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3 Reasons Why You May Not Be Able to Tolerate Coconut Milk

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Reviewed by Laura Beth Schoenfeld, RD, MPH

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Coconut milk is often a staple fat source for those following a Paleo diet. From a nutritional perspective, it’s an excellent choice. It’s high in saturated fatty acids and medium-chain triglycerides (MCT), which are both easily burned as fuel by the body. MCTs are particularly beneficial in that they don’t require bile acids for digestion, and they’re directly shunted to the liver via the portal vein.

Coconut milk and fruit can be a great snack for Paleo folks, and coconut milk smoothies make a great Paleo breakfast choice – especially in the summer.

So what could be wrong with coconut milk? Here are three things to consider.

Bisphenol-A

Bisphenol-A (BPA) is a chemical that has been used in consumer goods since the 50s. It’s found in reusable drink containers, DVDs, cell phones, eyeglass lenses, automobile parts and sports equipment. While the research on BPA is still mixed (some studies indicating harm and others not), given the uncertainty I think it makes sense to avoid it whenever possible.

BPA is used in the lining of certain canned foods. BPA especially leaches into canned foods that are acidic, salty or fatty, such as coconut milk, tomatoes, soup, and vegetables.

So what’s the solution here? In short, if you want to be on the safe side and reduce your exposure to BPA, you have to reduce your consumption of canned foods (including coconut milk) as much as possible. I made this recommendation in 9 Steps for Perfect Health-#3: Eat Real Food. A study published in Environmental Health Perspectives found that families who ate fresh food for three days with no canned food, and using only glass storage containers, experienced a 60% reduction of BPA in their urine. The reductions were even higher (75%) for those with the highest BPA levels at the beginning of the study.

The good news, however, is that there are brands of coconut milk with BPA-free cans or carton packaging. One is Native Forest, which you can purchase on Amazon if it’s not available at your local store.

Coconut milk can also be made quite easily at home, with coconut flakes, a blender and cheesecloth. Here’s a video to show you how (get a load of the soundtrack). I find that blanching the coconut flakes prior to blending improves the results.

Guar gum

The other potential problem with canned coconut milk is guar gum. Guar gum is a galactomannan, which is a polysaccharide consisting of a mannose backbone with a galactose side group.

It’s primarily the endosperm of guar beans.

Beans and legumes have a variety of compounds in them that make them difficult to digest, especially for people with digestive problems (1 in 3 Americans, from the latest statistics). In my clinical experience, many patients with gut issues improve when they remove guar gum from their diet—including canned coconut milk.

There’s no evidence that guar gum may cause serious harm. So, if you’re able to tolerate guar gum, there’s no reason to avoid it. If it does give you digestive trouble, look for a brand that’s free from guar gum. The other option, of course, is making coconut milk at home.

Fructose malabsorption

Fructose malabsorption (FM) is a digestive disorder characterized by impaired transport of fructose across the small intestine. This results in increased levels of undigested fructose in the gut, which in turn causes overgrowth of bacteria in the small intestine. Undigested fructose also reduces the absorption of water into the intestine.

The clinical effects of FM include: intestinal dysbiosis, changes in motility, promotion of mucosal biofilm, and decreased levels of tryptophan, folates and zinc in the blood.

Symptoms produced include bloating, gas, pain, constipation or diarrhea, vomiting and fatigue (to name a few). Recent research has also tied fructose malabsorption to depression.

Lest you think this isn’t a common problem, studies have shown that up to 30% of people in Western countries suffer from fructose malabsorption.

Even in healthy people without fructose malabsorption, however, only about 20-25g of fructose can be properly absorbed at one sitting. Glucose assists in transport of fructose across the intestine, so in general foods with equal amounts of glucose and fructose will be better absorbed than foods with excess amounts of fructose (in relation to glucose).

While fructose malabsorption can cause symptoms in anyone, those with Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) are particularly affected. While the prevalence of FM is the same in healthy populations and those with IBS & IBD, the experience of FM appears to be more intense in the latter group. This is probably due to the increased visceral sensitivity common in IBS and IBD patients.

