Caffeine against persistent fatigue in long-COVID: a randomized clinical trial, 2025, Cardoso

[MeSci]

This study does basically mirror the improvements I see on vyvanse (dextroamphetamine).

I suffered serious addiction to amphetamine in my 20s, so I suspect that any kind of amphetamine would have a similar effect. I certainly wouldn't risk it, although I did try it after I kicked the habit, and I suffered the usual after-effects ('comedown'). I wasn't tempted to restart.

 

[NelliePledge]

Strong coffee kept me going through several years of undiagnosed mild ME/CFS I ended up with significant sleep issues and worsening of symptoms to where I really struggled to work. resulting in diagnosis. I find coffee has a worse effect than alcohol which I can tolerate a small amount of.

 

[SNT Gatchaman]

the abstract makes no mention of PEM

That seems a pretty daft experiment. What about the after effects of the extra exercise? What about the longer term effects of extra activity enabled by the stimulant effect?

So stimulants make you able to do more and decrease fatigue, I thought we knew that a long time ago. We don’t prescribe them though for obvious reasons.

This study blantantly forgets about PEM, and is only focusing on fatigue which is problematic.

Coffee exhausts my energy both cognitive and physical.

No mention in the abstract, but —

Caffeine administration significantly increased lactate levels (p < 0.05, d = 0.71, power = 42%) and serum ferritin concentrations (p < 0.05, d = 1.38, power = 70%). No significant differences were observed between groups in creatine phosphokinase levels, and C-reactive protein levels remained within the reference range across both groups.

 

[Mij]

My understanding is that caffeine reduces iron absorption?

 

[ahimsa]

Wheneve I see any study about the effects of caffeine I wonder about differences in how people metabolize caffeine. Hasn't the impact of caffeine been shown to depend on several genetic factors?

I'm pretty sure I'm one of those folks who is a fast metabolizer of caffeine. I remember in college drinking coffee so I could stay up and study. But then I'd fall asleep really quickly. Caffeine has never bothered my sleep.

Even after ME/CFS the caffeine in either tea or coffee (although it's almost always coffee for me) does not bother my sleep.

I remember doing an experiment early on. I went on a diet without any sugar, caffeine or gluten for 6 months. I actually extended the experiment to 8 months because I kept hoping that some sort of diet change would help me. But there was absolutely no difference in any of my symptoms, including how well I slept.

 

[poetinsf]

Those seem to be extraordinary improvements, especially in the walking distance. That one doesn't seem that likely to me. I wonder about the blinding.

Or PEM afterwards. It's rather meaningless to boost the distance if the increased distance triggered PEM.

 

[poetinsf]

Caffeine didn't make any difference when I was sicker. Ephedrine had some effect though. But caffeine also started to have some effect, particularly for the afternoon crashes, since I moved to the mild side of the spectrum. Neither raises the PEM threshold, I don't think. But they do moderate the PEM for me.

 

[MeSci]

I remember doing an experiment early on. I went on a diet without any sugar, caffeine or gluten for 6 months. I actually extended the experiment to 8 months because I kept hoping that some sort of diet change would help me. But there was absolutely no difference in any of my symptoms, including how well I slept.

I have a feeling that caffeine doesn't affect my sleep either. I have cocoa in the early evening instead of coffee, but that also contains caffeine.

It's other things that affect my sleep, notably PEM.

 

[ahimsa]

I have a feeling that caffeine doesn't affect my sleep either. I have cocoa in the early evening instead of coffee, but that also contains caffeine.

It's other things that affect my sleep, notably PEM.

Yes, PEM makes my sleep much worse - no trouble falling asleep, but I don't sleep well, and I wake up many times during the night.

 

[Yann04]

Yes, PEM makes my sleep much worse - no trouble falling asleep, but I don't sleep well, and I wake up many times during the night.

which is a cursed vicious cycle, when poor sleep causes PEM…

 

[Utsikt]

which is a cursed vicious cycle, when poor sleep causes PEM…

I’m on five sleeping meds at the same time because of that!

 

[bobbler]

I see what they’ve done

it’s the old separation as a collection of symptoms ‘fatigue in’ then measure it as a short term phenomenon

except for me/cfs we all at various levels of severity did this short-term experiment

it’s the difference of saying paracetamol is a treatment for a broken leg because it makes it more walkable on for the few hours after you’ve taken it

yet the same people hand waiving to suggest it (if we are metaphoring to me/cfs and the expectation we should just keep meeting our obligations) then criticise when more and more is needed for the same effect as the person and the leg gets more damaged and exhausted as a result of being expected to just ‘use this fix for the pain and get on with it as if that’s the one issue’

this is reframing basically


But it is important if someone was doing this for the right reasons and was noting the raw data intricately so those running future trials had to heed the impacts of this and control for it

you wonder how many studies suddenly put strong coffee in the waiting room when patients who’d done a course if whatever came back to fill in their ‘after’ questionnaire or task

with chakder fatigue questions about sleepiness or how tired you feel or slips of tongue