There are a multitude of articles, books, interviews, studies and films that address this topic, and the most common problem is the contradiction of data. There are parties that claim that a ketogenic diet helps to balance the hormonal system, there are other parties that claim that it turns everything upside down.

We are dealing with a complex and, at the same time, delicate subject, and in the data we have at our disposal it is very possible that both of them are right and at the same time, paradoxically, neither one nor the other is right. This is because we live in duality, in a polarized reality, but also because there are missing pieces of the puzzle.

In this article you will find

In this article you will find information on:

• Introductory notions (hormones and their role, ketogenic nutrition)
• aspects to consider when interpreting the data: in vitro or animal studies, low-carb does not mean ketogenic – gray area, comorbidities, lifestyle, stress
• the main systems, disorders and hormonal interactions closely related to ketonutrition: metabolic imbalances, polycystic ovary syndrome, thyroid hormones, hypothalamic-pituitary system, sex hormones, stress
• conclusion: ketonutrition is a very demanding nutritional model

Introductory notions

Hormone (Greek ορμόνη, – horman, hormanus – to set in motion, to awaken) is a biochemical substance secreted by the endocrine glands or other tissues, which stimulates and coordinates the activity of certain organs, tissues or the whole organism.

The endocrine system is a system based on the activity of hormones and endocrine glands and tissues, which works through a feedback mechanism to their action.

The human body is one of the best performing machines in the Universe, but also very complex. Given this, its optimal operation involves a perfect synchronization between all components. Here, comes the importance of hormones and their actions. Any error, if not remedied, resonates throughout the whole body, no matter what level it is at. The paradox is that although the human body is quite complex, its needs to function optimally are simple. The problem is that we are bombarded with so many things from the outside, including information, that at this point, people are disoriented and no longer know how to use their own bodies.

Hormones, therefore, have an essential role in coordinating the whole body, but also in coordinating it in relation to the environment.

Regarding the ketogenic nutrition, this is a nutritional model that is based on the use of fats as the main energy resource, instead of carbohydrates. Changing the way the body chooses to use fats as the first option is done through a standard ketogenic diet, in which the percentage of carbohydrates in the daily food intake is below 5%. This causes the body to reach a state of ketosis (ketones in the blood> 0.5 mMol / L) and use them as an energy resource, a much more efficient and cleaner resource.

You have in these articles written by Gabriel Peșa more details about ketogenic nutrition and its benefits.

How exactly do hormones and fats influence each other? We will dissect this in the following lines.

Aspects to consider

Some studies that underlie claims regarding ketogenic nutrition and its influence on the human body, including the hormonal system, may be studies done “in vitro” or on laboratory animals, generally mice. It is true that we have certain aspects in common with them, but in order to formulate a conclusion regarding the human body, it is necessary that the information or mechanisms found be reintegrated.

Personally, I consider it is not logical, ethical and fair that data and information obtained out of context (on cell cultures), outside the playground, to be automatically considered valid in the playground, without being firstly reintegrated. Let us remember that we are unique as a species, but also as individuals.

Thus, it is advisable not to take for granted any information that is delivered, but to research on your own or to choose a source of information that inspires trust, that sorts and synthesizes information in an authentic way. This article was written by Dr. Anthony Gustin (PerfectKeto Founder & CEO) about keto and hormones. In the introduction to the article, Dr. Gustin highlights the importance and difficulty of maintaining an objective view, especially in the medical system, where there is a tendency to cling to that “scientific evidence.” The question is: if there is scientific evidence, as in this case, both for and against, what do we cling to? It is clear that something is missing.

Another aspect is that many of these data were obtained in “low carb” diets, ie diets low in carbohydrates. What is to be understood is that a low-carb diet is not the same as a ketogenic diet. In low-carb diets, the carbohydrate content may be higher than in a ketogenic diet, thus removing the body from the state of ketosis. A ketogenic diet is a low carb diet, but the statement is not valid and vice versa. Thus, in order to make statements about the influence of ketogenic nutrition on the hormonal system, it is necessary that the data be obtained from studies made using a truly ketogenic diet.

