Dial in the Carbs: Choosing the Right Dose for You in 3 Easy Steps

By Sara Gottfried, MD

Confused about carbs? You’re not alone. There’s a lot of conflicting information out there. Maybe you’ve been Paleo for a while, or perhaps you’ve just started to ditch carbs in hopes of shedding pounds. While low carb diets have proven to be healthful and therapeutic for a number of health conditions, it’s important to note that we are not one-size-fits-all.

Do any of these situations fit you? If so, read on to learn more about why you shouldn’t skimp on carbs.

  • Thyroid issues
  • Trying to conceive or pregnant
  • Postpartum and/or breastfeeding
  • Endurance athlete or distance runner
  • Feel weak and tired on low-carb diets
  • Constipated
  • Hypoglycemic
  • Adrenal fatigue

Did you know that super low-carb diets aren’t ideal for these conditions and, in some cases, may cause or exacerbate them? Women in particular tend to have more carb requirements than men, particularly when women are in their fertile years.

Not all carbs are bad, and we need to remember that in our current epoch of carb phobia. For example, flaxseeds contain 3 grams of carbs per tablespoon (all of which are fiber), and may reduce hot flashes in menopausal women.2 While flaxseed is primarily rich in fatty acids (4 grams per tablespoon), and has a small amount of protein (2 grams per tablespoon), many on low carb diets skip it in favor of fatty acid sources that contain no fiber at all (coconut oil or butter). Fatty acids can be healthful, but the body functions best with some carbs, preferably slow-burning carbs. Even low-carbers need fiber to regulate the function of the intestines and reset estrogen. This is where quality and choice come in: vegetable fiber is best.

Carbs and Biochemical Individuality

You may show similarities with someone externally or even in personality, but take a look at the DNA inside your cells and you’ll find a completely different blueprint. This is why no diet, no matter how proven it is, can be a one size fits all for everyone. Your mother or sister may have thrived on a low-carb diet, or your BFF may have dropped four pant sizes in four weeks, but that doesn’t mean it’ll work out the same for you.

The body needs carbohydrates—especially during prime reproductive years—for a number of reasons. Let’s look at a few of them:

  • Carbs convert to glucose in the body, and the right amount of glucose is necessary for proper thyroid function. I use the term “right amount” because consuming excessive amounts of carbs, which convert into large amounts of glucose, will cause hormone issues of a different kind, such as insulin resistance.
  • When it comes to the thyroid, T4 (inactive thyroid hormone), needs to be converted into the active form, T3, for your body to get any use out of it. T3 is what gives you the get-up-and-go energy you need to feel healthy. When this conversion process is lacking, you’ll feel lethargic, and may have trouble losing weight (or may even gain weight) as the metabolism—also regulated by the thyroid—slows from lack of proper hormone conversion. You’ll also probably feel cranky, since thyroid hormones have a big impact on mood, and indeed carbs themselves have an impact on overall mood and well-being. Low carb diets can seriously cramp the thyroid’s ability to function well in women, especially those who are prone to thyroid disorders or disease (i.e. those with family history, current or past problems). Impaired thyroid function isn’t ideal for any person, but women are more vulnerable compared with men. Which women? All women hoping to conceive as well as women who are well past their reproductive years. Pre- and post-menopausal women can experience thyroid issues in greater amounts than women who are younger, so dramatically reducing carbs (lower than 50 grams per day) can force the body to become dependent on thyroid medication simply from the liver’s inability to convert T4 in a timely manner.
  • Carbs are also essential for adrenal function, and so women experiencing adrenal fatigue should not go on super low carb diets. The adrenals produce many hormones, including reproductive hormones, stress hormones, and aldosterone, which maintain the body’s electrolyte and fluid levels. When the adrenals become taxed from the over-production of stress hormones, the last thing the body needs is to be carrying the burden of a super low-carb diet. Just as the thyroid needs carbs to convert its hormones, the adrenal glands need similar nutrient support.
  • Whether you’re improving your fertility so you can get pregnant, are pregnant, or have recently had a baby (or are breastfeeding), you need carbs. Carbs equal energy in the body, and reproduction requires a whole ton of energy. Making another human (or preparing to, or recovering from) is no small task, and without enough energy, hormone production will not be optimal for any of these tasks. Hormones regulate the entire reproductive and postpartum processes, and starving the body of carbs will pretty much shoot you in the foot.
  • Even if you’re past your reproductive years, you still have need for carbs. Perimenopause and menopause are times of major change in a woman’s body, and while some will respond well to highly restricted carbs, many will need support from moderate carb intake as their hormones shift during this time.

