Lifestyle & Hormones · ViveCura Berlin

Coffee. The cup that promises energy might be quietly taking it from you.

What coffee can do to your cortisol, your adenosine, your hormones and your sleep. From the perspective of physiology, PNI and clinical experience.

Cortisol & HPAAdenosine ReceptorsCYP1A2 & COMTFemale HormonesSleep Architecture
Why I am writing this

Coffee does not give you energy. It can borrow it for you, from your cortisol, from your adrenaline, from your nervous system. What is borrowed has to come from somewhere. That is worth knowing before coffee becomes your basic supply.

I bet you know this feeling. Still in bed, you think about your first cup. On the way to work, the second. After lunch the third, because otherwise it just does not work. And in the evening you wonder why you cannot calm down, why your heart feels different, why your sleep no longer goes deep.

Coffee is one of the most studied foods in the world. And at the same time, one of the most poorly understood. Studies celebrate it as a life extender. Others show damage to cortisol, sleep and hormones. Both are right. Because you are not the average of the studies.

What you will learn in this article

  • Why coffee does not give energy, it mobilises it
  • What adenosine is and why your sleep suffers
  • Why the first cup right after waking up might be unfavourable
  • How CYP1A2 and COMT shape your reaction to caffeine
  • What coffee can do to the female cycle and libido
  • Why iron, magnesium and zinc could suffer
  • What the term "adrenal fatigue" is meant to describe and what the evidence says
  • My personal habit: MCT, L-theanine, maca and medicinal mushrooms

Adenosine: coffee does not switch off your tiredness, it tapes over the warning lights

Imagine your body has a fatigue counter running all day long. With every hour your cells work, a small molecule accumulates and tells the counter: "It is time to slow down." This molecule is called adenosine. It is a byproduct of energy production in your cells, a leftover from ATP metabolism. The longer you are awake, the more you think, the more your brain works, the more adenosine builds up at your synapses.

Adenosine binds to its receptors, mostly A1 and A2A. The result: your brain becomes quieter, your sleep pressure rises, you yawn, your eyes become heavy. That is not weakness. That is biology, telling you: I need a pause.

When caffeine enters the scene, something clever and something brutal happen at the same time. Caffeine looks like adenosine to your receptors. It binds to the same spots without triggering the signal. It is like a key that fits the lock but does not open the door. As long as the wrong key sits in the lock, the real one cannot dock. You feel awake.

Reframe

You are not more awake. You feel more awake. Your fatigue is not gone. It is just no longer being reported. When the caffeine is metabolised, all the queued adenosine molecules press into their receptors at once. That is the afternoon crash.

What research observes

Fredholm and colleagues have described over decades how caffeine acts as a competitive antagonist at A1 and A2A adenosine receptors. With chronic intake, the brain might respond by building more of these receptors. This has been shown mainly in animal models, in humans the data are inconsistent. As an explanation for tolerance it is plausible, but not proven.

What this means for you: someone who drinks coffee daily for years might have more adenosine receptors than someone who does not. Without caffeine, this person does not feel normally tired, but especially tired. That could be the biological background of withdrawal headaches on the first coffee-free weekend. If you want to cut down, reduce step by step. Stopping abruptly after high intake can trigger headaches, irritability and concentration problems for several days.

Fredholm BB et al. International Union of Pharmacology. XXV. Nomenclature and classification of adenosine receptors. Pharmacol Rev. 2001. [Pharmacology review]

And now you know why. Coffee does not give you wakefulness that is not there. It hides a fatigue that is there. Once you understand that, the question changes. It is no longer "how much coffee do I need to get through the day", but "why does my system not have enough energy on its own for this day".

The morning mistake: why the first cup right after waking up might be unfavourable

May I ask you an uncomfortable question? Do you drink your first coffee before you are really awake? Before you have even gotten dressed? Sometimes still in bed, phone in one hand and cup in the other?

Then you are doing something that, from the perspective of your hormone physiology, is pretty much the opposite of what you actually want. You do not become more awake. You quietly burn through your own stress reserve.

The cortisol awakening response, your built-in espresso

Your body has its own beautiful mechanism to wake you up in the morning. It is called the cortisol awakening response. In the first thirty to forty-five minutes after waking up, your cortisol rises clearly. How strongly varies from person to person and from day to day. That is not a sign of illness. That is your biology saying: "Get up, the day is starting." Your own espresso, for free, always on time.

