Re: Caffeine
- From: rpautrey2 <rpautrey2@xxxxxxxxx>
- Date: Sun, 23 Dec 2007 14:47:37 -0800 (PST)
The effects appear to be source and dose related. - rpa2
A Pilot Study of Some Physiological and Psychological Effects of
Caffeine
Sanford Bolton, Ph.D.
Martin Feldman, M.D.Gary Null, M.S.
Emanuel Revici, M.D.
and LindaStumper, B.S.
from the Journal of Orthomolecular Psychiatry, Vol. 13, #1
Abstract
Eleven volunteers participated in a study to characterize some
physiological and psychological effects of caffeine in a double-
blind,
crossover study. During one week, the subjects were given a caffeine-
containing beverage, and during a second week, they were given an
identically appearing non-caffeine beverage. Data were accumulated
based on urine tests and a medical examination. Diary entries
revealed
typical effects of caffeine such as increased energy, nervousness and
restlessness which were observed after the week of caffeine
consumption. A medical examination showed increased adrenal function
for those subjects who were non-users or occasional users of caffeine
beverages. Habitual users of caffeine beverages showed no obvious
adrenal effects. Determination of pH, surface tension and viscosity
of
urine during the two weeks of the study showed evidence that caffeine
is an "anabolic" agent according to a theory suggested by Dr. E.
Revici.
Introduction
Caffeine, probably the most widely used drug, is a potent
pharmacological and psychotropic agent (Bolton and Null, 1981 a and
b;
Goodman and Gilman, 1975). Many studies in both animals and humans
have been performed in order to quantify and characterize its
physiological and psychological effects.
The research presented in this paper consists of two kinds of
observations resulting from consumption of caffeine beverage during a
two-week period: (1) effects on adrenal function determined by a
medical examination; and (2) physical-chemical measurements of urine,
an indication of the anabolic effect of caffeine according to a
theory
proposed by Dr. E. Revici (1961). In addition, perceived
psychological
effects of caffeine were studied by means of a questionnaire and
daily
diary.
Eleven volunteers drank a caffeinated and non-caffeinated beverage
during each of two weeks. Subjects were medically examined prior to
the study and after each test week. In addition urine samples were
tested both prior to the study and after each test week.
Perceived psychological effects are difficult to quantify. Goldstein
has published several studies in which reactions to caffeinated and
decaffeinated coffee were assessed in both caffeine and non-caffeine
users using extensive questionnaires (Goldstein et al.,1969). The
reactions depended on previous caffeine habituation and use. Heavy
users of caffeine had fewer effects on sleep, and showed less
irritability and nervousness as a result of caffeine intake.
Caffeine ingestion stimulates many bodily responses, some of which
are
opposite indirection (Goodman and Gilman, 1975). For example, after
ingesting caffeine, the heart rate is initially decreased, and then
increased about an hour after intake. "Caffeinecauses increased serum
lipids (Bellettet al., 1969) and affects glucose (Darragh et al.,
1979)
probably through catecholamine mediation."
Subjects who consume high levels of caffeine may, in part, enjoy the
effects of the drug which is stimulating their otherwise under-
functioning adrenal glands.
Previous experimental work has shown that caffeine increases the
output of epinephrine and norepinephrine from the adrenal glands
(Goodman and Gilman, 1981). In the present study, this effect of
caffeine was measured by physical examination and urine sodium levels
in the experimental subjects.
One of the principal objectives of this study was to study the
effects
of caffeine as an anabolic agent. Dr. E. Revici, after many years of
research has proposed that drugs can be categorized by measuring
certain physical-chemical properties of urine, as anabolic or
catabolic (Revici, 1961).
Methods
Various responses were observed for 11 subjects during a two-week
period. Each subject participated in a week of caffeine intake (110
mg
daily) from an herbal tea, and a week of consumption of an otherwise
identical non-caffeinated tea.
Subjects
The eleven volunteers were healthy persons between the ages of 20 and
35 years. They agreed to drink the test beverages during a two-week
period on a double blind basis. Four of the subjects (CE, ZK, AG and
AW) were chronic (2 or more years) coffee drinkers (2-6cups/day). The
other subjects either were abstainers or infrequent users of
caffeine.
Psychological Effects
In addition to keeping a daily diary, subjects were requested to
answer a questionnaire prior to, and after each week of the study, as
follows:
Have you noticed a difference in your energy level?
Have you had more or less difficulty falling asleep?
Have you had more or less power of concentration and/or attention
span?
