Coffee: The Highs and Lows

(Originally published as a newsletter for The Dragontree Holistic Day Spa)

I get asked about coffee by patients so often that I thought it was about time to write an article thoroughly examining it from all angles. About 83% of adults in the United States drink coffee, usually on a daily basis. Unlike stronger recreational drugs, the potential drawbacks of coffee are usually fairly mild. But if you endeavor to achieve great health – and especially if you’re struggling with a health problem – it’s worth being honest with yourself about whether coffee is contributing to or detracting from this goal.

What’s Good About Coffee

So many people worldwide depend on coffee to wake them up, get them motivated, make them feel sharp, promote digestion, and even lift them out of mild depression. Is that so bad? Well, depending on your constitution, maybe not.

Scientific research has shown that coffee consumption appears to reduce one’s risk of developing type 2 diabetes, Parkinson’s disease, and colorectal cancer. One constituent that’s especially interesting and abundant in coffee is called chlorogenic acid. Chlorogenic acid is an antioxidant, it seems to slow glucose release after eating (so it may help maintain stable blood sugar), it promotes bile secretion, reduces gallstone formation, maybe reduces the incidence of liver disease, and probably promotes weight loss. Chlorogenic acid is much more abundant in green (unroasted) coffee beans than the roasted ones, which has led to the fad of “green coffee extract” for weight loss.

A drawback of chlorogenic acid is that it may interfere with the absorption of certain minerals – namely zinc and iron – from the intestines. For this reason, it may be best to consume coffee or take green coffee extracts a few hours apart from food. Or consider taking extra zinc (or a multimineral supplement). I don’t generally recommend consuming iron supplements, though, unless you have a known iron deficiency. Incidentally, coffee isn’t the only thing that has the potential to interfere with iron absorption. Many compounds (knows as polyphenols or monomeric flavonoids) can do this, and they’re found in black tea, peppermint, chamomile, chocolate, and other natural foods and drinks.

Due to its flavor, coffee acts as a digestive bitter. Like other bitters, it tends to “activate” the digestive system, stimulating intestinal movement and the production of gastric juices. This is why coffee is a popular after dinner drink. However, if you add cream and sugar to it – diminishing its bitterness – you probably also diminish its value as a digestive stimulant.

What’s Bad About Coffee

The energy-boosting, mind-sharpening effects of coffee result from the fact that it’s chock full of vitamins, minerals, and everything else our bodies need for good nutrition. Every cup is like consuming a complete, balanced meal.

Were you excited for a moment? Of course, the truth is almost the opposite. Coffee is a stimulant. And we’re stimulant addicts. Let’s just be real about that. The first thing I want to know when a patient tells me about their coffee habit is, “How would you feel without coffee?” If the answer is “tired” or “withdrawn” or “constipated” or anything else unpleasant, then I think it’s worth considering whether or not coffee is the best remedy. There are dozens of possible causes of fatigue, and most of them are not coffee deficiency. These issues are best addressed in a more direct, non-coffee way. If coffee consumption masks them, it means putting off a real solution.

Fatigue: If someone is fatigued because of depletion – and often I think of adrenal depletion (the endocrine glands most directly involved in our stress response) – then coffee is specifically a bad idea. Stimulants just drain these glands of what little energy they have left, and make recovery impossible. Adrenal deficiency can lead to reduced immune function, lightheadedness, sleep problems, anxiety and depression, inflammation, hypoglycemia, and other symptoms. If this sounds like you, see a naturally oriented healthcare provider, and meanwhile, try quitting coffee.

Hypertension: Coffee can raise blood pressure, especially in people who consume a lot of it. Regular coffee drinkers tend to develop some tolerance to this effect.

Digestive Upset: The combination of coffee’s acids, its bitterness, and its strong stimulating effects can cause digestive discomfort, nausea, acid reflux, diarrhea, and exacerbation of ulcers in certain individuals. Those with irritable or inflammatory bowel disorders, ulcers, or GERD should be especially cautious with coffee.

Sleep Problems: Despite our visceral understanding of what coffee does to us, many folks with bad sleep don’t consider that their coffee might be part of the problem. If sleep doesn’t come easily and deeply for you, you should at least avoid coffee after noon. Sometimes even just a morning cuppa is enough to disturb our slumber.

Anxiety: As with insomnia, it shouldn’t be surprising that stimulation can contribute to anxiety. Yet most of my anxious patients consume it and nearly all of them improve when they quit.

