Caffeine Jitters | Hacker News Reader

Caffeine Jitters

cen.acs.org

56 pointszt46 comments

I wonder how many emergency room visits (and deaths) are associated with coffee usage. I suspect the number is negligible, if not plain 0. With billions of cups of coffee consumed daily, I'm skeptical that it's really caffeine that is the villain.

The guy in the beginning supposedly consumed ~600mg of caffeine over 7 hours, which is roughly equivalent to a pot of coffee. That's high usage, but not at all unusual.

>“Your typical cup of coffee comes hot; you wouldn’t usually gulp it down.”

Speak for yourself. I'm a guy who one-shots his coffee before it even cools down.

People have been drinking coffee and tea for thousands of years. Monster and 5-Hour-Energy, a decade? People seem to die from that stuff but not coffee. When in doubt, err on the side of stuff proven by time.

People have been hospitalised (and perhaps died, not sure) from too much coffee, however it does tend to be in quite extreme circumstances. I recall a teenage girl in the UK who drank 18 espressos about a year ago who ended up in hospital, for example. I completely agree with you, however.

I can drink a cool, sweet liquid like it's juice. Ingesting absurd amounts is much harder when the substance is hot, bitter and tends to give you a bad aftertaste and an acidic stomach.

You know I initially typed out a long comment agreeing with you.. I was sure there was a lurking variable in that plot, but I looked up the study and sure enough, about half are strictly caffeine related. Which makes their lines a touch misleading in my option, because in the entire other half of the data, caffeine is just one more point in a cocktail of alcohol and narcotics. So including them in the plot is a bit strange.

So, there are quite a few caffeine only emergency visits, but if we're just going on caffeine issues, there's not enough in the study to see if there's really such a significant uptick in recent years for purely caffeine related issues.

Also, note that a large portion of the visits simply list "adverse effects," not "misuse" (which I would interpret as over consumption). So who knows whether or not these are high doses, or simply people who happen to roll the short end of the stick in regards to caffeine tolerance.

Caffeine sensitivity is a real thing, as is slow caffeine metabolism (a different, but related situation.)

Please do not assume that everyone is the same.

The guy at the beginning of the article consumed only ~600mg of caffeine, but he consumed between 7,000 and 8,000 mg of taurine which is over 2x safe daily consumption[1]. I don't think that drinking 600 mg of caffeine is good for you, but I don't think it's the primary culprit for hospitalizations. I'm thinking the other ingredients in energy drinks, such as taurine and guarana, play a major role.

Here's an interesting quote from a recent Atlantic article[2]: "Still, despite the fact that a Starbucks venti coffee has three times as much listed caffeine as a can of Monster, some people swear they're more wired after drinking an energy drink. That may be because of the extra caffeine in guarana. Energy drinks can advertise that they have the same amount of caffeine as a cup of coffee; but when you include guarana, they have a much stronger stimulant effect."

I found this chart from the Seattle Times comparing stimulant levels in energy drinks[3]. Not only does Monster have 160 mg of caffeine in each can, it also has 5,000 mg of guarana and 2,000 mg of taurine. That's a lot of stimulants for one can. I would be interested in seeing more in-depth studies on guarana and taurine.

[1] According to the Mayo Clinic, the recommended maximum daily intake of taurine is 3,000 mg (http://www.mayoclinic.com/health/taurine/AN01856)

[2] http://www.theatlantic.com/health/archive/2013/01/how-much-c...

[3] seattletimes.nwsource.com/news/health/links/energydrinkchart10.pdf

    > Still, despite the fact that a Starbucks venti coffee has 
    > three times as much listed caffeine as a can of Monster, 
    > some people swear they're more wired after drinking an 
    > energy drink.

Sugar?

Sugar has been proven not to induce hyperactivity, it's a common misconception.

http://scopeblog.stanford.edu/2012/10/31/debunking-a-hallowe...

Energetic and alert doesn't have to mean hyperactive. I was thinking more of general blood sugar/glucose level.

Inserting quick carbs into your body will most likely start the engine in some way.

Energy drinks like Red Bull or Monster are also sweetened. Consuming sugar is going to raise your heart rate...

No one drinks house Starbucks coffee. They put two shots (80 mg of caffeine) into a 22-oz cup of milk and sugar. Drink enough of those to have a caffeine problem and you will have had an obesity problem long prior.

I'm not sure if you're being facetious about "latte drinking culture" or not, but I will tell you that there are plenty of people who order a Venti Bold coffee (actually less caffeine than a light roast) from Starbucks on a daily basis and don't add sugar or cream.

"I wonder how many emergency room visits (and deaths) are associated with coffee usage. I suspect the number is negligible, if not plain 0. With billions of cups of coffee consumed daily, I'm skeptical that it's really caffeine that is the villain."

