S03E67 How Much Caffeine is Too Much?

Have you ever wondered about the good, the bad, and the not-so-known about caffeine? Get ready to quench your thirst for knowledge as we dissect this popular stimulant, going beyond its ability to keep you awake. We're unveiling what credible research has to say about caffeine's links to cognitive decline and several neurodegenerative diseases. Yet, there's a thin line when it comes to caffeine consumption - a line you probably don't want to cross. We've got the low-down on how much is too much, as well as some insights on the potential risks and recommendations around caffeine intake.

Switching gears for the weekly thankful, have you considered the impact of a drug shortage on a specific medical field? Specifically, a drug critical for plastic surgeons and how it has left them grappling with its absence.

So tune in and enjoy this episode with your favorite cup of joe! Or should you?

#thoughtfulplasticsurgery #podcast #plasticsurgery #cosmeticsurgery #boardcertified #plasticsurgeon #beauty #aesthetic #botoxandburpeespodcast @crossfittraining @crossfit #crossfit #sports #exercise #health #movement #crossfitcoach #clean #fitness

Click on your podcast site to listen and subscribe!

S03E67 HOW MUCH CAFFEINE IS TOO MUCH?

[00:00:00] Sam Rhee:

How much caffeine is too much caffeine? You may be one of those who say, is it even possible to be over caffeinated? This question got stuck in my brain after hearing someone at the gym say last week that they drink eight cups of coffee a day.

I mean, I take caffeine daily, but eight cups just seemed too much to be healthy. Of course, caffeine is super popular. Even long ago, Thomas Jefferson once said, "Coffee, the favorite drink of the civilized world." And over 200 years later, it still seems to be true.

According to the marketing research company Drive Research, 74 percent of Americans drink at least one cup of coffee every day, and 50 percent of people drink three to five cups a day. If you lump in the other people who drink soda with caffeine, such as Coca Cola or Pepsi, 85 percent of the U.S. population drinks at least one caffeinated drink a day.

And the amount of caffeine consumed is growing with the younger population. Energy drinks such as 5 Hour Energy and Monster Energy continue to grow in popularity, with 32 percent of people aged 18 to 29 reporting that they consume energy drinks at least a couple times a week.

I see gym goers with the Starbucks or Dunkin Donuts stroll into class. And I see the pre workout fanatics with the new hotness energy drinks such as Celsius and Bang.

And even the latest teen boy trend Prime Energy drink from YouTube star Logan Paul has a whopping 200 milligrams per bottle, equivalent to six cans of Coca Cola. I mean, this definitely isn't your grandmother's Red Bull.

But hey, isn't caffeine good for you? At least something you can't live without? How many people would agree with famous classical music composer Johann Sebastian Bach, who once said, "Without my morning coffee, I'm just like a dried up piece of goat."

So let's dig a little bit into one of the more popular supplements in the world, caffeine, and see if it's really safe. Is it good for you? And how much caffeine is really too much?

So first of all, just remember that I'm going to open by reminding people that I'm talking about my own personal experience and I'm not giving medical advice as a physician.

This show is not a substitute for professional medical advice, diagnosis, or treatment. This show is for informational purposes only and always seek the advice of your qualified health care provider with any questions you may have regarding medical care and never disregard professional medical advice or delay seeking advice because of something in this podcast.

So what is caffeine actually? Let's do the two minute drill on the scientific breakdown of caffeine. Caffeine is actually a part of a family of organic compounds called xanthines, and this family of compounds all have stimulant effects on the human body.

One xanthine relative of caffeine, theophylline, is a drug used to treat asthma, or COPD breathing difficulties. Physicians may know theophylline by the brand name Slobid or Theodur.

Now caffeine is found naturally in many plants, not only the coffee bean, but tea leaves, kola nuts, yerba mate, guarana, and even cacao pods. Caffeine is also really cheap to make synthetically.

So as a stimulant, caffeine has two major chemical actions. It increases the release of neurotransmitters including acetylcholine. And it increases levels of cellular messenger cyclic AMP, cyclic adenosine monophosphate.

Now these cellular effects increase the sympathetic nervous system in the body, causing an increase in breathing and heart rate, as well as increasing mental alertness and physical energy. So is caffeine good for you? Well, many studies have shown caffeine can definitely have many desirable effects in the short term. So physically, caffeine increases aerobic endurance as well as aerobic performance.

