Should YOU be eating carbs?! [And is a Ketogenic diet for you?]

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.




Carbs—and the role they play in a healthy diet—are one of the most debated topics in nutrition circles.

When you hear that four-letter word, what comes to mind?


They are bad for you?

You need them for energy?

They make you fat?

They taste good?

Only those with ‘weak’ willpower eat them?

They are crucial for good health?


It’s no wonder I get handfuls of completely confused inquiries about whether or not a person should eat more or less. Even scientific literature doesn’t seem to agree on a common answer.



Many of us from the microwave generation were raised being told by the USDA to eat lots of healthy ‘whole grains’, as every cereal box, granola bar and sandwich bread package in the grocery store was labeled with the claims: ‘Enriched with B-vitamins’ or ‘Packed with iron’ or ‘Get your 6-11 servings a day.’ Runners touted carb-loading with a heaping plateful of spaghetti the night before a race, and low-fat dieters found sustenance in whole wheat toast, fresh fruit and Special K cereal or oatmeal and egg whites for breakfast, whole grain wraps with deli turkey or tuna fish on diet bread for lunch, and brown rice with chicken and broccoli or whole wheat spaghetti with red marinara for dinner, and snacks like sugar-free pudding, 100-calorie snack pack crackers or angel food cake in between.


Then, fast forward to recent years, when, as of late, a buzz phrase we’ve been hearing a ton more lately as well about the ‘ketogenic diet’ or ‘ketosis’—more or less, an upgraded version of the popularized Atkins’ diet of the early 2000’s.


In essence, ketosis is a state of ‘fat burning’, wherein your body is using fatty acids, or ketone bodies, as its primary source of fuel. In terms of nutritional intake, this looks like the consumption of 50-grams of carbohydrates or less in a given day (veggies and fruits included), moderate amount of protein, and lots and lots (and lots) of healthy fats.


Wherever you fall in your beliefs and current intake of carbs, there’s no getting around it that, every BODY is different and therefore every person’s ‘exact prescription’ for the amount and types of carbs the need is going to look a bit different.



While some people do incredibly well on a low-carb, higher fat and moderate protein diet, there are also many people who crash and burn, or struggle with an ongoing war with their bodies (‘I can’t seem to lose weight’; or ‘I have no energy’) on this type of plan.


I often find this to be the case, in particular, with women.


Very often, I come across females dealing with menstrual cycle irregularity, hormonal imbalance, ‘adrenal fatigue’, poor sleep function, hypothyroidism, weight loss/body-fat loss resistance, and poor exercise recovery. I hear stories of women who say the low-carb dieting was ‘working wonders for them’, then, all of a sudden—for some reason—it stopped.


Eggs and bacon or Bulletproof Coffee for breakfast, and lunches and dinners of chicken or fish with green veggies and avocado or olive oil instantly made them drop 10 lbs. They avoided fruit and starches—at all cost. They were rocking their workouts and fitting back into their old jeans, but then…seemingly out of nowhere, just looking at food made them gain weight. Their bodies started ‘holding onto weight’ in certain places. They couldn’t lose that ‘last 5 stubborn pounds.’ They grew more tired, and began to plateau in their workouts. Their cycle was off. And, not knowing what to make of it all, they decided to ‘try harder’—restrict their diet a little more, push it a little harder in the gym, and/or resolved to feel completely frustrated and at a loss about ‘what to do now.’


Sound familiar?


I write this, too, from a perspective of a personal experience with these things—the war with myself and my food to keep to a low-carb (i.e. no carb) diet because it is what I, as a woman, was ‘supposed to do’ (thou shall fear thy carbs).


I resolved to swear off fruit, avoid all starches, and if I was hungry, just eat more protein and a little bit of fat (at the time, I too, was ‘fearful’ of fat).



Scary Banana


The result?


You know: Not pretty. Poor recovery from workouts. Fatigue. Out of whack hormones (i.e. as in no hormones). Impaired digestion.


Little did I realize how eating a low-carb/no-carb diet can specifically impact your hormones (which in turn impacts your energy levels, your workout recovery, etc.).


The primary hormone that gets dysregulated in adrenal fatigue is cortisol, and cortisol has been shown to increase on a low-carb diet. 


In short, this means that a low carb diet is a potential ‘hormonal stressor’ in some individuals—or can become that way over time. Combine this with poor sleep, overtraining, stress at work or school, burning both ends of the candle, etc., and you’ve got yourself a recipe for burnout.


Realizing I didn’t feel 100% right, I began to question what, in my nutrition, could stand for a tweaking or a change.


Could the answer be as simple as adding back more carbs?


While the mind ‘feared’ the carbs (Was I weak for ‘giving in’?), I knew something had to change if I wanted to feel better, and resolved to ‘just try it’—to see what adding some carbs back into my diet could do.