Have you had a decrease or increase in mood, nervousness or
depression?
Have you noticed any difference in muscular strength, endurance or
stamina?
Adrenal Function
In addition to the data supplied by the diary, subjects were given a
physical-medical examination to assess adrenal function prior to, and
after each week of the study. According to Goodman and Gilman (1975)
caffeine stimulates "the release of catecholamines from the adrenal
medulla. Caffeine also releases catecholamines due to a central
action
and by affecting C-AMP.
The tests for adrenal function included the following:
Ragland Blood Pressure (Burch and de Pasquale, 1962).
Pulse
Blood pressure (seated)
Pupil size
Pupil response to light
Sodium content of urine
Ragland Postural Blood Pressure Test; Method and Physiological Basis
(Burch and de Pasquale, 1962):
This test is a means of evaluating adrenal activity. It detects
diminished adrenal function.
Method: The difference of the systolic blood pressure, measured with
the patient in the supine position and in the erect or standing
position, is an indication of adrenal function. The patient lies
supine for four minutes. The blood pressure is taken in this position
and immediately after the patient stands up.
Upon arising from the supine position and standing erect, the normal
subject has a rise or elevation of the systolic blood pressure. The
systolic pressure rises approximately 510mm mercury. Since the
cardiovascular system must pump blood to the head against the force
of
gravity, higher blood pressure is required.
When diminished adrenal function is present, the systolic blood
pressure taken in the erect or standing position may actually fall.
The degree of lowering of the erect blood pressure gives some
indication of the magnitude of diminished adrenal function.
Adrenal glands have a major role in controlling the tone of the
splanchnic veins. These veins do not have valves and are dependent
upon nerve function.
Koenigsburg Test for Urinary Sodium Chloride Excretion (Brooks,1925):
The adrenal gland produces aldosterone which instructs the kidney to
retain sodium. If adrenal gland function is diminished, aldosterone
production is decreased and salt is spilled into the urine.
Method: The Koenigsburg Test is a titration procedure. Ten drops of
urine are placed in a test tube. One drop of 10 percent potassium
chromate solution is added to the urine.0.74 percent silver nitrate
solution is added drop-wise until the color of the solution turns
brick red. The number of drops required for subjects with normal
adrenal function is17 to 25. Excessive sodium and chloride in the
urine will require more silver nitrate regent to turn the solution
brick red. The most common reason for spilling sodium into the urine
is diminished aldosterone level as a result of diminished adrenal
function.
Comparisons of the amount of sodium and chloride in the urine serve
as
an indirect reflection of aldosterone level and thus, indirectly,
adrenal function. In early stages of diminished adrenal function,
salt
will spill into the urine. However, late in the course of adrenal
exhaustion, there is very little salt left in the body and thus there
is little salt available to spill.
Description of Pupilary Response to Light
The pupil in the normal subject reacts briskly and remains
constricted
as long as the light beam is present. If the body is severely sodium
depleted, the pupilary constriction does not "hold" and the pupil
oscillates. It may even fail to constrict at all. Although salt
depletion may occur as a result of many abnormal physiologic
processes, the most common is diminished adrenal function and
diminished aldosterone and the subsequent chronic loss of sodium and
chloride into the urine (Feldman).
Urine Measurements (Revici Anabolic/Catabolic Index) (Revco,1961):
Fasting urine was analyzed prior to the study and after each of the
two study weeks to determine specific gravity, surface tension
(Revici
urotensiometer) and pH. These results were combined to form an index
to describe the catabolic/anabolic effect of the drug.
According to Dr. E. Revici, the best indication of catabolic/anabolic
effect is measured by a composite index of the urine measurements as
follows (Revici, personal communication):
Index = I = 2(74 - s.t.) + pH + last two digits of s.g.
Alkaline pH = 5 Neutral pH = 10 Acid pH = 20
For example if s.t. = 70, pH = acid and s.g. = 1.016, the index is 2
(74-70) + 20 + 16= 44. Values above 40 are considered to be a result
of administration of a"catabolic" agent and values below 40 are a
result of an "anabolic"agent (See Discussion).
Results
Tables I, II and III present the results of the study. Missing data
occurred because the volunteers either did not supply the necessary
urine, or diary results, or did not keep medical appointments for
examination of adrenal function.
