I have had so many patients over the years come to see me and are scared that I am going to take their beloved coffee away from them. For some reason being a coffee drinker is equated with bad health, just like eating saturated fat. We know however that saturated fat, like that found in coconut oil, is actually really good for us. Could the same be said for coffee? After all there are studies now showing that regular coffee intake can help prevent Alzheimer’s disease – but only in some people.

 It turns out that whether or not you should be a coffee drinker is determined largely by your genetics.

Caffeine is a drug that has to be metabolized in the liver by a series of enzymes called the cytochrome p450 system. This series of enzymes also breaks down pharmaceutical drugs like birth control and antidepressants, as well as environmental chemicals like paint and exhaust fumes.

The efficiency of this enzyme system will determine if you are a fast metabolizer or a slow metabolizer. Approximately fifty percent of the population possesses the slow metabolizing variation of the gene. This means these people process caffeine in the liver at a much slower rate (eg. up to 24 hours) than fast metabolizers (eg. about 6 hours).

In the slow metabolizers, even if you are only drinking one cup of coffee a day, you could always have caffeine in your system. When the caffeine builds up in the bloodstream, higher levels of adrenaline will also occur. This could in turn affect your blood pressure, heart rate, and ability to sleep properly in a negative way.

Differences in caffeine metabolism can also provide an explanation as to why the research results related to the health effects of caffeine can be so divergent.

So how do you know which genetic variant you have? Well, you don’t know for sure unless you do a genetic test, but here are a few questions you can ask yourself to see whether a caffeine holiday would be beneficial:

• Have you ever had heart palpitations after drinking coffee?
• Do you have trouble falling asleep or staying asleep?
• Do you have hypertension?
• Do you get a headache when you don’t have coffee?
• Are you sensitive to the smell of smoke, perfume, gas, or paint?

Now I would love to hear from you! If you were to guess do you think you are a fast metabolizer or a slow metabolizer? Have you ever taken a caffeine holiday? Leave a comment below and I’ll be back next week with another edition of Doctor as Teacher Tuesday.