If you have insomnia, anxiety, or digestive upset, come up with a scale to evaluate how bad it is, then quit coffee and re-rate it after a couple weeks. When coffee contributes to these problems, it’s due to overstimulation. Frequently, as with adrenal fatigue, there’s a background of “diminished buffer.” It’s like running high voltage electricity through thin wires with not much insulation on them. It’s worthwhile to consider what kind of wiring you have, meaning, how sensitive your nervous system is to stimulation. Thin, stressed, and underslept people tend to be less able than others to handle caffeine and other stimulants well.

Dyslipidemia: Coffee can raise LDL and total cholesterol when consumed in large amounts. However, this may be meaningless in terms of the actual health risk it represents. Also, this effect is thought to be mainly due to chemicals that are very effectively removed with a paper filter.

Inflammation: A 2004 study examined numerous markers of inflammation in the blood of over 3000 Greek men and women. It found that in people who consumed over 200 milliliters of coffee a day (that’s about 6.75 ounces), all indicators of inflammation increased. The funny part is that in their conclusion, they wrote, “A relation exists between moderate-to-high coffee consumption and increased inflammation process.” Moderate-to-high coffee consumption?! Clearly they’ve never been to the United States.

Bone Weakness: High doses seem to be associated with increased osteoporosis and hip fracture in older women.

Dehydration: Coffee is a diuretic – it promotes urination. Medically speaking, sometimes there’s a need for a diuretic, but for most people, this property of coffee just means an increased risk of dehydration. Drink extra water to make up for this effect of coffee.

Pregnancy and Nursing: Coffee, especially in larger amounts, probably slightly impairs fertility in women (perhaps in part by interfering with iron absorption), increases risk of miscarriage, and may contribute to low birth weight. Lots of coffee consumption by nursing mothers may degrade babies’ quality of sleep and make them irritable. Pre-term babies seem to be more affected.

Acrylamides: Roasting coffee produces chemicals called acrylamides which are considered a “probable human carcinogen” by several public health agencies. It may be worthwhile to choose a light or medium roast, which, in my opinion, also produces a better flavor, and is also likely to retain more chlorogenic acid. (Incidentally baking or frying starchy things, such as flour and potatoes, also produces acrylamides, with French fries having the highest content.)

Other Factors to Consider

Dosage: Many of the studies revealing health problems from coffee consumption looked at people who consumed large amounts – like five cups a day. But before you dismiss them because you only have two cups a day, consider that a regular cup of coffee is just 6 ounces. That means your Venti from Starbucks is more than 3 cups – which would put you right about at the average of 3.1 cups per day for an American coffee drinker.

Additives: What are you adding to your coffee? It might be worse for you than the coffee. A 16 ounce latte contains about 14 ounces of milk or milk substitute. That’s a lot of milk, especially for an adult. If you use soy milk, keep in mind that it’s bean juice and many people have problems digesting it. If you get your latte from a café, it’s unlikely that they use organic milk or soy, so the soy milk is almost guaranteed to have come from genetically modified beans (and probably also highly sweetened). Dave Asprey, a self-styled “biohacker” advocates the use of “upgraded” mold-free coffee beans to brew your coffee and then, instead of cream and sugar, pureeing this with a combination of butter from grass-fed cows and medium chain triglycerides or coconut oil. Stevia, xylitol, or erythritol can be used as a non-caloric sweetener. He calls it “bulletproof coffee.”

Pesticides: Many coffee producing countries happen to be rather indiscriminate users of agrichemicals, and often the kinds and application of these chemicals are unregulated. Luckily, there are still farmers who grow coffee in the same way they have for generations – all natural. Look for coffee from Yemen, Ethiopia, and Sumatra, or anything that’s certified organic.

Traditional Thinking: Although coffee is widely and indiscriminately consumed by everyone who likes the taste or wants a boost, it may be worth applying the wisdom of traditional medical systems, which tend to view it as more of a medicine than a food. That is, it has specific properties – stimulating, drying, and heating, for example – that make it appropriate only for certain people. Just as one wouldn’t assume that everyone could benefit from an antibiotic, it might be shortsighted to assume that everyone’s body and mind should benefit from coffee.

In conclusion, if you choose to drink coffee, here’s my advice: Consume it in moderation, meaning one or two cups (six to eight ounces each) per day. Remember to rehydrate – drink as much extra water as the volume of coffee you consume. Consider using a paper filter to remove some of the unhealthy constituents. Skip the sugar and minimize the milk/cream. Avoid non-dairy creamer, even if it’s the only option. Choose clean, good quality, light to medium roast beans. If you use a coffee maker, clean the water reservoir (which harbors bacteria) with vinegar at least once a month. Know how your body and mind respond to it (the big picture, please), and if they don’t like it, respect their wishes.

Be well,

Dr. Peter Borten