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Coffee? Pour a Cup!

While I don’t have the exact statistic, it probably isn’t far off-base to state that many, if not most, Americans start their day with a cup of coffee in their hand. For many years, the science on coffee has moved in competing directions, from studies that call it dangerous for long-term health, to those that endorse daily mass consumption.

In Grain Brain, I briefly explored the health benefits of coffee, notably as an activator of our Nrf2 pathway, and it’s a topic I return to in Brain Maker. Now, learn how coffee plays a roll in influencing the composition of our gut bacteria, and how that daily cup of joe might be fighting a leaky gut. Drink up!

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  • elisa

    como hago para traducir en español el video

    • TetraMom

      The problem here is that you can’t blanket prescribe any healthy/unhealthy food intake regimen for all. People are intolerant to different substances for different reasons, and too much of anything is too much.

      • David Perlmutter

        Absolutely true. You need to find the lifestyle plan that works for you and your body.

        • Kevin Screen


  • ri

    yeahhh i love coffee!!

    • David Perlmutter


  • Lynn Dell

    It’s been known for years that there is some association between increasd coffee consumption and decreased or delayed onset of type 2 diabetes. I wonder what the connection is, if any.

    • Anthony Llabres

      I have heard the same. The coffee lobby is so powerful for sure. I FEEL so much better when I am off caffeine. I actually cycle on and off for athletic
      performance. But for sure, I feel MORE natural energy when OFF coffee and caffeine products.

      • GemmaStar

        I have an adrenal problem and have had to eliminate my two favorite drugs: caffeine and alcohol.

        I always relished my nice STRONG cup of coffee in the morning. (I used to call it Serious Coffee.) But I’m happy to report that I feel better not drinking coffee. I never would have imagined this to be possible since, in addition to loving the flavor and “mouth feel” of coffee, I enjoyed the buzz it gave me.

        If anyone must eliminate caffeine, you might enjoy a product called Teechino, which is a grain-based “coffee”. It has the “mouth feel” that I really like and I’ve come to truly enjoy the various flavors in which the product comes. To find out more, visit the website: http://teeccino.com/category/11/Herbal-Coffees.html

        • Maureen

          So sad…I know how it feels. Me too.

  • Lynn Dell

    As in anything, it is probably a good thing to avoid additives to coffee, such as flavorings, that you don’t know much about, and to buy organic. Fair trade is a good concept as well. I like the full fat organic cream, but to minimize that, a little coconut oil goes a long way. That way I don’t add nearly so much cream.

  • Leonie Gittins

    I have raised blood sugar and insulin levels, and have been advised to avoid caffeine. I would love a comment here..

  • Gary Clark

    New follower… Apologies if you’ve covered this… Have you taken a position on coffee with butter (pasture fed of course) and coconut oil/cream as coffee additives? If not could you, if so where can I read?

    • Karen Brenneman

      I heard Dr Perlmutter say on the Diabetes Summit this week that coffee with butter was fine (bulletproof coffee)

      • David Perlmutter


  • Lauri T.

    I love #decaf coffee (organic) with almond milk – I can’t drink “leaded” coffee because I would be up for weeks! Is decaf similarly beneficial @DavidPerlmutterMD:disqus ? Thanks! 😉

  • Pierre

    Does taking steroid cortisone tablets weaken blood barrier’s resistance to virus or bacterial infection to brain tissue?

  • Liz

    I like coffee too, but unfortunately have a IgA reaction to it, darn! I can eat dark chocolate though, yum!

  • Sheila

    What about instant organic coffee? Does that have healthy benefits as well?
    As well as Bio Coffee? Would like to hear you opinion-

  • shirley

    I have been drinking coffee for many years. My itching legs has scars from scratching. The nighttime were the worst in bed. I decided to find out if coffee was the culprit. After 4 days without coffee, the itching of my legs stopped. No more placing ice cubes on my legs to soothe the itch. I stopped the coffee for 3 weeks. Then, I gave into my craving and purchased a cup of coffee. No itch. Drank another cup the following day. The itch returned. I knew it was the caffeine or the coffee or both. What a relief. I love coffee. It has been 2 months.

