Ketosis And Hormone Changes
While working as a nurse with Dr. Robert Atkins, I adopted a low carb diet. My goal was to avoid my genetic tendency for developing obesity and type 2 diabetes. I had the tools at hand to monitor urinary and breath ketones frequently. After months I noticed that a few days before my period, ketones would drop or even disappear. This coincided with mild PMS symptoms including weight gain and the re-emergence of hunger and cravings. Ketones would return by the 2nd day or so of my menses. I began to mention this to my patients who wanted to monitor urinary ketones. I didn’t want them getting discouraged if they experienced the same. Many would return and tell me they noticed the drop in ketones as well. They appreciated having advanced warning. We also observed that with low-carb regimen, PMS symptoms over time would decrease, sometimes to the point that a woman would be surprised when she began her flow. At the start of the plan others would mention that the first period would in some way be worse before getting better. To my knowledge this has not been studied. What I learned is that any hormone changes in women can increase insulin resistance, which makes the body produce more insulin to get the same insulin benefit. At puberty and menarche when girls need to gain body fat they become more insulin resistant. I have been a carb addict but my cravings increased significantly at this time as did my weight. Hormones also fluctuate during the menstrual cycle. During pregnancy, peri-menopause, and menopause there are significant hormone changes accompanied by increased insulin resistance. This change of life stage (peri-menopause) for me was difficult. I lost ketones but still gained weight on my maintenance plan (my strategy was to adopt a 20 gram carbohydrate level and st Continue reading >>
16 Ways Keto For Women Is Different + Doesn’t Need To Suck
As a female, we have to tinker the keto diet a little more than our male keto-ers do. For example, during shark week I can’t eat meat or I’ll end up on the couch in agony, with a heating pad, wanting to tear my ovaries out. So, I have to opt for things that are more easily digestible to my puffy, unhappy insides. Keto for women is just different. For one week every month we have brain-consuming cravings, we weigh more, have a hard time digesting, we get headaches and cramps and dammit we just want a blanket, some chocolate and a tub of icecream. end OK, but you get it. We also have other things to think about, like vaginas and boobies. For these two special things, we need to make some alterations too. You can’t just cut out some things. How to make keto for women easier and less grouchy Here are some tips I’ve cooked up over the past year that I’ve been told have been really helpful, enjoy! Eat yogurt. The diet says no, but I SAY YES. Men don’t need to care about the Lactobacillus acidophilus in yogurt, but a good healthy vagina does! Dannon makes a Light & Fit “Diabetic Friendly” vanilla yogurt that’s only 3 carbs per cup. Take cranberry supplements. Additionally, we need cranberry to ward away pesky urinary tract infections if we ever plan on forgetting to pee after sex again. So, take a cranberry supplement every day, and accept the carbs that come with it. Prepare for the lady in red. When the red devil is in town and you “need” sweets, opt for a handful of dark chocolate chocolate chips. The gourmet ones, real dark chocolate ones have the least carbs. The Milk Chocolate Almond Bars from Meleleuca only have 7 carbs for the entire bar, 9 for the DHA-enhanced dark chocolate ones which is also awesome. Remember that meats take more Continue reading >>
Have You Lost Your Period To A Low Carb Diet?
