Is a Low Carb Diet Healthy?

Is a low carb diet healthy

“Is a Low Carb Diet Healthy?” This question has been swirling around the blogosphere lately with many different answers.

Some claim that really low-carb is the only way to go, others claim that eating low carb messed up their thyroid or other hormones.

One important distinction that must be made is between low-carb and grain-free. These two are often lumped together and then the argument is made that grain-freeis unhealthy because it is too low-carb.

Certainly, one could eat a very high carb grain-free diet, or a somewhat low-carb diet with grains. For the sake of understanding the health aspects of either diet, they must be separated.

You know how I feel about the dangers of grains, so for now, let’s just address the low-carb aspect.

Can Low Carb Affect Your Hormones?

Short answer: Yes. But this can vary widely by individual and can be both positive or negative, depending on the person.

Some people (a very small percentage of my clients) who jump into low carb from a very high carb diet will experience some thyroid-like side effects a few weeks or few months after switching such as fatigue, coldness in extremities, hair-loss or other problems.

The interesting factor here, is that when these people have their hormones tested, most thyroid panels will come back normal (because most doctors only test Thyroid Stimulating Hormone or TSH and T4 hormones).

In my experience, these clients are also ones who went low-carb for weight-loss reasons and often have an underlying hormone issue to begin with.

Interestingly, even for those who have completely normal blood results, adding a lot (like Standard American Diet a lot) of carbs back to the diet will make these symptoms go away. This obviously means that low-carb is bad for these individuals…. right? Nope! And actually could mean quite the opposite.

I’ve noticed with clients that those with the worst “carb flu” in the beginning either had a lot of weight to lose or had an underlying hormone imbalance, and that logically, these people would benefit the most from going low-carb in the long run. Unfortunately, because of the carb flu, these people often had a to take a gradual path to low-carb, or the symptoms would be overwhelming and they’d be overly fatigued.

For a long time, I considered this slow-transition a problem, and was able to find some things (adding more natural salt into the diet, taking magnesium and gelatin, etc.)  that made the transitions easier.

While these supplements do help the transition, and I’d recommend them anyway, a recent article by Dr. Cate Shanahan helped me understand why some individuals experience these thyroid like-symptoms after going low-carb for a while and explains why the slow-transition might actually be the best thing for these people.

What Causes It?

Dr. Shanahan explains that advanced thyroid testing will often reveal that these individuals have an extremely elevated reverse T3 level (rT3) and at this point, most doctors will prescribe T3 and think that the problem is solved. Dr. Shanahan explains the rT3 has the opposite effect of regular T3 and essentially makes the body think it needs to hibernate and prepares for such (weight gain, fatigue, brain fog, etc.).

Since high levels of rT3 can also lead to high LDL Cholesterol (that’s the bad one) this is definitely something that needs to be addressed!

Dr. Shanahan has a theory on this and explains it much better than I could:

In doing research on rT3, I ran into afascinating article on a group of little-understood compounds called thyronamines (pronounced thigh-row-na-meens). The key to understanding rT3, and unlocking the relationship between carbohydrate consumption and thyroid function, may lie in these newly discovered compounds.

Thyronamines have powerful effects on energy metabolism

Studies performed in 2010 showed that injecting thryronamines into the belly cavity or brain tissues of experimental animals cause the following physiologic and behavior changes:

  • Impaired ability to utilize sugar as an energy source
  • Insulin resistance
  • Lowered basal body temperature
  • Weaker than normal heart contractions
  • A marked decline in activity (We can’t ask the lab animals, but presumably this would be induced by what we would describe as feelings of extreme fatigue)

She goes on to explain that this phenomenon is similar to bears before hibernation, and this drop in rT3 caused when berries and other readily available carbs disappear creates the fatigue needed for hibernation. Unfortunately, for those of us not interested in hibernation, this can be a problem.

So No Low-Carb?

That’s not what I’m saying at all, and compared to the amount of carbs that the average person consumes these days, “low-carb” is definitely more healthy. I still advocate removing grains, since, carbs or not, there is no need for grains.

If you are part of the group that suffers from severe carb flu when you remove carbs, or if you’ve gone low-carb for a while and then started to lose energy and gain weight, it’s possible that your rT3 is elevated.

Fortunately, while suddenly removing carbs shocks the system, doing it gradually often helps the system adjust. Dr. Shanahan recommends that patients who suffer from these symptoms go low-carb slowly beginning with breakfast and slowly reducing overall carbs over a period of time.

From what I’ve seen with my own clients, this can be helpful and necessary, especially for those who already have an underlying hormone struggle or who have a severe reaction to removing carbs.

I’d also suggest certain supplements to help support the body during the transition!

Bottom Line

Despite the recent firestorm of information about the possible “dangers” of low-carb and the “importance” of eating more carbs, especially from grains, I maintain that there is NO biological need to consume grains, even if you want to eat a high carb diet (try sweet potatoes, fruit, squash, etc.).

Most people will be able to transition to a low-carb diet, even quickly, without a problem, and those with a history of thyroid problems or hormone imbalances may just need to take it a little slower.

Unless a person’s endocrine system is severely damaged, he or she should be able to transition to a low-carb diet over a period of a few months without any adverse health reactions and see weight loss and health improvements as the body adjusts.

Do you eat too many carbs or too few? Are you even worried about your carbs? Weigh in below! (no pun intended!!)

