Caffeine use disorder
hub.jhu.edu
hub.jhu.edu
Frankly, it was a lot harder than I thought it would be. I was plagued with minor but persistent headaches for almost a month and was exhausted most of that time since I was used to grabbing a cup of coffee to get me started in the morning. I avoided caffeine for almost 15 years until about a year ago when I finally found a medicine that has successfully prevented Migraine (completely). Now and then I enjoy a cup of coffee (or a Coke -- I'm a skinny guy) but I've not gotten to the point of it being a regular thing.
The difference is huge. I am convinced that Caffeine is a much more powerful stimulant than we coffee drinkers think it is. When I am feeling tired, a cup of coffee will completely wake me up and I'm full of energy. I can't see how I managed to drink two of these every morning and still barely feel the effects. If I have two cups now, I'm overwhelmed with jittery feelings, my mind races, and I go from the heightened concentration of one cup to not being able to concentrate at all due to my mind going in every direction at once.
Absolutely. I really don't think I'm some sort of outlier, and when I'm not in a cycle of dependence on caffeine and have a cup of coffee I feel an intense high. I'd compare the euphoria to being very drunk. I definitely feel awake, alert, and very focused -- but I can also tell that I'm not using the exact same kind of judgement as I do sober.
Interestingly enough, this led me to discover that A&W cream soda is caffeinated; with my previous caffeine tolerance I would not have been so jittery after drinking one, and surely enough on the back of the can was a "contains caffeine" label.
I suffer from migraines semi-regularly and have at separate times taken Maxalt, Imitrex, or generic OTC migraine meds + caffeine.
Best of luck.
Also, since starting a low-carb keto diet two years ago, I haven't had a single migraine (I used to get 2-3 per month, both painful ones and visual auras). When I was a pediatric neurology prof a few years ago, a keto diet was standard of care for the kids, and the department was starting research into keto for chronic migraines. Give it a try!
Maybe some of that research can hold some pointers?
I didn't share the medication in the original post because there are a lot of caveats, but I take Depakote at 250mg twice daily and it works completely without side-effects (same dosage for 1.5 years and not a single instance of Migraine).
I happened upon this cure by accident, though, due to my body's intolerance for a myriad of common medicines used for Migraine treatment (and nothing OTC worked except Caffeine)
I cannot take Triptans (Maxalt/Imitrex). They work, but with huge mood side-effects. I was prescribed an anti-depressant (name escapes me) that showed promise in Migraine prevention. I got a Migraine headache while I was taking the anti-depressant and took a Maxalt (OKed by the doctor) and was hospitalized with Serotonin Syndrom. I cannot take anti-depressants, I learned later, due to my genetics[1].
I've seen many specialists but it wasn't until this hospital visit (on a holiday) followed by a misdiagnosis, that I was prescribed a rather high dose of Depakote (1000mg/day). It was prescribed in August and when I went through September without Migraine (this has never happened according to my log), I brought it to the attention of my headache specialist. He reduced the dosage at my request (Depakote is prescribed for BiPolar--an illness I do not have--and at the original dose, I felt emotionally flat[2]). At 500mg/day (2 doses), I don't have a single side-effect (other than headache relief, which is not why it is usually prescribed) and have been on that dose for 1.5 years without a single headache.
My headache specialist said that some of his other patients got relief from this medicine but that it's hit/miss. My experience is that this drug is basically everything you'd ever want in a treatment -- side-effect free, and works 100% of the time for me.
[1] Genesight test indicates that the medicine will remain in my system far longer than it should. I strongly recommend paying for this since it would have saved me a trip to the hospital. All of the SSRI medicines are in the high risk category for me. Glad I've never experienced depression!
[2] Nothing like the movies where a guy walks around with no expression on their face staring blankly. The best way I can describe it is that when something would happen and my wife would react, I'd feel like "Data from Star Trek" not understanding why she was reacting so strongly/emotionally. At this dose, I have the same level of intensity I'm used to.
Aside from jittery feelings, I am actually physically jittery if I drink too much caffeine so some hobbies involving couple square mm surface mount components have to be scheduled with tea or energy drink consumption. Two cups of nice black tea and I'm not hand soldering 0402 components that day, although its easy when I'm "sober".
