What the Keto Diet Does to a Woman’s Body

May 15, 2019
keto diet

Keto is not a one-size-fits-all diet – especially where women are concerned.

The Keto craze has taken the diet world by storm, and even some of America’s most popular doctors are on board. Joseph Mercola, MD, Josh Axe, DC, and Eric Berg, DC are singing the praises of the severely carb-restricted and high fat keto diet and how much weight people are losing. And while it’s true that many women are experiencing dramatic weight loss, there is an astounding number of women who aren’t.

If you find yourself among the women who are experiencing fatigue, bloating, hair loss, constipation, insomnia, stalled weight loss and more, you’ve likely been told it’s insulin resistance or adrenal fatigue – not keto. While those are common causes of these issues, there’s more they’re not telling you about what keto is doing to your body, and why women are struggling with it.

Women are not at a metabolic disadvantage. There’s nothing inherently wrong with your body that keeps you from losing weight or responding to a high fat, severely carb-restricted diet like keto. Over my 4 decades in the field of nutrition, I’ve met countless women like you, who feel like their weight won’t budge – matter what they try. Fortunately – for them and for you – I’ve done the research and unlocked the secrets to healthy, lasting weight loss for even the slowest of losers. But, before we get into that, let’s look at what keto really does to a woman’s body.

Carbs Are Not Your Worst Enemy

If you are on the keto diet and find yourself irritable, tired, and feeling like you can’t handle stress of any kind, then your body may be trying to tell you it needs more healthy carbs. You are likely in what I call hormone havoc – your stress hormones, sex hormones, thyroid hormones, and blood sugar balancing hormones are all out of whack and crying out for the nutrient-rich carbs they need.

Women, more than men, need low glycemic, nutrient-rich, complex carbs to keep hormone levels steady and balanced. Your digestion needs more fiber-rich carbs to keep it moving consistently, and your body is so busy breaking everything down from being in ketosis that it’s even breaking down lean muscle mass – the very thing you are trying to build.

The right carbs are not your mortal enemy. One thing I’ve learned over the past 40 years studying nutrition is that successful, healthy weight loss does not come from eliminating an entire food group from your diet. When I started in this field, the low fat craze was just building momentum, and I saw many women become obese and suffer with diabetes and heart disease. I’ve watched the low fat wave crest and then fall with emerging research that proved we need fats for brain health and so much more.

Fats have now gone from super-villain to superhero, so we looked for a new villain to fill the void – carbs. The problem is, when you go very low carb, your body thinks it’s starving. This starvation mode is the very thing that triggers the release of ketones and causes you to lose weight – but your hormone balance suffers as a result.

Keto Causes Hormone Havoc

Here’s the “Catch 22” with keto – the very mechanism that causes your body to dramatically shed weight also slows the production of all of your important hormones. The hypothalamus in your brain controls your hormone balance. When your carb intake is low, your body sees that as a type of starvation and this causes the hypothalamus to send signals that lower several types of hormones, creating hormone havoc throughout your body:

Sex hormones: Estrogen, progesterone and testosterone levels drop, causing changes to your monthly cycle, decrease in your libido, increase in belly fat, mood swings, fatigue, decrease fertility, and so much more. These hormones also affect your blood sugar balance and your stress hormone production, because they all feedback to the hypothalamus and interact with each other. This causes a cascade that leads to worse hormone havoc.

Thyroid hormones: Your thyroid gland is the master regulator of your metabolism, and produces several hormones that have a dramatic effect on the speed and efficiency of your metabolism. When your carb intake drops too low, the hypothalamus signals your thyroid to decrease the production of T3, an important metabolic regulating hormone. It also signals the conversion of T3 into reverse T3, which puts your metabolism into “hibernation mode,” where everything slows down and what you eat is stored as fat, with very few calories used for energy production.

Blood Sugar Balancing hormones: When you lower your carb intake, your insulin and leptin levels drop accordingly. When these drop into the normal range, you experience healthy weight loss, but dropping too much causes problems, especially when it comes to insulin.

Insulin is crucial for maintaining muscle mass. When insulin drops with carb restriction, it triggers you to break down muscle to release the sugars stored as glycogen inside of them, to be used for fuel. The end result is loss of lean muscle mass, which is what you actually want to be building when you lose weight. Healthy carb intake is the difference between being in a catabolic state, where everything is being broken down, and an anabolic state, where your muscles are being fed and built up.

Stress hormones: A carb-restricted diet like keto is stressful for your body not only because of the starvation mode it activates, but also because of the cascade of hormone-lowering reactions it causes. If you don’t get enough carbs while under stress, your stress hormone production goes up – as long as you have enough nutrients to meet the higher production needs. But, stress hormones like cortisol need nutrient-rich carbs to be produced in adequate amounts.

When stress hormone production suffers, so does your immunity, and you become susceptible to colds, flus, and worse immune issues. Stress hormone balance is tricky, and hormones like cortisol feedback to the hypothalamus, sending signals that worsen the hormone havoc already happening from carb restriction. You develop what’s called adrenal fatigue, which is where that wired-but-tired feeling comes from that makes you feel tired during the day and awake at night, unable to sleep.