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Reader Comments

  1. I find that I feel better, have a lot more energy and need less food when I eat low carb. I have gone on this diet several times. The first was after college and I was feeling terrible with fatigue for several months, a natural doctor I went to recommended going grain-free & bread-free for a couple months, taking a couple different supplements, and slowly add the grains back into my diet. Well, after a couple days the nasty symptoms I was experiencing were gone. I had no plan on incorporating grains back until I was pregnant and craving french toast… no problems during pregnancy but after the ONLY way I was able to loose the weight was to go low-carb again.

    • I agree, I’m the same way and definitely am not suggesting that people don’t go low-carb, just making sure to point out that some people need to do it slowly 🙂

  2. This debate intrigues me. What is your definition for the number of carbs considered to be low carb? How many carbs in the SAD diet?

    • I’m considering low-carb under 50 grams (which I’m not saying is a bad things at all) and SAD carbs are typically 300+

    • Actually, low carb, paleo style, is between 50 -150 carbs, but very low carb, like for ketosis is under 40-50, depending on the person.

  3. I have read her article and have to agree with most of it.  I am personally experiencing this myself and am struggling to come to terms with the fact that  the lifestyle/diet that was supposed to make me healthier than I had ever been has unfortunately made me about as unhealthy as I have been in 20+ years and fatter!  I am currently 10 pounds heavier than my heaviest body weight ever.  I have already spent hundreds of dollars on non traditional help and tried the route of upping my carbs thru veggies, sweet potatoes and fruit and it hasn’t really helped.  I am battling both adrenal fatigue and possibly  Thyroid issues brought on by a low carb Paleo diet.  I had been eating strict Paleo for about 9 months before I started having some pretty major problems.  I have seen this not only in myself but in friends who have gone Paleo (it hits around the 9-12 month mark), so I am pretty skeptical about the whole Low carb Paleo diet being healthy for anyone!  After some recent research I have added a sprinkling of rice back into my diet and once a week corn tortilla with  my tacos.  I still eat Paleo otherwise and love the idea behind it, but I find myself falling  more into the category of specialist suggesting that rice, corn and/or the inclusion of white potatoes is a good idea.  The problem with adding a lot of sweet potatoes and fruit is the sugar content of those can make you fat too.  

    • Sorry you are having those problems.  I’ve been Paleo for over a year.  I can’t say I am high or low carb.  I eat what I want, eat when I am hungry.  Many of my clients have also been Paleo over a year and are not suffering like you are.  I hope you can get your issues worked out.  A client of mine came to me with seriously messed up adrenals from Figure Prep diets (body building diets) and after getting help from a Naturopathic Dr and then switching to Paleo she is losing weight again and feeling amazing for the first time in years.  Paleo, or eating whole foods doesn’t always mean low carb.  They are not tied together.  Your health will still be better if you follow a whole foods diet versus going back to eating processed foods, gluten, wheat, etc.  

      • She never said she was going back to processed foods or gluten.
        One thing she did say that is not true is that the sugar in sweet potatoes and fruits will make you fat. This is a completely false statement; sugar does not make one fat. Eating of excess calories makes one fat (regardless of macronutrient: fat, sugar/carbs, proteins). If it were true, it makes no sense that she would state that when she is okay with eating corn tortilla and rice which have the same or higher glycemic load as sweet potatoes and fruits , in general.

        • Actually, newer research shows that all calories are not created equal and the same number of calories from sweet potatos and fruits will add fat more quickly than that number of calories from protein or fat will. So yes, eating too many ‘healthy’ carbs will make you fat if you eat enough of them. There are other problems with over eating protein and fats, but the old calorie counting thing is not scientifically sound. It takes relatively little effort for our bodies to break down those carbs so they get stored as fat more quickly. It takes a lot more effort for our bodies to break down protein and significantly more effort to break down fats. As a result, it’s harder for our bodies to store them as fat.

          • You want to know the problem with this idea? I got and stayed fat on almost a zero carb diet. I also got anxiety attacks and insomnia. Initially low carb worked but over time weight kept creeping up so I kept lowering the carbs but it just became more and more ineffective. By the time I chose to quit I was not losing any weight no matter how low carb or even low calorie I went. The worst part however was the anxiety and insomnia. Personally I’d rather be fat and feel halfway decent. And I don’t think that everyone can be thin.

    • Agree completely! Even for those who need more carbs temporarily, I definitely don’t encourage getting these carbs from grain or processed foods! There are plenty of natural and healthy sources of carbs that can work that don’t involve grains!

    • I have heard this a lot from a lot and it scares me to start the diet
      I have good metabolism and such I don’t want anything made bad coz of this diet
      but I do believe to focus on nutrition. which includes focusing on good fats vegetables fish and meat. everything else fills me up unnecessary so that I can’t fit in the good stuff. carbs being one if which.
      I also read though somewhere that if you eat low carb for extended period of time in ketones mode your enzymes have problem not having anything to burn
      this sooner or later can mess up your metabolism lipid etc and thyroid
      the suggested advice here from this doctor was to cycle carbs every once in awhile
      I heard weekly
      perhaps you and your friends didn’t know or try this at the time
      but basically you up the carb to sweet potato fruit oncr every week
      I don’t know if this will help
      or not
      but I reckon you need to balance your hormones and everything again
      do the autoimmune diet
      avoiding sensitive foods and such healing your system
      I also heard that the gut wellness and hormonal system is all connected
      if your gut is messed up
      your hormonal will be too in some way or big ways
      I don’t know for facts but these are just things I’ve learnt and passing them on as suggestions

  4. Does this happen to everyone who is hypothyroid?  I’m on day 6 and have lost a few pounds and am no longer obsessed with food!  I don’t want to go back to more carbs – I was counting on this way of life to GIVE me energy.  I felt like I was needing to hibernate BEFORE making the change and am freaking out a little bit at the idea of going back to that.  I don’t feel great yet; I tire easily and am achy but I no longer feel like I need to hide in bed. 

