I began promoting carbohydrates for women’s health more than a year ago. The point was not, much as it might have seemed, to elevate carbohydrates as something magical or to create a whole diet that was oriented around them. Rather, I just wanted women to eat them at least a little bit.
Since then, I have become one of the go-to bastions of carbohydrate advocacy.
It got even worse when I outed myself at paleo fx as a woman who eats six apples a day. Then came on my blog and went ahead and fessed up to occasional 12 apple days. (Um, if they’re small apples). Have you seen the cover of Sexy By Nature?
These days, I’d guess that carbohydrates make up maybe 45 percent of my diet when averaged across the whole thing. That comes in the form of vegetables such as zucchini but is mostly in the form of mangoes and apples.
Therefore it might surprise you to learn that, having received results from a blood panel for the first time in twelve months, my fasting insulin and glucose levels are lower than they have ever been.
In 2010, 2011, and 2012, at the points at which I was on a somewhat calorie-restricted, carbohydrate-limited diet (lots of vegetables but not much fruit or starch), my fasting glucose was rock solid at 79 mg/dL. Three weeks ago, that number dropped to 75 mg/dL.
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Moreover, following my own prescriptions in PCOS Unlocked, for a woman with “Type II” PCOS, I have reduced my stress, increased carbohydrate intake, increased calorie intake, and decreased exercise. I have also begun supplementing with magnesium. (This is my favorite magnesium) The result?
LH and FSH, two hormones secreted by the pituitary gland that regulate the menstrual cycle and are typically low in women with starvation type menstrual irregularities, were higher than they had ever been.
Estrogen is well above the lower limit for bone health and higher than it has been since I was diagnosed with PCOS.
Progesterone is also above the lower limit, for the first time since I was diagnosed with PCOS.
Testesterone is within the normal range, lower than it has ever been (a good thing).
DHEA-S, an androgen secreted by the adrenal glands, is also within the normal range, lower than it has ever been (also a good thing).
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All of which is to say, I am well, and certainly not the worse for wear because I eat a mango — or six! — here or there. Might it be unsustainable in the long run? Sure. But it works for now, and it works for my healing. Read PCOS: Unlocked for advice on how to use carbohydrates to your hormonal benefit!
n=1.
Thank you for making a step in the direction of “carbohydrates are not inherently evil.” It’s not something we hear enough about in the paleo community.
I don’t eat a lot of fruit because I’ve got some disordered eating issues, and fruit’s a trigger that can send me into a full-on binge. But I do eat a lot of starches from sweet potatoes and regular potatoes and quinoa and white rice. And I feel a helluva lot better for it.
Previously, when I did low carb, I become an emotional zombie obsessed with counting grams of carbs in everything that went in my face.
I know low carb works for some folks, but like everything, it’s not a panacea for everyone.
Hi Stephanie. Great update! Can you share what a healthy estrogen level that does not promote bone loss is?
This is interesting as I have been chasing some potential hormonal problems (main problems are belly fat gain and waking in the middle of the night) that started about a year ago and my recent feeling is that the cause of the problem is that I haven’t been eating enough carbs (esp. for an active person). A while back, one of the docs I’ve consulted with even said my A1C was lower than he would like to see. I’m now trying to eat more carbs and even plan to add in (shocker) gluten free oats…I did much better before I gave up my oats.
Hi,
I have been following your blog for a long time and thank you for sharing your story and informaion with us. I find all of your post so helpful. When you say you exercise less, how much did you have to cut back on your exercise to have regular cycles again?
Thanks so much!
Hey Stefani!
Thanks so much for sharing! I was wondering when you eat your fruit do you eat it as a mono meal or combined with something?
Do you think when eating copious amounts of fruit its best to eat them alone or at a certain time of day for women with pcos or blood sugar issues? just curious.
Thanks!
I think we’ve been emailing — thanks for doing so. For everyone else, I think it’s a matter of personal preference. I now tend to eat fruit in meals rather than alone simply because the more macronutrient diversity I have in my life the more satiated my body is, the more satisfied I Feel, and the easier I can get back to living my life and doing things like writing this blog 🙂
Hey Stephanie,
Glad to hear things are moving in the right direction for you. Is there a reason you choose fruits over starches? Is is just because you prefer the taste or are there other reasons? Do you think you would have the same results with more starch?
Thanks!
To be honest with you, I gain weight with starches. I don’t know if it is water weight or if its due to insulin or to gut issues or really anything, especially the fact that I just love sweet potatoes so. damn. much. and probably over-do them on calories…. but in all cases I almost always add a size when I add starch to my life. Fruit seems to work. It also seems to leave me feeling more energized and level headed throughout the day… starches I think give me a bit more of a blood sugar ride and also just feel a bit.. heavy, solid, weightier? in a plodding sort of way I do not enjoy.