Your Digestion Needs Carbs

If you’ve experienced bloating, constipation, or IBS-type symptoms while on keto, your body is telling you it needs more fiber-rich carbs. The fiber in healthy carbs not only provides the bulk you need for healthy bowel movements, it also binds toxins and sweeps them out like “nature’s broom” to eliminate them from your body.

These fiber-rich carbs also feed the healthy bacteria in your gut microbiome. Researchers have found that there are bacteria strains that signal you to gain weight. These bacteria are found in abundance in the digestive tracts of people who are experiencing famine, as a protective mechanism to keep them from starving. Feeding your healthy probiotic bacteria the carbs they need to increase their population, not only helps them to crowd out the unhealthy and fat-promoting strains of bacteria, but also boosts your immune system.

It’s Time for Women to Get Radical

While there are unhealthy versions of each of the macronutrients, the truth is, we need them all – fats, carbs, and proteins – from the right sources and in balanced amounts. If you want increased energy, better hormone balance, great digestion, optimal metabolism, and good health all the way to the cellular level, then it’s time to get Radical.

My Radical Metabolism plan was created for women like you – fat and fatigued, with a sluggish metabolism. My plan guides you into a healthy lifestyle with smart carbs, healthy fats, and the right proteins. It not only helps you lose those stubborn pounds once and for all, it also teaches you how to live a healthy lifestyle you can thrive with – and have your coffee, tea, and daily dessert, too!

In Radical Metabolism, you’ll discover how to get the benefits of a keto diet without being keto. You’ll find tips such as why you might want to trade your coconut (or olive) oil for hemp seed oil… why Uni Key’s Bile Builder should be your new BFF (this is a MUST for anyone without a gallbladder) … along with delicious recipes you can incorporate NOW to speed up weight loss without endangering your health (our Mocha Chai Breakfast Pudding recipe is an all-time favorite!).

Have you snagged your copy of Radical Metabolism yet? How is it working for you? Your feedback is appreciated.

Related Articles and Podcasts

Ann Louise Gittleman, PhD, CNS, is an award-winning New York Times bestselling author of more than thirty books including The Fat Flush Plan series and her latest book, Radical Metabolism. She’s been rewriting the rules of nutrition for more than 40 years and is internationally recognized as a pioneer in the field of diet, detox and women’s health issues. 

For a FREE daily dose of tips and strategies for maintaining healthy weight, conquering insomnia, and much more…check out my Radical Health Tips.

I’d like to meet and greet you on my Facebook groups, so won’t you check us out at the Radical Metabolism RevolutionFat Flush Nation, or my Inner Circle!


  1. Marilyn Luce

    Amazing to learn how all the nutrients work together in so many body systems. No wonder I didn’t feel good on Keto.

    • Grace

      Keto is a dangerous plan…Made me very very sick…Yest and made a mess of my hormones too..Not one hormone in the test was normal, either too high or too low. Feeling really sick from it too.

    • Team ALG

      Will be addressing men soon….Thanks.

  2. Sue

    Keto really bothered my gallbladder and liver!

    • Vicky

      Me too! I even developed bad eczema and i’ve Never had it in my life.

    • Sumi

      Me too. Ended up with gastritis. Am now a mess

  3. Cheryl

    Ann Louise, you are ever and always the most well-researched, well-documented and clearly stated voice of reason. Thank you.

  4. Tera Hecht

    I feel a surge of cortisol when I’m Keto. What can I take to control cortisol

  5. Marie

    I really have to disagree here, because doing a safe and healthy keto the way Dr. Berg suggests has been the best for my problems with a slow thyroid, adrenal fatigue, and insulin resistance. Instead of loosing muscle, my muscles are getting defined without exercise, my hair stopped falling, my blood pressure and blood glucose went back to normal, finally I can sleep 7 hours straight every night and wake up fresh, I can run like a kid again, my pores are closed and my complexion is glowing – these are great benefits, besides going from size 22 to 16, to be able to have these health gains at my age, 59yo, it is just great!

    • Susan Stevenson

      I’m having similar results also with with fasting. I’ve never felt better. My energy level is great. I don’t need to nap anymore and have more motivation than ever before. It’s not complicated, either. Sorry to say, but Radical was.

      • Team ALG

        Susan, Glad you are experiencing such good results. Radical Metabolism does give you choices you can personalize the plan but the plan itself is well laid out and most people find it simple to follow.

  6. Nancy D'Arcy

    I agree with Marie! I’ve also been following Dr. Berg, Dr. Fung, Dr. Berry, Dr. Gundry and Dr. Mercola. I can’t swallow the supplements that are required on Radical Metabolism and it’s a lot of work if and the supplements are pricey. I take thyroid support and that’s it. Keto diet is very easy to follow because you’re eating real food, grass fed meat, pasture raised chicken, wild fish and lots of veggies with butter and olive oil and I definitely feel lighter. If you drink a half cup of bone broth that will help you avoid the keto flu.

