Coffee on an Empty Stomach: What Doctors Say
- Drinking coffee on an empty stomach is a somewhat controversial practice on social media.
- A gastroenterologist says studies have not shown major problems with cortisol or blood sugar.
- Cortisol naturally peaks in the morning, so the “spike” may be a natural process.
- Caffeine relaxes the valve between the esophagus and stomach, which may cause heartburn.
- Both regular and decaf coffee trigger stomach acid and gastrin release.
- On an empty stomach, symptoms may include nausea, burning, or the urge to use the bathroom.
- Large amounts of cream, milk, sugar, or additives change the picture entirely.
Drinking coffee on an empty stomach is a somewhat controversial practice. Claims circulate on social media that it spikes levels of the stress hormone cortisol and harms the gut. But some gastroenterologists say it is not harmful.
One social media post claimed that drinking coffee on an empty stomach can damage the lining that protects the gut from stomach acid. In a post on TikTok, a medical professional advised against drinking coffee on an empty stomach, saying it can cause a spike in cortisol levels.
What Is Cortisol and Why Is It Linked to Coffee?
Cortisol is a steroid hormone produced by the adrenal glands, which are located on top of the kidneys. It helps regulate the body’s response to stress. High or low cortisol levels can affect a person’s health.
Drinking coffee can activate the nervous system. This can lead to an increase in blood pressure and sleep issues from the caffeine. However, Dr. Asma Khapra, a gastroenterologist at GastroHealth in Fairfax, Virginia, said coffee does not seem to cause major problems when drunk on an empty stomach.
“Coffee doesn’t seem to cause major problems when you drink it on an empty stomach. Studies haven’t really shown that it causes problems with your cortisol or blood sugar or any other kind of metabolic issues.”
— Dr. Asma Khapra, Gastroenterologist
Cortisol Naturally Peaks in the Morning
Cortisol naturally peaks in the morning. Therefore, the “spike” in cortisol that some people attribute to drinking coffee on an empty stomach might just be a natural process. It may not be a side effect of the coffee at all.
How Caffeine Affects the Stomach and Esophagus
Consuming caffeine relaxes the muscular valve between the esophagus and stomach. This can cause stomach acid to move up into the esophagus, possibly leading to heartburn. Both regular and decaf coffee trigger the release of stomach acid and gastrin, a hormone that regulates digestion.
This occurs whether a person has eaten or not. Without food, however, various symptoms can arise. These include nausea, burning in the abdomen, or the urge to use the bathroom. This was noted by New Jersey-based gastroenterologist Dr. Douglas Weine.
| Symptom | Likely Cause |
|---|---|
| Heartburn | Relaxation of the valve between esophagus and stomach |
| Nausea | Stomach acid release without food |
| Abdominal burning | Stimulation of stomach acid and gastrin |
| Urge to use the bathroom | Activation of the digestive system |
| Palpitations and anxiety | Central nervous system activation |
| Sleep issues | Caffeine’s effect on the nervous system |
Caffeine Is a Stimulant
Caffeine is a stimulant, so it can activate the central nervous system. This can contribute to an increase in blood pressure and heart rate. It can lead to anxiety, heart palpitations, and sleep issues.
Everyone handles caffeine differently. Some people are more sensitive to it than others. It is true that the body absorbs coffee, and therefore caffeine, more rapidly when the stomach is empty. However, some people experience no negative side effects when consuming coffee on an empty stomach.
“I Think It’s Fine If You Enjoy Your Cup of Coffee”
Dr. Khapra said drinking coffee on an empty stomach “shouldn’t really cause too many GI symptoms.” She added: “I think it’s fine if you enjoy your cup of coffee on an empty stomach.” She did, however, attach an important caveat. This applies provided the cup does not include a large amount of cream, milk, sugar, or other additives.
Additives Are the Real Difference
Additives, rather than coffee itself, are often the real source of the problem. A large amount of cream, milk, sugar, or other additives turns a simple drink into a high-calorie meal. This is exactly the caveat the doctor pointed to.
Practical Conclusion
Available evidence does not support the idea that coffee on an empty stomach is generally harmful. Some people may experience digestive symptoms or heartburn. This is especially likely if they are sensitive to caffeine or drink coffee without food. But most people do not experience major problems.
If you drink coffee on an empty stomach and feel comfortable, there is no need to worry. If you notice heartburn, nausea, or palpitations, try drinking it after a light meal or reducing the amount. And if the cup is loaded with cream and sugar, the problem is likely there and not in the coffee.