Based on increases in neurotransmitter activity, heart rate, and dozens of other measures, taurine is a stimulant.
I've tried to figure out if she was right but all the literature on the subject seems to say the same thing: "There's a lot we don't understand about how caffeine affects the brain, and there's a lot we don't understand about migraines."
For what it's worth, I mostly gave up caffeine fifteen years ago. My friends would have caffeinated drinks but at five o'clock when the party is dying down, I'd be the only one left with any energy. Anecdotally, it felt like caffeine didn't give you energy, but it let you borrow energy. (Later in life I discovered caffeine could also trigger hypomania.)
Now I just use caffeine to medicate my lack of interest in my current job.
I agree with that statement. It would reduce them by about 80% but during the fall/spring when I would get many in a row, they'd be more intense and caffeine would work less effectively.
Unfortunately, with pain, there are a lot of variables at play, here, so I'm not sure if it was tolerance and worse headaches or if it was perception that they were worse as a result of fatigue from the "OMG, another one?!" For me, it wasn't such a dramatic difference that I could convince myself that the caffeine was not working any longer. It was never "nearly gone" vs "barely helps" for me, but a feeling like they were getting, maybe, 10% worse each time. Duration was also, unfortunately, pretty consistent around 2-3 days (with day 3 being nearly symptom free).
I have heard the same. Very potent.
I've also detoxed from Caffiene in the past to reset, and been amazed at how little I can get by with.
I limit myself to one cup a day and I feel like it has very little impact on my alertness and energy levels. Do you think just one cup a day already makes your body build a tolerance?
Not that you should do an all-nighter in the first place.
Beforehand, I knew I had a bad coffee habit. In a typical day I'd drink, maybe 6 or 7 mugs of strong coffee. I'd tried to cut down many times, but never succeeded; there just seemed to be too many reasons in my life to have another coffee.
So when Ash Wednesday (the start of Lent) came, I thought, "Now's the time to quit."
The first day was fine. I didn't notice anything. I guess I was still flushing the remaining caffeine out of its system.
The second day certainly wasn't. I had a headache, and felt tired, dizzy and confused.
The headache didn't last long, but the other symptoms persisted for about ten days. In hindsight, I should have consulted a physician before attempting this, because it could have aggravated other medical conditions I have.
I now have twelve days left of my caffeine fast. Do I feel healthier? Do I sleep better? No, not really; I feel pretty much the same as I did before, but without the urge to drink coffee all the time.
I think the real benefits will come when I let myself drink coffee again. I intend to only use it when I really need a pick-me-up. The less often I use caffeine, the more effective it will be.
[1] Lent is a period of 46 days' self-denial observed in many Christian churches.
I've heard from many people on HN and elsewhere individually choosing something to give up for Lent.
In my understanding, the traditional Lenten restrictions in most Christian churches that observe Lent are pre-specified dietary restrictions that are the same for everybody (for example, it was unexpectedly convenient for me as a vegan to visit Eastern Europe because the Eastern Orthodox churches' Lenten fast was similar to veganism).
Is the practice of giving up a personally-selected thing for Lent something that many people have chosen to do individually as a sort of new interpretation of the tradition, or is it now also recommended by some churches?
In the modern Roman Catholic Church the fasting requirements have been substantially relaxed. The only requirements are fasting on Ash Wednesday and Good Friday and abstaining from meat on Fridays. The other days of Lent are still penitential days, but the bishops of the region have the authority to determine the form of the penance. In the United States the bishops have stated that it is acceptable to substitute fasting for some other form of penance determined by the individual.
My impression is that the Eastern Orthodox and Eastern Catholic churches still observe a much more rigorous fast, more like the Roman Catholic Church used to a few centuries ago. As a side note, I've always been the most impressed with the Coptic Christians. They observe, by far, the most rigorous fasting schedule. They fast 210 days out of the year! [3]
[1]: http://www.newadvent.org/cathen/02590c.htm
[2]: Hence Lent is strictly speaking only 40 days (a more biblically significant number) because the Sundays are excluded from the fasting.