A few weeks ago, I tweeted my concern about a low carb diet for young women. Apparently, my tweet was offensive to some people (men). They explained to me that it’s purely “anecdotal.” There is no known mechanism, they said, so it must not really be happening. Except it is really happening. Ask anyone who works with young menstruating women. Or not menstruating, as the case may be. True, we don’t know the exact mechanism. That’s because no researcher has yet asked the question: What does a very low carb diet do to periods? Until we have the answer, we can only surmise. I surmise that for some women inadequate starch signals the hypothalamus that there’s not enough food to reproduce. It may be via the hormone leptin. It may be via the microbiome. It is an adaptive starvation response, and may also be why a low carb diet can cause hair loss. [For an update and a possible mechanism, please see my 2016 post Are You Eating Enough to Get a Period?] In contrast, some women do well on a low-carb diet. They may even regain the periods they’d lost on a high-carb diet (see insulin-resistant PCOS discussion below). It comes down to this: There are different individuals in the world, with different glycemic responses. There are also different carbohydrates. For example, there is sugar and there is wheat, and they are two worst carbohydrates. Sugar is the worst carb Sugar is bad for health and for period health. High-dose fructose causes insulin resistance and inflammation and is more inflammatory than the long glucose chains of starch. That’s why some researchers have called for a ‘fructose index‘. I discuss fructose in my insulin resistance post, my PCOS post, and Chapter 6 of my book. Whole fruit is okay, but none of us should be eating desserts, sweet drinks, Continue reading >>
For Ladies Only: A Keto Guide
Shark week. Checking into the Red Roof Inn. Surfing the Crimson Wave. Getting a visit from Aunt Flo. The Red Badge of Courage. That time of the month. Whatever euphemism you use for it, women inevitably have to deal with menstruation and all the weird junk that goes along with it. We here at Ketovangelist get a lot of questions about keto and periods. A. Lot. So, at the behest of our coaches- and after much whining on my part- I’ve put together this little “what to expect” guide for women to help a sister out when it gets down to the issue of menstruating. You’re welcome. One thing to keep in mind: Your period is still your period. If I’ve said it once, I’ve said it a zillion times: keto is not magic. and it isn’t the cause of everything that will happen to you after you start eating this way. For the most part, your period is going to be your normal period while you’re keto. You might have cravings, you might cramp, you might be light or heavy, or early or late. All the same stuff you dealt with during menstruation pre-keto you will probably continue to deal with now that you’ve changed your food lifestyle. That being said, there are a few issues we do see pop up from time to time and I will address them, in no particular order: If you’re hungry, eat A direct quote, if I may, from our lovely coach, Mary Roberts: “Hormone hunger is real hunger.” And she’s right. Right after ovulation the body ramps up production of estrogen and progesterone, both of which can cause your body to feel hunger. The bottom line is that, as we all should know, our menstrual time is a stretch of a few days where hormones are screwy. We might be tired, we might be cranky, and we will probably be hungry. All of that is perfectly normal and you are not expected to sit an Continue reading >>
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Does A Ketogenic Diet Affect Women’s Hormones?
Does a ketogenic diet affect women’s hormones? Yes—you can count on your nutrition to affect your hormones. Does it ruin or destroy your hormones? No. The unfortunate part is that if women rely on hearsay and don’t source better information about ketosis and their hormones, they lose out on the benefits of ketosis, especially those who suffer from PCOS, endometriosis, and uterine fibroids. Women with these conditions can benefit significantly from the ketogenic diet.  In this post we’ll discuss the ketogenic diet’s impact on your thyroid and the HPA axis, then look at ways to evaluate your hormones, how you feel, and what adjustments to make. The Ketogenic Diet and Your Thyroid Is ketosis bad for your thyroid? No. Let’s break it down: It’s true that low-carb diets (like the ketogenic diet) and calorie restriction lowers T3, the thyroid marker hormone.   T3 make your cells use more energy. Because of its function, scientists have hypothesized that “a reduction in T3 hormone may increase lifespan by conserving energy and reducing free-radical production.”  Together with T4, these hormones regulate your metabolism, heart rate and body temperature. Most of T3 binds to protein and some free T3 circulates in your blood. But a lowered T3 doesn’t mean you get thyroid dysfunction or hypothyroidism. Hypothyroidism is often a case of high levels of TSH (thyroid stimulating hormone) and low levels of free T4. The pituitary gland tries to get your thyroid gland to produce T4: high levels of TSH. But the thyroid isn’t responding: low levels of T4. When T3 is reduced, the thyroid is called “euthyroid.” A normal thyroid. For a more in-depth look at what a low-carb diet does to T3, T4 and TSH levels, read Dr. Anthony’s article on ketosis and women Continue reading >>
Much Ado About Ketosis: Are The Adverse Effects Really That Adverse?
