Caffeine is an integral part of the American culture, particularly in the form of coffee, but is also present in tea, sodas, chocolate, and some medications. In fact, caffeine is the most widely used psychoactive drug in the world. Certainly, many of us rely on coffee on a daily basis. The question-especially for women-is whether or not regular caffeine consumption is in your best health interest.

In her book Active Wellness, Gail Reichler, MS, RD, CDN, explains that caffeine belongs to a group of drugs called “methylxanthines” which affect the body in numerous ways. Caffeine operates as a stimulant by targeting the central nervous system and triggering the release of stress hormones. Reichler states that caffeine may also alter blood sugar and triglyceride levels, increase blood pressure and heart rate, constrict blood vessels, induce anxiety, disrupt sleep patterns, and inhibit the body’s absorption of iron, zinc, potassium, magnesium, calcium, and sodium.

Clearly, caffeine has numerous effects that we may not consider as we sip our morning coffee, and appears to pose some particular health concerns for women. Caffeine consumption is ranked among the risk factors for osteoporosis and several studies have shown it to promote calcium loss from the body. In her book, SuperNutrition for Menopause, Ann Louise Gittleman explains that excessive caffeine consumption increases our risk of osteoporosis by reducing blood calcium levels, since calcium and other key minerals are more lost in the urine when we consume caffeine.

Gittleman asserts that caffeine’s diuretic properties may as much as double the rate of calcium excretion. Once calcium is excreted, the brain signals the parathyroid gland to draw additional calcium from the bone to keep blood calcium levels within normal boundaries. She states that coffee contains not only caffeine, but also twenty-nine other acids, and calcium must be drawn from the bone to neutralize each in the body.

A 1990 study in the American Journal of Epidemiology examined caffeine and the risk of hip fracture. The study concludes that only two or more cups of coffee per day increased urinary calcium depletion, leading to increased risk of bone fractures. A 1993 study in the Journal of Nutrition also looked at caffeine and mineral loss, noting that consuming caffeine increased the urinary excretion of calcium, magnesium, sodium, and chloride for at least three hours after intake. Consequently, you might want to consume caffeine separately from your main meals where you get most of your nutrients, and when you’re most likely to take your daily multi-vitamin/mineral supplement.

If you want to reduce your daily caffeine intake given these potential health concerns, how should you start? Many of us experience headaches when trying to scale back on caffeine, making it difficult to limit or omit it completely. Fortunately, you can minimize your discomfort by cutting back gradually. One way to do so is to combine regular with decaffeinated coffee, and slowly increase the amount of decaffeinated coffee over time. Also, note the caffeine you ingest from other sources, like as sodas, chocolate, and many medications.

If you enjoy your morning coffee, take heart. You don’t have to cut caffeine out completely to minimize your health risks. However, since consumption of more than two cups of coffee per day may compromise bone health over time, it seems clear that at least moderating your daily intake would be the healthiest move.