Caffeine and the Rheumatologist

As a passionate fan of coffee, I feel like a real ‘killjoy’ when I advise people with arthritis not to drink too much coffee. So why all the fuss?

The problem is that caffeine has an effect on a chemical in the body called adenosine which is also the target of Methotrexate. In theory taking too much caffeine could stop Methotrexate working, and some studies (in rats, I have to admit) suggest that this  is a real effect. If you want to read about this in more detail, check out a recent article by Bruce Cronstein. Dr Cronstein and his co-workers have done much of the research so he knows what he is writing about. Methotrexate causes release of adenosine which may have an anti-inflammatory effect whereas  caffeine blocks the adenosine receptor (i.e. stops it working). Interestingly, he also says that adenosine helps put us to sleep and this may be why people taking Methotrexate often feel tired. From a practical point of view, if your Methotrexate is working well I wouldn’t worry too much about this, but if it hasn’t had the desired effect then cutting down on caffeine might just work! There are some pretty good decaff coffees so you mightn’t have to give up your favourite drink, after all.

Finally, a poem about coffee and the thinking man…

21st Century Rodin

The upper right-hand
corner of my desk blotter;
a fresh, stark canvas
this morning, now a sepia
montage of concentric
accomplishments.
I sip,
I Think.
I sip,
I think.
I sip…
I think.
Sip.
Think.
Colin Harmon, award winning barista, in Dublin brews concoctions here!Sip.
Think.
Sip
Big sip
sip sip sip
sip sip sippppp.
Ahhhhhhh.
Final sip, cup down.
A caffeine-laced
still life of a Slinky.
Boy-oh-boy-oh-boy-oh-man
was-I-ever productive
today!

-Mark L. Lucker

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