The Truth About Caffeine Withdrawals

“I think my interest in it is deeply psychological,” says Catherine Manzanares, Thrive Market’s Content Marketing Manager. “I use it as an excuse to wake up.”

What about quitting? “Never tried. Probably won’t,” she replied.

She’s talking about coffee, the stimulant that fuels so many of our mornings.

Manzanares isn’t alone. This sentiment was echoed by several people when asked about their relationship with caffeine (or its popular carrier, coffee). Jill Russell, Thrive Market’s Executive Editor, said she quit drinking coffee at the advice of a doctor because she struggled with intermittent insomnia. It didn’t help, so after about a month, she went back to it.

Caffeine, one of the world’s most popular (if not benign) drugs of choice, is found in numerous plants. The most widely consumed are coffee, tea, cola nut, cocoa pod, guarana, and maté. It is estimated that between 80 and 90 percent of North American adults and children habitually consume caffeine. Among adults in the United States, coffee is the leading source of caffeine. For kids, it’s soft drinks.

While caffeine is often built into a routine or ritual that seems relatively harmless, it can be addictive. Thus, when someone misses out on their daily fix, they experience what any addict would: withdrawal.

What does caffeine do to the brain?

The stimulant effect of coffee comes from the way it acts on the adenosine receptors in the neural membrane. Adenosine is a central nervous system neuromodulator with specific receptors. When adenosine binds to its receptors, neural activity slows down, and you feel sleepy.

Caffeine acts as an adenosine-receptor antagonist. This means that it binds to these same receptors, but without reducing neural activity. By essentially blocking the adenosine from slowing neural activity, caffeine keeps you feeling stimulated rather than tired.

Caffeine also causes the pituitary gland to secrete hormones, which in turn prompts the adrenal glands to produce more adrenaline. Adrenaline, otherwise known as the “fight or flight” hormone, helps you focus and gives your system an extra blast of energy—exactly the effects many coffee drinkers want.

Lastly, like most drugs, caffeine increases the production of dopamine in the brain’s pleasure circuits, thus fueling your dependency on it.

The health benefits of coffee drinking

While reports on the matter do tend to oscillate between coffee being good for you and something to avoid, it can’t be denied that recent studies have uncovered there are associated health benefits.

One study found that women who drink coffee regularly may lower their risk of depression. Additionally, research points to a decreased risk of stroke in women—though only moderately. Finally, there is more evidence still that suggests it reduces the risk of Type 2 diabetes.

As for enhancing cognitive function, or mood, it depends on the person—not everyone metabolizes caffeine the same way.

About caffeine withdrawal

Back in 2013, caffeine intoxication and withdrawal became official mental disorders in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM-5.

“Caffeine intoxication and withdrawal both occur fairly frequently but only rarely cause enough clinically significant impairment to be considered a mental disorder,” Allen Frances, who chaired the task force that developed the previous volume of DSM, told the Wall Street Journal.

While Frances was a vocal critic of medicalizing every aspect of life and turning “everyone into a patient,” others felt it was valid. Alan Budney, a member of the DSM-5 Substance-Related Disorders Work Group, told the WSJ that the research in support of caffeine intoxication and withdrawal as a diagnosis is substantial—and that it could be useful to psychiatrists and other healthcare professionals seeing patients with those symptoms.

Caffeine withdrawal symptoms

To be officially diagnosed with caffeine withdrawal, a patient has to experience at least three out of five symptoms within 24 hours of stopping or reducing caffeine intake:

• Headache
• Fatigue
• Sleepiness/drowsiness
• Difficulty concentrating
• Difficulty working
• Irritability
• Depression
• Anxiety
• Flu-like symptoms
• Impairment in psychomotor, vigilance, and cognitive performances

These may sound familiar to anyone who’s tried to go cold turkey on their morning brew—but it’s only when it causes “clinically significant distress or impairment” that affects your functioning at work, home, or in a social setting that it’s a bigger cause for concern.

Withdrawal symptoms usually start to show about 12 hours after consumption, peaking at 24 hours. For most, it takes about a week for symptoms to disappear completely.

Of the Thrive Market employees interviewed, those who tried to quit coffee did notice that they experienced headaches for the first day or two—though they generally subsided after that. According to one study, about 50 percent of people who abstain from drinking caffeine for 24 hours report getting a headache.

When signs or symptoms of caffeine withdrawal occur, the severity can vary from mild to extreme. At its worst, caffeine withdrawal has been repeatedly documented to produce clinically significant distress or impairment in daily functioning. On rare occasions, it’s totally incapacitating. For example, in a double-blind caffeine-withdrawal evaluation at John Hopkins Medicine, 73 percent of individuals who met criteria for DSM-5 substance dependence on caffeine reported functional impairment in normal activities (like skipping an exercise routine, missing work, or losing patience with their kids) during an experimental withdrawal phase.

Can someone overdose on caffeine?

