Hi, Dr. Bernard here. I recently published a video on Chubby Emu about a man who accidentally dry scooped a lethal dose of caffeine. Link is in the description below. That's a de-identified case from a colleague of mine, but the general circumstance surrounding that accident was really familiar to me. When the idea of mixing supplements came up, as like the patient did in this video, it brought me back to a time earlier in my life where I did the exact same thing.
In fact, some of my closest friends immediately recognized it. When I was in college, I used to buy supplements to the tune of hundreds of pounds of protein powder. The more you bought, the cheaper it was per pound.
We're talking like two or three dollars a pound back in the mid-2000s, and I would save up all the money that I made working minimum wage at Target. It used to come in these big plastic bags. I remember hauling it down the dorm hallway.
What you would do is that you would mix a blend of casein and whey together, so you get slow and fast-acting proteins, and then you'd add your own flavoring in. But then I started to get into things like mixing in amino acids or something else called beta-alanine. There was a time when Waxy Maize was really popular. It's a heavy starch that would supposedly absorb into your body really quick. I think it was the first thing that you did post-workout, but you could also do it peri-workout.
And to be honest, I don't remember any of those things helping out very much. Sometimes what would happen was that I would mistakenly mix the wrong stuff together because I didn't label things properly. But when it came to amino acids, There was a very particular taste to them. The leucine would float up to the top. It kind of had a greasy feel in your mouth, but you distinctly knew that it was a powder because it was grainy.
And all three of the amino acids would stick to the back of your throat, so you had to wash it down with even more water. And then now you feel bloated. Beta-alanine also had its own taste. It was kind of like fish to me, and it would make the shake sour.
So I never mixed it with cookie dough flavored protein powder mixed in milk. except for the times when I would mistake the wrong things and mix the wrong supplements together. And I remember when those times happened because the shake was just absolutely disgusting, and everything had already been mixed at that point, so good luck dealing with those shakes for the next couple of weeks.
That's where the patient in the caffeine video got into trouble, because that was exactly what he did, mistake amino acids with caffeine, and that's what led to the overdose. Typically you take 5 grams of amino acids, 5 grams of caffeine, however, is more than 10 times the recommended daily limit. This is all the pretext for my own caffeine withdrawal experience.
I was pretty surprised that caffeine was included in this patient's mix, however he wanted to do it. In general, maybe it could pass for a pre-workout, but even then, caffeine is a stimulant. It's not a great one when it comes to giving you a pump at the gym, and really, it's included in so many regular drinks that you really shouldn't need to add it to anything to get the desired effect from it because you're gonna get it no matter what. But exactly how do you get that effect? Caffeine is a methylxanthine.
It's a stimulant natural product derived from plants. So when we look at the chemical structure, it resembles adenosine. For our purposes here, adenosine is an inhibitory neurotransmitter in the brain. Some natural chemicals are heavily conserved, so adenosine triphosphate. Adenosine is also used in RNA.
The ubiquity of it in humans and other mammals means that when a plant make something that's similar in shape, it's probably going to have activity. All of this gives us some context as to what we're working with here, and also how it can even cause a withdrawal effect in the first place, which at one point in time needed confirmation to even exist in the first place. So if we know that caffeine is a stimulant, and it resembles adenosine, which is an inhibitory neurotransmitter, then we can deduce that caffeine would somehow negate the effect of adenosine.
That is, caffeine blocks neuro- inhibition, thereby causing the opposite stimulation. When allowed to work properly, adenosine slows the heart rate down. You want that in times when a patient's heart is beating so fast and so erratically that it's not contracting in a way that moves blood. If caffeine is there to block adenosine, meaning that caffeine won't allow adenosine to slow down the heart, then the result is that the heart beats faster. Increasing adenosine also increases the person's need to sleep.
So blocking adenosine via caffeine would disturb one's sleep cycle, and we know when it comes to caffeine consumption, that topic in particular is widely documented. It goes so far as to people saying that our entire economic machinery has been widely impacted by caffeine because it causes one to stay awake to do more. Adenosine also helps keep blood vessels at normal diameter, so blocking it with caffeine causes vasoconstriction.
