Females, Carbohydrates, and Hormones

Oh, carbohydrates.  Just like politics and religion, discussion on this macronutrient is not dinner table material.  There are many strong opinions on just how many carbohydrates are “safe” to consume.  Some advocate “high” carb, others prescribe a “moderate” amount, others “low” or even “very low”. And to mystify things further, what’s considered a low amount of carbohydrates to some, may be considered too high for others.  Even the scientific literature doesn’t seem to agree on a common definition. See how it can get confusing?

The purpose of this post isn’t to tell you which way is better.  In fact, that is a decision you may never make.  What works for some people, won’t work for others.  What works for you now, may not work for you next week.  If something is working for you, great! Right now, I want to explore one piece on the topic of carbohydrates that isn’t discussed often in this community.

I bring up this topic because I personally struggled with finding the “right” amount of carbohydrates for my body.  I want to make sure others don’t have to go through what I did.  In the past, I’ve done damage to myself by going too low (almost on accident) and I want to stop you before it’s too late.  If you’re in the same boat as I was, I’m hoping this will be an aha! moment for you.

When I first started with my Paleo lifestyle, I realized just how amazing I felt going lower carb (probably in the range of 100 grams a day).  The problem was, I was also doing high intensity workouts (kickboxing, interval training) multiple times per week.  At first, I felt great.  I was recovering like a champ, my sleep was perfect, I had a very stable, positive mood, and even though I knew I would probably benefit from more carbohydrates, I stubbornly went on my way.

steph kb

Then I switched my training to solely heavy lifting (3 x 5, 1 rep max. style) + a few sprints.  I started hearing more about ketogenic diets and figured I’d give that a try, especially since I wasn’t doing all the high intensity stuff anymore.  Sugar is toxic anyways, right?

After all was said and done, I lost my cycle and messed up my hormones up pretty badly.  I began seeing this time after time in my consulting practice and started digging deep into the literature.  After many hours of research (and still counting), I found more and more evidence regarding proper amounts of carbohydrates for females with specific conditions.  We always talk about biochemical individuality and using Paleo as a template, but I think for the effect of carbohydrates on women, this is a big deal.

Once I made a few tweaks to my diet and lifestyle, including adding back more carbohydrates, my hormones rebalanced.  I also recommended that some of my clients follow similar protocols and they saw very positive results as well.  We didn’t have to start throwing back pounds of sweet potatoes and rice, we just needed to quit the chronic very low carb (<50ish grams) lifestyles that we were on and add in some root veggies and fruit.

taro img: wikipedia

Ladies – Your carbohydrate intake could be a missing piece of the equation when it comes to balancing your female hormones, losing weight, recovering from exercise, supporting your thyroid, boosting your energy, and so much more.

Very often, I see females dealing with cycle irregularity, weight lost resistance, and poor exercise recovery in my practice as a dietitian.  I’ll hear stories about how a Paleo template was working wonders for them and then all of a sudden they lost their cycle.  Sometimes these ladies were rocking their workouts and then started to crash.  Chicken, broccoli, and olive oil were working in their favor for weight loss, but now “just looking at that food made them gain 10 pounds.”  They immediately blame it on adrenal fatigue and start taking adrenal support supplements hoping that will do the trick.

Sound familiar? Read on.

Yes, of course some of the problems women experience with weight loss resistance, poor recovery, altered sleeping patterns, and cycle-related issues may be due to stress, thyroid problems, or their adrenals.  There are always other reproductive problems, such as PCOS and endometriosis, that can also create hormonal havoc and weight gain. Those are very probable guesses and something to consider; however, what if there was something even easier to implement that could help get you back on track?  Could the answer be as simple as adding back more carbs?

Maybe simple isn’t the right word.  In fact, nothing about nutrition is ever simple. I’m not talking about going back to eating legumes and healthy whole grains to lose weight and regain hormonal balance.

grains img: wikipedia

Not these carbs

There’s a catch with this.  There’s always a catch.  Remember when I said, “what works for some, won’t work for others?”  Let’s elaborate on that, shall we?


When you may need more:1207-allyson-felix

  • If you are active, especially with a focus on frequent, high-intensity based workouts
  • If you start having trouble recovering from your workouts
  • If your thyroid is underactive, even with a clean diet and support from medications
  • If you have adrenal fatigue
  • If you start to lose your period or have irregular cycles (pre-menopause)
  • If you’ve been very low carb for an extended period of time
  • During pregnancy and while breastfeeding


When you may need less:

  • If you have a condition such as PCOS, fibroids or endometriosis
  • If you are dealing with small intestine bacterial or yeast overgrowth
  • If you are insulin resistant or have diabetes
  • If you have a neurodegenerative disease
  • If you have certain forms of cancer


Other blog posts on this site have discussed the low-carbohydrate approach for insulin resistance, neurodegenerative diseases, and cancer, so I want to specifically discuss why going too low carbohydrate may be problematic for supporting a healthy female hormone environment.

When a female ventures to a Paleo diet, she will be, by default, significantly reducing the amount of carbohydrates in her diet.  Sure, starchy vegetables and fruit will provide her with some carbohydrates, but compared to the standard American diet, this is a dramatic shift.  She will do great on the diet and may notice weight loss.  After awhile, the weight loss may stall and she may read about the benefits and weight loss seen with lower carbohydrate Paleo diets. The thought is intriguing and she says goodbye to starches and fruit in her diet.  Maybe entirely, or maybe just scaled way back.  This new low-carbohydrate venture may work well for awhile, until at some point it doesn’t.

Getting your hormones back on track requires you to convince your body that it’s not in danger.  This may mean working on improving the quality of your sleep, cutting back on exercise, implementing stress reduction techniques, eating enough calories to maintain normal body functions (resting metabolic rate) and possibly eating more or less carbohydrates, if you’re dealing with some of the factors listed above.

But why?

The why deserves a lengthy discussion, so I’ll get into that in a future post.  In the meantime, let’s talk about leptin for a second.  This hormone may play a key role for women in balancing their hormones, so it’s worth mentioning in this blog.

Remember leptin?  Leptin is the new insulin.  Okay, stupid joke, but leptin is gaining popularity in the scientific literature.  Leptin is a hormone that circulates through your body assessing your energy availability.  Leptin receptors have been identified in human ovaries and pre-ovulatory follices.  Your fat stores represent a vital component in your body’s energy balance and reproductive function is dependent on energy availability.  Thus, it makes sense how leptin could play a role in menstrual cycle changes.

If you’re not consuming enough calories or are going too low in carbohydrates to support activity, you could be messing with leptin’s ability to regulate your reproductive hormones.  By going too low in both carbs and calories, you can also send signals to your body indicating that it is under stress. Your body isn’t not prioritizing a baby if it’s worried about its next meal.

Insulin stimulates leptin synthesis, so if you are dramatically cutting your carbs, you are likely further dampening your body’s leptin levels.  This is especially true if you are lean and are eating a low-carbohydrate diet.  Since women who have low body fat stores also have lower leptin levels, this can cause trouble.

What we know from the research is that we have a critical leptin level that is needed to maintain proper female hormone levels and menstruation.  Thus, leptin levels are a sensitive marker of nutritional status in women.  Insulin and glucose are key components of a complex feedback loop between fat stores and the hypothalamic regulators of reproduction.  Meaning, if we are cutting our carbohydrates too low we could be compromising our reproductive systems ability to function at its best.

Another interesting study focusing on the ketogenic diet in adolescents, found that while there was a significant reduction in the number of seizures experienced and a majority of participants lost weight, 45% of the girls reported menstrual problems.  These included amenorrhea and delayed puberty.  A majority of the girls experience return of normal menses after the diet was discontinued.  Yes, this is just one study, but it’s a pretty eye-opening to me.

