Why the Keto Diet May Not Be Ideal for Women

Is Eating Too Low Carb Causing Hormone Imbalance?

Women’s hormones are especially sensitive to calorie and carb restriction. Carbohydrates play a critical role in hormone production, blood sugar regulation, and even ovulation. When you cut carbs too low, it can increase cortisol (your stress hormone), suppress your thyroid, and even lead to irregular or missing periods.

I see so many women in their 30s and 40s who cut carbs or even try a strict keto diet to “fix” their metabolism. However, they often end up feeling exhausted, anxious, foggy, and more inflamed than before.

Why does this happen? Your brain needs glucose to feel safe. Without it, your body goes into stress mode and cortisol spikes. This might manifest as anxiety, poor sleep, low energy, hair loss, mood swings, or a metabolism that feels completely stalled out.

When cortisol levels remain elevated, it sends the body into HPA dysfunction. This response tells the body to go into "fat storage mode." The body doesn’t know how long it will be in a high-stress state, so it wants to conserve and store as much excess energy as possible. This is the opposite of what most women desire.

This is why women who stop keto, because it is not sustainable, often see the weight come back on, sometimes with additional pounds.

Is The Keto Diet Right for PCOS or Insulin Resistance?

While it’s true that a strict low-carb or keto diet can lower insulin levels, it’s crucial to work with a dietitian like myself. We can personalize your macros and sync your diet with your menstrual cycle to avoid disrupting natural hormone balance.

Insulin is necessary for converting the inactive thyroid hormone T4 into the active thyroid hormone T3. When insulin levels drop too fast or remain low for too long, it can lead to low T3 levels in the body. This can result in hypothyroid symptoms, which include:

• Fatigue

• Weight gain

• A puffy face

• Trouble tolerating cold

• Joint and muscle pain

• Constipation

• Dry skin

• Dry, thinning hair

  
  

When I work with clients who have PCOS or insulin resistance, I recommend a moderately low-carb diet tailored to each woman. There should always be a strong emphasis on complex carbohydrates, resistant starch, fiber, and polyphenols. This supports a healthy microbiome and metabolism.

What’s the Best Diet for Women and Hormone Balance?

The best diet is one that is personalized for you and your body. Factors like body type, age, genetics, and personal preferences should all influence your dietary choices.

However, I won’t leave you with just that. The best diet begins with ingredients. Aim to choose whole foods as much as possible and focus on a majority plant-based diet. This doesn’t mean avoiding animal proteins. Instead, it means incorporating a large variety of plants into your meals. Examples include vegetables, fruits, nuts, seeds, legumes, beans, and whole grains.

Women can absolutely thrive on a gluten-free or even grain-free diet. The same goes for those who need to avoid beans and legumes, or prefer not to eat animal protein. It is crucial for everyone to know the essential nutrients needed and in what balance to avoid nutrient deficiencies.

Instead of chasing extreme diets like keto, focus on hormone-supporting nutrition:

✔️ Slow carbs (like sweet potatoes, root veggies, beans, fruits, and whole grains)

✔️ High-quality protein

✔️ Healthy fats (make sure to use plenty of olive oil)

✔️ Fiber and colorful veggies

These foods help stabilize blood sugar, reduce inflammation, and support happy hormones.

As a Hormone Health Dietitian, I’m here to remind you: If your diet is causing burnout, it’s not working for you.

Strategies for a Balanced Dietary Approach

Prioritize Whole Foods

Choosing whole foods is essential for supporting your health. Whole foods are minimally processed and packed with nutrients. Focus on incorporating seasonal fruits and vegetables into your meals. They offer vital vitamins and minerals while keeping your body nourished.

Consider Meal Timing

Meal timing can also play a significant role in hormone health. Recognizing when to consume carbohydrates can be beneficial. For instance, eating slow-digesting carbs before a workout can provide the energy you need, while also supporting hormonal balance.

Stay Hydrated

Don’t forget the importance of hydration. Drinking enough water throughout the day helps regulate bodily functions, including hormone production. Proper hydration can also reduce feelings of fatigue and support energy levels.

Don’t Forget Supplements

In some cases, dietary supplements can help bridge the gap in nutrition. Vitamins such as B, D, and omega-3 fatty acids can support hormone regulation. Always consult with a healthcare provider to determine what’s best for your unique needs.

Want to Go Deeper?

If you suspect your hormones are out of sync, personalized nutrition and functional hormone testing can uncover what’s really going on. I offer 1:1 consultations and a comprehensive hormone testing package that dives into cortisol, estrogen, progesterone, organic acids, inflammatory markers, and more.

Link to My Foundations of Hormone Balance Program

Link to Comprehensive Hormone Testing Package

Liz Riesen, RD, CD

Registered dietitian and hormone health coach helping women address hormone imbalances, increase energy, and lose weight naturally. As a busy mom, I know that you need a clear and realistic approach you can fit into a hectic lifestyle. I developed my Foundations of Hormone Balance Method to meet this need. Helping women feel confident and comfortable in their bodies and with food is my passion.

Follow me @lizriesen