The Straight Buzz on Coffee

I've noticed an intriguing phenomenon over the last several years that I've fondly nicknamed coffee shame.  What is coffee shame?  Thewell-intentioned, but typically misguided, guilt or remorse over one’s coffee consumption.

As I obtain my patients’ full medical and social history, their alcohol, exercise, and green vegetable "habits" rarely seem to provoke the kinds of explanations their coffee consumption so frequently does. "I know I should be drinking less", "I tried so hard to give it up, but I just couldn't do it", and "I've been doing half-caff, that's better, right?"-just a handful of the disclaimers that patients tend to lead in with.  

All of this coffee shame, combined perhaps with my personal love for the age-old brew, has prompted me to attempt to set the record straight.  In the wise words of Clark Gable, “I never laugh until I’ve had my coffee.”  So here are some facts about coffee to smile about. The proven benefits of low to moderate coffee consumption are plentiful.  I have listed them below for you.  Of note, low to moderate is defined as less than three eight-ounce cups per day.

Benefits:

• Increase in alertness and ability to concentrate

• Decreased risk of Parkinson's disease

• Slightly lower or delayed risk of Alzheimer's disease

• Decreased risk of Type 2 Diabetes

• Improvement in acute headache symptoms

• Modest decrease in constipation symptoms

• Decreased risk of alcoholic cirrhosis

• Slowed progression of liver disease in those with advanced Hepatitis C

• Reduced risk of gout

• Decreased risk of liver cancer

With all of these incredible potential benefits that low to moderate coffee consumption can have, are there downsides?  Well, just like anything that is enjoyable, there are.  The downsides can include:

• Difficulty sleeping

• Increased anxiety and agitation

• Increased risk of cardiac arrhythmias and cardiac events in those that are susceptible

• Physical and/or psychological tolerance or dependence on caffeine

• Caffeine withdrawal symptoms in those that are tolerant or dependent

• Mild elevation in cholesterol when consuming unfiltered coffee (e.g. French press, espresso)

• Slowed growth and even potential risk of miscarriage or preterm birth when consumed in pregnancy (the studies are mixed on this so always ask your OB)

When I explain all of this to my coffee-loving patients, I usually tell them that there are two magic numbers to keep in mind. Those numbers are two and twelve. Try to keep your coffee consumption to two eight-ounce cups per day, and drink those two cups before twelve o'clock noon.  Pushing the limits of what is considered safe intake of anything is never a good idea, and drinking caffeine of any kind in the afternoon often leads to problems sleeping.  I do have several patients that I recommend stop drinking coffee altogether for various health reasons, so it is extremely important to always check in with your doctor before assuming that your cup of joe is a safe habit.  

Allison Fox, M.D.

Top 5 Misconceptions About HPV

1. “Once you have HPV, you have it for life.”

Not at all! If your immune system is healthy, you can get rid of the infection for good. It may take a little time, but by taking appropriate steps, you will again test negative for HPV.

2. “I had the HPV vaccine, I can’t catch the virus.”

Despite the HPV vaccine being highly effective at preventing certain strains of HPV, it absolutely does not protect you from every strain out there. You can get the HPV vaccine and still get HPV, I’ve seen it happen many times.

3. “Condoms protect you against all STDs, including HPV.”

This is a dangerous misconception. HPV is a virus that is spread through skin to skin contact. While condoms are clearly extremely important in the prevention of most STD's, they only reduce the risk of HPV spread.  In other words, you can use them 100% consistently and correctly and still get HPV.

4. “After a colposcopy removed the damaged cells, the virus is gone.”

The colposcopy procedure removes the cells of your cervix that have been damaged by HPV. However, the virus itself lives throughout your body, which is where my diet and lifestyle recommendations come in. A healthy immune system will help clear the virus up from your body for good.

5. “Older women don’t need Paps, they are for women of childbearing age.”

One in 4 cases of cervical cancer occurs in women over the age of 65. Forty one percent of cervical cancer deaths also occur in this age range. While every woman does not need a Pap every year, every woman does need a visit to see their physician to discuss their personal risk and decide on the best plan.

Allison Fox, M.D.

If You've Ever had an Abnormal Pap, This Article is for You

HPV (The Human Papillomavirus) is the single most common STD in the U.S., affecting upwards of 79 million Americans. It is so common that approximately 14 million people become infected every single year.  Based on my own experiences when counseling my patients about their HPV diagnosis, most people do not realize how much they can do themselves to help their body eliminate it.

HPV is screened for on routine Pap smears, which is of course only a fraction of the reason why seeing your healthcare provider routinely is so critically important.  The HPV virus causes genital warts, abnormal Pap smears, and ultimately, if left untreated, cervical cancer.  HPV is also responsible for several other less common, but unfortunately on the rise, cancers.

When HPV is found on a Pap smear, the conversation usually goes something like this: "You have an STD called HPV. Sometimes your body gets rid of it on its own, and sometimes it doesn't. We would like to get a better look at your cervix to see if the virus has caused damage. Be sure to schedule that test, which is called a colposcopy, before you leave. The procedure is quick, but it is not painless. You’ll want to take ibuprofen ahead of time to help with the discomfort. If left ignored and untreated, it could cause cervical cancer." Yikes! Is it any wonder that most people leave these appointments confused and mortified!?

Here is the part of the story that rarely makes it to prime time.  With so many other important topics to go over on you routine doctors visit, there is often not enough time for this. There are in fact things you can do to help clear the infection up.  I’ve outlined them below for you.

1) Eat your folate! Folate is a B vitamin found in dark green leafy vegetables, and it has been proven to  help rid the body of HPV.  It is always preferable to obtain your vitamins through food, but there are supplement options as well. Dosage and formulations vary, and make a huge difference, so I don't recommend navigating this one on your own.  It’s important to know that some people have a gene that actually makes synthetic folate (folic acid) dangerous. There is, however, no risk to experimenting with that new kale, swiss chard, broccoli, or spinach recipe you've been wondering about - your body will thank you!

2) Quitting cigarette smoking is also proven to help clear up the HPV virus.  If you smoke, your body is constantly fighting an uphill battle to stay healthy. The HPV virus loves smokers! My patients that smoke seem to be perpetually HPV positive despite their best efforts to heal the infection.  

3) Stress and poor sleep make recovery from HPV more difficult.  High emotional stress levels are associated with increased oxidative stress.  Oxidative stress is linked to an increase rate of progression of HPV to cancer.  If you needed one more reason to learn to meditate and get a good night's rest, perhaps your abnormal Pap smear is it.  Learn more about fighting oxidative stress here

4) There is convincing evidence that other essential vitamins and nutrients also play a role in healing from HPV. Some of those other supplements include Vitamin B12, Vitamin C, Vitamin E, Retinol, Beta and Alpha-Carotene, Lycopene, Lutein/Zeaxanthin, and Cryptoxanthin.

5) Long term use of hormonal contraceptives (the pill, the ring, the patch, etc.) is linked to persistent and aggressive HPV infection.  There are safe effective contraceptive options that do not involve the use of systemic hormones.  Talking to your provider about them is never a bad idea, especially if you have HPV.

The most important piece of advice I can give you is to rethink your body's relationship with the HPV virus.  You are not a helpless victim of this virus, you are at war with it - and if you work with a knowledgeable physician to make a few adjustments in your diet and lifestyle, you can win.   

Allison Fox, M.D.