We’ve talked about the Female Athlete Triad in an earlier post.  Part of the triad is menstrual disturbances (amenorrhea or irregular cycles) and another is low energy availability/intake.  This second part needs some discussion.  What we are seeing is that it low energy availability, rather than inadequate body fatness or exercise stress, being the mechanism by which exercise negatively affects the hypothalamic-pituitary-ovarian axis in females.  Of course if you are super skinny, your chances of having your hormones be in balance is highly unlikely.  What this is saying is that if you are suffering from a lack of calories, regardless of weight, you will face obstacles when it comes to reproducing, feeling your best, not biting someone’s head off during times of the month, and owning it at the gym.

What is so amazing about this point is that it suggests that you don’t have to be stick-skinny to be suffering from hormonal complications.  You may even be overweight, but your body can think you’re starving due to a true caloric deficit or potentially going too low on carbohydrates.  Maybe you think your cycle is fine because you are regularly menstruating every month.  Unfortunately, that is wishful thinking.  While the presence of menstrual bleeding is often used as an indicator of a functioning system, the length of the phases in your cycle and optimal LH/FSH/estrogen/progesterone levels could all be out of whack even WITH a regular period.  If you’re on any kind of hormonal contraception, that regular “bleed” at the end of the month doesn’t even tell you a whole lot about what’s really going on with your hormones.  It’s misleading.

So what’s a good amount of carbohydrates for females?

The answer varies significantly from person to person; however, if you are an active female that is having a poor time recovering for workouts, having issues with your thyroid, having a tough time leaning out even though you are doing “all the right things,” or are having an irregular cycle (pre-menopause), you may want to consider bumping them up to at least 100 grams and see how you do.

I usually recommend about 15-30% of your total calories as carbohydrates, unless you are highly active and/or are dealing with the conditions described above that would warrant going lower.  For females, eating about 2,000 calories/day, this is about 75-150 grams of carbohydrates/day.  75-150 grams/day may seem like a high carbohydrate diet to some of you eating very low-carb, but when compared to a standard American diet of 225-325 grams per day for a 2,000 calorie diet, it’s really not.

For a clean Paleo diet, 100 grams of carbohydrates would be equivalent to eating approximately two large sweet potatoes and 1 cup of blueberries.


In summary:

  • Lower is not always better when it comes to carbohydrates for females.
  • Experimentation and individualizing your diet to your specific needs is key!
  • If you’re a female and you’ve been doing very low carb for an extended period of time, you may find benefit with the health of your thyroid, adrenals, liver, and ovaries by bumping them up a bit.
  • Carb cycling may be a great tool if you’re not ready for a daily increase in carbs.
  • Changes in your cycle may not be related to exercise intensity or body fatness per se, but to inadequate energy intake (including carbohydrates levels) to meet the demands of the exercise.
  • Sleep, toxins, stress levels (both physiologic and psychological), and the health of your thyroid (which can also be negatively affected by a lower carb approach), among a multitude of other factors also play a role in regulating your hormones, so make sure to work with a practitioner to get these things sorted out instead of covering the symptoms with medications and upping your carbohydrate intake alone.




Thong, F.S.L., and Graham, T.E. (1999). Leptin and reproduction: Is it a critical link between adipose tissue, nutrition, and reproduction? Can. J. Appl. Physiol. 24(4): 317-336.

Corr, M., De Souza, M. J., Toombs, R. J., & Williams, N. I. (2011). Circulating leptin concentrations do not distinguish menstrual status in exercising women. Human Reproduction, 26(3), 685-694.

Mady, M. A., Kossoff, E. H., McGregor, A. L., Wheless, J. W., Pyzik, P. L., & Freeman, J. M. (2003). The ketogenic diet: Adolescents can do it, too. Epilepsia, 44(6), 847-851.

Hum. Reprod. (2002) 17 (8): 2043-2048. doi: 10.1093/humrep/17.8.2043



Categories: Athletic Performance, Fertility (PCOS, endometriosis), General, Paleo/Low Carb, Women's Health


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  1. says

    I experienced this myself! I went paleo to try and correct some hormonal imbalances, but then didn’t see results until I upped my carbs (among other things.) I also find I sleep much better when I’m getting around 25-30% of my calories from carbs.

  2. Kim says

    Thank you so much for this post. I think this was made for me. I haven’t had a period in two years (and I’m even on the pill with hopes of getting one). I’m 5’3″, roughly 110lb, and do CrossFit/strength work 5x/week. I typically try to keep carbs in the 20% range, but perhaps I need to rethink my eating.

    • says

      Hi Kim! I hear ya, I’ve personally been there myself and sometimes it takes more than just upping carbs to get your cycle back. It’s definitely a shot, but sometimes it’s the amount of total calories, getting your hormones back in balance, decreasing stress, etc that can make all the difference. I’m happy to help you figure this out if you want to set up a consult: http://robbwolf.com/about/team/stephanie-greunke/ Thanks for the comment!

  3. rs711 says

    Interesting balanced article Stephanie. I’d like to play devils advocate on a few points.

    1. The “thyroid carb” connection has been recycled around the blogosphere for a while now without every convincingly showing PATHOLOGICAL decreases/increases in the various thyroid hormones to my knowledge – Jaminet & other have pointed to ‘changes’ in levels that were far from ‘established pathologies’. However, granted, it is a fair and open question to nonetheless.
    — For example: when people eschew vegetable oils and include more mono and saturated fats in addition to a higher % of fats overall (compared to a SAD diet) their Total Cholesterol levels often go up (& sometimes not!): the Paleosphere is quick to suggest this is a ‘natural adjustment’ (which it most likely is). However, you can see here how we’re not applying to same ‘standard’ when talking about thyroid & cholesterol levels..

    2. Changes in macronutrient ratios also incur a whole host of changes in other variables: micronutrient, salt & water just to name a few. There isn’t much of an argument to be made that total carbs is the factor trumping all others…

    3. Women are unfortunately even more fat phobic than men & when lowering their carbs, often times fail to make up the difference with protein &/or fat (but especially fat)

    This leads to:
    4. Calories. High-fat, Low-Carb is very satiating and people aren’t used to this and are often tempted to reduce their calories to the point where their intake is insufficient for their activity levels or nutrient needs (as you pointed out)

    5. The cortisol thing (directly being linked to carb levels) is sort of a myth. All cortisol is not equal and its use/recycling/isoforms is far more complex than conventionally suggested. A recent and well researched/referenced post discussing this can be found here: http://www.ketotic.org/2014/02/the-ketogenic-diets-effect-on-cortisol.html

    Your point is well taken though, some people (women) definitely need to up their carbs. I would suggest they are in a minority though & that the “it’s not working –>ergo you should up your carbs” advice might not be the best FIRST line approach. I get it – it’s simpler to implement and to consider. But many other variables play in which shouldn’t be seen as 2nd or 3rd order priorities.

  4. rob says

    so you say the purpose isn’t to say which method of carb intake is better and that each person is different, but then you proceed to say that vlc is inherently wrong/bad….

    • says

      I think that there is no right/wrong way that can be stated as a perfect general guideline. For example, not EVERYONE should be low carb or high carb. I’m trying to make the point that carb intake is highly variable are requires some trial and error to get it right. Make sense?

  5. Michelle says

    I went very low carb and ended up eating too much protein, (lean meats, eggs, protein powder, nuts) and I believe that led me to have a kidney stone. With all the information out there it would be good if there was more information on how to balance the foods in the Paleo diet. I do realize everyone is different and needs to adjust accordingly. However, alot of Paleo websites suggest you can eat as much meat and protein as you want because your body will not let you over eat that type of food. I do not believe that to be true and would love to have more information about balancing Paleo foods. I find that I really do need more carbs to feel full along with the good fats!

    • says

      Hi Michelle! Thanks for the comment. I totally agree with you about making sure your plate is balanced. As a general guideline, I typically recommend between 3-6 oz of protein per meal for women and 4-8 oz per meal for men. The amount is variable depending on the individual’s needs/goals, but if you’re having 3 meals a day, this is a good target. No need for 16 oz steaks at each meal (even if it tastes delicious) :) I created a short post about this on my website, http://rockyourhormones.com/easily-create-balanced-meal-rockyourplate/.

