with thousands of clients, that caffeine is a health hazard. Anxiety, muscle
aches, PMS, headaches, heartburn, insomnia, and irritability are the most
common symptoms, and they can usually be lessened or eliminated simply
by avoiding caffeine. That’s good news for most people. However, if that’s all
caffeine has done to you, you’re lucky. Others are not so fortunate. Like the
woman whose baby was born with a heart defect because no one told her to
avoid caffeine during pregnancy.
Or the man who underwent three surgical operations and nearly had his
stomach removed because his ulcers would not heal. No one told him to
avoid coffee. And what about people misdiagnosed as neurotic or even
psychotic, who spend years and small fortunes in psychotherapy—all
because no one asked them about their caffeine intake? To those who claim
that caffeine is harmless, I say look at the facts—and, more important, look at
your life. Your health is your most valuable possession, and life is short. I am
convinced that to enjoy life to its fullest we must maintain health on three
levels: physical, mental, and emotional. At each one of these three levels,
caffeine is an adversary.

Caffeine versus Physical Vitality

On the physical level, we need a steady source of energy to accomplish our

goals. Nothing is more frustrating than to be motivated, to have a great plan,
but no energy to carry it out. When I ask patients about their reasons for
drinking coffee, the most common response is: “I need the energy.” The irony,
as you will see in Chapter 3, is that caffeine is a major cause of fatigue.
Depending on caffeine to get you through the day might work for a while, but
in the long run it will make your dreams harder and harder to achieve. To see
what I mean, try this experiment. Clench your fist tightly. Hold it closed and
very tight for thirty seconds. What happens to your arm and hand? They get
tired. This exercise illustrates what happens to your body when you ingest
caffeine.

First you feel strong, but soon afterwards you feel weak. That’s because
caffeine doesn’t give you energy—it creates tension, and the ultimate result of
tension is always fatigue. You felt the result of squeezing your fist, which only
involves a few muscles. Imagine the energy drain created by muscle tension
throughout your body after ingesting caffeine.

Caffeine versus Mental Vitality

On the mental level, we need to be consistently alert and aware to function

effectively in our daily lives. As you will see in Chapter 4, caffeine puts you on
a roller-coaster ride where mental clarity alternates with periods of confusion,
depression, and lethargy. You’ll also learn that caffeine does nothing to
enhance learning, but actually impairs memory and cognition. When patients
relate their coffee stories to me, a common pattern usually emerges. They
started drinking coffee occasionally, either as a morning “wake-up” or to stay
up late.

Gradually, they found themselves reaching for coffee or cola beverages

throughout the day just to stay alert. In time, the habit became an addiction,
with their only dependable mental energy coming from the coffeepot. This is
sad, because the coffee habit has a steep downside. We pay dearly for those
“borrowed” periods of clarity by sacrificing our true mental vitality.

“There is no doubt that the excitation of the central nervous system produced
by large amounts of caffeine is followed by depression”.

Source: J. Murdoch Ritchie in The Pharmacological Basis of Therapeutics,

Goodman and Gilman eds.

Vitality Is Our Birthright

What we must remember is that vitality is not something that disappears in

adulthood. We throw it away by becoming sedentary and damaging our
bodies and minds with caffeine. We set ourselves up for a life of ups and
downs, when each of us is capable of maintaining a high level of physical and
mental vitality well into our advanced years. A healthy child doesn’t require
caffeine to get out of bed in the morning, and there is no reason why you
can’t experience the same boundless energy of your youth!

But first you must stop punishing your body and mind with caffeine. Is it worth
it? The answer is an unqualified yes. Patients who have followed the Off the
Bean program outlined in Chapter 10 have found their bodies healthier and
minds sharper at fifty-five than they were at twenty-five. Of course, total
health also requires emotional stability, peace of mind, and an optimistic
attitude. The effects of caffeine diminish these qualities. Relationships with
friends, partners, and co-workers depend on harmony, which is destroyed by
anxiety, irritability, and tension.

