Why Women Need Carbs & How To Keep Them From Causing Chaos In The Body

Over the course of a decade of trying to heal my autoimmune disease and gut issues, I've had a love-hate relationship with carbs.

Love because pasta and potatoes are among my desert island essentials. And hate because of the conflicting advice I've been told about what my beloved bowl of Bolognese and side of fries will do to my body.

Some medical professionals treating my Hashimoto's thyroiditis said it was dangerous for women to be super low-carb. Others said I hadn't gone far enough by simply being gluten-free—strict approaches like the autoimmune paleo plan were the only way to get thyroid antibodies under control.

The same pushing of ultra-low-carb approaches came up yet again as I dealt with my next health hurdle: SIBO, small intestinal bacterial overgrowth. Some said I couldn't heal my gut without taking out all grains, while others claimed that removing them would be detrimental to the long-term health of my microbiome.

Meanwhile, I kept hearing from disaffected former keto-philes who had experienced the highs and lows of a restrictive diet and, ultimately, found themselves belly-up by the side of the road as the wagon full of cheese and meat sticks sped away. 

So, as I've done with my previous books—The Wellness Project and SIBO Made Simple—I used this experience as an opportunity to fall down the rabbit hole of metabolic health research.

While many health conditions are caused by chronically high glucose or insulin levels, extreme low-carb approaches can also cause problems.

Studies have shown that going ultra-low-carb can increase levels of cortisol1, our chief stress hormone. For women, cutting carbs overnight and keeping them too low for too long can spur symptoms of adrenal fatigue or HPA-axis dysregulation2, such as sleep problems, difficulty getting up in the morning, poor circulation, or thyroid dysfunction.

We need carbs to both make thyroid hormones3 and convert them into their active form. Particularly for those of us who already suffer from hypothyroidism or Hashimoto's, I've found that a drastic change in carb intake can make our thyroid even more sluggish, leading to more weight gain and fatigue.

As a rule of thumb, one of the easiest ways you can prevent refined carbs like white rice and pasta from getting broken down quickly and flooding your bloodstream with glucose is to fall back on your other macronutrients.

"Carb companions" are any ingredients added to your plate that have built-in fiber, protein, and healthy fats. Fat and protein both slow gastric emptying, meaning they make it so the carbs in your meal will reach your small intestines and get absorbed slower.

Fiber has its own superpowers when it comes to your metabolism. You can think of your intestinal wall as a fine-mesh sieve. If you poured a glass of apple juice through it, the liquid would pass easily and leave no residue. But if you were to add some mashed-up apple first? Well, the skins and seeds would clog up the mesh and make any liquid added take longer to make its way through. The result is a slow drip in the bowl versus an unobstructed stream.

In my years of working with women to overcome their autoimmune issues, I've noticed that sweet beverages seem to be a get-out-of-jail-free card. They stress about buying organic meats and avoiding pasta and bread, but a coconut water with 30 g of sugar gets chugged without a second thought.

Because blood sugar moderation is ruled by the hormone insulin, it can be affected by any other hormonal changes in the body. And for women, these changes happen several times a month by the very nature of our design. A woman's four distinct hormonal phases need to be fed slightly differently to maximize the body's ability to process estrogen, boost progesterone, and monitor all the other hormones.

Focusing on healthy fats and protein can restore energy during your menstrual period. Even if you've been conditioned to ease any discomfort with a hot water bottle and a box of chocolates, sweets will just add more insult to injury.

One of my mantras from early in my wellness journey is that if you're stressing about what you're eating all the time, no amount of kale will make you healthy.

When experiencing physical or emotional stress, your primary fight-or-flight hormones cortisol and adrenaline get released into the bloodstream. The result is higher blood pressure, an increased heart rate, and a rise in blood sugar6.

This is why having a regular practice to calm the nervous system is so important for overall carb tolerance—especially for women since cortisol has cascading effects for our whole hormonal motherboard.

In general, whole foods are always going to be better for your blood sugar than processed foods. Steel-cut oats take longer for your body to convert to glucose than quick-cooking oats and certainly longer than oat milk. Of course, we often choose processed foods for convenience. But opting for whole-food "slow carbs" instead can make a world of difference.