  • Jason Kannon

    David, As a holistic health coach who has personally survived and recovered from severe adrenal fatigue and all it associated problems, your one-sided discussion here, promoting indiscriminate consumption of coffee makes me wonder if you are leveraging your status as a respected author to get paid by special interests who profit in the billions via international coffee sales.
    Caffeine is a clinically proven neuro-endocrine disruptor, and while it can and perhaps should be enjoyed in moderation, daily use is also clinically proven to advance adrenal insufficiency–which we both know leads to digestive and detox system impairment….so in the end it does not matter if it helps the gut! Please tell both sides of the story if you are going to tout its benefits. The world deserves more from a man in your position.

    • David Perlmutter

      There are certainly two sides to the issue Jason, and there are many people for whom coffee is not a viable dietary option. However, for those without an allergy or similar such reaction, it can be enjoyed in moderation.

      • Jason Kannon

        Thank you for your response David. Again, I must agree to disagree. In my coaching practice I observed a very wide demographic of people who have consumed coffee daily (in moderation) for many years with no known allergy or reaction issues with coffee, yet nearly 100% if the clients who come to me for advice have developed symptomology related to their measurable adrenal insufficiency?? Nearly all of these fatigue clients have circadian rhythm problems while 7 out of 10 have a digestive pathogen via stool testing. Detox impairment is obvious in most which can be correlated to an acidic dysbiosis caused by consuming acidic food, drink and stress daily…The bright side of the story is that when adrenal support, diet/lifestyle support (including 100% g-free) and caffeine is eliminated I witness 9 out of 10 of my clients improve dramatically. Western medicine has yet to embrace this approach. I hope you can consider that the more “we” are honest about the source of internal stress, the sooner we put an end to the chronic stress crisis we are witnessing world wide.

        • Carlos Rivas

          Jason I’m really appreciative of your willingness and ability to be critical at a high level and sharing your professional experience. A question I have after reading your comments here (and I must admit I have a huge bias because I LOVE coffee): is it possible that there is a chicken-or-egg situation here with your clients? Let me explain: Client has stress & nutritional problems (e.g. high grain/carb diet) -> fatigue/circadian rhythm/microbiome problems ensue -> increased caffeine/coffee use -> worsened circadian rhythm problems. So then, when they come off coffee & fix their diet, the root of the problem (carbs/grains) is eliminated, and their need for an OTC socially acceptable fatigue treatment (coffee) is reduced/eliminated? 2nd Hypothesis: is it the sugar/artificial sweeteners added to most coffees that is contributing to your clients’ problems? 3rd: caffeine dependency does produce some mild/relative decrease in adrenal activity and if dosed too high or too late in the day or in very sensitive people (like those with pre-existing clinical adrenal insufficiency), can lead to circadian rhythm disruption and other clinical problems. Is this comparable to what happens with nutritional ketosis — causes a state that is similar to a disease state (ketoacidosis) but might be beneficial, or at least neutral when it is mild and happens in otherwise healthy people on a healthy (ketogenic or at least very low carb/grain) diet?

          • Kendal Au

            This is an old discussion but I have to join in. I’m here because I was searching for connections between caffeine & gut flora because I quit caffeine 2.5 weeks ago & have been having mild diarrhea & nausea for 10 days. I’ve ruled out flu& food poisoning.

            Carlos, I’m mostly answering you because I’m pretty paleo. I eat a scoop of ice cream/wk & resistant starch rice somewhat regularly, but no grains or refined sugar otherwise. I’m a veggie heavy paleo so I don’t over eat protein.

            I gave up caffeine (first coffee, then tea) because I have been suffering from fatigue (like utter exhaustion for 2 days) after 1 hour work outs. I’m a Pilates instructor – these work outs don’t get cardio much so I’m not over exercising either.

