Why ‘No Carb’ May Be ‘No Good’ For Some Women

Physicians who treat women with hormonal imbalances know that some women respond very well to regular consumption of certain carbohydrates, to maintain the delicate balance of hormones and neurotransmitters, control their moods and soothe their anxiety.

As one of these physicians, I can tell you it’s more common than you might think that a young woman tells me excitedly about her “new-found love for paleo” (or the increasingly popular ‘vegan paleo’ – whatever that is), but complains of wild mood swings and weepy moments about unwanted weight-gain soothed only by coconut milk ice-cream.

For many women, a no-carb diet is not the answer to perfect hormone balance.

And the reason why isn’t too surprising when you think about it – if you have adrenal fatigue (or HPA-axis dysfunction), a no-carb diet might be making your hormone imbalances worse.

HPA-axis dysfunction is a fairly common syndrome that results from chronic stress.  It presents with a fairly classic symptom picture (low morning and mid-afternoon energy, a “second-wind” before bed or trouble falling asleep, trouble maintaing the second half of the sleep cycle, abdominal weight gain, anxiety, brain fog, high or low blood pressure, and/or dizziness), and low cortisol and/or DHEA on a saliva or blood hormone test.

With chronic stress comes chronically elevated levels of cortisol, to which the body eventually becomes resistant (causing the HPA-axis dysfunction, or ‘adrenal fatigue’); this cortisol-resistance also impairs serotonin production (a feel-good neurotransmitter) and induces insulin-resistance.  This insulin resistance leads to blood sugar imbalances and hormone imbalances follow suit.

So essentially, chronic stress = cortisol response impairment = insulin dysregulation = blood sugar imbalance = hormone and mood imbalances

Whenever I see this picture, and discover that my patient is restricting carbohydrates, I know that getting her to eat some simple, gentle carbohydrates on a daily basis will greatly improve her moods and stress-management capability.

And what does that mean?

It certainly does not mean that I tell my patients to go pick up some Wonder Bread and grab a muffin on the way home.  Refined flour products like these might as well be labeled “sugar,” in my opinion, and do nothing to help balance blood sugar or regulate hormones.  The type of gentle carbohydrates I’m talking about include the following starches:





-sweet potatoes


Eaten, of course, with a meal containing protein, fat, and vegetables, and in appropriate serving sizes (different for everyone, but 1/4-1/2 cup of starchy carbohydrate should do the trick, depending on your activity levels and current weight).  In some cases, women will be sensitive to a certain type of carbohydrate that will cause bloating and weight gain – when I suspect this, I recommend Natasha Turner’s Carb Sensitivity Program.

There is actually some research to back this up:

In this article, carbohydrate intake was shown to improve the cortisol response in people with high stress.

No carb diets cause low insulin levels, which reduces the amount of leptin that is released.  Research shows that there is a critical leptin level required to maintain proper female hormone balance which may be missed on a no-carb diet.

This article shows that diets too high in protein decrease GABA, a soothing and calming neurotransmitter. Dr. Lara Briden discusses this link between Gentle Carbs and balanced GABA/cortisol in her article.

Chris Kesser explains in his book that a no-carb diet can exacerbate adrenal fatigue (HPA-axis dysfunction); he favours starches and fruits as carbohydrates of choice, as I do, because the refined flours wreak havoc on insulin and other hormone levels.

I have seen so many cases of this recently in the clinic, that I had to get it out to the masses – paleo is popular and has many health benefits for many people.  But if you’re a female with hormonal imbalances, suffering with HPA-axis dysfunction, and dealing with mood swings and a daily blood sugar roller coaster – I’m talking to you.  Try adding a small serving of nutrient-dense carbohydrates to each of your meals, and tell me how much better you feel.

In health,


4 thoughts on “Why ‘No Carb’ May Be ‘No Good’ For Some Women

  1. Hi Kali, Great post. I am seeing the same thing in my clinic. I have to beg patients to eat a just little rice or potato so that they can sleep!

    Low-carb diets cause HPA instability, but also hair loss, and sometimes a loss of menstrual cycles. Low carb also does weird things to digestion. In the short term, it relieves digestive bloating and IBS, but after about 12 months, a weird kind of constipation sets in that’s difficult to treat.

    I love that you use the term ‘gentle carbohydrate’. I wrote a blog post about young women and “Gentle Carbs” last year. As you say, anyone who treats women, knows this to be true.

    1. Hi Dr. Briden,
      Thanks for your comments – your Gentle Carbs article is fantastic! I’ll link to it in mine. That’s interesting about the digestion as well, I haven’t noticed the constipation link but will keep it in mind. I love your website, you have wonderful articles – very inspiring 🙂


  2. You described my day of early morning energy and mid afternoon energy, etc to a T. My mood swings are out of control and all my weight is in my belly :/

    1. Hi Elisha,

      It’s a really common symptom picture! Do some reading on ‘adrenal fatigue’ or HPA-axis dysfunction. Simple changes to support your adrenal glands can do wonders for your hormonal health, and can facilitate weight loss too. Best of luck!


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