Keep in mind, all of this is talking about a regular dose of caffeine, so let's just say the 400mg daily limit. When we come to overdose, like in the chubby emu case, everything changes. So again, right now, we're not talking about overdose, just a regular dose.
So just by this mechanism of how caffeine works, the analogy that we could use is that it's a molecule that doesn't allow the nervous system to step on the brakes, so to say. We can interpret that a couple ways. If in the case that the figurative vehicle that's analogous to your daily vitality, wakefulness, and concentration, aren't really moving that fast in the first place.
Caffeine not allowing the brakes to be engaged means that you just keep going. There's no indication of speed, so you could just be coasting. and you keep going, even when you don't want to.
So while we know caffeine is a stimulant, it's not as strong a stimulant at regular doses as some other things that are used to treat pathological conditions, or that just aren't lawful in the United States. In other words, we can say that caffeine doesn't cause excess stimulatory neurotransmitter release in key parts of the brain. Rather, it mostly prevents inhibition by blocking adenosine. Biological systems tend to adapt to the conditions placed on them.
So if the body needs adenosine for normal function, but you have an exogenous compound, caffeine, that's present in blocking the function of adenosine, then that biological system will want to respond by creating more adenosine receptors in the hopes that it can get some signal from adenosine. So in order to get the same effect from that exogenous compound, you will now need more of it because the brain has created more adenosine receptors to block. Sometimes people will overshoot it.
and then mass ingest a lot of exogenous compound, causing the body to adapt again and create even more receptors in response. Now you have a situation where there's way too many adenosine receptors present, and if you don't have some caffeine present every day, all the time, then there's an overactivity of adenosine. This is what we call dependency, and many other substances that are misused undergo a similar mechanism in the body. You've built up to a point where you're dependent on an exogenous substance. If you don't have it, you get symptoms of being ill.
There's a pain and discomfort associated that are so unpleasant, that all you need is just some of that substance to not feel that discomfort. And that's how the withdrawal mechanism happens as we know it today. All of this bringing me to my own experience with caffeine withdrawal.
I've had this a lot of different times in my life, and what's funny about it is that whenever I experience it, I don't necessarily realize that it's because of a lack of caffeine as it's happening. When 2020 happened, I definitely got myself into a nice caffeine ritual, because I could finally brew it at home for breakfast. Actually, it came out of the 2 gallons coffee video that I made on Chubby Emu in May of that year.
I bought the coffee maker as a prop, and then I used it to make and drink actual coffee. I remember I measured it out to be somewhere between 300 and 400 mg of caffeine daily. This wasn't my first foray into it, there was coffee, soft drinks, and even earlier in my life, energy drinks that were always around. I still have this coffee maker, but I don't really consume as much caffeine now as I did back then.
And here's how it went down. In May of 2021, I was brought on by my friend in Washington, D.C. to help make a video about a veteran who is advocating for VA policy on those who are exposed to burn pits while they were deployed overseas. That's exposure to burning garbage to everyone that's close by.
That video is published as a soldier was exposed to a burn pit. This is what happened to her organs. on Chubby Emu.
What was really cool about that project was that a local rental house called DC Camera agreed to let us borrow cinema lenses for that weekend for this particular shoot, as well as do some lens tests. So on the day of, we got to location, rest in peace, the patient who was covered in that video passed away almost a year after that shoot. We got there mid-morning around like 10 a.m. I hadn't had any coffee or caffeine, but I brought plenty of water. The shoot lasted to around 8 p.m.
and basically Anytime I've been consuming caffeine regularly, I don't drink anything containing it after around 2pm. So when we finished the shoot, no caffeine could be consumed that day. And the next day, I could feel it.
It started with a hangover-like headache the moment I got up. I was tasked with returning the lenses since my friend was the one who helped us get them in the first place. On the drive there, the headache kept getting worse and worse.
