Dear Alice,

Recently, I have noticed that drinking coffee makes me somewhat nauseous. I have never had problems with caffeine before and still don't with caffeinated soft-drinks. The only thing I can think of is that my diet at school tends to consist almost entirely of pizza and Chinese food. Could it be due to a dietary deficiency? What's up?

B-real

Dear B-real,

Ah, coffee — the drink so many turn to morning, noon, and sometimes even night for that little “pick me up.” Unfortunately, drinking coffee can sometimes cause discomfort or exacerbate other issues in the body. The two most common links between coffee and nausea are withdrawal from coffee (and the caffeine in it) and GERD (gastroesophageal reflux disease). Another thing to consider, B-real, is that your nausea is actually related to something else rather than the coffee. While nausea isn't considered a symptom of dietary deficiency, the combination of diet and coffee may be contributing to how you feel. Ultimately, talking with your health care provider is the best way to find out what exactly is causing the nausea.

Because nausea is a symptom of caffeine withdrawal, it’s worth exploring as a culprit. Quitting caffeinated coffee, after the body is used to it, can cause a whole host of unpleasant symptoms as the body adjusts. To think about whether this applies to you, ask yourself:

  • Have you recently stopped drinking coffee or drastically changed your coffee-drinking habits?
  • Have you noticed other symptoms like headaches, irritability, or fatigue?

GERD is another possibility to consider as a cause for your feelings of nausea because coffee (along with other food such as alcohol, tomatoes, greasy or spicy foods, and chocolate) is considered by some to be a trigger for GERD symptoms. Coffee stimulates the body’s secretion of gastric acid, which can be problematic for people with GERD. It’s worth mentioning that your main diet staples (pizza and Chinese food) may also be exacerbating the issue, as they fall into those common GERD symptom trigger categories as well. However, scientists aren't in agreement on the exact connection between coffee and GERD — with some studies showing a relationship and others suggesting there may be no association at all. More research is needed. People with GERD are generally advised to avoid trigger foods, but approaches differ across individuals in managing GERD. A visit to your health care provider is the only way to know for sure if you have GERD and what steps may be best for you specifically to manage it.

While avoiding what makes you feel green around the gills is certainly a good way to go, you may not have to give up on coffee completely. The type of roast you choose may make a difference. Some studies have examined the effect of different types of coffee (dark vs. medium roast) on gastric acid secretion. Although additional research is needed to provide more conclusive evidence, these early studies suggest that it may be other ingredients in the coffee (besides caffeine) that make a difference. In addition to caffeine, βN-alkanoyl-5-hydroxytryptamides (C5HTs) and chlorogenic acids (CGAs) are compounds found in coffee that may irritate the stomach lining. Because dark roast has lower amounts of C5HTs and CGAs, it may help to switch to a darker roast. The effect of these other ingredients  may also help explain why you react to coffee specifically and not to other caffeinated beverages. However, coffee has higher caffeine content than soda, so caffeine could still be impacting your body.

Rather than doing all the detective work on your own, consider bringing in a professional. Talking to your health care provider can help determine not only the cause of your nausea but the best way to reduce it as well. Wishing you relief from your sour stomach!

Alice!

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