Reflux is HORRIBLE After Starting Keto

(Amber) #1

I know there are a few topics on this but nothing seems to be my situation.
I started Keto 2 weeks ago (restarted actually) and it’s going pretty good.
I tend to have a coffee with MCT powder (perfect keto), collagen and cream each morning. Then I don’t eat until lunch where I have whatever is leftover from dinner. I will have some pepperoni and cheese sometime in the day then dinner.
I am having the WORST reflux I’ve ever had!!! Even when I ate carbs and super spicy foods I didn’t have it so bad as this. I have tried apple cider vinegar and I have tried lemon juice. It only seems to happen during the day while I’m at work. The WORST possible time.
I’m not on any meds for it either but have taken tums here and there (yeah I know they have sugar) But I don’t know what else I can do.

(Ryan James Dansby) #2


Same exact situation I’m in.

(8 year Ketogenic Veteran) #3

If this were me, I’d narrow down the possible suspects. First that comes to mind is MCT powder. I have known SEVERAL ketopians who have had this issue with reflux and MCT powder/oil.

Our body does change on keto as does our gut etc. You’ll need to experiment on yourself.

(M C) #4

Okay this might sound like the strangest old wives tale ever but here goes.

When I was pregnant I had acid re-flux so bad it was like liquid fire. I was given meds, chewed antacids, tried every home remedy known to man. None of them worked. Then one day a little old lady in a book group I was part of suggested that I take a teaspoon of yellow mustard (not English mustard) followed by a whole glass of water. It tastes nasty but it worked like a charm every time.

I know it sounds weird as heck and counter intuitive because mustard is acidic and spicy, but it has worked for me for 30 years. I have passed it on to my kids and anyone else along the way who had troubles. I can only hope it works for you.

Good luck and let me know if you are brave enough to try it!

(Amber) #5

I’m going to try my coffee without MCT and see if that helps. I really hope it’s not that as I love my MCT in the coffee but if it’ll relieve this I’m down to try anything. I already gave up carbs so how hard could it be to give up the mct in the coffee lol.


You might try substituting coconut oil instead of the next oil. Lots of people like it.

(melinda) #7

I’ve had debilitating gerd for years. When i first started keto it got worse BUT after a few months my stomach stayed to heal and now it’s better than it’s been in five years.

(Gabe “No Dogma, Only Science Please!” ) #8

I had terrible reflux for a few years UNTIL I lost a couple of dozen pounds on LCHF. I mean, I had reflux where I couldn’t eat for days because everything burned. Here are my recommendations:

  • Completely stop drinking coffee and alcohol, and absolutely no spicy food. This is a no-brainer. These (and fats/oils) are the prime culprits that cause the sphincter keeping your stomach out of your oesophagus to loosen and therefore expel stomach acid into your oesophagus. Don’t. Drink. Coffee. Or. Alcohol. Period.
  • If the above doesn’t solve your problem, reduce the fats/oils in your diet. They’re the next biggest culprit after coffee/alcohol/spicy. Yeah I know this is a low carb, high fat diet, but as @richard and @carl will tell you, the fat doesn’t have to come from your diet. It can come from your body fat. And if you’re like 99% of people with reflux, your reflux will improve after you’ve dropped 20 pounds. Or 30. So don’t think of this as forever. And by the way: I no longer have acid reflux (except after coffee/alcohol a bit!) but I’m still considering reducing my dietary fat intake so that I can drop the last 10 pounds! Plenty of ketoers are. You’re not alone!
  • Experiment with fats/oils. Some may be better for your GERD than others.
  • Consult a doctor. If your reflux is bad, you may need (a) to have an actual MD to scold you and tell you what I’ve just told you :wink: and (b) you almost certainly should have an endoscopy to check the lining of your oesophagus isn’t damaged from your reflux.

Hope this helps. Trust me, I thought my reflux (pre-LCHF) was a death sentence. And when I got on LCHF to begin with, it was not super-high fat. I’ve only ramped up the fats and oils since most of the reflux has disappeared, which usually happens after you’ve lost weight because the mechanical factors causing the reflux have eased (basically, your body fat is pushing the top of your stomach into your oesophagus, or at least pushing your stomach acid up into your oesophagus.) And I should note again: I get so satiated so quickly now that I’m probably going to ease off on the fat intake anyway.

You’ll get through this! Will you report back after a few days of quitting coffee and alcohol and spicy foods and let us know how you’re doing?



Magic tricks:
1/2 tsp baking soda in warm water (AKA “The Bomb”)
Apple cider vinegar 1-2 Tbsp in cold water
Try either or both!

(Brendan Cole Sweeney) #10

I have GERD to a very bad extent, @gabe is right no caffeine or alcohol period. I would be puking blood within hours of wine or liquor, and caffeine comes close to that point. (tea has caffeine too.)

Also if it bothers you any while trying to sleep, sleep on an incline.

