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Caffeine in Hypothalamic Amenorrhea Recovery

Caffeine in Hypothalamic Amenorrhea Recovery

I get a lot of questions about consumption of caffeine in Hypothalamic Amenorrhea Recovery. In this post I provide some context-specific advice on safe caffeine intake while working towards Hypothalamic Amenorrhea recovery.


In this post i mostly refer to coffee. Of course caffeine is also prevalent in many other drinks as coke, tea, chocolate and energy drinks as well. In this table you can see the caffeine caffeine content in popular beverages.


Adenosine promotes sleep


Before we turn our attention to caffeine, we need to address adenosine. Adenosine is an inhibitory neurotransmitter in the brain. It promotes sleep and suppresses arousal. When awake the levels of adenosine in the brain rise each hour. It also also increases the diameter of blood vessels in the peripheral organs as fingers and feet.


Caffeine inhibits adenosine


Caffeine works by blocking the effects of adenosine. This results in increased neuronal firing in the brain and an increase in the release of other neurotransmitters like dopamine (one of your ‘happy’ hormones) and noradrenaline (one of your 'stress' hormones). This stimulates your sympathetic nervous system to induce a stress reaction.

Caffeine increases cortisol level


In addition to inhibiting adenosine, caffeine is also increasing the serum level of cortisol. It is doing so by exerting itself on the pituitary adrenal axis. If you have been through the content on my blog, you know by know that the stress hormone cortisol is the main driver behind Hypothalamic Amenorrhea. You can read all about that HERE, but in short, your body is in a state where the hypothalamus senses too much stress (in form of cortisol). As a consequence, your hypothalamus slows down or shut down the Gonadotropin-Releasing Hormone (GnRH) pulses, which in turn down-regulates the cascade of hormones that trigger ovulation, resulting in Hypothalamic Amenorrhea. As a fact, habitual use of caffeine has been linked to menstrual abnormalities as increased risk for anovulation, short luteal phase (< or =10 days), long follicular phase (> or =24 days), long cycle (> or =36 days), or measures of within-woman cycle variability.


Besides messing with the sex hormones, cortisol also has a negative impact on blood pressure and digestion.


Caffeine before breakfast


For most people, also in those without Hypothalamic Amenorrhea, cortisol is highest when you first wake up in the morning. If you drink your morning coffee at a time of day when your cortisol concentration is at its peak, you’re already at your naturally highest level of alertness, and the coffee will spike your cortisol level even further. One way of reducing this effect is to have your morning coffee after breakfast, or at least add some full-fat milk to your coffee. You could also swap your regular coffee for decaf.



Why do you need coffee?


I am against categorizing or labeling food as good or bad. No food is good if consumed to the extreme. The same goes for caffeine; even in Hypothalamic Amenorrhea Recovery it is totally okay to enjoy a latte or a cup of coffee because you love the taste or as a routine while meeting with your friends! If you however


  • Use caffeine as a substitute for breakfast

  • Use caffeine as an appetite suppressant

  • Use caffeine to override your natural energy levels

  • Use caffeine to get hyper-focused

  • Use caffeine to get going in the morning


your relationship with caffeine/coffee could become a problem. If you agree to some or all of the above statements I would strongly advise you to reduce your caffeine intake and replace with adequate breakfast, food, sleep or rest.


Caffeine and nutrient absorption


I also wanted to briefly mention that caffeine reduces the bio-availability (the ability to be absorbed in the digestive tract) of several micro-nutrients as iron, zinc and calcium. It does so by binding to them. Given that women with Hypothalamic Amenorrhea often are low in these minerals, this can be quite problematic. These nutrients are involved in cellular energy production and hormone production and it’s all linked.


How much caffeine is allowed in Hypothalamic Amenorrhea Recovery?


So how much caffeine is allowed in Hypothalamic Amenorrhea Recovery? Studies show that a daily caffeine consumption above 300 milligrams is associated with an increased risk for early pregnancy loss. A daily dose above 200 milligrams is believed to increase the risk of low birth weight. Therefore it is recommended that women who are pregnant, trying to become pregnant or breastfeeding limit the daily intake of caffeine to maximum 200 milligram. This corresponds to 2-3 cups of coffee (1.5 deciliter each) or 4 cups of tee (2 deciliter per cup). This is about half of the amount considered safe for most adults.


I sometimes see HA Recovery as a way of preparing the body for a pregnancy. Close to all advises given in order to recover from Hypothalamic Amenorrhea also holds true if you try to conceive. In my view it is therefore reasonable to apply the guidelines on caffeine given to pregnant women in HA Recovery as well.


Closing recommendations on caffeine during Hypothalamic Amenorrhea Recovery


What we strive after in Hypothalamic Amenorrhea Recovery is to reduce all forms of stress. The most important stressors are under-eating and overexercising. These are for sure the most important factors to address. That being said, a too high intake of caffeine will do no good in recovery and it might be wise to think a little harder about your consumption during this period.


  • Reflect on your caffeine consumption. If you use coffee instead of food or sleep, stop.

  • Limit your daily intake to 200 milligrams of caffeine.

  • Time your intake - have your coffee after a meal instead of before or between.

  • Avoid coffee in the afternoon/evening - if drinking it too late it might mess up your night sleep.

  • Avoid coffee if eating an iron-dense meal.

  • Have your coffee with some full-fat milk.

  • Swap (some of) your regular coffee for decaf.


Further reading:





*All content is for informational purposes only. It is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.




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