In addition, a ketogenic nutrition is not the same as a ketogenic diet. We live in a reality that is constantly neuro-linguistically programmed, so it is important to pay attention to the language we use. Related to this aspect, I also offer a candy, an interview of Dave Letterman with Kanye West, in which the artist mentions that he does not like the word “diet” because it contains the word “die” in it. Worth watching. It is important to understand the role of each, whether it is a ketogenic diet (regime) or ketogenic nutrition.

It is also essential to be honest with yourself and, when starting a ketogenic diet, to be aware of the context in which this change is being made. Yes, it is possible that a major change in diet will be a stress factor, but at the same time, this may increase what was already there, but it did not come to the surface. What I mean is that it is very possible that stress and the level of stress hormones that grow in a ketogenic diet are not necessarily related to the diet itself, but are actually from somewhere else, and a major change (either in diet, or in another area) to trigger this state of stress.

As I said, we are unique. The fact that some conclusions were presented after studying some individuals does not mean that that information is valid for everyone, especially since today’s article refers to the hormonal system, which is perhaps the most representative for our uniqueness. He determines our biochemistry. There are so many factors, so many variables (age, gender, lifestyle, health, goals, environment), that all we know is still too little to draw any conclusions in this regard.

Moreover, research focuses on highlighting data and mechanisms, but once you have the big picture, once you know how the human body works as a whole, once you understand what it means to integrate into the Universe, once you know what tools you have at hand, whether it’s performance or returning to the waterline, it’s important to know that there are solutions, there are alternatives, there are shortcuts. After all, that is biohacking: knowing what and when to give your body so it can do its job.

Ketonutrition and Hormonal Interactions

The main hormones influenced by ketonutrition are insulin and its partner – glucagon, cortisol, catecholamines, growth hormone, steroid hormones, ghrelin and leptin – satiety control, thyroid hormones (T3). These are the most popular hormones highlighted in ketonutrition, because, in one way or another, they influence the metabolism of fatty acids[1]. However, the effects of ketonutrition in the body include other non-hormonal mechanisms, and hormones are influenced not only by diet, but by a lot of other factors.

Let’s dissect this material a little and take them one by one.

Although, in this article, for somewhat teaching purposes, the information is presented in fragments, mostly related to diseases, the mechanisms of action intertwine, sometimes overlapping and influencing each other. A rotten apple, if not removed from the basket, will affect the others.

Keto In Metabolic And Nutritional Disorders

Personally, I don’t like to use the term illness / disease. I prefer to use imbalance / disorder instead. Basically, diseases are, in fact, manifestations of imbalances in the body. The fact that it does not manifest does not mean that imbalances do not exist.

This topic is discussed in detail in another article, so here I will present the hypothesis and conclusions.

The most common diseases in this category are diabetes, obesity and cardiovascular disorders, some of which are components of the metabolic syndrome.

The main common mechanisms underlying these metabolic imbalances are leptin resistance, insulin resistance, inflammation, enzyme failure and others, mechanisms that have impact in fatty acid metabolism. Leptin resistance is the root mechanism, and by restoring it, it will automatically be reflected in all the others. This mechanism is discussed in detail in the article on ketonutrition in metabolic imbalances (link). Leptin resistance is the mechanism that, once understood, allows us to understand both dysfunctions at the cellular level and those between the human body and the environment. It is the connection between inside and outside, the connection between micro and macro.

For these conditions, the ketogenic diet is already considered a first hand therapeutic option. This is also highlighted in the movie .

All these mechanisms can be reset through a ketogenic diet, and there is even the possibility that patients may give up medication and lead a healthy life. Studies show that in the long run, no harmful effects of applied ketogenic diets were observed.