      • Michael says

        “I typically recommend between 3-6 oz of protein per meal for women and 4-8 oz per meal for men”

        That’s insane. If I were to eat 8 oz protein 3 times a day, that would be 2700 kcals. Even half that (your lower range) would be totally insane.
        Btw, you say no need for 16 oz steaks. well, a 16 oz steak probably will have less than 4 oz protein. So I would say that under your regimen it would be 16 oz steaks all the way. And then some.

        • says

          How would that be insane? I don’t see your argument? How do you figure a 16 oz steak would have less than 4 oz of protein??

          Each protein source is going to have different amounts of calories and grams of protein. For example, a chicken breast vs a ribeye steak.

          • Father Nature says

            Per cronometer.com

            “Beef, ribeye filet, boneless, separable lean only, trimmed to 0″ fat, select, cooked, grilled –

            Serving: 16 oz.
            Protein: 133.31 g.”

            133.31 g is 4.7 oz.

        • says

          Michael, I think you’re misunderstanding what she means by the weight of protein. For example, a 6oz steak isn’t 6 ounces of pure protein. It’s 6 ounces of steak, by weight, not 6 ounces of isolated protein, where you would multiply the grams in 6 ounces by 4 to get the total calories. Doesn’t work that way. It’s got water, fat, and other “stuff” in it besides protein.

          Kind of like a 3oz chicken breast is just a chicken breast that *weighs* 3oz. It’s not 3oz of straight-up protein.

          • Michael says

            No, I’m not misunderstanding and my calculations are spot on.
            Father Nature above got it! Note that his calculation is based on 0-fat steak. Based on a normal fatty cut of steak that I would buy, a 16 oz steak is indeed less than 4 oz of protein. I stand by my assertions. Perhaps Michelle is using “protein” as shorthand for “meat/fish”.

          • Michael says

            “Perhaps Michelle is using “protein” as shorthand for “meat/fish”.”
            Sorry, I meant Stephanie!
            And read again what Stephanie says: “I typically recommend between 3-6 oz of protein PER MEAL for women and 4-8 oz per meal for men.”
            At the upper end that is 3 x 8 oz protein per day = 24 oz of protein total. Not some cut of meat, no 24 oz of protein. (24 oz = 680 gm X 4 kcal = 2720 kcal.) Now where did I misunderstand?

    • rs711 says

      @Michelle @Stephanie

      See Michelle’s description of her VLC experience:

      “I went very low carb and ended up eating too much protein, (lean meats, eggs, protein powder, nuts)” —> this is a good ‘real life’ example of my points 3 & 4 (fat phobia & concomitant likelihood of insufficient calories, respectively).

      Why not lean & fatty meats?
      Why the protein powder seeing as how the human body can only metabolize so much protein & (as per your description) you seemed to already be getting more than enough?

  6. preguntona says

    When figuring on the carbs one consumes, does this include green veggies or not, i.e., broccoli and spinach? I have heard conflicting reports as to whether those actually count as carbs or not. Thank you!

    • says

      Such a great question! It depends on what your goals are and your individual carb tolerance. For high performing athletes, the green veggies or other non-starchy/high fiber veggies may not cut it for total carb intake. You may need to just focus on the starchier carbs to get you to your needs.

  7. Angie says

    Thank you for the article! I thought I didn’t do my keto right (perhaps ate too much protein) which caused a total hormonal havoc. I’m still not sure what was the real reason. Thinking back my hormones were probably never balanced. After few wonderful first weeks of keto all sort of issues came, just as you listed above. All my existing hormonal troubles multipied. I increased the carbs a few months ago, but I am still not like before keto. I have to admit though that my leptin and insulin got fixed and I my brain worked brilliant on keto, also the killing lower back pain completely vanished and I had some other belefits as well, but the sex hormones and thyroid got out of controll. I do paleo, meditation, moderate amount of workouts, supplements, but I am strugling to lose weight.I keep blaming myself for all little cheats. I wonder sometimes if I will ever be in balance and lose that extra 40 pounds.

    • says

      Please don’t blame yourself for all the little cheats! You can definitely get back in balance, just please be patient. It took me almost a year of dedication to get back on track. I did it all without taking any medications or hormone replacement therapy. I’m not saying that it will take you that long, but just understand that with time and effort, it will all pay off! Keep your head up! I’m happy to help develop a plan for you, if you’d like!

    • says

      Hi Kelli! Nutrient-dense carbohydrate sources such as sweet potatoes, yams, winter squash (butternut, buttercup, acorn), plantains, rutabaga, parsnips, beets, carrots, and pumpkin are great options to start with! Some individuals that are very active may find that they do well with rice in addition to these options, but it’s not for everyone.

  8. Emma says

    Thank you so much for this post! It confirms what I was starting to think myself, I do Crossfit and I was finding that if I didn’t eat around 100g carbs then I was just dragging myself through the workout and feeling dreadful and then not sleeping properly at night to recover. It’s nice to hear it is a “thing” and not just my imagination!

    • Emma says

      Oh, one question I had, I know you mentioned carb cycling, what would your recommendation be for non-workout days? Is carb cycling better or just sticking to around 100g carbs all the time no matter if it is a workout day or not?

      • says

        Glad you liked the article! Honestly, I’ve seen both ways work. I don’t know your specific situation, but if you’re active on consecutive days, multiple days a week (for example, you work out at a moderate level Monday-Friday, I’d try keeping the carbs up during the week and see how you do. If you following more of a 2-3 day a week protocol, you could try carb cycling.

  9. Rachel B says

    Thank you so much for writing this article. Do you see many female patients with acne (particularly “female hormonal acne” that is along the jawline) and cystic acne who benefit from upping their carbs? If you have time, or if anyone else in the comments does, the following is background info for context:

    I’m a 19-yr old female who has dealt with disordered eating years ago, overexercising for a period of time that was over a year ago, I ate vegetarian/vegan for two years until a year ago, eating a looot of soy protein, and I’ve been eating Paleo for a little over a year. I’ve been “Bulletproof Intermittent Fasting” 99% of the time until 12-4pm, eating pretty darn low carb most days, and generally under-eating a bit most days due to daily psychological stress from living at home / other psychological stress. I work out intensely without doing too many sets or reps or exercises for no more than an hour, and only every fourth day to allow for full recovery. And I need every one of those days between workouts to recover. Sometimes I’m not even fully recovered. My sleep most of the time is ok, 8-10h per night most of the time, but my sleep schedule changes frequently because of work.

    I’m seeing an endocrinologist who is still trying to rule out if I have PCOS even though my bloodwork says all my hormones are normal except prolactin which is high (I’m not pregnant). She says it’s weird bc I’m lean, I don’t have facial hair, and I don’t have high levels of androgens so she really doesn’t know what’s going on with me.

    I’ve also seen a dermatologist who says my acne is “severe”. I have a looooooooooot of cystic acne on my cheeks, temples, sides of my mouth, jawline, angles of my jaw, neck, and upper back. On top of that I have whiteheads every now and then, blackheads, and some other weird kind. He just wants to put me on antibiotics, Accutane, or he said I could try uv-phototherapy. The uv-phototherapy is the only one I’d consider.

    If anyone has any ideas or similar experiences to share, I’d really appreciate any thoughts and stories. Thanks.

    • says


      For someone with a history of disordered eating, veganism, and overexercising, I would highly recommend you ditch the fasting and bulletproof coffee. On a cellular level, your body is probably screaming out for rest and proper nutrition.

      Learn to *nourish* your body instead of starving and stressing it.

    • Cherie N says

      Hi Rachel,

      Interesting, I also have high prolactin, and am taking cabergoline for it. I have a tiny tumor on my pituitary gland, this is a common cause of high prolactin. I also happened to have bad acne at your age (I’m 42 yo now), and took two rounds of Accutane to clear it up.

      I also have Hashimotos hypothyroidism, diagnosed mid-thirties.

