Caffeine Withdrawal
Caffeine Withdrawal
Drink Less and Enjoy It More
The connection was painfully clear. Whenever she missed her daily dose of coffee, Jo-Ellyn Ryall, M.D., got a headache. An annoying one.
"If you're used to getting a certain amount of caffeine, and you don't get it, or you cut back abruptly, you can experience withdrawal symptoms, like headaches," notes Dr. Ryall, a psychiatrist in private practice in St. Louis.
Harmless as it might seem, the caffeine in coffee, tea, cola and chocolate can be quite addicting.
Cut off from caffeine or limited to considerably less than they're accustomed to, caffeine junkies complain of headaches, depression, difficulty concentrating and fatigue.
Given the consequences, why would anyone want to cut back?
"A fair amount of research suggests that moderately high doses of caffeine (more than a few cups of caffeine-containing beverages per day) can raise risks of miscarriage, fertility problems and, in some predisposed women, tachyarrhythmia (abnormally increased heart rhythm), high cholesterol and panic attacks," says Erica Frank, M.D., assistant professor in the Department of Family and Preventive Medicine at Emory University School of Medicine in Atlanta.
Some research indicates that high daily doses of caffeine may also boost a woman's risk of osteoporosis and aggravate fibrocystic breast disease, heart rhythm abnormalities, high blood pressure, ulcers and premenstrual tension, says Suzette Evans, Ph.D., assistant professor of psychiatry at Columbia University College of Physicians and Surgeons in New York City who has studied the physical effects of caffeine.
HOW (AND WHY) TO CUT CAFFEINE
If you're downing more than three or four 5-ounce cups of coffee, 8-ounce mugs of tea or 12-ounce cans of cola a day, you should cut back, Dr. Frank says.
The American College of Obstetricians and Gynecologists doesn't have a position on safe limits for caffeine consumption during pregnancy. But if you're pregnant or trying to conceive, you should cut back to less than two or three cups of caffeinated beverages, advises Elizabeth Livingston, M.D., assistant professor of obstetrics and gynecology at Duke University Medical Center in Durham, North Carolina.
You should also limit yourself to two cups of caffeinated coffee, tea or cola or less if you have fibrocystic disease, heart rhythm problems, high blood pressure, ulcers or premenstrual tension, says Dr. Ryall.
SURVIVING WITHDRAWAL
The worst symptoms of caffeine withdrawal--headaches, depression and poor concentration--usually let up after two days, and the rest dissipate within a week, notes Dr. Evans. After drinking less than your usual amount for a week or so, you won't miss it, since your body will adjust to the lower dose.
Better yet, women doctors say that there's actually a way to cut back, even give up, caffeine without experiencing withdrawal at all. If your doctor has advised you to cut back, here's how.
Have a little caffeine--for medicinal purposes. Are you in the throes of caffeine withdrawal right this very moment? Unfortunately, caffeine-free aspirin and other caffeine-free analgesics don't do a very good job combating the headaches that can accompany withdrawal, says Dr. Evans. And they don't offer any relief from the fatigue and depression.
The best remedy for the headaches and other withdrawal symptoms, says Dr. Ryall, is actually a moderate dose of caffeine--a pain reliever that contains caffeine (such as Excedrin Extra Strength) or a small cup of caffeinated tea, coffee or cola.
Rely on the 25 percent solution. Women experts say that by gradually cutting back, you can avoid headaches and other withdrawal symptoms in the first place.
"Each week, cut back on the amount of caffeine that you drink by 25 percent," says Kathleen Zelman, R.D., a nutritionist in Atlanta and a spokesperson for the American Dietetic Association. This method of gradually decreasing your caffeine intake will eventually allow you to eliminate it completely from your diet, while remaining withdrawal symptom-free.
What Women Doctors Do
Grab a Nap Elizabeth Livingston, M.D. Craving caffeine? Maybe you want caffeine, or maybe you think you need caffeine, when what your body really needs is a little more sleep, says Elizabeth Livingston, M.D., assistant professor of obstetrics and gynecology at Duke University Medical Center in Durham, North Carolina. "Especially during pregnancy, women can feel more fatigued," says Dr. Livingston. "When I was pregnant, I used to come up to my office between clinics just so I could take a nap on the couch." So if you find yourself reaching for caffeine to pull you out of a slump, Dr. Livingston suggests that you lie down for a 10- to 20-minute nap. (For more practical advice on dealing with an afternoon slump or fatigue, see pages 5 and 214.)
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Here is Zelman's formula: The first week, add decaffeinated coffee, tea or cola to your cup until it reaches the one-quarter mark. Then, fill to the top with regular. The following week, add decaf to the halfway mark and top off with regular. By week three your cup should contain three-quarters decaf to every one-quarter regular. If you started out with an eight-cup-o'-joe-a-day habit, you'll be drinking the equivalent of only two cups of coffee at this point. From here you can continue with this formula until you are drinking all decaf. If you are at home and don't want to make two pots of coffee to mix, you can blend caffeinated and decaffeinated coffee grinds following the same principles.
Reach for noncaffeinated beverages. An alternative strategy is to substitute a cup of decaf, herbal tea, skim milk, juice or water for a quarter, then half and, finally, three-quarters of the cups that you regularly drink, says Zelman.
Grab the biscotti, not the espresso. "You might also be experiencing a lull in energy because your blood sugar is low," Zelman explains. Rather than chug caffeine, have a little something to eat--half a bagel, an orange, a handful of raisins--to get your blood sugar back up there.
Take a hike. Cutting back on caffeine is particularly hard for women who rely on coffee or cola to propel them through tedious tasks or sluggish days. For a caffeine-free energy boost, Dr. Livingston suggests that you take a 20-minute walk.
Save caffeine for crises. If you're limited to just a cup or so of coffee, save it for when you most need a boost (like morning).
