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    Cautions for Coffee and Caffeine Drinkers


    Lauren Lindsey
    Image Caption: Photo: CC--DaveOnFlickr

    Celiac.com 10/31/2013 - I recently made a post on instagram that gained a significant amount of attention. A before and after photo with a caption that read “dairy and coffee free” had viewers confused. The attention was not due to my physique but instead to the concern of eliminating coffee as part of a wellness regimen. When over 1000 “likes” and 30 comments were made, I realized that little is acknowledged about the matter. There are certainly far worse things for your health than coffee and caffeine yet I’m compelled to share its undesirable effects. I do not claim that drinking coffee ruins your health and take into consideration that every individual has unique dietary needs and intolerances. Years following my celiac diagnosis, eliminating coffee (and dairy) changed my life. I hope it will do the same for you.


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    Photo: CC--DaveOnFlickrConcerns:

    •     Chronic Fatigue
    •     Suppressed Immunity
    •     Increased Inflammation
    •     Deflated Mood & Cognition
    •     Acidic Content
    •     IBS Symptoms
    •     Weight Retention

    Fatigue & Immunity
    There are few things more frustrating than the lack of energy to perform normal tasks. Fatigue is one the most common and difficult symptoms to treat with celiac disease.  When speaking to individuals about coffee consumption typical responses are, "I need the energy, I MUST have my coffee. I can’t go without it.” The irony is that caffeine is a major cause of fatigue. Most of us are familiar with the 2pm crash that comes with the workday. “Well no worries, I’ll have another cup of coffee” you might say. – This is where trouble begins. When it comes to caffeine, fatigue is determined by the amount of milligrams consumed. Studies have shown that fatigue heightened in individuals who had three cups of coffee and was the highest in those who had five cups.

    Continuous coffee and caffeine consumption places the body into a chronic state of stress or emergency. Caffeine signals the adrenal glands to produce stress hormones that are responsible for the “fight or flight” response. While useful for outrunning grizzly bears, it’s not intended for constant and sedentary use. The perked attention after drinking coffee is the body’s response to the unnecessary secretion of stress hormones. The energy felt after drinking coffee is actually your body battling the stimulated fight or flight response.

    Studies have shown that constant stress impairs the immune system to respond to normal hormonal ques.  The excessive amount of stress hormones deters communication within the immune system posing for additional complications with auto-immunity conditions. Once in this state of emergency the body seeks out reserves and depletes vitamins and minerals the immune system rely on. With celiac disease, inadequate absorption of vital nutrients and immune deficiency already pose as threats absent of caffeine consumption.  Not to mention, B-vitamins are also depleted which aids in utilizing food for energy, thus exasperating symptoms of fatigue.

    Deflated Mood and Cognition
    Coming down from the caffeine high (you’ll have to eventually) may cause exhaustion, hindered cognition, and moodiness.

    “Wait, moodiness? But caffeine elevates your mood and helps you concentrate.”

    There are claims that coffee aids in treating depression and moodiness and here’s why; within minutes of drinking coffee, the central nervous system is firing neurons, sending signals to the brain, and pumps out adrenalin. The perked attention for someone exhibiting depressive symptoms would certainly feel beneficial. Unfortunately, this is short lived, fails to treat the underlying cause of depression/moodiness, depletes vitamins that aid in brain functioning, and slows oxygen to the brain.  Have you ever heard an athlete use the term adrenalin dump? If adrenalin becomes too high before an event, the athlete will crash too early during their performance. It’s the same idea with coffee; after the alertness dissipates, the individual is left to crash and potentially in a worse mood.

    Although mild in comparison, caffeine manipulates the same neurochemical activity as amphetamines, cocaine, and morphine. (I’m NOT implying that coffee is equivalent to the previous examples but simply presenting the connection). Although different drug types, each stimulate the central nervous system to a degree causing temporary feelings of elation, pain relief, attentiveness, and suppressed appetite. These sound like great things but most of us understand the potential danger and addictive nature of these stimulants.

    IBS & Acidic Content
    “It sounds like caffeine is the culprit not coffee. So I’ll have decaf more often.”

    That’s a good start, but first: Cutting back is useful in combatting issues associated with caffeine but the acidic make-up of coffee must also be considered.

    It’s commonly understood that coffee is a trigger for IBS.  Even in modest amounts, coffee produces a laxative effect within minutes after drinking. This applies to decaffeinated coffee as well and provides that caffeine is not the only culprit for IBS symptoms. Decaffeinated coffee is found to contain higher amounts of acid than regular coffee and stimulates acid production in the body. Excessive acid damages the intestines, resulting in absorption, immunity, and over-all health issues. There are numerous drinks containing a higher acid content than coffee. Sports drinks for instance, contain nearly double the amount of acid as coffee. Having sports drinks in effort to rehydrate from a cup of coffee enhances potential complications from acid damage.

    “I don’t have IBS. I like coffee because it keeps me regular”

    Achieving regularity by means of coffee consumption may indicate the need for dietary changes. Using pro-biotics and eating adequate amounts of fiber achieve regularity and are conducive towards overall health.  Even if the constant need for the bathroom is not an issue, consider caffeine’s diuretic effects such as dehydration, impaired digestion, and constipation.