    • Nope, definitely not everyone… just a small percentage. I’m not trying to discourage anyone from going low-carb, just wanted to shed light on the potential for this to happen for that small percentage of people! If low-carb is working for you… go for it. If you hit a plateau at 9-12 months, (doesn’t sound like you will) then just consider adding in a small amount of carbs and then cutting back slowly to re-set the energy and weight loss benefits!

  5. I had carb flu when I first went very low carb but I got over it after a few weeks.   I have however suffered from hair loss and I’m glad to see you mention it here because most low carb diets claim that it is absolutely not a result of going low carb.   But I’ve seen it brought up often enough in chats that I know I’m not alone.   I’ve lost extensive weight being low carb and am fitter, leaner and healthier than I have ever been but the thinner hair depresses me.   Any suggestions?

    • Some people do really well with carb cycling for getting the hair to come back (A post on that coming soon!) or you could try slowly introducing 30-50 more grams of carbs per day for a few weeks and then cutting back again gradually which may bring down the rT3 levels and help with the hair loss without causing weight gain…

      • I have been wondering why I’m shedding hair so badly, and it definetly corresponds with the 1 year I have been lo-carb. Im almost 53 and not in menopause. I have a scedualed dermotogist appointment to address my sudden hair thinning which has really affected my self-esteem.

    • You should take Biotin, it is a form of vitamin B. It takes a few months but from pregnancy hair loss I noticed it really helped. You could also get extensions if it really bothers you. I had a row put in and it make my confidence go way up because I didn’t feel like such an overweight mother! It is costly though, around $300.00 but it really healped me!  Good luck!

    • Hi Allison ,
      I am having severe carb flu when i try to go low carb.Can you tell me how did you overcome it


    • Yes! Take Biptin!! Very cheap to buy and works wonders!!

  6. I was going wheat free, but not grain free or low carb for years. I found paleo 7 months ago and I’ve not looked back. When I first went paleo (moderate carbs 50-100g), I did have the ‘carb-flu’ for about a week. I was very sluggish and fatigued. In order to make it, I just reminded myself that this was part of the process and that my body was learning how to adapt to the lower carbs. I let myself be ‘lazy’, I read, went for walks for workouts and had fun planning meals. I got through it and felt like a switch had been flipped! I had a ton of energy (I also thank Vit D for this)!
      In these past 7 months I have played around with my carbs; moderate carb (50-100 g), low carb (no more than 50g) and “higher” carb (over 100). I felt the worst on the “higher” carb. I was making paleo ‘treats’ like banana bread, and desserts. I was hungry more often and was craving food constantly. I don’t and won’t own a scale, but I could tell by my clothes that I had started to gain some weight. I felt so bloated. I went back to the moderate/low carb, meaning some days I have no more than 50g and others I may have a little more. I am not really doing it for weight loss, but getting leaner is a nice side affect. My goal is just to feel good and not be so obssessed with food all of the time. The low carb paleo has really helped me with that.

    • That is exactly my experience! Higher carb amounts, bread, pasta, sugar etc mean more food cravings, I was thinking about food constantly. I was like this for years and always looking for answers because it was exhausting. When I went Paleo (not strict) my problem with obsessing over food was over.

  7. I’ve been experiencing fatigue lately.  Bone crushing fatigue.  Granted, I have been dealing with a husband with pneumonia (for 5 weeks – coughing tons at night) and also trying to keep my immune system up myself. We’ve been paleo about 7 months now.  I have found that making sure I keep up with my iodine and an extra D3 each day helps.  Also, to combat the cortisol dysregulation that appears to be my problem, I’m trying to stay off of stimulants (including sugar!), shutting off electronics about 30 minutes before bed, and going to bed with the kids at 8.  Those seem to be helping the most.  I don’t know what sparked it, but hopefully with these tweaks in our lifestyle, I’ll stop being cold, finally stop shedding hair at an amazing rate, and stop feeling tired. Going outside in the sun, even for 15 minutes a day is also helpful.

  8. I’m trying to decide what to do.  I had a slow and therefore pretty easy transition to low carb and initially lost a good bit of weight, but I have been stalled for a very long time (8 months!) with still a lot of weight to lose.  At least I have maintained my almost 40 lb weight loss, but I’ve been low carbing (no grains) pretty seriously (20 to 30 grams net per day) to do so. 

    I feel GREAT!  I’m warm, energetic, able to do things I couldn’t before lowering my carbs, BUT my TSH is high, which is probably a factor in the lack of weight loss.  My HMO will test only TSH and T4, and will not treat with natural hormone, so I’m not sure I trust them to treat thyroid at all if they don’t consider the entire thyroid function. 

    I read Dr. Shanahan’s article with interest, and I’m considering adding some starchy veggies like sweet potato and winter squashes in to see if it budges anything.  I’m not sure how much to add in and when I will know if it’s working or not.  Should I add in starchy veggies until the weight starts to go up and then stay at a slightly lower level for a while?

    I don’t want to be too far out of ketosis as I feel so good on it, and I am experiencing myriad health benefits.  But I’m also frustrated at the lack of weight loss, even though I’m being very careful with my diet. 