I love your pro-fruit attitude. 🙂 I really enjoy fruit. It makes me happy. I sort of get this guilt thing when people in the Paleo podcasts almost seem to treat fruit like sugar. And trust me, I know how I feel when I eat too much sugar and I definitely don’t feel that way on fruit.
I also love, love starches and eat them often but I have discovered that I do not digest sweet potatoes well. Not completely sure why they are different from other starches but I definitely do not feel as good with them. Does that stop me from very occasionally frying them like chips in coconut oil? No, no it does not.
Hi Stefani,
This is a bit of a personal question and I’d love your knowledgable advice as long as it’s no trouble to you…
I am a 20 year-old female. I haven’t menstruated in about 3 years now. I have always been active, but get plenty of sleep and am rarely stressed. Within the past 3 months, I cut down on my daily exercising schedule, to a more moderate approach. Knowing I have HA, I got a blood test to check my hormone levels. Everything seemed to be at normal levels except my estrogen which was extremely low. My doctor had me take a 200mg progesterone pill for 10 days to see if it would induce a period, but no success with that.
I also took an ultrasound and it was discovered that I had a few cysts on my ovaries. This was an alarm for her that I have PCOS. She has now given me Lo Loestrin Fe to help me get a period again.
I am hesitant to start taking a hormone pill. Clearly, my body is not properly regulating hormones, but I don’t think taking an estradiol pill is necessarily the best approach to fix things. I’ve followed a Paleo lifestyle for about 2 years now and it has not seemed to help me menstruation-wise. I get at least 75-200g of carbs/day depending on the season, eat plenty of healthy fats and I’ve increased my body-fat % in the last year. Still no period.
Concerned about my future fertility, I am trying to do the best thing to mend things. If you have any advice, I am all ears. Thank you.
Hi Lauren,
Unfortunately, estradiol can be a big nut to crack. How do we get our ovaries working again? The answer is not BCP. While you could take estrogen supplements to make you feel better, it will not help with your natural fertility.
What you are doing is all the right stuff. I recommend checking out the hypothalamic amenorrhea forum at https://fertilethoughts.org, one of the best resources for HA on the planet. (Seriously) There are thousands of women in that thread going through the same thing you are, and discussing all what has worked for them and hasn’t and such. It’s nice to read so much about what these women go through — and the answer almost always boils down to exactly what you are doing, and having enough patience to support your ovaries as they heal.
Thank you Stefani. I greatly appreciate you taking your time to give a thoughtful response! I always enjoying reading your blog and hearing you on various podcasts, and loved yours while it lasted. Best regards!
This is more or less in line with what I’ve seen in research regarding carbohydrates and fat. For acne, I think it’s a good idea to restrict carbohydrate intake somewhat, but research on metabolic consequences of fat vs. carbohydrates is quite ambiguous. As long as you eat low GI carbs and/or good quality fat it doesn’t seem to matter that much what you eat. Reversing of metabolic syndrome, insulin resistance, etc. has been shown in both cases.
Happy to hear you are healing so well and you have found what works for you! I agree with you that our needs change over time, but as long as you’re focused on the present and it is working for you, great! When it needs to change it will.
Hi Stefani,
Long time reader, first time commenting. I’m 26yo, 5’2, 117lbs, have had PCOS for 5 years. I struggle with insulin resistance and amenorrhea. Since incorporating meat back into my diet (I was pescetarian for 5yrs) and a more pale style of eating (no grains/gluten), I’ve gotten 5 periods over 10 months for the first time in 5 years (I was getting about 1 a year if I was lucky). This is definitely progress, but I still have a ways to go. I’ve been struggling lately with weight gain (I’m used to being 112lbs), low energy, and mood swings. LIke you, I tend to gain weight with starches (and even moderate quantities of fruit). Do you have any diet recommendations for stabilizing my energy and mood a little better? I read that on Mark’s Daily Apple that you recommend a low-insulin, anti-inflammatory diet. Could you elaborate or shed some light onto this?
Thank you for putting together the best website for women I’ve ever found.
Oh, thank you, Amanda! I certainly do what I can.
Did you make any dietary or lifestyle changes concurrent with the weight gain? That seems the most important thing to consider in all of this. And it turns out you and I are exactly the same weight and height. I am quite happy.
Nonetheless, I understand it can be concerning if you think you are going to continue gaining weight. It could be any variety of factors, too, possibly tied to the hormone re-calibration you are currently experiencing. I recommend eating enough carbohydrate to make sure you are not too low, so around 100 g a day, so perhaps one or a couple of pieces of fruit spread throughout the day on top of your regular vegetables. Make sure you have iodine in your salt. Coconut and avocado, fish and meat, much like you are doing. Perhaps you could experiment with the size and timing of your meals.