A ketogenic nutrition or diet can be used not only to cure certain pathologies, but also to improve human performance, and here we are talking about the same mechanisms already mentioned. Who doesn’t want a metabolic adaptability that is reflected in both physical and cognitive performance? Find more details in the article on the benefits of the ketogenic diet (Gabriel Peșa).

Keto And Sexual Hormones

It is about sex hormones, or, more precisely, about steroid hormones: testosterone, estrogen, cortisol, aldosterone. These hormones are synthesized from cholesterol molecules. In a ketogenic diet, in addition to the fact that there is a larger substrate for the synthesis of these hormones (fats) from the beginning, lipid metabolism (including stored fats) is also encouraged, so this process of synthesis of sex hormones is increased.

Regarding females, imbalances such as menstrual disorders, infertility, polycystic ovary syndrome, in which ketogenic nutrition has been shown to bring clear benefits[2], have been studied and observed.

A woman who changes her diet to a ketogenic one, whether she has obvious imbalances or not, may experience unforeseen, more frequent menstrual bleeding, as well as other symptoms, especially during the adjustment period. These signs are related to the increase in the sex hormone production following the change in diet[3].

Estrogen is the main female hormone. It is synthesized in the ovaries, adrenal glands and fat cells. So… the higher the fat store, the more estrogen we have. At first glance it seems like a desirable thing, right? But it is not that simple.

The difference between estrogen synthesized in the ovaries and that synthesized in adipose tissue is that the one synthesized in the ovaries has feedback, and the ovaries know when to synthesize or not more estrogen, depending on the amount already existing, but the one synthesized in adipose tissue does not has this feedback, and fat cells continue to synthesize estrogen, but also androgenic hormones (male specific), regardless of whether the existing estrogen is too much or not. Thus there is an excess of estrogen and testosterone, and as it is known, any extreme is harmful. This is the mechanism by which the symptoms of polycystic ovary syndrome appear (menstrual pain, infertility, menstrual disorders, facial hair, thickening of the voice, decreased libido, etc.).[4]

After the adaptation period, most women optimize their sleep periods, the menstrual cycle becomes regular and, in addition, the libido increases. It is important to note that this increase in libido is not only related to sex hormones, but especially to the optimization of neural functions. The orgasm takes place in the brain, which is the strongest sexual organ. It goes without saying that the optimization of neural circuits also involves an increase in its sensitivity to the action of sex hormones and pleasure-producing neurotransmitters, and a hyperglycemic diet in these patients may prevent this[5].

Dr. Annette Bosworth (Dr. Boz) explains these effects observed in practice in her patients in this article.

Although hormonal rebalancing have been observed (free testosterone levels, LH, FSH)[6] as a result of a ketogenic diet in women, these imbalances start from the increased level of insulin that is found in a low-fat and high-intake carbohydrates. Over time, insulin resistance appears, but let’s not forget that insulin resistance is preceded by leptin resistance (article link) by about 5-7 years, during which time it can act.

The mechanism is similar to that found in type 2 diabetes, and this is why diabetes and obesity are usually associated with a patient with polycystic ovary syndrome.

Thus, the correctly implemented ketogenic diet helps the hormonal rebalancing, but if the leptin resistance is very high, the ketogenic diet is not enough. Usually you reach a plateau where no improvement is obtained. The only solution in this case becomes the extended water fasting for a minimum of 72 hours, which has the ability to completely reset all metabolic processes in the body. Also, keep in mind that a single 3-day fast will not permanently reset some metabolic processes that have been corrupted by lifestyle over decades. No way. Resetting these mechanisms can be done, but it is a long process and requires a lot of work and will.

Repetition is what has established some habits that result in these imbalances. In the same manner, through repetition you can create habits that can result in rebalancing the body. One water fast may not be enough for a lifetime.

I recommend reading the article on ketonutrition and post (soon) for more details.

