*Updated 01/12/20*

There’s an awful lot about caffeine in the media these days, isn’t there?

Is it good for you? Bad for you? How much is too much? Are you addicted to the taste or the effect? It’s hard to tell from all the conflicting reports.

One day, you might see a headline telling you that caffeine is good for you; that it can promote good health, longevity, and weight loss. The next article may tell you that the stimulants in caffeine cause any number of ill effects, and the toxins that the beans are treated with will hurt you!

With so much contradiction from one report to the next, what should you believe?

I believe that a cup or two a day of coffee should be okay and unlikely to cause harm for many women, but there are some notable exceptions. First of all, some women are more sensitive to caffeine than others. There are also a number of conditions that can increase the risk of caffeine being problematic, including diabetes, insomnia or other sleep disorders, and anxiety.

The other concern I have, which is actually quite a common one, is with the use of caffeine for women whose adrenal health may be in question.

The Questions We Should Be Asking About Coffee

Media reports have flip-flopped over the years when it comes to embracing the health benefits of coffee versus planting seeds of fear about its possible risks and side effects.

Recently, the trend seems to be erring on the side of celebrating coffee and its health-promoting properties. Research has found that moderate coffee intake may reduce the risk of a number of chronic diseases, some cancers, neurodegenerative diseases like Alzheimer’s, liver disease, and type 2 diabetes, to name a few.

These generally positive studies and the flashy headlines that have accompanied them have led to the popularization of a new question. Instead of “is coffee healthy or unhealthy?”, many people are starting to ask “how much coffee is healthy?”.

This might seem logical at first, but this way of thinking can actually be a slippery slope! For example, a large study of more than 350,000 people published in 2019 found that 6 cups of coffee per day or more seemed to be the tipping point after which the higher risk of cardiovascular disease set in.

But does this mean that we can or should all start drinking 5 cups of coffee per day without a second thought, because anywhere below 6 and we’re in the clear (as some media outlets suggested following this study)? Not from where I’m standing!

There are so many other factors that go into any individual’s response to caffeine, and there are so many more nuanced effects of caffeine on the way our bodies and minds work, beyond the risk of developing specific diseases.

Instead of asking whether or not coffee is healthy, or how much coffee is the right amount, I think we should be asking ourselves (individually, and with the help of our healthcare practitioners) how coffee is or may be affecting us.

There are all kinds of factors that go into answering this question, including genetic makeup, hormonal balance, diet and lifestyle factors, current stress levels, and adrenal function.

Caffeine and Adrenal Fatigue

Coffee is a comfort for many of us. Drinking coffee is a central component of many of our social circles, and we often look forward to a warm cup of coffee first thing in the morning. Especially for women with adrenal fatigue, it might even feel like a necessity in order to function in the morning and throughout the day.

For many women, the surprising news is that this very cup of comfort in their hand could be disrupting the delicate balance of adrenal function.

We all know that caffeine is a stimulant — however, it’s actually a psychoactive stimulant. When ingested, it increases neuron firing rates in the brain and stimulates both the sympathetic and central nervous systems. In some ways, it mimics our instinctual ‘flight or fight’ response to stress.

With 200 mg of caffeine (the amount in a small coffee) your body will begin to push out stress hormones – the hormones that send the message to be on alert, think fast and act fast!

It makes sense doesn’t it? After all, this is the reaction many people are looking for when they reach for their ‘cuppa Joe’ first thing in the morning!

Caffeine makes your pupils open wide, your breathing intensify, your heart beat faster, and your liver release sugar and fatty acids into your blood. The question is do you really need all that? If your answer is “yes!” – then you really should think about your adrenal health.

When caffeine is used too often, or when used at the wrong time of day, it can cause disruption with your regular cortisol rhythm.

Caffeine causes your body to think it’s in a state of emergency – and so your body gets to work releasing the hormones to keep your prepared! Ultimately, these unnecessary hormones are going to work against you (maybe even make your symptoms worse) and you may feel the need to reach for more caffeine.

A cycle starts to occur – and up and down cycle that’s bound to make you more tired, more wired, and more unbalanced.

We have to remember that the adrenal glands have a variety of functions; one is that they also help maintain levels of sex hormones as a woman transitions through life. They play a critical role, particularly during the perimenopausal years as ovarian function tapers off.

These small glands can only do so much, and if they are constantly being called on to produce stress hormones, then keeping the sex hormones in balance may be compromised. Those extra caffeine boosts might very well be affecting your hormonal balance, which can lead to a whole range of other uncomfortable symptoms.

Many women are very surprised to learn that there is data proving caffeine is a highly active metabolic agent which impacts both adrenal imbalance and insulin resistance. It is very common for women to have both – and it’s so important to address both to ensure your body moves back into balance!

When you are under stress (either real or perceived!), higher cortisol levels will cause more glucose to be released. When this happens, your pancreas increases its insulin output to help get all that glucose into your cells.

Studies show that in women who are already insulin resistant, the caffeine will exaggerate their insulin and glucose response. So, a morning cup of coffee may explain the dip in energy and fuzzy thinking you experience in the afternoon! This is especially true if you add sugar or creamers to your coffee.

If you reach for more caffeine, and perhaps carbohydrates, for energy the cycle will start all over again.

Final Thoughts

The relationship between caffeine and health can be confusing – there are so many factors that impact the reaction.

Men and women vary significantly in their reactions. Other factors include whether caffeine is ingested alone or with food, what health challenges the body is experiencing, and if the caffeine is paired with carbohydrates.

Research is showing that tea does not affect insulin in the same ways as coffee. It actually suggests that tea has the opposite effect, helping to reduce blood glucose.

When I suspect that caffeine may be impacting a patient’s health, I’ll often suggest that it be eliminated from the diet for a day or two in order to complete a 24-hour test I use to evaluate adrenal function.

Some women can’t even consider it; they start to panic thinking about it, or may even break down into tears. We have to keep in mind that caffeine is an addictive substance – there can be both physiological and psychological connections. The last thing we want to do when healing the adrenals is to cause more stress!

So, please remember that cutting back or quitting caffeine doesn’t have to happen all at once. Decrease gradually, and be gentle to your body. But for some that morning cup of coffee is part of the morning ritual and can be very healing, Remember we are all different!

After all, healing and balance is your ultimate goal!

Reviewed by Dr. Mark Menolascino, MD