If I don’t drink coffee, I get a headache, what should I do?

If I don’t drink coffee, I get a headache, what should I do?

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  1. Coffee withdrawal headache is a common problem in surgical patients who are told not to eat or drink anything the night prior to surgery. The reason for the headache is the sudden withdrawal of caffeine. The brain itself cannot feel pain. In fact you can operate on the brain of a conscious patient as long as you use local anesthesia to all the layers until you reach the brain from the skin down to the meninges, a fibrous layer that covers the brain. But withdrawal of caffeine causes an increase of blood flow to pain receptors on the meninges resulting in a headache. Many of you have probably know about the over the counter drug migraine medication Excedrin. One of Excedrin’s active ingredients is caffeine.
    This question gives me the opportunity to talk about several topics.
    Why are surgical patients told not to eat or drink the night before surgery?
    Despite the fact that a surgery may be scheduled to be done under local anesthesia with sedation, or by some other form of nerve block, it is always possible that the anesthesia provider may have to induce general anesthesia. During the induction of anesthesia there is a period of time that it is possible for stomach contents to regurgitate and enter the windpipe. If a sufficient quantity of stomach contents pollutes the lungs, a condition called aspiration pneumonitis can result. This inflammation of the lungs can result in death. Certain patients are at higher risk for having an increase in the volume of stomach contents. For example, pregnant women because of changes of physiology have decreased stomach-emptying time. Their muscular sphincter that prevents regurgitation of stomach contents up the esophagus is more relaxed. Parenthetically, that causes a condition called GERD. So because they are increased risk for aspiration, we try to do their C-sections under a spinal or epidural block.
    So what is a spinal block?
    We just mentioned increase pain impulses to the meninges as a cause of a headache. The meninges are a fibrous tissue that adheres to the brain and spinal cord. It is composed of three layers, the Dura, the arachnoid, and the pie. Spinal fluid is located between the arachnoid and the pia, but the dura is thickest and pretty much if you penetrate the dura, you have penetrated the arachnoid. The spinal cord in adults ends approximately midway between your hips and rib cage. A spinal block, called a subarachnoid block by us anesthesiologists, is the introduction of a small amount of local anesthetic into the spinal fluid. We introduce this medication below the level where the spinal cord ends so that we don’t injure the spinal cord. Depending on how far up the patient’s body we want to make numb, we use more or less local. We can also make the level of numbness higher by tilting the patient’s head down letting gravity draw the local higher up the spinal cord. The advantageous of using a spinal block versus an epidural block is that the nerves branching out from the spinal cord are directly bathed with local anesthetic. This creates a faster, more reliable and more complete blockade of nerve signal transmission versus the epidural block, which I will describe later. The disadvantage is that it can cause a post spinal headache.
    What is a post spinal headache?
    This headache is fascinating to me, but not to patients. An adult has about 150 ml of a clear liquid called spinal fluid surrounding his brain and spinal cord. An adult produces about 500 ml a day. If someone has sprung a leak somewhere in the dura matter that causes more fluid to drain out then is produced, then the result is a decrease in volume and pressure of the cerebral spinal fluid. How this decrease in spinal fluid pressure and or volume produces the symptoms, which I will now describe, the scientific literature is probably still incomplete. First it can take days until the onset of the symptoms. For most patients the only symptom is a searing headache that is felt in the front or back of the head when sitting or standing up. But patients can also experience ringing in your ears, stiffness of the neck, double vision and even brain blindness (no actual eye disease). For most patients the symptoms resolve without treatment in seven days. But there are rare reports of the symptoms lasting years. But thank goodness there exists an almost magical cure. Some physicians found that if there was blood coming out of the needle when they first entered the subarachnoid space, that the chances that a spinal headache would occur were much lower. Because of this observation, a method of cure was developed, where a practitioner draws some of the patient’s own blood and then by an epidural technique which I will describe later, injects this blood into the epidural space. The result is an immediate cessation of symptoms. I have only done about a handful of these procedures during my career (because I am really good), but sometimes even after only a few ml of blood is injected, the patient’s symptoms vanish forever. The fact that many patients report having a stiff neck as a symptom, points in the direction that the pain comes from the stretching of the meninges. In the disease meningitis (inflammation of the meninges), which can have many causes, a stiff neck is often the presenting symptom. Guess what caffeine can help alleviate the symptoms of a spinal headache perhaps because it reduces pressure by decreasing blood flow to the meninges pain centers just like in caffeine withdrawal! See how I connected all of these medical facts back to the presenting question!