Ideal Conditions for Lowering Your Carb Intake

  • You have PCOS
  • You eat a lot of carbs (greater than 250 grams daily)
  • You have been unable to lose weight
  • You are diabetic (type 1 or type 2)

If you’re experiencing any of these situations, there’s a good possibility that your body is a little tipsy on carbs. In that case, reducing your carb intake—and therefore lowering your body’s glucose—could provide desired results, especially for women who have PCOS. That being said, it still doesn’t mean you have to go super-low-carb. If you’ve been eating 250 grams a day, drop back to 200 for a while, and then back to 150. You don’t have to go cold turkey.

If you happen to fall under any of these categories, something you’ll want to learn is glycemic load. This refers to, essentially, the quality of the carbs you’re eating. When it comes to carbs, there are certainly such things as “empty” carbs and these will have a higher glycemic impact, i.e. will be more likely to cause a blood sugar spike. Lower glycemic foods, like berries versus bananas, or beans versus refined bread, will help to reduce the immediate blood sugar spike and will help to spread out the energy use. Lower glycemic foods tend to be that way because they contain higher amounts of fiber, thus slowing digestion. The good thing is, a low-glycemic load diet can actually help to reduce systemic inflammation, which is good for all health conditions.

How to Optimize Your Carb Intake—3 Easy Steps

If you need to reassess your carb intake, start here.

  1. If you fall under any of the conditions we’ve discussed here, such as reproductive health, PCOS, hypoglycemia, or diabetes, etc., consider making appropriate adjustments to your carb intake over time. It doesn’t have to be cold turkey to be effective.
  2. Keep a food journal. This will help you not only pay attention to how many carbs you’re eating, it’ll also give you a space to notice whether things are trending better or worse. Make slow changes and listen to your body. Record how you feel each day, even if you think symptoms are unrelated to your carb intake. This can means moods or headaches, but also body aches, energy levels, bathroom habits, and even your appetite and food cravings.
  3. Pay attention to food quality and glycemic load. This can come down to simple logic (vegetables are better quality carbs than white rice), or it can come down to doing some research. You can calculate net carbs by subtracting total fiber from total carbohydrates on nutrition labels, or by finding nutrition data for almost any food online. Net carbs refer to the expected effect that carbs will actually have on your blood sugar. Foods with more fiber have a lesser effect on blood sugar, and thus have fewer net carbs, whereas foods with little or no fiber but many carbs will cause more of a dramatic increase of your blood glucose.

How Many Carbs Should You Eat?

This really comes down to you—your genetic individuality and all of the health factors at play. Fifty grams of carbohydrates is considered low carb; 50-150 is considered low-to-moderate, and 150-200 is considered high carb (without being dangerously-bad-for-your-glucose-high, which would be 250 and higher). Pregnant women should be getting right around 200 grams daily, as should athletes, women experiencing thyroid disorders, adrenal fatigue, and hypoglycemia (always paired with protein!). Women with diabetes, metabolic syndrome, or PCOS would benefit from having fewer carbs in general.

Don’t be carb phobic; carbs are an important part of a balanced meal plan and balanced hormones, but choose the slow-burning whole food options such as in vegetables and starchy tubers—sweet potatoes, yucca, and plantains.