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Is a Low-Carb Diet Ruining Your Health?

by Laura Beth Schoenfeld, RD

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Carbohydrates, and the role they play in a healthy diet, are one of the most hotly contested nutritional debates in the world, both in conventional and ancestral health circles.

One one side, you’ve got folks who say that carbohydrates are nonessential and increase your risk for diseases such as diabetes, cancer, and neurological disorders. On the other side, some say that carbohydrates are crucial for good health and should make up the majority of your calories.

It’s no wonder I have so many clients who come to me completely confused about carbs and whether or not they should eat more or less of them.

While some people do incredibly well following a low carb Paleo diet, there are many people who crash and burn on this type of dietary plan. So, how can you tell if you’re the type of person who shouldn’t be eating a low carb diet, and how do you figure out how many carbs you should be eating? I plan to teach you just that in this article.

Is your low-carb diet doing you more harm than good? Find out how many carbs YOU should be eating.


I recently discussed the role of carbohydrates during pregnancy in an episode of The Ancestral RDs Podcast. The most important reason why women need adequate carbohydrates during pregnancy is to ensure adequate fetal brain development and growth. Another reason is because a high protein diet can be dangerous during pregnancy, and when you cut out carbohydrate as a major macronutrient, you usually can’t help but increase protein as a percentage of calories. Protein intake greater than 25% of calories during pregnancy may lead to decreased mass at birth and increased perinatal morbidity and mortality for the baby.

The Institute of Medicine recommends a minimum of 175 grams of carbohydrates per day during pregnancy, which is 29% of calories on a 2400 calorie diet. Paul Jaminet advises pregnant mothers to restrict protein to about 15% of calories and to obtain 30% of calories as carbohydrates. Chris recommends a moderate carb approach for most pregnant women (except those with any type of diabetes) in his book, Your Personal Paleo Code (published in paperback as The Paleo Cure in December 2014).

Like these other experts, I generally recommend 30% of calories from carbohydrates for my pregnant clients, and also for those who are struggling with fertility. Unless you have diabetes or a serious neurological condition that requires carbohydrate restriction, it’s not worth the risk playing around with a low carb diet when you’re pregnant, and these diets aren’t conducive to fertility for many women either. (If you’re interested in more reasons why carbohydrates can affect fertility, read this great post by Stefani Ruper.)


If you’re a professional or recreational athlete who trains hard 4, 5, or even 6 days per week (I hope you’re not doing 7 days per week!) and trying to maintain this level of activity on a low carb diet, you may be doing more harm than good to your health and fitness.

While there are athletes who thrive on a well-planned low carb approach (LeBron James most recently!), there are many others who do not. Each athlete is completely unique in their ability to perform well on a low carb diet, and there’s nothing wrong with testing out the diet to see how it affects your athletic ability.

But if you’ve been trying a low carb diet for months now and your workouts are suffering, your weight isn’t budging (or maybe you’ve even gained weight!), and your recovery time is increasing, you’re probably not the type of person who can handle a low carb diet combined with regular intense physical activity.

I’ve had many clients come to me on a low carb diet who, after switching to a more moderate carb approach, found that their energy and endurance significantly increased, and they were able to make quicker strength gains than before. Many also were able to shed some of the stubborn body fat that they’d been retaining despite eating a low carb diet and training hard, which was a result they didn’t expect!

For my athletic clients, I usually recommend a minimum of 20% of calories from carbohydrate, and depending on the person’s health goals, training schedule, and current issues, I may actually recommend more like 40-50% of calories from carbs.

Again, each athlete is an individual and what works for one person, or even a thousand people, may not work for you. So don’t be afraid to experiment and pay attention to how your diet makes you look, feel, and perform! And don’t hesitate to get help if you need it!

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Hypothyroidism and HPA Axis Dysregulation (Adrenal Fatigue)

Hypothyroidism is one of the most commonly cited medical reasons for needing to eat a moderate carb diet. The main reason why carbs affect thyroid function so directly is because insulin is needed for the conversion of the inactive T4 hormone into the active T3 hormone, and insulin is generally quite low on very low carbohydrate diets.

So if you’ve suddenly started developing hypothyroid symptoms on your low carb diet, it’s a pretty good sign that you’d be better off upping the carbs (and getting your thyroid tested if you haven’t already!) For more about how low carb dieting affects your thyroid, listen to this great interview with Chris by Jimmy Moore.