Like with any other drug, technically, you can overdose on caffeine. Though it’s very rare, a brief hospital stay may be necessary to complete treatment. In severe cases, death can even result from convulsions or an irregular heartbeat.

Symptoms of caffeine overdose in adults may include:

• Breathing trouble
• Changes in alertness
• Confusion
• Convulsions
• Diarrhea
• Dizziness
• Fever
• Hallucinations
• Increased thirst
• Increased urination
• Irregular heartbeat
• Muscle twitching
• Rapid heartbeat
• Sleeping trouble
• Vomiting

Symptoms in children may include:

• Muscles that are very tense, then very relaxed
• Nausea
• Rapid, deep breathing
• Rapid heartbeat
• Shock
• Tremors
• Vomiting

So why quit caffeine?

When asking people who love coffee about their relationship with it, there are a range of responses: it’s everything from “a treat” to “an everyday indulgence.” One extreme coffee-drinker said “most of my personality is tied to [it].” Rarely do people associate caffeine addiction with any serious cause for concern—and many willingly admit they’re addicted. So what’s the big deal?

Aside from intoxication or withdrawal, there are other aspects to consider when using caffeine as a main source of energy. Additionally, it’s advised that certain people should avoid caffeinated products, such as those with anxiety, high blood pressure, insomnia, and diabetes. People who experience adverse effects from caffeine, such as the jitters typically associated with caffeine intoxication, may want to consider at least scaling back their consumption.

In a blog post, Dr. Mark Hyman wrote about his own experiences with caffeine. “I admit it. I was addicted to sugar, caffeine, and adrenalin. I am a recovering dopamine addict, and it almost killed me.”

“I lived on adrenaline—until my adrenaline ran out and I suddenly got very ill with chronic fatigue syndrome. Every system in my body broke down. I didn’t choose to change my life—my body chose for me. That is when I had to learn to rebuild my life and my energy and respect the way my body worked.”

In the article, he cites 6 ways to reduce or eliminate coffee from your diet, including:

• Caffeine increases catecholamines, your stress hormones. This elicits cortisol and increases insulin, which can cause inflammation.
• Habitual caffeine drinking decreases insulin sensitivity, which can make it difficult for cells to respond appropriately to blood sugar. High blood sugar levels lead to arterial deterioration and cardiovascular risks.
• Diterpenes in unfiltered coffee have been linked to higher levels of triglycerides, LDL, and VLDL levels.
• The helpful chlorogenic acids that may delay glucose absorption in the intestine have also been shown to increase homocysteine levels—an indicator for increased risk of cardiovascular disease.
• Coffee’s acidity is linked to digestive discomfort, indigestion, heartburn, GERD and dysbiosis (imbalances in the gut flora).
• Coffee “addicts” aren’t relying on the body’s natural source of energy.
• There’s a cultural addiction to coffee and its associations—those sugary, fatty drinks that are more of a meal than a drink. A morning latte epitomizes food packed with energy yet lacking any nutritional value.
• 5-HIA, an organic acid and component of the neurotransmitter serotonin, tends to be elevated in coffee drinkers. This can be disruptive to sleep patterns and promote anxiety and even depression.
• Coffee can interfere with the detoxification process in the liver.

It gives you pause before pouring another cup, or getting a refill on that soda.

How to avoid withdrawal symptoms

Hyman suggests slowly weaning yourself off of coffee to avoid extreme withdrawal.

To avoid crashing or feeling the effects of caffeine withdrawal, he offers these tips:

• Drink a lot of water, at least 8 glasses a day. It’s the best way to flush out the system.
• Eat clean foods (high-fiber diets with plenty of vegetables will give you clean bowels).
• Allow more time for sleep.
• Take 1,000 mg of Vitamin C with breakfast and dinner.
• Exercise daily to combat fatigue.
• Avoid low blood sugar by eating when you’re hungry, rather than substituting real food for coffee or a caffeinated beverage to give you energy.
• Drink green tea instead. It has antioxidants, but is also caffeinated.

Even if you decide quitting completely may not be the best choice for you, cutting back may be the answer. Roland Griffiths, a professor in the department of psychiatry and neuroscience at Johns Hopkins University School of Medicine, told the Wall Street Journal that the best way to get caffeine to “work” is to drink it at irregular intervals—like once a week—and limiting your intake to as little as 100 milligrams in a day (about ¼ of a cup).

A simple way to get more energy

So if you can’t get that pep in your step from caffeine, what are the alternatives? Dr. Hyman offers a solution to get a grasp of what raises and lowers your personal energy levels.

He suggests making a list with two columns. In the first column, list all of the things that give you energy. In the second column, list everything that drains your energy. Each day try to let go of one thing that drains you, and add one thing that energizes you.

Then of course, there are other alternatives to try if you like the warmth or flavor. This decaf dandelion cacao latte actually mimics the flavor of coffee.  Decaf teas and coffee beverages are also available at Thrive Market.

Photo credit: Paul Delmont