The Keto diet doesn’t always work well for women over 40

What is a keto diet?

In case you’re new to this, a keto diet or ketogenic diet is a diet where you eat very few carbohydrates and a lot of fats, in combination with an average amount of protein, although this depends on the keto diet that one chooses. There are several ways to keto.

keto is not always good for womenIt initially originated in the 1920s when it was found that epileptic seizures in children were significantly reduced with this diet. Keto is nowadays mainly used as a diet to (quickly) lose weight or to get rid of diabetes 2. It also appears to have a positive influence on the fight against chronic modern time diseases.

The energy factories in your body, your mitochondria, can make energy from glucose molecules (from carbohydrates) or fat molecules. The keto diet aims to make your body mainly use fats for energy instead of carbs.

When you eat carbohydrates, your body converts them into glucose. This raises your blood glucose level, which produces the hormone insulin, which carries the glucose to your cells. Here it can be converted into energy. An excess of glucose is stored in your fat cells: or extra kilos of weight. Unfortunately, this energy storage in fat cells is hardly used in many people because the body receives many carbohydrates that it can use limitless, which makes fat burning and thus losing weight difficult.

All the sweet temptations around us, all the sugars and grains hidden in processed food and the many carbohydrates we eat, ensure that our body does not need to use our fat cells as a source of energy.

When you stop eating all those carbohydrates, the body must switch to burning fats. Your body needs energy 24 hours a day to keep you alive. Your brain, in particular, is a significant energy consumer.

Your brain usually always uses glucose as a source of energy. It cannot use fats for energy. But fortunately, when glucose is no longer available (3 to 4 days after cutting out carbohydrates), your liver converts fat from your fat cells into molecules that we call ketones.

Ketones are made in your liver and can be used by your brain, and practically all of your other body cells, as an energy source.

If the body mainly uses fats as an energy source, we call this ketosis. Your body then uses both the fats you eat and the ketones that are produced in your liver. A healthy liver can produce up to 180 grams of ketones per day. Especially when fasting for a few days. One hundred years ago, doctors discovered that a high ketone level had a very beneficial effect on the brain and nervous system. Hence, children with epilepsy benefited so much. Follow-up studies have also shown this diet to be beneficial in neurodegenerative disorders such as Parkinson’s disease, ALS, Huntington’s disease, traumatic brain injuries and strokes.

Ketones are an excellent food for our brains.

Let me first state that I am in favour of significantly reducing carbohydrates in your diet! It is not for nothing that so many people start to feel much, much better by cutting out a large part of the carbs. The ketogenic lifestyle is also recommended for many people, but not for everyone.

The most significant advantage of this ketogenic diet is that our body has to produce much less insulin, and we get more stable blood glucose. A stable blood glucose level promotes insulin sensitivity and thus prevents diabetes II and obesity. It has a positive impact on heart and blood vessels; it strengthens the immune system, prevents chronic diseases and slows down ageing. The benefits are enormous.

Know that cancer cells feed on glucose!

It can also reduce the risk of depressive symptoms, and it will no longer surprise you that it lowers your risk of dementia and Alzheimer’s disease. Finally, it is an excellent remedy for PCOS and hot flashes. Sounds good, right? Why don’t we all go keto?

Because of women with estrogen dominance gain weight instead of losing weight through the ketogenic diet!

Food has a direct impact on our hormone balance.

There are women who do fine on a keto diet, but I also hear women, who do not lose weight and feel weaker. I also hear complaints about irregular periods, mood swings and after initially losing weight, rapidly gaining weight again.

Our female hormone balance is so sensitive that any change in nutrition has an immediate impact on it.

We can use it to our advantage that our hormone system is so sensitive to food, but it can also work against us.

Knowledge about how hormones work in our body is, therefore, fundamental.

Keto for women

I have compared several studies on women following a keto diet. Personal adjustments are needed to make it workable for women. Hormone balance is always the starting point when designing a new diet or lifestyle.

Especially women over 40 encounter diet problems and sudden weight gain. The menopausal transition starts with menstrual cycles becoming longer. This changes the entire hormonal balance in the body, including the thyroid hormones. The thyroid becomes less able to produce the same amount of T4 and T3, while rT3 (reverse T3) levels increase.

Keep your thyroid hormone T3 active.

Too much estrogen in the body can hinder proper thyroid function. Many women have to deal with this. It affects the overall metabolism. An underactive thyroid gland, in particular, can make it impossible to lose weight. Diet has a significant impact on your thyroid and the active thyroid hormone T3.

A female thyroid gland is susceptible. Too much estrogen, too much stress and food shortages have a significant impact.

Studies have shown that a low-calorie diet, as well as ketosis, can cause a decrease in the active hormone T3, which is precisely the hormone that ensures a proper metabolism. These problems did not appear to occur if the subjects continued to eat about 50 grams of carbohydrates per day.

Women (and athletes too) need a minimal amount of carbohydrates to keep their thyroid hormones active. A strict keto diet (20 to 40 grams of carbs per day) is therefore not healthy for them.

Make sure your body does not become acidic

The problem with most keto diets is that they are way too acidic for the body. Female hormones need an alkaline environment to function correctly. So exactly the opposite.