HPA axis dysregulation, also known as adrenal fatigue, is another condition where a moderate carb intake is important for general health. Kelsey and I talked about adrenal fatigue on our first Ask the RD podcast, so listen to it if you’re unfamiliar with this condition. The main hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to increase on a low carb diet. This means that a low carb diet is a potential adrenal stressor in susceptible individuals. Combine that with a stressful job, inadequate sleep, and overexercise, and you’ve got yourself a recipe for adrenal burnout.

So if you have adrenal fatigue, or if your current lifestyle is already high stress in a few different areas, you may want to increase your carb intake until you can get those additional stressors under control, as you may drive yourself into adrenal fatigue by having a chronically elevated cortisol output. Lara Briden has written a great article on the benefits of whole food carbohydrates in lowering cortisol and raising GABA, a calming hormone that is often low in adrenal fatigue patients.

If you’re experiencing symptoms of hypothyroidism or adrenal fatigue, you may be worsening them with a well-intentioned low carb Paleo diet. I recommend working with someone to help you figure out if your diet is indeed making these symptoms worse, and how to change what you eat to better support your thyroid and adrenal health.

Gut Health

One of the less discussed downsides of a very low carbohydrate diet over the long run is the potential for alteration of the gut flora. Chris recently covered this issue in a podcast with Jeff Leach, where they discussed evidence that a very low carb diet can lead to gut dysbiosis and a reduction in the diversity of the gut flora. A lot of the information on this topic is new and not fully understood, but it’s reasonable to believe that when you avoid carbs, you’re also avoiding important prebiotics (i.e. food for your gut flora) like soluble fiber and resistant starch.

These prebiotics are essential for promoting the growth of beneficial gut flora. Without them, your beneficial flora can’t produce as much gut-healing substances like butyrate and other short chain fatty acids, and your microbiome composition may even shift in an undesirable direction. And as Chris would say, you’re only as healthy as your gut is: an unhealthy gut contributes to everything from obesity and diabetes, to digestive illness, to autoimmune disease, to skin disorders.

Those who are doing very low carbohydrate diets, and who simply can’t increase their starch intake for whatever reason, should use prebiotic supplements such as resistant starch-rich unmodified potato starch or FOS powder. However, these products must be incorporated slowly into your supplement regimen, as you can experience severe gas and bloating if too many prebiotics are taken all at once, or if there is existing gut dysbiosis or bacterial overgrowth. In this case, it would be wise to work with someone who can help you get the prebiotics you need while on a very low carbohydrate or ketogenic diet to protect the health of your gut microbiota.

How Many Carbs Do I Need?

To determine how many carbs my clients need to eat in a day to reach their health goals, first I decide what percentage of calories from carbs they’d possibly do best with. As an example from above, a woman struggling with fertility issues may benefit from a carb intake around 30% of calories. I then determine her caloric needs using a calculator like this one. If we determine that her daily needs are roughly 2000 calories per day, 30% of calories from carbs is 600 calories. As there are 4 calories in a gram of carbohydrate, this works out to be 150 grams of carbs per day.

Usually I give my clients a target range to hit depending on their activity levels, and we use these targets to re-evaluate their food diaries and see if they’re hitting their goals. Most of my clients are surprised to learn how much carb-rich Paleo foods they have to eat to get up to 150-200 grams per day! But once they start making a real effort to hit those targets, the health benefits are immediate.

These benefits include weight loss, elevated mood, skin improvements, increased energy, normal menstrual function, more satisfying sleep, and more. It’s so exciting to see what a couple of starchy tubers and pieces of fruit can do for a person’s health when they simply need to eat more carbs!

Final Thoughts

The purpose of this article was not to bash low carb diets. I truly believe that there are many people out there who get amazing health results from a low carb plan, and there are dozens of health conditions that benefit from a very low carb or ketogenic diet, especially severe neurological conditions. Paul Jaminet has written some great posts explaining when a ketogenic diet may be useful and necessary, so I strongly suggest reading those posts if you’re still on the fence about where you stand with carbohydrates and your health needs.