    • I”d suggest going higher carb, slowly and temporarily, as a thyroid re-set and then gradually going back down to lower carb over a period of a few weeks. You could definitely add in healthier starches like sweet potatoes, extra fruit, winter squash, etc. The threshold that I’ve seen with other clients is getting 100-150 grams per day for about a month and then slowly tapering down. If the stall is thyroid related, this shouldn’t actually cause much weight gain, other than the first few pounds of water weight/glycogen, and that should disappear too as you go back down. You could also try carb cycling for a month, which would be even less likely to cause weight gain but which also might re-set the thyroid. I’ll be posting more on that soon. Whichever you do, I’d suggest taking magnesium, gelatin, vitamin D and possibly b-vitamins to support your body in the process. You aren’t by chance taking 5-HTP or L-tyrosine are you? I’ve also seen these cause a stall…

  9. I’m fairly new to eating low-carb, no grains, and sugar free.  I generally stay in the 50-100 grams per day range.  I can’t say that I feel great.  I am definitely lacking energy, but I lost 20 pounds this month, so I really think I should continue.  I’ve also noticed on days my carb count is below 50 I’m starving the next day.  Is that normal?  Does this mean I need more carbs?  Or less?  And do all carbs count?  I’ve heard people say they don’t count the carbs in fruits and veggies, but those are pretty much the only carbs I get.  I’m so confused!!

    • I count all carbs, fruit included, in overall carb count. It would be tough to know if the low-carb is making you hungry without knowing what the rest of your diet that day looked like, but for most people 50-100 is a good range for weight loss. If you hit a plateau or if your energy doesn’t improve, you might consider temporarily adding more carbs and then reducing again. How much fat are you eating? Not eating enough fat or not eating enough real salt could both contribute to the tiredness, and you’ll need more water eating low-carb.

      • This past week I average 54% fat, 23% carbs, and 23% protein.  Is that a good ratio?  I have a very hard time coming up with enough protein.  I’d love to hear some low-budget protein ideas.

  10. Thanks for the great info.

    Popping over from Conversion Diary.

    Curious as well if you count fruit carbs? It would make sense that you do but just wondering. Thank you!

    • I do include them just to have an accurate count. Again, definitely not trying to discourage low-carb, just caution about the transition to it 🙂

  11. I have been low carb for many years. It was the only way I could loose weight. I lost about 40kg. I now could not say I am low carb. BUT I am grain free. I totally agree grains are not required for a healthy body. In fact I would say to have a healthy body you cannot eat grains!  (my diet is still probably a lot lower in carbs than most of western society!) Now days I eat a tonne of green leafy vegetables  and some fruit that pushes my carb levels over 20-50g a day!

    I advocate grain free but not completely sold on low ‘low carb’ even though I lost 40kg doing just that!

  12. What sites do you use to tell you how many carbs food items have?

  13. Even though I’d prefer to eat meat/fat/vegetables, I have long term hypoadrenia & Hashimoto’s so I must eat more carbs (swt. pot/winter squash) than I want.  I’ve been doing Paleo for 2 months and find that I can get by with less carbs than when I started, so that’s encouraging.  When I’ve tried eating no starch, I’m fine during the day but cannot sleep at night, and sleep is primary!  Us autoimmune Paleo critters walk a much finer line.

    •  Update:  after doing Paleo for 6 months I finally ran a blood test and I have trashed my kidneys to the point of Stage 3 kidney disease.  All of that to say please Please PLEASE monitor your chemistry!!!  I have cut way back on my protein consumption and eat more carbs now and will re-run a blood lab this week.  Hopefully my eGFR, etc. will reverse.

      • Jan, a little-known effect of even having a little too much thyroid hormone over a long period is thyrotoxic myopathy which can destroy kidney and muscle tissue. My labs weren’t even out of range and it happened to me…although my TSH was a bit low and my Free T3 still in range but right at the top. My GFR was too low and creatinine too high (and I was peeing 11-14 times a day). Also, you, as an autoimmune patient want to be very wary of other autoimmune diseases that can cause kidney disease (like lupus). I’m not saying you’re not eating too much protein, not sure how much you’re eating…but I’m paleo and am not eating any more meat than before, just a lot more veggies, and of course, no starch.

  14. Thank you, thank you!

    I realize I’m late to this thread, but I have been preaching the idea of a slow transition to low-carb for those of us with autoimmune issues since I went paleo a few months ago. It was so horrendous for me when I was diagnosed with celiac disease ten years ago to cut out wheat cold turkey that I wonder whether the stress didn’t set my whole Hashimoto’s/Graves’ disease mess in motion. Like many people with celiac disease, my thyroid issues cropped up immediately after going gluten-free. 

     Once I found out about the role of opioids in wheat withdrawal, and now this new info on a direct effect to thyroid hormone production, I’m more convinced than ever that those who are choosing Paleo in an effort to feel better should convert to grain-free slowly and methodically. Cut down to a piece of bread a day for a few days, then only eat half a piece when you’re really feeling the craving…soon you just won’t crave it, then consider yourself totally off of it (so STAY off it). It’s pretty much the same process as going off Xanax or Ativan. If grains truly do contain opioids, perhaps we should treat this fact with the seriousness it deserves. 

  15. I always get a really bad carb flu after 3 days of low carb. So what’s your advice? Add some berries or something? Please help

  16. I am underweight and accidentally slipped into low carb Paleo after cutting out sweet potato and carrots simoly because Ibgrew tired of them. Little did I know it would cost me my hair and cause thyroid problems. My levels actually came back problematic and my hair just keeps falling out in clumps. How can I reverse this? Will it help to simply go back to 120 g of carbs a day?

    • I’d add the carbs back in and also really up the overall calories and add in a lot of coconut oil and grass fed butter if you eat it to help with the thyroid.

      • Thank you! I am eating about 2000 calories a day and 100g of raw butter. It is good to hear it will help with that too. I increased my carbs but they get me very bloated. However, it seems the hair loss already slowed down!

