Dependency and withdrawal — detoxing from caffeine
by Marcelle Pick, OB/GYN NP
* Breaking up with caffeine —why it’s hard to do
* Caffeine addiction quiz
* Quitting caffeine “cold turkey” — can it be done?
* How to support your body through a caffeine detox
“I don’t have a problem with caffeine — I have a problem without it!”
For some women, this statement (or something similar) is a rueful acknowledgment that they simply can’t get through the day without a pick-me-up from their favorite beverage. For lots of people caffeine intake does not cause problems, but there are several reasons why someone might want to end her love affair with caffeine. Perhaps you think it makes you jittery, or your practitioner has recommended you cut back or give it up. You may have tried to quit caffeine before and found yourself with a pounding headache.
Read more about caffeine:
* Caffeine and your adrenals
* Caffeine pros and cons
But while caffeine in moderation is relatively benign, you might just feel that kicking the habit (or simply cutting back) would improve your health. If you have had trouble with insomnia, adrenal imbalance, or anxiety — all of which can be exacerbated by caffeine — or even if you have some indefinable sense that you’d be better off without it, you may want to consider undergoing a caffeine detox.
Let’s learn more about how caffeine works in the body, then explore some simple ways to make the detoxification process go more smoothly for you.
Breaking up with caffeine is hard to do — here’s why
To detox or not — the caffeine addiction quiz
Wondering if you even need to quit? Some women can drink coffee every day of their adult life with no problem. Others tolerate caffeine well for years, only to find it causes symptoms as they approach menopause. And still others find that any amount of caffeine triggers more severe concerns.
Consider the following questions, and trust your inner guidance.
* Do you use caffeine to facilitate a physical activity (waking up, exercising, having a bowel movement, concentrating)?
* Do you have to have caffeine in the morning? Could you substitute hot water with lemon or herbal tea?
* Do you crash or have caffeine/sugar cravings in the afternoon/early evening?
* Do you grow irritable, get a headache, or feel disembodied if you miss your caffeine fix?
* Do you have difficulty falling asleep at night and waking up refreshed?
* Do you need caffeine to heighten the effects of other substances, such as nicotine, alcohol, or sugar?
* Do you feel your social routines would suffer if you went caffeine-free?
* Does a life without caffeine seem impossible to you?
If you answered yes to two or more of these questions, consider examining your attachment to caffeine.
For certain groups of women, even moderate caffeine dependency can cause problems, so you may also want to consider quitting if you’re:
* a woman who suffers from adrenal burn-out (a rapidly growing group)
* a woman who is insulin resistant and who isn’t getting enough energy from good food
* a slow detoxifier, meaning that it takes you longer to recover from encounters with toxins.
So the last and most relevant question for you to answer is: How do I respond to caffeine? (For further guidance, see our article on the pros and cons of caffeine.)
Most of us understand that caffeine is habit-forming, but we may not think about what it means to be addicted to it. Part of why caffeine is so hard to give up is that we may develop a strong dependency on it for a number of physiological, psychological, and emotional reasons.
* Physiological. Caffeine has measurable physical effects in the body, increasing our pulse, heart rate, and respiration, making us feel “more alive.”
* Psychological. Research shows that caffeine improves concentration and task performance. Caffeine also helps people feel more “social” and at ease, and we love to share the caffeine ritual with friends.
* Emotional. Perhaps the strongest aspect of our dependency on caffeine relates to its mood-lifting effects. We look forward to the times of day when we consume caffeine as treasured, oasis-like moments.
Many of us develop deep-seated patterns specific to our caffeine consumption. Some people always drink coffee right before an important meeting. Others like to knock back a caffeinated drink after lunch because it helps them stay on-task at work. And some avid exercisers regularly consume caffeine before working out.
As if these factors weren’t enough, over time, many women find that their response to caffeine changes so that, ultimately, they aren’t in charge anymore — their body needs that caffeine to feel “normal” or have energy. And if they try to ignore the desire for caffeine, they find themselves experiencing withdrawal symptoms. These symptoms are often uncomfortable enough to cause some to surrender to the confines of caffeine dependency. But if you’ve reached a decision to cut back or eliminate caffeine from your life, there are some simple, effective ways to meet your goal while easing the discomforts of withdrawal.