I recently read a blog post decrying anyone that would recommend a low carbohydrate / ketogenic diet to their patients. What?! In fact, this particular blog outlined a number of “adverse reactions” to a ketogenic diet, and based upon these perceived reactions, the writer advised severe caution with its use in just about anyone. It is important to note at the outset that most of the data this blogger quotes are from older studies completed in children for the treatment of epilepsy with specific liquid ketogenic dietary meal replacements. (Not what you’d expect in a low-carb / ketogenic diet for the average obese adult today.) Thanks to recent misinformation by a number of medical professionals, including the person writing the blog referenced above, a poor understanding of fatty acid metabolism by the general community, and a distinct lack of understanding of human adaptability recorded over the last 5,000-6,000 years, there is still significant confusion about ketogenic diets. It is important to recognize the crucial fact that the human body is designed to function quite well when supplied any of three macronutrients: carbohydrates, proteins or fats. It does so through an amazing series of enzymatic reactions referred to as the Krebs (tricarboxylic acid) cycle, producing needed ATP (adenosine triphosphate) required for our muscles to contract, our heart to beat and our diaphragm to expand our lungs. What’s even more amazing that that the body was designed to recognize the season we are in based up on the food we eat. That is, until we invented refrigerators in 1913. (Now our bodies think it’s year round summer time . . . wait . . . I live in Arizona where it is year round summer time.) No, this is not a post about unplugging your refrigerator, living on solar, Continue reading >>
Ketosis & Late Menstrual Cycle
Ketosis occurs when a person is deprived of dietary carbohydrates, causing the body to burn glycogen and fat stores for energy. This can lead to rapid weight loss, which may cause late or missed periods in some women. If you are experiencing ketosis and your period is much later than usual, consult your doctor. Video of the Day Your body burns dietary carbohydrates for energy. If you do not provide it with carbohydrates, it burns its fat stores instead. This process releases small carbon fragments called ketones into the blood, which causes the state known as ketosis. A common sign of ketosis is unpleasant fruity-smelling breath that results when your body tries to expel excess ketones by breathing them out. Although it is often marketed and promoted as a safe weight-loss and detox solution, ketosis can cause long-term liver and kidney damage. Ketogenic diets are extremely strict, high-fat, low-protein and low-carbohydrate diets that intentionally cause a state of ketosis, usually for quick weight loss. These diets may produce the desired results, but the weight loss is rarely sustainable since it returns quickly once you return to a normal diet. More importantly, they are not safe. Ketogenic diets can cause a host of problems, including kidney stones, constipation, cognitive problems, osteoporosis, high cholesterol and disruptions in the menstrual cycle. There are many reasons your period may be late. Some fluctuations in your menstrual cycle are normal, or may occur due to stress, your contraceptive method or even pregnancy. More serious causes include hormonal imbalances, thyroid problems or menopause. Extreme weight loss such as that caused by ketosis can cause your menstrual periods to diminish or stop altogether. If you are following a ketogenic diet and your peri Continue reading >>
Adverse Reactions To Ketogenic Diets: Caution Advised
As the ketogenic diet gains popularity, it’s important to have a balanced discussion regarding the merits of this diet. Let me emphasize right out of the gate that this is not a diet without merits (excuse the double negative); in fact, it has significant therapeutic potential for some clinical pathologies. However, it is also a diet with inherent risk, as evidenced by the extensive list of adverse reactions reported in the scientific literature—and this has not yet been a thorough enough part of the public discussion on ketogenic diets. The AIP Lecture Series is a 6-week video-based, self-directed online course that will teach you the scientific foundation for the diet and lifestyle tenets of the Autoimmune Protocol. This is the first of a series of articles discussing various facets of a ketogenic diet with an inclination toward balancing the discussion of the pros and cons of this high-fat, low-carb, low/moderate-protein diet. My interest in this topic stems from concerns I have over its general applicability and safety, simultaneous with its growing popularity. I feel a moral and social obligation to share what I understand of these diets, from my perspective as a medical researcher. The dangers of a ketogenic diet was, in fact, the topic of my keynote presentation at Paleo F(x) this year (links to video will be provided once available). This series of articles will share the extensive research that I did in preparation for this presentation, including all of the topics covered during my talk as well as several topics that I didn’t have time to discuss (also see the free PDF Literature Review at the bottom of this post). For every anecdotal story of someone who has regained their health with a ketogenic diet, there’s a counterpoint story of someone who derai Continue reading >>
Ladies: Extra Mini-periods?
