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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


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 (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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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



  • 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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Join the conversation

  1. I really think that you have concentrated to much on the ‘canned’ side of things here. You really do make it sound as though it’s the coconut milk itself that is mainly the cuplrit yet two out of your three reasons for this article place that blame squarely at the cans and not the product itself. Going on about BPA in relation to coconut milk is really the wrong way to ago about it. If you had written this article on coconut milk that comes in cartons then your ‘BPA in cans’ argument would be void and you would be left with one reason coconut milk could be bad for you. This being Guar Guam. Yes this can cause problems with people with IBS because it is a binding agent. However taken with lots of water it shouldn’t really be an issue at all.

    Of course however, if you have a GI obstruction then Guar Gum is bad as it can be with other similar ilnesses. This however is NOT a reason to say that coconut milk is bad for you, it’s better by far than cows milk in every way for vitamins and minerals and equal in other. It has more calories though which people trying to lose weight will not like but that is another issue.

    To quote you ‘I don’t need any more evidence than this: certain patients feel bad after eating coconut milk (even homemade), and then feel better when they remove it’

    Why do so many of your patients even drink coconut milk, this I find a strange statement.

    Finally, what would you siggest we drink for a our milk intake?

  2. Coconut milk is the only milk i drink with no problem, from carton’s no can’s. I do not drink cow’s milk.

  3. This makes so much sense to me. I didn’t understand why my stomach would hurt and I felt a little sick after eating coconut milk. How frustrating it must be to have to deal with so many argumentive people! thanks Doc!

  4. Superb site Chris what a wealth of knowledge from not only yourself but execellent comments thanks

    Recently looking into improving my healthy eating in general and added coconut milk in can to which
    I’ve had no trouble.However to be on the safe side after mentioned BPM I skip that. Makes alot of sense.

    Maybe simple solution would be eating a whole coconut. Although knowing where our food originally originates from is also opening up can of worms.


  5. Wow, I’m really surprised at how many negative comments this article got. Nowhere do I see Chris giving any advice that would be detrimental to someone’s health. He’s suggesting what you MAY want to watch out for if you have certain health issues. And after all, isn’t that what we’re all doing on the Internet, looking for help with our health issues that we aren’t finding through regular medicine? He’s not saying “Do this. It will definitely help.” He’s saying “If you’re having this problem, you may want to try this, or avoid that. This is what he’s found through helping his clients, and he’s offering the info to all of us. We can take it or leave it, try it, and if it helps, great, if it doesn’t, no harm done. I appreciate the advice.

  6. I just ordered a case of the Native Forest brand from Amazon. SO glad they have BPA free cans! I was starting to get worried since I do make dishes with the coconut milk and my kids eat them and love it.

    Thank you!! This was a very informative article!

  7. Question for Chris Kresser: I have diverticulitis. Why is it that when I eat my favorite dish, Pumpkin Curry, served at my favorite Thai restaurant and contains coconut milk, my stomach feels like I just gave it a soothing bath. It feels l just took some miracle elixir. I have no immediate reaction to this dish as I do with a lot of other foods I eat.

  8. So is organic coconut milk that is in a box from the store not okay? Like Silk or So Delicious? How about Trader Joe’s coconut milk that comes in a box?

  9. On BPA in cash-register receipts:

    I haven’t seen anyone express any concern for the poor shop-assistants / supermarket cashiers, who have to handle till receipts all the time (not to mention cash which has passed through thousands of hands).
    [Apologies if anyone _has_ expressed concern! – Anyway, I’m sure you get my drift].

    It would be good if there were some sort of concerted attempt to bring the problem to the attention of the retail industry, and the cash-register industry. (And the trade unions).

    And the employees concerned probably need to be wearing some sort of appropriate gloves.
    (They don’t, typically, here in the UK. I don’t know what happens in the USA).

    • I don’t know if the boxes are BPA-free but there is so much junk via the ingredients: sugar, carrageenan and other not such great stuff.

    • I have IBS and coconut milk causes major pains no matter how little I drink. Kind of sad considering how much I like it.