Caffeine detoxification is easier for some, harder for others
Taken together, caffeine’s modes of action in the body are complex, involving multiple systems. This may explain the wide variations in response, tolerance, and dependency on caffeine between individuals, and even in the same person over time. To the liver, caffeine is a drug-like substance it immediately sets about “detoxifying” — meaning, clearing it from the system. To the brain, caffeine has some potent psychoactive effects that make it habit-forming, as mentioned above. But chances are, if you’ve been consuming a lot of caffeine every day, you’ll notice a few unpleasant symptoms as you reduce your intake.
On average, it takes the body about 5–8 hours to eliminate caffeine, but many factors influence the breakdown of this molecule — including gender. It may seem unfair, but we think it’s important for women to know that research shows our bodies usually take longer to detox caffeine than men’s, and we can experience more symptoms of withdrawal than men do, too.
Other factors that influence the body’s response to caffeine include age, pregnancy, nutrition, and drug use (including birth control, hormones, antibiotics, NSAID’s, alcohol, and nicotine.) Altogether, these variables can significantly impact your liver function. Additionally, you could have one of several genetic variants that alter the way the liver detoxifies certain molecules, causing the rate at which you eliminate caffeine, its downstream metabolites, or some of the other substances present in coffee or tea, to be distinctly slower — or faster!
Why quitting “cold turkey” may backfire — or work
One notorious method for quitting an addictive substance is to stop “cold turkey,” which, in theory, is supposed to offer the immediate reward of vanquishing your demon. This technique is described by some as the “quickest and most painful” way to kick the habit, and many who have tried it claim it is the least effective as well.
If you try to quit caffeine all at once, you may find yourself muddling through for a few days, but your body can rebel with a slew of symptoms, including severe headaches and extreme grumpiness. Uncomfortable symptoms can even reduce productivity because you feel so awful and blurry. All this can make relapse more likely.
But for a stalwart few, going cold turkey with caffeine actually works. And it is a viable option for anyone whose caffeine intake isn’t all that high, or for those with a less “committed” relationship to caffeine. Here are a few helpful tips for going cold turkey with caffeine.
* Look ahead and try to reschedule any obligations that could interfere with your goal.
* Time your quit date to coincide with a vacation, so your productivity won’t be an issue.
* Grant yourself permission to be pampered for a few days (enjoy a massage or another spa treatment).
* Provide nutritional support — eat three small meals per day plus two healthy snacks. Choose low glycemic-load foods to keep cravings to a minimum.
* Enjoy plenty of delicious, non-diuretic liquids that you look forward to drinking. Water is the ultimate thirst-quenching, health-promoting drink.
* Rest, listen to your favorite music, and indulge in naps.
* To assist your resolve and ease symptoms of withdrawal, consider acupuncture or acupressure, gentle exercise, and meditation.
If you treat yourself well, stopping all at once just might turn into a pleasant “awakening,” where you find you’re finally freed of caffeine’s grip.
Quitting caffeine — slowly but surely
Common symptoms of caffeine “withdrawal”
We may be unaware of a dependency on caffeine, until we miss a cup, or try to give it up. Here are some common symptoms of withdrawal.
* Headaches (A throbbing, pressure-type headache is the most common symptom of both “overdose” and withdrawal.)
* Fatigue
* Sluggishness
* Daytime drowsiness
* Inability to focus
* Irritability
* Depression
* Anxiety
* Reduced sense of well-being
For most women, it’s probably a lot easier and less painful to detox from caffeine a little at a time. If you are a coffee drinker, start the day by first having a regular cup of coffee. For your second serving, pour a cup that’s half-regular and half-decaffeinated coffee — but any ratio will work, as long as you continue to taper down methodically. If you just want to cut back, you can hold the step-down at any point that provides the balance you seek.
If you normally drink coffee throughout the day and want to quit, you can begin directly by cutting your consumption in half right off the bat. You get to “zero cups per day” twice as fast. If your goal is total abstinence for health reasons, keep going until you are drinking all decaf. Once you reach this point, you may even decide to give up coffee altogether.
As you’re tapering off, you may notice symptoms as your system adjusts to lower levels of caffeine. But take heart: withdrawal symptoms peak within two to four days. Even if you quit cold turkey, most symptoms should disappear after just one week without caffeine. For help with headaches, supplement with extra vitamin C, take regular breaks, enjoy a walk, and get to bed on time. You can also try white willow bark tablets, which contain a natural type of pain-relieving salicylate. (Like aspirin, however, willow should be avoided for two weeks before and after surgery.)
Additional options for quitting caffeine include limiting your intake to before 12 noon. If you drink caffeinated beverages at “morning teatime,” they’re less likely to interfere with your natural cortisol curve. Cortisol — a wake-up hormone produced by your adrenal glands — is highest in the morning for alertness and gradually declines throughout the day. Another option is to take a “mini-break” from caffeine each month, to allow your body to rest from repeated stimulation.