It's really common to see NBA athletes traditionally drink many cups of coffee before a game. And mentally, caffeine has been proven to increase mental alertness, including reaction time, concentration, and memory. Another mental benefit of caffeine is that even though aerobic performance is enhanced, subjects don't feel like they're working harder than normal. So the perceived exertion rate is still the same.

Caffeine absorption takes about a half hour to kick in. And the half life of caffeine in the human body is about four to six hours. So there are definitely benefits physically and mentally to taking caffeine in the short term.

But what are the long term effects of caffeine? Well, first of all, if you do take caffeine regularly, you may find that your body starts developing a tolerance to caffeine, and it requires increasing doses to achieve the same effect. In addition, suddenly stopping caffeine intake after taking it regularly can result in mild withdrawal symptoms, which we've all probably felt if we are big coffee drinkers, including headache, irritability, and drowsiness.

Probably one of the biggest causes of headache after surgery that I see in patients is that they aren't drinking their morning coffee for a day or two while they're recovering after their procedures.

So is caffeine good for you to take for a long period of time? Well, there are some research studies that suggest that either long term coffee, tea, or even just caffeine consumption might reduce cognitive decline late in life, and it may actually reduce the risk of developing stroke, Parkinson's, or Alzheimer's disease.

However, these research studies are more observational. And the actual mechanisms for these benefits have not yet been proven. Also based on these studies, the actual doses for what these possible long term benefits might be are not known. And it appears that consuming more caffeine does not necessarily mean more benefit.

And there probably needs to be a lot more research for some better answers on this. I mean, remember, until very recently we used to say based on observational studies, a glass of wine or two every night was good for your heart, until we actually had better studies that showed that any amount of alcohol was not good for you.

And these observational studies confused the other positive behaviors that these wine drinkers had, which actually helped the heart, not the alcohol. But at least for now, if someone asked me personally what the effects of taking long term caffeine would be, I would probably say it's not bad for you, and it might actually be helpful, but we don't know for sure. But I'd say if you really like taking your caffeine every day, go ahead.

So before I start talking about what amounts are okay with caffeine versus what we consider excessive amounts of caffeine, let's first talk about a couple categories. Children, teenagers, and pregnant women. In children, now when I looked at the studies, I was surprised that there's no evidence that caffeine actually stunts growth, which shatters our family belief that my youngest brother is the shortest in the family because he was spoiled rotten and he was allowed to drink a lot of Coke when he was growing up.

But the problem is, is that the same effect that caffeine has on adults may actually cause problems in children. Many children have difficulties falling asleep or maybe staying asleep or have anxiety with even a small amount of caffeine. And remember, caffeine dosage is based on body weight, so even a small amount, say from soda, can have a big effect on a child. Therefore, no amount of caffeine is recommended as safe for children.

So what about adolescents? The neighborhood around my local Starbucks has tons of teens walking around with their caramel macchiatos in hand every day. The American Academy of Pediatrics recommends that between the age of 12 to 18, the recommended amount of caffeine is no more than 100 milligrams a day, which is about one cup of coffee, depending on your brew strength, and a can of Coke has about 40 milligrams of caffeine. There are a few studies that suggest that high caffeine consumption during adolescence may increase the risk of anxiety disorder later in adulthood. But again, this research data isn't strong. But if I was a parent, it would never be a bad idea to be careful.

Now for pregnant women, no one really knows the effects of caffeine on the fetus. Most of the studies are conflicting and based on very weak data. We do know that caffeine does last much longer in the system of a pregnant woman with a half life being 15 hours versus four to six hours in a non-pregnant adult.

The current recommendation from the American College of Obstetricians and Gynecologists is that up to 200 milligrams a day of caffeine is safe for pregnant women.

Okay, so let's get to the meat of this episode for the rest of us. If you're an adult, how much caffeine is too much? First of all, remember to check your medications to make sure they don't interact with caffeine. This includes, among others, thyroid medications, cold and allergy pills, asthma medications, some antidepressants, blood pressure, and even osteoporosis medications.

Second, there are just some people that are naturally sensitive to caffeine. So if you have insomnia, jitters, anxiety, rapid heart rate, upset stomach, nausea, or headache from any amount of caffeine, that's probably already a sign that you need to lower your caffeine intake or just cut it out completely.