      I used to do a lot of mid to long distance running and cycling, through high school all the way until my thirties. In my late thirties, I started Crossfit, and have had much better success in maintaining my weight and metabolism with Crossfit.

      I was thin until college when I gained a few pounds, tried to lose it by eating low fat (and high in processed carbs, bread, sugar – terrible idea, especially for me!!!), and that was when my metabolic problems began.

      I really struggled with my weight for over 10 years, but now I’m slim again with no struggle, unless and until I start eating like everyone else again (bread, pasta, sugar, all that crap). Eating paleo or mostly whole foods makes a big difference for me. I’m also gluten sensitive, which is common in people with Hashimotos.

      I don’t know how it all connects, but thought my story might be interesting and possibly helpful to you. Good luck! :)

    • Laurie Schaeffer says

      I was diagnosed years ago with PCOS. I didn’t understand it at all. I’m 45 now and I am just starting to figure it out. Cutting out diary and sugar have made the world of difference with respect to my hormones, moods, acne, excess hair, body temp. energy. Caffine not so nice either. Also, less intense exercise, like walking, kettlebells, heavy weights and body weight exercises(pull ups, chinups, pushups,). Avoid excess stress and sleep well. Hope this helps:)
      Laurie, Canada
      ps.I naturally got pregnant with two amazing boys.

    • says

      I can definitely see where Rachel is coming from and can understand her frustrations. I also come from a background of eating disorders, vegan diet, and am currently following a ketogenic diet. I got out of ketosis and am in the transition back into it so I’m going through the awful middle ground phase. When I was previously on it, I did notice weight loss much easier than any other “diet” I’ve been on before. However, the jawline acne is like I’ve never had. I’ve always had clear skin so now that I’m breaking out on my jaw and severely on my back tells me that my hormones are way out of whack. I don’t know if this is a sign that toxins are coming out, but I feel I’m passed the time frame that that should be occuring. I follow a ketogenic diet not just because I’m looking for weight loss, but it gives me structure and guidelines that give me simplicity to making food choices. Like I mentioned, coming from a disordered eating background, this kind of approach helps me with my recovery. Anyone know any answers to the jawline acne?

  10. Catherine says

    I wish you’d written this post 18 months ago… You would have saved me 6 months of misery! I am so happy someone is FINALLY addressing this.

    Honestly, I think you can go much higher than 30% of kcals from carbs, especially as a lifter. Just my 2 cents!

  11. Liza says

    I’m still struggling with finding the right balance of carbs for me. Typically, when I track my food, I eat roughly 30% carbs, 50% fat, 20% protein without even trying or thinking about it. I was diagnosed with celiac 4 years ago. And I have been on a steady gain ever since (30 lbs.). I am 51 and going through menopause. I try low carb, I gain. I up my carbs, I gain. The only time I was able to lose any weight was when I worked with a holistic nutrition coach. She had me on strict autoimmune paleo, no eggs, dairy, grains, nuts/seeds, nightshades, sugar (with the exception of fruit). I lost a whopping 3 lbs. in a month. Then it all went to hell after I broke my thumb and couldn’t hold a knife properly for food prep. I have an active job where I’m on my feet all day, lifting, walking, climbing ladders, squatting, etc. And I try to get to the gym 3 days a week. But I also find that my recovery takes longer. If I lift heavy on Monday, sometimes I’m shot until Thursday. So many weeks I can only manage 1-2 days. I know I will not see any strength gains at that rate. I’m at my wits end with this. I wish someone could tell me exactly what I need to do to see some weight (fat) loss.

  12. OzPaleoFemme says

    Have been on pill for over a decade, without problems. After going very low carb, started getting spotting which would last for a couple of weeks. very weird. Then reintroduced rice, and eating more sweet potatoes and spotting has stopped. Yay! Thanks for the post, totally agree, from personal experience going higher carb has restored my hormonal balance. I don’t weigh the rice, just eat as much as I feel like. I love rice and rice products so what a bonus!

  13. CV says

    Thank you so much for this article. It really got me thinking. I have SIBO so naturally I keep my carb intake lowish but I do consume sweet potatoes and winter squashes post my weight and hiit workouts. I have been struggling with losing some stubborn body fat even after doing “everything right.” I am on birth control and have a regular “bleed” at the end of the month but just this past month I started spotting which has never happened in the 2 years I’ve been on birth control. Would increasing my carb intake help? Thanks again for this informative article.

  14. says

    Fantastic post, I see this problem regularly in female CrossFitters. Today I learned that males may be able to tolerate lower carb diets due to an increase in urate, when testosterone levels increase at puberty an don.
    Anyone notice that very low carb diets were all designed and promoted by males?

    • says

      YES, thank you for pointing that out, where are the female LCHF experts! I have regained a lot of the 4 sizes I lost when I first went paleo/low carb and the only way to recover it is to go very LCHF – after three tries in two years I know for sure, each time go LCHF (not even keto), my cycle and sleep get completely messed up and it takes months of going back to more carbs to get levelled out again. I’m soooo disappointed this is not addressed by any LCHF experts.

      • Jeanne says

        Maria Emmerich would be the perfect person to answer some of these questions.! Marianutrition.com

        She only advocates a LCHF diet, and has since 2010.

  15. Meggrz says

    Goodness, what great timing. I’m almost a year Paleo, and I’m three weeks into trying low carb (<50g/day) hoping to kick those last few stubborn pounds. I also Crossfit, rock climb, and dance salsa.

    And this week I just experienced the worst PMS in my life. I have never had such bad cramps, for days, and the acne was as bad as when I was a HotPocket-addicted 14-year old. (And my skin's been clear since I started Paleo…) My calorie content has been pretty constant, so I was a little stumped.

    Maybe I'll start by logging a few weeks of carb counts at my "normal" eating habit, and dial it back 10 or 15g a week…

    I guess after starting Paleo with Whole30, my expectations of dietary changes are overly immediate and strict…

    Thanks so much for the insight!

  16. MichelleC says

    What a great article – thanks for venturing into this touchy topic. I’m continuing to experiment a correct amount of carbs for myself. So what if you are PCOS, insulin resistant, and don’t and haven’t had a natural period in a year? more or less?

  17. says

    Really, really good post. So refreshing reading articles that don’t use the one-size-fits-all approach. What works for me, might not work best for you – and vice versa. It takes some trial and error to find a permanent solution for each individual. But once you figure it out, no worries about too many carbs, too few carbs, counting calories, etc.

    Thanks for the great info!

  18. says

    This is a great article. It’s going to help a lot of people.

    I’d like to share my personal experience because I think it so closely mirrors this, and I want to share how I started adding carbs back in because I think the thought of that can be very scary for those people who have been VLC for a long time.

    Several years ago, I’d been pretty low carb for a long time. There came a point where I was unemployed, living at home (with parents), and other than applying for jobs, I had little else to do but work out. So I did. *A lot.* I was working out with high intensity *and* high frequency. I’m not sure of the exact numbers, but I was definitely <50g/day of carbs and it was all from LC veggies (no grain, no potatoes, no starch etc.). I started feeling pretty awful…sluggish, tired, depressed, and was gaining body fat. I had to force myself to go to the gym…it was a chore and I felt like I was actually getting weaker/losing strength in addition to getting pudgier. I was at my wit's end. I asked someone whose sensibility and physique I'd long admired on a forum and trusted her to give me some advice. She told me to eat more carbs. I was downright terrified to add some back in because I’d been low-carb for so long and it was what had gotten me in the best shape of my life (so far). So I was very scared to rock that boat. But I was logical enough to acknowledge that it just wasn’t working so well anymore and maybe I could muster the courage to introduce a few more carbs.

    So I did. And you know what? It was like someone flipped a switch. I felt better in about 2 days. Better physical energy and pep in my step, but even more, what was like night and day was my MOOD. My mental outlook. SO much better. At first, I just added more LC veggies because I was too scared to have something starchier. (So lots more red peppers, broccoli, bigger salads, etc.) But I gradually added in fruit (just 1/2 a piece at first…like half an apple with a protein shake post-workout, or a small plum) and even oatmeal once in a while, and not only did I not gain weight, but I started losing again and was doing well at the gym.