Cortisol daily rhythm, healthy pattern

06:00
Baseline
06:45
CAR Peak
12:00
Falling
18:00
Low
23:00
Trough

In a regulated system, cortisol is highest in the morning and lowest at night. Coffee at the wrong time can overlay this rhythm.

If you drink coffee right into this peak, a second stress response could layer onto one your body is already running. Whether this matters in the long run has not been studied, the trials are missing. I find the idea plausible and I do it this way myself, but I cannot sell it to you as proven.

Study story · Lovallo 2005 and 2006

A research group around William Lovallo gave healthy adults different doses of caffeine and measured their cortisol. They observed: caffeine clearly increases cortisol release. In habitual users, the effect was weaker, but it did not disappear.

What this means for you: even if you no longer feel an adrenaline kick, your endocrine system is quietly running with it. Tolerance to the feeling does not mean tolerance to the biology.

Lovallo WR et al. Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosom Med. 2005;67(5):734-739. DOI: 10.1097/01.psy.0000181270.20036.06 [Human RCT, crossover]
Reframe

Coffee is probably not neutral while your HPA axis is active itself. One thing you can try: wait 60 to 90 minutes after waking up. Let the natural cortisol peak run its course. Drink your coffee when your own wave is going down, not on top of it.

And now you know why. It is not that coffee in the morning is "forbidden". It is that your timing does more to your hormones than the cup itself.

Genetics decide: why your friend tolerates four espressos and you tremble after one

You know these sentences: "I have an espresso in the evening and sleep like a baby." Meanwhile, you drink half a cup at 2 pm and stare at the ceiling at 2 am. Both are right. Both live in different biochemical worlds.

CYP1A2, the enzyme that decides about your coffee

Caffeine is broken down to about 95 percent in the liver. The most important enzyme for this is CYP1A2. Imagine CYP1A2 as a garbage truck. Some people have a fast, well-equipped truck. Others have an old one that only drives half as often. There is a genetic variant that makes the CYP1A2 gene more or less active. Reviews on the genetics of caffeine place such variants as one factor among several, alongside smoking, hormones and liver health (Yang 2010).

Fast metabolisers

Rather short half-life

  • Tend to break down caffeine faster
  • Sometimes still tolerate coffee in the evening
  • In the Costa Rica study, coffee intake was not linked to a raised heart attack risk in this group. A protective effect cannot be derived from that
  • Athletic effect of caffeine often clearly noticeable
Slow metabolisers

Rather long half-life

  • Need longer to clear caffeine
  • Sleep can suffer even after lunchtime coffee
  • In the same study, their risk of a non-fatal heart attack rose from roughly two to three cups a day upwards
  • More trembling, irritability, "jumpy mind"

In the Costa Rica study, a good half of those examined carried the slower variant. The half-life of caffeine in humans lies roughly between three and nine hours. How much of that is down to genotype is hard to quantify. Smoking speeds up the breakdown considerably, while the pill, a pregnancy or a liver disease can slow it down markedly.

Study story · Cornelis 2006, JAMA

A large case-control study from Costa Rica investigated the relationship between CYP1A2 genotype, coffee consumption and myocardial infarction. In people with the slow variant, the risk of a non-fatal heart attack rose from roughly two to three cups a day upwards. In fast metabolisers, this link did not show.

What this means for you: there is no universal "healthy coffee dose". There is only one that fits your genetics. If you do not know which variant you have, listen to your body. Inner unrest, sleep problems and a sense of pressure are clues.

Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA. 2006;295(10):1135-1141. DOI: 10.1001/jama.295.10.1135 [Case-control study, n=4,000+]

COMT, the switchboard for stress and dopamine

There is a second enzyme that plays a role here. COMT, catechol-O-methyltransferase. COMT breaks down dopamine, noradrenaline and adrenaline, exactly the neurotransmitters caffeine ramps up in you. Here too, there is a fast and a slow variant.

Whether these variants allow reliable conclusions about personality or stress behaviour is scientifically contested and has not been reproduced well in large studies. I mention COMT because it could explain why people react so differently, not as an explanation that is already settled. What many people describe is the "jumpy mind": the constant back and forth that cannot switch off, the inner haste, even when nothing urgent is actually happening.

