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Low carb diets are all the rage right now in the nutrition and health world. And it’s true, cutting carbs can help with weight loss and health improvements for some people. There are plenty of examples of people who significantly improved their health by going low carb.
But for many people – women especially – keeping carbs too low for too long can have pretty unhealthy consequences, especially if you work out with any level of intensity. And even more so if you have hormone-related health issues like HPA axis dysregulation or hypothalamic amenorrhea.
When Low-Carb Makes You Feel Awful
If you’re sedentary, your carb needs are lower than someone who is active. Those who don’t train regularly might be able to get away with more carb restriction.
And even if you do work out regularly, you probably won’t immediately feel the consequences when you first cut most carbs from your diet.
It may take months to see the long-term impact, but at some point you might start to feel spaced-out, sluggish, cranky and sick.
Eventually, restricting your carb intake too much can lead to many hormone-related issues such as:
- decreased thyroid output
- increased cortisol output
- decreased or increased testosterone
- impaired mood and cognitive function
If you already had a pre-existing hormone related condition before cutting carbs, such as hypothyroidism, PCOS, or HPA-D (“adrenal fatigue”), eating too few carbs will only exacerbate your condition.
Bring Back The Carbs!
Your carbohydrate intake is a critical part of the equation when it comes to balancing your sex hormones, losing weight, recovering from exercise, supporting your thyroid, boosting your energy, and so much more.
Ultimately, people vary widely in their carbohydrate needs and tolerance. If you are feeling moody or lethargic, gaining weight, and feeling unwell on a low carbohydrate Paleo diet, it may be time to up your carb intake. Upping your overall carbohydrate intake may improve the symptoms you’ve developed from being on an inappropriately low carbohydrate diet.
If you think it’s time to pump up the Paleo-friendly carbs in your diet, let me help you out. Paleo carbs usually consist of fruits and starchy vegetables like potatoes and sweet potatoes.
Fruits are a great source of carbohydrates to fuel our bodies while also providing us with more vitamins, minerals and phytochemicals than most other complex carbohydrate sources.
Some dogmatic Paleo advocates suggest a limited fruit intake and often recommend sticking to small portions of low sugar fruits like berries. They see fruit as simply unnecessary sugar, only to be enjoyed on special occasions. They say the sugar in fruit is addictive and that fruit is far too easy to overeat.
This isn’t true whatsoever. Fruit is a perfectly healthy food to eat regularly and is a great way to increase your carb intake. Learn more about the health benefits of fruit in this article.
A few servings of fruit a day is a great choice for increasing the amount of carbs in your diet.
Most people starting a Paleo diet are totally fine with eating sweet potatoes for most meals… until they get tired of them. That’s enough of a reason to get creative with your starchy vegetable choices and not eat sweet potatoes and yams every single day.
This chart covers a wide variety of Paleo carbohydrates. You can get the highest amount of Paleo-friendly carbohydrates in your diet by eating one cup of potatoes, cassava, taro root, or plantains. Other good carb sources are carrots, beets, and winter squashes. Please note: spaghetti squash is not considered a carbohydrate source, since it’s only about 7 grams of carbs per cup.
What About Grains?
Last week I wrote about how grains are not quite as bad as the Paleo community makes them out to be, but that there are certain grains that are better choices than others.
Grains are not technically “Paleo” whether they contain gluten or not. And many people with significant health issues such as autoimmunity or GI disorders benefit from eliminating gluten and grains from their diet.
But for the vast majority of people, the consumption of grains is not only not harmful, but may help them reach their health and fitness goals. That’s because grains are dense sources of carbohydrates that allow for variety past the typical Paleo-approved carbohydrates that we just discussed.
And for some people, gluten-free grains or pseudograins like white rice and buckwheat are easier on their guts than potatoes or sweet potatoes. So to avoid these foods simply because they’re not “Paleo” doesn’t really make sense.
Many of my clients do quite well eating a variety of grains, and I personally include grains in my higher carbohydrate, real food diet.
How Many Carbs Should I Eat?
I usually recommend about 30-50% of your total calories as carbohydrates. If you’re eating about 2,000 calories/day, this is about 150-250 grams of carbohydrates/day. 150-250 grams/day may seem like a high carbohydrate diet to some of you eating very low-carb, but it’s lower than the amount of carbs in the standard American diet.