Caffeine not only intensifies the stress in our lives, but makes us less able to
cope. If I had a magic wand, I would instantly remove the stress from my
clients’ lives. Until that magic wand appears, I will do everything I can to help
them control their caffeine intake. For some, regaining mental vitality after
caffeine means learning a relaxation technique such as those described in
Chapter 10. For others, psychological counseling is recommended. But
everyone needs to start by taking a close look at their caffeine intake.

Caffeine and Anxiety

For five years, I worked in a team practice with physicians and

psychotherapists. Often, the psychological evaluation would include one or
more anxiety syndromes and the recommendation was for counseling. I
would point out that the person was consuming excessive amounts of
caffeine and request a trial month off caffeine prior to therapy sessions. In
about 50 percent of cases, the anxiety syndrome would resolve with caffeine
withdrawal alone. Of course, I recognize that counseling can play a vital role
in restoring wholeness and peace of mind. It’s just that counseling a patient
for anxiety who is drinking coffee is like trying to fill a leaky bucket.

Caffeine and Alcohol: Psychoactive Cousins

The undeniable fact is that caffeine is a psychoactive drug, affecting mind,

mood, and behavior. While the effects of caffeine are obvious but not always
recognized, the effects of alcohol, another psychoactive substance, are easy
to spot. We all know how intoxicated individuals behave. When they are
involved in automobile accidents, their blood alcohol is measured and they
may face criminal charges. No one would think of measuring blood caffeine
levels after an accident because there is no data to suggest that caffeine
impairs performance.

I would like to suggest, however, that the biochemical and behavioral

changes brought about by caffeine may very well contribute to auto
accidents. In the following chapters, I will present clear evidence that caffeine
disturbs normal decision-making processes. Is it far-fetched to assert that ill-
advised lane changes, tailgating, speeding, rage, and stress contribute to
auto accidents?. Watch your driving the next time you’re “wired” on caffeine
and tell me I’m wrong.

There Is Life after Caffeine

Life after caffeine does not have to be dull. In fact, there are delicious and
very satisfying alternatives, and I’m not talking about pallid teas, decaf, and
instant coffee “substitutes.” You’ll learn about rich, robust, and healthful
beverages that brew like coffee but contain no caffeine. Likewise, life after
coffee does not have to be lethargic. Breakthrough research in human
metabolism and brain biochemistry has made it possible for you to enjoy
greater energy and alertness without coffee than you ever experienced when
you were “on the drug”.

You’ll read about natural alternatives to caffeine that actually enhance

metabolic energy production while decreasing the tension in your body. The
difference, once you make the switch, is astounding. You’ll also learn how to
repair your nervous system, manage stress, and improve your energy
production naturally. Finally, you’ll learn how to obtain the quantity and quality
of energy you need for the rest of your long, healthy life. You’ll discover that
life without caffeine has the potential to be better than you ever dreamed
possible!
 CHAPTER 3

Caffeine and Your Body

“If five million people do a foolish thing, it is still a foolish thing” —Ancient
Chinese proverb

Ageless Wisdom Is Sometimes Unwise

Today nearly 90 percent of American adults drink caffeinated beverages. This

includes the scientists who explore caffeine’s effects and the journalists who
report the scientists’ findings. The result is that Americans are misinformed
because no one is willing to say, “This is a foolish thing.“ In this chapter, we
are going to look at the science of caffeine. Before we begin, I’d like to remind
you that no scientific study has ever shown that coffee is good for you. The
discussion only concerns the degree to which it will harm you. The scientific
method is an extraordinary systematic process for discovering what is real. In
other areas of human endeavor, exactly the opposite is true.

Take advertising, for example. Here is an entire system of communication

designed not to reveal the truth, but to manipulate behavior. Sometimes it’s
absurd. A cigarette brand, for example, is advertised as being “alive with
pleasure” even though everyone knows that cigarettes are the leading cause
of preventable death. Isn’t it interesting, then, to learn that most people are
influenced far more by advertising than they are by science? In other words,
we tend to make decisions that affect our lives and the lives of our children
based not upon what is real, but upon habit, or upon what other people want
us to think.

