Caffeine

[Kgizzle]

So I've been lethargic and brain fogged all day for no apparent reason. I just realized that I haven't had coffee in the last 2 days. I just looked it up and caffeine withdrawal can last up to 2 months (for heavy users). Should I just cut my loses and grab some coffee? Also, how many cups do med students tend to drink in a day?

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[HomeSkool]

Probably best to taper your caffeine consumption rather than going cold turkey, unless you're at a point in life where two months of withdrawal, lethargy, and decreased productivity won't hurt you.

 

[shisong]

"take it as needed" is what I prescribed myself

 

[Nucleophile1]

Why do you want to stop drinking coffee? I drink 1-2 cups a day with no ill effects thus far.

 

[Robotfishbrain]

Is there a reason you're trying to cut down on coffee? Are you having trouble sleeping or anything? I wouldn't try to put extra pressure on yourself to quit drinking coffee on top of med school. Coffee is love. Coffee is life.

I drink anywhere from 0 to 5 cups a day depending on where I study.

But seriously, if you're keen on quitting caffeine perhaps it would be a lot easier to do in the summer?

 

[ortnakas]

If you’re cutting back on purpose, highly recommend tapering. Caffeine withdrawal won’t kill you but it isn’t fun.

 

[pugsessed]

Switch to tea. That works well for the tapering part. I recommend green tea with mint!

 

[xClashx]

I have always been the type of guy who took a quick nap when I felt tired. Ever since rotations started, I find my self yawning a lot.
Never drank coffee ever, really hate the smell. Dont like tea either, any other supplement recommendations (I dont want to try those energy shots)

 

[deleted407021]

Haha. Cups.

I have to measure in milligrams

 

[Kr#36]

I have always been the type of guy who took a quick nap when I felt tired. Ever since rotations started, I find my self yawning a lot.
Never drank coffee ever, really hate the smell. Dont like tea either, any other supplement recommendations (I dont want to try those energy shots)

Caffeine pills work well. I bought a bag of 200mg pills when I was studying for the MCAT for less than 20 bucks and it seems like its going to last forever.

 

[Jojos]

I have come to terms with the fact that i will be a coffee fiend at least during med school. Sorry bones.

 

[NYCdude]

I have always been the type of guy who took a quick nap when I felt tired. Ever since rotations started, I find my self yawning a lot.
Never drank coffee ever, really hate the smell. Dont like tea either, any other supplement recommendations (I dont want to try those energy shots)

Stop being pretentious and just down the black gold.

 

[flapjack3d]

So I've been lethargic and brain fogged all day for no apparent reason. I just realized that I haven't had coffee in the last 2 days. I just looked it up and caffeine withdrawal can last up to 2 months (for heavy users). Should I just cut my loses and grab some coffee? Also, how many cups do med students tend to drink in a day?

I've tried cutting it many times before. Went months at a time without coffee or caffeine of any sort. Never felt any better. You may be permanently damaged, OP. Just keep drinking the coffee.

 

[Kgizzle]

I've tried cutting it many times before. Went months at a time without coffee or caffeine of any sort. Never felt any better. You may be permanently damaged, OP. Just keep drinking the coffee.

Coffee is life... Got it!

 

[Gorne]

Love the 1-4 cup a day coffee drinkers that are all of a sudden having life-altering withdrawal symptoms.

 

[Jdp00921]

Doesn't moderate coffee consumption offer some health benefits? I can't cite a specific reference but I know I've read numerous times that some coffee daily has benefits. I do agree with avoiding the QID Large McCafe Café Mochas, however.....

 

[xClashx]

Stop being pretentious and just down the black gold.

Trust me if I could remotely stand it, i would. I learned to yawn with my mouth closed.

 

[Redpancreas]

Sorry for disrupting the conversations but I started drinking coffee in college and it’s only made me less productive. Lately even the smallest bit is causing these periods of euphoria and I’ll do or say things I normally wouldn’t say to people. Same with alcohol. I would say cut cold and stop. Caffeine is incredibly dangerous in my opinion.

 

[Sephirakra]

I had an MD toxicology professor who never drank coffee, but took a caffeine pill with a glass of grapefruit juice every morning. She never seemed to be lacking in energy.

 

[akuko2]

I had an MD toxicology professor who never drank coffee, but took a caffeine pill with a glass of grapefruit juice every morning. She never seemed to be lacking in energy.

