Is It Okay to Drink Coffee on an Empty Stomach?

Every morning, millions of people across the world start their day with a steaming cup of coffee. But some social media users are raising concerns about drinking coffee on an empty stomach, alleging it can “destroy” your gut and cause the stress hormone cortisol to spike. Is there any truth to such claims?

“Coffee on an empty stomach is not the health emergency social media sometimes makes it out to be,” says Douglas Weine, MD, a gastroenterologist at Red Bank Gastroenterology, a division of Allied Digestive Health in Red Bank, New Jersey. “Most healthy adults tolerate it well.”

That said, coffee on an empty stomach can lead to uncomfortable symptoms for some. Here’s what to know about how having your morning coffee without any food can affect your health.

Drinking coffee, both regular and decaf, triggers the release of gastric (stomach) acid and gastrin, a hormone that keeps your digestive system working properly, Dr. Weine says. This happens whether or not you’ve eaten.

For most healthy adults, the stomach lining is strong enough to handle these effects. But they can still happen to anyone from time to time, says Paul Panzarella, MD, a gastroenterologist at Gastro Health in Maitland, Florida. People with acid reflux, diabetes, obesity, or a history of smoking are more likely to experience these reactions, he says.

But Weine calls this a modest, temporary increase in cortisol. “Since cortisol is naturally highest in the morning, this is usually more of a physiologic blip than a health crisis.”

It usually doesn’t lead to dangerous increases, Dr. Panzarella says. Regular coffee drinkers often develop a tolerance, so the effect diminishes over time, Weine adds.

Thanks to increased stomach acid and cortisol, there are three main ways drinking coffee on an empty stomach can impact your health. Here’s how:

Heartburn

Coffee may exacerbate acid reflux and cause heartburn, especially if you have a history of these conditions or gastroesophageal reflux disease (GERD), Panzarella says. If you tend to get heartburn after drinking coffee, he says it can help to take an antacid or H2 blocker, such as famotidine (Pepcid AC), on an empty stomach 30 minutes before eating or drinking anything.

Nausea or Diarrhea

This can cause nausea or trigger a bowel movement, Panzarella says. People with irritable bowel syndrome, caffeine sensitivity, heartburn, or gastritis may be more affected, Weine says.

Jitters or Anxiety

If you regularly drink your morning coffee on an empty stomach and aren’t sure if it’s causing issues, pay close attention to any symptoms you have and consider keeping a food and symptom journal to track them.

There are also a few ways to potentially lower the effects:

• Buffer with food. Weine suggests pairing coffee with oatmeal, whole-grain toast, fruit, yogurt, eggs, or “another modest meal with complex carbohydrates and protein.”
• Don’t drink too much. Start with a smaller coffee serving, or choose lower-caffeine or decaf options, Weine says. And avoid drinking several cups of coffee in a row.
• Be careful with creamer. Adding milk or creamer to your coffee can minimize symptoms for some. But Panzarella says it can increase acid production and worsen symptoms for others.
• Hydrate. Drinking water can sometimes lessen the impact, Weine says.

If acid reflux, upset stomach, or jitteriness persists, see your doctor.