  10. I cringe at the thought of people consuming coconut milk like a normal drink. I grew up with a diet full of coconuts but never did I drink a glass full of coconut milk. We normally only use it for cooking and that quantity of coconut milk is enough to feed the whole family of four or six. For a single person, two or three tablespoon of it per meal should be enough or better yet, just eat a piece of coconut meat to get the benefits of the fiber as well. However, I don’t really eat the meat from mature coconuts, only from young coconuts which is softer and thinner. So take it easy with your coconut milk consumption. Don’t overfed yourself.

  11. I have diabetes and have just gotten out of the hospital after a bad bout of diverticulitis – I also have hypo-thyroid disorder and boy am I having a problem trying to figure out what to eat. Right now I am on a liquid diet and I bought coconut beverage unsweetened and it lists only coconut as it’s ingredients – however, I am also on Nexium, 40mg twice a day and as soon as I made a smoothie using the coconut beverage I had to take a nexium and the reflux misery still hasn’t passed. I did add protein powder to the milk and strawberries and a scoop of a calcium supplement – any thoughts as to why it triggered the reflux or am I just one of the people who should avoid coconut? If so what can I use as a base for my smoothies given that I can’t have many carbs or sugars? I really could use some good advice please. Maggie

    • All of those processed foods you’re ingesting probably caused the reflux. Try to stick to things not in a box, bag, carton or can. Meat, veg, fruit. I’ll bet your reflux is gone overnight. Mine was.

  12. I swear. Coconuts are a functional food. Eat them FRESH. 30% of the world uses coconut in their daily diet and they are NOT fat. Sigh. Everyone has all of these food intolerences because they only eat crap store bought processed foods and a fresh coconut cleans them out by giving them the shits. Fresh coconuts are NOT bad for anyone!

    • I beg to differ~I dont eat processed foods, because I AM ALLERIC to them. If I am allergic to other nuts why NOT coconuts. *sigh* You fail.

      • A person allergic to peanuts will likely not be allergic to coconut. Look into it possibly to see why people really are allergic to nuts sometime. If we went with your silly logic, someone allergic to apples would be allergic to all fruits. SIGH. ya big dummy.

    • Coconuts ARE bad for someone if they have a Delayed IgG or Acute allergy IgA to them, especially if they are leaky gut. That needs to be healed first before adding any food intolerances back in the diet. Plus, some people cannot eliminate sulfur from the diet if they have MTHFR gene defects. Coconuts are high in sulfur.

  13. I’ve been buying Aroy-D coconut milk in a green carton. 2 ingredients … coconut extract & water.
    I drink a fair amount of it in a day including it in many dishes and also in my coffee.
    I think I’m probably overdoing it. I also use coconut oil in my cooking and have just ordered coconut manna.
    I may look like a coconut in the near future. 🙂

  14. You say at the end of this article “People with digestive problems (IBS, IBD, GERD, etc. may want to avoid coconut products entirely, except for coconut oil”
    Does the “etc” include people with Celiac Disease or gluten intolerance? As you may know, alot of people on Paleo do so because of food allergies ( I am allergic to dairy, grains, peanuts and of course gluten) but not tree nuts. I am assuming that a coconut is a tree nut. Lately I have been getting alot of uncharacteristic breakout type activity and I am wondering if I can’t process the protein in coconut (hence is true regarding legumes and casein for me and many others with Celiac) or if I am indulging too much and the fat content is messing up homeostasis or…what? Can you help?

    • Here is an academic paper from a FODMAPS expert in Australia indicating that coconut milk is in fact HIGH in fructose, so perhaps there is an issue with the data from other sources. It may explain why some people are sensitive to coconut milk who also have issues with other fructose sources.


      Reliable data about the chemical content (natural or otherwise) seems to be a big issue for those attempting to identify problem sources in their food. Oxalate content is another area where there are major discrepancies between sources.

      thanks for a wonderful blog Chris!

  15. Hi Chris, I am new to your site and would like to know how I can read, “When your normal blood sugar isn’t normal” PART 2 Thanks a bunch, Talayna

  16. Everything today that is in a can has some poison, so my advise don,t eat a case of coconut milk at every meal.