In fact, one of the most promising clinical approaches to managing IBS & IBD right now is the low-FODMAP diet. FODMAP stands for Fermentable Oligo-, Di- and Mono-saccharides And Polyols. These include:

  • fructose (fruits, honey, HFCS)
  • fructans (wheat, onions)
  • lactose (milk sugar)
  • polyols (sugar alcohols like sorbitol, xylitol & mannitol, along with fruits like apples, pears and plums)
  • galactooligosaccharides (legumes & beans, brussel sprouts, onions)
  • other sweeteners like polydextrose and isomalt

Studies have found that restricting FODMAPs can significantly improve the symptoms associated with IBS, IBD and fructose malabsorption.

What does this have to do with coconut milk, you ask? According to Drs. Gibson & Barrett, experts in fructose malabsorption, coconut milk is a FODMAP and should be avoided by people with digestive conditions like IBS & IBD.

According to NutritionData.com, coconut milk has very little sugar of any kind – including fructose. Nevertheless, I do have patients that cannot even tolerate homemade coconut milk (which has no guar gum in it), even though they are fine with coconut oil. I assume that they are reacting to the fructose in the coconut milk – but I can’t be sure. According to Monash University, small quantities (up to 1/3 of a cup or 80g) of coconut milk may be tolerable for those who are sensitive to FODMAPs.

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Recommendations

Let’s bring this together into recommendations for three different groups of people:

  • Women who are trying to get pregnant, pregnant or breastfeeding, children and other vulnerable populations (chronically ill): should avoid canned coconut milk products except for those that are BPA-free, like Native Forest and Arroy-D. Note: Native Forest is organic, but Arroy-D is not.
  • People with digestive problems (IBS, IBD, GERD, etc.): may want to avoid coconut products entirely, except for coconut oil
  • Healthy people: may be fine with canned coconut milk, provided they don’t react to the guar gum, and provided they’re willing to take the side of industry scientists that claim BPA doesn’t cause harm in humans

Want organic coconut milk – but without the BPA and guar gum?

There are available options to buy organic, guar-gum-free coconut milk in a BPA-free container. Or, with a little extra effort, you can easily make this at home yourself.

  • Purchase coconut cream (Let’s Do Organic and Artisana are good choices) and blend with water to make coconut milk.
  • Purchase shredded coconut (again, Let’s Do Organic is a good choice), and follow the instructions below for making homemade coconut milk.

Homemade coconut milk instructions

Ingredients

Instructions

  • Heat water until hot (but not boiling).
  • Add shredded coconut and water to blender (preferably a Vitamix!) If all of the water won’t fit, you can add it in two batches.
  • Blend on high for several minutes until thick and creamy.
  • Pour through a colander to filter out the coconut pulp, then squeeze through a cheese cloth or nut milk bag to filter the smaller pieces of coconut.
  • If you separated the water into two batches, put the strained coconut back into the blender with the second batch of water.
  • Drink immediately or store in the fridge. Fresh coconut milk should be used within 3-4 days of making it for the best flavor and texture.
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1,043 Comments

Join the conversation

  1. To Thinkingmom,

    That is pretty much my diet right now, meats, eggs and greens. I do have autoimmune and gut issues and if I stray very far from that limited diet, I can feel it right away. But I feel so much better, sleep better, more energy, clear headed without the nuts, coconut milk, chocolate, etc., so I choose feeling better and healing my gut. I just went slowly with an elimination diet to find out what was causing me problems, ended up on a FODMAPS/paleo/yeast-free diet. I know it seems overwhelming at first, but keep at it because it is so worth it.

    Chris, I love your blog, thanks for all you do!

  2. OK – so I am at a loss. O after reading this and the article on nuts, I am feeling incredibly frustrated about what I CAN and SHOULD eat – no flour or sugar, no nut flours, no nuts (without going through a 2 day process), no coconut milk, no coconut flour, etc. My goodness, is it just meat and greens and eggs – or are we going to find something wrong with those too? (To much oxalic acid in spinach maybe!) Maybe I am just overwhelmed but what seems to be on one place to be “THINGS TO EAT” is on someone else’s “FOOD TO AVOID” list. Maybe you could put together a list of acceptable foods, it should take too long as I don’t think it will be a very long list. Sorry if this sounds rude – not trying to be – just feeling really discouraged…

    • I understand your frustration, but as I said in the article phytic acid doesn’t need to be eliminated completely. Most people will be fine eating a large handful of nuts every day – provided they’ve been properly prepared. Putting nuts in water, and then dehydrating them requires minimal effort, although it does take some time. I understand that spending time on food preparation isn’t popular these days, but if you’re interested in health and wellness that’s what’s required.