Note: For some people, the love affair with caffeine is complicated by its presence in certain over-the-counter and prescription drugs, or by close associations with other habits like nicotine. In such cases, counseling and medical assistance may be helpful — or even necessary — for caffeine detox.
Taking away caffeine — adding more support
Again, it is your liver that breaks caffeine down so you can eliminate it from your body. You may want to talk to a functional medicine practitioner about supplemental nutrients that bolster the liver as it runs through its enzymatic detox steps.
These include:
* vitamin C (also helps with withdrawal symptoms and supports adrenal function)
* potassium
* calcium
* magnesium
* zinc
* B vitamins
* trace minerals
* amino acids (may also help balance energy levels)
* N-acetyl cysteine
* milk thistle
You can greatly reduce stress on your liver by eliminating foods and drinks that are likely to contain toxins or allergens, and make sure to eat enough protein. An alkaline diet — good for your health for many reasons — is helpful because it provides the mineral salts and antioxidants that help clear out reactive debris created during detoxification.
Ample dietary fiber encourages bowel function, which may slow down during caffeine withdrawal. Fiber promotes good bacterial balance in the digestive tract, to further assist nutrient absorption and detoxification.
One of the best tips for cutting down on caffeine is to drink a big glass of pure water or a cup of herbal tea immediately upon awakening, before you take in any caffeine. That helps quench simple thirst. Then eat your breakfast as soon as possible, making sure to include adequate protein. After breakfast, if you still want your usual caffeinated drink, go ahead and have it.
Even if you think that nothing could ever replace your favorite caffeine drink, there are lots of alternatives you can check out. “Grain coffees” are well-known substitutes brewed from a variety of ingredients such as almonds, malted barley, and chicory — a long-time staple in New Orleans. Teas made from dandelion root, peppermint, sassafras, ginseng, ginger root, comfrey, lemon grass, and red clover are other good options.
Respect your body’s natural rhythms
If you’re worried you might lose your edge if you quit caffeine, consider this: your body and mind are not designed to be “on” all day, every day. The body works best when its natural cycles are honored, with a time for energetic activity and alertness and a time for relaxation and rest. That period of rest is when it engages in much of its detoxification and repair processes, so respecting these natural rhythms will not only reduce your dependency on caffeine, but also any damaging impact it may be having on your health. So take it easy as you go about your caffeine detox — you’re being good to your body — without adding stress!
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Caffeine pros and cons: effects of caffeine on your body
* The health benefits of caffeine
* The flip side — spiraling insomnia and fatigue
* Caffeine — what else is in your cup?
* The bottom line — it’s between caffeine and you
Just like the rising sun or a crowing rooster, a mug filled with a caffeinated beverage says that morning has arrived. Whether it’s in the form of coffee, tea, cocoa, cola, or one of the new energy drinks, caffeine is a habit embraced by many women I know. We treasure the quiet moments spent sipping a hot drink, but mostly, I think people love caffeine because it helps them feel more alert.
In recent years, studies investigating the effects of caffeine on the body have shown mixed results. While some research shows that caffeine supports wellness and can even have protective effects, I know many women who worry that their caffeine consumption could be harming their health.
“Caffeine is not so bad when you have one — or even two — cups of coffee or tea a day. But if you need lots of caffeine just to function, or you’re having fatigue or insomnia, palpitations, or adrenal issues, you probably need to reassess your habit, and take a good look at your overall health picture.”
— Marcelle Pick, OB/GYN NP
Read more about caffeine:
* Caffeine and your adrenals
* Detoxing from caffeine
So what’s the real story? First, I want you to know that for most women, one daily 8–10-ounce cup of coffee or a similarly caffeinated drink is fine. But I have seen the caffeine habit sneak up on women, and it can catch up with you, particularly at midlife. Like most habits, moderation is key, and there is no one right answer for every woman. So when fatigue, insomnia, or stress cause women to become concerned about their caffeine intake, deciding whether to cut back or quit caffeine should be guided by each woman’s unique health history and needs.
Let’s take a look at the “pros and cons” of caffeine in the light of the current science, so you can make up your own mind.
The sunny side of caffeine
It’s not just your imagination: caffeine really does help you feel more awake — at least, at first. Brain studies show it reduces sleepiness and improves alertness, effectively jump-starts a sleep-deprived mind, and increases the ability to pay attention. Feelings of fatigue can be offset by caffeine consumption, and when tiredness does set in and you feel less focused, it can help increase your energy levels. This effect makes you feel more attentive — a real bonus when there’s no time to rest.