The result this time?…Halleluiah! (angel choir singing)


All of my ‘symptoms’ began to resolve—more energy, improved recovery from workouts, improved digestion.



And it was not a huge change—something as simple as adding back in some of my favorite things like sweet potatoes, potatoes, squashes, and tubers…even some fruit (Was I crazy?!—for years, I feared the sugars in fruit and believed fruit would ‘store as fat’) and ‘simple’ veggies like carrots and yellow squash (it’s crazy what a no-carb diet makes you fearful of)—made all the difference.


Several women I work with who have adhered to a no-carb/low-carb diet for quite some time even find that they not only are able to tolerate—but feel better—by adding back in some steel cut oats in the mornings, or ordering their sushi with rice and all. Quinoa can be delicious on some salad greens with protein and avocado (of course) on top. And there are sooooooo many varieties of potatoes and sweet potatoes, it’s crazy (you have to try Japanese sweet potatoes if you have never tried them).



So good with coconut butter on top!


In addition to preventing—or healing from—adrenal fatigue, including some carbs in your diet are imperative for your thyroid function, your fertility, your menstrual cycle and your digestive health.


How so? We’ll break it down:


Thyroid Function & Fertility

In terms of your thyroid  function (Note: Thyroid hormones help all your organs work well—including your reproductive organs. They control how your body uses food for energy), glucose (carbs) is necessary. Glucose promotes the conversion of the inactive T4 hormone to the active T3 hormone in the liver (i.e. the process that gets your thyroid function ‘revving’).  


While your liver is capable of producing its own glucose with gluconeogenesis if it must (it can convert proteins into glucose believe it or not!), that process can become extremely taxed over time, particularly if your liver is already taxed from a history of poor eating habits (hello microwave and fast-food generation), vitamin and mineral insufficiency, stress, or caloric restriction. In other words: you are not thriving; or you start experiencing the above mentioned symptoms ‘all of a sudden’ (weight loss resistance, more fatigue, poor digestion, impaired fertility, etc.).


So, when you eat glucose (carbs), you assure that your liver does not have to work overtime.  You provides the glucose that your body and brain needs (rather than forcing your body to make its on its own). Ultimately, this promotes optimal function for your bod—and less stress in general, while specifically optimizing thyroid activity—and your fertility.


On the other hand, if thyroid activity is not optimal, hypothyroidism often presents in the form of:  mood disorders, reproductive irregularities such as PCOS and amenorrhea, skin conditions, and in weight gain, among other things.


Menstrual Cycle

I came across this interesting statistic from a study focusing on the ketogenic diet (low carb) in adolescents, wherein researchers found that while “there was a significant reduction in the number of seizures experienced and a majority of participants lost weight, 45% of the girls reported menstrual problems—including amenorrhea and delayed puberty.” However, “A majority of the girls experience return of normal menses after the diet was discontinued.”


A huge part of menstrual disturbances (amenorrhea or irregular cycles) is attributed to low energy availability/intake.


Specifically, if you’re not consuming enough calories or are eating too low of carbohydrates to support activity, you could be messing with the hormone leptin’s ability to regulate your reproductive hormones (Leptin is a hormone that assesses your energy availability throughout your body; and, concerning your cycle, some leptin receptors are housed in your ovaries and pre-ovulatory follices). Insulin (from carbs), in particular, stimulates leptin formation, so if you are dramatically cutting your carbs, you are more than likely inhibiting your body’s leptin levels.


Case in point: No ‘energy’ or ‘booster’ for your ovaries to get the job of menstruation done.



I could talk all day long on digestion.


One of the less discussed downsides of a very low/no carbohydrate diet is the potential for alteration of the gut flora and impaired digestion (gut dysbiosis)—particularly if you aren’t getting in enough greens and veggies with your protein and fat-based meals.


Simply put: When you avoid carbs, you’re also avoiding important prebiotics (i.e. food for your gut flora) such as soluble fiber and resistant starch. These prebiotics are essential for promoting the growth of healthy gut flora. Without them, your body can’t produce as many gut-healing/protective substances such as butyrate (a critical mediator of your colon’s inflammatory response) and other short chain fatty acids, and your microbiome composition (100 trillion microorganisms that live in our gut, mouth, skin and elsewhere in our bodies) may shift in an undesirable direction.


The bottom line?: Carbs are not a bad thing. 


So how do you know how many carbohydrates YOU need?


The answer is not cut and dry—and this is where consulting with a Nutrition Therapist or knowledgeable coach and/or holistic practitioner can most certainly come into play.


Generally speaking, if you are a woman struggling with—or presenting with—any of the previously discussed symptoms (weight loss/body fat loss resistance, low thyroid function, poor recovery from workouts, low energy or fatigue, cycle irregularities, hormonal imbalances, poor digestion, even low weight/poor weight management), consider your nutrition—and the role of carbs in your current diet.


