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'''Caffeine''' is a central nervous system stimulant and the active ingredient in [[coffee]].<ref name="Medlineplus">{{Cite web | url = https://medlineplus.gov/caffeine.html | title = Caffeine | last = | first = | author-link = | date = | website = MedlinePlus|archive-url=|archive-date=|url-status= | access-date = 2022-05-23}}</ref><ref name="WebMD">{{Cite web | url = https://www.webmd.com/vitamins/ai/ingredientmono-979/caffeine | title = CAFFEINE: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews | last = | first = | author-link = | date = | website = WebMD|language=en|archive-url=|archive-date=|url-status= | access-date = 2022-05-23}}</ref><ref name="Mayo">{{Cite web | url = https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678 | title = Caffeine: How much is too much? | website = Mayo Clinic|language=en | access-date = 2022-05-23}}</ref> For most healthy people, it is not harmful to consume up to 400mg of caffeine a day.<ref name="Mayo" /><ref name="FDA" /> ==Uses== Caffeine occurs naturally in [[coffee]], [[tea]], [[cocoa]], chocolate, [[guarana extract|guarana]], and many other plants, foods and drinks.<ref name="WebMD" /><ref name="Mayo" /> Caffeine can also be taken as a supplement and may be added to other food or drinks, especially energy drinks.<ref name="FDA" /> Caffeine is typically used for: * increased mental alertness *[[migraine]]s and [[headache]]s, including in over-the-counter and perscription drugs * improved athletic performance * to improve [[short-term memory problems|short-term memory]] * [[obesity]]/[[weight loss]] * less commonly, for [[asthma]] or gallbladder disease<ref name="WebMD" /> ===Energy drinks=== Drinks marketed as '''energy drinks''' or sometimes '''sports drinks''' typically contain a number of different stimulants, including: * high or very high doses of caffeine * high or very high amounts of simple sugars * [[taurine]] * [[guarana extract]] * [[methionine]] * [[ginseng]] * other [[amino acid]]s or natural stimulants<ref name="Clauson2008" /> Energy drink brands include such as Spike Shooter, Pimp Juice, Red Bull, and Cocaine. <ref name="Clauson2008">{{Cite journal | title = Safety issues associated with commercially available energy drinks | date = 2008-05-01 | url = https://www.sciencedirect.com/science/article/pii/S1544319115312097 | journal = Journal of the American Pharmacists Association | volume = 48 | issue = 3| pages = e55–e67 | last = Clauson | first = Kevin A. | last2 = Shields | first2 = Kelly M. | last3 = McQueen | first3 = Cydney E. | last4 = Persad | first4 = Nikki|language=en|doi=10.1331/JAPhA.2008.07055|issn=1544-3191}}</ref> ===Caffeine powder=== The FDA has issued a warning against the use of caffeine powder, which can provide 1200mg of caffine per 0.15 tablespoons of pure caffeine, this is three times the suggested safe daily limit and a level high enough to cause toxic effects, including [[seizure]]s.<ref name="FDA"/> ==Theory== ==Evidence== ===Perscription drugs === Caffeine is FDA-approved for: *[[migraine]] and [[tension-type headache]]s, when combined pain relief drugs *Preventing headaches after surgery (for people who regularly consume caffeine) *Caffeine citrate is approved for pauses in breathing that may be followed by low heart rate and low oxygen levels in newborns. ===ME/CFS === Many people with ME/CFS use caffeine to improve mental alertness or [[concentration]] or to reduce [[fatigue]] in the short term, but the 2014 [[International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis]] primer cautions against excessive usage due to the risk of [[tachycardia]] and [[agitation]].<ref name="Primer2014">{{Citation | date = 2014 | url=https://www.massmecfs.org/images/pdf/Primer_2014.pdf | title=Chronic Fatigue Syndrome Myalgic Encephalomyelitis Primer for Clinical Practitioners | last1 = ((International Association for Chronic Fatigue Syndrome / Myalgic Encephalomyelitis)) | author-link = International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis | last2 = Friedberg | first2 = Fred | author-link2 = Fred Friedberg | last3 = Bateman | first3 = Lucinda| author-link3 = Lucinda Bateman | last4 = Bested | first4 = Alison C | author-link4 = Alison Bested | last5 =Davenport | first5 = Todd | author-link5 = Todd Davenport | last6 = Friedman | first6 = Kenneth J | author-link6 = Kenneth Friedman | last7 = Gurwitt | first7 = Alan R | author-link8 = Alan Gurwitt | last8 = Jason | first8 = Leonard A | author-link8 = Leonard Jason | last9 = Lapp | first9 = Charles W | author-link9 = Charles Lapp | last10 = Stevens | first10 = Staci R | author-link10 = Staci Stevens | last11 = Underhill | first11 = Rosemary A | author-link11 = Rosemary Underhill | last12 = Vallings | first12 = Rosamund | author-link12 = Rosamund Vallings|location=Chicago, USA| publisher = International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis}}</ref> Consuming caffeine in the afternoon or evening is also advised against for ME/CFS patients due to the likelihood of it causing or contributing to [[insomnia]].<ref name="Primer2014"/> Adolescents and children with ME/CFS are advised to limit the use of caffeine for concentration/attention to times when it is particularly important, such as for exams, and to be aware of the caffeine found in energy drinks.