Reflux is HORRIBLE After Starting Keto

(Whitney Lee) #61

Thats a good point, im no longer eating citrus so that might be my issue… thanks!

(Steve) #62

Yep, can’t recommend the ACV in water enough. :slight_smile: Been fantastic never getting heartburn anymore. :slight_smile:

(Hannah Ml) #63

Thanks for this - it is helpful. I weirdly never had GERD symptoms until a couple months ago, when I was already 4 months into keto.

does losing weight only help if you are technically overweight or will it just help in general? I am at the higher end of what is considered the healthy range for my height. Not overweight, and not doing keto to lose weight, doing it to keep my sibo in remission and reduce inflammation, but I will go for it more if I know it will help.

(Gabe “No Dogma, Only Science Please!” ) #64

Sorry Hannah, I just saw this now.

Sounds like the SIBO could be the cause of your reflux – in fact, that’s one of the first things they tested me for when my reflux got really bad a few years ago. I was technically obese at the time, and now I’m still quite overweight in spite of LCHF.

I definitely noticed that my reflux improved once I dropped down to around 79kg, and when I put some weight back on (back up around 84kg now), I noticed the reflux reemerging. So for most people who don’t have an underlying condition like SIBO, weight loss can really help.

If you’re at a healthy weight, that may not be the case for you. I suggest you speak with your physician. My gastro a few years back told me “lose 20 kilos.” If yours isn’t a result of the SIBO, then it could well be the amount of fat you’re consuming on keto.

If I were you, I’d probably switch to a Whole30 style diet that was not ketogenic and included more (gasp) healthy carbs like vegetables to make up for the calories you’re not getting from fats, and see if that does anything for you. After all, if your biomarkers are great and you’re at a healthy weight, you have nothing to lose by playing around with your diet to see if that helps the GERD. Plus, if you’ve had the SIBO for a long time, it sounds like the proximate cause of your GERD is probably the change in your diet – and fat consumption is a trigger for GERD.

As always, playing the heretic,
– Gabe

(Mandy) #65

This is an old thread but I thought I would throw in my 2 cents. I have a history of GERD. When I started keto it went into overdrive. I mean it was so bad I could compete with a dragon. It was so painful. I came to the forum and asked about it. Turns out coconut oil has some trigs that can cause heartburn. I cut coconut oil from my daily routine and BAM, no more heartburn. It’s the only thing I changed. I may try to add it back as its such a good fat but I am super thankful to have figured it out.

(Empress of the Unexpected) #66

What are the significant differences between Whole 30 and keto? I fit into that category you mentioned. I am 116, and at this point simply trying to work on body recomposition. Not sure if strict keto is for me.

(Bunny) #67

The Benefits of Digestive Bitters for Acid Reflux: They tone the valves and sphincters in the digestive tract, preventing acid reflux and encouraging movement of food through the tract. They encourage the production of hydrochloric acid. …Non-Alcoholic Fatty Liver Disease (NAFLD) is one of the risk factors of GERD or chronic acid reflux? …More


  1. NAFLD fibrosis score - Online calculator
  1. Nonalcoholic fatty liver disease increases risk for gastroesophageal reflux symptoms.

(Gabe “No Dogma, Only Science Please!” ) #68

Whole30 doesn’t restrict carbs and doesn’t seem to set any macro targets. It’s been a couple of years since I looked at it, but as far as I remember the only real difference in terms of food choice is that it allows fruits of all sorts. I know it restricts grains, but I’m not sure whether it limits starchy vegetables. You’ll have to check, but from memory it’s a fairly high fat diet compared with SAD.

(Kel Ta) #69

Consider first the root cause of GERD and LPR- fermentable carbohydrates, gastroparesis, dysmotility of the gut, bacterial dysbiosis or low HCL/Pepsin- Check out Dr. Robillard’s work- the only thing that helped me

(Campbell smith ) #70

I had the complete opposite experience when starting low-carb/keto. Acid reflux disappeared overnight – literally. That has allowed me to identify which foods were causing it over time, so now I know what to avoid. I have to guess your intake of some food items has gone up to compensate for the carbs. One or several of those items are the likely culprits. You can try to figure it out by removing some foods from your diet for a day or two, and see if you notice any improvements. I hope this helps!

(Dee Mila) #71

I never had acid reflux before and after a month of keto I ended up at the ER 5 times in a month. No one knew what’s going on…they thought I was anxious. It was all keto:(

(Dee Mila) #72

I have never suffered from acid reflux until I started Keto. I ended up 5x at the er. Doctors didn’t know what is going on…It was terrible I thought I was going to die.
I would not recommend Keto to anyone.
There’s just not enough research on it. It’s making a lot of people sick.

(Steve) #73

Sorry for your experience, but we’ve seen Keto help a lot more people that it’s hurt (few and far between from what I’ve seen in terms of it not agreeing with people).

