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The Wellness Blueprint: With Dr. Caleb Davis
Welcome to The Wellness Blueprint with Dr. Caleb Davis, where we uncover the secrets to living a long, active, and pain-free life. Hosted by Dr. Caleb Davis, an orthopedic surgeon and fitness enthusiast, this podcast is your ultimate guide to musculoskeletal health, injury prevention, and wellness.
Dr. Davis combines his expertise as a shoulder and elbow specialist with a passion for empowering people to take charge of their health. From deep dives into cutting-edge restorative medicine to practical tips on avoiding surgery and optimizing recovery, The Wellness Blueprint offers valuable insights for anyone seeking to preserve their body and thrive at every stage of life.
Join us each week for professional guidance, fascinating medical discussions, and actionable strategies that help you move better, feel stronger, and stay functional for years to come. Whether you're an athlete, a weekend warrior, or someone looking to age gracefully, The Wellness Blueprint provides the tools to design a healthier you.
The Wellness Blueprint: With Dr. Caleb Davis
Episode 18: Caffeine Chronicles: The Risks and Rewards of Your Daily Buzz
Could your daily cup of coffee be doing more than just waking you up? Join us as we explore the complex world of caffeine with our special guest, Nicole, who shares her journey of swapping energy drinks for more natural sources like coffee and tea. We promise you'll gain insights into the science behind caffeine's absorption and metabolism, its impact on focus and athletic performance, and even its potential protective effects against neurodegenerative diseases. From morning rituals to pre-workout supplements, discover how this legal stimulant plays a pivotal role in our daily lives.
Ever wondered why you crash after that afternoon espresso? We tackle caffeine’s less savory side, including its impact on sleep and overall health. Explore the fascinating mechanics of how caffeine blocks adenosine, potentially leading to energy crashes and withdrawal symptoms. We also bring a dose of levity to the discussion with humorous anecdotes about caffeine tolerance and the metric system, while highlighting the real dangers of excessive caffeine intake—think arrhythmias and elevated blood pressure. Learn what constitutes a lethal dose of caffeine and compare the caffeine content in everyday beverages.
Finally, we address the broader health implications of caffeine. While there's buzz around its benefits for heart health and potential to reduce risks of Alzheimer's and Parkinson's diseases, moderation remains key. We delve into the murky waters of the supplement industry, emphasizing the lack of regulation and urging caution when choosing products. With tips like the intriguing "caffeine nap" and advice on mindful consumption, this episode offers a balanced look at how caffeine can enhance or hinder your health journey. Tune in to unlock the secrets of responsible caffeine consumption and maybe even transform your morning routine.
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Hey everybody and welcome back to the Wellness Blueprint. Today we're going to dive into something many of us use every single day but may not fully understand all of the implications and side effects from this particular type of product. Let me start over.
Speaker 2:Okay.
Speaker 1:Hey everybody and welcome back to the Wellness Blueprint. I'm your host, Dr Caleb Davis, and as usual, I'm joined by the wonderful and talented and absolutely percolating Nicole Davis.
Speaker 2:Ooh, percolating. I like this word. I think it fits into our theme for today, right?
Speaker 1:What are we covering today, Nicole?
Speaker 2:We are covering my very favorite legal drug that I take every day to function.
Speaker 1:And what would that be?
Speaker 2:That would be caffeine.
Speaker 1:That's right. So a good friend of mine um, very good friend of mine, Dan, who's a regular listener of the show, asked us to cover pre-workout and energy drinks and caffeine and coffee. So we we just turned this all into one episode, so we're going to discuss this ever prevalent, ubiquitous stimulant.
Speaker 2:I can tell you, I've taken pre-workout a handful of times and my scalp felt tingly.
Speaker 1:Yeah, we'll get into that a little bit too, because that's one of the best parts of a pre-workout if it has the product, that does that.
Speaker 2:Okay.
Speaker 1:From that morning coffee to those bright cans of energy drinks at the gym. These stimulants fuel our days, workouts and sometimes even our all-nighters. But how much do we really know about them? Are they helping? Are they hurting? Today we'll uncover the benefits, risks and hidden truth behind these popular energy boosters. We'll also talk about surprising facts like the caffeine nap phenomenon, what really happens during caffeine overdose, and some lesser-known alternatives. Plus, we'll dive into the detailed pharmacology and metabolism of caffeine straight from the scientific sources. Nicole, I'm sure you're absolutely thrilled about that.
Speaker 2:Yeah well, you know, mostly I'm just worried they're going to make me do dry February of no caffeine.
Speaker 1:We'll talk about caffeine abstinence too, so grab your coffee or energy drink, or maybe reconsider it, and let's get started in the show.
Speaker 2:Herbal tea. How about that?
Speaker 1:There you go. That would be a good alternative for you. So, as you know, I'm prone to get into the weeds and the science a little bit about this stuff, so you stop me if you feel like it. But we're going to start with how caffeine is absorbed into the body and how it's distributed and metabolized. So caffeine is very rapidly absorbed. About 99% of the caffeine you drink is absorbed within 45 minutes of drinking it.
Speaker 2:Yeah, I figured that.
Speaker 1:Yeah, so that's pretty quick and you'll have peak plasma concentrations about 15 to 120 minutes from absorption, meaning that's when it's most concentrated in your blood, and the half-life, which means how fast it's eliminated from your body, ranges from an hour and a half to nine and a half hours. It's influenced by a number of factors like age, if you smoke, if you're pregnant, if you're taking oral contraceptives, birth control and many other factors. Also, if you're on an empty stomach or how hydrated you are Hydrated. I guess they should have listened to our previous episode.
Speaker 2:It's not Also if you're on an empty stomach or how hydrated you are Hydrated. I guess they should have listened to our previous episode.
Speaker 1:It's not too late, it's still there. Metabolism primary occurs in the liver by the cytochrome P450 enzyme. That may seem irrelevant information to you, but all the people, all the med students out there, biochemists, understand that it's a very commonly used enzyme that can be influenced a number of different ways, but it converts caffeine into parazanthine, which is a metabolite that also contributes to its pharmacologic effects. How was that, nicole?
Speaker 2:Wow, that made I zoned out.
Speaker 1:Oh, did you? Yeah, if Nicole's not even listening to the podcast, we're doomed. So let's talk about some of the supposed, or at least proposed, benefits of caffeine. Some of the obvious ones improved focus and alertness. Caffeine can enhance cognitive performance, particularly in tasks requiring sustained attention. This has been established for decades that this has this positive effect. It can actually have potential cognitive protection as well. Some researchers have linked regular caffeine intake to lower risks of Parkinson's and Alzheimer's disease. These are in some older studies that I found linking these, so I don't know if there's more up-to-date research that's given a little bit more of a conclusive link to this, but that proposal is out there.
Speaker 2:Okay, but that's not as dubious a link as the whole. Oh, you drink red wine and that'll protect your heart from heart disease.