    What is an epidural block?
    An epidural is much more technically difficult then a spinal block. Sticking the needle through the skin and tissues beneath the skin, then a ligament that covers all the whole spinal column, one breaches into a space between this ligament and the dura matter. Because there is no fluid in this space, it can only be found by a loss of resistance technique where the practitioner can suddenly easily inject fluid or air through the needle, or in pain management some use fluoroscopy and a radio opaque dye to find this space. For pregnant women, epidurals are a godsend not only for C-sections but also more importantly to them the diminution or complete elimination of labor pain. But because they are technically more difficult, the blockade of nerve impulses can be spotty or incomplete. A patient can also experience some pain from nerves well below the level that the needle was inserted. It has a slower onset of action because it has to fill a large space, so the surgeons have to be more patient until they can operate (They hate that fact!). The other problem is that the needle is much bigger then a spinal needle and is therefore much more likely to produce a spinal headache.
    Enough already lets get back to Coffee!
    One can safely consume between six and eight Starbuck shots of espresso a day. That’s equivalent to about sixteen cans of coke. If you go well over these levels, you can have an irregular heartbeat, a heart attack, seizures or more fun yet hallucinations.
    Taken in moderation Coffee is really good for you! Go Starbucks! Besides the obvious increase in alertness and mental energy, it improves reasoning, memory, attention and perception. It has many more or less proven health benefits. A reduction in headaches as we have described, reduction in rates of developing Parkinson disease, maybe even Alzheimer, protects against heart attacks, and Type 2 diabetes mellitus. Coffee does not raise the risk of cancer. It actually lowers the risk of mouth, liver and prostrate cancer. COFFEE INCREASE ATHLETIC PERFORMANCE.
    My favorite effect is that it reduces constipation.
    Pregnant women should drink coffee in moderation; because of the hormones of pregnancy slow the GI tract resulting in greater reabsorption of water in the colon and so increases constipation. This constipation increases the risk of hemorrhoids, Yuck! My favorite treatment for constipation is oral tablets of magnesium. First of most American’s diets are already deficient in magnesium which is a very important electrolyte in the function of smooth muscle, including heart muscle. So taking magnesium will lower your risk of irregular heartbeats. As long as you have a healthy liver and kidney, its very unlikely you will overdose on oral magnesium. If you are constipated and start with one gram, wait a day, if no relief take 2 grams, wait two more days and take three grams, its very unlikely that after a week you will be constipated. Its more likely you will have to cut down by ½ gram every day until you find the happy balance your body needs. Of course everyone needs to stay well hydrated, especially if you are constipated.
    By the way I would also advise you pregnant mothers to lubricate yourself down there with mineral oil and or preparation H suppositories. Lubrication is such a key overlooked technique. You should also cut your food into smaller portions, chew very thoroughly and moisten your food with liquids while you are eating. You will have much fewer problems with gastro esophageal reflux. Oh and by the way, if you have adequate levels of hydration and magnesium, you will be much less likely to go into premature labor.
    By the way, I did do a year of OB/GYN a long time ago; I did approximately about 250 deliveries. I worked a half a year in lower Manhattan where we had a lot of Chinese patients. They had the shortest labors of any race. But they had the worst tears around their vagina. I finally figured out if I really used tons of lubricant through the delivery process, I would get many less and more mild tears. I was really time stressed; I hated spending time sewing those things up. So , any Ob/Gyn residents who are reading this , really slap on something slippery down there. Don’t worry I only dropped one baby!