            Until about 6mo. ago, I was getting 6-8 disputed hrs of sleep each night for 2 yrs straight because I had a baby to care for. Hrs finally sleeping longer hours at night, waking only once in the morning just before the sun rises. So I became frustrated when, despite getting what appears to be enough sleep, I was still suffering fatigue on this level. I’m also 48 and still 15 lbs heavier than my prenatal weight & stl breastfeeding.

            I’ve read Dave Asprey’s bullet proof diet & did it too. He also talks about coffee & pre-biotics. I came here in my search for answers about caffeine & gut flora, not just coffee, because my guts are all twisted up despite bone broth being a regular fixture in my diet. I should probably eat more probiotics. Maybe that will settle my gut.

            So, just trying to say, even with a paleo diet, caffeine had at minimum very addicted in my post natal self, and if the severity of my withdrawal is any indication (I got every symptom except constipation – had no idea when I quit that anything but a headache was possible!) then caffeine has ready been jacking me up in some deep and horrible ways!

            Jason is talking the position of an alkaline diet – That’s pretty healthy, tho I’m skeptical of the premise & remain paleo in my thinking (more meat & fat from meats than alkaline likes).

            I’m not going alkaline but I really hope quitting caffeine temporarily will help me get past this fat and tired time in my life. I may never go back to coffee full time, but green tea is so healthy in so many ways! I plan on coming back too light green tea eventually.

            Currently I’m still suffering withdrawal so I can’t give any conclusions, but I hope quitting caffeine is like a magic button to let my endocrine system calm the hell down so I can have my energetic normal self back!

            In the meantime, I’ve gotta figure out how to readjust my gut!

          • Jejkka

            Guess what, coffee is fucking good for the gut. Like anything don’t abuse it and you’ll be fine . I’ve had a real bad gut, bad diareah and today I drank loads of coffee for the first time in ages .guess what, my stomach is returning to normal

          • John John

            First, Dr. Perlmutter is a professional, hence this is a professional forum. I think vulgarity shows a lack of respect for his forum, if I’m to be honest. With regards to the topic, the purpose of a robust immune system or any other organ system is to be able to ward off any threats whether it be endogenous or exogenous. Being asymptomatic does not mean that whatever you ate or encountered is not affecting you. Your body is supposed to respond as you put it. That’s what being in balance is. We encounter threats to our system daily. A healthy body achieves homeostasis “regardless” of what it encounters, unless it is doing its normal cleaning and gets sick to purge toxins via catarrh, etc.

            I see both sides of the argument as having truth. Within that truth, and other truths, there are exceptions. As the adage goes, rarely is anything ever “always” or “never”. I personally look to nature for the highest truth as it is free from dogma and doctrine. The purpose of all species, animal or plant, is propagation of the species. All species contribute in some capacity to life on earth. That being said, what is the purpose of coffee? There has to be one. If you can find a good purpose other than for human consumption minus what we put in it to alter the flavor, then I think you have an argument at the most basic level which supersedes it not being meant for consumption.

          • John John

            I would also add that most all people have some level of adrenal insufficiency. As we get older, most all of us develop kidney yin/yang deficiency in Chinese medicine which the adrenals are associated, so in 2 different forms of medicine, both illustrate that the adrenals/kidneys are deficient in so many people. We live in a predominantly sympathetic world. Rarely do people do anything to stimulate their sympathetic nervous system (SNS). The last thing people need to do is to increase their SNS. And this increased state has so much adverse effects for the body. All the benefits of coffee can be achieved by other means. I think when you look at these variables and truths, by in large far more people than not should not be drinking coffee. Moreover, how many people just drink black coffee? Most people put refined sugar, mucous forming milk or other products which contain artificial flavors, etc.

