Cup of Pain

Have you have ever awoken to a python basking on your forehead, or a devil banging a chisel into your eye? If so – and you were not dreaming or otherwise wired to your unconscious! – you know the pain of headache.

Headaches take many forms: tension, sinus, migraine and cluster headaches, to name but a few. Some are mild enough to ignore, or to soothe with a glass of water or a walk on the beach. Others – such as migraine – can send you to a darkened room for days with stabbing pain, crashing fatigue, overwhelming nausea and a relentless need to retch.

As a life-long sufferer, I believe head pain has many causes. Food allergies, barometric pressure, the menstrual cycle and alcohol have all been known to spark headaches and migraines, as have sugar, dairy products, injuries and emotional stress. And that’s just for starters.

But I have also come to believe there is a shadow player at work in the aetiology of headache and migraine – a cause so omnipresent that it is hidden in plain sight. What is it? Wake up and smell the coffee!

Caffeine is a natural pesticide employed by plants to persuade predators to buzz off. Natural sources include coffee beans, tea leaves, cacao (cocoa) beans and kola nuts. It delivers an adrenal kick to the unfortunate consumer that masquerades as energy but is actually chemical stimulation. A few nasty jitters and the marauding party is supposed to avoid that plant. In theory.

Caffeine stimulates the adrenal glands and nervous system, releasing stress hormones into the body. These provide the fight or flight impulse we need to fight tigers! But humans mistake that buzz for vitality, not realising caffeine’s perceived benefits come not from an input of energy but from the body’s attempt to cope with stress hormones in the blood. If Shere Khan (or his corporate equivalent) is indisposed and you fail to burn up those hormones by fighting him or legging it, they continue to create the muscle tension and nervous energy you need to tackle him, regardless of his absence. Before long, the tightness and anxiety build up. And caffeine is rarely blamed.

In the modern world, stress inducers, such as caffeine, lead to a host of physical and psychological problems if experienced or imbibed day after day. To give you an idea of how stress can hurt you, try this experiment. Clench your fist tightly. At first, it feels strong and powerful. But if you keep it up, your hand will get tired and sore. Likewise, caffeine-created stress and muscle tension eventually lead to pain, feelings of mental and physical deflation and, ultimately, profound exhaustion.

Wise animals shun caffeine. But human apes reach for a second shot to lift the tiredness caused by the first hit. Before we know it we are hooked. Coffee and tea drinkers need their morning cuppa to relieve withdrawal symptoms such as headaches and exhaustion. Non-addicts leap out of bed without a fix. (Annoying electro-bunnies!)

But Nature is not our only mistress. Manufacturers, noting caffeine’s addictive quality, have added it to countless comestibles too. Read the labels if you love sodas, fruit drinks, ‘energy’ elixirs, chocolate, flavoured goods and the more obvious caffeine gum (we know who you are 😉 ).

How does caffeine cause headache and migraine? In several ways. It increases muscle tension in the shoulders, back, neck and jaw, which can spark head pain. It depletes the body’s store of muscle-relaxing, anti-migraine magnesium. And it has a powerful vasoconstrictive effect in the brain, contracting blood vessels and decreasing blood flow. As little as 250mg of caffeine has been shown to decrease total brain cerebral blood flow by 30 percent. That is one mug of percolated coffee, or less than two mugs of black tea. If you use caffeine regularly, the habitual ingestion of only 100mg of caffeine per day (a cup of tea or two sodas) can result in headache upon withdrawal. When you deliberately or inadvertently miss your fix, your blood vessels start to open within a few hours. As circulation in the brain increases to normal, you begin to feel the ice-pick agony of a caffeine withdrawal headache. Once your brain gets used to normal blood flow the pain subsides. But it can take days. And the more caffeine you drink the worse the headache is likely to be. (1)

According to nutritionist Stephen Cherniske, whose book Caffeine Blues (1998) details the many deleterious effects of caffeine consumption on human health, the relationship between caffeine and headaches is confusing. For half a century, a major cause of headache has been promoted as a cure; many compound painkillers contain caffeine. But caffeine only helps ‘cure’ a headache by potentiating the other ingredients (e.g. codeine and paracetamol) and halting withdrawal. Until the next time. A cup of tea can be more effective (cos your brain is cravin’ that darned caffeine!).

I have been a caffeine addict most of my life. I have found coffee and tea harder to quit than cigarettes. Unlike nicotine, caffeine has kept a low profile, so people are unaware of its dangers and rarely try to bin it. They are unfamiliar with the exhaustion and headaches that can burn a trail right back to the espresso bar if they stop too fast. The trick with caffeine withdrawal is this: never go cold turkey. If you are on medication, consult with your doctor before withdrawing from caffeine, as it could affect your dosages. Drink the same number of cups each day but make them gradually weaker over a two-week period. For coffee drinkers, there is a useful quitting plan on the Teeccino herbal coffee website. You can order Teeccino online (it is delicious!) but you can also use organically-grown, non-chemically decaffeinated coffee. Just remember to quit drinking decaf afterwards; it contains acids, oils and caffeine (albeit a small amount!) that your body can do without.

For tea drinkers, use loose tea, a measuring spoon and a tea ball (they’re hangin’ in The Hopsack!) when making tea and time the infusion. Decrease the amount of tea you use over a two-week period. You can also reduce the amount of water per cup; if you don’t, the tea might taste insipid. This method is a bit of a pain but it gives more accurate results than tea bags.

Soda drinkers can drink the same number of cans per day; just don’t drink the whole can each time. Instead, measure it into a glass, slowly lessening the amount you drink per glass over the course of a fortnight.

While you’re decreasing your caffeine intake, slowly increase your intake of pure water and vegetable juices. Green juices, in particular, help with detoxification and counter fatigue. Freshly made juices are great for real energy! But check with your doctor first if you are on any medication. Some drugs, such as Warfarin, can interact lethally with greens. Transdermal magnesium may be helpful too. Again, check with your doctor before using it. The main thing is to crawl along and not to be too ambitious. Ambition leads to headaches, despondency and failure. But success leads to far fewer aches and pains. And those you do have are likely to be milder.

A word about herbs. Guarana, maté and ephedra (Ma Huang) all contain forms of caffeine. Don’t be fooled by promises of vitality. Green tea, white tea and chocolate (including raw cacao) also contain caffeine. While they do confer antioxidant benefits, their caffeine content may be giving you grief. And if you decide to take ginkgo biloba while still ingesting caffeine, watch out! You could unwittingly trigger a withdrawal headache, as ginkgo quickly dilates the blood vessels that caffeine constricts. Come off caffeine before you start taking ginkgo. Oxygen also widens blood vessels, so if you’re hanging in LA, quit caffeine before visiting the oxygen bar!

You may already know the pain of unintentional caffeine withdrawal if you have snoozed til noon and awoken in agony. Yep, you forgot your 7am fix…! Another example is the post-operative headache, when a patient has fasted prior to surgery. He wakes up post-op with a blinding headache – not, as was once believed, due to anaesthetics but to caffeine withdrawal!

I suffered post-operative migraine years ago. More recently, I quit coffee and tea before two major surgeries. I awoke from my operations headache-free and dreaming of home-made cheese sandwiches (that’s what hospital cuisine will do to ya!). So if you know you’re going under the knife, quit caffeine first. You’ll be glad you did 🙂

(1) All figures/studies mentioned above are referenced in Stephen Cherniske, Caffeine Blues (New York, 1998) pp185-190 and pp421-22