Speaker 1:Yeah, the studies aren't the highest quality. In my book it really is looking at more of these people who you look at people who drink caffeine and the amount of drink. You look at people who drink caffeine and the amount of caffeine they drink every day and they looked at them over 40 and 50 years, and so there's a lot of confounding factors in these studies, exactly like the wine studies. So it's take that with a grain of salt. Athletic performance increases endurance and mobilization of fatty acids and helps spare muscle glycogen, so that can help with endurance and people who are trying to do high intensity athletic performances.
Speaker 2:Does it have to do with caffeine?
Speaker 1:Yeah.
Speaker 2:Well, I don't understand. This is the benefit of taking caffeine?
Speaker 1:Wait, okay. So I talked about focus and, yeah, I don't understand this is the benefit of taking caffeine?
Speaker 2:Wait, okay.
Speaker 1:So I talked about focus and alertness.
Speaker 2:Clearly I need some caffeine.
Speaker 1:Yeah, no, so we were going down a list of benefits Okay, improved focus and alertness, which you could use a little bit more of that. Yep, we talked about potential cognitive protection.
Speaker 2:Yes.
Speaker 1:And now I'm talking about athletic performance.
Speaker 2:Okay, so caffeine will make you perform better athletically.
Speaker 1:It increases endurance by helping mobilize fatty acids in your body and helps spare some of the muscle glycogen in your body, so that you can have better performance and endurance.
Speaker 2:Okay, but the sparing glycogen thing. Can you explain that a little better?
Speaker 1:Yeah well, you have sugar or carbohydrates stored in the form of glycogen in your liver and your muscles and you use that during intense exercise and then, basically, once you run out, you have to move into other energy stores.
Speaker 2:So you're trying to tell me to eat more pancakes.
Speaker 1:Where did you get that? Where did you get that?
Speaker 2:Because you said that it's stored in the muscles and stuff using carbohydrates, and so if I eat more pancakes, then I have more carbohydrates to store.
Speaker 1:I don't think I said the word pancake once.
Speaker 2:No, I know, but that's just the logical conclusion.
Speaker 1:You know what? What you know? Last episode, I told you there wouldn't be a quiz at the end of this. There's going to be a quiz at the end of this.
Speaker 2:I've already failed.
Speaker 1:Yeah, there's also some studies. Stay with me now. Okay, more studies. We're talking about caffeine, remember? Yeah, all right.
Speaker 2:Squirrel, squirrel.
Speaker 1:I do see that you're drinking coconut water over there, which we talked about on the last episode.
Speaker 2:Yes.
Speaker 1:So you're staying hydrated.
Speaker 2:I am staying hydrated.
Speaker 1:Did you do hot yoga today?
Speaker 2:I did.
Speaker 1:All right, see, we've said yoga already, so you don't need to bring it up, for this been some studies that have concluded that heart and cancer protection I shouldn't say concluded there have also been some studies that have proposed that there may be some heart and cancer protection from caffeine as well. Moderate caffeine consumption is associated with a 15 percent lower risk of coronary heart disease and up to a 20 percent reduced risk of liver cancer and endometrial cancer.
Speaker 1:Again a little bit of an older study, but these associations are observed question sorry, go ahead is endometrial cancer like from the endometrial lining of the uterus, so like endometriosis is a thing, but that's not cancer no, you can have endometrial cancer, unregulated growth of the endometrium huh, didn't know that that was a type of cancer it, it sure is.
Speaker 2:New fear unlocked for women everywhere.
Speaker 1:Yeah, yeah.
Speaker 2:Okay, sorry Please continue.
Speaker 1:That's okay. All right, let's talk about some of the risks of caffeine. You know there's probably some pretty obvious ones. Nicole, tell me what you could think of for potential risks of caffeine.
Speaker 2:Well, I talk way too fast when I drink caffeine. So that's one downside, but the more serious downsides were you going to say something or was I talking too?
Speaker 1:much. I was just going to say you're like a hyper little joy bubble, you know. You're just so happy and high energy all the time.
Speaker 2:Yeah.
Speaker 1:Unless you are not on caffeine.
Speaker 2:Yeah. So one of the serious effects, though, is I mean, I've heard of Marines and you know other people who have very stressful, very high intensity jobs drinking really, really intensely caffeinated drinks, and then their hearts give out on them.
Speaker 1:Yeah, the story you're talking about, I believe, was of two Marines who took a high dose of pre-workout, which is highly concentrated caffeine, and then other chemical compounds, before intensive cardiovascular exercise, and I believe two of them did die before intensive cardiovascular exercise and I believe two of them did die.
Speaker 2:Yeah, and I mean I know there's instances of other people who have felt like they were having heart attacks, almost went to the hospital, did go to the hospital, whatever. So caffeine can be too much, that's right.
Speaker 1:And we'll actually get into some of those hospitalization numbers as well. Probably the most common one that most people would experience is sleep disruption. So consuming caffeine within six hours of bedtime helps reduce total sleep duration by at least an hour estimation, and even moderate doses of 100 milligrams can delay sleep onset and reduce deep sleep. So you know the people recommend that you stop drinking coffee. You know a lot of people just say by noon, that's sort of an arbitrary number. A lot of people just say by noon, that's sort of an arbitrary number. But a lot of studies have said six hours before bedtime, which can leave a lot of room depending on what time you go to bed.
Speaker 2:Yeah, personally, if I have caffeine after 3 pm, then I'm going to be in for a rough night of sleeping.
Speaker 1:Yeah, I built up a huge tolerance to caffeine where I could drink a Monster and go to bed. But I don't have that tolerance anymore because I've weaned down since residency. There's also the caffeine crash. Has this ever happened to you, where you drink a bunch of caffeine and you come off of it and get really sleepy?
Speaker 2:Oh yeah.
Speaker 1:Oh yeah, so we'll get a little bit more of the mechanism of action of caffeine here in a minute, but just in brief. Caffeine acts by blocking a chemical called adenosine which helps make you sleepy. It doesn't stop adenosine from being produced in your body, it just stops the receptor where basically it plugs in to make its action on your brain. And so once the caffeine is gone, all that adenosine has been building up and all of a sudden floods your receptors and makes you sleepy and want to crash. And then if you combine that with a big sugar spike from an energy drink and then also coming off the sugar spike, it's compounded in effect of just being sleepy. That's why you get a big crash from it. High doses of caffeine can also lead to arrhythmias. Do you know what that is?
Speaker 2:Ooh, that's when your heart's beating irregularly. That could be quite dangerous, right.
Speaker 1:It sure can, and also elevated blood pressure, increased heart rate in general, and this can be a particular big risk in people who already have pre-existing cardiac or blood pressure related conditions.
Speaker 2:Right.
Speaker 1:Then you can also talk about tolerance and withdrawal, which I have experienced both significantly. Dependence develops when you use it regularly and withdrawal can cause headaches and fatigue and irritability. And boy can it ever.