If you feel nothingSome people say: "Caffeine does nothing to me." That can simply mean you clear caffeine quickly. It can also mean you have got used to a high level of arousal and therefore no longer notice the difference. Which of the two applies cannot be read off a feeling. If you want to know for sure, the only way is to look.

And now you know why. You do not react "wrong" or "right" to coffee. You react genetically. And genetics is not a verdict, it is an invitation to look more closely.

Coffee and women: when the cup quietly pulls on cycle, libido and mood

In my practice, I see a pattern. A woman in her late thirties, demanding job, mother or about to be. She comes with the feeling of "no longer being herself". Tired, irritable, libido in the basement, PMS, cold hands, sleep bad. And she drinks three to five cups of coffee a day, often plus energy drinks or matcha lattes on an espresso base.

An observation from my consultations

A picture I meet often

In practice I meet this picture often: exhausted, irritable, cycle complaints, little desire, plus high coffee intake over years.

What I do in such situations depends entirely on the individual history and the individual findings. That is exactly why I do not write down an approach here that you could transfer to yourself.

What I can say: in this picture, coffee is almost never the only construction site. But it is often the one you can look at first.

The question is worth asking: do I drink coffee because I want pleasure, or because I am bridging a deficit? The answer does not change the cup. It changes what you look at next.

What could be happening in the body

Coffee can interact with several hormonal levels. First, via the HPA axis. In PNI, a link between chronically high cortisol demand and low progesterone is discussed under the heading "progesterone steal". To be honest: in classical endocrinology this model is considered outdated, because steroid production runs in separate tissues. What can be observed is a temporal link between chronic stress and cycle disturbances. The path there is probably a different one than the image suggests. Second, caffeine can be associated with estradiol levels. Third, it can impair iron and zinc absorption, both important building blocks for thyroid, mood and libido.

Study story · Estrogen and caffeine

Schliep and colleagues observed in the BioCycle study in healthy premenopausal women that a caffeine intake from about 200 mg a day upwards went hand in hand with shifts in estradiol levels, depending on ethnic background. In women of Asian descent, estradiol was higher with high consumption, in women of Caucasian descent slightly lower.

What this means for you: the study measured estradiol levels, not estrogen metabolism. It also found that caffeinated soft drinks and green tea went along with higher estradiol in all groups. That makes the simple coffee story more complicated. It is not an argument for a ban, but one for observing your body closely.

Schliep KC et al. Caffeinated beverage intake and reproductive hormones among premenopausal women. Am J Clin Nutr. 2012;95(2):488-497. DOI: 10.3945/ajcn.111.021287 [Prospective cohort, n=259]
Observation Woman

Sensitivity to hormonal effects

Women appear more sensitive to coffee-related cortisol shifts. During ovulation and the second half of the cycle, the half-life of caffeine can lengthen. The pill can slow CYP1A2 further. So the same cup can feel very different from week to week.

Observation Man

Sensitivity to autonomic effects

Men appear to metabolise caffeine faster on average, but react sensitively to sympathetic activation. High consumption may go along with elevated reactivity, blood pressure triggers and reduced heart rate variability. Here too: genetics beats average.

I cannot prove anything here with large RCTs, because large RCTs on "coffee and libido in women" do not exist. What I can describe is an impression from my consultations, nothing more. Some women who change their coffee intake and at the same time work on sleep, recovery and nutrients experience themselves differently afterwards. What exactly is behind that, I do not know, it will never have been only the coffee.

Reframe

If your cycle is chaotic, your libido is gone and you are tired, coffee is rarely the only cause. But it is often the factor that quietly continues to burden a system already on the edge. Questioning it is not a punishment. It is self-respect.

And now you know why. Hormonal complaints are rarely a single problem. They are the sum of many quiet burdens. Coffee is one you can adjust first.

Stomach, acid, nutrients: what coffee might do to your digestion

You drink coffee. Shortly afterwards, you feel "empty" in the belly or "in need of the toilet". That is no coincidence. Coffee can stimulate gastric acid production, activate the gallbladder and speed up bowel movement. In combination, this becomes a very functional little cocktail. And a conflict with your own digestion.