        • Thank you for updating us
          gives hope for the wary afraiders like me
          don’t like losing full control esp of my body
          now I know what back ups I have 🙂

  17. The Paleo diet has been shown to be really bad for people. Don’t go on it is all I have to say.

    • What do you think is radical about the paleo diet and how has it been shown to be really bad for people? By the way, there is fructose in sucrose (as well as glucose).

    • Wow, you might consider referencing your source(s) for this ridiculous statement. How can eating non processed whole foods “be really bad for people”?

  18. Thank you for this dialogue. I went on a nutrition challenge a month ago
    with my exercise class – no grain, no dairy, no prepared foods. Pretty
    radical. Dropped some weight and felt stronger, then all of a sudden I
    get fatigued in the afternoon and a little moody, also a little hair
    loss like I had prior to the big M. Your site is the first one that gave
    me any idea this could be “carb flu” – I may have to moderate?

  19. Depends on where you are getting your carbs! I eat 12 bananas a day as well as smoothies, rice, huge salads, and burn over 2500 calories exercising (daily) and have never felt better or more energized. Never slept better, looked better, smelled better, ask my girlfriend. 😛

  20. Wow, that is great information that I haven’t seen before. I have a very specific question that I’ve been unable to find any answers to and would really appreciate it if you would share any thoughts on the subject. I started a (very) low carb diet in September 2013, lost 40 lbs by January (~10 lbs per month), but then suddenly stalled despite eating the same foods I had been eating all along. In the past 3.5 months, I have only lost 12 lbs total, averaging 1 lb. per week or less. Starting in March, I added exercise to my routine, an hour long water aerobics class at least 3x a week but there has been no improvement in weight loss. I am significantly overweight and still have at least 70-80 lbs to lose to get to a normal weight, so I am baffled. I’m currently eating 20-50 carbs per day, mostly from green veggies and on most days my calories actually come in under the recommended daily value of 1,200 to 1,500. I actually don’t mind the low carb diet, I feel happy that I broke my cravings for processed garbage and I’m hungry less often, so I don’t want to quit–but honestly I’m not sure where to go from here because I am determined to get this weight off. I just feel like something must be wrong for me to no longer be losing weight on this plan. Thanks in advance for any advice!

    • You may need to add in healthy starches like sweet potatoes, squashes and fruit. Some women will have negative results from going too low carb…

      • Thanks for taking the time to reply. I will try that for a while and see if it helps.

  21. I think oversimplifying and exaggerating – going into extremes – is never healthy, in any part of life. People who live close to nature understand that nature is constantly re-creating balance. If you stay out of balance for a longer time, there will be consequences. People seem to like exaggerating, perhaps as an illusion of control or a breakthrough, and especially if it gives them an excuse to indulge.

    I think low-carb works initially for the same reason most other diets work for a short time: because it eliminates highly processed food, especially refined starch and sugar, and reduces calories. But if people put all grains, fruit and even vegetables into the same category as processed carbs, they will have long-term consequences.

    My theory is that whatever we as a species really like and crave, we were evolved to crave because it was scarce. There was no need for nature to make us crave something that was abundant, like vegetables. We needed extra motivation to invest effort into obtaining scarce nutrients. But once they are so readily available and people start emphasizing them, the balance is disturbed again, whether the emphasize is on starch, fat or protein. .

    The main problem with Western food, IMO, is that, even when we try to eliminate processed food, we still eat too much high-density food (low water content, high in calories). That is most of what is available in shops. I do my best to eat lower amounts of concentrated food and higher amounts of low-density food (high in water, low in calories). I try to keep macronutrients balanced. And I absolutely avoid processed food. Once a week I cook some more indulgent food to avoid feeling deprived, but still try to make it light and without highly processed ingredients. So far, very good.

  22. I am very late to this but was intrigued when I saw a comment about developing thyroid issues right after going gluten free. I did this but wasn’t sure if I already had thyroid problems, so I never made the connection. It also severely changed my endurance for my “running” (it was so slow, it needs quotes) and I eventually stopped running. It was so bad after quitting gluten.

    I have gained about 20 pounds in a year since going gluten free and actually improving my diet. This is just so dang frustrating to be making healthy improvements but seeing negative (and frankly, with the weight gain, embarassing) results.

    I do eat sweet potatoes, meats and eggs, coconut oil, some butter (but I limit since finding out lactose seems to now be a problem too), veggies and fruits (mainly apples and some berries). I feel like I’m running out of things to cut out. Any suggestions? Will this get better?? I never knew making healthy choices could leave me even more confused.

  23. Thank you so much for this article and all your great information. This is me exactly. I have Hashimoto’s and started Low Carb Paleo not strictly about a year ago (eat some high fat raw dairy), But didn’t lose much weight and started to get very fatigued, with brain fog, bone numbing cold legs and feet and felt I had to stay in bed half the day. I thought it was my thyroid playing up as these are the symptoms, but my tests came back all normal. I was starting to worry as I could not think straight anymore. I googled low carb and found your article. Adding some rice to my diet and some more fruit has done wonders. THANK YOU. Just need to find out how much starchy carbs I need to maintain my brain function without putting on weight. Also I found adding some coconut oil helps too.

