Why you feel bloated on a ketogenic diet

Feeling bloated on keto, in the beginning, is common and is due to your body adjusting to your new diet and the dying off of unfavorable bacteria that prefer carbohydrates as food. Bloating that lasts longer than a few weeks can be due to the preexisting condition hypochlorhydria, also known as low stomach acid. There are simple supplements to alleviate hypochlorhydria and reduce stomach bloating on keto.

Are you doing a ketogenic diet to improve your mental health? Are you feeling better on keto but still having bloating and gas? Does your stomach extend or get bloated about an hour after eating? While everyone else seems to be raving about improved mood and digestive health? This post is for you!

There is SO much misinformation about keto causing gas and bloating on the internet. I couldn’t believe it as I did my keyword research looking for things to write about that might help people.

I am not saying that you don’t get gas and bloating after going on a ketogenic diet for your mental health. I am saying that gas and bloating when you are doing a ketogenic diet (for any reason, mental health included) is NOT because of any of the following reasons you may come across on the internet:

• Gas and bloating is NOT part of the keto flu
• NOT the absence of or inadequate levels of fiber

Usually, we see a bit of bloating or other symptoms early on in the keto diet because the gut adapts to your new lifestyle change. Your digestive system has to use micronutrients to upregulate certain digestive enzymes it needed less of before your dietary change, and you may already be deficient in those micronutrients as you begin your ketogenic diet. Your gut microbiome is also dealing with many harmful bacteria die-off now that you are reducing your carbohydrates. Usually, the bloating goes away in a couple of weeks.

But what if it doesn’t?

Keto catches a lot of blame for health conditions created long before someone goes keto. One of those is stomach bloating after eating. But the condition that creates a persistence of this problem happened long before you went keto. One of the most common reasons there is sustained gas and bloating on keto is a condition you had before starting the diet, called hyperchlorhydria (low stomach acid).

But wait a minute, you might say! I don’t have low stomach acid. I have too much stomach acid because my doctor put me on proton pump inhibitors and antacids, and now I don’t get heartburn or GERD as much.

Doctors putting people on proton pump inhibitors and antacids for long durations is one of the major factors decreasing your stomach acid. You need to get off of those PPIs and antacids, and functional medicine and naturopath doctors have protocols for that. 

Other reasons for low stomach acid, otherwise known as hydrochloric acid (HCL), include: 

Having impaired stomach acid production (low stomach acid) can create the following signs and symptoms:

• Aging – lower HCL production is associated with aging and can happen in your 40s or sooner based on lifestyle
• Stress – shuts down your stomach’s ability to make HCL
• Carbohydrate overconsumption (probably how you ended up on the PPI in the first place)
• Zinc and thiamine (B1) deficiency – these are needed to make HCL
• Prescription and OTCs – too numerous to mention, but the most common are birth control pills, NSAIDs, antacids, and proton pump inhibitors
• Inadequate amounts of protein – Eating protein triggers the stomach to make HCL, and if you eat too little protein, it will not be triggered adequately
• Low estrogen levels – some women who are going through menopause may experience this
• Marijuana use 
• Active H. pylori infection (with or without actual ulcers)
• Chronic overeating
• Autoimmune diseases that attack the parietal cells in the stomach

Many people have these things going on long before they attempt a ketogenic diet. It doesn’t mean that the ketogenic diet is causing these issues, and it just means we need to fix what is going on with your HCL production and give you a bit of digestive support as you fix or manage this condition. 

So beyond wanting to stop feeling bloated after eating, why would you want to fix hypochlorhydria (low stomach acid)? 

How could untreated hypochlorhydria (low stomach acid) undermine my keto diet treatment for mental illness?

There are many really important reasons to fix this problem, especially if you are using a ketogenic diet to improve your mental health. You will need good stomach acid production to get the full benefits. 

Poor digestion of proteins due to low stomach acid means that the protein will not break down sufficiently into amino acids. You need lots of amino acids to make neurotransmitters and do cellular repairs to areas damaged by neuroinflammation. 

Low stomach acid can cause pancreatic insufficiency, resulting in the inability to produce important enzymes you need to break down your food. This condition can cause severe malnutrition. A malnourished or undernourished brain can cause and maintain your mental illness.

If your stomach acid is low, you will reduce the pool of important nutrients you need for your mental health and get in the way of their actual absorption. And all of them happen to be very important for treating mental illness, including B12, zinc calcium, and iron.

Low stomach acid increases your risk of bacterial infections. When you suffer from a bacterial infection, your immune system becomes active and will trigger inflammatory cytokines in the brain. If you are treating a mental illness, you will want to do things that help protect you from avoidable bacterial infections that increase neuroinflammation. 