Coffee directly with a meal can be unfavourable

Digesting runs mostly through the parasympathetic system. Rest, saliva, gastric acid, enzymes, absorption. Coffee pushes more towards the sympathetic side. Both systems do work at the same time, but the weighting shifts. Coffee directly with a meal can make that shift unfavourable. Some people notice it as a feeling of fullness or reflux.

1

Gastric acid rises quickly

Coffee can stimulate parietal cells to secrete acid. Many people notice nothing of it. If you tend towards heartburn or stomach complaints, coffee can make them worse.

2

Polyphenols bind minerals

Chlorogenic acid and tannins in coffee can bind iron, zinc and calcium and make them insoluble. What is insoluble cannot cross the intestinal wall.

3

Magnesium is lost via the kidneys

Caffeine acts mildly diuretic and can promote renal loss of magnesium and calcium. With low stores, this can become noticeable.

4

The gut gets moving

Coffee can stimulate bowel movement, among other things via messengers such as gastrin and cholecystokinin. Whether a faster transit with regular intake really leads to poorer nutrient absorption is not well studied. That is a consideration, not a finding.

Study story · Morck 1983

Morck and colleagues tested how strongly a cup of coffee with a meal reduces non-heme iron absorption. The result: about 39 percent less iron absorbed, and with especially strong instant coffee absorption dropped much further. Tea showed similar effects, even stronger.

What this means for you: in Morck’s study the timing was decisive, but differently than many people think. Coffee one hour before the meal did not inhibit iron absorption. Coffee together with the meal and coffee one hour afterwards inhibited it to the same degree. So if you want to protect your iron, coffee before the meal is the better option, not coffee after it.

Morck TA, Lynch SR, Cook JD. Inhibition of food iron absorption by coffee. Am J Clin Nutr. 1983;37(3):416-420. DOI: 10.1093/ajcn/37.3.416 [Human controlled study]
Reframe

If your iron is low, drink your coffee before the iron-rich meal rather than after it. Afterwards it inhibited absorption in the study just as strongly as with the meal. And one more thing: iron is not a blind-guess supplement. Take it only after laboratory testing, because too much iron in the body can damage organs.

And now you know why. It is not only the coffee itself. It is also the timing that helps decide how much reaches you.

"Adrenal fatigue" is not a buzzword. It describes exhausted stress physiology

This is not weak nerves. This is neurobiology. The term "adrenal fatigue" is not recognised as a stand-alone diagnosis in conventional endocrinology, because the adrenal glands rarely become "tired" in a structural sense. But what can clearly be measured is an HPA axis dysregulation. An exhaustion of the stress response. Flattened cortisol curves. Low DHEA. Elevated sympathetic baseline. Loss of heart rate variability.

Whoever uses coffee for years as a substitute for sleep, recovery and energy trains their stress axis like a marathon runner trains the knee. At some point, the answer no longer comes.

The typical story: at 25, one cup is enough. At 30, it is three. At 35, you no longer feel anything, but drink five because without them nothing works. At 38, comes the day when even five cups can no longer lift the fog. That is not "I got older". That is possibly an exhausted stress system.

Study story · Sleep, caffeine and tolerance

Drake and colleagues gave subjects caffeine 0, 3 or 6 hours before going to bed and measured sleep architecture. Even 400 mg of caffeine 6 hours before bed reduced total sleep time by more than one hour. The subjects did not reliably perceive the difference subjectively.

What this means for you: "I still sleep well" is not proof. Your brain may be sleeping objectively less and more shallowly without you noticing. That can add up over years.

Drake C et al. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. J Clin Sleep Med. 2013;9(11):1195-1200. DOI: 10.5664/jcsm.3170 [Double-blind, placebo-controlled RCT]

PNI thinks in networks. A nervous system kept chronically in sympathetic mode by caffeine can weaken the immune system, overwork the mitochondria, quietly throttle the thyroid and pull the hormonal system out of balance. Four lenses, one source. That is why exhaustion rarely feels one-dimensional. It sits in the entire system.

"Energy is not luxury. Energy is freedom. Pumping it instead of building it is not a strategy in the long run."

And now you know why. Adrenal fatigue is not "in your head". It is a measurable shift in your stress response. Coffee is not the cause. But it can be the most loyal companion of that shift.

