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Consider the popularity of Tea houses in China, the Japanese Tea ceremony, British afternoon tea, and of course, morning coffee in the United States. All of these rituals involve caffeine. But what is caffeine and what does it do?

Caffeine is a stimulant that affects many parts of the body. Let’s talk about the brain first. According to Goodman & Gilman 5th ed., caffeine produces faster and clearer trains of thought, fights drowsiness & fatigue, elevates the mood, and decreases reaction time at normal doses (below 250mg.). Higher doses of caffeine may cause insomnia, nervousness, restlessness, and even mild delirium. Moving to the heart, caffeine does slightly increase blood pressure at normal doses and can cause tachycardia (increased pulse rate) and arrhythmias (abnormal heart rhythm) at higher doses. Caffeine also dilates the bronchi in the lungs & most of the blood vessels in the body. This dilation of blood vessels also causes increased blood flow to the kidneys which may explain another effect of caffeine, increased urination. Finally caffeine also affects the muscles of the body by increasing the force of contraction and decreasing fatigue.

Now that we covered the effects of caffeine (in a very brief manner), let’s see how all this relates to you and me. First of all, studies have shown that caffeine does increase motor activity. For example typists are able to type faster and more accurately. On the other hand, tasks which require more delicate coordination showed no improvement. Furthermore, other studies have shown that tired people do not perform better in tasks requiring alertness and psychomotor coordination. In other words, caffeine might improve your performance in certain tasks if you are not tired, but will not help if you are already tired!! To further complicate things, it has been shown that some caffeine may benefit athletes who participate in aerobic type of events, such as cycling. In one study the subjects worked 7% harder and in another test they had 19% more endurance.

Caffeine appears to decrease the amount of glycogen used and increase the amount of fat released into the blood. In any case, caffeine is tested for by the Olympic Committee and other sports bodies and only small amounts are allowed. Also, caffeine should be avoided after a strenuous work-out since it increases urination and may dehydrate you. Finally, if you get only one thing from this article, remember this: Caffeine will not sober you up, it will only turn a sleepy drunk into an awake drunk!!

Having said all this, is caffeine good or bad for you? One or two cups of coffee or tea in the morning or an occasional cola should not harm the average adult. What you want to avoid is drinking large amounts of caffeinated beverages during the day, getting insomnia at night, and then having to drink even more caffeine the next day in order to function. Dependence on and tolerance to caffeine may occur.


1 CUP BREWED COFFEE ......100-150 (MG)

1 CUP INSTANT COFFEE .....86-99 (MG)

1 CUP DE-CAFF COFFEE .....2-4 (MG)

12 oz. OF COLA DRINK .....40-72 (MG)

1 CUP OF TEA .............60-72 (MG)

1 CUP OF COCOA ...........50 (MG)

1 oz. OF MILK CHOCOLATE ..3-6 (MG)

The author Mark Szof is a practicing Pharmacist and Martial Artist with a Shido-In license.

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This months column is on heel spurs (plantar fascia), a condition which I have become very familiar with. Basically, a heel spur is a calcium deposit where the calcaneus (heel bone) meets the plantar fascia (a ligament that runs from the heel to the toes). When this area is put under a stress, the body compensates by forming calcium over the area in order to protect it. Unfortunately the calcium tends to irritate other tissue in the area and causes a great deal of pain. There are four possible causes for heel spurs:

1. A sudden trauma to the foot like a sharp turn. 2. Shoes with poor arch support. 3. Stiff soles on shoes. 4. Feet with excessive pronation.

Quite often the cause is usually a combination of more than one of the above and may take a long time to be noticed.

How do you know if you have heel spurs? The best way is to have your doctor or podiatrist examine & x-ray your foot. A telltale symptom is pain, usually in the center of your heel. Often, this pain is worse after waking up or after being off of your feet for a long period of time. Furthermore, this pain tends to “work itself out” after a few minutes of walking.

Until you can get the foot looked at, there are a few things you can do to ease the discomfort. First, you can stay off of the foot and rest it (easier said than done!). Secondly, you can apply ice to the area and take anti-inflammatory drugs such as aspirin or ibuprofen (Advil, Nuprin, Motrin IB, etc.) to reduce inflammation and ease the pain. Lastly, consider getting some heel cups to cushion the heel. These heel cups are available in many pharmacies and cost about $10 to $ 15.

Once the heel spurs are confirmed, what are your treatment options? The first option is cortisone shots to reduce inflammation. However, they do have many side effects and cannot be overused. Secondly, there are orthotics which your doctor or podiatrist can prescribe for you. These devices are inserts that are molded to the shape of your foot and can compensate for some flaws in your foot like a high arch or excessive pronation. Regrettably, most insurances will not cover orthotics, and you may have to foot the bill yourself ($200-$400). Like cortisone shots, orthotics do not cure heel spurs, only relieve the symptoms. The only cure is surgery to grind away the excess calcium. This is commonly done as outpatient surgery and recovery takes about 2-6 weeks. It is worth noting that most patients do not require surgery, and can get by with only heel cups or orthotics.

The author Mark Szof is a practicing Pharmacist and Martial Artist with a Shido-In license.

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