Speaker 2:I feel, attacked.
Speaker 1:No, no, I'm talking about myself. Oh, okay, yeah, when I get off caffeine, if I go cold turkey, I'll get a splitting headache for about three days. So it's, it's pretty bad. Lethal doses and caffeine are pretty rare. However, the fatal dose is estimated to be about 10 to 14 grams. Now remember, caffeine is typically measured in milligrams, so we're talking about 150 to 200 milligrams per kilogram of a person's body weight being the lethal dose.
Speaker 2:Okay, break that down for those of us who are a little less inclined.
Speaker 1:Well, if you're 100 kilograms, then you would need to multiply that by 200 to make that the milligram lethal dose. So if your body weight's 100?
Speaker 2:Yeah, when people talk about milligrams per kilogram they're. So if your body weight's 100?.
Speaker 1:Yeah, when people talk about milligrams per kilogram, they're talking about your body weight. I'm sorry, I wasn't clear on that. Yeah, the fatal dose is estimated at 10 to 14 grams and if you want to get a little bit more precise, you're going to say 150 to 200 milligrams per kilogram of body weight.
Speaker 2:Yeah, except we live in America. Did you know that? Yes, yes.
Speaker 1:Yes, yes, who did you vote for for president? I'm just curious. Yes, I know we live in America, but medical science usually uses the metric system. I'm sorry, but you can do a quick conversion because a kilogram is 2.2 pounds. Oh yeah.
Speaker 2:Do the quick conversion for us there, dr Big Guy. A hundred kilograms is 220 pounds, if you got to go. Oh yeah, do the quick conversion for us there, dr Big guy.
Speaker 1:Well, a hundred kilograms is 220 pounds. Okay, all right. Okay, man, you're sassy, have you? Are you in caffeine withdrawal?
Speaker 2:I am.
Speaker 1:Okay, anyway, let's just go easy math, that's about a hundred cups of coffee. Oh, okay, yeah, a hundred cups of coffee. Symptoms would include tachycardia, convulsions and vomiting, and then death. Do you ever see that episode of Futurama where Fry drinks 100 cups of coffee and when he finally drinks his 100th cup, he enters this zen state of perfection and he's able to move at light speed and save everybody from a burning building?
Speaker 2:I don't think. I did see that episode, but I'm sure that there's. There's another 35 year old male out there who has yeah, Well, I'm sure a lot of people.
Speaker 1:well, I was going to say a lot of people, but a lot of people don't listen to this show. So I guess, so let's talk about the average caffeine content found in drinks, because I'm sure everybody listening to this is pretty familiar with caffeine and almost everybody who has had caffeine. In fact, it'd be hard to imagine somebody who hasn't had caffeine really in this country, although I will say my dad's never had coffee and he's probably listening to this.
Speaker 2:Yeah, but he drinks soda products.
Speaker 1:He likes to drink Pepsi, yeah, yeah yeah, it counts.
Speaker 1:It's caffeine. You know it is Absolutely so. A Starbucks coffee just a regular black coffee, a grande size is 310 milligrams of caffeine. Some specialty drinks can exceed 400 milligrams of caffeine. The larger size is if you order extra espresso shots and things like that. I will say a regular cup of coffee on average is closer to 100 milligrams of caffeine, but Starbucks tends to have a higher content. Your standard 16 ounce Monster Energy has 160 milligrams of caffeine and 54 grams of sugar, which is equivalent to 13 and a half teaspoons of sugar. So it's quite a bit of added sugar. Although I never drank the sugar moderate, I never drank the sugar variety. Whenever I drank energy drinks it's always sugar free, which, yes, we are getting to that episode about artificial sweeteners.
Speaker 2:We'll get there eventually. Well great, we're not pumping our body full of sugar, we're just pumping it full of chemicals. Hooray.
Speaker 1:Yeah, everything's chemicals. We're all chemicals.
Speaker 2:Uh-huh, uh-huh.
Speaker 1:Bang energy. When that hit the market, that was one of the higher caffeine contents. It had 300 milligrams of caffeine, but all of those were zero sugar, and then what's touted as a little bit more of a healthy alternative is Celsius.
Speaker 2:That's the one that I will occasionally drink if I'm desperate.
Speaker 1:That's a 12-ounce can and that has about 200 milligrams of caffeine and also zero grams of sugar. There's lots of things like Red Bull's another popular brand, rockstar Ghost Energy drinks. I mean, the list goes on and on. There's so many things out there on the market.
Speaker 2:Yeah, I remember. Do you remember the 5 hour?
Speaker 1:energy droplets or whatever that you could.
Speaker 2:Yeah, five hour energy shots?
Speaker 1:Yeah, I think those also had B vitamins and other things. It's not, it wasn't just caffeine, but a lot of these drinks have taurine and like other other types of compounds that are supposed to promote energy as well. So let's let's actually talk about caffeine itself. It's the world's most widely consumed psychoactive substance. It's found in coffee, tea, energy drinks, chocolate and even some medications. But how does it work? I can see Nicole's eyes glazing over already.
Speaker 2:No, no, no, I'm just listening intently.
Speaker 1:I'm focusing. I'm using my little ADHD preventer thing to listen to you Very good, very good. Caffeine is a plant alkaloid. You still with us, nicole.
Speaker 2:Alkaloid. I was trying to spell it in my head A-L-K-E-L-O-I-D.
Speaker 1:The chemical name is known as 1,3,7-trimethylxanthine. I'm going to throw this at you With a molecular structure resembling purines. Log that away. Wow, it works by blocking adenosine receptors, which typically induces relaxation and fatigue. Adenosine induces relaxation and fatigue. This results in increased release of dopamine, norepinephrine and acetylcholine, enhancing alertness and wakefulness. So that's how caffeine's main mechanism enacts on our bodies.
Speaker 2:I don't understand how it increases, the thing that makes us feel calmer but yet increases our energy. Is that what I'm understanding from this, or not?
Speaker 1:Hold on, let me clarify. Thank you, yeah, that's what it does okay, so say that one more time, just so I understand it better when caffeine blocks adenosine receptors, it results in increasing releases of dopamine, norepinephrine and acetyloline, and this enhances alertness and wakefulness.
Speaker 2:You said before that, though, whatever you said before, that was a thing about it making you calmer, or something.
Speaker 1:Adenosine makes you more sleepy and drowsy.
Speaker 2:Okay.
Speaker 1:Yeah, we're going to have to keep moving on.
Speaker 2:Yeah.
Speaker 1:So caffeine consumption, as you know, and I think as everyone knows, is very widespread in the United States and various sources contribute to the daily intake, including coffee, energy drinks, pre workout supplements. Caffeine consumption is very prevalent among US adults, primarily through coffee, but energy drinks are on the rise as well, especially in young adults. So I've seen a lot of numbers out there. The one that I settled on was really that the about was about 85% of us adults consume caffeine daily, with an average intake of about 135 to 200 milligrams of caffeine. Now I saw some numbers that quoted up to 95% of adults, but it's it's really hard to nail that number down.