My hope is that by reading this article, you’ll be able to understand the many factors that play into how a person handles a low carbohydrate diet, and whether or not their health will improve on such a plan. Everyone is different in their ability to thrive on a low carbohydrate diet. If you’ve found yourself identifying with any of the issues I’ve written about in this post, you may be in need of a macronutrient adjustment in your diet.

Helping people optimize their carb intake is a challenge I truly enjoy. As a dietitian, I love to help people evaluate their diet to determine if they’re meeting their health needs with the food they’re eating. If you think you could benefit from a Paleo diet makeover, I’d love to chat with you about where you’re at and where you want to go with your health.

Your carb intake shouldn’t be the major factor that’s preventing you from reaching your health goals. I hope you use the information I’ve shared today to evaluate your own nutritional needs and make the changes that make sense to you.

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Laura Beth Schoenfeld, RD
Laura Beth Schoenfeld, RD

Laura Schoenfeld, MPH, RD, is a licensed registered dietitian and women’s health expert trained in Functional Medical nutrition therapy. She assisted in the creation of educational materials for both the ADAPT practitioner and health coach training programs.

Her passion is empowering women to nourish their bodies, develop true strength, and ultimately use their improved health to pursue their purpose. Laura guides her clients in identifying and implementing diet and lifestyle changes that allow them to live a healthy, fit, symptom-free life without being consumed by thoughts of food and exercise. She draws from a variety of sources to form her philosophy on nutrition, including ancestral diets, principles of biochemistry, current research, and clinical experience. Her areas of expertise include women’s hormones and fertility, gut health, autoimmune disease, athletic performance, stress management, skin health, and weight loss. Recognizing that health goes far beyond just diet and exercise, Laura teaches her clients how to focus on and implement life-changing mental and spiritual health habits as well, including changing their thoughts and beliefs to ones that drive health-supporting decision-making around food, fitness, and life in general.

Her greatest mission is to help health-conscious women realize that, while their health is priceless, they are so much more than a body. When she’s not educating and serving her coaching clients and community, Laura loves traveling with her husband, Sundays with her church family, hikes with her dog, beach trips, live music, and strength training.

Professional website: lauraschoenfeldrd.com

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Join the conversation

  1. 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.
    I think yes, Low-carb can affect our health. But this can vary widely by individual and can be both positive and negative, depending on the person.
    For more details you may visit at http://www.thediabetessolutions.com.

  2. A proper low-carb diet always means you get a lot more energy from natural fat.So there is question that how much fat should you eat? As much as you need to feel satisfied and great. Eat when you are hungry. Stop when you are satisfied. Then repeat. It’s that simple.

  3. I went on the Paleo diet when I found out I had cancer, but my coach wanted me to try ketogetic. The problem is I have leaky gut and nothing I’ve tried seems to help

  4. I don’t really fit your categories above, but I was already thin when I dropped the carbs and have been losing too much weight . I have a high metabolism and burn food quickly. I need the extra calories so I’ve added more fat and protein but they are not putting on the fat for me. I have decided to add carbs back into my diet. Good idea?

  5. This information is 100% true as I am now in the middle of it and trying to recover via carb reintroduction and some back loading. I am A type, work out 6 days a week the past 6 months, ketosis diet 30 grams and IF on top of that! I also am 50 years old and use to have pre-diabities and had a heart event MI in 2011. Lost all the weight via low carb and exercise as I have always been akin to fitness, but moved to keto and lost some stubborn weight, then it all hit. Could not sleep, could not say asleep even with an ambien, neck and traps hurting etc. Another sure symptom that I found and verified as true with low T3/4, is low fluctuating body temperatures, mine went from 95.5 at the worst to 97.1 if lucky. The last 3 days I added back loading (am a Kiefer fan too) to introduce carbs but at the right time, but still get them up (ate pasta and meatballs with garlic bread last night, what a treat) and a cherry turnover before bed. I am still a bit sore, However last night was a better sleep. Body temperatures are coming back up already. I am still going to see the endocrinologist and get test done since the damage was done and I do take a topical test cream, and I read that that can cause issues with aromatase (estrogen) long term, and the keto high fat diet can make the T3 receptors on the cell less responsive?? Anyway, this is a good topic and area for all keto/low carbers to be aware of, and perhaps is accelerated based on age, ie: older athletes pushing protocols too hard and too fast, beware.