Bean, roast, acid: what actually lands in your cup

Imagine you did not roast the coffee bean. You would eat it like a nut. It would be hard, grassy, bitter, barely edible. Coffee, as we love it, is basically a highly heated product. Roasted at 200 degrees Celsius and more in a drum. Maillard reactions occur, aromas, but also substances that were not designed for the body in raw form.

~95 mgCaffeine in an average cup of filter coffee
~63 mgCaffeine in a typical espresso (30 ml)
3–9 hHalf-life of caffeine, depending on the person

Light roast, dark roast, mycotoxins

Lighter roasts contain more caffeine and more chlorogenic acid, which can act as an antioxidant but is also more irritating to the stomach. Darker roasts are slightly lower in caffeine but milder for the stomach. Important: coffee beans can be contaminated with moulds and their metabolic products, the so-called mycotoxins like ochratoxin A, depending on cultivation, storage and processing. High-quality, carefully processed beans reduce this risk.

What helps in the cupOrganic quality, fairly traded, freshly roasted if possible, ideally just ground. For a sensitive stomach, choose medium to dark roast. A water filter, because heavy metals and chlorine change the overall result. And honestly: one very good cup beats three mediocre ones.

And now you know why. The bean is not neutral. It is an agricultural product with a story. What happens between plantation and cup decides whether you take in pleasure or burden.

The alternatives: my personal lifehack and what the plant kingdom has to offer

I am not anti-coffee. I am pro-awareness. If you want to keep drinking coffee, you can do it with much less collateral damage. And if you want to flip the switch, there are exciting alternatives.

My lifehack · concrete

Coffee plus MCT oil plus L-theanine

This combination is my personal standard when I drink coffee at all. Three building blocks that smooth each other out:

  • Medium roast, good quality. One to two cups a day, not before 8 am, not after noon.
  • One teaspoon of MCT oil alongside. MCTs are processed directly in the liver into ketone bodies and can offer your brain a second source of energy next to glucose. This takes the sharpest edge off caffeine.
  • 200 mg of L-theanine. This amino acid from green tea promotes alpha waves in the EEG and acts as a gentle counterweight to the sympathetic activation of caffeine.

The result feels, according to many: awake, but not jumpy. Focused, without that "racing inside" feeling.

Study story · L-theanine and caffeine

Owen and colleagues investigated how 50 mg of caffeine, 100 mg of L-theanine and the combination of both affect cognitive tasks. The combination improved attention and reaction time clearly more than caffeine alone. The combination also reduced self-reported tension.

What this means for you: L-theanine is no hocus-pocus. It is an evidence-based way to use the coffee effect without the stress surcharge.

Owen GN, Parnell H, De Bruin EA, Rycroft JA. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutr Neurosci. 2008;11(4):193-198. DOI: 10.1179/147683008X301513 [Double-blind RCT]

What else works: maca, Lion's Mane and mushrooms for clarity

Option 1

Maca (Lepidium meyenii)

Adaptogenic root from the Peruvian Andes. Traditionally used for energy, mood and sexual vitality. Acts not as a stimulant like caffeine, but as a modulator on the HPA axis. Several small human studies suggest effects on libido and mood.

Option 2

Lion's Mane (Hericium erinaceus)

Medicinal mushroom, also called bearded tooth fungus. Contains hericenones and erinacines, which in animal models can stimulate nerve growth factor NGF. First small human studies suggest effects on focus and mild cognitive impairment.

Option 3

Cordyceps

Medicinal mushroom, traditionally used in TCM for endurance and energy. May promote ATP production in the mitochondria. Smaller RCTs hint at better oxygen uptake in sports, giving cautious plausibility for energy without a stress response.

Option 4

Reishi and shiitake

More immunomodulating and calming than stimulating. Can help the system run more quietly, which indirectly can lead to more energy. Not for the quick kick, but for the calm depth.

Meta/RCTHuman studiesAnimal modelIn vitro

For maca, Lion's Mane and cordyceps, biologically plausible mechanisms exist alongside first positive human studies, but no large meta-analyses yet. If you try them, observe yourself carefully and do not change everything at once.

If you take only three things with you

Lever 1

Delay your first coffee

Drink it at the earliest 60 to 90 minutes after waking up, not straight out of bed. Let your cortisol awakening response finish in peace. Water with a little salt and lemon, maybe a short walk into daylight, then the coffee.