If you have been eating very low-carb or no-carb, try ‘changing it up’ and experimenting with incorporating or boosting your carbs to at least 100 grams and see how you do.


And keep it simple—aim for real, whole food sources—like your squashes, potatoes, some fresh fruits, veggies of course, and even if you get a wild hair—some oats, rice, quinoa and sprouted grains could do a body good.


This could look something like:



Peach-Blueberry Pancakes (recipe below) with a side of chicken sausage for breakfast;


Or, a small serving of steel cut oats with cinnamon, a splash of unsweetened almond milk and 1 tbsp almond butter stirred in with a hardboiled egg or two on the side;


Or pulled pork-and-sweet-potato hash (recipe below)



A hearty spinach salad with chicken or burger patties, avocado, broccoli and zucchini, and diced sweet potato wedges thrown in;


Or, tuna or chicken salad (dijon mustard and avocado mashed with chicken/tuna + diced grapes or diced apples and celery) with homemade crackers (see recipe below) and a side of raw veggie sticks (carrots, zucchini, squash, etc.);


Or, salmon or chicken + butternut squash, cranberry and kale salad




Spaghetti squash with homemade grass-fed beef meatballs and tomato sauce, broccoli sautéed in butter


Flank steak + Japanese sweet potato with coconut butter + sautéed kale


Homemade bean-less chili with green side salad and homemade cornbread muffin (see recipe)


Summing it up…how do you know if you need more carbs? You may thrive off of more carbs if:


-You are experiencing signs and symptoms of adrenal fatigue

-You are active-specifically with a focus on higher-intensity or weightlifting-based workouts

-You don’t seem to recover as quickly or fully from your workouts

-You have a low-functioning thyroid—even with your efforts to eat clean and/or medications

-You have irregular cycles or have lost your period

-You are pregnant or breast-feeding

-You can’t seem to make the scale or your body fat-loss efforts ‘budge’

-You are underweight or wanting to put on a little bit of nice body shape

-You’ve been eating low carb/no-carb for a long period of time



Some delicious and nutritious recipes to try…

Peach-Blueberry Pancakes (from the Primal Desire)


•1¼ cup peaches pureed (approx. 2 small peaches- they just need to be pitted, not peeled)

•4 eggs

•¼ tsp baking soda

•¼ tsp salt

•2 tbsp coconut flour

•½ cup blueberries



1Pit peaches pop into a food processor, or blender.

2Add eggs and pulse until blended.

3Add salt, baking soda, and coconut flour, pulse until blended.

4Stir in blueberries and pour or scoop onto a griddle (approx. 350F).

5Cook for 3-4 min. (until bubble pop and don’t fill in.

6Carefully flip and cook for approximately the same amount of time.

7Serve with real (B grade or better) maple syrup, and grass fed butter.


Pork & Sweet Potato Hash



Pulled pork tenderloin (about 2 lbs.)

For the Hash:

1 large sweet potato, diced

6-8 nitrate-free bacon or turkey bacon slices, chopped and/or eggs over easy (optional)

2 onions, chopped

2 tbsp grass-fed butter or ghee

1 tsp garlic powder

sea salt & pepper



For the pork: Whip out your crockpot, throw 1-2 cups low-sodium or homemade chicken/bone broth into the pot. Throw in your pork, and season liberally with sea salt, pepper and garlic to taste. Let cook on low for 6-8 hours.


For the hash: In a large saucepan, add the bacon (if using). When the bacon starts to cook and grease appears in the pan, add the rest of the ingredients. Saute the bacony buttery goodness for 10-15 minutes, stirring often. It’s your choice if you’d like to place the pork on top of the hash, or just side by side.



Homemade Crackers (from Elana’s Pantry)

2 cups almond flour

1 large egg

½ tsp sea salt

½ tsp black pepper



Place almond flour, egg, salt, and pepper in a food processor

Pulse until dough forms

Place dough between 2 pieces of parchment paper

Roll out dough to 1/16 inch thick

Cut into 2 inch squares using a pizza cutter or a knife

Sprinkle with extra salt and pepper if desired

Bake at 350° for 12-14 minutes


Cornbread Muffins (by Empowered Sustenance)



1/4 cup coconut flour

1/4 cup coconut oil, butter or real lard, liquified

2 eggs, at room temperature

1 Tbs. unsweetened applesauce or 100% pure apple butter

1 Tbs. raw honey

1/4 tsp. baking soda

1 tsp. apple cider vinegar



1. Preheat the oven to 350. Line 6 muffin cups with cupcake/muffin lines. Mix together the coconut flour and oil until smooth, then beat in the eggs until smooth. Add the remaining ingredients and stir well.

2. Divide between the prepared cups and bake about 20 minutes, until a toothpick comes out clean and the top springs back when lightly pressed.

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