During the early stages of the keto diet, you may notice a few changes that are hard to keep up with.

Some of these physical changes can include symptoms like nausea, insomnia, fatigue, indigestion, and even heartburn.

There’s mixed opinion out there as to whether the keto diet directly causes heartburn, and some suggest that being in ketosis can actually help cure it. However we do know that certain elements of adjusting to a new diet, especially one high in fat, can lead to acid reflux pretty definitively.

In this article, I’ll explain in depth how keto causes heartburn, and what you can do to help combat it if you’re struggling with acid reflux.

What Is Heartburn?

Heartburn is a fairly common issue that stems from a condition known as acid reflux. When acid reflux takes place, the contents of the stomach that you eat are forced back up into your esophagus, which results in a burning sensation in your lower chest and throat.

Heartburn is just one symptom of a larger issue known as GERD, or gastroesophageal reflux disease, which is characterized by persistent acid reflux that takes place more than at least twice per week.

Roughly 15 million Americans struggle with heartburn every single day, and there are a lot of different contributing factors that make up its causes, and it can also be identified by a few different types of symptoms.

• Symptoms of acid reflux

The primary symptoms that take place in most cases of heartburn are pretty easy to detect, but there can be lesser experienced outlier symptoms as well.

The primary symptoms of heartburn include a feeling of warmth or burning in the chest and throat, directly related to stomach acid that’s being forced up into the esophagus. This generally takes place either immediately or shortly after eating certain types of foods (we’ll get into the food list later in this article).

Other types of symptoms can include the following:

• • Burning indigestion pain
  • Increased amount of sweat after eating
  • Acidic taste in the mouth coming from the back of the throat
  • Painful burps or hiccups

• Causes of acid reflux

The causes of acid reflux can vary quite a bit. There are certain medical conditions or types of diets (like the keto diet, as you’ll see later) that can definitely contribute to acid reflux as well as GERD, and other types of eating habits that can contribute as well.

Some of the most frequently associated foods and drinks that stimulate an increased production and secretion of stomach acid (which is the main driver of heartburn) include the following:

• • Acidic foods like tomatoes, lemons, and pineapple
  • Caffeine
  • Alcohol
  • Chocolate
  • Grain-based foods like wheat and certain types of rice
  • Carbonated beverages
  • Juices high in sugars and other processed ingredients
  • Certain types of dairy (this varies from person to person)

Additionally, smoking cigarettes is a significant driver of heartburn in a lot of people, as well as certain types of prescription medications, including:

• • Aspirin or ibuprofen
  • Naproxen
  • Certain antibiotics
  • Certain anxiety medications
  • Certain high blood pressure medications
  • Certain antidepressants

Lastly, there’s a variety of medical conditions to look out for when assessing the root of your heartburn.

Medical conditions like pregnancy have been widely linked to increased rates in heartburn, as well as general obesity, untreated sleep apnea, and certain skin disorders like scleroderma.

Additionally, those who are older in age like seniors are more likely to experience GERD than younger people.

Determining the exact cause of your heartburn is one of the best ways to devise a treatment plan, because you’ll know exactly what you’ll need to eliminate in order to evade these symptoms.

If you only just recently started experiencing flare ups of heartburn after transitioning to a keto diet, ketosis may be the culprit.

Fortunately, there’s a few ways to circumvent ketosis-induced heartburn, which I’ll get into next.

Can Keto Cause Heartburn?

More research evidence needs to be conducted to fully assess whether or not following a keto diet will directly cause heartburn, but there’s definitely some indications that it could be a big contributing factor that you may want to pay attention to when getting started with this new lifestyle.

• Fatty foods and heartburn

A lot of people associate the keto diet with being a low carb diet, which is generally true, but just about as important is the fact that it’s a high fat diet.

Following an ideal ketogenic diet should involve getting the majority of your calories from foods that are high in natural fats, such as from healthy fatty cuts of meat, or foods rich in fat like coconuts or avocados.

However with fatty foods can come some dietary issues, including in some cases increased stomach acid production and secretion.

A recent study found that a group of people who ate foods with higher fat content actually ended up having significantly higher reported rates of acid reflux problems, and even fully developed GERD.

This is attributed to the way that natural compounds in high fat foods interact with the sphincter of the esophagus, which can cause some irritation that can contribute to mismanagement of stomach acid over a long period of time.

This isn’t at all a cry to stop eating foods high in fat, but if you suspect fatty foods to be part of the problem, you should consider testing out the elimination of certain types of fats within your diet to determine the true cause.

Some people have an easier time digesting animal fat instead of plant fat, and sometimes you may be eating fatty foods that have been cooked in certain types of irritating and inflammatory oils. Once you’re able to figure out the root of this cause, curing your heartburn will be a much simpler process.

• Changes in gut bacteria

When you undergo a drastic change in your diet, it can dramatically affect the bacteria balance within your gut. And as you might expect, changes in gut bacteria balance can have a direct role on changes in stomach acid secretion, causing more heartburn in many cases.

Various studies have found that going form a high carb, low fat diet directly to a low carb, high fat diet caused unwanted changes in gut microbiomes, including increased rates of experienced acid reflux.

There are a few ways that doctors and keto experts recommend to combat these changes in gut health, and the most effective is with probiotic foods.

Eating healthy probiotic foods can be a great way to restore balance to your gut microbiome, and reduce the inflammation and irritation that’s contributing to this heart burn issue.

Some great natural ways to get probiotics into your system include eating the following:

• Kimchi
• Sauerkraut
• Kombucha
• Kefir
• Yogurt
• Tempeh
• Miso

If you’re having a hard time enjoying any of the above, or fitting them into your macro targets, you can also try supplements. My personal favorite supplement that’s keto-friendly is the Probiotic 40-Billion, which is a natural way to replenish your gut flora and reduce rates of bloating and swelling.

Remedies for Heartburn

As I mentioned above, probiotics are a great start when it comes for remedies for heartburn, if your heart burn is being caused by gut health.

But sometimes you simply won’t be able to figure out exactly what’s causing it. We know that using the elimination method can be a good way to try and isolate the problem, but unfortunately it won’t always work perfectly.

So what do you do if you aren’t sure what to eliminate and add?

A lot of people will suggest taking antacids like TUMS or Alka-Selzter, and they do work for short term relief, but they’re more focused about symptom management that actually curing your acid reflux.

Like those two, products like Pepto Bismal can be a great preventative to take before you anticipate a meal that could cause heartburn, but it still doesn’t quite get to the root of the issue.

Ultimately for a lot of people, losing weight will be one of the best and most effective ways to curb the effects of heartburn. And what not a better way to do that than through keto!

If you don’t believe that your acid reflux is weight related, you should look into some of the following lifestyle fixes:

• Try eating your meals slower
• Try to fix your posture over a long period of time
• Consider sipping on apple cider vinegar
• Try out chewing gum or breath mints
• Wear looser fitting clothing around your chest and neck
• Consider trying licorice supplements

If you’re looking for other natural ways to combat heartburn while following a ketogenic diet, I highly recommend checking out this video from Ken D Berry MD, one of my favorite keto diet YouTubers. He lays out a lot of new facts about keto and acid reflux, and offers cheap, and sustainable ways to combat and cure it.

Final Thoughts

As you can see, there are definitely a few different ways that a ketogenic diet can contribute to heartburn, but that doesn’t mean you should avoid the diet altogether.

If you’re able to identify exactly what’s causing it, you should be able to effectively eliminate or fix certain contributing factors, without giving up on keto altogether.

Do you have any keto heartburn fixes that I didn’t mention here? Drop them in the comments below!