Much has been said and written about caffeine over the past half century. There have been over 20,000 studies conducted looking at the various effects and benefits of caffeine over this period of time. Numerous studies have demonstrated the tremendous health benefits that can be derived from regular daily consumption of caffeine, most commonly delivered through the consumption of coffee or energy drinks such as Red Bull or similar beverage. All of these have a high caffeine content.  In almost any way that caffeine is consumed, there are certain health benefits that it delivers. Despite all the negative press that has been attributed to caffeine, there has never been a study that has shown that caffeine has long term negative health effects, quite the contrary. The vast majority of studies have shown some beneficial effect in the regular consumption of coffee and caffeine. In that sense, caffeine is truly one of nature’s own wonder drugs.

The use of caffeinated beverages  by humans is documented  since the 15th century. Over the past 100 years there has been an explosive growth in the manner that we get our daily “caffeine fix.” Coffee has been a staple beverage in most countries and cultures of the world. Prepared in various ways, it is all still derived from the humble coffee bean. There are many different types of coffee beans and many more ways to roast and grind the bean. The combination of these factors leads to preparation of coffee and related drinks. Caffeine is also added to various soft drinks and energy drinks, which gives these beverages the ability to make a person feel a “boost” in energy and alertness. In contrast to regular, black coffee – the healthiest of caffeinated beverage genre – many coffee preparations, soft drinks and any energy drink contain high quantities of sugar and/or fat. It is these ingredients that may contribute to the undeserved reputation that coffee or caffeine is not healthy. Of the regular, commercially available coffee, Starbucks has the highest caffeine content coffees.

Caffeine is a complex compound which is used both recreationally and medically. It has the ability to attach itself (the caffeine molecule) to adenosine receptors in the body and brain. Adenosine is the chemical transmitter in the body that helps us to shut down, prior to sleep. It is the body’s own natural braking system that is responsible for us feeling tired, fatigued and go into sleep mode. Caffeine has the quality of being able to “plug into” the adenosine receptors thereby preventing this chemical transmitter from doing its job. This is particularly true in the brain, spinal cord and muscles. Without the “shut down” signal from adenosine, caffeine is able to “rev” up the brain and give the classic caffeine jolt that so many of us are familiar with. Within minutes of being ingested, caffeine speeds to our brain causing a release of another brain transmitter, dopamine. Dopamine is one of our body’s own internal energizers and antidepressants. The release of dopamine in the brain gives us a sense of well being, pleasure, increased awareness and alertness and improved problem solving abilities. Caffeine has the ability to improve brain activity and cognition. Psychological studies done on university students taking a test showed that those students who consumed caffeine prior to the test scored statistically better that their non-caffeinated counterparts. Studies done by the United States military showed that infantrymen or jet pilots scored higher and performed better on training and flight missions when they had consumed caffeine prior to performance testing. With increased alertness and improved problem solving abilities, it is no wonder that those individuals who consumed caffeine did better.

Many other health benefits have been attributed to caffeine and coffee. Some studies have shown that regular daily consumption of coffee may have an effect of protecting one later in life from developing Parkinson’s disease, Alzheimer’s disease, diabetes, high blood pressure and heart disease (coronary artery disease.) Although occasional consumption of caffeine can temporarily raise your blood pressure, a Harvard study showed that the regular consumption of six cups of coffee daily did not increase the chances of developing heart disease. Another study showed that in individuals with regular consumption of coffee actually reduced their chance of dying from a heart attack by 53%. Habitual coffee drinkers bodies become accustomed to the transient elevation of blood pressure, by caffeine, and their blood pressures most commonly normalize. That is true assuming you do not start off with mildly elevated blood pressures. Many foods have high antioxidant levels, but regular, brewed coffee has a very high concentration of antioxidants. It may be this particular component of coffee that provides the health benefits of reduction in risk for stroke, coronary artery disease (heart attack), diabetes, Alzheimer’s and Parkinson’s disease.

Caffeine has a slightly different effect on muscles but can help improve strength when combined with regular exercise. Muscles have adenosine receptors on them. Caffeine can plug into these muscle adenosine receptors. As a result, there is more calcium released when muscles contract. Calcium is the main chemical component involved with muscle contraction. The more calcium released during a muscle contraction, the stronger the muscle contraction. When muscles are repeatedly strengthened with muscle contractions, such as with weight resistant exercise, it is this increase in muscle contraction strength that help build stronger muscles. It is perhaps the effects of the energy drinks, loaded with both sugar and caffeine that provides the increased exercise performance. One study showed that it was actually caffeine tablets, high caffeine content soft drink or energy drinks that provided this benefit as compared to coffee. A cautionary note: if you have known heart disease, check with your cardiologist before consuming caffeine or caffeinated beverages.

Diabetes is a growing epidemic in the United States with over 30% of the population being considered to be obese. Obesity, defined as being over 20% over ideal body weight (BMI over 30), with morbid obesity generally defined as being 100 pounds or more over ideal weight, represents multiple health risks. The concept of metabolic syndrome: central obesity, high blood pressure and diabetes is an ongoing major health concern in the U.S. Drinking regular, black coffee without any sugary additives or even sugar itself can help reduce the risk of developing diabetes. A different Harvard University study showed that drinking 5 cups of regular coffee a day reduced the risk of developing diabetes by 50%. Much of this effect was attributed to the high antioxidant levels contained in regular, brewed coffee. If you must have your coffee sweetened, it may be better to consider a sweetener alternative such as NutraSweet, Splenda or Sweet’N Low over sugar.

