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 >>
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 >>
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 >>
The Keto Diet Podcast Ep. #042: Optimizing Your Menstrual Cycle On Keto
Interview with Alisa Vitti, a functional nutritionist, women’s hormone expert, best-selling author and founder of floliving.com, chatting about how to adjust the ketogenic diet to compliment your menstrual cycle, heal your hormones, and boost energy and vitality… every day. For podcast transcript, scroll down. SHOW NOTES + LINKS TIMESTAMPS Fats that cause PMS (14:34) FREE hormone testing from the comfort of your home (33:43) Eating to support your cycle (50:56) PARTNERS OF THE KETO DIET PODCAST 100% grass-fed & finished FERMENTED beef sticks with 1 billion naturally-occurring, gut-healing probiotics! Go to Paleovalley.com for 20% off. The podcast is partnered with Wolfe Clinic Royal Flora, my choice in soil-based probiotics. Get 20% off your soil-based probiotics with the coupon code GUT at checkout. Use the coupon code HEALTHFUL all in caps, no spaces, for 15% off your first Perfect Keto order at perfectketo.com/hp. Once you’ve loaded up your cart, use HEALTHFUL for 15% off your first order. Again that’s HEALTHFUL at perfectketo.com/hp for 15% off your first order. TRANSCRIPT FOR THIS EPISODE Leanne Vogel: You’re listening to Episode Number 42 of the Keto Diet Podcast. Today, we’re chatting about fats that cause PMS, free hormone testing from the comfort of your own home, and eating to support your cycle. So, stayed tuned. Hey, I’m Leanne from HealthfulPursuit.com, and this is the Keto Diet Podcast, where we’re busting through the restrictive mentality of a traditional ketogenic diet to uncover the life you crave. What’s keto? Keto is a low-carb, high-fat diet where we’re switching from a sugar-burning state to becoming fat-burning machines. All listeners of the podcast receive a free seven-day keto meal plan complete with a shopping list and everyt Continue reading >>
Absence Of Periods On Low Carb With If
Can a low-carb diet combined with intermittent fasting result in an abscence of periods? And if so, what do you do? Get the answer to this and other questions – could dairy be a problem in PCOS? – in this week’s Q&A with the fertility specialist Dr. Fox: Loss of period Almost five months ago I started LCHF due to insulin resistance and PCOS. I lost about 40 pounds (18 kg), and feeling great. But, after two months of regular periods (31-35 days), I simply lost them. The last was on March 26th. This is now my third missed period. When I look back, it seems to me that perhaps I shouldn’t have done IF, (i didn’t fast first two months, and then I had my periods). Now my doctor has put me on progesterone to induce periods, and gave me cyclo-progynova to restore hormonal balance. What has happened doctor Fox? The last ultrasound showed that my endometrium is very thin (before was great). Though, my right ovary had no cysts. Can these hormonal pills harm my health? I am also taking glucophage xr 1000mg a day. I’ve also noticed increased hair loss… Thanks in advance, P.S Keep up the good work!!! Thanks for every advice, lecture, interview! Ivana Dr. Fox: That overall is a hard question. My best guess and it is a guess, is that you may have an underlying hypothalamic dysfunction, maybe due to prior exercise, or eating disorders, hypoglycemia, sleep apnea etc, that has predisposed you to be very sensitive to physiologic stress. The IF if not done during a time of absolute ketoadaptation, could produce such a stress signal that then could have shut off the signals from the hypothalamus to the pituitary and hence decreased the FSH (follicle stimulating hormone) signal to the ovary. This could explain your scenario and would be the most likely thing we would see. Evalua 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 >>
Common Ketosis Killers
“I’ve tried your low-carb diet, Dr. Nally, and it didn’t work.” “Hmm . . . really?” If your mumbling this to yourself, or you’ve said it to me in my office, then lets have a little talk. I’ve heard this statement before. It’s not a new statement, but it’s a statement that tells me we need to address a number of items. If you’ve failed a low carbohydrate diet, I’d suspect you are pretty severely insulin resistant or hyperinsulinemic. You probably never really reached true ketosis. I’d want to have you checked out by your doctor to rule out underlying disease like hypothyroidism, diabetes, other hormone imbalance, etc. Next, switching to a low-carbohydrate lifestyle is literally a “lifestyle change.” It requires that you understand a few basic ketosis principles. And, it takes the average person 3-6 months to really wrap their head around what this lifestyle means . . . and, some people, up to a year before they are really comfortable with how to eat and function in any situation. I assume, if you are reading this article, that you’ve already read about ketosis and understand the science behind it. If not, please start your reading with my article The Principle Based Ketogenic Lifestyle – Part I and Ketogenic Principles – Part II. If this is the case, then please proceed forward, “full steam ahead!” There are usually a few areas that are inadvertently inhibiting your body transformation, so let’s get a little personal. First, this is a low carbohydrate diet. For weight loss, I usually ask people to lower their carbohydrate intake to less than 2o grams per day. How do you do that? (A copy of my diet is accessible through my membership site HERE.) You’ve got to begin by restricting all carbohydrates to less than 20 grams per day. Continue reading >>