[3]: https://en.wikipedia.org/wiki/Fasting_and_abstinence_of_the_...
I know a lot of this changed with Vatican II; in particular the no-meat on Friday rule was previously year-round, and it is now purely during lent, though one is supposed to do some form of abstinence on Fridays year-round.
I had thought that giving up things for Lent was peculiar to the Roman Catholic and Orthodox religions until I chatted with friends in High School (1990s) and found that some Lutheran and Presbyterian denominations also encouraged the practice.
[edit]
I also forgot to mention that a large fraction of Protestant congregations are either not part of any particular denomination, or are part of a denomination that is fairly silent about appropriate ways of daily worship; individuals in those denominations often eclectically adopt forms of worship from other denominations.
Increased prayer and almsgiving are also part of the Lenten fast; one idea is that the money you would have spent on meat and cheese should instead go towards charity. In my experience, I haven't really found other Orthodox specifically give up a particular thing intentionally, except for incidentally in the sense of spending more time in prayer means less time for video games, for instance. :)
What's most important is achieving self discipline in not being controlled by food. If we fast from meat but "consume" our neighbor through gossip, for instance, then we've missed the whole point.
Traditionally, Catholics choose to do additional self-discipline during Lent. The big three things that the Catholic Church encourages are increases in prayer, fasting, and almsgiving. The fasting part is where people often give up some type of food or drink, like coffee.
So the practice of giving up a personally-selected thing is not required, but it is encouraged and traditionally done as a way to come closer to God and prepare for Easter.
All I did to quit was pop advil for a few days. Quitting caffeine wasn't remotely difficult physically. I used to drink 3-4 liters of soda a day, so not some small amount. I quit because I was worried about diabetes even though I was a healthy weight (as per my doctor's instructions).
Be careful when you try to drink it again. One cup of coffee is enough to get me from a hard-to-focus-after-lunch-dip to fully awake and focused. If I drink another cup I become all jittery and have symptoms resembling a minor panic attack.
Good luck!
When I worked in an office I'd drink coffee as an excuse to take a break, switched to fruit teas (careful they're not all caffeine free). Ginger cordial makes a lovely hot drink too.
I'm not sure how much caffeine I'm able to administer through mate - but it must be much, much less.
I also haven't noticed it influencing my sleep or anxiety - I'm still anxious and I sleep well most days.
I just couldn't taste the thing anymore, it was very bland..
Later I discovered I was self-medicating my ADHD...
Now I am taking proper ADHD meds, and this allowed me to greatly reduce my caffeine use (that was wandering into dangerous and expensive territory, with me needing to drink litres of red-bull clones to work), still need it sometimes though, my ADHD meds dosage is still too low it seems (my medic is adjusting my meds still).
Without caffeine + meds I can't do anything properly, I lose random objects (including a cup of coffee! I made myself a coffee yesterday, moved it somewhere in the house, and could not remember where, I spent 5 minutes wandering around looking for where I put my coffee), forget to do stuff, including important stuff, forget to eat/drink water/sleep, and all other sorts of not good behaviour.
Is this 'self-medicating'? Focus and tiredness have always been big problems for me. I scored in the 80th percentile on the Wender Utah Adult ADD test a few years ago. Nothing any doctor has plied me with has worked for more than a few days before tolerance sets in.
IMHO, much of this 'quit caffeine - you'll feel even better without it' is uninformed zeal. Some will, some won't. Mileage will vary.
Coupled with L-theanine caffeine has really been a useful tool for me.
I ask because I'm not sure if I have ADHD or just regular anxiety/lack of focus that could be fixed by exercising/meditation/finding another job. And I don't want to go to the doctor to get hooked on drugs I don't need...
And I've been hearing about the ADHD overdiagnosis problem for a while, and I've been staunch that I didn't had ADHD until my life was the shithole that it is now (I am 28, unemployed, don't own any property, have negative net worth, no friends, no romantic partners...)