  2. I had no idea there were so many quack websites about caffeine. No wonder you needed to come here to quora.
    Caffeine is a stimulant and when you stop taking it you are basically going through withdrawals. Headache irritability etc. You don’t really get addicted to caffeine, but it’s really just splitting hairs to say or not say it.
    Most people get a headache for a few days and that’s about it.

  3. I wonder if you would still get a headache if you drank Coca-Cola or Pepsi. Some headache remedies have caffeine added to help speed the med through the body, so possibly you tend to have a headache that is banished by coffee. Thanks for the A2A.

  4. I was having bad habit of consuming tea every morning. The day I skip tea, i feel bad headache throughout day. So, I promised myself to get out of this bull shit thing which is not good for body.
    I didn’t leave tea at one shot, i started by reducing the quantity intake. It took one week to come out of this.
    Day 1 :- 75 % quantity of intake.
    Day 2:- Follow the same above 75%.
    Day 3:- 50 % quantity of intake.
    Day 4 :- Follow the same above 50%.
    Day 5:- 25%
    Day 6 :- 25%
    Day 7 :- 10%
    Day 8:- Only Green Tea 🙂
    This is my personal experience. Rest depends upon your body’s metabolism .

  5. You have a caffeine dependency (re: addiction). When you skip your morning cup of coffee, you actually start going through caffeine withdrawal. Personally, I would recommend trying to cut caffeine out of your life as much as possible, but understand it will involve a degree of withdrawal which can be uncomfortable. There are two links below that can help you to quit your caffeine addiction.
    Caffeine Detox: How to Quit Caffeine and Break the Addiction
    How to Quit Caffeine

    Victor Allen’s

  6. Actually you have made it a habbit to yourself, you should avoid drinking coffee, you need to start decreasing the amount and slowly slowly you’ll be okay with that!

  7. As long as your coffee habit is not excessive, there is no medical reason to quit. Coffee contains some healthy anti-oxidants. Two 8 ounce / 250 ml servings is considered to be moderate consumption. Coffee: Health Benefits, Nutritional Information
    If you must eliminate coffee, try having instant coffee. Buy a supply of caffeinated coffee, and one that is decaffeinated. You can very gradually shift the mix of caf:decaf until you are drinking only decaffeinated.
    Effects of Habitual Coffee Consumption on Cardiometabolic Disease, Cardiovascular Health and All-Cause Mortality

  8. Caffeine Withdrawal

    If I don't drink coffee, I get a headache, what should I do?

    This is called caffeine withdrawal and it typically happens 12-24 hours after your last coffee, peaks at about 3 days, and can affect you for up to 9 days ( Study ).
    Caffeine constricts your blood vessels and when you become accustomed to this, withdrawal from caffeine is proven to increase cerebral blood flow (wider pipes in the brain) and trigger headaches ( study ).
    “What’s happening on a molecular level in my head?”
    Science is not there yet. Increased blood flow may activate pain sensors in the meninges surrounding the brain. This is a common side effect in vasodilator (bigger veins) supplements such as Nitrous Oxide or medications like Viagra. Why this happens is still somewhat of a mystery.
    What happens when I drink coffee?

    If I don't drink coffee, I get a headache, what should I do?

    Drinking coffee can release dopamine in the frontal lobe, increase energy metabolism (meaning you think faster), and temporarily block inflammation in the brain (study 1 , 2 ).
    What might happen when I stop?
    We know for sure that we can build a tolerance to caffeine and blood flow increases from caffeine withdrawal. This most likely means that dopamine release will be low, brain metabolism will be low, and inflammation will be released because that’s what happens when blood vessels widen. When we constrict blood vessels, various inflammatory sources that hurt the human body are blocked, but after the constriction goes away, they might come back in full force. Think of it as closing your house door with a few zombies outside, and then opening the door wide open when there are a lot of zombies outside.
    Other factors
    Some studies have found that over consuming caffeine will increase cortisol and stress throughout the day. One study found that one coffee per day can double your risk of withdrawal headaches, but others have found that coffee may decrease headache risk. You will find a positive study for every negative study on caffeine and the research is divided.
    What to do
    Small amounts of caffeine have successfully prevented rebound headaches and this will help you slowly taper off caffeine (i.e. full cup, 3/4, 1/2, 1/4, etc…). After 3 days, it becomes much easier to withdrawal from caffeine. You can also try green tea to taper off coffee.

  9. You’re experiencing coffee withdrawal headache s, see http://www.sciencedaily.com/releases/2009/05/090501162805.htm . The paper they discussed Caffeine withdrawal, acute effects, tolerance, and absence of net beneficial effects of chronic administration: cerebral blood flow velocity, quant… – PubMed – NCBI showed that it’s the sudden stopping of coffee intake when otherwise chronically on coffee dailythat induces these headaches.
    So either stop drinking coffee altogether by phasing it out gradually, or don’t omit your daily coffee to avoid having these headaches.

  10. I stopped drinking coffee due to some other health issues I have. It took about 2 weeks for the headaches to completely disappear. It’s the coffeine withdrawal side effect, just be ready for it, and good luck!

  11. Everyone gets headaches from time to time. And most of us have caffeine in what we drink and eat every day. Have you considered whether there’s a connection? It’s possible for caffeine to both cause and cure a headache.

  12. Your body is addicted to coffee and is going through withdrawal symptoms. Yes, it is difficult to withdraw coffee after having addicted to it. Start reducing number of cups and also the quantity of coffee before stopping it completely. Or, try with mix of regular coffee and decaffeinated coffee, switch to decaffeinated and then stop.

    Eight O’Clock

  13. You are addicted to caffeine. You need to either decide never to run out of coffee or wean yourself off it by gradually reducing daily consumption over a week or so.
    Personally, it’s a vice I’m prepared to accept. I’ve stocked up on caffeinated chewing gum in case I end ul in hospital without prior notice. 😉


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