Dr. Tom Ferguson wrote the Medical Self Care column in this magazine in the early 1980s.
Millions of law-abiding North Americans are physically
addicted to caffeine—a potent central nervous system
(CNS ) stimulant—and aren't even aware of it. When
deprived of their "fix," such addicts often experience
severe withdrawal symptoms. These may include
depression, throbbing headaches, disorientation,
constipation, nausea, sluggishness, and irritability. And,
as with other addictive drugs, heavy users often develop a
tolerance, and require even higher doses to obtain the
Other negative effects of caffeine include a dramatic increase in
the rate of oxygen use by cells, muscle tension , stomach acid secretion, and blood pressure—as much as 14% when taken in the form of two to three cups of
Caffeine has also been
implicated as a possible contributing factor in birth
defects and fibrocystic breast disease. (In fact, extremely
large doses are potentially fatal.)
In spite of its potency, caffeine has only one medical use:
the treatment of poisoning by CNS depressants. In
fact, if caffeine were a newly synthesized drug, its
manufacturers would have great difficulty getting it
licensed for sale. And if it were licensed,
it would certainly be available only by prescription.
Yet more than two billion pounds of coffee are
consumed in this country each year. And caffeine is
also found in teas, cola drinks, chocolate, and
many over-the-counter "medicines."
A Case of Caffeinism
People's reactions to caffeine differ greatly, but an
intake above one's Individual limit—whatever that may
be—produces "caffeinism," a condition with symptoms
indistinguishable from those of anxiety neurosis: extreme
nervousness, irritability, tremulousness, chronic muscle
tension, difficulty falling asleep, trouble sleeping
soundly, sensory disturbances, increased frequency of
urination, frequent loose stools, gastrointestinal upsets,
and those alarmingly strong and rapid heartbeats that are
known as palpitations.
However, in spite of caffeine's harmful effects, a
researcher who recently reviewed the medical records of 100
randomly selected psychiatric outpatients found that not a
single form contained any information about the person's
tea or coffee habits, although 42% of the records made
mention of anxiety symptoms. (One wonders just how
many tranquilizer prescriptions have been handed out to
clients suffering from undiagnosed caffeinism ... a
condition that's estimated to affect up to 15% of all
Most surveys of U.S. coffee drinkers agree that about 25%
consume at least five cups of coffee per day, a
caffeine dose of 500-600 milligrams (mg.). Various
researchers have used values ranging from 200 mg. to 750
mg. of caffeine per day as presumed "danger points," above
which one is assumed to be at a high risk of caffeinism.
(Since the drug's effects depend on both dose and body
weight, a young child who drinks one cola may experience
the same problems—irritability, irregular heartbeats,
insomnia—as does an adult who has four cups of
A lethal dose of caffeine for a healthy, adult male is
approximately 10 grams, the equivalent of 80-100 cups of
coffee, but—because our bodies can break down
caffeine and excrete it rapidly—deaths from overdoses
of the stimulant are virtually unknown.
However, both moderate and heavy coffee drinkers
can experience withdrawal symptoms if they go without
caffeine for 24 hours. For most people, the first sign of
deprivation is a headache that may develop as early as 18
hours after their last "fix." It typically begins with a
feeling of cerebral fullness and progresses to a diffused,
painful throbbing that's frequently made worse by exercise
... but is, of course, relieved by drinking coffee or
tea, or taking a caffeine-containing pain remedy such as
Anacin, Vanquish, Excedrin, etc.
Special Caffeine Risks
The caffeine equivalent of five to six cups of coffee per
day has been shown to increase the risk of birth defects in
laboratory animals. One recent study showed that,
among women who exceeded 600 mg. of caffeine per day, only
one in 16 had a normal delivery. The other 15 pregnancies
ended in spontaneous abortion, stillbirth, or premature
An Ohio State researcher found that many women with
fibrocystic breast disease (benign breast lumps) could
shrink or eliminate the cysts by cutting caffeine from
their diets. In fact, in 65% of the women observed, these
problems disappeared completely within two to six
months after giving up the drug.
Studies on the correlation between caffeine and heart
problems are in conflict, but until this controversy
is settled, it would seem wise for people with heart
disease or high blood pressure to confine their caffeine
intake to low levels.
Watch Your Habit
Though caffeine can be a useful tool at times, many people
who decide to reduce or eliminate this substance altogether
experience an improvement in the quality of their lives.
Here are some things to keep in mind when trying to
determine just how great a role caffeine plays in
Most folks tend to substantially underestimate their
caffeine intake ... so try maintaining a log to learn how
much you really consume.
Remember that reactions to this drug are extremely
variable. Some people can't touch it, while others ingest
substantial amounts without undesired results. Also, an
individual's response can change over time.
If you decide to eliminate caffeine, consider tapering off.
If you stop "cold turkey," you may experience a headache or
morning drowsiness for as long as a week. (One way to cut
back is to mix decaffeinated coffee half and half with your
regular brew. Tea can also help a heavy addict taper down,
as the average cup of the beverage contains less than half
the caffeine of brewed coffee.)
Consider, too, using nonliquid coffee substitutes. Many say
that caffeine helps "get them going" ... but a short
morning run, 15 minutes of yoga, or a brief meditation
session may have the same positive effect without any of the negative ones.
At any rate, experiment with your caffeine intake.
Consider, perhaps, going for a week without coffee to see
how it feels. One friend who recently did just that decided
afterward to use caffeine only occasionally.
"I feel I'm so much more in control of my life ... even
emotionally! " she explained. "Before, I was always
rushing. Now I'm moving at my proper pace. It's so nice to
wake up in the morning without the need to drink something
in order to function."
In 1976, Tom Ferguson—then a fourth-year medical student at Yale—launched a magazine called Medical Self-Care, which he hoped would serve as "a Whole Earth Catalog of the best medical books, tools, and resources."
Tom spoke of his plans for the publication and of his conviction that self-care could raise the general level of health in this country and lower our inflated levels of medical spending in a MOTHER EARTH NEWS interview, and left no doubt that he would work toward making those "dreams"come true.
Well, Tom Ferguson is Doctor Ferguson now, and the medical self-care "movement" has flourished. People are beginning to assume more responsibility for their own well-being and are eager for information that will help them take better care of their bodies.
So in an effort to provide just such very necessary data, MOTHER EARTH NEWS offers this regular feature by Tom Ferguson, M.D.