Covering the male side, studies show that a ketogenic diet can increase testosterone levels[7]. The mechanism is mainly the same.  A ketogenic diet actually optimizes the level of sex hormone production, the body knowing what to synthesize for each person, whether it is female or male.

Keto And Thyroid Hormones

One of the most common concerns is related to the function of the thyroid gland. Here it is very important to understand how this gland works, but this mechanism is very complex and is not the purpose of the article. Very briefly, the pituitary gland secretes, based on a feedback mechanism, the hormone TSH, which controls the thyroid’s secretion of T4 (inactive), which turns into T3 (active), and the latter acts on the peripheral tissues.

A normal normal profile of thyroid hormones (TSH, FT4, T4, T3) does not necessarily mean that we cannot have the symptoms of hypothyroidism, just as an abnormal profile of thyroid hormones (in ketonutrition, usually low T3) does not necessarily mean that we have hypothyroidism.

In the first scenario, it is important to dose that hormone, reverse T3. It is a competitive inhibitor for thyroid hormones T3 and T4. This means that reverse T3 is in competition with thyroid hormones for the same receptors. Reverse T3 has been found to increase leptin resistance, so it blocks thyroid hormone receptors, and they have no effect in the body. So, even if the classic thyroid profile is within normal limits, it does not mean that everything is fine from a functional point of view. We can thus have the symptoms of a hypothyroidism (weight gain, hair loss, lethargy, depression, etc.), with decreased basal metabolism. The thyroid works normally, but the receptors for thyroid hormones are blocked.

In the second scenario, in which decreased T3 levels are often associated with a ketogenic diet, it does not mean that we have hypothyroidism or symptoms of hypothyroidism. Hypothyroidism is diagnosed by elevated TSH and elevated FT4, has nothing to do with T3. Even if we have low T3 levels, in the absence of symptoms of its insufficient activity, there is no reason to worry. In contrast, it has been observed that in a low T3 ketogenic diet there are higher energy levels, and some catabolic processes (such as muscle fiber damage) are lower[8] [9], thus even bringing benefits. The idea is that the thyroid works perfectly normal, but it does not take higher levels of T3 for the body to do its job.

Keto And Stress

There are also debates on this topic, whether a ketogenic diet induces stress or can help relieve stress. It is possible that both variants are a result of such a regime, so it is very important that the implementation of ketonutrition is adapted for each individual.

Stress is a normal response of the body in extreme situations, but when stress becomes chronic, we have a problem. We tend to believe that stress is caused only by mental and emotional aspects, but that’s how we get rid of what’s in front of our eyes again.

Whether we have a stressful job or not, whether we do sports or not, or whether we meditate or not, we all certainly do one thing: we all eat. What does this have to do with stress? Well, look, it has. The diet of the last decades based more and more on carbohydrates causes a chronic stress in our body.

How so? We have the two hormones that have complementary actions when it comes to glucose: insulin and glucagon. Every time we eat carbohydrates, the pancreas secretes insulin to introduce glucose into the cell. Each time the blood sugar drops, glucose is secreted to increase blood glucose through various mechanisms. With each such process, cortisol, known as the “stress hormone,” is also secreted. Basically, we stress our body every time one of the two processes takes place. And … guess what? Obviously, these take place only in a nutrition in which carbohydrates are present … Pam pam. Advantage: Keto.

So, just eating carbs is in itself a stress factor. If the consumption of carbohydrates is chronical and the stress that comes with it is chronical.

Seen from another angle, stress, and implicitly the level of cortisol, is related to leptin resistance, which, over time, leads to adrenal resistance, and then, when the adrenal glands can no longer compensate for the level of stress hormones, they are exhausted. (See the article on keto ketonutrition in metabolic imbalances).

Ketonutrition can also help reduce stress levels by optimizing the glutamate (excitatory) / GABA (relaxing) balance[10].

If we go to the cellular level, ketonutrition inhibits the production of reactive oxygen species at the mitochondrial level[11], thus reducing oxidative stress. Automatically, if the level of stress at the cellular level is optimal, this is reflected throughout the body.