    I think it helped that I limited the fruit and starchier items to just after a tough workout. In other words, I didn't wake up and have a pear or potatoes with breakfast. I had them within an hour of a good workout, when my body was best "metabolically primed" to handle the carbohydrate and not make me crave more all day long. (Glycogen depleted and muscles hungry for carbs and amino acids. So I think it helped to have the carbs and protein together as well.)

    Over time, I’ve been able to add small amounts of carbs in at other times of day, but for people who are, like I was, “afraid” to add the starchier foods, maybe easing into it and keeping them (at first) to after a good workout is a gentle way to up the carbs. Probably wouldn’t hurt to just cram half a sweet potato down at *any* time for someone who’s overtraining and fatigued, but if someone’s genuinely too scared to hit the ground running that way, I think adding carbs back in timed strategically around certain metabolic windows can help.

    And thank you, Stephanie, for emphasizing the need to *individualize* all this. More carbs can be a godsend for some people, but it’s not appropriate for everyone. People seem to miss this key, key point every time something new comes along. Fasting! Ketogenic diet! Safe starch! People want to jump head-first onto whatever bandwagon rolls down the road next without understanding whether or not it’s appropriate for *their* body, *their* health history, and their goals.

    I’d like to recommend a book that I very seldom hear talked about in Paleo circles. It’s probably one of the BEST books I’ve read that talks about darn near everything – diet, sleep, stress, hormones, sunlight, overtraining, carb cycling – the author’s program for diet & carb cycling worked like friggin’ magic for me. Natural Hormonal Enhancement, by Rob Faigin. He was way ahead of his time. His book came out before almost all the popular Paleo-oriented books of the last few years.

  19. Chelsea says

    Wish this was posted two years ago when I got myself into the hormonal nonsense.
    How long does it take for a cycle to come back after increasing carbs?

    • ch says

      its not really “low carb” when she is gorging on “junk carbs” every 2-3 days now is it. and i dont see how you think that is a positive thing…

      • says

        She was actually low carb for a long time, but started to crave and consequently eat carby foods. But being gluten sensitive that backfired too. but I get your point. I’ve seen a number of paleo low carbing women who just eat lots of nuts instead of crap carbs. As soon as root veg carbs are added back in and the nuts reduced the problems dissapear – both with cravings for crap carbs and food in general

  20. Jessica says

    This is interesting to me. What do you consider highly active though. Compared to some of the athletes that my trainer coaches I’m not super active, but am I comparing myself to the wrong group? I Dragon Boat 2 hours a week, indoor rowing 1 hour a week, lift 2-3 days a week(not Crossfit), and Duathlon training 3 days a week. I do take days off and have a non-athletic full time job (which involves some night shifts). My weight has been stagnant for months even though I know that I have more fat to lose. I gave up fruit over a year ago because it just feeds my desire for baked goods too much, but eat sweet potatoes and larabars occasionally.

  21. jess says

    I’d just like to add to those ladies seeing ‘spotting’ please also go & get a smear test or see your gynae. Not to scare you but this is a possible symptom of cervical cancer& better safe than sorry, I’ve had it and a smear test saved my life. Thanks ladies!

  22. Dawn says

    I am finding this all very fascinating, I have a problem I have not seen addressed yet. I have been Paleo for about 9 months now. I have gradually being going more low carb as most people do without realizing it, but I have not had any symptoms of going too low carb. I’ve recently begun tacking them and I get somewhere between 25 – 35g per day on a regular basis. I went in for a physical a few weeks ago and my labs showed that my glucose and insulin reactivity were in the danger zone! My doctor tested my body fat% which is 14.1. I am a classical Pilates instructor so I am quite toned, but I do not do regular cardio. (Although my treadmill test came back perfect) So my question is could this be related to a hormonal imbalance caused by low carbs even though I do not experience any other symptoms?

  23. Callum says

    Hi Stephanie,

    Have you read any of Dr Bernardot’s work? (Advance Sports Nutrition 2nd Edition is his main one).

    As an active male (70kg, fat percentage at ~7-10%), I expect my carb levels to be quite higher than a female. Going on Dr Bernardot’s recommendations for carbohydrate consumption – for a 3100 calorie plan to support my level of activity (as a enthusiast gymnist who is in the military) the recommendation is for 350g – 490g of carbohydrate with 105 – 120g protein and the remainder of calories in fat. This is significantly higher than what you advocate above (noting the gender difference) – I was just wondering your thoughts (however brief 😀 )?

  24. RW says

    This crashed on me like a load of bricks. I’ve been eating keto and a lot of health benefits came with it. Better skin, my period that was missing for five months due to stress finally came back, Im getting in better shape etc. However, something was just not right. I got down to pretty much zero carb, under 20 every day if that even. Part of it was Im struggling with money so I was buying the bare basics to survive: i.e meat, eggs, butter and living on that. I’ve noticed lately that I am not sleeping well, feel irritable and stressed. Also pretty sure I have adrenal problems so I was really doing myself in with the zero carb. So glad I found this!

  25. says

    I’m glad I stumbled on this. I’ve been paleo for about a year and a half, but noticed some changes back in October. I’ve had changes in my period, and I haven’t had a “real” one in three months. It’s just been some spotting here and there every 30 days or so. I’ve also had some terrible acne appear out of nowhere, consistently on my chin in painful lumps. I’ve tried a Paleo-AIP diet, which turned out to be very very low carb, and the past few months I’ve been under a lot of stress at work and in school. I started CrossFit back in October, and I’m wondering now if my body is starving a little. I eat a ton of fat and protein, so I don’t often feel very hungry. I was thin when I started paleo, and at 5’6″ I hover around 115 pounds. I’ve had painful ovarian cysts in the past, but I have never been diagnosed with PCOS. I have taken birth control in the past for the cysts, but haven’t been on it for about three years, as it seemed to help the cysts but make me feel bad in general. I have my annual exam coming up next month, and I am nervous to explain about my nonexistent periods, thinking the doc will again recommend the Pill. I’m going to up my carb intake to see if that helps.

    • Becca says

      Emily I beg you to do anything you can to avoid being put back on the pill. I was on it for 20 years and it has completely screwed my hormones and libido. Avoid it at all costs. Doctors often use it as an easy solution. (In my case, painful periods.) If I had known at 18 what I do now, I would NEVER go on it.

  26. says

    Thanks so a great article Stephanie!! We have both been eating paleo for 2 years. We have gone through high carb to low carb and now back to introducing more carbs!! It’s crazy once you cut all the other crap out how you are so much more aware of what your body needs. Eating to nourish based on paleo principals is how we roll now!! Thanks again.

  27. Tracy Lynn says

    So weird that this was sent to me just now. I have been doing ketogenic for about 3 months now to help heal my gut. The first month I felt amazing. I was smashing it at the gym and my appetite was completely satiated due to the heavy fat loading. But my eczema not only didn’t get better,not got worse. And to add to that my thyroid meds just got bumped up. I love the paleo lifestyle. I prefer gluten and grain free and I love my fats. But in ketogenic dieting your carbs no higher than 10%. Truly it’s impractical. Also I started to gain weight, I’m cranky, my skin is out of whack, and I skipped my cycle….which was something that happened years ago when I used to run. Put simply, I feel awful. Drained.

    I started this so I could heal my adrenals, thyroid, and gut. But I’m seeing now that once again I’ve gone into the direction of imbalance. Im grateful for this article as it proves to me that I am an individual with individual needs that need more laying attention to. Even before going keto I followed a very low carb diet….generally no more than 75 grams a day…and I workout a lot. I think adding in the sweet lots toes and berries is where it’s at for me….but it’s interesting how all of the sudden there is a fear behind that.

  28. Jane Wallace says

    I like how you emphasize “what works for some, won’t work for others?”. I have friends who went Paleo all of a sudden without even consulting a nutritionist or a dietician. Thank you for this article, this will serve as my guideline. I’ll share this with my friends.

