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What are some unexpected sources of caffeine?

I recently was diagnosed with extremely high blood pressure and had a urine test to detect possible stimulant causes. The test results were positive for caffeine. My doctor has put the onus on me to determine the source of and eliminate all caffeine from my diet but I honestly cannot figure out where it is coming from.

I do not eat, drink, or use any of the following:
coffee
tea
soda
chocolate
Rx or OTC medications or supplements (not even topical)
illegal or recreational drugs
energy or nutrition drinks/potions/snacks/meal replacements

I have even checked the ingredients of every product I put on my hair, skin, or nails to ensure they do not contain caffeine.

I've exhausted all the possibilities I can think of and honestly cannot figure out where it is coming from. Can someone please help?

Female | 52 years old
Medications: None

2 Answers

I highly doubt if your high blood pressure is caused by caffeine, especially since you have eliminated all major sources of caffeine from your diet. The likelihood that you have significant levels of caffeine in your body is dubious and the test is probably wrong. You most likely have essential hypertension. That needs to be treated with antihypertensive medication. And the most common dietary influence on blood pressure is salt. You need to drastically reduce your salt intake, by avoiding all salty foods and not adding any salt to your diet. Obesity also contributes to hypertension. While large amounts of caffeine can raise your blood pressure, caffeine is a stimulant not unlike other stimulants which can also raise your blood pressure. Are you on any diet drugs like phentermine or decongestants (nasal or oral) such as phenylephrine, pseudoephedrine, or ADHD medications such as Ritalin or Adderall? Street drugs such as methamphetamine and cocaine can also severely raise blood pressure. There is a saying in medicine: "When you hear hoofbeats, don't think of zebras." Caffeine as the cause of your hypertension is probably a zebra-unlikely to be the cause.

William Z. Cohen, M.D., FAAFP
Please ask for a repeat test. Obviously a strict diet/food journal over a 2 week period will be helpful. If this all leads to your current starting point one should look elsewhere as the caffeine issue is probably less significant than initially thought.
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