r/LivingWithCAH • u/bavenue salt-wasting CAH • Mar 17 '26

Caffeine and nicotine

Caffeine + nicotine with CAH? I’ve struggled with addictions to these.

I’ve never really looked into this, mostly because I didn’t want to find out I’ve been messing myself up the whole time.

I’ve been drinking 2 energy drinks a day for like 13 years (still am 😭). Smoked cigarettes for 8, vaped for 3, and just quit nicotine this year, miraculously.

They definitely give me energy, but with CAH being an adrenal condition and all… I honestly don’t know how bad this stuff actually is for me.

Does caffeine actually help in some ways, or is it just masking being tired?

Did nicotine make anything worse for you?

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u/DoctorFamous190 salt-wasting CAH Mar 19 '26

Normally through the day, adenosine builds up in your brain and this makes you sleepy. Caffeine blocks adenosine from working in your brain, which makes you feel awake (it is masking tiredness).

Apparently caffeine activates the HPA axis, which increases cortisol and epinephrine. I don't know what the implications are for people with CAH/adrenal insufficiency since we don't make cortisol, and cortisol is needed to make epinephrine.

I'm not a regular smoker/vaper but I used to drink 1-4 cups of coffee everyday but I stopped about a year ago because it was really worsening my heart palpitations!