  24. Hi Katie.
    I am wondering if, in your Hashimoto’s journey, you have found any link between lo carb with rapid fat loss and the triggering of Hashimoto’s. I lost a good bit of fat quickly doing Carb Nite Solution and HIIT. Felt great! Better than I had in a LONG time, but grew nodules in my thyroid (visible enlargement was the only reason I went to endo for check). ‘High’ positive TPO (think it was 99) and 3.9 TSH. Working with a nutritionist which seems to be helping alot, including detoxing a great deal of aluminum (released from all the fat I lost???). Completely off gluten, refined sugar, caffeine. Also currently off high intensity exercise, sadly, due to sapped energy resources. Have you found, as a rule that those of us with Hashi’s need to be taking in at least some starchy carbs every day, even if we feel much better on a lo carb diet? As in, you really NEED to get at least 50-100 grams a day? I get the interplay from Dr. Cate’s article between the carbs and metabolism, but I can’t figure out how that plays into the auto-immune factor. Yes most commentary I see from Hashi’s people seems to imply it. I just want to help my body heal and not get back to that point. Haven’t tried an AIP diet yet, but probably need to. Sorry if this is too long/TMI.
    Thank you for all you do!

    • Right now, I do best on an AIP diet that is low carb in the morning and incorporates 75-100g or so of carbs in the evening. My doctor, Dr Christianson, has a book coming out at the end of the year with a lot more specifics but I’ve tried it with good results.

  25. I am interested in taking your 30 day challenge and I have read the tips on your website, but I am a bit concerned as it sounds like another type of Atkins diet. Most of my friends went on Atkins diet, lose loads of weight, but they all put it back on after a couple of months.

    Please let me know how Atkins is different from yours as I want to lose weight and keep it off.


  26. I’ve been eating low-ish carb for a couple months (I’ve had to adjust a few times – going from high to low). What you say really comforts me. I’ve been noticing a LOT of hair loss and all my blood work keeps coming out fine. So I know that my body is readjusting to low carb. I also had extreme hormonal imbalances before going low-carb (acne – all over my face), so I’m really glad you’re suggesting that it’s healthy that I just go through this carb flu. I might increase carbs a little bit, but it’s difficult with high FODMAP sensitivity.

    Thanks! 🙂

  27. I’m so glad I read this article!!! I didn’t realized how bad starches were for me until I quit them. Low carb is my new lifestyle. Its taught me how to say “goodbye” to my muffin top, given me more energy and made me happier.

  28. Have Hashomoto’s,never had high TSH, till I went grain free the first time. Than I stopped , and went grain free for the second time, trying to incorporate more carbs. Felt really tired and made labs after few moths, TSH 15 (whatttttt, have never had it like this) and antibodies doubled. (even these were stable in years like number). One of the nodules I have had grown during the last year. So I am pretty unsure what to do. I feel good without grains (great digestion, no bloating), but I ‘am getting scared that no grains (or too low carb) drived me to hypothyroidism. I’ve incorporated some white rice back in my diet, waiting to see the results. Any thoughts?

  29. have enjoyed reading all of your comments, helps to know there are others out there experiencing a myriad of things on LCHF.
    For me, I did it for 3 months (50-70g carbs per day avg), also tried CarbNite with horrible weight gain resulting, then hit with exhaustion, bronchitis, cold, adrenal fatigue (it does exist!), I had to stop. I took 2 weeks off work as I could hardly get out bed. Tests revealed high TSH, and hormones of a menopausal woman – I am 29.
    Whether or not I had these issues 2, 6, 12 months ago, who knows. I would be keen to hear from women especially in my age group who have experienced similar stuff..
    I am kind of unsure about LCHF at this point, not willing to make any conclusions, especially when hormones are involved, when there aren’t tangible things you can hold on or refer to, and how individualistic body responses can be, AND when your body is bigger than it used to be – and that feels really deflating – , well it’s tough not to know what to do.

  30. I am really happy to have found this article, since lately I’m quite puzzled…
    I have been eating LCHF for a couple of months (like, 20g carbs a day), and apart from some improvement in the first weeks, I never really lost much weight, and now I’m losing none. In addition to that, my hair are definitely thinning and that scares me a lot.
    I’m not fatigued at all, I feel very good when I eat LCHF, but I don’t see any other of the benefits I should have, not even weight loss. And now I read in your article that going low carb might cause thyroid problems to some, and that contributes to hair loss.
    What should I do? Should I add more carbs, then? I do not want to go back to eating carbs like I did before, because I tried and it makes me feel bloated and gives me pain in my joint (most of all hips and knees), but I really don’t know what should I do now, first of all to stop the hair from thinning… (by the way, I already take a lot of supplements to help my hair, like biotin, zinc, selenium, ecc. ecc)
    Thanks to whomever would like to help me!

  31. I’m not going low-carb; I’ve actually been ingesting no carbohydrates and no sugar.
    I’ve been carb and sugar free for just shy of a week and I’m already down 16 lbs (with no change on physical activity).

    I do feel lethargic from time to time. However for the most part I’ve honestly been gradually feeling better.
    On top of the weight loss, it seems that by completely cutting out carbs and sugar that I’ve been able to get a handle on my insomnia as well.
    I still drink coffee and tea, and my water intake is just shy of half a gallon a day.

  32. According to my calculations, by eating a low carb diet of a little over 60 gm a day, depending on exercise, I eat two meals a day with negative amounts of calories.

    I can’t tell about the thyroid function as I have been taking Thyroxine for a long time, from before starting low carb, but I have tried all sorts of diets and not one caused significant weight loss – in fact some made me gain weight. My doctor had me eating 600 calories a day at one time, and I still did not lose weight. I might be down a little one month but then back up again the next, and I looked like a ghost.

    I am 60 now, but don’t feel it, I’ found’ low carb and my aging seemed to reverse itself. In just a few days my hips and knees were pain free and I could walk and ride my bicycle again.