Your tox prof, 'You see Mrs. Tox prof, grapefruit juice is actually a suicide inhibitor of CYP450 and will extend the half life of the caffeine allowing me to feel its effects for longer!'

Mrs. Tox prof, 'Harold, you've been saying that every morning for 16 years...'

 

[mistafab]

I drink about 3-4 coffee equivalents every morning. It rocks, honestly. Why give it up? That smooth bitter love in your glass. No additives... Pure. Silky. Love.

 

[787593]

So I've been lethargic and brain fogged all day for no apparent reason. I just realized that I haven't had coffee in the last 2 days. I just looked it up and caffeine withdrawal can last up to 2 months (for heavy users). Should I just cut my loses and grab some coffee? Also, how many cups do med students tend to drink in a day?

Take some preworkout like a man

 

[harkas]

Bulletproof coffee (or something similar) is a god send.

 

[Crayola227]

It's legit to want to quit, all I'll say about it.

I wasn't able to on clinicals, but I did for the most part during didactic.

It gave me wicked PVCs (premature ventricular contractions), or "heart skipping a beat." Once in a while when you get a jolt of adrenaline or something is one thing. Having it like 20 times a day.... It's sorta like how cardioverting someone awake with adenosine, you need to give a warning - why?

Feeling your heart stop beating even if for a moment, holding your breath metaphorically as you sorta wait that long microsecond of empty silence and stillness in your chest, before it gives a compensatory pounding thud, at random, is just a primally scary feeling. Not too surprising I suppose, but stimulation of the vagus nerve is associated with feelings of impending doom.

I didn't like weekend withdrawal headaches, that I didn't recognize as such, that I was having on days off.

Also, caffeine would sorta make me feel cracked out, anxious, irritable, having trouble focusing, and lead to a "poop out' feeling usually late afternoon.

If I drank it then to combat that feeling, I could feel the long half life of caffeine making me roll around in bed half awake most of the night.

It suppressed my appetite which I suppose was sort of useful, but I think contributed to that low energy feeling. And an upset tummy.

All of it made me feel empty and dead inside. Maybe that was just the empty tummy or the training more than caffeine, but they are inextricably linked in my experience now.

I didn't have the luxury of using caffeine the way I do now.

One reason tea, and with milk, became so popular in England - the coal miners would drink "builder's brew," which, the caffeine plus sugar and milk, gave them a quick way to recharge.

The double shot vanilla skinny vanilla latte with whipped cream, basically had enough calories, with a touch of fat and protein, to be the American suped up crack version of the same.

I needed all the extra stuff added since I don't like the flavor of coffee.

 

[Crayola227]

Now I just have the occasional soda or some tea when I want a gentle jolt.

English breakfast tea with milk has less caffeine, fewer tannins, less bitter, less acidic, than coffee. It's easier on the tummy by far. I'd always watch British tv and not understand how these people were drinking a cup every 5 min, until I started the habit. (I also thought milk in tea sounded repugnant, until I tried it in the right blend - English breakfast, for example. Whole new world.)

All of this means you can drink more cups, and not get as caffeinated. It's easier to maintain a steady concentration and titrate it for however you feel, compared to coffee which is much more powerfully concentrated, to me.

When tea gets a bit cooled down, it doesn't get nearly so bitter as coffee.

The habit is lovely and lends itself nicely to lots of little pleasant warm breaks in an otherwise damp and drafty clime.

If I drink like 8 cups of tea, it's almost the same as back in the day when I used to chug 2 doubleshot espresso drinks, one in the AM and one at lunch, but experientially it's not the same at all.

Which is why it was very difficult to use tea as a trainee.

 

[Crayola227]

I would make a thermos of tea for morning didactics as our class allowed this during lecture.

If I was on a rotation where I might spend a good deal of time in the workroom, same thing.

Now that I've discovered tea with milk, I make my own builder's brew with tea, milk, sweetener, in a thermos.

The key was to learn to make a good cuppa.

That sorta thing won't get you through surgery or IM or any real hospital based rotations for the most part. Outpt I could get along.

 

[Crayola227]

TLDR:
I don't like to "have" to drink caffeine.
I couldn't get away with not in training.
Don't stop cold turkey - experiment with teas.
I have lots of tea ideas if you like.

 

[Crayola227]

Sorry for disrupting the conversations but I started drinking coffee in college and it’s only made me less productive. Lately even the smallest bit is causing these periods of euphoria and I’ll do or say things I normally wouldn’t say to people. Same with alcohol. I would say cut cold and stop. Caffeine is incredibly dangerous in my opinion.

