Coffee: friend or foe for inflammation, diabetes, menopause and more?

By Nonie DeLong, ROHP, CNP

Dear Nutritionist,

My question is about coffee. I have to go for some stress tests for my heart because I’ve been diagnosed with a heart condition. I have to cut coffee out for a week or so for the tests, but I really find I need it in the morning. I imagine it’s the caffeine I have to avoid. Is there anything else I can substitute to help give me some morning get-up-and-go without the caffeine? And is there a healthier alternative in the long term, assuming coffee might not be okay, given that I have a heart condition now? 

Much thanks!

Soon to be, Shawn of Yawn

Dear Shawn,

You are not alone in your reliance on a morning cuppa or two. The love of coffee has steadily grown over the last 20 years – with Canada among the top 3 countries for consumption. With so many tempting variations, even school kids are now exposed to it in a variety of seriously marketed, hip-whip-sugar-laden-slushie-drip hybrids. 

Caffeine, found in the leaves and fruit of over 60 plants – including coffee – boosts alertness and increases the impact of mood-enhancing neurotransmitters (dopamine, serotonin), while inhibiting the action of a key neurotransmitter that makes us feel tired (adenosine). If you’ve heard of neurotransmitters before, it’s probably in talk of antidepressant drugs. Yes, caffeine can be said to be a more natural and mild antidepressant, with a bit of study now into why that is. So, it’s no wonder you’re apprehensive of going without!

I agree, the caffeine is what you need to avoid for the tests you’re undergoing. And you’re likely going to feel it because the reason we love it so much is that caffeine is a potent psychoactive drug. It’s effects on the central nervous system are nothing short of astounding, given that it’s so widely available. 

Despite this, there’s a lot of back and forth on whether you can become addicted to coffee (or just dependent on it) and whether it is, in fact, healthful. So instead of spouting data from one camp or the other that you can Google-Fu for yourself, I’m going to insert my own clinical experience with coffee to best answer your question. Just give me a moment to grab my morning cuppa.

Now let’s unpack this murky little beverage a bit. 

Coffee inhibits the release of GABA, a neurotransmitter related to anxiety, social phobias, and an inability to relax. Add to this that it also stimulates the autonomic (stress) nervous system, and you get a pretty wild picture for some. Clinically, the people I see with panic attacks, night time restlessness, and general anxiety frequently respond well to the addition of GABA, zinc, and magnesium. (Sometimes also B6, but we cover that in my article on Pyrrole Disorder.) So, coffee and caffeine consumption cannot be overlooked as a possible causative factor, since it inhibits GABA. Indeed, removing it seems to make a big difference for most people with these type of symptoms.

In more than a few cases, I’ve heard of full out panic attacks precipitated by drinking a cup of coffee, often with heart palpitations, sweating, and nausea so intense a person can feel they are having a heart attack. This usually only happens in a person who is not used to the beverage or someone who has become sensitized to it by going off it for a time then trying it again or by switching to decaf and then accidentally getting caffeine. 

You see, our bodies adapt to stressors and over time learn to cope with regular hits of caffeine, so going off it for a couple weeks then trying it again can be very telling to determine exactly what it’s doing to you. 

Be advised, however, this may not be a pleasant experience. 

In addition to inducing anxiety in some, I have witnessed caffeine induce psychosis in schizophrenics. My son has schizophrenia and his drug of choice (when unwell) is an energy drink. Or two. Or five. Why? The medications that are used to treat schizophrenia and bipolar can be deadening and energy robbing and seriously reduce the feel-good neurotransmitters in the brain. Antipsychotic medications, for example, specifically target and reduce the transmission/binding of dopamine. Caffeine increases dopamine, and is excitatory, triggering the release of adrenaline. The impact counterbalances the meds, in essence. And, if the late Dr. Hoffer was correct, adrenaline has a lot more to do with psychosis than is recognized. But I digress. What I’m saying here is that in those with low or otherwise blocked dopamine receptors – caffeinated beverages are a classic case of inadvertently self medicating to feel ‘normal.’