As an EMS provider, my anecdotal data would say the number is low, but definitely not zero. Typically, associated with excessive and/or irresponsible usage (witness people who take their first ever dose of Hydroxycut and chug two Monsters, having a bout of tachycardia and an accompanying panic attack - certainly nothing life-threatening in and of itself, but on the other hand, if there's an underlying cardiac sensitivity...)

He's specifically asking about coffee as opposed to other caffeinated drinks, I think.

That's right. The article was indicting caffeine, yet the presented graph is "ER visits associated with energy drinks"

And, again anecdotally, I experience much more concerning side effects from drinking a couple red bulls or monsters than I do from downing 4 espressos at once.

This suggests a certain amount of safety:

"According to FDA, at least 80% of adults in the U.S. consume caffeine every day."

That is a very large scale test. That a few dozen people get sick, out of almost 200 million daily drinkers, is not very surprising. The reality is, this is a drug that is safe for the overwhelming majority of its users.

This is a great example of responsible stimulant usage. A similar drug that is consumed every day by millions of people is alcohol. It has a much higher death rate than caffeine and seems to be over-used quite often. However, the vast, vast majority of users are responsible.

I think we can agree that moderate usage is acceptable and useful. I think the major point of the article is that we have to be aware of how much caffeine is in drinks so that people can use it responsibly. The danger in energy drinks is that they are fairly opaque and people don't know how it compares to something like coffee. Most people will dislike the effects of overstimulation, but we want to make sure that everyone has the tools to protect themselves and their children.

TL; DR:

these recommended “safe” levels of caffeine are just statistical averages over the population. Some people tolerate caffeine and can ingest large quantities of the compound without ill effects, and others can’t

This is a good point. I get a little jittery from one diet coke and two diet cokes makes me feel really sped up and gives me insomnia. A cup of coffee is almost unbearable.

I'll drink a tea for a little caffeine, but that's about it. I have no idea how people tolerate drinks with multiple shots of espresso. Tolerance must vary wildly between people.

My tolerance has changed a lot going from my early 20's to my late 20's. I used to regularly drink 8 cups a day, but now start to feel awful after 2.

I think its a combination of losing the acquired tolerance, increasing a latent sensitivity, and more awareness of my physiology.

Metabolism is also a factor, which begins to slow in many people's late 20's.

Genetics play a role. I had 23 and Me sequence my DNA two years ago and one of the things they check for is caffeine tolerance. I don't have it. I can drink a 20oz Mountain Dew for lunch (11:30 AM) and it will keep me awake till at least 10:30 PM if not 11 or 12 or even later, without fail. Some people do not metabolize it. Often, I'll get jitters after a single cup of coffee. I restrict my caffeine intake because of this.

"Ballpark favorite Cracker Jack will soon come as Cracker Jack’d—2-oz packages of the familiar candy-coated kernels jammed, in certain flavors, with 70 mg of caffeine from coffee."

WTF?

Weekend app from a while back:

deathbycoffee.heroku.com/(yourname)

This is pretty fun, going to play with this today. Suggestion - add a button to plot when you feel an associated negative symptom?

Could be cool to hack your ideal caffeine ingestion. Also a cup here is measured as 8oz right? So a large coffee is 2 clicks?

https://github.com/michaelkirk/death-by-coffee

I was hospitalized after drinking 2 cans of Monster energy.

But I still defend energy drinks.

My hospitalization was due to too much caffeine that exacerbated a pre-existing bout of pericarditis-- the actual cause was most likely an infection or cold.

The individual ingredients of an energy drink have no proven ill effects:

- Carbonated Water - Completely Neutral. It might harm your teeth but the evidence is related to sugar + carbonated water

- Glucose - Major energy source

- Citric Acid - Needed for Krebs Cycle

- Taurine - Essential amino acid that has benefits for heart and blood

- Sodium Citrate - flavoring, used for kidneys and is an antacid

- Panax Ginseng - amazing supplement; good for mood, immunity, cognition

- Caffeine - good in moderation, bad in excess - Sorbic Acid - preservative with no adverse health effects

- Sucralose - sweetener with no proven side-effects. Chronic effects occur on a dosage above 9 mg/kg

- Benzoic Acid - preservative that naturally occurs in berries. Stay under 5 mg/kg

- L-Carintine - wonderful little supplement that is good for you, potential nootropic

- Niacinamide - vitamin B3

- Acesulfame Potassium - sweetener, potential carcinogen although studies lack confidence

- Sodium Chloride - table salt

- Glucuronolactone - aids circulation, is good for your heart

- Inositol - good for you, prevents colon cancer, sold as a supplement

- Guarana Seed - caffeine source, aids memory and physical endurance

- Pyridoxine HCL - vitamin B6

- Riboflavin - found in your wheaties

- Maltodextrin - starch, no known health issues

- Cyanocobalamin - vitamin B12

Beyond that, there may be a dangerous interaction between two ingredients that has yet to be nailed down.

