In the paleosphere, it is very common to hear low carbohydrate diets recommend for all sorts of reasons: weight loss, insulin management, stable blood sugar, gut health, and mental health.

Yet after several years doing research and working with women in the scene, I have discovered that there are in fact many potential risks of being on a low carbohydrate diet.

Of course, not all women suffer from these dangers and risks. I know that. That’s obvious. Plenty of women do well on low carbohydrate diets.

Yet plenty do not, too. As the paleo world’s go-to resource on women’s health, then, it is my duty to broadcast warnings about low carbohydrate diets.

I am not saying you need to stop being low carb. Really. There are just some potential problems you should be aware of, so you can prevent them, or at the very least keep your eye open for them.

Here are the 7 most major dangers of low carbohydrate diets for women:

1. Hypothyroidism

Perhaps the most common and most harmful damage a low carbohydrate diet can cause for women is hypothyroidism.

The body needs glucose (carbohydrate) in the blood in order to create T3, the active form of thyroid hormone. Without T3, you cannot burn fat mass, skin quality suffers, and hormone production slows down, resulting in infertility and low libido, among other things.

You could also suffer symptoms of hypothyroidism like being cold easily, having brittle hair and nails, and gut problems like constipation. If you think you may have hypothyroidism, check out this list of 19 indicators you may be hypothyroidor my favorite book on overcoming hypothyroidism, Izabella Wentz’s Root Cause.

2. Weight Loss Plateaus

Because thyroid hormone often slows down in response to a low carb diet, many women experience weight loss plateaus on a low carbohydrate diet. The body simply slows down when it’s not getting the carb-fuel he needs. I know a great many people, including many famous paleo writers, who jump-started their weight loss back into life by adding carbohydrates back into their diets.

(If you want to learn more about weight loss plateaus and how to rocket through them, you definitely don’t want to miss out on my weight loss manual designed specifically for women, Weight Loss Unlocked.)

3. Hormone imbalance

Without sufficient carbohydrate in the diet, thyroid production slows down, which negatively impacts other hormone production.

Moreover, leptin and insulin are secreted in response to carbohydrate intake. In the paleosphere this is often talked about as a bad thing, but it actually isn’t. In fact, leptin and insulin are the two primary hormones responsible for assuring the hypothalamus that you have been fed, which is in turn responsible for giving the “green light” to the pituitary gland for hormone production.

Without leptin and insulin, it is challenging for the body to feel sufficiently fed, and therefore to make the right amounts of hormones you need to be healthy, fertile, and happy.

4. Serotonin insufficiency

Carbohydrates actually play a role in serotonin production in the female brain. This has been demonstrated in the medical literature. I have also witnessed it first hand in many women, who appear not only to be more mentally stable, but also to sleep better, after a meal with carbohydrates in it.

Serotonin is important for many things, least of which being feeling calm and peaceful, being happy, winding down, and sleeping well.

To help boost my own serotonin production at times, I either take a tryptophan supplement, or Serotonin Fx, the only supplement still left in my supplement cabinet.

5. Insulin resistance

Even while low carbohydrate diets prevent blood sugar levels from spiking, and therefore prevent insulin levels from rising too high, they actually cause insulin resistance.

Now, this doesn’t mean that this kind of insulin resistance is necessarily unhealthy. The body is simply trying to hold onto as much blood sugar as possible, because it likes having glucose in the blood but has been deprived of regular glucose consumption.

What this does mean is that when you do eat carbs it becomes all the more difficult to process them healthfully.

Rather than trying real hard to stay super low carb most of the time…. then eating carbohydrates and causing blood sugar spikes and fat gain, I prefer instead to regularly include carbohydrates in my diet. This way, my body doesn’t think that it’s being deprived of carbs, and it doesn’t become insulin resistant or overweight as a result.

6. Sugar cravings

The body needs a steady amount of glucose in the blood. If you do not eat carbohydrates, the liver can produce the glucose it needs, but it really would prefer not to.

The female body needs glucose. If you do not feed it the carbohydrate it needs, it will start sending you stronger hunger signals.

Moreover, insulin and leptin are powerful satiation hormones. They help you feel full. Without them, sometimes it can be hard to feel full.

Finally, the psychological aspect of low carbohydrate dieting can be damaging. Many women begin obsessing over sweets and treats when they go low carb because those foods have been forbidden.

A much healthier way to approach dieting, in my opinion, is to regularly include at least some carbohydrate in the diet, so that you don’t feel restricted, and get obsessive over and perhaps even start bingeing on sugary foods. This is the approach I take in my program for happy, healthy, and speedy weight loss, Weight Loss Unlocked.

7. Adrenal spikes and fatigue

When the liver makes it own glucose for the sake of maintaining stable blood sugar, the stress (adrenal) glands get involved. How?

The body secrets cortisol, the stress hormone, in order to help elevate and manage blood sugar levels.

Once in a while this is perfectly fine and healthy. Yet when this becomes routine, the body may begin to develop hypercortisolemia — that is, excessively high cortisol levels — or hypocortisolemia — excessively low cortisol levels.

With cortisol levels that are too high, the body’s circadian rhythm gets off, you fall asleep poorly and may wake during the night, your heart races, and you often feel tired but wired.

With cortisol levels that are too low (which can happen after levels are too high for too long), the body’s circadian rhythm gets off, you feel sluggish, you lose energy, you cannot think very clearly, and you often feel tired but wired.

The adrenal glands are very important to keep in tip-top shape. They regulate so much of health and behavior. Throwing them off can lead to serious mental health problems like anxiety and depression, sleep disorders, hormone imbalances, and other problems down the line.

What to do about it

Some women do better on low carbohydrate diets than others. I recognize this! This is totally important and awesome.

Nevertheless I caution women who are low carb to keep their eyes open for any symptoms related to the problems I described above. If you develop symptoms of hypothyroidism, hormone imbalance, poor sleep, mood dysregulation or sugar cravings, you may be able to alleviate them by re-introducing some carbohydrate back into your diet.

You do not have to eat a lot of carbohydrate, just some.

I recommend that all women start with 100 grams of carbohydrate a day. This is the equivalent of four servings of fruit (like four biggish apples), or two cups of rice.

That may sound like a lot to women used to being very low carb, but really in the grand scheme of things it is not.

You can go below that level, but not too far. I think 50g is the absolute lowest limit I recommend for women.

If you are athletic, recovering from hypothalamic amenorrhea, recovering from hypothyroidism, have struggled with food issues in the past, or simply like carbs, then you can feel free to eat more than 100 grams a day. I personally eat probably around 250 grams of carbs a day, and I don’t gain any weight or suffer from symptoms.



And that’s a wrap! Here are two other posts about carbohydrates for women’s health: Carbohydrates for Fertility and Health, and 8 Signs You Need to Eat More Carbohydrate.

Also, if you’d like to learn more about macronutrients like carbs and fat, and especially how they relate to weight loss, you may want to check out my program for weight loss for women specifically, Weight Loss Unlocked.


What do you think? Agree? Disagree? What has been your experience with a low carb or with a carb-inclusive diet?!

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