Psychological Effects (Diary and Questionnaire)
Most of the subjects indicated no difference between the two weeks
with regard to questions concerning changes in "concentration" and
"strength"(questions 3 and 5 in diary). Differences which were
recorded by the subjects are shown in Table 1. Three of four subjects
indicated more energy during the "caffeine"week. Two subjects
reported
sleep problems during the second week, both of which were chronic
caffeine users. Five of six subjects reporting an effect were
more"nervous" and "irritable" during the caffeine week. This part of
the study did not show clear cut effects due to caffeine, because of
the small number of subjects and short duration of the study.
Adrenal Function
Table II is a summary of the adrenal function tests performed on ten
subjects. The two criteria which were most affected by the ingestion
of caffeine were Ragland blood pressure(standing minus supine
diastolic blood pressure) and sodium excretion as measured by
the"indicating" solution. (See Methods.)
Adrenal function was based on a clinical examination and an overall
assessment of the blood pressure and sodium excretion as discussed
above. With a couple of exceptions, the pupilary response to light
did
not show discrimination between the treatment weeks. Although,
overall, the two weeks were not differentiated, an obvious pattern
emerged. Most of those who were caffeine abstainers (5 of 6) were
evaluated as having diminished adrenal function during the week of
caffeine ingestion, whereas all of the habitual users of caffeine (4
of 4) showed no difference between the two weeks. Statistical
analysis
(test) showed that the difference between the two groups (chronic
users and abstainers of caffeine) is statistically significant (P <
0.05) for Ragland blood pressure and sodium excretion (P < 0.05).
Urine Measurements (Anabolic Effect)
Eight of the eleven subjects had urine measurements taken before the
study and after each of the study weeks. The analysis of the urine
was
performed under blind conditions.(The analyst did not know whose
urine
sample was being tested or the beverage being taken.) The results are
shown in Table III. There is a tendency toward a lower index (see
Methods) during the "caffeine" week (Week 2) compared to the"non-
caffeine" week. (Interestingly, the pre-study week showed results
similar to the "caffeine" week). The ingestion of caffeine results in
higher surface tension, more alkaline urine and a lower specific
gravity on the average. Six of the eight subjects tested had a lower
catabolic/anabolic index during the "caffeine" week compared to the
caffeine-free week (P < 0.10). This is in conformance with the
proposal of Dr. E. Revici ( 1961): Caffeine is an anabolic agent. Dr.
Revici has been engaged in research for more than 50 years, during
which he has spent considerable time building up his theory of
anabolic/catabolic properties of therapeutic agents. This is the
first
time such an experiment has been independently carried out by others.
Discussion
The results of this double-blind study indicate that clinical tests
show an apparent caffeine effect after one week of use as observed in
a relatively small group of subjects.
Psychological Effects Subjects apparently observed some differences
in
(1)energy (increase with caffeine); (2) sleep patterns (more
difficult
sleeping with caffeine); and (3) mood (more problems with caffeine).
Eight of the eleven subjects observed some difference between the two
weeks of caffeine and non-caffeine use. There was no obvious
tolerance
in the group who were regular caffeine users, although it would be
difficult to document such effects in a panel of this small size.
Although there was some suggestion of a caffeine effect in this very
small group of subjects, subjective effects of caffeine were not
obvious after one week's relatively moderate intake of a caffeine
beverage.
Adrenal Function Caffeine has many effects upon body function. One of
the major effects is to stimulate the adrenal glands to secrete
epinephrine and norephinephrine, resulting in an immediate boost of
energy. However, in time, the adrenal glands become exhausted
(Feldman).
In our society, the stress of day-to-day living has a tendency to
"wear out"our adrenal glands. This diminished activity results in
fatigue. In order to revive adrenal function many people ingest
moderate to high quantities of caffeine. This is an external
stimulant. In time, this stimulation wears out the glands. Thus the
immediate benefit is at the cost of eventual exhaustion (Feldman).
In day to day clinical practice, many patients come to the doctor's
office complaining of fatigue. The severity of this symptom varies
from "mild" to"severe". An example of "severe" fatigue is a feeling
of
being tired and drained of energy even upon awakening from a restful
sleep. At the other end of the spectrum, is a diminished ability to
work efficiently at the end of the day (Feldman).
Occasionally, the fatigue is a result of anemia, depression,
malabsorption, a toxic state or a hypothyroid condition. However, it
is our observation that most of the time fatigue is a result of
diminished adrenal function or adrenal exhaustion. The level of
adrenal function can be ascertained by appropriate physical
examination and laboratory testing. As nutritional therapy corrects
or
improves adrenal gland function the patient's energy improves. If the
adrenal gland returns to a normal state of function, the fatigue is
minimized or is alleviated (Feldman).
