Keto And Hormones: What's The Real Deal?

The ketogenic diet is a popular weight-loss approach that involves drastically reducing carbohydrate consumption and emphasising the intake of healthy fats and proteins. While the keto diet can be highly effective for weight loss and offer significant health benefits, some experts argue that it may negatively impact hormones, particularly in women.

The diet's restriction of carbohydrates can lead to increased cortisol levels, also known as the stress hormone. This, in turn, can affect other hormones, including serotonin, progesterone, and insulin. These hormonal changes can cause various issues, such as acne, endometriosis, and irregular menstrual cycles.

Additionally, the keto diet's high-fat content may lead to increased estrogen production, which can suppress thyroid function and result in weight gain. However, not all experts agree, and some argue that a well-executed keto diet can help restore balance to female sex hormones and mitigate issues like weight gain, hot flashes, low energy, and mood swings.

While the keto diet may offer benefits, it is important to recognise that it can be challenging to maintain and may not be suitable for everyone. Consulting with a healthcare professional is essential before starting any restrictive diet to ensure it is safe and appropriate for your individual needs.

Keto can cause weight gain for women

The ketogenic diet has become a popular solution for people facing weight gain and related issues like type 2 diabetes and PCOS. The diet is based on sharply restricting carbohydrates and emphasising the high consumption of healthy fats and proteins. Typically, the standard ketogenic diet contains 75% fat, 20% protein, and only 5% carbohydrates.

However, despite its popularity, the keto diet can be challenging for women. Hormonal experts have noted that many of their female patients struggle with maintaining a healthy weight on the keto diet, with some gaining weight, losing muscle, and developing signs of adrenal fatigue. This is supported by a 2018 study on mice, which found that while male mice lost weight, female mice gained weight.

So, why is keto causing weight gain in women? Here are some reasons:

Hormonal Changes

The keto diet can cause hormonal changes in women, particularly affecting serotonin, progesterone, and insulin levels. These shifts can cause insulin levels to rise, leading to weight gain. Additionally, the diet's restriction of complex carbohydrates can cause an increase in cortisol, the "stress" hormone. This can further disrupt the balance of hormones, including estrogen and testosterone, leading to potential weight gain.

Estrogen Dominance

Estrogen dominance, caused by excess estrogen or a lack of progesterone, can lead to weight gain. The keto diet's high-fat content can contribute to this by increasing estrogen production. Higher estrogen levels can suppress the thyroid, leading to weight gain. This is particularly relevant for women experiencing estrogen dominance, which is common among women aged 15-50.

Cortisol and Stress

The keto diet's restriction of carbohydrates can be stressful for the body, leading to increased cortisol levels. Cortisol is the "stress" hormone, and prolonged high levels can cause hormonal imbalances, including increased estrogen and testosterone levels, which may contribute to weight gain. Additionally, using protein as an energy source, as the keto diet encourages, can place undue stress on the body, further spiking cortisol levels.

Macronutrient Restrictions

The keto diet places extreme restrictions on macronutrient consumption, particularly carbohydrates. This can have harmful effects on the body's natural hormone production, leading to fluctuations that can cause physiological symptoms, including weight gain. The diet's restriction of complex carbohydrates can also lead to shifts in serotonin, progesterone, and insulin levels, which can cause insulin levels to rise and contribute to weight gain.

Individual Differences

It's important to note that the impact of the keto diet can vary from person to person. While some women may experience weight gain, others may benefit from the diet and achieve their weight loss goals. Individual factors such as activity level, health conditions, and lifestyle choices can influence the effectiveness of the keto diet.

In conclusion, while the keto diet has been touted as a successful weight-loss strategy, it can cause weight gain in women due to various hormonal changes and individual differences. It is essential to consult with a healthcare professional before starting any restrictive diet like keto to ensure it is safe and appropriate for your specific needs and health status.