In clients who have autoimmune disorders that involve pain – in the joints or muscles – I see an incredible intolerance to caffeine. In those with fibromyalgia and rheumatoid arthritis it can be the missing link that causes 90 per cent of their aching and pain. I have researched why this might be and believe it to be attributed to the way the liver is burdened to break down caffeine. There are other explanations, as well. In those who have a reduced liver capacity due to chronic inflammation and immune system activation, the impact of the drug is more toxic. In any client with these conditions, I recommend trying a zero-caffeine diet for a month then re-introducing the drug. It’s such a factor I don’t know why I can’t find medical literature on it. I myself have experienced this with rheumatoid arthritis (RA) for which Tylenol 3 was given. Not until I ran out of the drug did I realize what was causing my pain and escalating symptoms. Tylenol 3 here in Canada contains caffeine. Taking it regularly caused my RA to flare horribly.

In clients with insomnia and or jimmy legs, coffee or caffeine consumption is often a factor. It can actually take up to 12 or more hours to clear caffeine fully from the system in sensitive people, or those on birth control or who are pregnant or menopausal. A good indicator that it’s too excitatory for you is if you notice a hot flash or jittery feeling starting just after you take it. Ladies, that is actually your liver speaking to you! A hot flush will often follow a trigger – emotional, environmental, or food – which requires your attention. Best to switch to Swiss water decaf or change your beverage altogether. 

Caffeine can also wreak havoc on blood sugar levels and create issues for diabetics. If you have diabetes, I suggest you read more here. 

Last, but not least, caffeine can be used therapeutically for those suffering depression, keto blues (shortly after switching to a keto diet), migraine headaches, and as a natural treatment for ADHD. It’s also well known to induce peristalsis – the natural muscle contractions of the intestine – to help get you going in another way. 

But, in a society wherein so many people have such a hard time switching off and relaxing, I can’t help wonder if we haven’t become a bit too obsessed with caffeinated beverages.

In my opinion, coffee is truly a powerful medicinal plant, not just a tasty-make-happy beverage, and if you have a pre-existing heart condition, it’s best to forgo caffeine in favour of other ways to boost your energy. Unfortunately, you will likely experience withdrawal symptoms and none of the alternatives are quick fixes.

The withdrawal symptoms can include brain fog, difficulty concentrating, fatigue, headaches or migraines, lack of energy, anxiety, depressed or low mood, irritability, and tremors. Your strength and stamina may also be impacted in the short term. Most of the withdrawal symptoms fade rather quickly after a week or two, as your body adapts.

For those who suffer cluster headaches or severe migraines it can be very difficult to go off caffeine without triggering the headaches. In these cases, it’s best to wean off very incrementally.

The good news is that there are healthy alternatives to coffee and they will have an impact that increases over time, quite the opposite of the impact of caffeine, which decreases over time.

So, let’s first look at tea as an alternative. Green tea is a great option. While it does naturally contain some caffeine, it’s less than that of coffee. Tea leaves – green and black included – have four brain stimulants compared to coffee’s one. These help explain why coffee and tea have such a different impact on the body. How does it compare? It has 35-50mg of caffeine per 8oz, compared to brewed coffee’s 100-200mg per 8oz, and espresso’s 200-700mg. So, while it has caffeine, it has much less and it acts very differently on the brain and body.

Additionally, green tea has numerous other health benefits. It’s a potent antioxidant, which inhibits ageing on a cellular level and it can increase insulin sensitivity to offset and improve type II diabetes. It’s also been shown to improve brain health and be protective against Alzheimer’s and cardiovascular disease. However, it’s really important to ensure green tea is organic, because the plant draws toxins from the soil that are harmful otherwise, with an affinity for fluoride.

Like green tea, matcha comes from the Camellia sinensis plant. However, it’s grown differently and has a unique nutrient profile.

Powdered green tea, called matcha tea, has a much higher caffeine content, but doesn’t always aggravate people the way coffee does. Although they both come from the Camellia sinensis plant, they are grown differently. Matcha crops are covered the last month or so before harvesting – which increases the chlorophyll and likely the antioxidant profile. It also increases the amino acids and deepens the colour.

What does a matcha buzz feel like? Think coffee without the wound-up nervousness, jitteriness, and energy crashes – owing to other compounds in matcha. L-theonine, for one. This amino acid has a mitigating effect on caffeine so you don’t feel the crash after, while simultaneously boosting GABA, decreasing the impact of stress and helping to improve sleep.