When it comes to coffee, the most common reaction I hear is, “How can it be
bad for you? People have been drinking coffee for centuries.” To a scientist,
this observation is meaningless. History is filled with cases where millions of
people made serious mistakes. There are herbs in China, for example, that
have been used medicinally for thousands of years, and are still being used
to treat sinus congestion. But repeated use of these herbs over time can
cause cancer of the nose and throat.

Epidemiologists (scientists studying the distribution of disease in populations)

have estimated that this habit has caused premature and painful death for
millions of Chinese people. Clearly, great numbers of people can be wrong,
especially when they don’t know the facts.

Facing Reality

Today, nearly 100 million American adults drink three or more cups of coffee
each day.1 So what is reality? Is coffee “good to the last drop,” or is it a
powerful drug with dangerous side effects that needs to be used with caution
and moderation? To discover the truth you need science, and you need to be
willing to dismiss the advertising and hype surrounding the beverage. Forget
the schmaltzy pictures of two female friends sharing a special moment over
coffee.

Those two women are increasing their risk for heart disease, osteoporosis,
anemia, PMS, panic attacks, and fibro-cystic breast disease. You should also
question the sanity of common statements that we hear from friends,
celebrities, and co-workers. In the movie Shadow of a Doubt , Joseph
Cotten’s famous line was, “I can’t face the world in the morning. I must have
coffee before I can speak.” Now, substitute for the word coffee any other
drug, say amphetamines. If a person said he or she can’t face the world
without amphetamines, we’d call him or her an addict.

We’d whisk the person off to rehab and maybe even throw him in jail. But
because coffee is a drug we consume ourselves, we wink and nod and say,
“Yeah, ain’t it the truth!”

Biochemical Individuality

When it comes to nailing down the precise effects of a drug, scientists always
run up against the fact that people are different. Because of what is termed
“biochemical individuality,” the appropriate dose of a drug for one person may
be an overdose for someone else. Physicians need to make educated
guesses when prescribing many of their medications, taking into account the
patient’s size and age in order to arrive at the optimal dose. Often, further
adjustments are made during treatment. This is especially true with caffeine.
We know that a single 100-milligram dose (about six ounces of regular coffee)
can cause palpitations and ringing in the ears in one person, while another
may experience only a pleasant boost in alertness. This is because caffeine,
like all drugs, has to be detoxified by the body, and the organs responsible for
that feat perform their jobs at varying rates of speed and efficiency. We know
that caffeine is rapidly and completely absorbed by everyone. Getting rid of
the toxin, however, is another story.

Caffeine’s Cumulative Effect

Scientists measure the rate of which a drug is eliminated or broken down by

its “half-life”: the time it takes the body to remove one-half of the dose. With
caffeine, this varies widely from person to person, depending on age, sex,
general health, weight, metabolic rate, and current medications. Genetic
factors also affect the rate at which the body eliminates caffeine. Thus, the
half-life of a single dose of caffeine can range from three to twelve hours.
Obviously, then, in real life, there is a very important cumulative effect, since
most coffee drinkers have additional cups before the first dose wears off.

This cumulative phenomenon is overlooked by most researchers. They take a

group of people, give them a quantity of caffeine, and administer various
tests. When the people don’t have heart attacks, they make the absurd
statement that coffee is safe. Or they report various side effects, but conclude
that coffee in “moderation” is safe. In reality, no one —not a scientist, your
doctor, or your psychic aunt —can tell you how much coffee is safe for you
.Nor can you rely on symptoms like sweaty palms and rapid heartbeat. These
symptoms tend to go away as the body adjusts to the drug.

What does not go away, however, is the damage being done to your
adrenals, blood vessels, breasts, brain, gastrointestinal tract, DNA, immune
system, and bones. And all of that is silent. In the remainder of this chapter
we take a close look at twelve critical points—organs, glands, and processes
in the body where the cumulative effects of caffeine become most evident
over time.