So caffeine is a drug, if you take it in a high enough dose, it will definitely kill you. The number most quoted as a lethal amount of caffeine would be 10,000 milligrams. But some studies have quoted as low as 5,000 milligrams. So 5,000 to 10,000 milligrams is about 50 to 100 cups of coffee, or 20 to 40 Five Hour Energy drink shots.

So that amount of caffeine can cause death by heart arrhythmias, seizures, or strokes. However, even a 1,000 milligrams could potentially kick off some of these effects in some people, not to mention the other less threatening negative side effects I mentioned, such as severe anxiety or insomnia.

So if you're close to a thousand milligrams of caffeine a day, you're probably not doing your body any favors. So eight strong cups of coffee a day, depending on how strong your brew is, could put you right up there. And if I was drinking that much, you'd see a fuzzy outline around me because my body would be trembling and vibrating so much.

Most medical organizations recommend up to about 400 milligrams a day as being safe. So that would be four cups of regular brewed coffee, ten cans of soda, or maybe a couple of energy drinks depending on the brand.

What do I do personally? I personally take 200mg of caffeine daily. I'm not really a coffee or tea drinker. And I don't take it later in the day because it messes up my sleep, which I already have enough issues with. So I'll just take a 200mg caffeine supplement pill first thing in the morning. And sometimes if I have something really important like a competition or some other major physical event, I might take an energy drink such as 5 Hour Energy or a Monster maybe a half hour before.

The supplement pill that I do take is I get from Amazon and the company that supplies it is called NutraCost. And from the best of my Googling ability, NutraCost does do independent third party testing, although they only really test for contaminants such as lead, arsenic, and such, and I didn't see any formal third party test results for the actual content of the active ingredient, so I don't know exactly how much caffeine I might be getting per pill, but at least I know that they're not poisoning me with anything really bad.

So, that's reasonable enough for me. Although, if I was a competitive athlete, I probably would find a pre workout caffeine product that was NSF Certified for Sport. Now, if you go to Amazon and you type NSF Certified for Sport, you will probably find a lot of supplements in that category. Unfortunately, most of them also have something like beta alanine in them, and that makes my face itch, so I try to avoid those.

Anyway, there you have it. Caffeine can definitely help you out physically and mentally on a daily basis. There might be some beneficial long term effects. Healthy adults can take up to 400mg of caffeine a day. If you're taking close to a thousand, you really ought to probably cut back. And just be mindful of your coffee and energy drink consumption. You could be consuming way more than you mean to without even knowing.

And as always, as I said before, if you take a supplement, make sure that what you're taking is tested appropriately. And if you're someone who just can't live without caffeine, you're not alone. 85 percent of the United States is taking it, and so to paraphrase an advertising jingle, the world really does run on caffeine.

My weekly thankful is the numbing medication, lidocaine. Discovered in 1946, lidocaine is injected and it causes immediate numbness in the area. Without it, I would either have to knock out all my patients with gas or intravenous anesthesia, even for little cases like a mole removal in the office, or I'd have to go back to the old days and hand them a shot of whiskey and a stick to bite on.

Now, over the past couple of years, there's been a huge lidocaine shortage, which has made it challenging for us plastic surgeons who use a lot of it, for procedures such as liposuction.

The price of lidocaine has skyrocketed over the past couple years from 5 dollars a bottle to up to 50 dollars a bottle, if you can find it. Now, anytime there's a supply listed in stock, I rush to buy as much as I can, no matter what I need. And I have to check weekly, scouring my suppliers for availability. It feels almost as bad as looking for toilet paper during the pandemic.

Unfortunately, the lidocaine shortage is not expected to end until sometime next year, but until then, all we can do is grit our teeth, pay through the nose, if we can even find the product right now. But without this magic numbing drug, we plastic surgeons couldn't do what we do easily. And as always, sometimes we don't appreciate something until until you don't have it.

As always, thank you to everyone who sends me messages, comments, or reflect on their own experiences about the topics on the podcast. I really appreciate it very much. Keep them coming. And as always, DM me @BotoxAndBurpeesPodcast on Instagram or leave a comment at YouTube.com/@BotoxAndBurpees. Thanks very much.