Speaker 1:Yeah, as of 2024, 67% of American adults reported drinking coffee daily, marking a 20-year high. So it's always on the rise. Energy drink consumption varies much more by age group 18 to 29-year-olds report that 31% consume energy drinks and 30 to 49-year-olds report that 33% of this demographic consume energy drinks. And then pre-workout's a little bit more of a niche, but it's very common in people who do a lot of exercises, fitness enthusiasts, and they typically consume this product about four to five times a week, centered around exercises. Hence the name pre-workout supplement.
Speaker 2:Is that mostly weight-based exercises? Because if I were to do that before something like CrossFit, I'm pretty sure I would die.
Speaker 1:You know, when I used to use pre-workout, it was always around weight-based exercise. I would never take it before cardio exercise. But some people have done pretty foolish things around. We'll get into this. But there's all these TikTok and Instagram challenges about people doing some pretty foolish things with pre-workout.
Speaker 2:Anything related to TikTok challenges, I assume is going to be idiotic.
Speaker 1:You're showing your age, but I love it.
Speaker 2:Yeah, I love it. No, it's true. Curmudgeon alert.
Speaker 1:Uh-huh. So let's talk about the health implications and potential medical burden when coming to caffeine consumption. The prevalence of energy drink consumption-related emergency room visits on a typical day increased significantly from 2003 to 2016 among young adults and middle-aged adults. Those are not the numbers I was looking for. Okay, here we are the emergency department visits related to energy drinks. Between 2007 and 2011, the number of energy drink related emergency room visits in the United States doubled from 10,000 to 20,000.
Speaker 2:That's because that's when the rock star and bang and stuff really first started getting promoted. Red Bull and everything. Red Bull has wings or whatever.
Speaker 1:Red Bull's been around for a long time, but all these other energy drinks started shooting up. Yeah, the age group that's most vulnerable, or at least most prevalent, is 18 to 25, accounting for the highest number of emergency room visits related to energy drinks. The FDA recommends that you don't exceed 400 milligrams of caffeine daily. I should throw that in there.
Speaker 2:And if you're pregnant, I think that's even a smaller number.
Speaker 1:That's correct. Energy drinks, often containing high caffeine levels with other stimulants like taurine and guarana, have been associated with life-threatening cardiac events. Research indicates that these beverages can disrupt cardiovascular function, increasing the risk of arrhythmias and sudden cardiac arrest, especially in individuals with underlying cardiac conditions.
Speaker 2:How do you know if yours has a combination of caffeine, taurine, and what was the other one, guava?
Speaker 1:Guarana. It'll say on the label it's all in the ingredients. I think that's a pretty common combination. That's why people are worried so much about Bang, I think is because that one can is pretty much your limit for the day.
Speaker 2:Yeah.
Speaker 1:And you're drinking it in a go. When I was a resident, I drank more than one of those in a day, for sure. Wow, yeah, but I didn't drink them both at once.
Speaker 2:Is Guano. That's not a bat poop, is it that?
Speaker 1:reminds me that's Guano Guano. Guano is bat poop.
Speaker 2:Yeah, just remember from Ace Ventura.
Speaker 1:Hold on, hold on. We are, oh, 22 minutes into recording and that's the first time we mentioned poop. That's pretty, oh man. Okay, let's talk a little bit more about pre-workout supplements, because maybe not as many of the listeners are aware of what that is or what it contains. So it's designed to enhance gym performance. Most of them contain a mix of caffeine, creatine, beta alanine and nitric oxide boosters. A lot of people are familiar with creatine. I imagine it's a very common supplement. Nitric oxide boosters just help with blood vessel dilation, getting more blood flow to your muscles, in simple terms.
Speaker 2:Okay, what's the beta?
Speaker 1:other one Beta alanine is that compound that makes your scalp tingle.
Speaker 2:Oh okay.
Speaker 1:Yeah, that makes your scalp tingle, oh okay yeah, that's the scalp tingle one that stuff's weird now I don't think that's the intended purpose of having it in there, but I actually really kind of dig that sensation. To be honest with you, I've never done any sort of a recreational illegal drug. I've never used alcohol. But beta alanine, I guess, is my, gives you the scalp tingle.
Speaker 2:Yeah, you know those scalp massagers. I feel, like I got to use one of those when you've taken. Oh, that'd be incredible. Wow.
Speaker 1:No, I haven't taken pre-workout in years. I like years, so I I haven't had that sensation over a long time.
Speaker 2:Well, now I know what to slip you when you're unexpecting.
Speaker 1:Excuse me, do you make it a habit of slipping things into my drinks? No, yeah, very likely story. So let's talk about some of the benefits of pre-workout. So the whole idea is increase energy for workouts. Caffeine delays fatigue, enhances peak power output, helps with endurance we discussed all that. The nitric oxide boosters, like L-arginine, help promote better circulation of blood. It also helps people just focus and stay motivated in the gym, gives them that mental clarity so they can do the task and get it done. So risks We've already kind of covered a lot of these risks.
Speaker 1:High caffeine may lead to palpitations, anxiety, nausea and if you combine that with something that's already very strenuous on your heart, can be significantly detrimental. And then there's the wild west of supplements. Then you're never actually sure what's in your supplement. It's not that tightly regulated and a lot of times there can be a lot of stuff in there that you don't necessarily know what's in it. So you need to make sure you're buying from a very regulated company who goes through a lot of testing to make sure they know exactly what's in it, and that they have third party testers that are verifying that it is true to the label. That's something you have to think about all the time. There are several reported cases, though, of pre-workout overuse leading to cardiac arrest. Just one case study that I read was about a 23-year-old male who collapsed during a workout after consuming a double dose of a high-caffeine pre-workout supplement, and he died. So this has happened. It's not an incredibly common cause of death, but it's common enough that you can find multiple case studies on this.
Speaker 2:I wonder what year that was.
Speaker 1:For this study. It was 2014.
Speaker 2:Okay.
Speaker 1:Chronic use of high-caffeine pre-workouts can contribute to hypertension, which is high blood pressure strain on the kidneys, elevated cortisol levels which we've talked about in past episodes and it can increase long-term risk of cardiovascular disease. Now we talked about that. Maybe moderate to low intake of caffeine and coffee might actually be cardioprotective, but chronic abuse of it may actually lead to cardiac problems. So it's a balance let's dive more into now. Just energy drinks, commercial energy drinks. Nicole, do you drink energy drinks?
Speaker 2:I drink Celsius typically.
Speaker 1:How often do you do that?
Speaker 2:Oh, you know I've cut back lately. Actually I would say I'd have it maybe up to three times a week at my maximum, but now it's more like once every three weeks.
Speaker 1:Yeah, so you cut back on that. What's your caffeine delivery system of choice?
Speaker 2:Well, in the mornings it would be coffee.