  29. Rachel E says

    Interesting article and definitely something I’ll have to give some thought to.

    I’ve been keto/paleo for 9 years. Successfully lost 185lbs but I hit a wall and have been unable to lose my last 50lbs for well over a year now. I might occasionally drop 5lbs but it comes right back. I had such an easy time losing the 185 that even the thought of upping my carbs almost sent me into a full blown anxiety attack. Where does one begin with trying to increase carbohydrate intake when you’ve programmed to exist on less that 20g net per day? I keep tracking and counting and blaming my failure on that 5th bite of broccoli or the tomatoes I grabbed on my lunch break. I used to work out daily and for the last 16 months it’s all I can do to function. I’m exhausted and weak and no longer have a fraction of the energy that I had the previous 8 years.

  30. Elee says

    Hi, I’m hoping this post is still active and you may be able to give me some guidance. I’ve been out of training for 2 months letting a broken rib heal. In that time I’ve just been running and eating low carb (20-30g) high protein to lose weight. I have been doing well with this but now am starting back into training (9 sessions over 6 days a week (high intensity dragon boating, free weights, running) and want to find a way to keep losing weight (I have another 5-7kg to drop) whilst keeping energy up for workouts. My conflicts come in that I have PCOS so even looking at carbs adds a couple of kg to me, and it’s not all about measurements – the kgs have to drop to keep our boats balanced. How can I start adding carbs without piling on weight…is there a best time to eat them to fuel a workout? Or a minimum amount I should be having to fuel the 1.5hr water or weights sessions? I need to find a way to be able to lose fat, build muscle, and lose kgs….

  31. Cale says

    I was wondering if whenever the carb count came up, you meant carbs – fiber or just total carbs consumed? I’m 15, approx. 108lbs, female, right now I crossfit 6x per week, olympic lift 2x, yoga 2x, with one day of total rest. My carbs are around 100-115 per day, but minus fiber they come out to around 30-55 net. Performance is great, soreness isn’t an issue, strength is constantly increasing, but sleep could be a lot better. I’ve been 80/20 paleo for more or less a year now, and lost my cycle a couple of months before that. Would adding in white rice/more sweet potatoes/yuca/taro etc.. be a good idea for both hormonal health and performance? Thanks in advance!

    • says

      I wouldn’t really count carbohydrate from non-starchy vegetables.
      You could definitely add in more starchy carbs and try it out and see if it helps. I would definitely figure out why you lost your cycle and work on getting it back.
      IF you’re doing crossfit 6x per week, make sure you’re not overdoing it and not constantly beating the piss out of yourself. I don’t know what you’re doing, but just say that because I see people do it all the time and run into trouble.

  32. says

    I had really bad cystic acne my entire life…I even did 2 rounds of accutane…all my dr.”s said it wasn’t diet related…my jawline and my cheeks were especially bad. I was able to completely clear my skin by giving up ALL CHEESE, I still eat grass fed butter and eggs, and also by taking a higher dose probiotic. My skin is great now! and once in a blue moon I can have some cheese but only if its imported from Europe ..NOT any cheese made in the states even if its organic I immediately will get a cyst on my face. Good Luck.

  33. CJ says

    excellent post. I feel like this article was written about me. I started Paleo about 3 years ago at the same time I started CrossFit and found immediate success (lost weight, body fat, ran faster, lifted more, etc.). I of course attributed my success to the low carb aspect of eating paleo. About 1.5 years in I found myself wrought with sleep issues, hormone problems and very bad anxiety. I chose to up my workouts and go even lower carb to try to lost more body fat. After being sick for 5 months straight with sinus issues I finally decided to up my carbs. By only upping slightly (from <50 to about 75g) showed incredible results. Ove the past year I have gradually accepted that my body just needs more carbs to function and as I've (very hesitantly) added them back in my sleep, hormonal and anxiety issues have all but disappeared. I still eat about 85% paleo w/ added ezekiel bread, real potatoes, and oats a few times a week and have never felt better. I hope this post reaches people like me so they can save themselves from the scare that I had. Thank you and keep up the good work!

  34. xkandakex says

    I know this article is a few months old, but I just wanted to point out that monthly menstruation in humans is NOT normal, nor is it a marker of hormonal stability or physical health. It’s amazing what modern, Western women believe is “normal functionality” for their bodies. If not for my obsession with research, I too would still believe the CW view on female fertility, my own included. I personally follow a ketogenic diet with 10% carbohydrate, and I have gone from very heavy, painful, two week long monthly periods starting at age 10 (yes, ten years old – that’s not a typo, and I am currently 29) to extremely light, painless, three day long bloat-free periods about every eight to nine weeks. I have been examined by an endocrinologist as well as two different gynecologists and it is of their opinions that I am in good health.

    Here is a Newsweek article that mentions how modern women have FOUR TIMES AS MANY CYCLES as hunter-gatherer women (with source):

    This article describes in detail the development of artificial hormone regulation for contraceptives, and how a young anthropologist studied a semi-agricultural African tribe (the Dogon) and revealed how incredibly different their menstrual cycles were compared to American women’s cycles, ultimately questioning the need for – and indeed the safety of – such medications:

    And how about menstruation and rates of disease? Well those Dogon women who only have 100 cycles in their entire lifetimes only have 10% of the risk of breast cancer as American women AND their average life span is similar to
    North American women:

    This excellent contemporary textbook on reproduction talks about the “Estrogen Epidemic” in first world societies and how detrimental it has been to women’s health, especially since Western women are fertile for so much longer that they should be:
    http://books.google.com/books?id=M4kEdSnS-pkC&pg=PR11&dq=Human+Reproductive+Biology+By+Richard+E.+Jones,+Kristin+H.+Lopez&hl=en&sa=X&ei=P4XJU_utO8mHyAS104Bo&ved=0CCcQ6AEwAA#v=onepage&q&f=false [See pg. 44]

    I also found this small study on fertility rates in different types of subsistence societies, comparing hunter-gatherers to agriculturalists. Their results are very interesting, showing that agrarian woman are 1.0 points higher in fertility cycles than hunter gatherer women…and the fact that population growth for homo Sapiens was nearly zero until the advent of agriculture.

    While better fertility might seem like a good thing, let’s not forget that now there are 7 billion of us, and it’s getting harder to feed the populous with each new generation. Starvation, pollution, overcrowding, elimination of natural resources…the imbalance of having so many of us on Earth is apparent.

    So ladies, don’t use regularity as evidence of bad or good health. Get examined by an endocrinologist if you’re concerned about hormone balance and non-monthly cycles. The results might surprise you. But most importantly is the n=1 factor: some women DO need more carbs to feel their best. For me that is not the case, but for others it certainly is. Do what makes you feel good!

  35. R. Meibaum says

    Very informative article, and just what I needed to read at this point in time. I am just starting on a Paleo/low carb adventure, in an effort to get rid of psoriasis and it’s accompanying myriad of symptoms, as well as candida overgrowth. I originally researched the GAPS diet and thought it the best cure for me, but decided against it when I learned that all focus is on drastically reducing carb intake, which would be impossible once I start working out again. Paleo seems the healthier route. I’m so glad to have come across this article before making any detrimental diet mistakes.

  36. Andrea says

    Thank you so much for the article! Very informative.

    I have missed my cycle for the last 9 months and have had trouble recovering from workouts. However, the ‘low carb’ diet referenced in the article is considered consuming under 100 carbs daily. On average, I consume about 150 carbs. I also limit my caloric intake to ~1,450 calories and try to at least consume 140 g of protein.

    I exercise (what I like to think is strenuous) 5-6 days per week, alternating between cardio and weights.

    I’m curious as to what your thoughts are as to what the issue could be. I have been on the diet for almost a year now and had my hormone level tested recently in a blood test (all was normal). Would a blood test pick up on low leptin levels?

    I am concerned with my cycle and would love your input!

    Thank you!