            I think people might have a better argument if the discuss using it once in a while such as staying awake to guard the village on night watch which probably happened thousands of years ago. I doubt they used it every day. Maybe they even did use it for certain health benefits, but nowadays, with they sympathetic driven world, I just don’t see the benefits outweighing the adverse effects it has on our body. Lastly, people drink coffee mainly because they are sleep deprived. Just ask people. And no one drinks coffee because they LOVE black coffee. They have to jazz it up with all kinds of artifical things because they hate the taste! Think about that. No one reports on that though in the studies, or anything else I mentioned. Why is that?

          • Ciaran Ryan

            You may have poor stomach acid. Try HCL see if that helps.

          • Maureen

            Personally, I went of carb and sugar and it was not enough. I still had terrible nerve issues. Then I went of coffee. Feeling the cure now. FYI…I was recently diagnosed with Adrenal Fatigue.

          • Maureen

            Meant to say I went off gain and sugar and reduced carbs to 100 grams per day.

        • MrRealist00

          So let me get this straight.. 100% of your clients have adrenal insufficiency, and they also drink coffee, so you’ve concluded that it must be due to coffee? This is completely ridiculous. I’ll bet 100% of your clients also wear pants. Do they wear pants because they drink coffee? Or is wearing pants the real reason behind adrenal insufficiency?

          Or maybe, just maybe, there’s some kind of pre-selection bias going on.. as in, only sick people come to you for help, so they all have adrenal insufficiency (and they all also happen to drink coffee and wear pants, just like everyone else who isn’t sick)?

          • John John

            I’d concur. I’d say that most people who drink coffee are sleep deprived. So then how much is from reasons other than drinking coffee, and how much is due to drinking coffee. How many people have SNP’s in the CYP 450 system? Lots of variables.

          • Ciaran Ryan

            I suffer with IBS and my gut goes haywire with coffee. Now don’t get me wrong, I love coffee, what it does to my focus and emotions is divine. Christ I love it. But my IBS goes mental – my stomach sticks out a mile and I get insomnia even if I have the coffee before none. I would love to find a way to be able to drink coffee without these side effects. Perhaps when my gut is healed. You’ll have to accept – coffee is a gut irritant. It’s fine if your gut is well but if there is a problem, sadly and I mean very sadly, it has to go, for a while at least 🙁

        • Maureen

          You are right on. I removed grains and sugar but still had so many nerve issues. Finally I was diagnosed with Adrenal fatigue and I knew coffee had to go. Feeling so much better and it has only been one day! Thanks for your post. Also…I am allergic to avocados and every book these days says eat these. You can’t do everything suggested in ONE book…readers beware. There are lots of caveats taking nutritional advice without knowing your areas of weakness.

    • Joshua Lee

      Its ironic how satisfied that probably made you feel! The way you get so emotional may signal an issue in your microbiome lol! Yin and Yan, moderation and balance is key. And sometimes balance means when one place is out of order another place has to balance it out. In cases where distress is already apparent obviously coffee cant be used as a benefit. And if there is gut distress but the adrenal activity is normal than coffee would have greater benefits. I also believe coffee, redwine, and even olive oil are health improving choices for the average american (western diets, deficient in polyphenols, healthy fats, and prebiotic foods ), but NOT a health improving choice for someone who already gets all these nutrients from their diet. But i will say the clashing of heads, trying to play king of the kill, is selfish and does not progress the world as a whole. So leave the ego at the door if you truly want to make a difference. Don’t fail to see that balance is the absolute key to everything.

    • Jejkka

      And that’s the reason you are a ‘holistic health coach’ you’re a snake oil salesman with no real scientific training. You say coffee is a neuro-endocrine disruptor to sound smart but don’t know what the hell you talk about . Sure excessive caffeine is bad as with anything . Coffee alters the amount of neurotransmitters released across the synapses of neurones but that’s how it works. Coffee has been enjoyed by many cultures for years , and while it’s a very large industry , it’s so
      Abundant anyone should be able to afford
      A cup. My grandmother once gave me ground fresh coffee and yoghurt when I had food poisoning . I was hesitant as I thought coffee was bad for the stomach . Almost like a miracle , my diahrea stopped. This is because of coffees effect as a prebiotic

  • Barb

    In your book Grain Brain you indicated that coffee was bad for Gluten intolerant people. You don’t mention that here. Should someone trying to avoid gluten drink coffee or not?