Stress can be reduced by a CORRECTLY implemented ketogenic diet, ie according to individual needs. In the same way, an improperly implemented ketogenic diet (too aggressive, too early, unmonitored) can induce much more stress than the body can compensate. Monitoring is needed and balance is needed.

Also, the source of stress can be far beyond ketonutrition, even if it is discovered with its implementation. Therefore, ketogenic nutrition helps in, but does not solve mental and emotional problems.

Other Interactions

Ketonutrition could influence how the hypothalamic-pituitary axis works. In the study animals it was observed that, in a ketogenic nutrition, certain peptides independent of this axis are used, through which the information is transmitted. There are studies that show that ketones cross the blood-brain barrier and act as neurotransmitters for these peptides[12].

This mechanism may be even more efficient than the classical one, and the classical path does not seem to be altered.

Conclusion

This is probably the most ambiguous conclusion I have ever written. It is a conclusion with several conclusions, which, in the end, lead to the importance of personalizing a ketogenic diet. In general, but more obvious in the game with hormones, ketonutrition shows its importance, but it also shows that it is very demanding.

Conclusions:

• “not everything that flies can be eaten”
• To bring benefits, a ketogenic diet needs to be monitored and customized
• the sources of hormonal imbalances can be mental-emotional, but nutrition occupies a large place both in their physical manifestation and in their optimization

For proper guidance in ketonutrition, feel free to contact me!

References:

[1] Alberti KG, Johnston DG, Gill A, Barnes AJ, Orskov H. Hormonal regulation of ketone-body metabolism in man. Biochem Soc Symp. 1978;43:163–82.

[2] Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study. Nutr Metab (Lond). 2005 Dec 16;2:35.

[3] Liepa GU, Sengupta A, Karsies D. Polycystic ovary syndrome (PCOS) and other androgen excess-related conditions: can changes in dietary intake make a difference? Nutr Clin Pract. 2008 Feb;23(1):63-71.

[4] Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment of obesity in polycystic ovary syndrome: A position statement of the androgen excess and polycystic ovary syndrome society. Fertil Steril. 2009;92:1966–82.

[5] Castellano CA, Baillargeon JP, Nugent S, Tremblay S, Fortier M, Imbeault H, Duval J, Cunnane SC. Regional Brain Glucose Hypometabolism in Young Women with Polycystic Ovary Syndrome: Possible Link to Mild Insulin Resistance. PLoS One. 2015 Dec 9;10(12):e0144116.

[6] Mavropoulos, John C et al. “The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study.”Nutrition & metabolism vol. 2 35. 16 Dec. 2005.

[7] Ketosis Diet and Testosterone | Low Carb Diet Increases Testosterone: Thomas DeLauer

[8] M U Yang, T B van Itallie, Variability in body protein loss during protracted, severe caloric restriction: role of triiodothyronine and other possible determinants,The American Journal of Clinical Nutrition, Volume 40, Issue 3, September 1984, Pages 611–622.

[9] Kaptein EM, Fisler JS, Duda MJ, Nicoloff JT, Drenick EJ. Relationship between the changes in serum thyroid hormone levels and protein status during prolonged protein supplemented caloric deprivation. Clin Endocrinol (Oxf). 1985 Jan;22(1):1-15.

[10] Yudkoff M, Daikhin Y, Melø TM, Nissim I, Sonnewald U, Nissim I. The ketogenic diet and brain metabolism of amino acids: relationship to the anticonvulsant effect. Annu Rev Nutr. 2007;27:415-30.

[11] Maalouf, M et al. “Ketones inhibit mitochondrial production of reactive oxygen species production following glutamate excitotoxicity by increasing NADH oxidation.” Neuroscience vol. 145,1 (2007): 256-64.

[12] Pardridge, W.M. Transport of nutrients and hormones through the blood-brain barrier. Diabetologia 20, 246–254 (1981).