Does a ketogenic diet affect women’s hormones? Yes, you can count on your nutrition to affect your hormones. Does the keto diet ruin or destroy your hormones? No.
In fact, ketosis may offer some real benefits for women — especially those who suffer from PCOS, endometriosis, and uterine fibroids[*].
In this post, we’ll discuss the ketogenic diet’s impact on your thyroid and the HPA-axis, then look at ways to evaluate your hormones, how you feel, and how to make adjustments to your diet and lifestyle.
Is ketosis bad for your thyroid? No. Let’s break it down:
But a lowered T3 doesn’t mean you get thyroid dysfunction or hypothyroidism.
Hypothyroidism is often a case of high levels of TSH (thyroid stimulating hormone) and low levels of free T4. The pituitary gland tries to get your thyroid gland to produce T4: high levels of TSH. But the thyroid isn’t responding: low levels of T4.
When T3 is reduced, the thyroid is called “euthyroid.” A normal thyroid. For a more in-depth look at what a low-carb diet does to T3, T4 and TSH levels, read Dr. Anthony’s article on ketosis and women’s hormones.
The HPA axis is the triumvirate of hormonal production: the hypothalamus secretes hormones and talks to the pituitary and adrenal glands into doing their jobs toward producing those hormones.
Cortisol is the notorious stress hormone but it starts out innocently. When you’re under stress, cortisol taps into protein stores and produces glucose for your body to use to flee or fight the stress. Good thing, right?
Because the ketogenic diet leaves the HPA-axis unaltered or potentially improved, then cortisol — produced within the adrenal gland– is fine. In fact, cortisol levels are low for those in ketosis, or completely unaffected[*][*].
If you feel particularly bad, here are a few points to consider:
Think of your priorities. Is it performance with your HIIT 3+ times a week? Or achieving ketosis?
If you go for both, you are overtraining. This may lead to cortisol levels shooting up (your body is stressed from what you’re putting it through) and other hormonal problems. Overtraining is the root cause of it, not ketosis[*]. A ketogenic diet may not be the best match for rigorous training goals.
Here are a few symptoms of cortisol elevation and other hormonal issues caused by overtraining[*][*]:
You are in ketosis when AND ONLY WHEN you meet this condition: your body is breaking down fat into ketones as an energy source. How do you know this? By testing your ketone levels. Pee sticks and breath meters are not accurate because ketones are in your blood.
You use a blood meter like the one used to measure blood glucose. Prick your finger for a drop of blood and set the machine to tell you your BHB (beta-hydroxybutyrate) levels. In ketosis, your measurement would be consistently above 0.5, without using exogenous ketones.
High fat and low carb diets don’t feel good.
If you’re on such a diet because you’re starting keto, you may feel terrible before you achieve ketosis. This is called the keto flu. Your body is changing gears and protesting a little. Do things properly and you may avoid the keto flu.
There’s no comparison between ketosis and a ‘low-carb/high fat but non-ketogenic’ diet[*].
The ketogenic diet regulates energy in an entirely different way and breaks through the blood-brain barrier, which means your brain gets fed, and feeding your brain means improved mental acuity and physical energy[*]. You feel great, like you can do anything!
Stick around long enough and you’ll read/hear stories about how being in ketosis helps so much with intermittent fasting (IF). People don’t get hungry or crave food like they used to and have no trouble following their fasting schedule[*].
But make no mistake, keto-ers who do IF for its benefits are fastidious about measuring their calories and eating enough when they eat. Because calorie restriction only makes you feel bad, and is proven to affect hormones negatively, especially in women[*][*]. In this case, it’s not ketosis making you feel bad. You’re not getting enough food to support your body.
Measure your ketones, measure your food intake, and make sure it’s adequate to the demands of your day.
If your periods have always been bad, or if you have chronic pain you can’t explain (back ache, severe headaches), you may have a hormonal imbalance, which needs correction and consultation with your doctor before you do something drastic as undertaking the ketogenic diet. If already in ketosis, SEE YOUR DOCTOR if you’re concerned about any drastic changes like amenorrhea (lack of menstruation), clotting, pain, etc.
Stress can lead to hormonal problems, especially in women, and managing stress may help solve those problems[*][*].
Instead of rigorous training, aim for light movement like yoga, and try meditating, walking and journaling to take control of your anxiety and stress levels. When your stress is persistent enough, you need medical intervention.
Hormonal imbalance has other root causes:
These other causes need to be ruled out—and treated—before you and your doctor can conclude/diagnose a bad experience with ketosis—if you have actually been in ketosis.
Measure your ketones and make sure your caloric intake matches the physical demands you put yourself through. Go after healthy fitness goals and keep your stress levels down.
Wondering about how keto has affected other women when it comes to their periods, or in their senior years, during/after menopause? Check out the discussions in the Perfect Keto Community. For information about ketosis and pregnancy, go here.
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