Whoo! Sit down with a nice hot cup of tea. I've got a big answer. Pardon me, while I dust off my soapbox. ;) DISCLAIMER #1: If you want to have children some day, then you should seek specific professional guidance (ie someone who deals specifically with reproductive health) when dealing with reproductive hormones. What you do today could have serious consequences years from now. That said, most women can correct years of hormonal imbalance in just a few cycles and still conceive. DISCLAIMER #2: It's hard to say what's "normal" for someone doing paleo while on the pill, because I don't think being on the pill can be considered paleo. As people following a paleo diet, we're basically trying to regulate our hormones by eating quality food and getting quality sleep. Unless we have a real medical condition that requires prescribed hormones (the use of which usually tends to follow natural rhythms); we should not be messing with our body's natural monthly hormonal rhythms by using the pill. So here's another situation where it's important to understand how the hormones are working and how they affect your body. Every cycle, under the influence of Follicle Stimulating Hormone (FSH), about two dozen eggs start to mature. Each egg is encased in a follicle. The follicles produce Estrogen. Estrogen is the hormone necessary for ovulation to occur. Eventually, when Estrogen reaches a threshold that is high enough, one eggs bursts out (ovulation!). This usually takes about two weeks from the beginning of menses but can take anywhere from 8 days to several months! Following the release of the egg, the follicle that held the egg begins to release progesterone (typically for only 12 to 16 days). This is known as the Luteal Phase. Progesterone prevents the release of all other eggs and Continue reading >>
Does Low-carb Prolong Your Period?
It was bound to happen at some point or another. And now it has. I got an e-mail from a fan of my blog and my book (she said she has already read it twice!) a few days ago who wanted to know why her period continues on indefinitely for weeks at a time while she is livin’ la vida low-carb. Uh, heck if I know! Hee hee! As much personal experience I have had with the low-carb lifestyle over the past couple of years, that is DEFINTELY one area I will NEVER have any primary knowledge about (thank you, Jesus! LOL!). But, thanks to some key friends who are all women (WOO HOO!) and experts in the low-carb lifestyle (BONUS!), I am able to assist this reader with some invaluable information and learn some things in the process. Here was her very interesting e-mail dilemma: “I have question that you personally have never had to deal with, but I am hoping you will tap your resources and be able to answer for me. I have lived low-carb and then stopped several times for the same reason. I lose a lot of weight very quickly and then it tapers off to 2-3 pounds a week. I currently weigh about 283 pounds. When I start on the low-carb lifestyle, I lost 15-20 pounds in the first month and then my period started and would not stop. I have had this happen now several times. I spoke with my doctor about this and the answer he gave me I have never seen in a blog or book before. His explanation was as follows: your body fat retains estrogen and when you lose body fat quickly, then your body doesn’t know what to do with the explosion of extra estrogen so it makes your cycle unexpectedly start prematurely. Then the estrogen level stays elevated because of your weight is dropping so your cycle never stops. I have searched many blogs and books and can’t find any mention of this phenomenon. Continue reading >>
Paleo And Menstrual Cravings
