First off, let us understand and realize that caffeine is a drug. I have talked to many patients who are appropriately leery of taking prescription medications but don't think twice about the amount of caffeine they ingest. One patient responding to how much caffeine he typically drinks by saying, "two a day." I answered, "well, that's not too bad." He looked down and a bit sheepishly clarified, "two....pots" Well, that explained his chronic headaches, his indigestion and having to urinate constantly. Caffeine is chemically in the xanthine family of drugs. You can buy caffeine in pill form. Just because it is also found in some of the food and beverages that we drink does not make it any less of a drug. Remember, at one point cocaine was in Coca Cola. 
As a medication, then, what effects does it have on the body? Its two major effects is as a stimulant and a vasoconstrictor. It causes blood vessels to tighten and the heart rate to speed up. It acts quickly but tolerance develops after just a few days. This is why it both treats and causes headaches. Through its vasoconstricting effects on the blood vessels of the scalp and face, vascular headaches (such as migraines) can be aborted. However, if used on a regular basis, the body will no longer respond or will respond just transiently and then be followed by a rebound phenomenon, triggering more headaches. The same is true for its effect on fatigue. The quick surge of wakefulness rebounds into lethargy and the dreaded brain fog. Many respond by redosing the caffeine, making matters even worse. My philosophy is to keep my system as free from caffeine as possible so that when I want to use its effects to my benefit, it will work for me. I try not to use a medicine containing caffeine (like excedrin) more than three times a month.One of caffeine's effects that has been used to our advantage is its ability to relax the airways in asthmatics. However, given its short duration, its deleterious effects on the heart, and the fact that we now have better, less toxic agents to achieve the same goal, it is no longer used for that purpose. In regards to the heart, caffeine may increase the blood pressure a bit but mostly it causes the heart rate to speed up. This accounts for the "buzz" from energy drinks. Potentially dangerous heart arrhythmias may result. This metabolic stimulation is used by manufacturers to promote products for weight loss. Echinacea falls in this same category. Many think that if it is "natural" it is safe. Not so. The only safe way to increase your body's metabolism is through cardiovascular exercise. Any weight loss achieved through caffeine will come right back as soon as the product is stopped.
In addition to its affect on headaches, promoting chronic fatigue and over stimulating the heart, caffeine can also contribute to heartburn by affecting the sphincter muscle of the lower esophagus. This muscle normally constricts when we are not swallowing, keeping acid in the stomach where it belongs. Caffeine weakens that muscle. Lastly, caffeine is a bladder irritant and a mild diuretic. Bottom line? If you are running to the bathroom more than you think you should, pay attention to how much caffeine you are ingesting. In summary, just be careful with this medication. Used sparingly for infrequent periods, it may have beneficial effects. If used on a regular basis, it is likely to cause problems. Here is a quick test to know if you are using too much caffeine. If you ever refer to your caffeinated beverage by using a possessive pronoun such as "my coffee" or "my diet coke," you need to cut back.
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