Caffeine is one of the most widely consumed stimulants in the world. Most adults can safely have up to 400 milligrams of coffee per day (about two to four cups of regular coffee).

People with primary biliary cholangitis (PBC) want to slow disease progression and may wonder if caffeine affects liver health. The good news is caffeine doesn’t seem to affect PBC, which means it’s safe to consume as long as it makes you feel good and you’re not overdoing it. Here’s why.

What Foods and Drinks Have Caffeine?

Caffeine is a natural substance. It’s found in over 60 plants, including coffee beans, tea leaves, and cacao pods (used to make chocolate). Caffeine can also be made synthetically (in a lab). The synthetic kind is often used in medication and energy supplements.

People usually associate caffeine with coffee consumption. But coffee isn’t the only source of caffeine. In addition to coffee and other espresso-based drinks, caffeine is also found in black and green tea. Most herbal teas, however, don’t have caffeine. Soda usually has caffeine in it, too, unless the label says it’s caffeine-free.

You may be surprised by the different ways caffeine can sneak into your diet. Chocolate and cocoa, including milk and dark chocolate, contain caffeine. White chocolate usually doesn’t, since it’s not made from cacao. Many energy drinks, snacks, and even some medicines — like painkillers, cold medicine, and weight loss supplements — also have caffeine.

Does Caffeine Affect Your Liver?

Research on the effects of caffeine and coffee on liver health can be confusing. Some scientists think that caffeine — or other coffee compounds — may have protective effects against the risk of liver disease. This is because caffeine has anti-inflammatory and antioxidant effects on the liver.

Caffeine is also thought to help prevent liver fat buildup (steatosis) and liver fibrosis, which can both lead to liver cirrhosis and even liver transplants if they progress. However, studies don’t always support this theory.

One study looked at 100 people with type 2 diabetes and MASLD (metabolic dysfunction-associated steatotic liver disease), which was previously called NAFLD (non-alcoholic fatty liver disease). Researchers split participants into different groups. Some were given caffeine and chlorogenic acid (a coffee compound). Others only had caffeine. Both groups received these substances daily in the same amounts you’d find in two cups of coffee. The third group received a placebo (inactive drug).

After six months, the study found no differences in liver fat and fibrosis (markers of poor liver health) between the groups. There were also no significant beneficial effects on liver function. However, it’s possible that a study with more participants or higher doses of caffeine would lead to different findings.

Can Caffeine Provide Health Benefits for PBC?

For most people with PBC, their main concern is preventing liver damage that could lead to liver failure. Overall, having a couple of cups of coffee or tea may not affect your PBC. Coffee drinkers don’t need to switch to decaf or cut back unless their doctor says so. However, there’s also no proven benefit to consuming large amounts of caffeine, especially through supplements or energy drinks, which may carry risks.

What you mix with your caffeine may matter more than the caffeine itself. Too much sugar from chocolate candy or sugary coffee or tea drinks can be harmful to your liver health. Dairy products high in saturated fat, such as half-and-half or full-fat cream, may overwork your liver and cause inflammation. Healthier options include drinking coffee black, or using lower-fat or plant-based milks, like almond milk. If you’re used to the sweet taste of coffee creamers, try slowly using less sugar over time. This gradual change can benefit both your liver and your overall health.

Caffeine and PBC Comorbidities

People with PBC often have other health conditions at the same time. These are called comorbidities. Common examples include autoimmune diseases like lupus and rheumatoid arthritis, which can make life with PBC more challenging.

Unfortunately, as with liver disease, the research on whether caffeine might be a risk factor for autoimmune diseases is unclear. One study on rheumatoid arthritis suggested that coffee and tea may lower inflammation, along with evidence that showed just the opposite. Scientists still don’t know for certain whether caffeine helps, harms, or has no effect on autoimmune diseases.

Caffeine Conversations on myPBCteam

Most members of myPBCteam seem to enjoy drinking caffeinated drinks, especially coffee. One member shared, “I was told coffee is good for your liver, so I drink two cups a day and appear to have no adverse effects.” Another said, “Decaffeinated coffee does not help like caffeinated coffee does. I have two big mugs of coffee a day or more!”

However, some members have noticed that coffee drinking and PBC medication give them stomach issues. “I drink about 4 to 5 cups of coffee per day, and it does not seem to bother me. But when taking my meds, I make sure I have a banana or something in my belly. The rest of the day I just drink lots of water.”

For others, the effects of coffee’s acidity causes more trouble than caffeine. “I drink tea, coffee, warm water with honey and lemon juice. Drinks don’t bother me, but I have digestive issues with acid. I cut way back on how much coffee I drink, but then I was more tired!”

Some report that caffeine increases their itching. “I really try not to drink things with caffeine, but if I do, it kind of makes me itch, but not bad,” one member said.

Another noted that caffeine is best when consumed without sugar. “I was told to drink plenty of coffee and tea to protect my liver but to avoid sodas and energy drinks that pair lots of caffeine with lots of sugar.”

Caffeine affects everyone differently. Some people are naturally more sensitive to caffeine than others. If you’re living with PBC, listen to your body and your healthcare team when deciding how much caffeine is best for you.

Talk With Others Who Understand

On myPBCteam, members come together to find support and information about primary biliary cholangitis. This social network connects members with others who understand life with primary biliary cholangitis.

Do you think the consumption of coffee or caffeine reduces liver inflammation or prevents liver damage? Have you noticed any negative side effects from coffee intake with your PBC meds, like more itching or gastrointestinal issues? Share your experience in the comments below, or start a conversation by posting on your Activities page.