One of those common types of bacterial infections that happens due to low stomach acid is gut dysbiosis. This also affects your gut microbiome negatively, which, as you know, has a direct impact on your mental health. Usually, keto takes care of this. But you may need a little extra help to kill something off that was deeply rooted in there for a very long time.

How do I know if I have hypochlorhydria (low stomach acid)?

To determine if hypochlorhydria (low stomach acid) is the reason for your issues, you need to know the signs and symptoms of it:

• Gas, belching, or bloating within one hour of eating
• Bad breathe that smells a little “yeasty”
• Stomach easily upset by taking vitamins
• Fingernails chip, break easily or peel
• History of anemia that didn’t get better taking iron
• Sense of fullness after eating
• Hair loss, especially in women

Hypochlorhydria (low stomach acid) has a strong association with and possible causative roles in various chronic illnesses. You may recognize some of these illnesses as those people commonly use a ketogenic diet to treat. They include diabetes, asthma (in children), thyroid dysfunction, skin conditions like psoriasis and eczema, osteoporosis, autoimmune disorders, and digestive issues such as irritable bowel issues like gastric inflammation that cause diarrhea and constipation. Improving your stomach acid levels can help treat these conditions. 

So what do you do about hypochlorhydria (low stomach acid)? 

If you are on antacids or proton-pump inhibitors, you start by getting off of them. This can take weeks or months, depending on how long and chronically you take them. But don’t worry. As I wrote prior, there are many good protocols for accomplishing this, and you can work with any natural wellness provider to learn how. 

If you are taking a lot of NSAIDs for pain or using cannabis products chronically to deal with pain, I hope that as you stick with your ketogenic diet, you will need less and less over time. Ketogenic diets are powerful interventions to heal inflammation- assuming your carbohydrate intake is low enough to keep ketone levels stable to act as signaling bodies for those pathways. 

If you are self-medicating with cannabis for a mental illness like anxiety or depression, keep in mind that you will need it less often as you stay on your ketogenic diet. In the meantime, use HCL with your meals. 

You can supplement HCL, which I recommend to clients using the ketogenic diet and having some bloating issues. I have clients take two of these with each meal, sometimes three or even four if it is a very protein-heavy meal.

If you don’t want to buy a supplement, get some apple cider vinegar (ACV) and use that instead. Just take about 1 or 2 tablespoons in a small glass of water and drink it down right before your meal. You can also increase your HCL production by increasing your salt intake. The Chloride part of sodium chloride (salt) helps make hydrochloric acid. But don’t have increased salt be your only intervention to fix your low stomach acid problem. Use it as an adjunct to treatment with HCL or ACV

Using the liquid version of the vinegar is an excellent remedy for when you feel the beginnings of heartburn come on. It shocks the stomach sphincter at the top of the esophagus closed, keeping that stomach acid inside where it belongs!

What will I notice if my hypochlorhydria (low stomach acid) is fixed?

The most obvious will be less bloating and more comfort after meals. But you may also notice an improvement in your energy and mental health.

With the improved nutrient breakdown and absorption that comes from adequate levels of stomach acid, rest assured that you are directly improving your mental health. You are going to super-charge your already excellent ketogenic diet intervention. 

If adding HCL or ACV doesn’t do the trick, you might need some additional help to figure out the problem. It could be you have developed an intolerance to a particular food, that you are eating too many sugar alcohols or you have an untreated intestinal issue like parasites. These are all things that can increase neuroinflammation and might get in the way of feeling the full benefits of your ketogenic diet for mental health. This would require some testing to figure out. But HCL is actually an excellent place to start and to use as a rule-out before spending a lot of money on expensive testing.

And so if you appear to have symptoms of low HCL, give this a try first!

It is also important to know, that chronic heavy metal exposure can interfere with enzyme production and contribute to hypochlorhydria. And so learning about it may help you on your wellness journey.

Heavy Metals and Mental Health

Comment below and let me know if your bloating or other digestive issues improved using HCL or apple cider vinegar with your meals. Tell me if you want to know more about getting off antacids and proton pump inhibitors or if you need help with any other digestive issues that are getting in your way of feeling successful on your ketogenic diet. 

If you are feeling overwhelmed and need help on your ketogenic journey towards better mental health, don’t hesitate to learn more about my Brain Fog Recovery Program.

Brain Fog Recovery Program

If you are looking for other articles about the role of micronutrients and how they can enhance your ketogenic diet you may enjoy the following:

Drug induced nutrient depletion – a cautionary tale

How thiamine deficiency can undermine your ketogenic diet for mental health

Nutrition and supplements for antidepressant withdrawals

Have other types of digestive issues on your ketogenic diet that you can’t figure out? You may benefit from this article:

Why do I have chronic diarrhea on keto?

Because you have the right to know all of the ways that you can feel better.

If you are feeling overwhelmed and need help on your ketogenic journey toward better mental health, don’t hesitate to learn more about my online program.

Brain Fog Recovery Program

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