I have another theory-- the devil's in the dosage.

I can take down a pot of coffee if I have a good night's rest, but if I am up before 7 and have a single cup, it does not go well for me. This could be related to how caffeine interacts with existing cortisol levels, and if I am stressed and not well rested the effects are amplified.

This is probably why it's so hard to figure out an accurate lethal dose of caffeine, because small changes in biochemistry can significantly amplify how your body acts with caffeine.

I would also (weakly) argue that why we don't see many overdoses with coffee is because you don't start drinking large amounts of coffee on the first go-- because the substance is bitter, it is hard to down a full pot in one sitting.

Due to a built in taste moderation, it is hard to hit your natural upper limit. But because energy drinks are sweet and easily drinkable, novice caffeine users can hit their upper limit in a short amount of time.

And because the half-life of caffeine ranges from 5 hours to 15 hours (!) you can get a strong excess build up in your body in a quick amount of time. There may be an ingredient in the drinks that increase the half-life, which leads to higher risks over time.

"Due to a built in taste moderation, it is hard to hit your natural upper limit. But because energy drinks are sweet and easily drinkable, novice caffeine users can hit their upper limit in a short amount of time."

It's an interesting hypothesis. I'd add that coffee is (most often) served hot, and as such, consuming a cup of coffee takes quite a bit longer than chugging down a cold can of Red Bull.

And about that chugging: it's a different use case. People are conditioned to treat energy drinks like stimulants. The drinks are even marketed as such. Coffee, on the other hand, is primarily consumed in moderation (aside from classic tales of all-nighters, etc., which probably represent a fraction of a percentage of coffee usage). People see coffee as a morning ritual, whereas they see energy drinks as -- for lack of a better word -- speed. The use cases are very different, as are the consumption patterns.

I would hypothesize that energy drinks are inherently no more dangerous than coffee, at least as far as their ingredients go. Rather, they're more dangerous because they're consumed in greater quantities and at greater speed -- rapidly injecting the body with massive quantities of caffeine, and thus shocking the unprepared system. Coffee is more of a slow drip of caffeine, as it were.

Well, there may be a bit of a confounding factor in there.

The availability of energy drinks has made them more widely regarded as the way one goes about consuming lots of caffeine, whereas coffee/espresso tends to be thought of as a smaller scale pick-me-up. Meaning that in situations where people set out to intentionally consume lots of caffeine they are choosing to do so via energy drinks instead of coffee. A study of historical data may show whether or not this is a significant effect. But it could be the case that sans energy drinks we'd still have the same level of problems, through coffee consumption, but perhaps that problem has merely been shifted to energy drinks rather than arising from nowhere.

Save for being an infant or on certain anti-depressants, how, exactly, did you come to the figure of a 15 hour half-life? Do you have a source for this?

http://en.wikipedia.org/wiki/Caffeine#Metabolism

That backed up my argument - the half-life is nowhere near 15 hours unless pregnancy or other drugs are involved.

If you are interested in better living through chemistry then I encourage you to peruse this site:

http://examine.com/supplements/Caffeine/

Why do energy drinks get all the heat? Starbucks coffee has around twice as much caffeine/oz and an even higher ratio per serving

Quantity of consumption. It's a lot easier to buy Monster in multi-packs and gulp through three or four cans in an hour or two. Nobody buys multiple cups at Starbucks or returns to the store that frequently.

Energy drinks have other stimulants in them than just caffeine. See some of the other posts here about stuff like taurine and guarana.

Guarana is just a different source of caffeine.

http://en.wikipedia.org/wiki/Guarana

I wonder how green tea compares to that. After drinking 5 half liter cups of green tea throughout the day I felt in my chair like on the subway station with trains passing by. I had to lie down and sleep.

According to their chart. Starbucks coffee should be killing you but the article mostly about energy drinks. Has it not occurred to anyone that caffeine isn't the only contributing factor?

I wonder how many of these cases are due to the combination of caffeine and other risk factors such as dehydration or hyponatremia.

Caffeine goes swimmingly with magnesium, L-Theanine and Noopept.

why is an 8oz cup of brewed coffee 133mg of caffeine and a 16oz starbucks 330mg?

I'd guess starbucks uses a higher water temperature for brewing.

Caffeine content of tea and coffee will vary widely.

For coffee, smaller grind size, brewing method, the bean type (there are low/decaf cultivars,) roasting method, and water temperature (to name a few) will affect how much caffeine ends up in your cup.

Expecting Starbucks to give you a consistent dose cup after cup, month after month is probably a bit optimistic.

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