Speaker 1:You just drink black coffee, right.
Speaker 2:I do From a drip machine. I do, although when I'm feeling fancy, I have a French press and I have a pour over Uh-huh.
Speaker 1:Yeah, okay, and then, if I have my, favorite sexy barista.
Speaker 2:Make me something, then. Who's that? That would be you. Okay, I just want to make sure, then I would be getting myself a latte from a hot day. Thanks a lot but then in the afternoon uh, if it's not too late then I like to have some caffeinated green tea or black tea that's got a little bit of caffeine, but not quite as much as coffee taper down, yeah gotcha, so you're not a big energy drink consumer I try not to that's.
Speaker 2:That's really only reserved for emergency situations, where I'm late on my way somewhere and need caffeine but don't possibly have time, uh, to drink, to drink like a hot drink.
Speaker 1:And you don't want to drink, uh, and you don't want to sit in a 40 line, 40 car line at Starbucks.
Speaker 2:Yeah, you know, I do you remember that one time we were going to the airport I had a super early time in the morning and I chugged like half of a bang or something? Or a rock star that sounds familiar and then I spent like the next half hour in the airport throwing up Um, so it can have like a bad effect on me if I am sleep deprived and have that much caffeine and a higher stress situation like traveling internationally. That's a no go for the Nicole.
Speaker 1:Yeah, all right. So Nicole's not a big fan of energy drinks, all right, no problem. Well, so a lot of energy drinks have are very high in sugar, you know. Some of them contain up to 50 grams of sugar, but they also make a large variety of those that are sugar-free with artificial sweeteners. Some people actually have mixed these energy drinks with alcohol, and this can be a dangerous trend because it helps mask intoxication. It delays that feeling of intoxication because you're having all these powerful stimulants.
Speaker 2:I'm guessing that's worse than like a. What is it a whiskey martini? All these powerful stimulants? I'm guessing that's worse than like a. What is it a whiskey martini or crap?
Speaker 1:espresso, martini Espresso. Well, that would be an example of mixing caffeine and alcohol.
Speaker 2:Yeah, but I'm guessing that the energy drink version is probably worse because that's a higher concentrated dose of caffeine.
Speaker 1:I guess it depends on how much espresso you use.
Speaker 2:Yeah.
Speaker 1:I don't know, I never had one of those. As we mentioned before, there are case reports of people over-consuming energy drinks leading to arrhythmias of the heart, seizures and hypertension. And then there's lots of reports about excessive caffeine triggering anxiety, restlessness and panic attacks in people who may be susceptible to that sort of thing people who may be susceptible to that sort of thing. So there's actually sections in the DSM-5, which is one of Nicole's favorite books talking about caffeine abuse or caffeine leading to induction of negative side effects associated with psychiatric disorders.
Speaker 2:Very nice, that was pretty sexy. You brought that up.
Speaker 1:Thank you, I did that for you, babe. Regular consumption of energy drinks has been linked to chronic insomnia, increased stressed and higher risks of metabolic syndrome due to prolonged exposure to high sugars and caffeine levels. Now, if you take the sugar out of the equation, I don't know that metabolic syndrome would really be associated with this, but you can definitely see the insomnia and increased stress and blood pressure problems I.
Speaker 2:I wonder if restless leg syndrome becomes an issue too. I feel like that was always worse for me when I was trying to sleep and I'd had a lot of caffeine.
Speaker 1:I'm sure it doesn't help, especially if you already have restless leg syndrome. So this is something that I read about, which I don't think I've ever actually used this. But have you ever heard of the caffeine nap?
Speaker 2:Well, I just assumed that would be the crash you get.
Speaker 1:No, apparently and this is new to me apparently drinking caffeine about 20 minutes before a nap can maximize your alertness when you wake up from your nap. You know. If it takes 45 minutes to absorb it in your bloodstream, you take it before the nap, then you wake up and sit without feeling groggy. Apparently, people use this so that they can have a nap in the middle of the day and then still be super alert and awake. Instead of that, have you ever fallen asleep in the middle of the day and you woken up and not know where you are, what day it is?
Speaker 2:Yeah, like four times a week, yeah, wow.
Speaker 1:She's a hard napper, oh she's a hard napper. Oh man, you know there's some. There's some interesting medical applications when it comes to caffeine as well. It's not all just recreational, um, caffeine has a vasoconstrictive property, which means that it helps tighten blood vessels, and this is actually used in some migraine treatments to narrow dilated cranial vessels that are associated with migraine headaches.
Speaker 2:Yeah, I feel like that was in Excedrin when I used to take that for migraines back in the day. Yeah, I'm pretty sure it still is Back when I didn't drink enough water and I would get bad headaches.
Speaker 1:Yeah, you don't get headaches as much now that you're nice and hydrated, do you?
Speaker 2:Yeah Well, the combination of hydration and also working on my back muscles so that my back and neck posture isn't as bad that's really helped.
Speaker 1:As we know, it's not all just about drinking water, right.
Speaker 2:That's true.
Speaker 1:What else is there?
Speaker 2:There is salt and electrolytes.
Speaker 1:There you go. Yeah, last episode, go check it out.
Speaker 2:Yeah, but you made me lose my train of thought, dude. What were we just talking?
Speaker 1:about Migraines Headaches.
Speaker 2:Oh okay, thanks. Yeah, I'm also pretty sure that Midol, that medication, has caffeine in it, because that's the women's, you know if you're having premenstrual cramps.
Speaker 1:Mm-hmm, I don't know, I didn't look that up.
Speaker 1:I guess I can Google it for you so let's talk about people who may want to avoid caffeine or at least significantly limit their consumption People with anxiety disorder. Caffeine, as we talked about, is a stimulant and it can exacerbate anxiety symptoms. It can lead to increased nervousness, restlessness and even panic attacks in people who are susceptible. People with a pre-existing heart arrhythmia or severe blood pressure issues should also significantly cut back on their caffeine or consider not consuming it at all. Interestingly enough, people with heartburn, or what we call gastroesophageal reflux disease, or GERD for short, caffeine can help relax the lower sphincter of the esophagus and worsen acid reflux symptoms.
Speaker 2:Wait, there's more than one sphincter in the body.
Speaker 1:Oh yeah, there's sphincters all over the place. What? There's sphincters galore babe.
Speaker 2:I only knew about the one.
Speaker 1:Oh no.
Speaker 2:We got sphincters all over this. Maybe that should be a fractured fact.
Speaker 1:Yeah, we'll just do a sphincter-related episode sometime.
Speaker 2:That will probably get a lot more downloads.
Speaker 1:Yeah, maybe I don't want that kind of attention. No, the esophagus has an upper and lower sphincter and if you are dilating the sphincter and allowing more of the contents of your stomach to get up into your esophagus, it can actually worsen your heartburn.
Speaker 2:Okay, cause I was going to say I would expect that drinking coffee, which is pretty acidic. I think that that would actually worsen things for somebody with GERD.