It really was like a hangover, or the kind of headache that I get when I don't drink enough water. Before arriving to DC Camera, full circle, I had to stop at a Target that was close by, because I was going to puke. A lot of times in my videos I'll talk about somebody having a tinge in their cheek and a sour taste rushes into their mouth with saliva flooding under their tongue as they empty their stomach in a way like never before.
And that was exactly what was happening to me. I remember standing at the sink in a Target, gripping the sides of the counter, and I could feel my guts wrangling in a way that it normally doesn't do. It felt like there was an earthquake in my abdomen and I just remembered like the absolute struggle to just not empty my stomach into the toilet completely.
All during this time there were shoppers who were going in and out of the bathroom looking at me like What the heck is this guy doing? All this time I had no idea that this was caffeine withdrawal I hadn't had that kind of headache for a long time because I don't really drink liquor and because Stay at home was such a thing in the year prior. I had always had adequate water intake What I didn't have was the coffee that I would normally drink for two mornings in a row at that point.
The symptoms were severe headache that kept getting worse as the morning continued, that ended in severe nausea. The reason how I knew that it was caffeine withdrawal was because at that Target, I bought two bottles of Mountain Dew and I chugged them and within an hour, basically everything went away. Chugging them in the first place was pretty terrible because anyone who's ever had that kind of hangover headache knows that when you put anything into your stomach during that time, you feel like it's going to come right back out.
Given the pretext, we have a pretty decent idea of why this happened. I did have caffeine tolerance that came from that one pot of coffee that I would drink every day, you suddenly take it away and you don't have it for two days. In my situation it was to record a video.
Other reasons can vary. And now all those extra adenosine receptors that were created in response to this inhibition are now being stimulated and activated by adenosine in the absence of caffeine because the body doesn't make caffeine naturally. Do you remember that point that caffeine causes vasoconstriction? Well if caffeine isn't there to do that constricting, then it means that way more blood is flowing into the brain than what one would be normally used to.
Actually, if there's more adenosine than normal, it also means, hypothetically, it's simply just more blood than regular function flowing in. There could have also been another mechanism of the vagus nerve and how neurotransmitters there, including adenosine, mediate emesis. That's what would have caused actual vomiting that I fought so hard to keep back, and ultimately was successful in doing so. But that sour taste and the flood of saliva under my tongue meant that there was a signal being conducted there.
You just don't get that much saliva there in any circumstance. And with the administration of caffeine, which pharmacokinetically we know is bioavailable and quickly absorbed from the gut, the normal adenosine blockage that my body was used to kicked in, and I'm guessing that there wasn't such a flood of blood into my brain at that point, and the symptoms then quickly alleviated. And that's how it happened for me.
There's other reports of caffeine withdrawal describing anxiety, insomnia, mood changes. I didn't have any of that, but for each person, one may have some of those symptoms, all of those symptoms, or maybe just something completely different. Now, if you're wondering what you do to not have caffeine withdrawal in the first place, you have to get to a point where you're not consuming any caffeine daily.
And you do that by slowly weaning off of it. Like I said, While it builds a dependency and causes withdrawal, it's not really as addictive like other stimulants because it's really just blocking inhibition rather than amplifying stimulation at normal amounts. So suppose you drink 6 cans of caffeinated soft drink. Move down to 5 for a couple days, then to 4. By then you might feel like a low grade headache in the morning, maybe feel kinda groggy throughout the day. Then move down to 3, then to 2, and then it's up to you if you want to keep going.
In my life having some caffeine is fine. too much and I can't sleep well, which then causes me to function kind of weird during the day. Too much caffeine mostly affects me not being able to speak coherently.
There's a lot of breaks in speech, a lot of ums and ahs, and I can't really seem to say what I want to say in regular conversation. And all that results from caffeine causing me to not sleep that well. So it's worth checking out a life that has a little less caffeine, if you'd like. Thanks so much for watching. Take care of yourself, and be well.