Then what I found was the opposite, as an adult, seeking for ADHD diagnosis (or diagnosis of whatever I had), led to most doctors spin around in circles trying to find everything that I could have that is NOT ADHD, because they assumed I was just some kind of junkie or someone wanting to cheat tests in university, because here in Brazil all ADHD meds are of highly controlled nature (ie: they are classed the same as Morphine for example).
Eventually I found my current medic... that still is going VEEEERY slow in the dosage, the highest dosage she ever gave me was 1/5 of the maximum, and about 1/3 of what people get on average.
Still, even this low dosage helped, before I had the meds, I reached a point where I was spending more on caffeine than food every day (and this is in a country that exports coffee and erva mate, thus caffeine in general here is really cheap)
I live in the US and had the same reaction from doctors. One doctor spoke with me for a few minutes (literally like 5 minutes) and decided I was trying to abuse uppers to gain an edge at school/work, despite having been previously diagnosed with ADD and treated as a teenager (and despite asking for help, not medication). It was a really, really humiliating experience. I eventually was prescribed medication but I've since lost and regained medical insurance, so I no longer have that prescription. I often have difficulty staying on task, but I cope with it myself out of fear of going through that awful process again.
To me it seems that adults seeking help with ADD/ADHD are looked at with immediate suspicion. I always assumed it was a lack of mental health education for doctors in the US, but now I suppose it might be a global phenomenon.
- fewer head aches - much better sleep - reduced mid afternoon blahs - easier wake ups - ability to use small amounts of caffeine for medicinal purposes. (by itself or to enhance the effects of other drugs)
The frequency of migraines for me is independent of caffeine consumption; I've gones months with no caffeine and suffered though migraines, just as I've gone through months of heavy coffee/tea drinking and suffered (a little less) through them
I can go without coffee for weeks, have gone 2 months last year. Everything seems fine, but some days, I wake up in the morning with a terrible, terrible headache that fortunately goes away after a rather high dose of paracetamol+aspirin.
Sometimes it occurs in the evening when I come home, seemingly fine, but then bam, hammer to the head.
If I drink coffee regularly, I pretty much never get them...
I felt cheated :)
If you're comparing how you feel drinking coffee, to how you feel a few days after quitting, then of course the coffee will feel better.
If this doesn't describe your situation, then disregard.
Personally though, I love the taste and enjoy the experience of "waking up" with a cup of coffee over the course of the first 20 minutes of the day.
Yep, which is why I switched to decaf. Still the same taste (there are ok decaf coffees out there) but none of the bad effects of excessive caffeine.
(Most decaf still has ~10% of the caffeine of regular coffee, but even with 4 or 5 cups of decaf a day it's not enough for dependency; I get no withdrawal symptoms if I stop for any length of time).
I still drink the odd normal coffee (if someone/somewhere doesn't have decaf) but a maximum of one a day otherwise it will affect my sleep that night; it also gives me a proper coffee buzz for the short period after drinking it.
The roasting process is probably introducing some nice awful compounds into the mix anyway.
As another commenter mentioned, not drinking caffeine makes it's effects much stronger when you actually need it. I don't drink tea/coffee/soda/energy drinks etc. So on the rare occasion that I down an energy drink the effect is extremely pronounced. Literally buzzing.
I went off adderall as it was not a great solution, turned out I was mostly miserable and bored at that company. I was trying to keep myself engaged by getting high on caffeine. After quitting, I drink 3-4 cups a day and some days none.
As an aside, the whole "8 hour half-life" is astonishingly high, to me. Caffeine is nice, but it doesn't seem to have that strong an effect on me, and certainly nothing I notice 5-8 hours after. I drink quite a lot of caffeine these days, but even at times when I went off caffeine for a few weeks, I didn't get effect durations any longer than 1-3 hours.
I have the genes that extend caffeine half-life. If I drink an American large coffee, I get anxious. I can drink a whole pot or two of green tea and feel a nice lift in mood.
As others have mentioned, any coffee after noon and I can't fall asleep until around 2am. I avoid caffeine most days except for the occasional morning kombucha.
[1] https://www.reddit.com/r/nootropics/wiki/faq#wiki_l-theanine
Might have something to do with the strength of the tea, though.
