Tuesday, September 12, 2006

stress management : Decrease or Discontinue Caffeine

In terms of "bang for the buck," it is hard to beat this simple intervention. Most patients do not realize that caffeine (coffee, tea, chocolate and cola) is a drug, a strong stimulant that actually generates a stress reaction in the body. I tell patients that the best way to observe the effect of caffeine is to get it out of the system long enough to see if there is a difference in how they feel. Three weeks is adequate for this purpose and all my patients accept this suggestion, especially when I frame it as an experiment. ("If you dont notice a difference, you can go back to it; but if you feel better without it, you will probably want to stay off it.") I would guess that 75% to 80% of my patients notice a benefit. They feel more relaxed, less jittery or nervous, sleep better, have more energy (a paradox, since you are removing a stimulant), less heartburn and fewer muscle aches. Many patients feel dramatically better and cannot believe the difference.

One warning, however. Patients must wean themselves gradually or they will get migraine-type withdrawal headaches. I suggest decreasing by one drink per day until they are down to zero, then they should abstain for three weeks. When they feel better, they will thank you. In fact, you will be a hero because it is such an easy thing to do and delivers a big payoff. Incidentally, I do not believe caffeine is a highly addictive substance. I have never met a patient in 10 years who could not give it up within one week.

copyright © 1995-2005 by Phillip W. Long, M.D.

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