More than anything, I think the most important thing is relaxation and patience. As you regain your cycle, you might come in and out of greater estrogen and progesterone levels, which can cause mood and energy fluctuations. I have noticed this in my own body, too. Your nutrient stores are filling up and your body is doing its best to kick up hormone production, and it’s going to be a little while before things settle down into more regularity.
You might want to try a Mg/Ca supplement to support healthy hormone production, which has the benefit of sensitizing insulin as well.
You’re the best. Simple as that. 🙂
Dietary changes were mainly eating a lot more fruit and one too many gluten free treats and drinks. I’ve been traveling for the past few months and am in the process of moving across the country (in 4 days! CA–>MA). Additionally, b/c I’ve been traveling, my workouts haven’t been as consistent and can’t include my typical heavy Crossfit weights (I wish I could bring 100+# to squat with me 🙂 so more body weight and cardio (yuck). Lastly, I think this has a lot to do with it, I’ve been extremely stressed w the move & all that it encompasses.
The weight isn’t such an issue; it’s more that the fat accumulates primarily in the belly area which always worries me. If it was more evenly distributed (in a perfect world?) then I’d be content with the gain. I think per your recommendation, I’ll start paying attention to the macronutrient portion of my carb intake. I’m pretty sure I’m way over 100g a day.
I didn’t know Mg/Ca supported healthy hormone production; I thought is was more for gut healing! Do you have a brand that you trust/recommend?
Thank you so much for your insight. Your website has helped me tremendously and I’ve even referred my newly PCOS diagnosed cousin to it (she’s also comes from a bio background).
Haha, Amanda, sounds to me like you know what facilitated the weight gain… and that means that by going back to your treat-free, less-stressed life, you should balance back without much of an issue. It’ll happen naturally as your life goes back to normal.
Magnesium is necessary for performing just about every cellular function, hormone production included. It also gets depleted in times of stress, so making sure that you get a little bit of additional magneisum every day can be a life saver in terms of cravings, insulin sensitivity, mood, and hormones. I wrote about my own experience with it a few weeks ago if you want to scroll through the posts and check it out.
Welcome to the east! I have no idea why you’d move here from California, but we welcome you nonetheless. 🙂
A less stressed life is what I’m worried about! I’m moving to Boston (I know, it’s really hard to leave these southern california palm trees and ocean breeze) to get my PhD in Clinical Neuropsychology. As I’m sure you’re aware, it’s going to be pretty intense and stressful (hello 5 yr program)! I’m worried about the potential damage to my hormones/progress. Hopefully I can mitigate some the effects by watching my carbs (100g a day) and supplementing properly (I just recently introduced grassfed gelatin into my life which may have helped bring this last period since I experienced a solid 4 month gap of no period while traveling/stressed).
I’ll definitely look through the magnesium article! Thanks for the warm (cold? at least my husky will enjoy the winters) welcome to the “right coast!” 🙂
Hi Stefani,
First I want to say thank you for your wonderful blog. I can’t praise it enough! You’ve filled in so many gaps in my knowledge and of course, you’re filling in the giant gap out there of information on women’s health. Thank you so much.
Secondly, I wanted to mention something about acne. I suffered with acne for my whole life. Then I did an allergy clearing diet, to figure out the cause of my hayfever. Unexpectedly, I discovered the cause of my acne, too. Dairy.
These days I avoid dairy and I have perfectly clear skin, all of the time. It’s a miracle! If I have some cheese, I’ll get a pimple the next day. But if I don’t touch dairy, my skin is radiant. Before, I lived on yoghurt, milky coffee, and cheese, and my skin was awful. As a person who had dreamed and longed for beautiful skin all my life, these days I am constantly giving thanks for my clear face.
How to do it: To figure out if dairy affects you, you should cut it out entirely for two weeks. Be fanatical about zero dairy just for those two weeks. Then, do a “trial”: add dairy back in for a day, or a few days. Have quite a lot of dairy – you’re trying to provoke a reaction in your body, so have some cheese on a sandwich, some yoghurt, and a milky latte. As soon as you notice a reaction, stop – you now know that you have some kind of dairy intolerance. If you notice no reaction at all after a week of eating dairy, then you know it’s not affecting you.
In me, dairy causes acne, itchy skin, and dark circles under my eyes. It’s the milk solids that are the problem for me, so butter is basically fine, but low fat milk or yoghurt are the worst. I have read a fair bit of research lately linking dairy to skin problems, and it seems to be quite common. I even wonder if sometimes people’s skin improves on paleo simply because they’ve cut out dairy.
I hope this comment helps you or even just one other person to clear up their acne!
Helen
My blood sugar is low low low and I live off of perhaps 60-80% carbohydrates from fruits and veggies.