Speaker 1:Yeah, that in particular probably doesn't help things either. It probably adds compounds that affect. So we already talked about restlessness and sleeplessness. So people who tend to have problems with insomnia should also probably avoid or cut back caffeine or only have it first thing in the morning and try to avoid taking it much during the day.
Speaker 2:Okay, so if you have GERD, don't drink coffee.
Speaker 1:Well, caffeine just might help, it might just exacerbate it.
Speaker 2:I see.
Speaker 1:Yeah, we're talking about caffeine in general. The coffee might even be worse with this acid.
Speaker 2:Gotcha Okay.
Speaker 1:People who are pregnant. High caffeine intake during pregnancy has been linked to adverse outcomes such as low birth weight and preterm birth, meaning they deliver too early. So it's generally recommended that pregnant individuals limit their caffeine consumption pretty significantly. Are you angry because I said pregnant individuals?
Speaker 2:Yeah, but I'm not going to say anything about it. I don't necessarily disagree. I just dislike it.
Speaker 1:During my research for this episode, I found some articles suggesting that caffeine can in some way contribute to osteoporosis. This was actually new information to me. There are some studies showing that excessive caffeine intake can actually interfere with calcium absorption from your food and from your diet, potentially contributing to bone density loss. But I dug into this a little bit more and those studies show a very limited effect. And there's other studies that show that it has no significant effect whatsoever. So I added on the list as a curiosity, but that's not really super high on my level of concern. And then certain psychiatric disorders, not just anxiety, can be exacerbated by caffeine, like bipolar disorder, and it has actually been shown to trigger manic episodes or increase anxiety to trigger manic episodes or increase anxiety.
Speaker 1:So what practical tips can we go day-to-day? What practical tips can we give you for day-to-day use? Let's talk about how to optimize caffeine use safely. Stick to safe limits. The FDA recommends no more than 400 milligrams of caffeine daily. That um that leads. That adds up to about four to five cups of coffee. But that's just like your folgers coffee at home. It's not a starbucks, that's a starbucks coffee. That's gonna be way more can I?
Speaker 2:can I ask a uh controversial question? Yeah, are we actually trusting the fda on this? Because we don't necessarily trust them on things like the food pyramid.
Speaker 1:Yeah, well, no, I mean, that's a great question. I think when it comes to limiting things, they're more on the conservative side, which is so am I personally, you know, I don't think you should really be trying to consume much more than 200 to 300 milligrams myself, so I think I'm comfortable with following this guideline. On this particular topic, avoid caffeine at least six hours before bedtime, but personally I stopped drinking caffeine after lunchtime. Pair it with hydration balance caffeinated drinks with water to help you stay hydrated. Now, as we discussed in the last episode, a small amount of caffeine doesn't necessarily dehydrate you, but if you're constantly consuming caffeine throughout the day, it can have a little bit of a dehydrating effect.
Speaker 1:Try to choose low sugar options. If you can just drink black coffee, that's the best. Unsweetened tea or natural energy drinks without a lot of added sugar would be better options. And then maybe consider cycling your caffeine use. I'm doing that right now. I'm having just my one coffee in the morning and that's it. I'm avoiding any caffeine related energy drinks, sodas, tea, coffee after my one coffee in the morning, that's it. I'm trying to cut back because I'm trying to decrease my dependence on it, and then it's also important to try to avoid sugar crashes. A lot of times people get these super hyper sugary drinks from Starbucks that are just loaded with caffeine and sugar and then they have nothing else and then they have a huge crash. So if you're going to drink coffee, I would encourage you not to have so much sugar with it and maybe pair it with some protein to slow down the absorption.
Speaker 2:Thoughts no, seems pretty clear.
Speaker 1:So we got into all the health benefits and risks of caffeine in particular, but there are a lot of people who have talked about whether coffee in particular is good or bad for you, so I did want to talk about that a little bit.
Speaker 1:Okay, so let's just take pre-workout and take energy drinks out of this equation, because we're talking about coffee in particular, because coffee is touted to have a certain level of antioxidants and other compounds that have been studied that may help with longevity and other different types of health issues. It's been proposed that coffee might help with cancer prevention. There have been studies that have showed that regular coffee consumption is associated with a 40% reduction in the risk of liver cancer. The protective effects are thought to arise from coffee's ability to lower liver enzymes and reduce inflammation, although that's still not perfectly sussed out. As we mentioned before, endometrial cancer and colorectal cancer have also been shown to have lower rates in people who drink two to three cups of coffee a day. Now, whenever you're looking at population studies like this, where you observe people over time, it is important to realize that you can only take so much information from this, because there may be a lot of other confounding lifestyle factors at play here.
Speaker 2:Yeah, that's probably a good point.
Speaker 1:Yeah, that's something I try to think about whenever I read any kind of study. Then neurodegenerative diseases as well. Coffee may have a protective effect. Caffeine may delay the onset of Alzheimer's disease by reducing beta amyloid plaques in the brain. Research suggests that up to 65% of a lowered risk for regular coffee drinkers consuming three to five cups per day. Again, almost all of the data I found on this were older studies, so I'd be really curious to see if there's people doing more recent research on this, because this is sort of you know, the science constantly changing.
Speaker 2:Well, when you say older, do you mean like early 2000s or 1960s?
Speaker 1:I'm talking early 2000s. Okay, you know I would. I would be curious to see if there's something um more recent, but this is what some of the more prevalent studies that I found. And then there's also lots of studies that show that coffee drinkers have up to a 30% lower risk, due to caffeine's neuroprotective properties, of developing Parkinson's disease. Again, this is all with a grain of salt. If you're not a big coffee drinker and you don't want to drink coffee, it doesn't necessarily mean your brain's going to degenerate. Drink coffee, it doesn't necessarily mean your brain's going to degenerate. Moderate coffee consumption has also been shown to help reduce risk of coronary artery disease being heart disease. Coffee's antioxidant compounds have been proposed to be the mechanism for why this is. But, as we discussed before, too much coffee, too much caffeine, can actually cause damage to your heart. Potentially All right. So this is a super interesting one. I personally, I think I learned this probably within the last year or two. So did you know, Nicole, that the way you brew your coffee might actually change its health benefits?
Speaker 2:Actually, I did know that.
Speaker 1:What do you know?
Speaker 2:I'm not sure if I remember it correctly, but it has something to do with if you use a liner in your coffee, the oils from the coffee beans can have an effect on your cholesterol.
Speaker 1:Yeah, look at you. Look at the big brain on Nicole. Yeah, yeah, yes, that's right.
Speaker 2:so that's how they know me big brain nicole that's her nickname, so the it's unfiltered coffee.
Speaker 1:So think french presh, think french press and turkish coffee. Unfiltered brewing methods allow higher concentrations of certain compounds in coffee to remain in the coffee, and this has actually been shown to increase LDL cholesterol.