I know so many women who say, “I can’t even think ‘til I’ve had caffeine.” And there is good evidence behind the contention that caffeine improves productivity and task performance. It has also been shown to improve response time and accuracy, especially in those who don’t use caffeine regularly.
But for those who do consume caffeine regularly, an even more intriguing benefit may be its capacity to stimulate positive feelings and perk up mood. Researchers think this mood-enhancing effect reinforces the consistent use of caffeine — and may explain why some individuals get “hooked.” And though recall studies show varied results, predictable, moderate caffeine consumption may genuinely improve both long-term and short-term memory.
These are some of the suggested advantages of caffeine consumption that make it seem so appealing. And taking in caffeine — in whatever form you prefer — is a comforting ritual that makes you feel good, and one we love to share with others. So there is often a powerful psychosocial component to caffeine consumption as well. What about the drawbacks?
The flip side: extra stress hormones and sleep interference
How we react to caffeine differs from person to person. Even though there is evidence that moderate caffeine intake has mostly positive effects on behavior, excessive use may lead to problems, especially in sensitive individuals and especially as we grow older.
By the time they’re using caffeine habitually many women observe that, while it does pick them up at least for a while, it may induce deeper fatigue later on. That drop-off in energy may occur later in the day or even the next morning, when they find themselves reaching for more caffeine. For some, this rebound effect interferes with normal sleep patterns and disrupts their natural circadian rhythm.
In the brain, caffeine blocks the areas that receive adenosine, a biochemical compound with sedative effects. As the day wears on, the overworked brain naturally releases more adenosine to slow activity and trigger sleep. But when you take in caffeine, these receptors get blocked, your heart rate speeds up, and you get a jolt of heightened alertness — which might be what you want so you can keep going, but meanwhile your brain is looking to sleep, not caffeine, for restoration.
The caffeine buzz also comes at the expense of the adrenal glands, which are prompted by caffeine to pump out more of the stress hormones norepinephrine, adrenaline, and cortisol. As the adrenal glands become overworked, the daily rhythms of cortisol release are thrown off and we get both lasting fatigue and insomnia (something we talk about more in our articles on caffeine and adrenal health and adrenals and insomnia). This is how the caffeine habit often backfires: the more you drink, the more it saps your energy.
Because the effects of caffeine are so entwined with our stress response, it can exaggerate our reaction to everyday stressful events, elevating our blood pressure and raising levels of hormones linked to feelings of anxiety. In some people, adverse effects also include “withdrawal symptoms” when trying to eliminate caffeine.
More than a feeling: caffeine’s effects on brain health
Aside from the way it makes you feel, we’re now seeing some surprising research on how caffeine affects long-term physical health. Results from a range of studies worldwide have been mixed, but moderate caffeine use seems to not only reduce the risk of developing dementia and Alzheimer’s disease, but also to slow their progression. In Finland, where coffee consumption is higher than anywhere else in the world, the lowest risk of Alzheimer’s and dementia later in life was found in those who drank three to five cups of coffee per day.
Another degenerative condition of the nervous system, Parkinson’s disease, can be affected by caffeine consumption. Though studies produced decidedly different results, one study suggests that the chemical action that creates caffeine’s buzz-like effect may help protect against Parkinson’s by preventing loss of the all-important neurotransmitter dopamine.
Another study shows that drinking three cups of caffeinated tea per day can delay the onset of Parkinson’s by nearly eight years, but if you replace that tea with coffee, onset actually speeds up by almost five years! Additional Parkinson’s studies show positive effects from caffeine in black tea, but not green tea. These confounding factors for Parkinson’s disease suggest that the protective ingredient in tea is something other than caffeine.
These assorted findings underscore the need for you to draw your own conclusions about caffeine, by evaluating your unique health history and risk set.
Heart health and caffeine
How caffeine affects your cardiovascular system depends on several factors: how much you consume; how well your liver detoxifies it (to the liver, caffeine is a toxin); and to a certain extent your genetic makeup. Some research shows that when people with a certain gene variant drink lots of caffeinated coffee, their risk of myocardial infarction, or heart attack, increases. In contrast, those with a slightly different variant of this same gene have been found to metabolize caffeine more quickly, and for them, caffeinated coffee may actually be protective against such an event.