    Weight Retention
    “I like coffee because it curves my appetite.”

    Adrenaline stimulation releases and emits stored blood sugar. Insulin releases and blood sugar drops below normal. You’ll be hungrier than before in no time.

    Keep in mind that excess insulin is known to:

     

    •     Promote the storage of fat = weight gain
    •     Retain sodium = holds water weight and causes high blood pressure
    •     Increase amounts of inflammatory compounds in your blood! Inflammation is a killer and especially dangerous in increasing symptoms for those with celiac disease.

    I believe that individuals suffering from gastrointestinal disorders could greatly improve their life by eliminating coffee. I also understand that making such claims are “fighting words” for those who love their daily brew. Although uncomfortable and challenging to give up, consider the potential hindrance coffee and caffeine poses for healing. It may be your answer and missing ingredient to feeling better.  

    Best of luck.

    Sources:

    • Active Wellness By Gayle Reichler MS RD CDN, page 12
    • Disease Prevention And Treatment by Life Extension Foundation, page 739
    • Textbook of Natural Medicine Volumes 1-2 by Joseph E Pizzorno and Michael T Murray, page 433
    • Caffeine Blues By Stephen Cherniske MS, page 10 Lane, J.D. 1994.
    • Neuroendrocine Responses to Caffeine in the Work Environment. Psychosomatic Medicine. 546:267-70. Rao, S.S., Welcher, K., Zimmermn, B. and Stumbo 1998. Is coffee a colonic stimulant?
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    I agree with your view on coffee and caffeine. Good article. I've read articles suggesting caffeine can be bad for people with adrenal fatigue issues. To me it is like a medicine. Anything we take regularly has a tendency to cause changes in the body IMHO.

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    I've had celiac disease for fifteen years and gave up coffee nine months ago. I've never felt better, especially my gastrointestinal track. It was a difficult transition accompanied by headaches and fatigue since I had been a daily coffee drinker for forty years, but after only a few days I felt dramatically better.

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    Guest Lauren Lindsey

    Posted

    I've had celiac disease for fifteen years and gave up coffee nine months ago. I've never felt better, especially my gastrointestinal track. It was a difficult transition accompanied by headaches and fatigue since I had been a daily coffee drinker for forty years, but after only a few days I felt dramatically better.

    I'm so glad to hear that Kathy. I was merely scraping by before I gave up my coffee addiction. It completely changed my life as well.

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    Guest ACurtis

    Posted

    I have gluten intolerance; one of the 300 symptoms people with Celiac and gluten intolerance should be aware of is that people with these issues are at heightened risk of developing/having Caffeine Sensitivity. I developed it after my ND had me drinking 3-4 cups of green tea/day for chelating/detoxing. He shouldn't have had me on this regimen for over a year, and I didn't know enough about nutrition at the time to realize I shouldn't have been drinking that much caffeine. Symptoms for me were cuts/sores at the corners of my mouth (chelitis/stomatitis), puffy lips, purple lips, cracked lips. I have since tapered way back on how much green, black, and white tea I drink; mainly, I drink water and herbal teas when I need something with flavor. I've also discovered liquid flavored Stevia drops; my new flavor is vanilla creme in my water once in a while. And yes, caffeine definitely can wreck havoc on both the adrenals and the thyroid.

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    Guest Doug Knight

    Posted

    I began getting sick about a decade ago, but didn't really start to deteriorate until approximately 5 years ago. I became so sick that my cognitive abilities decreased dramatically (I couldn't do simple math in my head, and I'm a math wiz), and I began to be overrun by opportunistic infections which centered around my mouth and anus and manifested as fissure-like sores that seemed to be eating through my skin. My skin felt like it was too thin and felt as if it was not properly attached. Grains, especially wheat, made my sick to the point of vomiting and even when I avoided grains I felt sick to my stomach. Soft tissue injuries never healed, and even chiropractic adjustments made me sore for days or weeks. I was so tired and becoming more tired every day. I was in rough shape.

     

    When I was in my mid 20s (20 years ago), I had had major stomach problems that prompted my doctor to stop drinking the 20 cups of tea or coffee I drank on a daily basis, so I had tried giving up the 3-4 cups a week I was drinking at that time, but without much improvement.

     

    Then I had a revelation. A decade ago I was in a car accident and had been taking Tylenol 3s ever since. T3s have a small amount of caffeine! So, I got my doctor to prescribe straight codeine and cut out the coffee/tea again. Eureka!

     

    It has now been a year and a half and I am almost back to my old self. My stomach is rarely upset, injuries heal, the infections all went away and I can now consume grains without any difficulty!

     

    I'm not saying that Celiac is all down to caffeine, but in my case, it was! Had I not realized that my pain medication contained caffeine, I would still be sick today! Instead, I can sit at my computer, research the connection between Celiac and caffeine, and write a response to an excellent article that is cogent (I hope; you be the judge!).

     

    I don't know if giving up caffeine can heal all celiac sufferers, as this article points out, we're not all the same, but it changed my life, and figuratively brought me back from the dead.

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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.