Metabolism of drugs like caffeine is genetically quite variable and is quite an issue for pharmaceutical companies.
short summary: 200mg at 7 a.m., and going to bed at 11 p.m. had following effect: "Compared to placebo, sleep efficiency and total sleep time were significantly reduced."
The effects are 6 hours for me, less than 1 hour for my father (who smokes), and can last over 18 hours for my wife and mother-in-law.
I haven't seen the studies on caffiene half-life, but I suspect the variation is very high.
I personally take it early morning and after a siesta.
Green tea is less of a problem (then again, the way I prepare it, it contains much less caffeine).
I'll drink my 3-4 cups of black filtered coffee a day with a good conscience.
[1] Not including other high-caffeine drinks (energy drinks) or mixing your coffee with lots of sugar and milk, which would be bad mostly for other reasons than the caffeine itself.
3-4 cups might be on the high end of the safe spectrum, depending on what your idea of a "cup" is. (For the record, 3 half-litre beer steins of coffee a day turned out to be a spectacularly bad idea, even if hearing colours was briefly entertaining.)
I've consumed caffeine to the point of serious gastric distress and very mild heart palpitations and I've never experienced synesthesia. I'm unwilling to push beyond that to higher doses, but two or three 12-cup pots a day of light roast filtered black coffee is about average for me, so what the Hell? Is there just that much individual variation here?
Perhaps someone can design an (safe) experiment to measure the effect of caffeine in synesthesia ...
A "medium-size coffeehouse coffee" (at Starbucks) is 16 fl.oz. Here in Europe, that's not really a normal cup of coffee.
If you're in the Bay Area and really want to go nuts with your caffeine for whatever reason, Dutch Bros in North Bay / East Bay (usually go there when I'm by Sac) has drinks on their menu with 6 shots: http://dutchbros.com/AboutUs/OurMenu and they're atypically strong per-shot.
Sounds similar to what I used to drink. I now drink similar amounts of decaf black coffee a day and sleep a whole lot better. This is partly why I quit and definitely why I won't go back to regularly drinking normal coffee (it's been 6 years or so).
(Yes, I know decaf still contains ~10% of the caffeine of normal coffee, this just means I'm down to the equivalent of half a cup of coffee a day, which is below dependency levels as I get no withdrawal effects if I stop this for a few days.)
Many of those 'alarming' articles are mainly studying the point from where the use of anything is dangerous for our health. It is easy to get the numbers and to publish, and the website gets a clickbait.
It's widely knew that too much coffee is dangerous. But a normal dose has plenty of benefits, and a lot of research supports both points.
I'd be interested in reliable cites for either of those.
Here's what Cochrane Collaboration says. http://www.evidentlycochrane.net/caffeine-and-health-evidenc...
It's a short list.
> Most studies did not include data on decaffeinated coffee, either because too few people drank it or because data were not available. The few studies that did, though, had differing results. With respect to cardiovascular disease, decaffeinated coffee did not seem to have the same protective effects as regular coffee. With respect to the one stroke meta-analysis, it seemed to be just as protective as regular coffee. In two breast cancer analyses, decaffeinated had the same nonrelationship as regular coffee. Decaffeinated coffee was also protective against lung cancer, not as protective against Parkinson’s disease, and protective against diabetes and overall mortality, but perhaps to a lesser extent than regular coffee.
> But for most studies, there just aren’t data available. The conclusion to take away: There’s less evidence overall for a potential benefit, but still, there’s no evidence of harmful associations.
For example: If you have problems with sleep, and just can't give up caffeine use and take sleeping pills instead, you have a drug problem.
1) Dark roast coffee has less caffeine and is (in my subjective opinion) tastier. So if one wants the taste of coffee without less of the effects, consider an espresso or a Turkish coffee. The latter is just called "coffee" in much of Eastern Europe, one can pick up a beautiful cezve on Amazon http://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3D...
2) Yerba Mate is 75 mg of caffeine per serving: higher than tea, but less than coffee. Can be made in an French Press or a tea pot and served like conventional tea.
3) Caffeine gum: not particularly pleasant to chew, but comes in a more precise dose (100mg) and is "kicks in" faster.