But there’s more to cardiovascular health than risk of heart attacks! Scientists have found a connection between habitual use of caffeinated coffee and inflammation, which, when coupled with caffeine’s tendency to raise blood pressure, may increase the risk of cardiovascular disease. These factors have also been associated with mental stress, an effect that can linger for as long as a month after a person quits drinking caffeinated coffee.
Meanwhile, another ingredient in coffee, cafestol, has been named by food scientists as “the most potent cholesterol-elevating compound known in the human diet.” But cafestol is found only in unfiltered coffee, the kind that’s made with an old-fashioned percolator or a French press. Fortunately, cafestol is mostly removed by paper filters, such as those used in drip coffee makers. (Keep in mind that removing the caffeine does not remove cafestol — you’ll still get it in percolated decaf!)
My advice about caffeine and cardiovascular disease is simple: if you are already at high risk for heart trouble, you may want to limit your intake of caffeine, especially in coffee. But that brings us around to the fact that not all caffeine drinks are created equally.
Caffeine keeps close company with other ingredients
If you drink coffee, consider these suggestions:
* Know that the darker the roast, the lower the caffeine content.
* Eat a nutritious, low-glycemic index snack along with your java.
* Choose the best quality you can afford, and consider purchasing “Fair Trade” brands to help protect growers.
* Look for organic beans, and if you add milk or cream, make that organic too.
* Save it for a relaxing setting — try to avoid it when you’re already hyped-up or anxious. Savor each sip and enjoy the quiet, comforting moments that a cup of coffee offers.
While we often equate caffeine with coffee, it is also found in tea, sodas and soft drinks, cocoa, energy drinks, and of course, chocolate. Caffeine content varies widely among these options, and certain choices seem to carry more benefits than others.
When we tally up the pros and cons for each, taking tea may well be the healthiest way to take in caffeine. The reason for this is because most types of tea are also rich in a number of plant-based chemicals that promote wellness and healthy aging in a dozen or more ways. The tea most of us know — Camellia sinensis — is probably the most widely consumed beverage in the world, and it’s been that way for centuries. The antioxidants it contains help counteract inflammation, certain kinds of cancer, and the oxidative stress that can damage DNA. Tea can also have the paradoxical effect of relaxing us — all in all a good choice — as long as the caffeine it contains doesn’t bother you.
With other forms of caffeine consumption, there is an unfortunate tendency to take in unhealthy ingredients at the same time. Sodas, chocolate candy, and many of the new energy drinks are loaded with sugar or, worse, high-fructose corn syrup. High-carb content in foods and drinks like these may magnify the jolt you get from caffeine, but this is likely to be followed by an even bigger “crash” when those effects wear off. And most of the wildly popular caffeinated diet sodas usually contain chemical additives, so it’s a good idea to check the labels for chemicals like artificial sweeteners, phosphoric acid, and brominated vegetable oil that may not be friendly to your system.
The bottom line — taking a personal account of caffeine’s health effects
As suggested in my quiz on detoxing from caffeine, perhaps the most relevant question for you to ask yourself is How do I personally respond to caffeine? You may be in touch with the impact your habits have on your health and quality of life. If so, you can trust your intuitive guidance on caffeine. If you’re more analytical, you may want to ask yourself further questions when pondering caffeine’s pros and cons:
* Does caffeine make me feel jumpy, jittery, anxious, wired, or fatigued?
* What are my specific health issues, especially with regards to cardiovascular and adrenal function?
* Does caffeine affect my sleep patterns?
* Am I socially or emotionally attached to caffeine?
For older women who consume caffeine, getting adequate dietary calcium and other minerals is important, as the diuretic effects of caffeine can cause us to more rapidly excrete vital minerals. Women with anxiety, fatigue, heart palpitations, high cholesterol, or medical or neurological conditions, may want to weigh their caffeine intake carefully against these health concerns.
Remember to keep the notion of balance in mind when it comes to caffeine. For example, if you’re drinking four or five cups of strong coffee a day just to function and you’re still feeling “spent,” it may be time to look at your overall health picture. Some women who fit this category notice intense and uncomfortable withdrawal symptoms when they try to quit caffeine. These are red flags that suggest complications related to caffeine intake that are worth looking into.
It’s reassuring to know that if you’re feeling well, and your consumption is moderate, you can keep enjoying caffeine-containing foods and drinks. In the meantime, I would encourage you to check in daily to monitor the effects of caffeine, so you can adjust your intake accordingly. And if you do decide to quit or cut down, our article on how to detox from caffeine can help smooth the way.
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