Critical Point #1: Your Liver

The liver performs an enormous range of tasks. On physiology exams, it was

a common joke among my colleagues that for any question, you could simply
write “the liver” and be correct most of the time. The liver is in charge of
collecting and distributing nearly every nutrient from every bite of food you will
ever eat. It’s also primarily responsible for removing anything from the
bloodstream that you don’t want. Sometimes that takes real ingenuity.

Faced with a substance it cannot chemically reduce or eliminate (like DDT),

the liver breaks up the dangerous material into tiny fragments and distributes
it to remote areas of the body in order to decrease the concentration of the
poison in any one site. Fortunately, the caffeine we consume is also
distributed throughout the body and, unlike DDT, the liver does have the
machinery to break it down. When we drink a cup of coffee, however, an
enormous amount of the toxin is dumped in the bloodstream all at once.

Caffeine is rapidly absorbed by every organ and tissue in the body and
diffuses into body fluids, including saliva, semen, breast milk, and amniotic
fluid. Caffeine goes everywhere and easily crosses the blood-brain barrier.
Only then does the liver begin the task of reducing this troublesome toxin,
and it’s not easy. Usually, drug detoxification is a job shared by the liver and
kidneys. The kidneys remove what they can and excrete it in the urine. Not so
with caffeine. The kidneys try to get rid of the molecule, but it is reabsorbed
into the bloodstream before it reaches the urinary tract. Thus, the burden falls
entirely on the liver. Remember that coffee contains a host of chemicals, not
just caffeine, among them a group of extremely toxic compounds known as
polycyclic aromatic hydrocarbons (PAHs). You might remember them as the
cancer-causing agents isolated from barbecued meat. The liver also has to
deal with all the aldehydes, alcohols, and sulfides found in coffee.

Caffeine alone is broken down into more than twenty-five by-products or

metabolites, the primary ones being paraxanthine, theobromine, and
theophylline. Interestingly, each of these metabolites has its own biochemistry
and effect on the body.

A DEADLY DUO: CAFFEINE AND YOUR MEDICINE CABINET

At any one time, more than 36 percent of American adults are using some
prescription or OTC (over-the-counter) medication. Among the elderly, that
percentage is much higher. Hundreds of these drugs contain caffeine but,
more important, many of them, like birth control pills and cimetidine (brand
name Tagamet), interfere with the liver’s ability to detoxify the chemicals
found in coffee. Common antibiotics such as ciprofloxacin (brand name Cipro)
also inhibit the detoxification of caffeine, and researchers warn that ingestion
of caffeine while taking such drugs can increase risk for liver disease, cardiac
arrhythmias, and even epilepsy.

Other pharmaceutical drugs have been shown to increase blood levels of

caffeine by more than 600 percent. Later in this chapter you will learn just
how dangerous and damaging this can be to the body. In turn, coffee can
drastically affect the metabolism, blood level, [Link] of
pharmaceutical drugs, including a laundry list of commonly consumed
medications. When your doctor prescribes a drug for any condition, it is
important to ask about possible interactions with caffeine.

What’s more, even moderate liver disease can remarkably reduce caffeine
clearance. Individuals with disorders involving the liver (e.g., alcoholic
cirrhosis, hepatitis) can have elevated blood levels of caffeine for two to six
days from a single cup of coffee. For cigarette smokers, on the other hand,
caffeine clearance is accelerated. Apparently, in a heroic effort to rid the body
of the potent carcinogens delivered by tobacco smoke, the liver produces
more enzymes capable of detoxifying caffeine. This interaction of powerful
toxins has two important results.

First, smokers will tend to drink more coffee than nonsmokers in an effort to
achieve the same level of stimulation. And second, smokers who drink coffee
have the deck stacked against them when they try to quit. That’s because
without the cigarette stimulation, their caffeine detox system slows down,
resulting in enormous increases in blood caffeine levels (up to 200 percent).
As you can imagine, this produces severe anxiety, nervousness, irritability,
and insomnia. Added to the symptoms of nicotine withdrawal, it’s enough to
send even a highly motivated person running back to Marlboro country.

