Dr. Roach: For coffee benefits, it doesn’t matter if it’s caffeinated or decaf

Keith Roach
To Your Health

Dear Dr. Roach: I switched from drinking caffeinated coffee to Swiss water process decaffeinated coffee about two years ago. The reason I switched to decaf is that I was experiencing dizziness when I would get out of bed at night to use the restroom. The dizziness lasted for only a few seconds, but it was unsettling. My doctor suggested switching to decaf as the caffeine may have been the issue. I only drink one cup a day in the morning, but I thought I would switch anyway. Sure enough, I did not experience any dizziness. Does this type of decaf coffee or any decaf coffee offer the same benefits as regular coffee? I’ve read that caffeinated coffee has some benefits, such as lowering the risk of Alzheimer’s disease, Parkinson’s disease, some cancers, diabetes and may protect liver, etc.? While I’m not sure if this is 100% accurate, is it the caffeine that has the benefits?

— N.

Dr. Keith Roach

Dear N.: Drinkers of coffee – both regular and decaf — have a lower risk of heart disease than nondrinkers. There are other benefits that have been associated with coffee drinking, including a reduction in the risk of Parkinson’s disease, Alzheimer’s disease, alcoholic cirrhosis and gout. Both caffeinated and decaffeinated coffee are also associated with a lower risk of Type 2 diabetes. The risk of cancer overall is not decreased among coffee drinkers compared with nondrinkers.

What is not clear is whether drinking the coffee is causing these benefits! It may be that coffee drinkers have other behaviors that are responsible for these benefits. Not all studies have shown a benefit, and the largest study suggests a 16% decreased risk in all-cause mortality associated with coffee drinking.

Consumption of high levels of caffeine can be associated with short-term adverse effects, including headache, anxiety, tremors and insomnia, depending on prior patterns of caffeine use. Chronic users are less sensitive to the adverse behavioral effects of caffeine than non-users. Stopping caffeine can cause withdrawal symptoms, especially if done quickly.

Dear Dr. Roach: I have severe tinnitus resulting from a bicycle accident-related head injury a few years ago. Recently I have been barraged with ads on social media purporting amazing cures of tinnitus (as well as many other afflictions) from CBD gummies. Is there any reputable evidence backing up these claims?

— R.F.

Dear R.F.: I also see ads for many medical conditions touting the curative properties of cannabidiol (CBD), a nonpsychoactive (meaning, it doesn’t get you “high”) chemical naturally present in cannabis. CBD has several potential medical uses; however, the hype has so far exceeded the solid evidence.

In the case of tinnitus, there are theoretical reasons why cannabis extracts, especially CBD, might be beneficial. The evidence for effectiveness is not strong. There are a handful of studies, at least one of which showed some benefit. Pure cannabidiol is safe, and it might be worth a try. I would emphasize that not all products sold as CBD are in fact CBD, and some of them contain THC. The best way of being sure you are getting what you want is a third-party laboratory analysis (often called a Certificate of Analysis) showing you are getting CBD and not THC, the main psychoactive chemicals in cannabis.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.