(Karen Fricke) #11

Also might be whatever is added to MCT oil to make it powder. Since I started eating a whole food diet, additives set off reflux.

Nausea reflux
(Cathy) #12

My experience was that I already had gerd and was taking zantac and tums by the hand full. When I went keto, I continued to suffer 24/7 with it and continued with the o.t.c. meds. It was about 6 months in when a person on a forum I participated in suggested that it was actually a problem with low stomach acid and that I should stop all medications and allow my body to correct it.

I am so glad I did it. It took about 2 wks. and poof - all gerd gone. The only time I ever experience a hint of it is when on vacation, I sometimes have a beer.


Prior to starting I would have gerd and usually a couple of days of generic priolosec would take care of it. I know you are supposed to take it longer but a couple of days was enough. Wheat would aggravate it. I think tomato sauce did too. When I started fasting I started taking ACV. OMG that would aggravate it! Once I realized that I have not touched it since. I started in March, just last week I realized that it has not bothered me in a while except for the occassional burp after a meal. The 30 lbs weight lost has helped I would imagine although I have more to lose.

I heard on a podcast recently that the big culprits are cocoa, peppermint and I think coffee (not 100% on that last one) and MCT oil. As they work to loosen the spincter at the top of the stomach. Also if you have a haietal hernia

(Carpe salata!) #14

For me it was over- eating.

In hindsight : duh

(Liz ) #15

My GERD manifests as an unclearable throat after eating pretty much anything. There’s no burning, but it’s incredibly frustrating as it can feel like I’m choking or having asthma.

I’ve tried enzymes, ACV, baking soda, nothing really works. I’ve been Keto for 6 months, lost 30 pounds with 30 more to go. I really hoped I’d get relief & I’m pretty disappointed. I even had it when I fasted 48 hours! That was a blow. Sometimes if I massage just under my rib cage I think that helps close the valve but it doesn’t always work. I hope that if I just KCKO & try some of the other things suggested in this thread I will get relief.

(Gabe “No Dogma, Only Science Please!” ) #16

Part of the problem is that LCHF implies high fat, while fats are one of the biggest triggers for GERD. The science is in: those foods loosen the Lower Oesophegeal Sphincter and literally cause you acid reflux.

Those of you with GERD who insist on eating and drinking those well-known trigger foods – please stop being stubborn and try completely eliminating all triggers for a while. You may well find that you even have to substantially cut back on fats even though you want to do LCHF.

Again, that’s ok. You can burn your own body fat. And yeah it sucks that you won’t be able to enjoy all those fatty recipes and your coffee (let alone your bulletproof coffee - which frankly I think is overrated anyway!) But this is your health we’re talking about!

P.S. all the homemade remedies – drinking milk, eating cucumber, apple cider vinegar – didn’t work for me, and I expect they won’t work for you. You have a medical condition, magic potions don’t usually work.

However: Losing a lot of weight 99 times out of 100 will severely reduce or eliminate GERD.

(Christopher Avery) #17

I empathize Amber. I’m sorry you are dealing with this.

I dealt with chronic reflux disease for years. I’ve eliminated mine (I don’t claim that I’m cured – see the referenced post) with a combination of

  • diet change (mostly MUCH less alcohol),
  • medical intervention (endoscopy checking for pre-cancerous cells in esophagus – a potential complication from chronic GERD – found only “patchy” gastritis in stomach which was addressed with a 30-day course of a prescription), and
  • Application of Tension Myositus (TMS) Syndrome self-treatment (see link below).

In no way am I attempting to diagnose you. I’m not a physician. I am incredibly impressed with the mind-body connection in disease (dis-“ease”) and symptoms, and have as part of my life purpose to raise awareness of the power of the sub-conscious mind as well as the limitations and biases of traditional western medicine.

I wish you wellness, peace, and joy.

(Amber) #18

Thank you for all the help! I don’t really drink anymore so that’s not too much of an issue. I have stopped MCT powder in my coffee and for 2 days have not had the reflux so I am thinking that was what was causing it. The particular powder I was using apparently was causing me problems. But I’m thinking giving up coffee soon would be good anyway.

(Sardelle) #19

It sounds like you might have already found your culprit, but just thought I’d mention for others that might be having trouble that dairy is a very common food intolerance, and a lot of people really up their dairy on keto. Nuts and eggs can be problematic too. I’ll get reflux from dairy and almond milk (too bad since almond milk lattes are yummy).

(Gabe “No Dogma, Only Science Please!” ) #20

Great to hear you’re feeling better! My advice is to get off the major triggers entirely for a few months even given your good results quitting the MCT oil, wait till you’ve lost a decent amount of weight, and then test some of those triggers out again on yourself.

I now have 2-3 coffees a day with very little problem. I still have some reflux, but it’s minimal. But I only started coffee again after 20 pounds of weight loss last year. I’m now down about 30 pounds, and I figure in another 10 or so pounds when my weight starts stabilizing, there’s a chance I may not have any reflux at all.