Any kind of cravings can be the death of good dietary intentions, but menstrual cravings get a special mention because they’re so common (roughly 1/4 to ½ of premenopausal women, depending on which study you look at) and they can be so intense. So where do those cravings come from? Looking at the evidence shows that they’re probably not a direct effect of hormone shifts (which affect hunger, but not cravings) or caused by a nutrient deficiency. They’re more likely to be a complicated combination of mood changes, cultural factors, and the woman’s level of dietary restraint (i.e. whether or not she’s really worried about weight and dieting). Here’s a look at where menstrual cravings come from and what kinds of nutritional strategies help with fighting them. Hunger vs. Cravings First of all, it’s important to distinguish premenstrual hunger from premenstrual cravings. It’s actually normal for a woman to be hungrier right before her period, because her metabolism speeds up at this time of the month, so she’s burning more calories. Healthy women naturally eat more during the luteal phase (the part of the menstrual cycle right before bleeding starts), and one study found that they also eat more protein and specifically more animal protein. Other studies have shown an increase in carb consumption. It’s not a huge difference, but this really is a documented thing that happens, and there’s no reason to fight it because it’s completely normal. How do you know if you’re experiencing premenstrual hunger? It’s probably hunger if… A nutritious meal of animal protein, healthy fat, and vegetables sounds good. You’d dig right into a big plate of chicken drumsticks and roasted broccoli. The desire to eat goes away after a healthy meal without any sweets o Continue reading >>
Ketosis And Menstrual Function: A Canary In The Mine?
In the 1920’s, researchers at the Mayo Clinic used a ketogenic diet to treat adults with ideopathic epilepsy. In 1930, Dr. Clifford Barborka published a paper detailing their findings with their first 100 patients. Among other findings, Barborka notes that 20% of the women involved in the study experienced complete cessation of menstruation during treatment, which didn’t return until a normal diet was resumed. He only reported on menstrual cessation, but given more contemporary research on the subject we can reasonably speculate that many more women experienced menstrual irregularities that stopped short of complete cessation. Subjects were eating appropriate calories to maintain their weight, so weight loss was not a confounder here. He speculates that it may have been related to a vitamin B or E deficiency, but has no clear explanation. (Note that this was many decades before the discovery of Leptin and it’s role in hormonal regulation.) In 2003, researchers published their retrospective study of 45 adolescents aged 12-19 treated for epilpsy with a ketogenic diet over 8 years. They noted that 45% of the girls involved in the study reported menstrual irregularities, most (2/3) of whom experienced complete cessation of menstruation (the other 1/3 were reported as experiencing delayed puberty or menstrual irregularity). Most resumed menstruation after ending the diet. 2 were treated with hormone therapy to induce and regulate menstruation. A majority of the girls did not lose weight on the diet, so again, weight loss was not a confounder in most cases. Researchers speculated that: “The diet may mimic the menstrual side effects seen in starvation and certain female athletes.” In 1999, a group of researchers published a review of a small group (9 women, 2 men) of Continue reading >>
Do Very Low-carb Diets Mess Up Some Women's Hormones?