Speaker 2:LDL is the bad.
Speaker 1:That's what most people would call the bad cholesterol. Studies have shown that consuming five to eight cups of unfiltered coffee daily can actually increase your LDL cholesterol, potentially elevating cardiovascular risk. Filtered coffee, like a drip coffee machine, effectively removes all of these compounds and then there's no real LDL cholesterol effect at all. So if you're concerned about your cholesterol, you may want to skip the French press. So if you have cholesterol issues or are concerned about this, you might want to skip the French press. So if you have cholesterol issues or are concerned about this, you might want to skip the French press or Turkish coffee.
Speaker 2:Yeah, I think that might be one of the reasons why I stopped doing French press for a while, even though it's delicious.
Speaker 1:Yeah, do you find French press is better tasting than other coffee?
Speaker 2:Well, honestly, so much goes into it, caleb. I mean it's anything from the quality of the beans to the uh, to the grinding experience, to the, to the heat of the water, and then the shape of the craft in your hands. You know it's getting very sensual, uh, thinking about it.
Speaker 1:So that's not the first thing that came to my mind, but I guess you're really into coffee.
Speaker 2:So there's just a lot of factors there at play.
Speaker 1:Yeah, well, you know I think it's pretty exciting to talk about what good things coffee might do for us. But you know, coffee may contain these beneficial antioxidants and when consumed in moderation, they might actually have some health benefits. But the method of preparation is important and if you're concerned about cholesterol levels, you may want to worry about the filter. And also you have to really make sure you're consuming it in moderation. And also you have to think about the context in which you're drinking it. If you're adding lots of cream, lots of sugar and other things, you're probably having more negative health side effects than you're getting any benefit from.
Speaker 2:That's true. If your coffee is just a delivery system for heaps of sugar, that's maybe not great. Yeah, probably not good for your heart. People used to ask me how do I like my coffee? And I would say black, like my soul.
Speaker 1:But your soul is not black at all. You're just such a happy person.
Speaker 2:Yeah, no, it's true, the joke doesn't really work for you. No, I guess not. It worked better for me. Yeah, I think it would work best for Wednesday from you know the Addams.
Speaker 1:Family From Wednesday.
Speaker 2:The show Wednesday yeah.
Speaker 1:Yeah. So here's my final thoughts on caffeine. You can enjoy caffeine responsibly, but it does have its pitfalls. Track your caffeine. Pretty much any commercial product that has caffeine is going to tell you how many milligrams it has in it. Try to stay under 400 milligrams if you can. You may want to consider cycling down where you try to lower that dose significantly more to see how you do with it. Make sure you're hydrating, pairing it with other drinks, not just your coffee and tea and energy drinks. Try not to rely so much on caffeine drinks for energy. If you're finding that you have to drink coffee and caffeine and energy drinks every single day because you're not getting adequate sleep, that may be a sign that you may want to change some things. And then read your labels, pre-workouts, energy drinks especially those two. They can often have all sorts of hidden ingredients that you're not considering. And make sure you're buying from a reputable company.
Speaker 2:Okay, so what was the trifecta of? Concerning ingredients, Was caffeine, taurine and.
Speaker 1:Guarana.
Speaker 2:Guarana.
Speaker 1:And there's other compounds out there I probably haven't even heard of that can cause problems, and with these less reputable pre-workout companies, they may have stuff in there that's not even on the label. Yeah, and I'm not saying that you can't drink energy drinks. I'm just saying think about how much caffeine you've consumed, how much food and water is in your system, whether you're going to do something super strenuous, whether or not you have some sort of underlying heart condition, and just listen to your body. If you're having palpitations, if your heart feels like it's being beating out of your chest, if you're having increased anxiety, if you're not sleeping well, maybe it's time to cut back. So caffeine, pre-workout supplements, energy drinks these can all be very powerful tools for energy and focus, but they come with risks if used unwisely. So remember moderation is the key. If you have any questions or stories to share about your caffeine addiction or your abstinence, I'd love to hear it on our social media.
Speaker 2:Are you going to talk about TikTok challenges or something?
Speaker 1:are you going to talk about tiktok challenges something? Oh yeah, um, speaking of social media, there's just lots of people who are um. The one story that I read about was people who are dry scooping pre-workout. Have you heard about this? No, where they take the powder and a scoop and they just put it in their mouth and dry scoop it. And then I've even seen videos. I don't know if they're drinking it, but I saw a video. I gotta take four energy drinks and pour pre-workout into all four of them and then put four straws into it and start drinking out of all four straws simultaneously. You know, people are just doing silly things on Instagram and TikTok to get clicks and views and who knows if it's real or not Right?
Speaker 2:Who knows if?
Speaker 1:it's staged or if it's real. But there are reports of people who are doing that sort of thing who have died.
Speaker 2:Right, it's a real thing, not just in 2014, I'm guessing.
Speaker 1:No more recently than that.
Speaker 2:Yeah, it's sort of like the Tide Pod thing. Yeah, it's a little bit of Darwinism at work, I guess.
Speaker 1:Yeah.
Speaker 2:That might have been too mean. Maybe cut that out.
Speaker 1:Okay, well, okay, well. Before we wrap up completely, I would like to take a break for Fractured Facts.
Speaker 2:Ooh? Love it. Are we going to talk about sphincters?
Speaker 1:No, we're not going to talk about sphincters, okay, all right. Hey everybody, welcome back to Fractured Facts, the segment that is not about sphincters. So since we're talking so much about caffeine and energy drinks today, I wanted to talk about the ultimate stimulant. Do you know what that is?
Speaker 1:well, I'm afraid to say yeah, you got it cocaine so just because we're talking about stimulants, cocaine came to mind. Yeah, believe it or not, this infamous drug actually has a fascinating history in medicine and, surprisingly, is still used in certain modern medical settings. So let's go back to the history of cocaine. Cocaine was first isolated from the coca leaves back in the mid 1800s. Back then it was celebrated as a medical marvel. Doctors thought it was the ultimate multitasker. It helped relieve pain, it helped boost your energy and even treated depression. Sigmund Freud was actually a Speaking of depression. Sigmund Freud was actually a big fan of cocaine himself. He wrote lots of papers talking about all of the benefits and potential of cocaine being a cure-all for multiple problems. Spoiler alert that did not end well, but here's where things get really interesting.
Speaker 1:By the late 1800s, cocaine was being used in some truly groundbreaking ways. Have you ever heard of a local anesthesia? Yeah, of course. Are you familiar with that? So cocaine was actually the very first substance used as a local anesthetic. As a local anesthetic. In 1884, dr Carl Kohler, an ophthalmologist, discovered that applying cocaine to the eye numbed it so that he could perform surgery. So this was revolutionary at the time. For the first time, he could do surgery without putting patients completely under or without him having to endure significant amounts of pain while operating on the eye.
Speaker 2:I kind of wonder how he stumbled upon that. Was it? Like you know, somebody in his office was sniffing cocaine. That's a mechanism for taking it right.