  6. Interesting, every time a attempt a ketogenic diet, I lose weight extremely fast, and I really need to loose weight but my sleep apnea worsens at the same time. I use the cpap machine and instead of an AHI reading of .6 to 1.9 episodes per hour, I get readings of 2.0 -3.5 episodes per hour. I have read that sleep apnea may be associated with cytokine dysregulation.

  7. Your article only talks about adrenal fatigue & HPA dysregulation in terms of high cortisol levels. What about if you have chronically low cortisol/low DHEA? Does the same advice apply?

  8. So this explains why I can’t tolerate low carb & have to eat moderate amounts. Funny, it was the physician I went to for Hashimoto’s & adrenal problems who was angry that I could not do it.

    So, what do you do if you have blood sugar issues, too? I can’t keep my insulin levels both lower and higher at the same time.

    • Eating carbs with fat and protein slows and/or reduces the output of insulin so you don’t get a spike.

  9. I lift 4 days a week and I walk 2 miles about 3-4 days a week. How many carbohydrates would you recommend I consume for the above stated activity?

  10. Hi I would like your opinion.. I have suffered IBSC for 2 years and I recently decided to try the LowCarb, ModProtien, HighFat diet. Although it didn’t help my constipation at all, my energy levels sky rocketed and my anxiety/brain fog completely vanished. I was the calmest and most productive I had ever been. Then from no where I started experiencing seizures. My doctors couldn’t find anything that was causing them except low thyroid levels with a really high TSH of 28.7 and TPO antibodies. I was diagnosed Hashimotos and put on Armour. My problem is that I can not put on weight, I am so skinny compared to before, I am literally fading away. I don’t know what to do and I am wondering if my diet started all my thyroid issues! I desperately want to gain weight but now I am finding out with hashi’s I have to be on an A.I.P diet which means I have had to exclude even more foods, no dairy, no soy, no gluten, no nuts, no grains, no legumes, no nightshades, no coffee… the list goes on. How I am supposed to gain weight when all I can eat is meat/veg/fruit.. where can I get more carbs from.. please help

    • Plantains are your friend. I make flatbread this way: 400g green plantain (peeled), 1/3 cup oil/butter, 1/2 tsp sea salt blended til smooth in a Vitamix. Pour on a baking sheet lined with parchment paper and bake at 350 for 20 minutes or until just browned around the edges – experiment until you find how you like it best. For fluffy bread, I blend the above, then pour in a bowl & use a handmixer to add in 1/2 tsp cream of tartar & 1/4 teaspoon of baking soda. Today, I tried it as cinnamon raisin bread – I added 1 tbs cinnamon, 1/2 tsp vanilla, 1/2 tsp molasses & stevia to taste (optional), then the leavening & a handful of raisins I folded in. Baked the same way. Delicious. (I use butter, but you can use coconut oil for AIP – I am allergic to almost everything you must eliminate on AIP + shellfish, coconut, tapioca & arrowroot, so I feel your pain!). Best of luck! If I needed to gain weight, I would do a lot of hearty stews with sweet potatoes, yucca, beets, carrots & a side of this bread or plain ole tostones. Trust me, that should do it!

      • Hi Michele, Great advice.. I am only sorry I didn’t see it sooner. I have the a.i.p Paleo cookbook and a lot of the recipes use plantain’s so I am really going to get serious about them now. I am also going to try the stews you mentioned! I increased my carbs over the past months and I am not eating potato and rice again. Been gluten free 5 months. I managed to gain weight and I now look healthier however my mood disorder / anxiety is back. The ketogenic diet cured my mood disorder but ruined my health and weight. It’s very annoying because now I am considering medication for the moods when I know that keto can cure it but I am scared to drop all the weight and get sick again. Anyway thanks for the great advice, I will try Paleo instead of keto with healthy carbs like sweet potato’s so I don’t drop to much weight! 🙂

        • I’m sorry to hear about your situation – that is a very tough choice to make! My son has neurological abnormalities that cause him to have Bipolar 2; he has also had a couple very mild seizures. For him, neurofeedback helped immensely. He was cycling ultra-rapidly; sometimes as many mood swings as 3 dozen per day. Neurofeedback helped bring him down to 1-3 per week, which was amazing. He has maintained the benefits 2 years after stopping treatment. Anyway, it might be something to look into before medication; usually they try ketogenic diets for people with his brain condition who end up with seizures, and the neurofeedback stopped those, as well.