Lever 2

Make 2 pm your cut-off

No more caffeine after 2 pm, ideally stop already at noon. If you are a slow metaboliser, perhaps only once in the morning. Your sleep will thank you with objectively deeper recovery, even if you do not feel it subjectively at first.

Lever 3

Build energy, do not borrow it

Ask yourself once a day: why do I need this cup right now? If the honest answer is "because I did not sleep enough" or "because I am stressed", the cup is a symptom, not a solution. Sleep, iron, magnesium, daylight, movement are the real energy sources.

Bonus

Listen to the body, not the cup

Palpitations, inner unrest, thin sleep, irritable mood in the afternoon, tiredness despite eight hours of sleep, loss of libido, poor stool: these are signals. They do not say "drink more coffee, you will manage". They say "I am overloaded".

To take home

You do not have to stop. You just need to understand what you are doing every time you lift that cup. Conscious consumption beats performed discipline. If you keep drinking coffee, do it as pleasure, not as an emergency exit.

If you do not just want to read but want to start directly with an honest assessment of your HPA axis, your minerals and your energy sources, you will find the option to book an appointment below this article.

Sources and studies

  1. Fredholm BB, IJzerman AP, Jacobson KA, Klotz KN, Linden J. International Union of Pharmacology. XXV. Nomenclature and classification of adenosine receptors. Pharmacol Rev. 2001;53(4):527-552. [Pharmacology review]
  2. Lovallo WR, Whitsett TL, al'Absi M, Sung BH, Vincent AS, Wilson MF. Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosom Med. 2005;67(5):734-739. DOI: 10.1097/01.psy.0000181270.20036.06 [Human RCT, crossover]
  3. Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. DOI: 10.1016/j.pbb.2006.03.005 [Human RCT]
  4. Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. J Clin Sleep Med. 2013;9(11):1195-1200. DOI: 10.5664/jcsm.3170 [Double-blind RCT]
  5. Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA. 2006;295(10):1135-1141. DOI: 10.1001/jama.295.10.1135 [Case-control study, n=4,000+]
  6. Yang A, Palmer AA, de Wit H. Genetics of caffeine consumption and responses to caffeine. Psychopharmacology. 2010;211(3):245-257. DOI: 10.1007/s00213-010-1900-1 [Review]
  7. Morck TA, Lynch SR, Cook JD. Inhibition of food iron absorption by coffee. Am J Clin Nutr. 1983;37(3):416-420. DOI: 10.1093/ajcn/37.3.416 [Human controlled study]
  8. Schliep KC, Schisterman EF, Mumford SL et al. Caffeinated beverage intake and reproductive hormones among premenopausal women in the BioCycle Study. Am J Clin Nutr. 2012;95(2):488-497. DOI: 10.3945/ajcn.111.021287 [Prospective cohort, n=259]
  9. Owen GN, Parnell H, De Bruin EA, Rycroft JA. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutr Neurosci. 2008;11(4):193-198. DOI: 10.1179/147683008X301513 [Double-blind RCT]
  10. Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam. 2003;20(1):1-30. DOI: 10.1080/0265203021000007840 [Safety review]
  11. Mori K, Inatomi S, Ouchi K, Azumi Y, Tuchida T. Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial. Phytother Res. 2009;23(3):367-372. DOI: 10.1002/ptr.2634 [Small RCT, n=30]
  12. Gonzales GF, Cordova A, Vega K et al. Effect of Lepidium meyenii (Maca) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002;34(6):367-372. DOI: 10.1046/j.1439-0272.2002.00519.x [Small RCT]
  13. Smith AP. Effects of caffeine on human behavior. Food Chem Toxicol. 2002;40(9):1243-1255. DOI: 10.1016/S0278-6915(02)00096-0 [Review]

A note on the evidence: there are many human studies on coffee. At the same time, several endpoints such as female hormones, libido or adrenal fatigue are methodologically hard to capture in large RCTs. Some of the connections presented here therefore rest on physiological principles, smaller studies and observations from clinical practice. They are biologically plausible, but not as firmly established as, for example, sleep effects or cortisol responses. I make this transparent so that you can decide for yourself how much weight to give each statement. This article is not a substitute for medical advice.

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