Speaker 1:I guess Sniff it Snorting, snort it. Yeah, this is somebody who's snorting it, but then they like sneeze. I guess sniff is like a polite snort Can you imagine.
Speaker 2:You know just a little, just a little sniff, so maybe they were.
Speaker 2:They were sniffing it instead of snorting it and and they know what, no one's gonna worry that we have used cocaine, by the way and and maybe it tickled their nostril hair, and so then they sneezed and then the cocaine flew everywhere, including into the eye of the patient, and they were like I can't feel my eye. And the doctor's like, hey, let me take this scalpel and try to carve some stuff out and like that's how we determined this sounds like an episode of sawbones. Yeah, yeah we should ask them.
Speaker 1:I love those guys yeah, yeah, we should check that out. No, I I don't know how he first. Uh, I imagine people felt that there was numbness in other areas when they had cocaine, so that's, that's probably how they experimented with that. So let's talk about the mechanism of action of cocaine. So cocaine is a sodium channel blocker and it has a sympathomimetic effect, meaning it activates your sympathetic nervous system.
Speaker 2:Okay, so there's a difference between sympathetic and parasympathetic nervous system, but why don't you explain what the difference is?
Speaker 1:Sympathetic is more of the fight-or-flight response and the parasympathetic is what I like to call the rest-and-digest response. So sympathetic means you're getting all amped up ready to fight a bear in the forest.
Speaker 2:Right or a man?
Speaker 1:Or a man, but which one do you choose? Yeah, so cocaine affects the nervous system and the heart. Cocaine inhibits the reuptake of certain neurotransmitters like dopamine and norepinephrine and serotonin, at the synapses in the brain, so they're just staying floating around in there instead of being reabsorbed. So when you experience something pleasurable or stimulating, your brain releases dopamine, the quote-unquote feel-good neurotransmitter. Normally dopamine would be reabsorbed quickly, but the cocaine helps block that reabsorption and it sticks around. So you're getting this feeling of euphoria and energy and focus.
Speaker 2:No wonder.
Speaker 1:But really the more interesting mechanism is the sodium channel blocking in nerve cells. We talked about this in the last episode actually, where you have to have a very specific gradient of ions across cell membranes to be able to transmit nerve signals, electrical signals, down nerve fibers. You remember we talked about that. And if you block the sodium channels that help maintain that gradient, then you're not firing these transmissions down the nerves anymore. So that's how it has that anesthetic effect that you just basically temporarily numb the nerves. Now, as you might listen to the name cocaine and think of that ane at the end, you may think now about lidocaine, novocaine, marcaine, bupivacaine. These are all sodium channel blockers that developed afterwards.
Speaker 2:Sneaky, sneaky, that's right.
Speaker 1:So they all have the similar mechanism but don't have that same effect on the heart and the euphoria and are just local anesthetics. But that's the same root word. Now cocaine becomes even more specific for a surgery because it has a very specific vasoconstrictive effect, so it narrows blood vessels. So if you're doing things like eyes, ears, nose, throat surgery, applying cocaine can be a local anesthetic and decrease bleeding during surgery. It's actually one of the nasty side effects of cocaine, if you are one who sniffs it, that you can actually lose blood vessels in the septum of your nose, the membrane between your nostrils, and it can actually decay because it dies without blood flow. You can literally erode away the septum of your nose.
Speaker 2:So then you look like Lord Voldemort.
Speaker 1:I guess that's a possibility. Do you think he was a crack addict?
Speaker 2:Probably he's really big into the coke.
Speaker 1:Yeah. So cocaine is still used, albeit very limited and very restrictive, in ear, nose and throat surgery in the modern medical world today. I never have any use for it in my medical practice, but it is used and heavily controlled. Cocaine is one of those drugs that has a really interesting history and really interesting mechanism, but obviously there's a lot of harmful side effects. Elevated heart rate, hypertension, arrhythmias and, uh and heart attacks are not uncommon when using an abusing cocaine.
Speaker 2:Wasn't it originally used in like Coca-Cola, and that's one of the reasons why Coca-Cola has its name.
Speaker 1:I believe they use small amounts of cocaine and Coca-Cola a long time ago, but yeah they don't.
Speaker 2:Yeah, yeah, uh, a long time ago, a long time ago.
Speaker 1:Yeah, yeah, but they don't anymore, right, yeah?
Speaker 2:But no, and I just remember, like I remember going to.
Speaker 1:There's this little like historic medical museum in New Orleans.
Speaker 2:You remember that place? I do. Yeah, that's pretty cool Shout out to them, but I vaguely remember there being a display about how doctors would prescribe it particularly to women who were in quote hysterics, and that would help calm them down Well, not really calm them down, but make them feel better, I guess.
Speaker 1:Yeah, no, it's pretty crazy to think about all the medical, all of the different substances people used willy-nilly back then.
Speaker 2:I don't recommend most people using cocaine in almost any setting. Yeah Well, I just I wonder what, what it is in our current generations that people 200 years from now are going to look back and go. Y'all were dumb.
Speaker 1:I'm sure there'll be something. Yeah yeah, let's go ahead and get back to the episode We'll wrap up. So I can personally tell you that monitoring my caffeine intake and limiting it down to just one serving a day now and staying really well hydrated has been very beneficial for me. I get better sleep, my heart rate is better, my hands shake less my let's leave that part, yeah, yeah.
Speaker 1:I get better sleep, my energy is more regular. I don't feel like I'm relying on it anymore. I'm not worried about getting that caffeine, so I don't have a splitting headache later in the day. So I recommend everyone consider doing the same. At least observe how much caffeine you're consuming to see if maybe it's something you would consider. And I definitely recommend cutting back on the cocaine if you are using it. So remember everybody, be humble, be happy, be happy, be healthy and get off that cocaine we'll see you next week.
Speaker 2:How's that?
Speaker 1:yeah, that's good, that reminds me, let me add, let me splice a little section. Sure, sure, nicole, what do you think? Are you going to cut back on your caffeine?
Speaker 2:Well, actually, I think I've been telling you that in the last few weeks I've been more reliant on it, especially if I want to avoid my afternoon naps.
Speaker 1:So what are your thoughts? Do you think this is something you'll want to track, or see how much you're actually consuming? Or do you think, nope, I'm perfect.
Speaker 2:I can quit anytime. I can quit anytime. I think it's worth tracking for sure. Yeah, yeah, because I think I drink about one and a half of my mugs worth of coffee in the morning.
Speaker 1:Yeah.
Speaker 2:And then I drink another source of caffeine a little after lunchtime.
Speaker 1:Yeah, it might not be that bad what you're consuming. I don't know, but it'd be interesting to track and see. Yeah for sure, all right. Well, if you do cut back on caffeine, I hope to see you next week. Thanks for being here.
Speaker 2:Thanks, yeah, always a pleasure.