          It seems like you tried different amounts of carbs already to see if you could maintain the mood benefits at a middle ground level? Have you tried/been able to try achieving ketosis by exercising, while being able to eat more carbs?

          I hope you can find a way that works for you!

        • For the mood disorders I would try doing intermittent fasting with the diet that is working for you. Do not eat less, just shrink your eating windows. You actually may need to eat more this way if you notice weight loss on the same amount of calories. Your metabolism works more efficiently when your body has a time out from constant digestion. A keto diet tricks your body to thinking it’s in a fasted state. Possible it’s the reasons for the mood benefits. Don’t quote me, I’m sure a little Google research will give you some clearer answers. I’m hypo thyroid and ketosis made me I’ll within days. I still do the IF, love it. I’m not religious about it, I listen to my body, if I need to (or want to for whatever reason) skip a day or break the fast early, I do it. Good luck.

    • When you went low carb did you use sweeteners? I had a terrible reaction to Xylitol and it caused me to have 20 plus episodes (TLE) in one day after not having any for YEARS. I check all labels now.

  11. Here’s my story. I’m hypothyroid, have been since age 25. After my daughter was born six years ago at age 35 , my thyroid levels went crazy and I gained 40 pounds despite regular exercise and healthy eating (no joke). I’m now getting back to normal thyroid levels and weight is coming off slowly (as it should) with healthy eating and exercise. My new endocrinologist is awesome but has a nutritionist on staff who recommended a low carb diet with a food journal. I tried low carbs for a week and felt like crap. I told the nutritionist and she said to stick with it. Then the end of second week, I still felt horrible and another problem surfaced. Backstory: I had an eating disorder in my teens and early 20s and this carb counting started making me obsess over what I ate. For example, I started feeling guilty for wanting an extra bite of fish or fruit. I went back in my food journal and questioning if I ate too much at a given time. I got scared, my husband got concerned, and I stopped carb counting and threw out my journal. I purposely started skipping appointments with her, (about two weeks worth), which I decided today that I’m going to make the next appointment so she will leave me alone or start a new approach that won’t play into my obsessive tendencies. I eat really healthy thanks to food sensitivities and not being able to eat much processed foods, and stick with healthy carbs, but I can’t figure out why this nutritionist wants me to count carbs knowing my obsessive tendencies. Is it because it’s textbook? I refuse to be the food obsessed person I used to be.

    • I have run into similar problems, although I have been lucky enough never to have had to deal with an eating disorder. It sounds like this nutritionist, like most physicians I have run into, is more interested in forcing a round peg into a square hole to justify her favorite food fad than in helping patients.

  12. The problem with people is our tendency to go to extremes. To say that this is better or that is better, when if you look across the expanse of human-history, it’s really not an either-or.

    Like right or left, liberal or conservative, idiot or genius.

    The reality is, and has always been, that the answer is dynamic. Sometimes this is better. Sometimes the opposite is better. Sometimes both must be mixed. It’s dynamic thing, not a progressive thing. We sometimes go this way, and then times call for going back, and then this way again, and then back again.

    In human diet throughout the ages, it would seem that carbs and meat and fat and sugars, all of it in ample amounts is ideal.

    And we can see that it’s ideal because ideal is the most efficient at making us all fat. And what is fat if not the definitive indication of more than enough.

    All of our health-problems isn’t because we eat certain foods . . . well except those laced with unnatural additives that have cumulative affects. However, we’re talking just normal sustenance food here.

    Our problems come from a consistent excess of those foods, not the periodic feast at Thanksgiving, Christmas, and birthdays, but the consistent feast of every single day. Eating till you’re stuffed, or being in a perpetual state of full/suffed is not natural. For herbivores, this might be natural as they tend to eat all day long, but not for omnivores nor carnivores. And look through the world, most omnivorous animals are more carnivorous than herbivorous with the exception of a few, and when they’re small, and when they eat seeds. I think when they’re small and eat seeds, they tend to eat more plant than animal.

    Our bodies, like most of macro-animal life, are designed to go without or less-than-adequate for short periods time.