OK medically speaking, incredibly dangerous is quite the overstatement for the vast majority of humans, and I'm in the camp that I don't love it myself. Still, just because you have an extreme reaction doesn't mean you should extrapolate that to a medical opinion that it's dangerous and apply that to others.

Also, data has been mixed as far as various measures of health/symptoms in a dose dependent response curve, so it's also not terribly accurate to say it's "good" or "bad." It's relative to various measures. So it's more appropriate that I discuss side effects/benefit the patient experiences, and share the different takes on its use that the data can give, and let the patient sort for themselves what's best when it isn't clear.

If a patient is having sleeping disturbances, GERD/gastritis, mood lability, I come down pretty hard on the side of eliminating caffeine or drastically cutting back on it.

Also, there's not a whole lot of centrally acting meds that it's just a good idea to "cold turkey." This is also really poor advice in general, most things go better with a taper.

I get annoyed when physicians overextend their own personal health experiences to patients without taking into consideration the data and the fact that every person is different. Just because you can't have a cup of coffee without exacerbating some sort of hyperactivity, impulsivity, doesn't mean that Mrs. Anderson shouldn't enjoy her morning cuppa.

 

[Crayola227]

I've found that coffee drinkers who like cream in their coffee seem to take to tea with milk more than just tea alone. It's much like coffee but much much milder.

 

[Crayola227]

Using blue light therapy in the am or early afternoon can give some people an increased sense of alertness. Possibly look into that.

Also a brisk walk or jaunt up stairs, getting the heart rate going a bit. Chair stretches.

One might consider APAP or other OTC meds for caffeine w/d headache, with the supervision of their personal health care provider. One should be careful because it's possible to develop rebound headaches if they are overused.

 

[Atom612]

Take some preworkout like a man

Implying one precludes the other...2 cups of coffee to wake up for the day followed by a scoop of that sweet, sweet 1,3-DMAA juice.

 

[mehc012]

I have always been the type of guy who took a quick nap when I felt tired. Ever since rotations started, I find my self yawning a lot.
Never drank coffee ever, really hate the smell. Dont like tea either, any other supplement recommendations (I dont want to try those energy shots)

The energy shots are nasty, and they overload you with niacin so you get flushed and feel like it's doing something - serves no other real purpose. Plus they're expensive and you don't always have them on you.

I have never drunk a cup of coffee (can't stand the stuff), and only occasionally drink tea. However, I do take caffeine pills now and then. In my mind, it's a way to control it so that I get a dose when I really need it, but don't end up with a tolerance or associate it with a comforting ritual (warm drink) or other motivation. For me, this means that I take caffeine maybe 1x/month in med school, about half as much as a cup of coffee when I do take it, and then during exam periods sometimes jump up to once almost every day for a week or less, sometimes working the quantity up to 1-1.5 cups of coffee depending on how much I procrastinated that block.

The advantage of the pills is: it's cheap (probably 30-60 doses for the price of one fancy Starbucks drink), easily portable (chuck a few tabs in the bottom of the Advil bottle in my backpack and I always have it on hand), requires no extras (coffee pot, hot water, creamer), and I can know how much I take, and take it only when I need the dose. The downside is, everyone thinks you're a major caffeine addict when you probably consume less than them.

 

[Crayola227]

I know a surgical intern that got interstitial cystitis from all the B vitamins in those little energy drink shots - they were up to like 5 bottles a day and had to entirely quit.

Just because it's water soluble and you piss it out doesn't mean it can't make it burn like frak when you pee.

 

[Redpancreas]

OK medically speaking, incredibly dangerous is quite the overstatement for the vast majority of humans, and I'm in the camp that I don't love it myself. Still, just because you have an extreme reaction doesn't mean you should extrapolate that to a medical opinion that it's dangerous and apply that to others.

Also, data has been mixed as far as various measures of health/symptoms in a dose dependent response curve, so it's also not terribly accurate to say it's "good" or "bad." It's relative to various measures. So it's more appropriate that I discuss side effects/benefit the patient experiences, and share the different takes on its use that the data can give, and let the patient sort for themselves what's best when it isn't clear.

If a patient is having sleeping disturbances, GERD/gastritis, mood lability, I come down pretty hard on the side of eliminating caffeine or drastically cutting back on it.