Myself included - had reflux often until I went Keto (and lost the weight) - and using ACV helps ensure I never get acid reflux or heartburn ever again.

(Bunny) #74

I have found (personally) that besides ACV digestive bitters and fermented foods eliminate it (acid reflux, heart burn, GERD etc.) completely and a good indication I also had a fatty liver also gone thanks to the Ketogenic lifestyle and by preventing NAFLD by upping my choline methionine[1] in % ratios to regulate my weight loss and eating non-GMO’s…


  1. Methionine and choline regulate the metabolic phenotype of a ketogenic diet: Low-carbohydrate ketogenic diets are commonly used as weight loss alternatives to low-fat diets, however the physiological and molecular adaptations to these diets are not completely understood. It is assumed that the metabolic phenotype of the ketogenic diet (KD) is caused by the absence of carbohydrate and high fat content, however in rodents the protein content of KD affects weight gain and ketosis. In this study we examined the role of methionineand choline in mediating the metabolic effects of KD. We have found that choline was more effective than methionine in decreasing the liver steatosis of KD-fed mice. On the other hand, methionine supplementation was more effective than choline in restoring weight gain and normalizing the expression of several fatty acid and inflammatory genes in the liver of KD-fed mice. Our results indicate that choline and methionine restriction rather than carbohydrate restriction underlies many of the metabolic effects of KD. …More
  1. Heartburn – 12 Clinically Proven Natural Cures - Dr. Akil Palanisamy MD
  1. 10 Steps to Beat Acid Reflux Naturally - Dr. Jockers
  1. Acid Reflux Medication Linked to Liver Disease (& Better Alternatives) - Dr. Josh Axe

Problems with stomach acid/GERD
Nausea reflux
(Jen Andrew) #75

Same here, my GERD went from few times a year to every day since I started Keto. My doctor said I have weak LES and that the fat keeps it open. I also got tested positive for h. pylori which supposedly makes my stomach less acidic, no ulcers or pain. I will try to kill it naturally with mastic gum and other supplements. When I used to eat carbs with fat I guess carbs were absorbing the fat and it wouldn’t spill back up… Vegetables don’t absorb the fat probably because there is too much fiber. So I just cut on added fats and I get less severe GIRD and less often, which I manage with Zantac. But still its not fun to live like this.

(Thurston ) #76

As long as I stay away from tuna and keep nuts chicken and bacon to respectable quantities I’m ok. I didn’t realize carbs were the source of my gerd until I went keto.

(Navachi Brinkley Jackson) #77

What is LCHF? I have been suffering with Gerd since I started Keto 3 months ago. I have been taking Pepcid but the Gerd keeps coming back. I only drink wine 2 a month. But I drink coffee/tea daily with MCT oil. Please help me to continue on keto without Gerd🤢

(Amy) #78

Pepcid will make it worse! You need to increase the acid in your stomach to trigger the esophageal sphincter to close. Some use apple cider vinegar, but find it irritates my esophagus on the way down. I use HCL with Betaine tablets. I needed it a lot in the beginning, while my body was getting used to digesting so much fat, but now I only take it when I eat beef or eggs.

(Gabe “No Dogma, Only Science Please!” ) #79

I’ve actually been dealing with this issue this week – saw the doctor for it. I have to take Zantac twice a day, cut the coffee and alcohol for a while, and try losing more weight (I’ve put on some weight on keto.)

Definitely stop drinking the coffee and tea. Coffee with MCT oil is pretty much the perfect trigger for GERD. Also: Don’t touch spicy food. Reduce the amount of fatty foods that you eat – if you have a good amount of weight to lose, then you shouldn’t be eating a very high amount of fat anyway. This is all pretty standard advice for GERD.

Let me know if this helps – but for sure the #1 thing I would do if I was you is STOP DRINKING COFFEE!

(LCHF = low carb high fat)

(Old Baconian) #80

“LCHF” stands for “low-carbohydrate, high-fat,” though some people prefer to say “healthy fat.” LCHF and keto mean the same thing to me, but many people make a distinction on the basis of the amount of carbohydrate allowed. On these forums, people referring to “keto” generally mean under 20 g/day of carbohydrate, and they say LCHF if they are referring to a higher carobhydrate limit.

Dr. Phinney, who coined the term “nutritional ketosis,” uses the terms LCHF and keto interchangeably. When he was working with fat-adapted athletes, he used to talk about “low-carb” as being somewhere between 100g and 125g of carbohydrate, and he used to talk about people getting into ketosis while eating that much carbohydrate. Now that he’s working with diabetic patients at Virta Health, his recommended maximum is 50 g/day. The Dudes recommend 20 g/day, because that is a level at which virtually everyone who’s not severely metabolically deranged can be sure to get into ketosis. People with really bad metabolic derangement may need to eliminate carbohydrate from their diet completely.