    That IS what a diet IS, fundamentally speaking. It’s designed to simulate what would naturally occur if humans did not live in abundance.

    When we have a keto-diet, or vegan diet or one of the bazillions of all-food diets, it’s really just to simulate the natural struggle of survival at those times where food is more scarce and harder to come-by.

    The reason the keto-diet is so effective, so utterly effective for those disciplined to stick to it is because it more naturally simulates what humans actually went through in times of scarcity where the largest amount of their diets came from what they could find and kill and by chance happen upon growing, probably while out hunting.

    If you haven’t noticed, when on a keto-diet, even just beginning one, once those ketones are really in there, you never feel as weak when you haven’t eaten for a while. I remember, I get shaky when I haven’t eaten in 5 to 6 hours. Sometimes, I get shaky after eating a large amount of cereal within 3 hours. That never happens on a keto-diet.

    Your mind feels a bit sharper. Maybe not dramatically, but it feels a bit sharper.

    You feel less energy to do things at first, but that eventually goes away. And it’s not the less energy that makes you just want to eat, but the less energy where you just don’t feel as energetic.

    You feel more potential energy. Like for me, I feel like I could run much more than I actually could. I feel healthier. I feel less sluggish and run-down, even when I haven’t eaten in more than 6 hours.

    At any rate, it seems to me that what I’m feeling is more in-line with what would make me more capable of hunting down my own food in a time of scarcity. Having the patience to focus instead of just wanting to eat, the bit sharper mind to focus, the ability to go hours without feeling some dramatic increase in sluggishness that just thinks food, food, food, and it doesn’t make me feel like I just need to sit and do nothing.

    Carbs makes you feel all of those things, especially when you don’t have any to eat.

    I mean, you still feel those things in the keto-diet too if you don’t eat anything, which happens to me because I’ve just never had a palate for meat and fat by itself. It gets annoying to me to eat meat every day all of the time. It starts to feel bland, and the taste starts to wear on me.

    But, even though you feel that way, it’s a less sharp feeling. It’s never as bad as the way I feel when I’m going hungry from a diet that is full of carbs.

    If you’re on a carb diet, you’re hungry all of the time. It’s ridiculous. It’s just constant gnawing making you crave whatever you can find to eat. Constant growling 1.5 to 2 hours after eating that never stops. Gas like crazy. It’s relatively mild in its stink compared to meat-diets, or even processed-food, but still, it constantly builds up whenever I’m hungry.

    That doesn’t happen to me on the keto-diet. I can literally feel weak due to not eating anything for hours and hours, and desiring to eat anything, and it’s still not nearly as bad as when I’m going hungry from a carb-based diet.

  13. I ran across your article and was greatly encouraged to change my VLC induction diet. I have hypoglycemic episodes, on the VLC diet I had them every day,; gained weight and had brain fog ALL the time. I can not do grains or gluten. Please tell me how to slowly include some carbs, too many and I have episodes of drop in blood sugar. Thank you!

      • Me, too. I got panic attacks on low carb, although normally I do not have hypoglycemia. I tried to tell my physician, but he was too busy yelling at me that I had no self control, to care about my symptoms. It seems I am not alone.

    • To Ruth — or anyone with her question — grains are not the only source of carbs! If you want to “up” your carbs, eat some fruit every day. It full of nutrients and rich in carbs. Make a salad from apples, oranges, berries, grapefruit, pineapple. Eat a half cup of it. Have a glass or raw milk or kefir. There are hundreds of foods you can eat that are rich in carbs (if that’s your goal) without eating wheat, gluten or grains.

  14. I’m 25 years old, and I am delving into the world of nutrition. Since my older brother’s background is a Paleo and Ketogenic based, I decided two weeks ago to start a low-carb, high-fat ketogenic diet that consists of intermittent fasting from dawn through noon. I consume two “fatty” coffees through my fasting period followed by a high fat/protein based meals. I am struggling, as I stride into my third week. My sleep cycle, for one, is not consistent. I wake up a few times throughout the night, but I am able to fall asleep easily after each time I wake. Moreover, I suffer from low energy, mood swings, and high stress life with work/school, cravings, sleep interruptions, cognitive issues, and some bowel issues that I have yet to discover.

    I am a novice in the world of paleo nutrition, and I am asking for help. Please help guide me towards a healthier lifestyle.