What Everybody Ought To Know About Ketosis
Recently I wanted to explore the world of Ketosis. I thought I knew a little bit about ketosis, but after doing some research I soon realised how wrong I was. 3 months later, after reading numerous books, listening to countless podcasts and experimenting with various diets I know have a sound understanding of ketosis. This resource is built as a reference guide for those looking to explore the fascinating world of ketosis. It is a resource that I wish I had 3 months ago. As you will soon see, a lot of the content below is not mine, instead I have linked to referenced to experts who have a greater understanding of this topic than I ever will. I hope this helps and if there is something that I have missed please leave a comment below so that I can update this. Also, as this is a rather long document, I have split it into various sections. You can click the headline below to be sent straight to the section that interests you. For those that are really time poor I have created a useful ketosis cheat sheet guide. This guide covers all the essential information you should know about ketosis. It can be downloaded HERE. Alternatively, if you're looking for a natural and sustainable way to improve health and lose weight head to this page - What is Ketosis? What Are The Benefits from being in Ketosis? Isn’t Ketosis Dangerous? Ketoacidosis vs Ketosis What Is The Difference Between a Low Carb Diet and a Ketogenic Diet? Types of Ketosis: The Difference Between Nutritional, Therapeutic & MCT Ketogenic Diets Is The Ketogenic Diet Safe? Long Term Effects Thyroid and Ketosis - What You May Want To Know What is a Typical Diet/Macro Breakdown for a Ketogenic Diet? Do I Need to Eat Carbs? What do I Eat On a Ketogenic Diet? What Do I Avoid Eating on a Ketogenic Diet? Protein Consumption a 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 >>
Keep Yourself In Ketosis
When talking about a Grain Brain lifestyle, and the very similar ketogenic diet, it’s frequently mentioned that we are aiming to keep our bodies in ketosis. However, if you’re new to my work, it may be that you’re not exactly sure what ketosis is, or why we should be worrying about getting our body into this state. Allow me to explain. Ketones are a special type of fat that can stimulate the pathways that enhance the growth of new neural networks in the brain. A ketogenic diet is one that is high in fats, and this diet has been a tool of researchers for years, used notably in a 2005 study on Parkinson’s patients finding an improvement in symptoms after just 28 days. The improvements were on par with those made possible via medication and brain surgery. Other research has shown the ketogenic diet to be remarkably effective in treating some forms of epilepsy, and even brain tumors. Ketones do more than just that though. They increase glutathione, a powerful, brain-protective antioxidant. Ketones facilitate the production of mitochondria, one of the most important actors in the coordinated production that is the human body. And that’s just the tip of the iceberg. Our bodies are said to enter ketosis at the point when blood sugar levels are low and liver glycogen are no longer available to produce glucose as a fuel for cellular energy production. At this point, not only is the body doing the natural thing, and burning off fat, it’s also powering up the brain with a super efficient fuel. We can jump start ourselves into ketosis with a brief fast, allowing our body to quickly burn through the carbs that are in our system, and turn to fat for fuel. A ketogenic diet is one that derives around 80% or more of of its calories from fat, and the rest from carbs and prote Continue reading >>
Ketosis & Measuring Ketones
Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>
7 Reasons Your Period Goes Mia Sometimes
Got two X chromosomes? Then you probably know your period can be more like your flaky friend who always shows up late to drinks (and sometimes not at all) than that super-organized friend who's early to every group dinner. First of all, don't freak out. Irregularities in menstrual cycles aren’t all that rare. Many women experience a missed period every once in a while, and three to four percent of all women will skip at least three cycles at some point in their lives (a condition technically known as oligomennorrhea). While your initial—and very valid—reaction to skipping a cycle might be that you're pregnant, a number of lifestyle and health factors can also prompt our menses to take a mini-vacay. (Still, never wait to take an OTC pregnancy test or visit your doc for a blood or urine test to rule out a potential pregnancy.) But if you’ve skipped three or more periods, and you’re sure you aren’t pregnant, paying a visit to your OB/GYN, GP, or an endocrinologist is non-negotiable. In the meantime, here are seven common reasons your periods could be AWOL—and what you can do to get things back on track. From feeling like we have no control over our job to being abused or living in an unsafe environment, chronic stress takes a serious bite out of our bodies' well-being. Too many stress hormones coursing through our bloodstreams signal our brains to slow down or temporarily stop ovulation until our environments become safer for bringing a new baby into the world. What and how much you eat play a big role in how regular your cycle is. Not noshing on enough healthy food deprives the body of key nutrients like calcium, magnesium, iron, and zinc—all of which are required to make sex hormones (among other internal upkeep). Low nutrient and calorie availability str Continue reading >>