      I’ve never made any absolute statements like the ones you’re making “no coconut milk, no coconut flour, etc.”. I’ve simply pointed out that some people have trouble with canned coconut milk, and that many varieties of canned coconut milk have BPA – a known neurotoxin. I think you are overwhelmed, and that’s understandable – but there’s no reason to freak out. There’s still plenty to eat. My diet is extremely rich and varied.

      I think I’ll take you up on your suggestion to provide a foods to eat and avoid list. Stay tuned.

      • Hi Chris, I’d really appreciate that list of ‘foods to eat’ and ‘foods to avoid’ too. I’m afraid I’m in much the same boat as Thinkingmom. A single page image you can print out and stick on your fridge or something would be awesome. I know you did something similar in the ‘9 steps to perfect health’ articles, but a little more detail on the food side would really be appreciated.

        Cheers for your blog.

        • I appreciate this article Chris and also feel the frustration of thinking mom. I have psoriasis and because of that am supposed to avoid nightshades, eggs and dairy. Additionally I find the case for eating in a primal way compelling (as a self diagnosed carb addict and general overeater) so am trying to transition to that as well. I think myself and others cling to foods like coconut milk with all our might because we already feel as though we’ve given up so much. Of course you are just a messenger and it’s likely that many of us end up overdoing it on coconut or nuts, etc. because we have an underlying need to consume a lot in general. Anyway, I’m glad that you dont just tell people what they want to hear and emphasize that everyone has to be their own experimental subject.

  3. With all due respect, I would add a FOURTH reason that coconut milk, and especially coconut oil might not be good at all for some people…

    The high salicylate/phenol content. In those with anxiety issues, many of which can be a direct result of salicylates and/or phenols (as in many autism spectrum disorders), if one eats too many, or in some cases even low amounts of salicylate containing foods, they might experience a severe anxiety or agitation problems, along with other neurological issues.

    • Thank you Kelly, coconut is high in sulfur too.some people are sensitive to sulfur and cannot eliminate sulfur from their body as quickly, especially people with MTHFR gene defect

  4. Hi again,

    Another product I have been purchasing is Coconut Dream which contains Gellan Gum. Is this another thickener like Guar Gum?

    I have experienced bloating after consuming this and had wondered what was the cause. This product has other additives.

    I appreciate your feedback!

  5. Hi. After reading your article, I thought to email the manufacturer of the coconut water that I buy to find out about BPA content. Here is the question and response given to me. I wrote to them again to ask what exactly did they mean about ‘detectable amounts’ as it was unclear to me if the cans are lined with BPA still despite her response. What do you think? I’m not sure~

    Product: All Natural Coconut Juice, natural isotonic beverage unsweetened 100% Juice no preservatives
    Brand/Manufacturer: amy&brian amyandbriannaturals.com
    Ingredients: young coconut juice
    a product of Thailand

    Q: I love your coconut drinks, I would like to know however if the can containing the juice is lined with Bisphenol-A (BPA). Please advise.

    A: We have chosen a liner that contains no detectable amounts of BPA in either the liquid or final form.

    Please let me know if you have any additional questions.

    Thanks,
    Rebecca Matthiesen
    Market Connections Group
    360-433-2325
    Fax 360-828-7851

    • Here is the second reply from the manufacturer’s rep:

      Because our supplier does not claim that the liner is BPA free we cannot use that claim either. All we can state is what we know – that we have done multiple tests on both the liquid and dried forms without detecting ANY amount of BPA in either form. We began doing these test nearly 10 years ago, before most people knew what BPA was, so that we could offer the purest product possible. I hope this helps.

      Thanks,
      Rebecca Matthiesen
      Market Connections Group
      360-433-2325
      Fax 360-828-7851

  6. Coconut contains lauric acid: an atypical antibiotic. There have been studies using coconut oil for atopic dermatitis and skin infections caused by MRSA. It works. Possibly consumption of coconut products may help with various gastric issues as well. The fatty acid chain is 8 to 14 carbon atoms long. It is short enough to permeate the outer wall of bacteria. The reason for using the term ‘atypical’ is because traditional antibiotics are only effective when bacteria are active metabolically. Bacteria routinely go through periods of quiescence or ‘hibernation’. The lauric acid fatty acids in coconut oil penetrate the cell walls regardless of whether the bacteria is active or ‘hibernating’.