  15. I also have researched ketogenic diets and would recommend the very low carb diets for people with certain medical conditions that haven’t responded well to higher carb intakes. I also think it’s important to get enough protein regardless of which low-carb diet you’re on, which seems to be missing in these very low carb/high fat ketogenic diets.

  16. Started low carb dieting no starchy vegetables and feel tired the person I am seeing said to drop carb intake to 70-80g in order for them to see me in a fat burning state as I have done a test to see which fuel I am burning. This test showed I was burning mostly glucose.

  17. I started low carb about 6 days ago and Ive been in a fog. People on support groups keep telling me to stick with it but it seems to make me feel bad. I have increased anxiety at night and not able to sleep. It’s 3 am before I fall asleep. I have subclinical hypothyroidism. I recently took a test for adrenal problems and havent gotten the results back yet. How do I find out how many carbs I truly need for a day? I dont think extremely low carb is for me……

    • Maybe you could try the PHD diet Perfect Health Diet. You remain off of the processed carbs, but still eat the safe ones.

        • Slowly drop your carbs. 150-200 seems to be a decent starting point. Do that for awhile and when you’re ready taper down, or drop down. Whatever works for you.

          I’m week 6 over here and I dropped way to quick but I’m in too far to stop. So, do the realistic thing.

    • My dad had great success with a diet of 2 low carb meals and a one hour reward meal begun with a salad as part of the Carbohydrate Addict’s Diet. I haven’t tried this approach, but I have reduced my carb intake to less than 20 grams per meal, and let me tell you, I felt horrible!!! I don’t know how anyone can sustain this. I feel almost like I have the flu or a major sickness, I’m so lethargic, when I do low-carb. I can hardly do anything, and I feel crappy and irritable. A couple of days ago, I tried it again for weight loss reasons, but it wasn’t worth the loss of productivity and how bad I felt. It took a whole day of eating moderate carbs to feel human again. Low carb is not for me!

      • Doing low carb, under 20 gr
        is NOT something you want to do off and on. You will perpetually be miserable. I have found eating enough protein to be key to my low carb lifestyle. So many people fear protein in the low carb world! Once adapted life and eating is a dream life. I feel fantastic, energy to burn, can workout fasted, can fast and feast with ease. Blood markers are fantastic, hormones greatly improved, etc. Going on two years now. It took some tweaking and the way, but is amazing now. Such freedom from food. Love it. Optimal protein, moderate fat and low carbs is working for this 49 year old mama to nine. ?

      • You will feel crap to start with. Your body is getting used to a new way of eating. You probably need to give it time. If after a month you still feel crap then it’s maybe not for you.

        • Christy,
          Most likely your electrolytes were off. One must learn about a diet before jumping in. Sounds as if you were half in to ketosis when you bailed out.

  18. What A refreshing, responsible, balanced article – if only I had read it sooner. I have been literally killing myself trying to recover from anorexia whilst sticking to a low carb diet. I had read so much about the Paleo Diet and read The Grain Brain and, in my vulnerable state, believed that by taking in carbs I would be doing myself, body and brain, more harm than good – actually, omitting carbs was doing exactly that. I have been suffering extreme insomnia, burning at the back of my throat, severe stomach and digestion problems, chronic fatigue – I could go on. I have suffered from anorexia for 22 years and in all my time I have never felt so unwell as this time and I truly believe it was partly due to lack of carbs. I am sure that the low carb diet suits many, but I wish article praising it would be a little more balanced/responsible. People preach it like it is a religion and make the foods they advocate avoiding sound like poison. That is why this article is so good, it is balanced and doesn’t insist either diet is right or wrong – it merely points out the pitfalls. Thank you for writing this, you have helped me beyond belief – in fact, I have just had my first bowl of buckwheat porridge!

