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Going Keto? Here's The One Time Of Month Women Should Eat More Carbs

Ali Miller, R.D., L.D., CDE
July 7, 2019
Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator
By Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator
Ali Miller R.D., L.D., CDE is a Registered Dietitian and Certified Diabetes Educator with a naturopathic background.
July 7, 2019
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The ketogenic diet—a low-carb, high-fat, moderate-protein approach to eating—continues to gain steam with testimonials of significant weight loss, mental clarity, reduced inflammation, and more. As a functional medicine practitioner seeking to address the root causes of chronic conditions, I often use the ketogenic diet with women and men for the benefits above as well as to mellow out the mood and reduce anxiety

In my book The Anti-Anxiety Diet, I share how ketones have the ability to cross the blood-brain barrier serving to reduce oxidative stress in the brain, supporting optimal neurotransmitter signaling and directly influencing GABA, a powerful inhibitory neurotransmitter that reduces the fight-or-flight response, serving to provide a grounding anti-anxiety effect.

That said, in some individuals—and particularly among women who are stressed out and/or have a lower body fat percentage—a long-term keto diet can cause imbalances in the body that counteract some of these benefits. The good news: This can be avoided or resolved by incorporating something called carb cycling into your keto diet. 

Here, I cover why keto can lead to problematic hormone imbalances in some people and the simple (and satisfying) way you can get your body back in balance via carb cycling.  

First, you have to understand that keto is a stressor on the body.

While keto can be a magic bullet for metabolism and mood, it can also throw you into an imbalanced state if you're not careful. That's because it's technically a stressor on your body and contributes to your overall allostatic load—the cumulative impact of stressors, both physiological and mental, on the hormonal and regulatory function of the body. 

In many healthy individuals, the fact that keto is a stressor is usually fine and often healthful—after all, in addition to keto, many health-promoting practices (e.g., exercise, intermittent fasting, using a sauna) are also stressors and, as such, help the body become more resilient over time. But when your allostatic load becomes too great—say, for example, you're chronically stressed, under-sleeping, practicing intermittent fasting, and following a keto diet—your body is simply overtaxed and hormonal imbalances can result. 

Keto can positively or negatively affect hormones—depending on your overall stress load.

The ketogenic diet generally has a favorable impact on hormones. Case in point: Insulin resistance is often seen with hormone imbalance, but a reduction in carbs in your diet aids in the reduction of insulin levels in the body and thus supports insulin sensitivity—which can help prevent or reverse diabetes. Additionally, hormones are produced from fat, so a high-fat diet aids in hormone production. This is why many people see fantastic outcomes using a ketogenic diet to support PCOS, hypothalamic amenorrhea, and fertility struggles.

Beyond insulin and sexual hormone production, leptin, a hormone of satiety and metabolic regulation, is affected by the ketogenic diet. Leptin—produced by fat cells and in the small intestine in response to consumption of fat—helps suppress appetite, and this is a primary reason many people on keto see a significant reduction in hunger and cravings. Leptin also has an impact on excitatory neurotransmitters in the brain, serving as one of the mechanisms by which the ketogenic diet reduces seizure activity and anxiety. 

Leptin can be seen in excess in obese and overweight individuals, and at high levels, leptin's signals become resistant—which can trigger overeating. The ketogenic diet, which includes dietary consumption of fat and supports the mobilization of body fat in the production of ketones, will naturally reduce leptin levels, aiding in optimal leptin signaling in overweight individuals who were previously in a state of leptin resistance, which can help curb hunger.

However, individuals who are at a low body fat percentage, or who are over-stressing the body with mental demands, calorie restriction, intermittent fasting, or too much exercise, are ramping up their allostatic load and setting themselves up for declining leptin levels—which, over time, can drive anxiety, insomnia, and hunger. And because leptin has a significant influence on the thyroid and ovaries, individuals with hypothyroidism, and menstruating women leading a high-stress lifestyle who don't carry extra body fat, are especially susceptible to leptin imbalances when they enter ketosis. This can interfere with thyroid hormone production, throw off a woman's cycle, and suppress hormone production.

When too low, leptin requires a surge of glucose followed by insulin to tell the body it's being adequately fed and ultimately "safe," supporting a shift back into healthy regulatory function versus reactive survival mode. The good news: This can be accomplished by carb cycling.

When to consider carb cycling. 

Not everyone needs to carb cycle, but you may be a prime candidate if any of these symptoms or characteristics apply to you:

  • You are at a low or healthy percent body fat
  • You have experienced an unfavorable change in cycle length since starting keto
  • You are dealing with insomnia
  • You are not satisfied and constantly hungry
  • You feel anxious, wired
  • You experience heart palpitations
  • Your thyroid levels have declined since going keto

What does carb cycling look like on a ketogenic diet?