Also, there's not a whole lot of centrally acting meds that it's just a good idea to "cold turkey." This is also really poor advice in general, most things go better with a taper.

I get annoyed when physicians overextend their own personal health experiences to patients without taking into consideration the data and the fact that every person is different. Just because you can't have a cup of coffee without exacerbating some sort of hyperactivity, impulsivity, doesn't mean that Mrs. Anderson shouldn't enjoy her morning cuppa.

I sincerely apologize. reading my post, it was inappropriate to state that caffeine is incredibly dangerous and did not intend to advise anyone even though it was may sound like that. Last few months have been stressful for me and even though I said it’s my opinion, I encourage anyone not ignore my original post for advice.

 

[Crayola227]

I sincerely apologize. reading my post, it was inappropriate to state that caffeine is incredibly dangerous and did not intend to advise anyone even though it was may sound like that. Last few months have been stressful for me and even though I said it’s my opinion, I encourage anyone not ignore my original post for advice.

Lol, it's fine. I didn't mean to get on you so hard. Just hit on a peeve. I see know it was more a rhetorical device than offering a medical opinion.

I agree that caffeine is often abused and at the root of a lot of dysfunction in our society, and it also is needed as the fuel in a grueling post-Industrial world in perpetuating all of the above.

 

[xClashx]

On a side note, anyone take anything for focus? Whats this L-theanine stuff?

 

[Redpancreas]

On a side note, anyone take anything for focus? Whats this L-theanine stuff?

Taken with caffeine it can decrease jitters and anxiety. Without it, it can lead to brain fog. Also known to increase creativity. Also, it will make you calmer and able to think through things, but usually only recommended when you mix with caffeine. I used to do this kind of stuff, but then got mood swings with l-theanine too and had to stop.

 

[mistafab]

As another side note - coffee is associated with lower all cause mortality. So on the contrary, coffee appears to be protective.

 

[Dr. Scribe]

Better to drink coffee than take adderall like all the gunners do

I try to stick to less than 200mg a day and not at all on the weekends (unless exams are right around the corner). 200 mg = about 2 cups of coffee





EDITED TO ACTUALLY ANSWER OP'S QUESTION

 

[Crayola227]

Yes, because all around education about caffeine was clearly unwarranted in this thread, when someone asks about side effects...

 

[mehc012]

Better to drink coffee than take adderall like all the gunners do

I try to stick to less than 200mg a day and not at all on the weekends (unless exams are right around the corner). 200 mg = about 2 cups of coffee





EDITED TO ACTUALLY ANSWER OP'S QUESTION

Depends on the coffee. Starbucks drip has a pretty high caffeine load, you'd probably hit 200mg in 1 cup there, depending on the blend/brew.

 

[Gurby]

Your tox prof, 'You see Mrs. Tox prof, grapefruit juice is actually a suicide inhibitor of CYP450 and will extend the half life of the caffeine allowing me to feel its effects for longer!'

Mrs. Tox prof, 'Harold, you've been saying that every morning for 16 years...'

This comment was vastly underappreciated imo. I see you.

 

[Kgizzle]

It's legit to want to quit, all I'll say about it.

I wasn't able to on clinicals, but I did for the most part during didactic.

It gave me wicked PVCs (premature ventricular contractions), or "heart skipping a beat." Once in a while when you get a jolt of adrenaline or something is one thing. Having it like 20 times a day.... It's sorta like how cardioverting someone awake with adenosine, you need to give a warning - why?

Feeling your heart stop beating even if for a moment, holding your breath metaphorically as you sorta wait that long microsecond of empty silence and stillness in your chest, before it gives a compensatory pounding thud, at random, is just a primally scary feeling. Not too surprising I suppose, but stimulation of the vagus nerve is associated with feelings of impending doom.

I didn't like weekend withdrawal headaches, that I didn't recognize as such, that I was having on days off.

Also, caffeine would sorta make me feel cracked out, anxious, irritable, having trouble focusing, and lead to a "poop out' feeling usually late afternoon.

If I drank it then to combat that feeling, I could feel the long half life of caffeine making me roll around in bed half awake most of the night.

It suppressed my appetite which I suppose was sort of useful, but I think contributed to that low energy feeling. And an upset tummy.

All of it made me feel empty and dead inside. Maybe that was just the empty tummy or the training more than caffeine, but they are inextricably linked in my experience now.

I didn't have the luxury of using caffeine the way I do now.