  33. Hi! This was a really interesting post. I am mostly vegetarian (eat sea food when I eat out but do cook it at home).
    I started a no grain, high fat, moderate protein diet in June 2014. I went from being completely low energy, brain fogged, depressed to the exact opposite within the first month. I had super high energy levels, my adult acne cleared up,skin felt great, the cloud lifted I could think clearly and I felt great.
    However by about December I started gaining a little weight and for the first time in 8 years my TSH was elevated, after a while my skin became so dry, I developed eczema , and last week I got my first zit since last June.
    Nothing has changed except for my diet… Could I be too low carb? Is that what is causing my tsh count to rise? (My free t3 is normal).

  34. This is very interesting! I have been low carb for about 6 years, but its more of a lower carb paleo approach. I have lost 80 lbs, and it is easy to keep off. My problem is, I cannot for the life of me, lose anymore weight. Even through extensive nutrition information, being a personal trainer, visiting doctor after doctor, there is no reason why I cant lose weight anymore. So this leaves me in a weird position…I sit here and watch all my clients getting really fit…but no matter how I eat or how much I workout, nothing will budge. I have done low-low carb, moderate, high carb days or “refeed” days….you name it…nothin! lol. At least lower carbs helped me get off the 80 pounds though, I also reversed pre-diabetes, high cholesterol, high blood pressure, vitamin deficiency and all my joint pain went away, so I can appreciate that 🙂 I should go do more extensive thyroid testing now.

  35. I went on the AIP paleo diet for 7 months last year and became terribly ill. My antibodies went way up, I doubled my thyroid medication, started getting horrible boils and cold sores, joint pain, numb hands, no sex drive, awful depression, fatigue, and significant weight loss (110 on a 5’6” frame) and this is WITH rice added to my diet and around 100g + of carbs a day. I started eating normally again, which for me is still incredibly healthy..only grain is quinoa and very occasional corn/beans…and all my levels normalized and my symptoms disappeared. That said I gained 20 pounds seemingly all in my belly. So I went back to Paleo (not AIP) to see if I stayed higher carb if it could go better this time around. Nope. Two weeks in and I have another horrible boil, fatigue, had to up my thyroid meds…etc. Seriously, what gives? At this point I do not think the paleo diet is right for me. I have no idea how to eat enough carbs to stay healthy. Any tips? I am glad to read the above comments and see many of us are in the same boat, though, the paleo diet proponents don’t have many answers for why some of us get horribly sick when LC.

    • Recently I had to reduce my thyroxine, as my regular blood tests showed very low levels of TSH and high T4 – I did recently add coconut oil to my diet, but no other change I am still eating the acceptable foods for Atkins and enjoying life immensely. I bought the coconut oil as it was on sale at a reasonable price in a local shop, and thought I’d see if it tasted nice – it does.

      It is a mystery to me why someone would be ill if they were eating fresh vegetables and good quality meats and fish, eggs and cheese. I do take a multivitamin every day as some days I don’t feel like eating much, I don’t drink much coffee, only herb teas, mint and liquorice, and water.

      • I was also perplexed Anne! The only thing I could figure is my carbs were to low. On the AIP, the only starchy carbs allowed were sweet potato, plantains. It just wasn’t enough! Personally, I think the Perfect Health Diet is better suited for many with thyroid issues. VLC is not good.

        • I don’t know the full list of foods acceptable on a paleo diet – but sweet potatoes and plantains are very carb dense, both sugar and starch and they might not have sufficient vitamins to keep you healthy – personally I don’t eat either, but I know that the ‘ordinary’ potato, which is lower in sugar, if eaten with the skin, can sustain life fairly well.

          There must be something lacking or out of balance – boils affected sailors back in the days of sail.

          Carbs are not an essential foodstuff at all – Humans can exist without them if they have meat or other sources of protein, plus fats. It is how people manage to survive in the far North.

          I eat just about any vegetable which is low carb and in the shops. I used to grow my own but our garden is so small it is impossible to have a vegetable patch. I don’t eat grains or lentils other than green beans and peas.

  36. Katie, what are your thoughts on Whole 30 vs. Paleo?

  37. I have PCOS and after researching, I’ve read that I could benefit from eating a low glycemic index diet. It’s all so confusing… From what I’ve read that means a low carb diet for me. I’m wanting to get pregnant, and hoping this new diet of mine will help with that. Anyone had success with the low GI diet who has PCOS?!

  38. I too have PCOS and have done some research online which contradicts one another. One site says to not go to low on carbs and the other says to go very low on carbs. I’ve been on the paleo diet for about 5 months now and I lost weight to begin with but I seem to have put it back on now. I’m stuck between increasing my carbs or going down the ketone diet path. Any suggestions ??

  39. Hello! I did Carb Nite for a few months a while back and really enjoyed the weight loss and saw a number of other health benefits. I ended up getting off of it (for other reasons), around the same time went to the doctor and got bleak news about my thyroid and my LDL levels. When I was on Carb Nite I was admittedly abusive of my red meat, cheese and bacon intake, which I attributed to my poor cholesterol. Six months later my levels are all back to normal and I am planning to do it again only this time with seafood, more greens and less cheese. I am also planning to start the P90X program. I have a terrible time trying to lose weight and am now concerned about my thyroid and cholesterol levels going up again. Problem is nothing seems to be definitive, everyone has a way to “lose weight” and it’s mind numbing. I’m stuck trying this for now and seeing if it works, while hoping that in my attempt to lose 35 lbs I don’t end up with an irreversible health condition. I do like the concept of Carb Nite and the science behind ketosis makes sense, I’m stuck then on what to do after Carb Nite….