Keto can cause menstrual irregularities

The ketogenic diet has become a popular solution for weight loss and the management of health conditions like type 2 diabetes and PCOS. The diet involves a significant reduction in carbohydrate intake, with the body entering a metabolic state known as ketosis, where it burns fat as its primary energy source. While keto can be effective for weight loss, it can also have some unintended consequences, particularly for women. One notable side effect is its potential impact on the menstrual cycle, with some women experiencing irregularities during their time on the diet.

The Hormonal Impact of Keto

The female body is sensitive to nutritional changes, and a drastic reduction in carbohydrates can lead to shifts in serotonin, progesterone, and insulin metabolism. These changes can cause a rise in insulin levels, which can lead to weight gain. Additionally, the body burning stored fat and muscle can result in increased cortisol levels, often referred to as the "stress hormone." Prolonged elevated levels of cortisol can cause a hormonal imbalance, with estrogen and testosterone levels rising while progesterone levels may decrease.

The Connection to Menstrual Irregularities

This hormonal imbalance caused by keto can have a direct impact on menstruation. Increased estrogen levels can lead to heavier periods and more severe PMS symptoms. In some cases, the menstrual cycle may even cease temporarily or become less frequent. These changes are a sign that the body may not be getting sufficient nutrients and can indicate potential underlying health issues.

The Role of Estrogen

Estrogen plays a crucial role in the challenges some women face when adhering to the keto diet. Studies have shown that premenopausal women with normal estrogen levels may find it more difficult to enter and maintain ketosis. This challenge is further supported by research on mice, where female mice on a keto diet gained weight and exhibited poor blood glucose levels, while male mice lost weight and maintained better blood glucose control.

Correcting Estrogen Imbalance

For women experiencing estrogen dominance, which can lead to weight gain and blood sugar control issues, an estrogen detoxification protocol may be recommended. This protocol involves a high-fiber diet rich in cruciferous vegetables, which helps restore a better balance between estrogen and progesterone. Additionally, supplements containing diindolylmethane (DIM) can also be beneficial in positively affecting estrogen metabolism.

The Bottom Line

While keto can be beneficial for some individuals, particularly those with specific health conditions, it may not be the best choice for everyone. The potential impact on the menstrual cycle is an important consideration for women, and consulting with a healthcare professional before starting any restrictive diet is always advisable.

Keto can increase cortisol levels

The keto diet can increase cortisol levels in the body, at least initially. Cortisol is often referred to as the "stress hormone". It is largely involved in our stress response, sending signals to break down fat and protein, and helping to modulate sleep and blood pressure. While it is important, elevated cortisol over a long period can increase the risk of disease.

When you restrict carbohydrates to the degree that the keto diet requires, the body goes into a starvation response. In an effort to increase energy levels, the body triggers the release of stress hormones like cortisol. This is because it has less sugar to work with. The cortisol and other stress hormones will then increase insulin resistance and stimulate gluconeogenesis to help increase blood sugar levels.

Chronically elevated levels of cortisol can cause a range of issues, including cognitive performance disruption, sleep problems, lower immune function, increased abdominal fat, and blood sugar imbalances.

How to Reduce Cortisol on Keto

Once you are in consistent ketosis, your cortisol levels will decrease. This is because you will be using alternative fuel sources like ketones and fat, and will have a greater capacity to spare glycogen (your body's sugar stores). Therefore, you will no longer need as much cortisol to promote an increase in blood sugar levels.

Other Factors to Consider

It is important to note that a well-formulated keto diet containing adequate sodium is unlikely to alter cortisol levels significantly. Additionally, while cortisol levels may increase on a ketogenic diet, it is certain measures of cortisol that are raised, and the overall effect on cortisol metabolism may be positive.

While keto may increase cortisol levels in the short term, this is not necessarily detrimental to health. In fact, for those with metabolic syndrome, a group of symptoms including high blood sugar, excess abdominal fat, and abnormal cholesterol levels, the overall effect of the keto diet on cortisol metabolism may be beneficial.