<ref name="Rowe, et al, 2017">{{Cite journal | last1 = Rowe | first1 = Peter C. | author-link1 = Peter Rowe | last2 = Underhill | first2 = Rosemary A. | author-link2 = Rosemary Underhill | last3 = Friedman | first3 = Kenneth J. | author-link3 = Kenneth Friedman | last4 = Gurwitt | first4 = Alan | author-link4 = Alan Gurwitt | last5 = Medow | first5 = Marvin S. | author-link5 = Marvin Medow | last6 = Schwartz | first6 = Malcolm S. | author-link6 = Malcolm Schwartz | last7 = Speight | first7 = Nigel | author-link8 = Nigel Speight | last8 = Stewart | first8 = Julian M. | author-link8 = Julian Stewart | last9 = Vallings | first9 = Rosamund | author-link9 = Rosamund Vallings | last10 = Rowe | first10 = Katherine S. | author-link10 = Katherine Rowe| title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer| journal = Frontiers in Pediatrics | volume = 5 | issue = | pages =121 | date = 2017| doi =10.3389/fped.2017.00121}}</ref> ==Risks and side effects== For most adults, a limit of 400mg of caffeine daily is likely to be safe, although this may not necessarily be safe long term.<ref name="Mayo" /><ref name="FDA" /> Just four cups of brewed coffee, ten cans of cola or two typical energy shot drinks provide the maximum recommended amount of 400mg of caffeine.<ref name="Mayo" /> Caffeine sensitivity varies greatly between people so some people will experience harmful effects at much lower doses.<ref name="FDA" /> ===High doses === Large doses of caffeine can cause serious adverse reactions, including even fatalities resulting from excessive consumption, especially in the form of [[#Energy_drinks|"energy" drinks]] or [[#Caffeine_powder|caffeine powder]].<ref name="FDA">{{Cite web | title = Spilling the Beans: How Much Caffeine is Too Much? | date = 2021-12-02 | url = https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much | last = Office of the Commissioner | first = | author-link = |language=en| publisher = [[Food and Drug Administration]] | access-date = 2022-05-23|quote=|via=}}</ref><ref name="Clauson2008" /><ref name="Calabro2016">{{Cite book | title = Neuropathology of Drug Addictions and Substance Misuse | date = 2016 | chapter-url=https://www.sciencedirect.com/science/article/pii/B978012800634400072X | volume = 3 | pages = 723–732 | last = Calabrò| first = Rocco S. | author-link = | last2 = Naro | first2 = Antonino | author-link2 = | last3 = Bramanti | first3 = Placido | author-link3 = |isbn=978-0-12-800634-4|chapter=Chapter 72 - Caffeine and Taurine and Energy Drink Abuse|language=en|location=San Diego| publisher = Academic Press|editor-last = Preedy|editor-first = Victor R.|doi=|quote=|edition=|url=| editor1-link = |editor-last2 = |editor-first2 = | editor2-link = |veditors=|others=}}</ref><ref name="WebMD" /><ref name="Mayo" /> Caffeine is mildly addictive, but other substances found in energy drinks are more addictive.<ref name="Calabro2016" /> Caffeine withdrawal is not considered dangerous. Excessive caffeine intake causes: *[[Restlessness]] and shakiness, sometimes called "jitters" *[[Insomnia]], especially if drunk/taken in the afternoon *[[Headache]]s *[[Dizziness]] *[[Tachycardia|Fast heart rate or racing heart]] *[[Dehydration]] from increased urination *Nervousness *[[Irritability]] *[[Anxiety]] *Dependency, meaning that higher amounts of it are needed to get the same results *Upset stomach or [[heartburn]] *Reduced [[calcium]] absorption *[[hypertension|Increased blood pressure]] *Muscle [[tremor]]s<ref name="WebMD" /><ref name="Medlineplus" /><ref name="FDA" /> ===Interactions=== Caffeine may interact with certain perscription drugs or other supplements, particularly: * [[Ephedrine]], which is used in decongestants *Theophylline, a medication used to open up bronchial airways. *[[Echinacea]], a herbal supplement sometimes used to prevent [[colds]] or other [[infection]]s<ref name="Mayo" /> ==Costs and availability== Very widely available and inexpensive. ==Notable studies == *2015, Brain-derived neurotrophic factor concentration may not be depressed in chronic fatigue syndrome<ref name="Patrick2015">{{Cite journal | title = Brain-derived neurotrophic factor concentration may not be depressed in chronic fatigue syndrome | date = 2015-04-03 | url = https://doi.org/10.1080/21641846.2015.1024004|journal = Fatigue: Biomedicine, Health & Behavior | volume = 3 | issue = 2 | pages = 122–125 | last = Patrick | first = David M. | last2 = Miller | first2 = Ruth R. | last3 = Steiner | first3 = Theodore | last4 = Gardy | first4 = Jennifer L. | last5 = Parker | first5 = Shoshana M. | last6 = Tang | first6 = Patrick|doi=10.1080/21641846.2015.1024004|issn=2164-1846}}</ref> - [https://www.tandfonline.com/doi/full/10.1080/21641846.2015.1024004 (Abstract)] == See also == *[[Guarana extract]] *[[Taurine]] == Learn more == *[https://medlineplus.gov/caffeine.html Caffeine] - MedlinePlus *[https://www.webmd.com/vitamins/ai/ingredientmono-979/caffeine/ Caffine] - WebMD *[https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678 Caffeine] - Mayo Clinic *[https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much Spilling the Beans: How Much Caffeine is Too Much?] - FDA == References == {{Reflist}} [[Category:Potential treatments]] [[Category:Herbs]] [[Category:Supplements]] [[Category:Diets]] [[Category:Central nervous system stimulants]]
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