Why You Need To Stop Worrying About The Color Of Your Ketostix
Yeah, I know you like to use them, but there are so many misconceptions about what they are telling you, that I need to intervene and make sure you get it. But before I go there, let me urge you to just buy The Art and Science of Low Carbohydrate Living, and read pages 164-165. Phinney and Volek have the best description of this that has probably ever been written, and you should really just read it from them. If I could copy these pages verbatim and paste it here, I would. Seriously, it’s only a few bucks and it’s quite literally the book you want to own if you’re interested in low carb ketogenic diets. OK, while you wait for your book to arrive, let’s dig in… What ketostix measure First off, we need to understand what ketostix actually measure, and more importantly, what they don’t. Generally speaking, ketostix measure excess ketones in your urine. They are considered excess, because they are removed from your serum and shunted to your urine by your kidneys. Their caloric content is thereby wasted. Of the three types of ketones (acetate, acetoacetate, and beta-hydroxybutyrate) produced by your body, ketostix only measure acetoacetate. This is extremely important to understand, because it turns out that your body produces different quantities of these different types of ketones depending on how long you’ve been in ketosis. If you’ve been in ketosis for a while, you’re going to see a reduction in the “intensity” of what you register on your ketostix for two reasons: A change in the relative volume of the ketones produced/present in your body A reduction in the volume of ketones in your urine as your kidneys reduce the amount they secrete Both of these are covered below. Changes in the types of ketones you produce When you first start your ketogenic Continue reading >>
Ketosis & Amenorrhea
-I've had amenorrhea for about... 3 1/2 years. -I did in fact have a ED for a couple of those years. (eh...) -I'm at a recovered weight (5.1" ... maybe 5.2" - 113lbs - muscular build/medium build - 17 years old). -Started eating "my paleo" (includes greek yogurt, organic fruits, organic potatoes, a little organic basmati white rice, raw macadamias, occasional almond/coconut flour baked good), but otherwise, have stuck to the meat (mostly grass fed), organic veggies, organic greens, organic Japanese sweet potatoes, omega-3 sources of fat, salmon, tuna, sardines, chicken, coconut milk/unsweetened-flakes/butter... what have you. etc etc. -I exercise about 3ish times a week, sometimes less. Not much cardio, more "muscle training". -I think I may be in Ketosis (regardless of my carb intake... even though those "odd" starches I listed are in my diet, I do not "over consume" them). -I never started my period in between now and... well 3 1/2 years ago, and am afraid Ketosis might be hindering it further. -Is there a certain amount of calories that also induces Amenorrhea, or is it fat/carb percentages? Plain and simple: I want my period, what the heck do I have to do to get it back. Continue reading >>
Will This Kick Me Out Of Ketosis?
A common question people have when starting keto is “will this kick me out of ketosis?” I’m going to address as many items as I can think of and explain why it will or will not kick you out of keto. This is going to be as comprehensive as possible so either use ctrl + f to find what you’re looking for or buckle up and read on. How do humans enter ketosis in the first place? Things will become much more clear if we explain how humans enter ketosis. Mainly, liver glycogen is what determines if ketones will be produced. Specifically, glycogen in the liver signals malonyl-coa to be formed by carboxylating acetyl-coa. Acetyl-coa is used in many processes and it’s the main substrate used to be turned into ketones. The wiki on regulation of ketogenesis which applies to this scenario says “When the body has no free carbohydrates available, fat must be broken down into acetyl-CoA in order to get energy. Acetyl-CoA is not being recycled through the citric acid cycle because the citric acid cycle intermediates (mainly oxaloacetate) have been depleted to feed the gluconeogenesis pathway, and the resulting accumulation of acetyl-CoA activates ketogenesis.” Basically, when there is more acetyl-CoA than oxaloacetate, the acetyl-CoA becomes acetoacetate, a ketone body. In plain English, carbs provide oxaloacetate, so if it doesn’t have carbs, it likely isn’t going to kick you out of ketosis. I’ll state the exceptions later. Why do humans enter ketosis so readily? Humans enter ketosis faster than any animal on the planet. It usually takes 24-36 hours before we enter ketosis.This is because we have huge brains and tiny bodies. Our brains need ~400 calories/day, which for most people that equates to 20% of our total energy demands. To put this in perspective, most anim Continue reading >>