Studies show that low-carb diets can cause weight loss and improve metabolic health (1). However, even though low-carb diets are great for some people, they may cause problems for others. For example, following a very low-carb diet for a long time may disrupt hormones in some women. This article explores how low-carb diets may affect women's hormones. Your hormones are regulated by three major glands: Hypothalamus: located in the brain Pituitary: located in the brain Adrenals: located at the top of the kidneys All three glands interact in complex ways to keep your hormones in balance. This is known as the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is responsible for regulating your stress levels, mood, emotions, digestion, immune system, sex drive, metabolism, energy levels and more. The glands are sensitive to things like calorie intake, stress and exercise levels. Long-term stress can cause you to overproduce the hormones cortisol and norepinephrine, creating an imbalance that increases pressure on the hypothalamus, pituitary and adrenal glands (2). This ongoing pressure may eventually lead to HPA axis dysfunction, sometimes controversially referred to as "adrenal fatigue" (3). Symptoms include fatigue, a weakened immune system and greater risk of long-term health problems such as hypothyroidism, inflammation, diabetes and mood disorders. Many sources suggest that a diet too low in calories or carbs can also act as a stressor, causing HPA dysfunction. In addition, some evidence suggests that low-carb diets can cause increased production of cortisol ("the stress hormone"), making the problem worse (4). One study found that, regardless of weight loss, a low-carb diet increased cortisol levels compared to a moderate-fat, moderate-carb diet (5). Eating too fe Continue reading >>
The Side Effects Of A Low Carb Diet
Who should go on a low-carb diet? Low-carbohydrate diets — like the ketogenic diet — are effective for weight loss and improving health. They are also especially helpful for anyone who: Is overweight or obese Is sedentary Has epilepsy Has polycystic ovarian syndrome (PCOS), fibroids or endometriosis Is diagnosed with type 1 or type 2 diabetes Has a neurodegenerative disease such as Alzheimer’s or Parkinson’s Has certain forms of cancer Has cardiovascular disease A typical low-carb diet limits the daily intake of carbohydrates to between 60 and 130 grams, while a ketogenic diet tends to stay below 30 grams of carbohydrates. This is done by excluding or limiting most grains, legumes, fruits, bread, sweets, pasta and starchy vegetables from the diet and replacing them with added fats, meat, poultry, fish, eggs, non-starchy vegetables, nuts, and seeds. When we eat in this way, our bodies begin to change dramatically — especially for those who habitually eat plenty of carbohydrates with each meal. Not all of these changes, however, are going to be positive. When carbohydrates are restricted, it is stressful for the body because it must find another way to fuel itself. This can cause side effects, like nausea and headaches, that is commonly called the “keto flu”. The lack of carbohydrates will also lead to fluid and mineral loss and hormonal changes that can cause health issues if not addressed. The Most Common Side Effects The most common side effects that are experienced when restricting carbohydrates are: Headache Bad breath Weakness Fatigue Constipation or diarrhea It is important, however, to consider how common these symptoms actually are. In studies that put obese patients on a ketogenic diet for 6 months or longer (up to two years), no side effects or co Continue reading >>
11 Reasons Your Period Is Missing (besides Pregnancy)
iStock/flocu Birth control pills, patches, rings, shots, patches, and IUDs aren't guaranteed to stop your cycle entirely but missed periods are a recognized side effect of hormonal birth control—one many women are quite happy about. This is because hormonal birth control methods are designed to both inhibit ovulation and thin the lining of the uterus, explains Alyssa Dweck, MD, ob-gyn and co-author of V is for Vagina: Your A to Z guide to Periods, Piercings, Pleasures and so much more. No egg to protect and no lining to shed means a lighter or non-existent period. The Mirena IUD and the Depo-Provera shot are the types most known for this side effect, along with pill packs, like Seasonique, that are designed for this express purpose. iStock/mihailomilovanovic The "female athlete triad" refers to a pattern of undereating, amenorrhea (loss of periods), and osteoporosis that stem from an extreme workout routine. But despite the word "athlete" in the name, you don't have to be bound for the Olympics to be at risk. According to a recent study, it can affect women in any shape, form, or weight—not just the stereotypical "ballerina physique"—who are exercising too much. How much is too much? The answer is specific to each woman's body and circumstances, but a good rule of thumb is if your workouts make your period go missing, it's too much for you. Here are other bizarre side effects of exercise. You have PCOS iStock/shironosov Polycystic ovarian syndrome (PCOS) is an increasingly common cause of amenorrhea, says Renée Volny Darko, DO, a board-certified ob-gyn practicing in Pennsylvania. PCOS is the most common hormonal endocrine disorder in women, affecting 5 to 10 percent of all women and is thought to be responsible for up to 70 percent of infertility. The syndrome is Continue reading >>