“I’m useless ‘til I’ve had my morning coffee.” How often
have you heard this statement from a coworker, a friend, or even yourself? It’s
almost a cliché in our culture that to get ourselves going in the morning, we need
a caffeine jolt first thing — many of my patients reach for coffee, tea, or
cola before they’ve even gotten dressed or had breakfast.
And you know, there’s nothing wrong with that — in moderation. But for
many women, caffeine masks an adrenal imbalance that may be preventing them from
restful sleep. If a woman says she simply can’t function in the morning without
caffeine — or that she needs “booster cups” later in the day —
that’s when she might start thinking there could be an issue with her adrenals.
Caffeine itself isn’t the sole cause of
adrenal fatigue, but many of the changes our bodies undergo when we use
a lot of caffeine can strain our adrenals. If we substitute a cup of coffee for
sleep or for a nutritious meal, it can undermine our adrenal health. So let’s
take a closer look at how caffeine affects our bodies — our adrenal glands,
Caffeine stimulates the stress response
Caffeine is a psychoactive stimulant, which means it increases the rate at which
neurons in the brain fire and stimulates both the central and sympathetic nervous
systems. This stimulation is similar to our natural “fight or flight”
reaction to stress. Both originate along the HPA axis: with just 100–200
mg of caffeine (less than one short cup of Starbucks drip coffee), your Hypothalamus,
Pituitary, and Adrenals begin pumping out stress
hormones — epinephrine (aka adrenaline), norepinephrine,
These stress hormones are needed for our bodies’ innate response to a real
or perceived threat, sending the message: Think fast! Act fast! That’s
why, after that cup of coffee your pupils dilate, your heart beats faster, your
blood vessels dilate, your breathing intensifies, your muscles contract, and your
liver releases sugar and free fatty acids into the blood for instant energy. You
may also feel more anxious and worried, with no more cause for these feelings than
the shot of caffeine you just drank. You are literally poised and ready to outrace
and outwit any danger — but most of the time you’re sitting at your
desk or behind the wheel of your car.
That’s great for productivity and alert driving. Your adrenals’ “mission
critical” is to ensure survival. But the secondary function of our adrenal
glands is to provide for hormonal balance across the life span — and this function
is particularly important as we get older.
Caffeine, adrenals, hormones, and insulin — a complex relationship
Caffeine isn’t likely to do most women much harm if it’s just a cup or two a day.
Of course, some women are highly sensitive to caffeine, but that’s rare. For many
more women, caffeine becomes a problem when it’s used too often or at the wrong
time of day (in the evening, for instance). That’s because caffeine disrupts the
regular rhythm of cortisol. In effect, it distances you from your natural energy
cycles, tricking your body into a state of emergency or
high cortisol — which ultimately makes you feel more tired. If you use caffeine
to offset fatigue, your solution may actually be part of the problem — especially
if you become too wired to rest when the time comes, and start reaching for more
But the adrenal glands don’t just produce stress hormones — they also
help to maintain levels of sex hormones as a woman transitions into menopause and
her ovarian function tapers off. They just can’t do that when they’re
constantly under siege — whether from real stress in your daily life, or from
a turbo-charged caffeine hit every few hours, day after day. So indirectly, caffeine
may be affecting your hormonal balance.
Another piece of the puzzle is insulin resistance. Normally when you’re under
stress, an increase in cortisol levels will prompt more glucose to be released into
your bloodstream. Then your pancreas increases its insulin output, to usher all
that extra glucose into your cells, where they can fuel your “superhuman”
response to the “threat.” But in women whose cells are already insulin
resistant, studies show that caffeine exaggerates their glucose and insulin responses.
That’s one reason why you may experience sudden energy dips in mid afternoon
if you’re caffeine-dependent in the morning — not only has the caffeine
jolt worn off, but it has affected your insulin activity such that your blood sugar
can become low in the mid afternoon, making you feel fuzzy-headed and fatigued.