Carb cycling on a keto diet means you are intentionally increasing carbohydrate intake during specific times of the month to ensure that leptin levels don't get depleted and the body maintains an active metabolic balance—as opposed to increasing the body's stress response, causing potential imbalances in the body. 

For the majority of your keto diet, you'll be consuming somewhere in the range of 30 to 60 grams of total carbs per day, give or take a bit, depending on your activity levels. But when you carb cycle, you'll be consuming an additional 45 to 60 grams of carbs per day—for a total of 75 to 120 grams of carbs—for two days of your cycle. 

Typically, I recommend carb cycling on days 19 and 20 of your cycle (which is five days post-ovulation), when leptin levels are naturally the lowest. This is also when your body is supposed to be making the most progesterone, but often, women who are under a lot of stress aren't able to produce enough progesterone due to a phenomenon called pregnenolone steal, which diverts the building blocks of progesterone to produce the stress hormone cortisol. Upping your carb intake at this time helps take some of the stress off your body so you're able to produce appropriate levels of progesterone and enjoy overall hormonal balance. It's also best to carb cycle in the evening to support serotonin and melatonin demands, and to help your body enter a parasympathetic rest-and-digest state. 

I recommend trying the above approach for a few cycles and seeing how you feel. (Using a period-tracking app like Clue can be incredibly helpful in determining where you are in your cycle.) But, if it doesn't seem to be helping, you can experiment with carb cycling on days 1 and 2 of your menstrual cycle—which is the very start of your period and the other point in your cycle when leptin levels are lowest. This can be a nice way to support your body as it undergoes the process of shedding the uterine lining.

If you don't get a period, you may follow the moon cycle, using the full moon to signify ovulation. Additionally, anyone can use carb cycling as a way to practice food freedom and schedule their "carb-ups" to correspond with social commitments or travel. If you are a postmenopausal woman or a man, simply carb cycle on the first two days of the month, or any other consecutive two-day period, and try to stay consistent.

What I eat during a typical keto carb cycling day.

When carb cycling, I recommend choosing paleo-friendly, nutrient-dense sources of carbs (e.g., sweet potatoes, beets, squash, carrots, peaches, berries, apples, raw honey, dates) to help keep inflammation down and nourish your body. On the days you carb cycle, you may consider reducing your dietary fat intake, especially if weight loss is your goal, but this isn't necessary. Here's a rundown of what I might eat on a "carb cycling" day of my keto diet (I've bolded my sources of extra carbs for easy reference):

  • 7 a.m. / 32 oz. of water with lemon
  • 9 a.m. / 2 eggs, ½ avocado, ¼ cup sprouts; and 8 oz. coffee blended with 2 teaspoons coconut oil and 1 teaspoon grass-fed butter
  • 1 p.m. / 2 tablespoons nut butter + 1 tablespoon chia seeds + ½ cup berries 
  • 6 p.m. / 6 oz. grass-fed rib-eye, ⅔ cup sweet potatoes roasted in coconut oil, ½ cup Brussels sprouts roasted in avocado oil with herbs, and 3 dates wrapped in bacon
  • 7:30 p.m. / ½ cup peaches sautéed in coconut oil and cinnamon + drizzle of raw unfiltered honey

Listen to your body and tweak as needed.

When carb cycling, you will likely experience an increase in satiety, reduction in cravings, deeper sleep, and improved hormone regulation and thyroid function. Additionally, incorporating carbs once a month into a ketogenic diet may also aid in supporting your microbiome and antioxidant status—thanks to the diversity of fibers and phytocompounds in nutrient-rich, moderate-to-high-carb foods—while supporting metabolic flexibility and providing food freedom to help remove the potential fear associated with carb consumption. 

To ensure you reap these benefits, I encourage you to listen to your body for feedback on what feels right and tweak (the frequency of your carb cycling days and/or the number of carbs you consume on those days) as needed to support your body.

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Ali Miller, R.D., L.D., CDE author page.
Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator

Ali Miller R.D., L.D., CDE is a Registered Dietitian with a naturopathic background and a contagious passion for using nutrients and food as the foundation of treatment protocols and programs. She received her bachelor's in nutrition and dietetics from Bastyr University. She is the author of the cookbook Naturally Nourished: Food-as-Medicine for Optimal Health, The Anti-Anxiety Diet, and The Anti-Anxiety Cookbook.

Her Food-As-Medicine philosophy is supported by up-to-date scientific research for a functional integrative approach to healing the body. Ali is a certified diabetes educator (CDE) and renowned expert in the ketogenic diet with over a decade of clinical results using a unique whole foods approach tailored to support thyroid, adrenal and hormonal balance.

Ali’s message has influenced millions through the medical community and media with television, print, and her award winning podcast, Naturally Nourished. Ali’s expertise can be accessed through her website: offering her blog, podcast, virtual learning, and access to her practice and supplement line Naturally Nourished.