    As a side note: I found the title of the article to be somewhat misleading. I read it in its entirety.

  7. Woa this is crazy because for awhile I tried have coconut milk ice-creams, hemp ice-creams to try replacing dairy and both my husband and I really didn’t feel well after eating them- headaches and stomach hurt- I didn’t know why at the time but I bet it was the gums they add!

  8. I found frozen coconut milk at the asian market and the only ingredient is coconut milk- no gums- it’s frozen in flat plastic bags- seems like a great alternative to the cans with bpa. Check the frozen section at some of the ethnic markets- especially asian markets. I’m in the east bay area as well.

  9. Hi Chris,

    My coconut oil is made by centrifuging coconut milk. Is that ok? Or should I be looking for a different type of coconut oil?

    Thank you!

    Amanda

  10. Chris, In the Recommendations section you say “avoid canned coconut milk products except for those that are BPA-free, like Native Forest and Arroy-D”

    Is Native Forest BPA-free? I can’t find anything on their website that says so … I emailed them (no response) and Natural Value. Gary Cohen, President of Natural Value, replied: “Yes, our coconut milk cans contain BPA….and contrary to what you may have read on the Internet, NOBODY is packing coconut milk in BPA free cans yet….we are working on that….”

    • Hey Mike! I have been in contact with Native Forest and Gary Cohen. Native Forest sent me a long email confirming that their cans are indeed BPA free. Gary told me the same thing he told you and did seem a bit angry when I told him what NF said. He didn’t believe me and wanted me to send him the email from NF. I would hope that NF is telling the truth. 🙂

  11. I have had stomach problems with coconut milk in the past. I believe it was when I combined whey protein powder with coconut milk. I now don’t consume much coconut milk or whey protein powder. I think it might be the guar gum for me.

    I LOVE shredded coconut, coconut flakes, coconut butter and of course coconut oil. I still do coconut milk on occasion.

  12. Thanks Chris for this article. I’ve noticed that each time I eat something with coconut milk (at least canned),I don’t feel good and have digestive issues. It’s helpful to read I’m not the only one and to understand a bit more about potential causes. It’s too bad as I love adding coconut milk in recipes, but I think it doesn’t do well with me (at least the canned one).

  13. @Sue – Too funny. My thoughts exactly! I had the exact same line of thought. So when I shopped at WF Monday and she handed me the receipt, I managed to hold the blank side against my fingers and folded it in half and stuffed it in my purse! Of course, come bill time the next day, I forgot and handled it and all the others due for entry!

  14. How do you not touch the receipt – How about wearing gloves?? Imagine the looks I would get wearing gloves! I always touch and look at receipt as the supermarket usually makes some error with price.

    Is Xanthan gum okay – any issues with it?

  15. I love the website and am very grateful for all the information you provide, but I, too, was surprised by the misleading tone of the article. While the title does not explicitly say that coconut milk is bad, it is a sensationalized alert that calls into question the safety of consuming coconut milk. While the last two points in the article are valid, the first actually has nothing to do with coconut milk not being your friend and everything to do with cans and BPA not being your friends. It is a logical fallacy I was surprised to find on a site that I usually feel is cogent and balanced.

    I purchase coconut milk in a carton and was dismayed when I began the article, only to find out it was about CANS and NOT about milk. As for the latter points, I understand that there are individuals who are negatively effected by coconut milk, and this might have been a very helpful article for them, but perhaps it would have been more straightforward to gear the article toward said people (e.g. Does Coconut Milk Disagree with You? Here’s Why. or something like that), and then title the sections clearly: one for those who don’t do well with guar gum (again, simply listing guar gum is a misappropriation of blame, since you cited that there shouldn’t be a problem with guar gum if one can tolerate it), and the other for those who have problems with fructose absorption.

    I can drink coconut milk without any negative effects, so the misleading tone of the article and the lack of appropriate organization made me feel like I had been tricked into spending time reading an article that was not relevant or particularly helpful for me. It also made me question how balanced information on the site actually is. I only write this because I genuinely do appreciate the information you provide and respect the way you handle issues, and because of that, I hold the site to high standards. Thank you for your hard work!