    • David Perlmutter

      I avoid gluten, and enjoy a daily cup of coffee. However, if someone has an allergy or less than favorable response to coffee consumption, it should certainly be avoided.

  • Reid Peryam

    Advocating neuro-stimulants for gut-flora? Oh dear.

    • there’s a lot of research supporting daily coffee consumption, black unsweetened or mildly sweetened. however, that may not apply to your 10oz latte which has almost no coffee and it’s full of processed milk. we have to learn to differentiate 🙂

  • Pingback: "Caffeine/coffee addiction and you" - Page 11 | Mark's Daily Apple Health and Fitness Forum page 11()

  • john from greece

    Did anyone read caffeine blues?if NOt then do so..you will be surprised by the evidence against caffeine…LIterally ALL human systems suffer after caffeine ingestion,including the gut,adrenals,liver,brain,gaba-dhea levels,cns,blood pressure,exhaled nitric oxide,circulation(should i continue?)…there is no such think as good coffee,not even decaf..and coffee is not only caffeine,it contains other harmful substances as well(more than 25),as well herbicides,pesticides and preservatives..As the doc says,ENJOY..and destroy your life with your bad attitude and temper..

  • Irene

    Jason you are very behind, you should read the latest and not rely on outdated infomations.

  • Beth Zupec-Kania

    Yerba matte has been my coffee replacement for years. Its a little lower in caffeine than coffee and does not have the acidity and its also high in antioxidants. I started drinking it in Argentina where it is the beverage of choice for adults and have been hooked since.

  • Tom

    I love coffee but coffee doesn’t love me, probably due to hypoglycemia/weak adrenals. What can I do to enjoy coffee again as I used? Please consider writing a book about adrenal weakness and/or hypoglycemia. Many thanks for what you have written and published so far.

  • blindanddumb

    the coffee industry is second only to crude oil there is so much money in it that your guaranteed to come across some propaganda about it,
    if you read this you just have

  • gabriel suner

    I like the idea of taking coffee which I do almost everyday… I heard about that coffee is a great irritant for the intestinal mucose. is this right?

  • John Reggie

    I love coffee and drink it with family and at work with my peers. However, the less I drink the better I feel in the long run. In fact, I too as many have stated, feel the best when I don’t drink it at all. My reasons for drinking it are purely social.

  • Bakeno

    How could it help with leaky gut when IT IS the cause of it

  • Terry

    Hi, I was just reading the discussion and am very curious to how coffee can heal the gut. I am a low carb vegan and had my first latte a couple weeks ago. I’ve never done well with caffeine and again it made me feel horrible. I switched to a fair trade organic decaf and I gotta tell you, I feel pretty amazing! My first thought reading the conversation is where is the coffee the people having gut issues when drinking, coming from? Do you even know where it’s from? You could be taking in pesticides which cause leaky gut. Also I’m no expert on caffeine but if it makes me feel like death compared to decaf maybe too much of a stimulant to the body is not so good. Just thought I’d throw in my two cents. I think a high quality coffee should be looked at when accessing what’s healthy or not for your body. After all, it is nature that has provided the coffee bean. So it must have some health benefits. Thanks!

  • silvia vazquez

    I have to join the discussion and say that coffee has been ruining by gut health, not too mention the adrenal exhaustion. I do believe coffee as anything is good in moderation (One or 2 cups of coffee a week) a daily cup of coffee has lead me to a leaky gut, brain fog, morning allergies, and high stomach acidity (this by drinking regular coffee, I cannot imagine what flavored coffee will do). After doing serious search, I decided to stop drinking coffee and start working on my adrenals, I feel wonderful and my allergies are gone. Each person is different, perhaps my liver and my gut are not that strong to deal with a daily cup of coffee.

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