So you reach for more caffeine to clear your head, and sometimes more carbs as well,
which just makes the cycle repeat all over again — and simultaneously worsens
the insulin resistance (particularly if your caffeine is paired with sugar).
A lot of factors determine caffeine’s effect on insulin sensitivity. For example,
it varies significantly between men and women; what condition the body’s in; whether
caffeine is taken when fasting or with meals; and whether it’s paired with carbohydrates
— particularly when taken with sugar. What’s more, tea does not appear to have the
same insulin-deregulating effects as coffee. In fact, research suggests that tea
does the opposite — it actually helps reduce blood glucose — because of its polyphenol
content, rather than any action of caffeine. But even though we’re still connecting
the dots on all this, the data clearly cast caffeine as a highly active metabolic
agent that impacts both insulin resistance and
adrenal stress imbalance. The two issues compound one another, and it’s
very common for women to have both. Which comes first is like the chicken-or-egg
question --, so for optimal healing, you should address them both at the same time.
Finding healthy balance between caffeine and adrenal health
We realize that caffeine is not an easy drug to quit for some women. Caffeine is
an addictive substance, both physiologically and psychologically, so stopping “cold-turkey”
may cause you so much stress and discomfort that its absence does you more harm
than good. (After all, when healing the adrenals, the goal is to minimize stressors!)
So when you’re ready for a
caffeine detox, remember that it’s not something that needs to happen
all at once. If it takes you a while to cut back, that’s okay. Adrenal healing
doesn’t happen overnight, and we wouldn’t want you to expect it to!
The message here is not that you must live the rest of your life without caffeine
— rather, you may want to consider a caffeine holiday to help your adrenals heal.
But you’ll need to look at your eating habits and stress patterns, too — which will
actually be easier if you eliminate the “noise” that caffeine creates between you
and your body’s natural rhythms. There are great
herbs for energy that can help boost your adrenals too. Once the adrenals
recover, you’ll be in a much better place to create a healthier relationship with
1 Brain, M., & Bryant, C. 2000. How caffeine works. URL: http://health.howstuffworks.com/caffeine.htm
2 Robinson, L., et al. 2009. Acute caffeine ingestion and glucose tolerance
in women with or without gestational diabetes mellitus. J. Obstet. Gynaecol. Can.,
31 (4), 304-12. URL: http://www.ncbi.nlm.nih.gov/pubmed/19497149 (accessed
Lane, J., et al. 2008. Caffeine increases ambulatory glucose and postprandial
responses in coffee drinkers with type 2 diabetes. Diabet. Care, 31 (2),
221–222.URL: http://care.diabetesjournals.org/content/31/2/221.full (accessed 08.07.2009).
Lane, J., et al. 2007. Caffeine in coffee exaggerates postprandial hyperglycemia
in type 2 diabetes. Endocr. Pract., 13, 239–243. URL (abstract): http://www.ncbi.nlm.nih.gov/pubmed/17599854
Graham, T., et al. 2001. Caffeine ingestion elevates plasma insulin
response in humans during an oral glucose tolerance test. Can. J. Physiol.
Pharmacol., 79 (7), 559–565. www.ncbi.nlm.nih.gov/pubmed/11478588 (accessed
3 Lane, J., et al. 2008.
4 Brain, M., & Bryant, C. 2000.
5 Thong, F., & Graham, T. 2002. Caffeine–induced impairment of glucose
tolerance is abolished by beta-adrenergic receptor blockade in humans. J. Appl.
Physiol., 92 (6), 2347–2352. URL: http://jap.physiology.org/cgi/content/full/92/6/2347
6 Louie, JCU., et al. 2008. Delayed effects of coffee, tea, and sucrose
on postprandial glycemia in lean, young, healthy adults. Asia Pac. J. Clin. Nutr.,
17 (4), 657–662. URL: http://www.ncbi.nlm.nih.gov/pubmed/19114405 (accessed
7 Stote, K., & Baer, D. 2008. Tea consumption may improve biomarkers
of insulin sensitivity and risk factors for diabetes. J. Nutr., 138 (Suppl.),
adrenal symptoms today