Coffee has some benefits and some drawbacks for everyone, but for people living with multiple sclerosis (MS) , the pros and cons may be more important to consider. Coffee, and other caffeinated drinks, may help some symptoms of MS and worsen others — and this may depend on your particular symptoms and when and how much coffee you consume. “The effects of caffeine can vary widely,” says Lisa Doggett, MD, MPH , family and lifestyle medicine physician at the Multiple Sclerosis and Neuroimmunology Center of University of Texas Health in Austin. “Everyone is different, but many people experience negative side effects from caffeine, like increased bladder urgency, anxiety, or sleep disruption — symptoms that are already more common in MS, says Dr. Doggett, who also lives with MS.
Caffeine and MS Fatigue Fatigue About 8 in 10 people with MS live with fatigue, according to the National Multiple Sclerosis Society (NMSS).e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a6cdb9a-c20d-4d9a-a22f-5ec9b0046e84 Coffee , of course, is a stimulant, and can help you feel more alert in the morning or give you an energy boost later in the day. This can be helpful for people coping with fatigue. In fact, one study reported that nearly half of people with MS who drink coffee in the morning do so because it helps them start the day with more energy.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296712c459-95ac-4d4c-905d-2e4ad39423d0 But is this a good strategy for dealing with MS fatigue ? “Caffeine can enhance alertness, attention, and energy levels, which can help counteract the persistent fatigue many people with MS experience,” says Doggett. The study mentioned above found that coffee helps reduce fatigue and some symptoms related to fatigue like trouble concentrating, inability to focus, and a lack of energy to do activities throughout the day.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296712c459-95ac-4d4c-905d-2e4ad39423d0 Most people in the study had about two to three cups of coffee a day. “I tell most of my patients to avoid caffeine after about 2 p.m.,” says Doggett. Depending on your metabolism and other factors, caffeine can stay in your body for up to 10 hours and affect your sleep.e60dc2a1-f33c-4a05-9b50-8e3e8e59762952849988-6655-4a62-989a-29a60464a725 But it’s important to pay attention to how caffeine affects you and make appropriate adjustments.
Caffeine and Cognitive Function Cognitive Function About 45 to 70 percent of people who have MS have problems with thinking, learning, and memory.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ab07b44-ff3a-46c5-b440-1024b4edda67 For the general population, caffeine has been shown to improve alertness, vigilance, attention, reaction time and attention.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a5fa3a50-5a0f-4a83-86ec-c15d7ba8f784 And it also seems to help cognitive function in people with MS.e60dc2a1-f33c-4a05-9b50-8e3e8e597629315c4498-a021-40b5-8049-018ac6498a4f Caffeine works as a stimulant by reducing the release of adenosine, a neurotransmitter. Adenosine has a calming effect, so blocking it causes a stimulating effect on the central nervous system.e60dc2a1-f33c-4a05-9b50-8e3e8e597629393d9576-d80b-430b-b31b-bc1f31711c0e That may improve cognitive function, reaction time, concentration, and alertness, and there’s some evidence it helps with motor coordination.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298bca885a-366e-4318-8ad4-c36dd0fa5a29
Caffeine and MS-Related Bladder Problems Bladder Symptoms MS is known to cause bladder symptoms , including frequency, urgency, and incontinence. The lesions caused by MS — areas of damage to the myelin sheath that protects nerve fibers — can affect how the bladder functions. The bladder can be either overactive or underactive. Caffeine can worsen an overactive bladder. It can stimulate bladder muscles and can act as a mild diuretic. This can lead to increased urinary frequency, urgency, and potentially, incontinence, says Sarah Anderson, PharmD, senior director of clinical resources and programming at the National MS Society. “Caffeine is considered a bladder irritant and should typically be avoided in people with urinary dysfunction,” Dr. Anderson says.
Caffeine and MS-Related Bowel Problems Bowel Symptoms Bowel issues are also common in MS — both bowel incontinence and constipation. Your bowels depend on signaling through your central nervous system, but when these pathways are damaged, the signaling is dysfunctional. People may not feel an urge to go until suddenly they do — causing incontinence. And because they may not feel the need to go on a regular basis, it can lead to constipation. Coffee is known to stimulate the bowels, so it can help for constipation but also worsen incontinence symptoms by suddenly overstimulating the bowels. “Listen to your body and note how your body reacts to caffeine and coffee,” says Anderson. Discuss your coffee consumption with your healthcare provider to determine whether coffee should be avoided if you have these issues.
Caffeine and Mood Mood Your morning cup of coffee may help reduce depression , though the effects are likely mild.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e58a966e-e74c-47ab-9124-c748cd4cf9b8 And it may make anxiety worse, especially if you drink too much of it. “Caffeine stimulates the central nervous system and can trigger the body’s fight-or-flight response, which can mimic or exacerbate anxiety symptoms like increased heart rate, restlessness, and even feelings of fear or panic,” says Doggett. Though what is considered “too much” can vary from person to person, in general, consuming 400 milligrams (mg) of caffeine a day (about two 16-ounce cups) is considered safe.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8f4038c-567c-463d-a5ed-c9b2a4e30995 But again, some people may be so sensitive to caffeine that even one cup is too much. It’s also important to be aware of other sources of caffeine you may be consuming, like tea, some sodas, energy drinks, and chocolate.
Caffeine and MS Medications Medications People with MS may take disease-modifying medications to reduce relapses and slow progression, and these medications do not typically interact with caffeine. But other medications that people with MS may take to help with symptoms may interact with caffeine, says Anderson. These include: Antidepressants Antipsychotics Thyroid medications Anticoagulants Osteoporosis medications Talk to your healthcare provider about your medication list and coffee consumption to determine if you need to avoid coffee or alter when you drink it based on your medication schedule.
Alternatives to Coffee Alternatives to Coffee If you want a bit of caffeine, but don’t feel great drinking coffee, try green tea . Green tea is full of antioxidants, but contains less caffeine than coffee. An 8-ounce cup of green tea has 29 mg of caffeine, compared with the 96 mg in 8 ounces of coffee. Black tea is another health-boosting option, with about half the caffeine of a cup of coffee.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295685cb76-1c0d-460e-82af-8f95462def1f
The Takeaway For most people with MS, having a cup of coffee or two in the morning shouldn’t be a problem and may even help some symptoms like fatigue and cognitive function. If you have bowel or urinary symptoms, it’s important to consume caffeine judiciously and try to figure out how much and when it helps you, and when it may be exacerbating your symptoms. Caffeine may interact with some medications taken for MS symptoms. Check with your doctor if you’re concerned about your caffeine intake.
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