  37. gogi says

    I am experiencing this right now! I have been eating very low carb (~15g) until recently and at first I felt great because I had candida overgrowth and allergies… The ketogenic diet did wonders for me (occasionally I did refeeds)! But about 3 month ago I started feeling worse – poor sleep, fatigue, I was not recovering from training, low progesterone, irregular periods… So I have increased my carb intake to 50g on non training days and 120g on training days and I started recovering better immediately and progesterone is back to normal (which is great) but on some days I feel dizzy and lightheaded – I just cannot figure out what it is…I was expecting to feel dizzy when I started the ketogenic diet but I actually felt great immediately… Now I am confused and not sure if I am doing the right thing… Maybe someone could give me some advice :)? Thanx and great article!

  38. Kate says

    I’ve been able to find info about breastfeeding and Paleo and PCOS and paleo. Generally breastfeeding = eat more carbs and pcos symptom management = eat less carbs. What about breastfeeding with PCOS? I want to eat enough carbs that I’m not compromising milk supply in any way and giving my baby as much as he needs, but I don’t want the extra carbs to affect my pcos in a negative way. Eating low carb is how I got pregnant with pcos. But the main pcos symptoms that affect me apart from infertility are depression and insomnia, not things I want to try and deal with while taking care of a newborn. Can anyone point me in the right direction for figuring this one out? Thanks!

  39. Diana says

    Holy crap, could starch really cure me? I’ve been low carb for over 11 years and for the last 5 I’ve been struggling with thyroid and adrenal issues. I have had ammenoreah this whole time and also suffer depression and severe anxiety. After switching to Paleo 4 years ago I felt so much better for a few months but the adrenal symptoms returned. I’ve overused stimulants to give me “energy” and keep the weight off and often overeat on large amounts of non-starchy veggies just to keep my from not being hypoglycemic. I’ve slowly added starch in the last 2 years but still only about 30g on workout days only. I can’t believe this whole time I thought starch was enemy. After reading numerous blog posts I can see the light. Can I really be “normal” and feel good again? I hope so. While the news that I may actually get my life back is relieving, it is scary at the same time. I thought I had this whole food thing figured out. Back to the drawing board I suppose. Thanks for sharing this blog post. I’d love to hear more on your show about other women’s experiences.

  40. Rayca says

    I think it’s important to point out that the number of carbs that women need to consume is not really a wavy line. That is, hormones thrive at about 120g daily. I think it’s misleading to target a % of calories when one doesn’t know how many calories we’re talking about and what that calculation of carb will result in. It may be a little high for some gals and a little low for others. But going below that amount is decreasing hormone(s) production, in some way. Now having said that, those of us that are overweight and/or insulin resistant, etc. need to make a decision. What will I be jeopardizing by allowing my carbs to go to say 60-75g? I don’t think it’s wise to be doing marathons, lifting weights 7d a wk., etc. on a low-carb diet. Carbs can also be manipulated and still hit your target (as suggested) but proper hormone balance is not negotiable. It takes a certain amount eaten daily, during child-bearing years, no matter how big/small/fat/skinny you are. Same with calories but ah, I digress. That discussion would be for another post.

  41. melisa says

    Hello . . can spotting in between my period be a bad sign ? . . I’m taking a new protein shake, I’ve been taking it for a month already and this had never happened to me, and i was wondering if it was because of my new weight gainer shake i am 23 years old and 5’3 tall n i weight 108 I’m kind of scared please help

    • Tanja says

      I know this is an older post… but i would suggest a pregnancy test. This could have easily been “implantation spotting”… the spotting that occurs when a fertilized ovum implants on the uterine wall.

      No shake is going to make you spot mid-cycle.

  42. Karen says

    I began the Paleo diet three years ago (January 2012). November of 2013 I started having problems I’ve never had in my life. I developed fibroids, massive ovarian cysts, and irregular cycles. I truly attribute these changes to relinquishing foods that a females body needs. I’ve since then started incorporating carbs into my diet and my cycles seem “more” normal than before. I don’t think Paleo is great for females AT ALL!!

    • says

      Keep in mind that paleo isn’t necessarily low carb. There are lots of paleo friendly carbs: sweet potatoes, yams, winter squash, taro, cassava/yucca, plantain, fruit, etc.

  43. Kaitlyn says

    I’m not sure what to think of this. I’ve been on the Keto WOE for 4 or 5 weeks, and while it intuitively seems to ‘fit’, I’ve noticed strange mood issues within the past several days. Not to mention, I seem to be gaining fat, even though my macros are in check and I’m not overfeeding. I began intermittent fasting a couple of days ago in a desperate effort to shift these stubborn 10 pounds.

    What concerns me is how few success stories I can find of women on keto. I define success as achieving one’s weight loss goals, in addition to the nebulous “feeling better”. (So to me, if someone remains 20-40 lbs from a realistic goal weight, something’s not working.) I came to this way of eating to cure my carb addiction and get to my goal weight and remain there. But it feels like my body is fighting me. I don’t even know how it’s hanging on to extra weight when I’m supposedly in “fat-burning mode”. 5′ 5″, 129 lbs, 1200-1800 calories/day, <20 carbs/day, moderate protein, high fat. I never cheat. Ever. I eat eggs, cheese, butter, sour cream, cream cheese, ground beef, fatty cuts of chicken, coconut oil, spinach, and truvia. Mainly eggs, (cream) cheese, spinach and truvia. I've tried heavy cream a few times, but it seems to stall me even more.

    I feel happiest and look best at around 122, and I'll do whatever it takes to get there. My research led me to believe that once in "fat-burning mode", the body will chow down on body fat with gusto, but that's just not happening.

    Like other commenters, I'm terrified at the thought of adding back carbs, however healthy, with the subsequent weight gain and being thrown out of ketosis. But this doesn't seem to be working, and I feel frustration setting in. I'm going for a run tomorrow morning, hoping to kick-start my metabolism again.

    Thanks for reading; hopefully someone's got some answers. :)

    P.S.: On a side point, keto gave me the least-problematic period ever. For that alone, I'd hate to go back to carbs.

    • Rachelle says

      1800 calories seems pretty high to be trying to lose weight, but maybe not. Even if you’re eating Keto, you can still consume too many calories for your body to consume.

      I had been on strict 1100 calories or less, tracking everything by MyFitnessPal. For 3 weeks, I wasn’t really losing much, and couldn’t figure it out. I did lose a little, about 3 pounds in 3 weeks. Good, but not what I was looking for.

      I’m 5’1, 150 when I started. I ranted on FB about how this was possible, to be eating 1200 calories/day of whole healthy food, and not losing weight, and out of 43 responses, i found gold: My carbs were too high.

      I was eating around 105-110 carbs/day, protein was about 65 and fat was about 50g.

      I did a lot of research, and switched to 20% carbs, 50-60% fat, 25-30% protein, and that did the trick!

      In about 5 days, I lost over 2 pounds of fat once I switched to that. Measuring inches, I lost over 6 inches – waist, calves, butt, bust, arms, and clothes are fitting better.

      the % breaks down to 60g. fat, 55 g. carbs, and 85-90g protein. In MyFitnessPal, in the Goals section, you can customize the % for the macros and it will tell you how many grams. I drink about 8-10 glasses of water/day.

      My husband (triathlete) told me that sometimes the body just holds on to fat then suddenly lets it go. the key is to get our body to burn the fat instead of the carbs, AND not eating too many calories. You might try these percentages, and reduce your caloric intake to 1300 and see how you feel. Be sure and use a tape measure to measure calves, individual thighs, butt, bellybutton, true waist, bust, and upper arms, and weight. I put them in a vertical column, and measure weekly so it’s easy to compare.

      I also use a good probiotic to help aid digestion in the gut, and take Mannatech Omega 3 with Vitamin D3. If you would like to see my food journal for recipe ideas, let me know.

      Honestly, I am really, really full with this method of eating. Sometimes I can’t get 1100 calories/day!

      Everything I eat is real, whole food. I haven’t had a problem with my periods/cycles at this point, and I do 20-30 minutes workouts 3 times/week.

