Healthy caffeine? It’s personal

Coffee has superpowers that can’t be denied.

It can buoy college students through all-night cram sessions on final exams week. It can steel overworked adults for a demanding day on the job. It can make you run for the restroom following a too-long air flight. It can deliver a withdrawal migraine that flattens you for a week.

More than 85 percent of Americans consume at least one caffeinated drink per day, and coffee is the largest contributor to caffeine intake. But coffee’s effects—and side effects—can leave us wondering whether it is a friend or foe. Researchers have examined coffee for years trying to decide. Recently, studies have tipped the balance towards healthy.

In August, a study reported in the Journal of the American Medical Association Internal Medicine said people who drank coffee, no matter which kind or how much, were less likely to die over a 10-year period than non-coffee drinkers. The findings suggest coffee drinking can be part of a healthy diet and offers reassurance to coffee drinkers, researchers said.

That may be true, said Muhammad Ghazi, MD, a family physician with Baptist Primary Care. But whether you see health benefits from coffee depends on a lot of case-by-case factors.

“This type of research is not a clinical trial. Things are not as simple once you get into the clinical world with multiple variables affecting patients’ health,” he said.

The ups and downs of coffee

Research has shown coffee lowers people’s risk for cardiovascular disease, liver cancer, colon cancer and Parkinson’s disease, Dr. Ghazi said. A Johns Hopkins study showed coffee improves memory over a 24-hour period. European studies have shown people who drink coffee are less likely to develop Alzheimer’s disease.

However, the benefits of coffee peak at three to four cups a day. There are reasons why things may not go that way in real life.

 “Not everybody can drink that much coffee. I personally get heart palpitations after two cups,” Dr. Ghazi said. “Also if you add sugar or cream, that’s not going to be beneficial, or it may cancel out beneficial effects.”

Certain people won’t feel good drinking coffee either. If you suffer from a leaky bladder, coffee will increase your symptoms because coffee makes people urinate more often, Dr. Ghazi said. Coffee stimulates the cardiovascular system, which can be fine in a healthy person. Not so much if you have an underlying heart condition.

“It can give you high blood pressure and abnormal rhythms,” Dr. Ghazi said. “Too much caffeine can actually worsen your health.”

In other cases, coffee delivers beneficial effects. Caffeine can stimulate the colon and relieve constipation, Dr. Ghazi said. It can smooth and dilate muscles in the respiratory tract, which can ease lung disease symptoms slightly.

Caffeine appears in some pain medications, especially those used for migraines, Dr. Ghazi said. But doctors are reluctant to prescribe caffeine for pain because of some downsides.

“It has an adverse effect on people who have osteoporosis and rheumatoid arthritis. It can weaken bones if used for long periods of time,” he said.

Coffee and your brain

Coffee works its stimulating magic in your brain within 15 minutes of entering the bloodstream. The caffeine in coffee is chemically similar to adenosine, which is a “tiredness” hormone in the brain.

Adenosine accumulates during the day, locking into receptors in the brain and making you feel more and more tired. Caffeine works by attaching to brain receptors in place of the adenosine, blocking the tiredness effect.

Because caffeine is a drug, people who drink coffee regularly become addicted to it. The brain over time creates extra receptors to compensate for the ones being blocked by coffee, which means you’ll have to drink more and more to have the same effect.

Withdrawal from coffee delivers an energy crash. You may have a lack of energy, headaches, drowsiness and irritability, and you may even experience nausea and vomiting, Dr. Ghazi said. In extreme cases, people may alternate between caffeine and depressants like alcohol to control their energy and mood.

“Addiction is a reality in our society,” Dr. Ghazi said. “So my message is, balance is everything. If your balance is off, you lose potential benefits, and coffee can actually do harm.”

Whether coffee is helpful or harmful is a very individual matter which depends on underlying conditions and risk factors. For answers about coffee in your diet, contact your primary care physician. If you don’t have a primary care provider, visit baptistjax.com/bpc. Care to find a doctor near you.