In fact, I don’t usually recommend eating less than 25-30% of your calories as carbs in the first month you are making dietary changes unless I know that the client does very well with a low carb approach.
Here are my general starting points of the percentage of carbohydrates for hormone related health issues:
- For most women, I recommend a minimum of 25% of calories from carbs, particularly if she is active
- For patients already dealing with an HPA Axis issue (“adrenal fatigue”), I start them at 30-40% calories from carbohydrates.
- For women who are dealing with health issues surrounding fertility and hypothalamic amenorrhea, I recommend 40-50% of calories from carbs.
What is HPA Axis Dysregulation?
The hypothalamic–pituitary–adrenal axis (HPA Axis) is a complex set of direct influences and feedback interactions among three endocrine glands: the hypothalamus, the pituitary gland, and the adrenal gland. This system is your body’s primary stress management axis, and your adrenals are responsible for producing cortisol to help your body respond to stress appropriately.
HPA Axis Dysregulation (“adrenal fatigue”) refers to a collection of nonspecific symptoms, such as body aches, fatigue, and nervousness, sleep disturbances and digestive problems. These symptoms arise when our stress response is no longer appropriate and our adrenals over- or under-produce cortisol.
You may be wondering how carbohydrates affect your HPA axis. Reducing carbohydrates excessively can affect stress hormone production in many people, usually causing a significant increase in cortisol.
Chris Masterjohn, PhD has a great podcast on how the body treats gluconeogenesis as a stress response, and that day-to-day regulation of gluconeogenesis is strongly dependent on normal healthy levels of cortisol.
If you’re under a lot of stress already, going too low carb can cause further HPA dysregulation and increase its symptoms. Adding in carbs should help you feel better!
How Do I Know What My Carb Needs Are?
In general, everybody has different dietary carbohydrate needs primarily depending on their activity levels, but also dependent on their age, gender, stage of life, and goals.
As I mentioned earlier, if you are sedentary you can likely eat fewer carbs and feel fine. However, if you regularly participate in intense, glucose-demanding activities like Crossfit, heavy powerlifting, and/or high-intensity interval training (HIIT), your body will begin to rely on stress hormones like cortisol to produce the glucose the brain and muscles need.
When this happens, you may eventually develop symptoms associated with hormone related health conditions such as HPA Axis Dysregulation (Adrenal Fatigue) or hypothalamic amenorrhea.
This Seems Like Too Much Food
I get it… it’s not easy to get 40-50% of your calories from healthy carbs, especially on a Paleo diet.
The truth is that healthy carbs are incredibly filling! Plant based carbs like fruit and starchy veggies are filled with water and fiber, which make you feel full. Play around with different types of carbs, and don’t be afraid to try adding back grains, beans and legumes, or even some natural sugars if you tolerate them.
While you’re still getting used to this new way of eating, you might want to track your food intake on an app like MyFitnessPal.
Tracking food can often feel like a drag, but when you’re making big changes to your macronutrient intake, it helps to track for a few days to make sure you’re hitting your new goals. Accidentally under-eating carbs is super common you’ve been avoiding them for a long time.
If you are having trouble increasing your carb intake, work with an RD to find the carbs that work for you.
I’ll admit that even when I work one on one with clients, it’s hard to know their ideal baseline macronutrient percentages right off the bat. I have to make the best guess based on my professional experience and go from there. But my clients benefit greatly from having a professional coach or RD establish baseline percentages and then work with them to determine when to try something different.
And some people have health issues that affect their ability to tolerate carbs. I always recommend that clients figure out what is causing digestion problems and treat it before eliminating carbs from their diet.
Many times, if you are suffering from digestive issues, a round of antibiotics or antimicrobials, or some appropriate probiotics or prebiotics, help to clear up any gut dysbiosis and a low carb approach isn’t needed anymore.
Many clients I work with do better with weight loss, digestion, stress, and overall health when they eat more carbs. This is particularly the case for people with hormone-related health issues that stem from the hypothalamus, like HPA-D and hypothalamic amenorrhea.
If you’ve been feeling poorly on a low carb diet, perhaps it’s time to try switching your macronutrient goals to a higher carb style of eating! And share this article with a friend who needs to add more carbs to her diet.