    • ADDITIVES in the coconut milk CANS and CARTONS also cause problems. GUAR GUM and CARAGEENAN….. LOOK THEM UP BY Ray Peat, Ph.D or better yet, read this:

      “In the 1940s, carrageenan, a polysaccharide made from a type of seaweed, was recognized as a dangerous allergen. Since then it has become a standard laboratory material to use to produce in-flammatory tumors (granulomas), immunodeficiency, arthritis, and other in-flammations. It has also become an increasingly common material in the food industry. Articles are often written to praise its usefulness and to claim that it doesn’t produce cancer in healthy animals. Its presence in food, like that of the polyester imitation fat, microcrystalline cellulose, and many other polymers used to stabilize emulsions or to increase smoothness, is often justified by the doctrine that these molecules are too large to be absorbed. There are two points that are deliberately ignored by the food-safety regulators, 1) these materials can interact dangerously with intestinal bacteria, and 2) they can be absorbed, in the process called “persorption.” — Ray Peat, Ph.D

  16. I use the unsweetened So Delicious coconut milk in a carton
    ingredients: organic coconut milk (water, organic coconut cream(, carrageenan, guar gum
    all ingredients non gmo and no sulfites

  17. This article caught my eye, because after changing to a paleo/primal/perfect health diet about 2 months ago, I have noticed improvements in ALL aspects of my health (including cutting thyroid hormones for my Hashimoto’s in half). However, the one negative experience I’ve had is with acne, cystic painful lesions below the corners of my mouth. In the last couple of months I removed more items from my diet than I added, but I pinpointed 2 items that I have been consuming in moderate to significant amounts: coconut milk and sweet potatoes. I know that the right way to test sensitivity to these would have been to eliminate one at a time, but I was anxious to rid myself of the acne, so eliminated both coconut and sweet potatoes, with great improvement so far.

    Has anyone else had skin reactions to coconut? Or sweet potatoes?

    • @Stefanie – Ha! Yes, I too broke out on my chin and to both sides of my mouth with the coconut milk! It’s unbelievable that it affected us the same way. I couldn’t figure out why everyone kept saying their complexion improved on Paleo and mine had gone from glorious to pebbly! Once I stopped the coconut milk, at Dr. Kresser’s podcast mention of guar gum and bloating, the eruptions went away. Sweet potatoes have not affected me this way. I wonder if it’s the guar gum? I’ve eaten “real” coconut all my life with no problems. Went raw foodie a few years ago and ate lots of it with never a problem. Hmmm. Very interesting.

      • Sandra, that is so interesting! Gives me hope that I can have my sweet potatoes back! : ) I’m going to give it a few weeks before trying. I’ve never noticed trouble with coconut before either, but then I’ve never consumed it on a daily basis before. I’ll have to try coconut without the guar gum and see what happens there.

        • i’ve had that reaction with the painful acne/lesions on the corners of my mouth and both sides of my nose. i narrowed it down to starbucks. cannot drink it or even let my husband grind beans in our coffeemaker. i called them to ask if they put roasted chicory on their beans and they said no. i was suspecting roasted chicory as it is in many celestial seasonings teas and i’ve read that it can cause an allergic skin reaction: http://www.livestrong.com/article/457640-chicory-root-side-effects/ however, very interesting about the guar gum. i will have to do a trial and see if i react to that.

    • I had this same reaction to a pretty severe degree! The skin on my lips was crocodile-like and the corners of my mouth were cracked and bleeding for months. It was miserable! Im not sure it was thr guar gum, though – I wondered about other preservative/stabilizer-type elements that might have caused it.

      • Cracks and lesions at the corners of the mouth can be caused by a B vitamin deficiency.

    • Did you find it was canned coconut milk? I’ve been trying to figure out what has been going on with my skin for the past month and one thing I’ve been doing is drinking tea with canned coconut milk because I was told I’m allergic to dairy. My skin has never been this bad. I was just having a cup of tea now and thinking about the coconut milk and guar gum and started googling and it sounds like it might be the culprit.

  18. I believe that Trader Joe’s canned goods are BPA free with the exception of their tomato products. They sell canned coconut milk but only the light one. However, the ingredients read only coconut milk.