One reason tea, and with milk, became so popular in England - the coal miners would drink "builder's brew," which, the caffeine plus sugar and milk, gave them a quick way to recharge.

The double shot vanilla skinny vanilla latte with whipped cream, basically had enough calories, with a touch of fat and protein, to be the American suped up crack version of the same.

I needed all the extra stuff added since I don't like the flavor of coffee.

Now I just have the occasional soda or some tea when I want a gentle jolt.

English breakfast tea with milk has less caffeine, fewer tannins, less bitter, less acidic, than coffee. It's easier on the tummy by far. I'd always watch British tv and not understand how these people were drinking a cup every 5 min, until I started the habit. (I also thought milk in tea sounded repugnant, until I tried it in the right blend - English breakfast, for example. Whole new world.)

All of this means you can drink more cups, and not get as caffeinated. It's easier to maintain a steady concentration and titrate it for however you feel, compared to coffee which is much more powerfully concentrated, to me.

When tea gets a bit cooled down, it doesn't get nearly so bitter as coffee.

The habit is lovely and lends itself nicely to lots of little pleasant warm breaks in an otherwise damp and drafty clime.

If I drink like 8 cups of tea, it's almost the same as back in the day when I used to chug 2 doubleshot espresso drinks, one in the AM and one at lunch, but experientially it's not the same at all.

Which is why it was very difficult to use tea as a trainee.

I would make a thermos of tea for morning didactics as our class allowed this during lecture.

If I was on a rotation where I might spend a good deal of time in the workroom, same thing.

Now that I've discovered tea with milk, I make my own builder's brew with tea, milk, sweetener, in a thermos.

The key was to learn to make a good cuppa.

That sorta thing won't get you through surgery or IM or any real hospital based rotations for the most part. Outpt I could get along.

TLDR:
I don't like to "have" to drink caffeine.
I couldn't get away with not in training.
Don't stop cold turkey - experiment with teas.
I have lots of tea ideas if you like.

OK medically speaking, incredibly dangerous is quite the overstatement for the vast majority of humans, and I'm in the camp that I don't love it myself. Still, just because you have an extreme reaction doesn't mean you should extrapolate that to a medical opinion that it's dangerous and apply that to others.

Also, data has been mixed as far as various measures of health/symptoms in a dose dependent response curve, so it's also not terribly accurate to say it's "good" or "bad." It's relative to various measures. So it's more appropriate that I discuss side effects/benefit the patient experiences, and share the different takes on its use that the data can give, and let the patient sort for themselves what's best when it isn't clear.

If a patient is having sleeping disturbances, GERD/gastritis, mood lability, I come down pretty hard on the side of eliminating caffeine or drastically cutting back on it.

Also, there's not a whole lot of centrally acting meds that it's just a good idea to "cold turkey." This is also really poor advice in general, most things go better with a taper.

I get annoyed when physicians overextend their own personal health experiences to patients without taking into consideration the data and the fact that every person is different. Just because you can't have a cup of coffee without exacerbating some sort of hyperactivity, impulsivity, doesn't mean that Mrs. Anderson shouldn't enjoy her morning cuppa.

I've found that coffee drinkers who like cream in their coffee seem to take to tea with milk more than just tea alone. It's much like coffee but much much milder.

Using blue light therapy in the am or early afternoon can give some people an increased sense of alertness. Possibly look into that.

Also a brisk walk or jaunt up stairs, getting the heart rate going a bit. Chair stretches.

One might consider APAP or other OTC meds for caffeine w/d headache, with the supervision of their personal health care provider. One should be careful because it's possible to develop rebound headaches if they are overused.

I read this whole thing... I will have what you are having.

 

[Espressso]

Currently an MS1 and i had to stop caffeine completely during first semester due to bigeminal PVCs that was noted during our EKG lab during Cardio block. Went through the entire cardiac workup. Three different cardiologists all told me the same advice:

No caffeine pills
No caffeine from cans or bottles like energy drinks or 5 hour shots. Just natural occurring (coffee, tea, espresso)
No caffeine after a set time, each day. They mentioned noon or 2 pm.

It was either that or start a beta-blocker. No thanks to the beta-blocker

 

[Crayola227]

Currently an MS1 and i had to stop caffeine completely during first semester due to bigeminal PVCs that was noted during our EKG lab during Cardio block. Went through the entire cardiac workup. Three different cardiologists all told me the same advice:

No caffeine pills
No caffeine from cans or bottles like energy drinks or 5 hour shots. Just natural occurring (coffee, tea, espresso)
No caffeine after a set time, each day. They mentioned noon or 2 pm.