It also has an incredible health profile. It’s high in antioxidants and chlorophyll for one, both associated with cellular health and longevity. In some studies, matcha has been shown to help reverse liver damage and boost liver and kidney health, as well as increasing insulin sensitivity in diabetics. It’s been shown to boost brain health, including concentration and focus. This is likely in part to it’s L-theonine content. This amino acid mitigates the effect of caffeine so you don’t crash after, while simultaneously boosting GABA, serotonin, and dopamine levels. These powerful neurotransmitters help regulate mood, thinking, how alert you are, energy, and even sleep. Increasing these helps with all these functions.

In some studies, a component of green tea, EGCG (epigallocatechin-3-gallate) has shown anti-cancer capabilities. This nutrient has both brain-boosting and anti-tumor properties. In other studies, it has been shown to reduce the cholesterol that is controversially linked with heart disease and to keep cholesterol from oxidizing. Drinking tea has been correlated to a decreased risk of heart disease and stroke.

A surprising thing about matcha is that it gives a long-lasting energy. It can be added to health food drinks of various kinds, but beware of sugar in the commercial matcha smoothies! 

When matcha powder is added to a smoothie or mixed drink it seems to absorb more slowly than coffee, and does not produce such a spike in energy, anxiety, or heart rate. However, this buzz lasts a long time. You do not want to take it less than eight hours before you sleep! The first time I tried it was in an evening smoothie and I was up all night. My house has never been so clean!

After experimentation, I recommend a smoothie with high fat coconut milk (not beverage), 1 tsp to tbsp of matcha, erythritol/stevia sweetener (like truvia), and some vanilla whey protein (I prefer fermented whey) whizzed up in a blender. Energy and healthy breakfast all in one! This will keep you energized and satiated for hours. A bonus is you will not be tempted by goodies colleagues bring to the work place! 

If matcha isn’t your thing, black tea’s caffeine content can range from 25-100mg, and it has its own health benefits, so it can be an improvement for your condition. It does not hold a candle to the benefits of green tea, though, so if you’re going to make a change, it seems a no-brainer to me. 

I am going to suggest another option herein that may surprise you. It has nothing at all to do with caffeine. Part of the reason I think so many of us rely on caffeine so heavily to get going in the mornings is because we are so full of inflammation – which is usually most noticeable on waking. Removing the primary inflammatory foods (sugars, wheat, dairy) from your diet for two weeks, then adding one back in at a time, will tell you if this is indeed a factor and which ones trigger you. I think you may be really impressed with this test. It makes an incredible difference to most of my clients! Waking up stiff and achey, with low energy and brain fag is NOT a normal part of ageing!

Lastly, I want to recommend you add an adaptogenic tea to your routine – morning or night. This is a tea that helps the body cope with inflammation, fight ageing, and become more resilient to stressors. I’m speaking of jiaogulan tea. It’s not well known yet, but I predict it will be one of the big superfoods that catches on. It’s native to China and is used to enhance numerous health conditions and promote youthfulness. It contains many of the same compounds of ginseng and then some.  The studies keep accumulating! It’s used to boost immunity, mood, longevity, heart health, digestion, sleep, energy, weight loss, skin, respiratory conditions, and as a protective against cancer. Adaptogenic herbs both promote energy and sleep, as odd as that sounds, but it’s a well known fact among herbalists. But jiaogulan is bitter, so I recommend blending it with hibiscus tea, which is naturally sweet and packed with antioxidants and its own health benefits. Taking matcha in the morning and this combo in the evening would likely really improve your health!

Other than that, I recommend some morning exercise to help get you going, but you already knew that! Taken together, these tools will help transform you from Shawn of the Yawn to Shawn of the Dawn! 

As always, if you have your own health questions, don’t hesitate to send me an email at nonienutritionista@gmail.com. You can find out more about my work via my website at hopenotdope.ca. Until next week!

Namaste!

Nonie Nutritionista

Nonie DeLong is a registered orthomolecular health practitioner, licensed nutritionist in both Canada and the U.S., and student of the Ontario College of Homeopathy.  

Photo credit: © Kevin Menajang via Canva.com