Female hormone balance requires an alkaline body.

Meat, fish, eggs, and dairy are often a significant part of many keto diets. These are all highly acid-forming foods. They release acidic residual waste into the cells that accumulate somewhere in our body.

A lot of acidifying food also causes a magnesium deficiency, which can cause poor sleep, anxiety attacks, headaches and all kinds of other problems in a woman’s body. That is why I recommend magnesium as an essential supplement that I recommend to every woman.

Provide enough fibre

Several women find that they experience constipation or other intestinal problems when switching to keto. When I look at the average keto diet, I see remarkably little fibre there. Fibre is indispensable for a good, daily stool. Proper digestion is one of the four pillars of female hormone balance.

Remember that fibre is only in plant products, never in animal products.

If a large part of your meal consists of meat, fish, eggs or dairy, there is not enough room for vegetable products. Therefore, make sure that your plate is at least 75% filled with vegetable products. Indeed, vegetables also contain carbohydrates, even lettuce, but these are carbohydrates that you need. Don’t be afraid of it. Provide plenty of green vegetables and eat some of them raw. Vegetables are alkaline and therefore also help you to combat acidification of your body.

Learn to distinguish between carbohydrates that you can omit and carbohydrates that your body needs.

Women who cut out too much fibre and carbohydrates will sooner or later feel bad.

I think of eggs with bacon a lot as a keto breakfast. Preferably with a sausage on the side. All proteins. Few people know that excess protein will behave like sugar in our body; you get a glucose boost from it. That’s what we don’t want. Just like with carbohydrates, not all proteins are healthy.

Know the difference between long and short-chain fatty acids

Even if you continue to eat plenty of vegetables and fibre, your body may still not be able to handle the extra fats that you are going to eat with keto. Bile is needed to break down fats. Bile is produced in your liver and stored in your gallbladder. You may have trouble breaking down fats, especially if your gallbladder has been removed.

Diarrhoea is often a sign that your body cannot break down fats properly. The nutrients from fats are then not absorbed, which can lead to nutritional deficiencies.

What you can do if your body has trouble breaking down fats is to reduce the long-chain fatty acids (meat and eggs) and increase the medium-chain and short-chain fatty acids (butter, ghee, coconut oil).

The longer the chain, the more bile it takes to break it down.

That is why I advocate the use of medium and short-chain fatty acids such as coconut oil, MCT oil and butter. I recommend meat in moderation. Of course, then grass-fed (or wild-caught fish) to get as few hormone disruptors as possible.

Even people who follow a keto diet fanatically and are trying to get into ketosis don’t know that we can eat ketones directly.
Particular medium-chain fatty acids in coconut oil, especially C6 (caproic acid), C8 (caprylic acid) and C10 (capric acid), are directly absorbed from the intestines into the blood and transported to the liver, where they are converted into ketones. The same goes for MCT oil. These fats are, therefore seen as direct nutrition for the brain. (4) You now know why.

Stress acts like sugar in your body

Being in ketosis is a signal to the body that there is starvation, even when You eat enough calories. Famine always means stress to your body. Your thyroid can slow down, and this can lead to increased estrogen production, which can cause heavier or more extended periods.

Too much stress causes the body to produce higher amounts of cortisol. Long-term too much cortisol puts your hormones in chaos. Cortisol is just such an energy source for your body as sugar: after all, you need extra energy during stress. In the event of prolonged stress, your thyroid gland will also slow down in an attempt to calm your metabolism (read: your pace).

Losing weight becomes very difficult if your thyroid slows down your metabolism.

So is keto suitable for women?

Having said all this, I still advocate a diet that is low in carbohydrates and includes healthy fats. But not to the extreme and with all the caveats as mentioned above.

Keto is not suitable for all women. Especially for women over 40 with an already vulnerable hormone balance, it is essential to be careful. It quickly has an acidifying effect, and you may lose weight, but you will not get healthier. Women with thyroid disease would do well to talk to their doctor and keep an eye on their carbohydrate intake.

Also remember: keto and stress just don’t mix well. Strict keto is stress for a woman’s body.

The positive aspects of keto, incidentally of any diet, can be enhanced by combining it with intermittent fasting. I am a big believer in this. I can recommend it to everyone, whatever diet you follow.

What ultimately matters is whether you feel good / start to feel better. There is no single diet that can prescribe exactly what you need. You can weigh, add and measure carbohydrates until you weigh an ounce, but ultimately your body determines what it needs.

Therefore: do not let yourself be prescribed and do not be too stressed with nutrition. Don’t make it too complicated. Keep experimenting and learn to listen to the needs of your body: that is the winning combination.

What works for someone else does not have to work for you. What works for you now may be different next year.

If you liked this article and find it valuable for your health and vitality, please help spread it by sharing the message. This is possible by using the social media buttons. I love to hear your feedback! Do you have experience with the keto diet? How did it affect you?





Mathieson RA, Walberg JL, Gwazdauskas FC, Hinkle DE, and Gregg JM. 1986. The effect of varying carbohydrate content of a very-low-caloric diet on resting metabolic rate and thyroid hormones. Metabolism. 35 (5): 394-398.

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