The take-home message here is: If you’re going to quit smoking (the most
positive step you can take to improve your health), it is highly advisable that
you decrease your caffeine intake at the same time. In fact, I recommend that
you quit coffee altogether (see Chapter 10, “Off the Bean’) because studies
show that removing caffeine will greatly increase your chance of quitting
cigarettes for good.

Caffeine Does Not Help Weight Loss

There is a popular belief, most likely derived from the inclusion of caffeine in
diet pills, that caffeine is an aid to weight loss. This notion is debunked in
Chapter 8, but I mention it here in order to clear up yet another popular myth:
drinking coffee when you quit cigarettes does not help prevent weight gain,
either. This concept was carefully tested in a controlled scientific experiment,
and caffeine (even when combined with another stimulant known as
ephedrine) provided no benefit. There was no difference in success rate,
weight gain, cravings, or withdrawal symptoms between the caffeine and
placebo groups.

Source: J. Norregard, S. Jorgensen, K. L. Mikkelsen et al., ’the Effect of

Ephedrine Plus Caffeine on Smoking Cessation and Postcessation Weight
Gain,” Clinical Pharmacology and Therapeutics, December 1996;60(6):679–
86.

Critical Point #2: Your Adenosine Receptors

Caffeine and its breakdown products (collectively called methylxanthines)

have a number of effects on the body. First, they disrupt the normal function
of adenosine receptors, biochemical control switches found throughout the
brain, kidneys, gastrointestinal tract, cardiovascular system, and respiratory
system. Now stay with me here; this sounds complicated, but it’s important,
and by the time you finish this page, you’ll know more about the biochemistry
of coffee than most MDs.

Have you ever inserted the wrong key in a door and found that the key fit just
fine but it wouldn’t unlock the door? That’s what caffeine does in an
adenosine receptor. It fits, but does not perform the adenosine function. Now
imagine that you’re standing there and you can’t get the wrong key out of the
lock. You are thus prevented from entering the room. Likewise, when caffeine
plugs an adenosine receptor, an important biochemical message that was
supposed to be sent to the cell is not delivered. In the brain, adenosine
dampens or slows down neuron firing. It acts like a fuse box to prevent your
circuits from getting overloaded.

When caffeine inactivates this control mechanism, your neuron circuits keep
firing, and you feel alert. The problem is, your circuits keep firing, and firing,
and firing.…

Critical Point #3: The Stress Response

It doesn’t take a genius to see that there might be a downside to all of this
neuron activity. In fact, uncontrolled neuron firing creates an emergency
situation, which triggers the pituitary gland in the brain to secrete ACTH
(adrenocorticotrophic hormone). ACTH tells the adrenal glands to pump out
stress hormones—the next major side effect of caffeine. A single 250-
milligram dose of caffeine (the equivalent of about 21/2 six-ounce cups of
coffee) has been shown to increase levels of the stress hormone epi-nephrine
(commonly known as adrenaline) by more than 200 percent.

Caffeine also stimulates the production of norepinephrine, another stress

hormone that acts directly on the brain and nervous system. Epinephrine and
norepinephrine are responsible for increased heart rate, increased blood
pressure, and that “emergency” feeling. In fact, the emergency is quite real.
Caffeine can trigger a classic fight-or-flight stress reaction with all of the
results listed in Illustration 1.

ANATOMY OF THE FIGHT-OR-FLIGHT RESPONSE

Caffeine can produce a cascade of physical and emotional changes as a

result of increased stress hormones. This fight-or-flight response is hardwired
into all animals as a survival mechanism.

NOWHERE TO RUN

Take a moment to consider a “then and now” scenario. Remember that the
fight-or-flight reaction was in great part responsible for our survival as a
species. For 1.6 million years, this neuroendocrine response gave us
increased strength, stamina, and speed when we needed it. But today, the
same trigger mechanism is killing us. That’s because even though our bodies
haven’t changed at all in the last 25,000 years, everything else has.