    • I don’t know what carb nite is exactly – but it is something unsustainable, so I’d say forget it and find something which is going to be your way of eating for the rest of your life.
      Eating a diet of low carb foods – as opposed to low carb dieting – gives you a wide range of foods to chose from and you can decide to lose a few pounds whenever you like, without the sort of deprivation normally required for weight loss.
      I have not been able to find any reason for the normal rules of calorie consumption not to apply when eating low carb foods. No one seems to want to do any sort of research into the accepted rules of eating even though there has never been any testing of such things as the low fat diet being a healthy one.
      I heard a doctor being interviewed for a BBC radio 4 health program asked about a decrease in survival rates after heart attacks amongst men fed on a low fat diet, and they waffled dreadful nonsense.

  40. Wellness Mama, most of the time I consume no more than 500 carbohydartes a day. Usually its about 300 to 400 carbohydrates a day. I did go extremely low carb for a short amount of time and I felt good, but unfortunately I cannot eat that way all of the time because I do not know what to cook on a diet like that. At my current 150-400 carbohydrates a day diet, I feel low energy and when I cut back on my carbs a bit i gain weight most of the time. My diet mostly consists of grass fed ground beef, factory farmed and sometimes grass fed eggs, grassfed cheese, factory farmed milk, grassfed butter, factory farmed bacon, tomatoes, jalepenos, one slice of sourdough bread, small amounts of spinach, and small amounts of white potatoes and beans. I also occasionally have a flour tortilla with my meals. I also drink two drinks a day which come to about 56 carbs. The drinks are Mountain Dew Kickstarts and Monster Javas. So most of the time I am low energy and if i go too low carb I gain weight. It has been this way for about a year now, maybe a year and a half. When I go to my parents house and eat a carbier meal (for example, brocolli, a pork chop and a larger serving of mashed potatoes, and maybe drink it with a soda) I feel better. Can you tell me what I am doing wrong and if this feeling will ever go away. A lot of times I feel like my body is craving carbohydrates. Thank you

    • If you were to cut out the sugary drinks, the bread and potatoes and increase the low carb but nutritious plant based foods then you would not be spiking insulin, which lowers blood sugars and makes you feel groggy and weary,
      At the rate you are consuming carbs – if the figures are grams of carbohydrate, you will never be in a prolonged state of ketosis and so never reduce your fat stores.

      • But Wellness Mama says you can eat up to 400 carbs a day and still be healthy. Are you saying she gets most of those carbs from vegetables. She has at least one recipe that has sweet potatoes in it. Are not her zucchini and squash recipes at least 100 carbs per meal?

  41. I forgot I also eat avocados.

  42. I’m glad I read this, because I’ve had many health struggles and trying to figure myself out. I have Hashimoto’s thyroiditis, EBV, fatigue, and I always feel drained and get sick often. I restarted the grain free diet 7 months ago, and now removed sugar as well. I feel horrible. I feel like my glands/nodes are tender and my thyroid inflamed. Sometimes, I’ll grab an apple and eat it quickly to see if it improves my symptoms and, at times, it does. With my busy schedule, school, being a mom, and extreme fatigue, I’m scared that I won’t be able to continue this restricted diet. I read this could last months!

  43. I’ve done low carb before with great success, but of course the minute I introduced the carbs back into my diet, the weight came back. The biggest and the most concerning struggle has always been the hormonal/period changes that always accompany me removing carbs from my diet. I’ve somewhere before that it’s a normal symptom but it raises concern every time. I have been trying to do more research and how to alleviate the breakthrough bleedings. I have spoken to my doctor and she suggest birth control, which I don’t want to use, as I don’t need it anymore. Please offer any suggestions on how to stay low carb and hopefully regulate my hormones. Which after reading this article I think I will keep with it as the health benefits are definitely significant. Thank you!

  44. The problem is that you stopped eating a low carb diet.
    It was never expected that you would start to eat the things which make you fat – if you read Dr Atkins New Diet Revolution book it will all become clear.
    Low carb eating is all about keeping excess carbohydrates out of your diet. You reduce right down to lose weight, but introduce healthy types of carb as you reach your goal.
    You should taper off the weightloss gradually,
    Personally, I would advise not reintroducing grains, as I find that I get aches in my joints when I do, and they are not an essential part of the Human diet.
    Be sure that you are not consuming more unsaturated vegetable oils than necessary – they play havoc with the hormones. Omega 3 oils should be promoted, vegetable oils contain an abundance of the unwanted Omega six oils. I know that they are often promoted as healthy sources of fat, rather than more natural ones from fish and meat, but there isn’t much evidence that they are actually good for you. I suspect that rather like the ‘fat is bad’ myth, it was something made up to promote sales of the stuff.

  45. I often hear that low carb dieting doesn’t work, or even that it wrecked something.
    It was Dr Atkins who usually got the blame – even when it was obvious that his rules for doing low carb were not being followed.
    Eating a very low almost zero carb diet is not part of the plan, but people will insist that as low is good really low must be even better. I’m not a doctor but I am a Batchelor of Science, and so before I changed my diet I read what I could and studied Dr Atkins New Diet Revolution. It is not quite correct in some of the things it claims, but the advice given on how to do low carb is fairly sound.

  46. I have read some but not all the above voluminous content and great discussions. One theme I noticed was people talking almost as if their diet had no carbs, with comments about adding some fruit or sweet potato once a week. That sounds a lot like a starvation diet to me. Im not an RD or a nutritionist but even #LCHF diets recommend 40-100gm carbs daily for health reasons, so the idea of adding carbs weekly is strange. Also there are many people who have a LCHF diet for years and enjoy excellent health. Read the Blue Zones magazine by National Geographic which is a very interesting review of the longest lived population groups worldwide and their eating/drinking habits. Many different choices from Italy to Japan and to California.