It was either that or start a beta-blocker. No thanks to the beta-blocker

Mine weren't so bad, so I wasn't told I had to do that, but for the most part, I think if you want your heart to feel normal and be A-OK all around it's hard to go wrong keeping things to coffee and tea. (unless you have other issues, there are conditions were even coffee and tea have to be cut out, and large quantities of chocolate too).

And the advice not to have it after a set time is good because of the long half life of caffeine, it's good for sleep hygeine too.

Their advice is pretty much what I would tell any human to do with caffeine use. Plenty of people abuse it get away with it, sure. Not ideal imo.

 

[Crayola227]

Currently an MS1 and i had to stop caffeine completely during first semester due to bigeminal PVCs that was noted during our EKG lab during Cardio block. Went through the entire cardiac workup. Three different cardiologists all told me the same advice:

No caffeine pills
No caffeine from cans or bottles like energy drinks or 5 hour shots. Just natural occurring (coffee, tea, espresso)
No caffeine after a set time, each day. They mentioned noon or 2 pm.

It was either that or start a beta-blocker. No thanks to the beta-blocker

lol just realized the irony given your username

 

[Espressso]

Mine weren't so bad, so I wasn't told I had to do that, but for the most part, I think if you want your heart to feel normal and be A-OK all around it's hard to go wrong keeping things to coffee and tea. (unless you have other issues, there are conditions were even coffee and tea have to be cut out, and large quantities of chocolate too).

And the advice not to have it after a set time is good because of the long half life of caffeine, it's good for sleep hygeine too.

Their advice is pretty much what I would tell any human to do with caffeine use. Plenty of people abuse it get away with it, sure. Not ideal imo.

Yeah lol at my username. I love a good espresso. But What I think did it for me was drinking daily pre-workout in the AMs on an empty stomach. That stuff is wicked. I was using C4 and it's no beuno. The cardiologist was blown away that I was using that every single morning. But yeah, I think coffee and tea is the way to go. I also have noticed drinking a big glass of lemon water every morning first thing when I wake up, helps me energy wise in the mornings.

 

[mehc012]

Mine weren't so bad, so I wasn't told I had to do that, but for the most part, I think if you want your heart to feel normal and be A-OK all around it's hard to go wrong keeping things to coffee and tea. (unless you have other issues, there are conditions were even coffee and tea have to be cut out, and large quantities of chocolate too).

And the advice not to have it after a set time is good because of the long half life of caffeine, it's good for sleep hygeine too.

Their advice is pretty much what I would tell any human to do with caffeine use. Plenty of people abuse it get away with it, sure. Not ideal imo.

I don't understand, though...literally I use caffeine pills because it keeps me to a far lower caffeine intake than anyone I know who drinks coffee. Coffee to me means nigh-inevitable tolerance and ever-increasing baseline doses.

 

[Crayola227]

Christ my stomach can't take the acid on an empty stomach. I have to have a good deal of milk and carbs (latte, oatmeal, cereal) to do it.

 

[Crayola227]

I don't understand, though...literally I use caffeine pills because it keeps me to a far lower caffeine intake than anyone I know who drinks coffee. Coffee to me means nigh-inevitable tolerance and ever-increasing baseline doses.

Pills vs coffee makes no difference for tolerance. Can you see why?

I'm not entirely sure why the cardiologists would have said no to caffeine pills. If I have to guess, it might have to do with speed of administration, peak plasma concentration and the area under the curve, or just that frankly, cups of liquid ARE actually more rate-limiting than pills. This effect is similar when you look at beer drinkers vs those who drink spirits only. I also wonder what if any role the various flavenoids and whatnot in coffee/tea do to the absorption or metabolism of caffeine as well.

When I advise patients, I tell them the amount of caffeine in 1-2 cups of regular coffee, would be the ideal. I don't think I'm very helpful in translating that to various teas, espressos, pills, 5 hour shots, etc.

I'll bust out Google for some patients, but plenty of them, hey, here's something you can pull out Google for if you want to play Dr. Google.

If you press me, I would say I think 2 shots of espresso are like 2 cups of coffee. I think 3 cups of black tea is probably similar. If you really want to split hairs on mg, than I think you need to bust out a conversion calc or maybe rethink your usage.