Personally, I'd like to see more genetic studies on this: I am not particularly affected by caffeine: I've never experienced withdrawals (despite consuming caffeine heavily -- from coffee and energy drinks for a long period of time) nor do I see coffee raise itself in potency after a week or two of abstinence. This is different for others and I would really like to understand why.
I don't believe you. How long have you gone without it? When did you start drinking caffeine? What's your definition of withdrawal?
Edit: with -> without
As a kid I was taking 30mg amphetamine daily, which I stopped taking abruptly and had no withdrawal (I did eat a huge amount in the days following, but the drug was causing me to not eat and lose weight). I had been taking it for about 6 months. Later I was taking 54mg methylphenidate 5 days/week for about two years, and I stopped taking it abruptly and again experienced no withdrawal symptoms.
Different people react differently to drugs.
Headaches (the most frequent symptom my wife experiences, as do my friends), excessive sleepiness, exhaustion, shaking hands, etc...
It's possible, however, that I may have been slightly more tired, but beyond the threshold of noticing this; or slightly slower reaction times. This isn't a scientific study.
Caffeine, like all drugs affects people differently and can cause an array of side-effects. , Besides interfering with sleep, a few are worth mentioning.
Caffeine can cause increase in gastric reflux or other GI conditions. Anyone who needs "acid reducers" is well-advised to avoid caffeine. Caffeine is also notorious for increasing anxiety symptoms, those prone to panic attacks may be more vulnerable. Cardiac effects are also a potential issue, as caffeine can contribute to abnormally rapid heart rhythms. Naturally as always mileage varies, universal rules don't really exist.
If a person has such conditions, no harm in reducing or avoiding caffeine for a while. If the problem improves, then you know what to do, if not, well, resolving the problem is going to require at least a bit more investigation.
Of course eventually I took it up again - unfortunately after a couple of weeks of withdrawal, it tastes really good.
But what fascinates me is that being easy to quit might be part of why it is hard to quit. It's easy to say "heck, I'll quit tomorrow, it is so easy after all".
I went cold-turkey a few years ago, lasted several months, helped immensely with palpitations and sleep-pattern problems. In fact, I should probably do it again at some point this year, but with kids and work it becomes difficult to plan the inevitable couple of weeks of "zombie time". Maybe doctors should start considering it a real addiction, justifying off-time for treatment.
My current strategy is to replace coffee with caffeine pills so I can control the amount exactly and reduce it slowly until it reaches zero.
Also, having to take pills when I feel bad feels rather ridiculous and makes it obvious that I am addicted.
Is there a specific brand / type of pill that works well for reducing amount over time?
Also, I always use an L-theanine supplement when I take caffeine, it's amazing how much it changes things. Instead of feeling all jittery and agitated I just feel less tired and more alert. This is roughly the equivalent of just drinking strong green tea.
The most common brand seems to be Pro Plus but they cost a bit so I shopped around and found cheaper generic brands on Amazon.
The cheaper brands (apparently intended for sports) come in 200mg pills which I break in half with a knife.
These work fine, but one thing I discovered is that I need to remember to drink water as some of the symptoms of dehydration are similar to caffeine withdrawal.
I prefer theobromine.
And the same as many others have said... I sleep better, feel better, etc, etc.
The worst soft drink is orange soda. There were orange soda ads many years ago that used the Beach Boy's "Good Vibrations".
For those who have quit, am I likely to see any benefits from stopping tea as well?
* And fictitious
If you measure the same two people year after year, you just measure their genetic predispositions and personal habits more and more precisely. You cannot distinguish them from the results of your coffee/tea intervention.
Anyways, did you read the article on wikipedia? The prisoners were twins and their rations was the same - 3 intakes per day.
With only one person per group, you can't eliminate many possible reasons for their differing life spans: one may have caught a disease the other was not exposed to, they may have had different nutrition, different amounts of exercise, different habits, a zillion other things.
After all, do other twins die at exactly the same time? No. They die years apart for many other reasons. Unless this twin experiment could eliminate all those possible reasons, it shows us nothing about coffee specifically.
Also, this is supposed to be a joke, right? :~)