    • Team ALG

      Hi Marie and Nancy! We are so pleased that you are doing so well on your Keto diet. As you know, we focus on real food, grass fed meat, pasture raised chicken, wild fish, lots of veggies and healthy oils as well. The supplements that you struggled with are well tolerated and effective for most. Although suggested for enhanced weight loss results and health benefits, the supplements are not required for success. As you know, not all diets are the same and not all diets work for everyone. We are so happy you have joined the conversation and please keep us posted on your success!

      • Kristen

        Ladies, just stay on keto for a year or two and unfortunately you’ll find out the hard way… this website is exactly right! Keto results in weight loss in the short term but hair loss, reduced muscle mass, no energy and cray-cray mood swings/hormones in the long term. But sometimes you just have to experience it yourself to understand. I did. I used to be firmly in the keto camp. Not anymore. Wish I would have listened to the warnings. I would have lost weight the healthy way.

  7. Patrice

    Ann Louise, Thank you for an insightful article on this “hot topic”. Your research and knowledge never cease to amaze me!

  8. Lori

    What carbs do you recommend? Should they be eaten with proteins?

    • Team ALG

      Lori, Starchy veggies, legumes and low lectin grains like millet and white basmati rice. Yes, they can be combined with proteins.

      • Fairlie Scott

        Why are starchy, high carb and low nutrient foods like rice included here? I think that very high glycemic foods with low nutritional value should be avoided (unless for a treat on rare occasion).
        There are many lower starch (aka sugar) veg and fruits that are bursting with nutrients.

        • Team ALG

          Fairlie, Yes all veggies and fruits contain some carbs. These lower carb sources are also on the plan. Generally when someone asks about carbs they mean the higher carb sources which are mentioned above and included in the book. These are medium glycemic foods and do have nutritional value.

  9. Trisha

    Hi, I’m on the opposite end of the spectrum. I have Celiac or NCGS and have had to give up gluten & dairy, thereby missing out on many carbs & perhaps even sources of essential serotonin.

    I have dropped to 96 pounds (I’m 5’5”). HOW can I gain weight ???
    I’ve lost all of my muscle mass especially in my shoulders and upper torso (I’m a swimmer) and I once looked tremendous.


    • Team ALG

      Trisha, I suggest that you follow the maintenance plan in Radical Metabolism, modifying for your dietary needs. You could add extra healthy fats and protein as you can to gain weight.

  10. Rae

    Hello, I was on the Keto plan for 8 months and after my hair started falling for 4 of the months I had to incorporate healthy carbs back in. I felt good on Keto, but was very constipated. Since starting on Radical Metabolism plan I am feeling much better in the gut area. I agree with Ann Louise that it is not a plan for everyone and as a 55 yr old, I needed other kinds of nutrients. I love the juicer drinks in her book. I have always had great success with The Fat Flush program and I think I will stick to this instead of Keto. My hair feels much better and healthier now. I did lose 18 lbs on Keto, but I also lost half of my head of hair. Radical Metabolism is a plan you can live with and enjoy life!! You can have your cake and eat it too…. Thank you Ann Louise!!

  11. Lisa Behling

    When I went on Keto I lost weight fast! My thyroid function also dropped to below the “ normal” range and my Free T3 dropped significantly. My body may have been really thin, but it was clearly not happy.

  12. Rosemary

    I am 69 and I have been on basically a Keto diet for a couple years. I have lost 10 lbs without trying. I have lost muscle and my skin is wrinkled and sagging. I bought the Radical Metabolism book for my daughter but have not read it. The Fat Flush diet is the only diet i’ve ever used and it was always amazingly successful whenever I needed to lose weight. I know Ann Louise to be a font of knowledge and always ahead in her thinking. I need to know what to do to get my skin and muscle back to normal.

    • Team ALG

      Rosemary, To rebuild muscle you need protein. Fat Flush Whey is especially good to build lean body mass based on the balance of amino acids. To help with skin tightening CLA-1000 taken with every meal and doing exercise every day, like rebounding, have been shown to be effective.

  13. Cynjay

    I do great on Keto. And I get carbs from veggies…not bread, cookies. Pasta, etc. In fact most people I follow on Facebook…mostly women excel doing Keto. The other wonderful thing about doing Keto…NO supplements to purchase. Just buy food. DONE!

    If you have issues processing the high fats, due to gallbladder issues, or no gallbladder at all, buy Betaine HCL and good enzymes. Other than those there’s no need for supplementation.

    To each his own.

    • Team ALG

      Cynjay, We’ve also found that bile salts are helpful when you have gallbladder issues or trouble digesting fat. The UNI KEY HCL+2 formula also includes ox bile for this purpose. Bile Builder is very helpful when there is a sluggish liver or problems with stones and fat digestion. It also contains bile salts.



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