      There are some ideas out there of carb cycling, but I’m not sure it would totally work with keto, but you might look into it. Look up Shaun Hadsall online. If I plateau with Keto, I will probably follow that plan, he has a great video on balancing hormones, keeping metabolism balanced, and burning fat.

      One other thing I learned – stubborn fat cells have more alpha receptors than beta receptors, and the alpha ones are related to stubborn fat….it’s all about blood flow. The more blood flow that we can generate in the area of stubborn fat, the more easily our body can begin to utilize that more stubborn fat. Look up info on that, too.

      For me, I find that if I go over 20% carbs in a meal, my ketone levels drop, so for now, I’m sticking with Keto.

      BTW, have you bought Ketone sticks from the pharmacy? I got 50 for $10 at RiteAid. Instant gratification to see the stick turning purple! That might help you see if you’re even IN ketosis for sure.

      Still learning about all this, but I am really happy to be losing fat I’ve never been able to lose before.

      This article doesn’t address a ketogenic diet, which I think allows for more carbs than Paleo, and it also doesn’t talk about ketosis.

      Make minor adjustments, drink 8-10 glasses 8oz water/day, and reduce your calories a little. You will get there!!!!!! This is a lifestyle change, not just fat loss.

      • Steph says

        At 1200 calories a day, you were downregulating your metabolism and also not eating enough protein. That’s why it was hard to lose the weight. I am actually cringing that you recommend someone ELSE be in that huge of a caloric deficit, too. Dangerous.

  44. says

    I have been on atkins for just over a month and taking 20g of carbs a day. My periods are every week at the moment. Ive been to my gp and im having a scan just to make sure. How many grams a day would settle this down and I will still loose weight. Also what kind of carbs should I add. Please help im at my wits end

  45. Rachelle says

    Actually, I just realized that the author was advocating keto at 50g or less/day, so I totally agree, it’s been the magic formula for me!

  46. Salina says

    Thank you so much for this article. This happened to me. I was low-carb for a long period while hitting the weights at high intensity regularly. My weight and performance stalled so I went keto for an extended time which worked in the beginning but then I started gaining weight, my energy level plummeted and my skin completely dried out. I was so scared and did not know where to go. I researched and saw that I may need to up my carbs. You would not believe the trepidation and fear I experienced the first time I went back to eating a banana – all the carbs! I have to say I do feel better after adding back all the carbs but haven’t found the ratios that work for me yet so haven’t experience the weight loss. I still feel great eating real food though… Hopefully I will find my happy micronutrient ratio and heal whatever metabolic damage I may have done. I’m 26% BF and need help!

  47. Chase says

    My significant other is female, 21, fairly sedentary, and needs to lose weight. She’s been doing ketogenic stuff for several months, and has solved a lot of problems for herself: mood swings, she’s getting leaner (lost about 20lbs of fat), and she doesn’t have insane sugar cravings anymore. However, she’s semi-plateau-ing weight wise. I know this doesn’t mean she isn’t burning fat, but her progress definitely seems to be slowing down. Not to mention, she has all of the classic ketogenic associated hormonal issues: no sex drive, completely RANDOM menstrual cycle, bleeding while not menstruating etc.

    If she still needs to lose maybe 20 more pounds to be at her target weight, should she still take this advice and go above the 20 carb keto limit?

  48. says

    Sometimes it’s about coming to terms with the fact your body may need to be ‘bigger’ than you would like. I have had one period in 18 months, since coming off the pill. My hormones were apparently normal levels from my bloods (although I do not trust UK GP’s one bit – I don’t know what they actually look at) and my ultrasounds came back clear. The only advice I was given was to start taking the pill again. When I increase my carbs I do gain weight, and I have to get my head around the fact this needs to happen. I have a very active job which also needs to be considered. That said, I have definitely been eating around the 100g+ mark for a while now and still am not seeing anything. And my sex drive is non-existent, to add insult to injury. How long do I wait before I seek advice elsewhere? What else could it be?

  49. Rachel says

    Really interesting article, thank you. I’ve been on a low carb routine for the last 6 months, it started as a diet to lose a few pounds but as it progressed I enjoyed eating lighter foods and stuck to it. I wasn’t eliminating all carbs, but I was probably only eating small amounts once a day if that. Not enough. And I started exercising more, for the pleasure of it. All of a sudden, within a couple of weeks I had pretty bad anxiety and low mood, low energy and I started to feel ill. I can’t handle alcohol anymore either! Not even one beer. And then my hormone cycle just went crazy, three periods in a month, and I felt just terrible. Well, yesterday I’d had enough, I bought good quality carbs like dark rye bread. Since yesterday I’ve been feeding myself up with plenty of it, I feel much better today! I’m shocked at how bad it had become. I hope my hormones and cycle return to normal after rebalancing my diet, if they don’t I’ll go to the doctor. It’s made me realise how important carbs are, the right kind, in moderation…

  50. Michael Tran says

    Hi Stephanie!

    Wow, you’re really smart and I admire your prose. It’s great to see someone make great use of the English language! (Sorry about the weird fetish—I’m an English Major.)

    Thank you so much for diving into that scientific literature and babble. I was wondering, did you find anything on men? I guess the same fight or flight stimulation/sympathetic response could be potiential for men but estradiols and progesterones are more fat dependent hormones. I was a triathlete and took a year off of training due to the dreaded and common “life” and I’ve reintroduced a ketogenic diet into my life once again. Everything’s great! Tons of energy, super recovery, great sleep and if I need to wake up early and cut the sleep short, then I don’t feel so bad or cranky. (I get to stay up really late and write the night away—Keto has helped me bleed my soul into these pages.) But I want to be prepared if things go awry; I’m a one of those “planner” types, you know, a doomsday prepper :p

    Thank you and hope to hear from you soon!

    – Michael

  51. Elean says

    . I’m 35, female, started out weight lifting(3x a week, 2hrs per session) and a carb restricted diet (100gm protein, 20gm carb, 40gm fat) 2 yrs ago at 130lbs bf 25%..

    Results were astonishing and within 1 year, I stand at 110lbs, bf 16% which was my perfect shape. But, I stopped having my periods and I felt weaker in gym. So I suppose I should let my hormones recover and i took a 1.5 month period of deload and added in more carbs and calories into my diet.

    My weight slowly gained… I expected that. I regained 10lbs within a month and my period came back normal. Yeah.

    Done with my breaks….I reset my diet back to how it initially began and adding back more intensity at gym. But, this time round it didn’t work for me. 1 month after i restarted my regime, I continued to gain weight (another 10lbs) back to 130lbs now looking fluffy and bloated. Ahhh im getting frustrated but not giving up. But why is it so different and difficult on 2nd attempt?

    Any advice will be deeply appreciated.


    • ronnie says

      Try adding in some HIIT 2-3x a week if you haven’t already (HIIT can be good for jump starting hormones and metabolism).

  52. Carla says

    I’m glad I stumbled across this post. I’ve been eating a low-carb diet on and off since 2000 when I was first diagnosed with PCOS. I started eating a Paleo diet for heath reason 5-6 years ago and then lower my carb intake to net 20 grams per day in an effort to lose the last 15-20 lbs. I lift heavy 4 days a week and had an session or HIIT once a week. I was never successful with losing the weight and now I know why.

    I have PCOS, SIBO AND chronic Lyme, hypothyroid and I work out hard and frequently. How do you balance the carb intake with health issues and activity?

  53. Christina says

    I am experiencing amenorrhoea right now. I have lost period over 2 years already, with low carb diet, and I have blood sugar issue. What should I do? more or less carbs? I really need help.

  54. Brandi says

    Fascinating as ive only seen a return of regular menstrual cycles when eating very low carb diet, but i only lose weight the 3 days following my menstual cycle. If i add carbs over the ketogenic level my blood sugar elevate to a level i find physically unacceptable maybe as time goes on ill find my menstrual cycles waining or maybe every women is different.

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