In the active nutritional practice of one of the authors (Dr.
Feldman), a recent review of medical records showed that more than 65
percent of new patients complaining of fatigue as a major medical
symptom were drinking three or more cups of coffee or tea daily. Many
patients reported increased intake of coffee and tea as their day-to-
day fatigue became more severe. Upon interview they reported the
necessity of coffee, tea, chocolate, or certain soft drink beverages
to "boost" their energy. It is very likely that caffeine's ability to
stimulate adrenal gland activity accounts for the popularity of
caffeine beverages in our society.
In this study, the results of the physical examination and urine
sodium excretion evaluation showed that chronic users of caffeine can
be differentiated from non-users based on tests which reflected
changes in adrenal function during the two test weeks.
Of the six subjects who used little or no caffeine intake prior to
the
study, four had diminished adrenal function when they were examined
prior to the study. Five of this group of six had marked, measurable,
diminished adrenal functions after the week of caffeine intake.
Of the four subjects who had a high intake of caffeine prior to the
study, all had some degree of diminished adrenal function prior to
the
study. This diminished adrenal function remained about the same
during
the week of caffeine ingestion as well as the caffeine-free week.
The diminished adrenal function was mainly characterized by Ragland
blood pressure measurements and sodium excretion in the urine.
Anabolic Effect (Revici Index)
A most interesting result was the effect of caffeine intake on
certain
physical-chemical properties of urine. Dr. E. Revici has developed a
theory based on almost 50 years of research that body processes and
the effect of drugs on these processes can be categorized as anabolic
and catabolic (Dualistic Concept). Agents influencing these metabolic
states mostly comprise the usual nutrients. However, drugs and other
chemical agents may be categorized as anabolic or catabolic according
to which process they stimulate. The result is an excitation of
either
the catabolic or anabolic effect. Caffeine is considered an anabolic
agent because of its ability to donate methyl groups in anabolic
processes according to Dr. E. Revici. Dr. Revici has used coffee
(with
2 boiled eggs) to help elucidate the nature of symptoms of a disease.
If the caffeine and eggs decreased the symptoms, the disease has
catabolic character. If it increased the symptoms, the disease is
anabolic. Caffeine can then be used to treat anabolic imbalances as a
result of the disease.
Urine surface tension, specific gravity and pH are indications of
catabolic or anabolic nature of the agent. If surface tension is
above
69 dynes/cm, the agent is considered anabolic; alkaline urine is
anabolic and a specific gravity below 1.016 is anabolic. The contrary
results are catabolic. Each of the individual measures is quite
variable, and it would be difficult to accurately categorize an
active
substance based on a single measure. The best way of analyzing such
data is a composite index of all three effects, as recommended by Dr.
Revici (1961). (See Methods.)
Conclusions
Caffeine use, at a relatively moderate level (2-3 cups of tea/day),
results in distinct observable effects. In this research we have
shown
that various physiological and clinical effects can be ascertained
after one week of caffeine ingestion compared to a control week.
The moderate intake of caffeine in the subjects not accustomed to
caffeine produced marked diminution of adrenal function. In the
subjects accustomed to moderate or high caffeine intake, the effects
of the moderate caffeine load which we administered were
indistinguishable from the baseline prior to the study and the week
of
no caffeine intake. Apparently, caffeine users become tolerant to
these effects of caffeine on the adrenal glands.
Instead of stimulating the glands with caffeine, the adrenals should
be supported nutritionally in order to repair them, according to Dr.
Feldman. The nutritional program should include:
Diminished stressors
Learning how to diminish anxiety
Pantothenic acid
Vitamin C
Bovine adrenal gland processed to remove possible toxins and any
hormone
Caffeine ingestion changed the physical/chemical characteristics of
the urine, conforming to Dr. E. Revici's Dualistic Theory. Caffeine
appears to be an anabolic agent, stimulating anabolic processes,
according to this theory. The results showed a lower index for 6 of 8
subjects during the week of caffeine ingestion compared to the
caffeine-free week. (The index also suggested an intake of anabolic
substance(s) in the period prior to the study for most of the
subjects.) According to Dr. Emanuel Revici, disease may have anabolic
or catabolic character. The anabolic nature of caffeine suggests that
this drug may be effective in catabolic disease states. However,
because of its powerful physiological and psychological effects, the
indiscriminate use of caffeine is not warranted. Excessive intake of
caffeine is to be discouraged.
Copyright (c) 2000-2007 Gary Null & Associates, Inc.
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