    • Hi Natalie,
      Have you looked into the relationship between eating and your microbiome? There is a free course on it with Coursera. Rob Night and his crew are most interesting.
      I believe as you say that everyone needs different things and that ingredients that might be poison to one may not affect the next person adversely. I suppose the blood type diet that Mercolla talks about is something I should take a closer look at for myself to make the connections personally.. The thing is……….there are so many fuzzy lines. I mean I was recently convinced to up my carbs in order to relieve dry eyes. (I’m talking- opening my lids at night was beginning to feel like ripping off a band aid……lol) and while increasing my carbs with white rice (turns out brown is not as safe a choice for me) and potatoes did help, I am beginning to think it was actually the sodium increase that made the most difference. While searching for answers, I came across a Dr. Steven Phinney who talked about lack of sodium causing problems in the diet. I thought I was taking in more than enough because my husband is heavy with the shaker when he cooks (to the point of needing to rinse it off). Even though my taste buds were rejecting the heavy hits of salt, I think I may have been low in an overall sense. I was eating a little too many apples, avocado, bananas berries, and plain raw vegetables with no salt etc………..and no processed foods.
      Even though I wasn’t craving bread, cereal or pasta which I used to live on, I was still craving potato chips in a big way. I couldn’t understand this obsession until reading what Dr. Phinney had said. Now I wonder if upping the carbs in the form of potatoes and such is merely helping the electrical and chemical activity in my body because of the sodium increase and resulting electrolytes. It’s worth checking into…………. I almost didn’t.
      Note. Since my increased intake of “safe” starches has not caused me any adverse neurological effects, I’m moving forward with the Perfect Health Diet (with less rice).

      • Too many confounding variables. You increased your salt, but also started eating several other things.

        And just FWIW: Salt makes my dry eyes worse.

  19. There is an interesting new theory that not only explains why Europeans are much slimmer without low carb diets, and why Mississippi and southern states were the first and hardest hit with the obesity epidemic in the US.

    Iron Enrichment of food appears to be the culprit.

    Iron overload has been linked to nearly every major chronic disease, including heart disease, cancer, diabetes, Parkinson’s and Alzheimer’s. However, new studies are now linking iron overload, and/or disturbed iron homeostasis, to obesity.

    Iron supplementation has also been linked to increased mortality and studies have also shown that iron-fortified flour increases inflammation and is not safe for non-anemic men. Non-celiac gluten sensitivity was also rare before the 1950s. It should also be noted that most free-radical injury is iron related.

    States and countries with the highest iron intakes (food enrichment, meat, etc.) appear to have the highest obesity rates. Mississippi—the most obese US state—was one of the first states to make fortification mandatory for flour, bread, cornmeal and corn grits during the 1940s—they and other southern states were using it to fight pellagra. The state made it practically illegal to take a bite of food that wasn’t high in iron (i.e. flour, bread, grits, pasta, rice, meat).

    Although enriched flour was widely available by 1950 thanks to “War Order Number 1” enacted for WWII , some states went a step further and enacted the Newfoundland Law, requiring enrichment in flour, bread, rice, pasta and corn grits. Notice the similarities of states that had the most obesity in 1994? (1994 was the first year CDC data was available from all states).

    In 1954 Canada unified and adopted the Newfoundland Law requiring enrichment of flours and breads across the country. Newfoundland is currently the most obese province in Canada.

    In 1983, the FDA mandated that all white flours, pastas, rice and corn grits produced in the US be fortified and the FDA also raised the minimum level of iron significantly in 1983. Canada, the US and UK are the only developed nations to fortify their foods with iron.

    Like many EU countries, France has never allowed their flour to be enriched. Some European countries, like Denmark, have even banned fortification of foods. Low carb diets are not as popular in unfortified countries—they have very few problems eating breads and pastries.

    For more on this theory, see: Iron, Food Enrichment and The Theory of Everything

    Here in the United States, people lose weight fast when they avoid refined and fortified carbohydrates. According to FAOSTAT, the French consume 40% more (unfortified) wheat than Americans do, but have 1/3 the obesity rate.

    If obesity is an inflammatory disease, then it stands to reason that supplemented iron, through fortification, may be counterproductive for those who are inflamed. At the very least, obesity researchers need to make attempts to distinguish between diets that are fortified with iron and those that are not, going forward.

    If the theory is true, carbohydrates may indeed be safe for most people, provided they are not fortified with inflammatory iron supplements. If nothing else, the theory appears to explain virtually all dietary paradoxes.


    • So interesting, about the iron-fortification theory! Which I’ve begun to hear about elsewhere. Doesn’t iron feed certain gut microbes as well? And aren’t mixed-up gut microbes implicated in obesity?? It is truly a tricky place we industrialized humans have found ourselves in…