Keto can cause fertility issues

The ketogenic diet has been linked to fertility issues in women, with some studies suggesting that the diet's high fat content can lead to an increase in estrogen production, which can interfere with thyroid function and potentially impact fertility. Additionally, the diet's restriction of carbohydrates can cause hormonal imbalances, including increased cortisol levels, which can also affect fertility.

Weight Gain and Blood Sugar Control Issues

The presence of normal amounts of estrogen in premenopausal women seems to limit or even block ketosis, which can lead to weight gain and problems with blood sugar control. Until the imbalance is corrected, getting into ketosis and maintaining weight loss will be challenging.

Irregular Menstrual Cycles and Amenorrhea

A very low-carb diet can also cause irregular menstrual cycles or amenorrhea, which is defined as the absence of a menstrual cycle for 3 months or more. Amenorrhea occurs due to a drop in levels of hormones such as gonadotropin-releasing hormone, luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone, and testosterone.

Impact on Fertility

The ketogenic diet could have serious consequences for fertility. The strict macronutrient restrictions on keto can put the body into a state of chronic stress, leading to cortisol spikes that suppress the hormones supporting fertility. This can be particularly detrimental for women with Polycystic Ovary Syndrome (PCOS) who are already struggling with infertility.

Nutritional Deficiencies

Following the keto diet in a healthy way can be challenging, as it restricts carbohydrates and may not provide enough nutrient-dense whole foods. This can lead to nutritional deficiencies, which are associated with health risks and may impact fertility.

Alternative Dietary Approaches

The Mediterranean diet or a Dutch-style diet that emphasizes a balanced distribution of macronutrients, including fruits, vegetables, meats, fish, whole-wheat bread, and healthy fats, may be a better approach for supporting fertility and overall health. These diets provide a more varied and flexible range of food choices, reducing the stress and restriction associated with keto.

Keto can have adverse effects on thyroid function

The thyroid is a small gland in the neck that produces hormones that play a significant role in metabolism, energy expenditure, and weight management. Thyroid hormones also influence key metabolic pathways involved in energy balance, and they are active in lipid and carbohydrate metabolism.

The ketogenic diet is a low-carb, high-fat diet that triggers the body's natural metabolic process known as "ketosis". While in ketosis, the body uses stored fat as fuel instead of glucose. This reduction in carbohydrates can put stress on the body, increasing cortisol levels, also known as the "stress hormone".

The impact of keto on thyroid function

Studies have shown that the keto diet can lead to a decrease in thyroid function, specifically in the production of the active form of the thyroid hormone, triiodothyronine (T3). This reduction in T3 can occur even while the body remains in a state of nutritional ketosis, and it is more commonly seen in premenopausal women due to the presence of normal amounts of estrogen.

The decrease in T3 can be attributed to the reduced intake of carbohydrates, which are necessary for the production of thyroid hormones. Carbohydrates provide the body with glucose, which is the preferred fuel source for the body. When glucose is not available, the body turns to stored fat for energy, which can lead to a decrease in thyroid function.

The risks of decreased thyroid function

A decrease in thyroid function can lead to a range of issues, including:

• Fatigue
• Weight gain
• Low mood
• Increased risk of long-term health problems such as cardiovascular disease and mental health conditions

Managing keto and thyroid function

While the keto diet may not be ideal for those with thyroid function issues, there are ways to manage the potential adverse effects:

• Combine an anti-inflammatory diet with keto: Leafy green vegetables and other foods that reduce inflammation can help balance the body's pH and reduce the risk of chronic inflammation.
• Identify dietary triggers: Common culprits for inflammation include gluten, dairy, soy, eggs, corn, nuts, shellfish, and preservatives. Understanding your triggers can help you make more informed dietary choices.
• Increase water consumption: Drinking enough water can improve weight, energy, mental clarity, and overall health.
• Improve stress management: Stress affects thyroid function, so finding ways to manage and reduce stress can help improve thyroid function.
• Reduce environmental toxins: Endocrine disruptors are chemicals that interfere with hormone systems and can be found in plastic bottles, food packaging, cosmetics, and pesticides. Reducing exposure to these toxins can help improve hormone balance.

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