In summary, the multiple health benefits of caffeine and regular, black coffee cannot be overstated. Thousands of studies have shown different, multiple health benefits from daily consumption of coffee. With the exception of heart disease, stomach ulcers and uncontrolled high blood pressure, adverse effects of consuming 3-6 cups of coffee have not been shown. The long term benefits of daily coffee consumption are quite clear and the protective effects of this complex drink are tremendous. If you are not a coffee drinker, then the next best thing would be to try caffeine pills. Either way, you have everything to gain for a healthy supplement, in addition to regular exercise and a sensible diet.

Recent studies have suggested that qualifying Parkinson patients benefit from earlier treatment with deep brain stimulation, as reported in Clinical Neurology News. The study indicates that younger Parkinson disease patients are more likely to benefit from early brain stimulator treatment. There is information that may suggest that this therapy may have a protective effect in delaying the progression of Parkinson’s disease. Deep brain stimulation (DBS) was FDA approved in 2002 for treatment of Parkinson’s disease. Symptoms that are best controlled include tremor and dyskinesias although brain stimulation can also help reduce freezing and off time. Younger Parkinson patients develop motor complications such as dyskinesias, off time and freezing much earlier than older patients with Parkinson’s disease. As reported by Dr. David Charles, a Vanderbilt University Medical Center Parkinson neurologist, “No therapy…has bee shown to slow the progression of Parkinson’s.” The previous thinking was to wait until a patient had severe motor complications that could not be controlled with medications prior to considering DBS therapy. The new thinking, and research, is exploring benefits of DBS in earlier stages of Parkinson’s disease. In various reported cases, patients not only benefited from better control of their Parkinson motor symptoms but also had improved quality of life. Added advantages is that Parkinson patients treated earlier with DBS used less medications over an 18 month period, as shown in one small study. There are two studies currently looking at the benefits of early DBS therapy in Parkinson patients: EARLYSTIM is a French study and a smaller study at Vanderbilt University are in progress. It should be noted that Parkinson’s disease is a progressive neurodegenerative disorder. Even patients with DBS therapy do have progression of their symptoms. Memory loss can be a part of the Parkinson syndrome and is not helped by DBS therapy. DBS is not a substitute for optimal neurological and medication management of Parkinson symptoms. Dr. Kassicieh, at Sarasota Neurology, provides medical and neurological management for patients with Parkinson’s disease and brain stimulators. For more information click here.

Essential tremor is a common disorder than is characterized by involuntary shaking of the head, jaw, hands or legs. It is estimated that there are 5-10 million affected individuals in the United States. Unfortunately, many patients are incorrectly diagnosed as having Parkinson’s disease when they actually have a form of essential tremor (ET). ET tends to run in families and can have onset anywhere from 20-60. Parkinson’s disease most commonly starts after the age of 60 and is generally thought not to be hereditary. The characteristics of essential tremor and Parkinson related tremor are quite different. Typically the tremor seen in Parkinson’s disease occurs in the hands and is seen with the hand at rest. The tremor has a unique “pill-rolling” quality to it. The Parkinson tremor stops when the individual moves or uses their affected hand. Essential tremor is not present when the affected limb is at rest. When an individual moves their arm or tries to grasp or hold an object, then their tremor becomes apparent. This is most readily seen when trying to write, hold a beverage container or use eating utensils. Writing is affected in both conditions. In essential tremor, the writing becomes jerky with a zig-zag appearance to letters whereas with Parkinson patients, their writing becomes progressively smaller, trailing off into a non-legible line. It is uncommon for Parkinson patients to have head, jaw or leg tremor. These are much more commonly seen in the ET population. Patients with Parkinson’s disease have other clinical features that benign tremor patients do not have.

Treatment for patients with essential tremor (benign tremor, familial tremor) is readily available. Many patients have already discovered that small amounts of an alcoholic beverage will temporarily stop their tremor. Medications used to reduce tremor severity may include primidone, clonazepam, propanolol, mirtazepine or Topamax. All of these medications can be helpful but there is a potential for side effects, as with any treatment. For patients with severe, disabling tremor that is not responsive to medical treatment, surgical treatment with deep brain stimulation can be very effective. This procedure is highly effective in minimizing or completely controlling tremor. It has been approved for use since 1997. This procedure can dramatically improve a patient’s quality of life.
In summary, if you or one of your family is affected by obvious tremor, it is in their best interest to see a movement disorder specialist to get the correct diagnosis and treatment. The treatment and prognosis of essential tremor and Parkinson’s disease is quite different. The medications used for one will not help the other. Significant problems with unwanted side effects can develop if each condition is not treated properly.

Deep brain stimulation is an innovative way to control severe tremor or some of the motor symptoms of Parkinson’s disease. This medical device was approved by the FDA in 1997 for treatment of patients with severe tremor that was not controlled by medications. A few years later, it was approved for treatment of Parkinson tremor and dyskinesias (involuntary head, arm and leg movements.) The main deep brain stimulation unit, manufactured by Medtronic, is called Activa Soletra. This is a small pacemaker-like device that is placed under the skin, just under the collar bone. The small electrode wire is then run under the skin, behind the ear and through the skull. The electrode tip is placed in a specific area in the brain that is responsible for tremor and dyskinesia control. A patient may need one or both sides done with a stimulator unit, depending on the severity and nature of their movement disorder. The risk of brain stimulator therapy is low other than at the immediate time of surgery. Once healed, patients can expect fewer side effects from deep brain stimulator therapy than from the several medications they may have to take to control their Parkinson symptoms. It should be noted that the best possible result from brain stimulator therapy will not exceed that of a Parkinson patient’s best response to levodopa therapy. Essential tremor patient’s can generally expect to completely stop medications that they are on for tremor control. Brain stimulator therapy is a safe, scientifically proven method for control of disabling tremor or other limb movements. It does not substitute for Parkinson medication but may help in reducing the amount of medication a patient has to take.