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Ultimately caffeine is a drug; let’s not fool ourselves. It gives us a surge of energy, clarity and the ability to take on the day. When we have some we feel on top of the world, when we don’t we come crashing down into fatigue, lowered mood and a post endorphin let down. Sounds like a drug now doesn’t it. I often joke with my patients that I love caffeine, but it doesn’t love me. I love the smell of coffee, the taste and the euphoric rush. My body however hates the adrenalin overload, the anxiety, the palpitations, the insomnia. It hates the let down, the lowered mood, and the fatigue post rush. It’s a spectacularly addictive substance with a predictably magnificent addictive cycle. Up you go and down you crash. As much as I love it, my body simply does not.

I once saw a patient who consumed – I kid you not – 25 cups of coffee per day. Bless him; he drank 25 cups of espresso no less. He saw me and explained that he wasn’t sure why but he was finding it hard to sleep, to eat, to maintain his relationship with his wife. The only real reason he was initiating treatment was simply that his 2-year-old son was imitating him as 2-year-old boys do and he was worried what this would do to his health.

In addition to all the effects listed above, caffeine is also an incredibly potent diuretic. One coffee or tea and you’ve lost at least another glass of hydrating water. As our bodies are comprised of between 45-75% of total body mass, if you take the average coffee or tea drinker, 1L of fluid loss is quite substantial. If you also account that you need a minimum of 30ml per kg body weight per day then it’s easy to realize that most people are in serious hydration deficit. Don’t underestimate the power of dehydration. Dehydration causes many things from headaches to fatigue to allergies.

If you are going to drink it, enjoy it, savor it and make it the best you can find. If you really can’t give it up, at least make sure you reduce, drink a glass of water for every cup and please don’t just switch to decaf thinking it better. Ever wondered how they strip the caffeine out?