Hormone health is a popular topic in modern wellness, and more people than ever are concerned about hormone balance. In fact, recent reports show over half of women and about half of men tested their hormone levels within the year (1).
Despite the growing interest in hormone balance, the concept is often generalized, especially on social media. For healthcare professionals, an understanding of how to individually support hormone balance is essential for determining personalized dietary interventions.
This article reviews the basics of hormone balance and explores conditions where low-carb eating may be an effective tool for supporting hormone health.
What is Hormone Balance?
Hormones like insulin, cortisol, estrogen, and testosterone are chemical messengers that play a vital role in well-being. They communicate through an interconnected signaling network and work together to regulate metabolism, reproduction, stress, and body composition.
The term “hormone balance” refers to having optimal amounts of each hormone, keeping in mind that levels fluctuate on a regular basis (day to day and even hour to hour).
Hormonal imbalance is when normal fluctuations are disrupted. Symptoms of hormone imbalance can also occur if the communication process, known as hormone signaling, is impaired (2).
Hormone balance, signaling and overall function can be influenced by several factors, including:
- Diet
- Energy availability
- Inflammation
- Stress
- Medical status
A whole-body, metabolic approach that considers diet, medical status and individual lifestyle factors can help patients support hormone health.
How Diet Influences Hormones
One way diet affects hormone signaling is by influencing the body’s metabolic and inflammatory status. Dietary patterns that promote frequent blood glucose fluctuations, chronic low-grade inflammation, or excess adiposity can disrupt hormone receptor sensitivity. This can alter communication between different hormones and lead to symptoms.
Blood glucose fluctuations
Repeated blood glucose spikes and insulin resistance can increase metabolic stress and inflammation (3). This can indirectly affect other hormones, including cortisol, testosterone, and estrogen.
Chronic inflammation
Chronic metabolic or psychological stress can elevate cortisol levels. This may suppress reproductive hormone signaling by inhibiting gonadotropin-releasing hormone (GnRH), lowering testosterone levels, and promoting visceral fat accumulation. This cascade further reinforces inflammatory and hormonal feedback loops (4, 5, 6).
Excess adiposity
Increased fat mass alters estrogen storage and metabolism, promoting an increase in overall estrogen levels (4). Excess adiposity is also associated with lower testosterone levels (particularly in men), likely through inflammatory and metabolic pathways (4,9).
When Low-Carb Diets Can Be a Tool for Hormone Health
Several hormone-related conditions share common underlying metabolic features, including:
- Chronic inflammation
- Metabolic overload
- Impaired hormone signaling
In these cases, reduced carbohydrate intake may alleviate metabolic stress and support hormone function. Evidence suggests lower-carbohydrate dietary patterns may be beneficial for the following hormone-related conditions.
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) involves disrupted reproductive hormone signaling alongside metabolic dysfunction. In women with PCOS, studies show lower-carbohydrate and ketogenic dietary approaches may help balance hormones like androgen and improve levels of sex hormone-binding globulin (SHBG), a protein involved with hormone balance (7, 8). These benefits may stem from improvements in metabolic health seen with low-carb diets (7).
Obesity-Related Hormone Disruption
Excess adiposity is associated with impaired hormone signaling and lower testosterone levels in men. Research suggests dietary approaches that reduce metabolic strain, such as low-carb eating, may support improvements in testosterone and SHBG levels through indirect metabolic and inflammatory pathways (4,9). It’s worth pointing out that there are misconceptions linking low carb, high protein diets to lower testosterone levels. While this can be seen when daily protein intake is greater than 3.4 grams per kilogram body weight, this does not occur with more conventional “high protein” diets, which are typically 1.8 to 3 grams per kilogram body weight per day (10).
Nonalcoholic Fatty Liver Disease (NAFLD)
The liver plays a central role in hormone metabolism, including estrogen processing and SHBG production. Dietary interventions that reduce liver fat and improve liver function, including low-carb patterns, may indirectly support hormone regulation (11,12).
Key Takeaways for Your Practice
Though more research is needed in some areas, current evidence suggests lower-carbohydrate dietary patterns may be a tool to support hormone health in people experiencing metabolic stress and chronic inflammation. This includes people experiencing PCOS, obesity-related hormone disruption, and fatty liver disease.
Low carb approaches that reduce metabolic and inflammatory stress may have benefits for:
- Blood sugar regulation
- Adipose-related hormone activity
- Liver function for hormone metabolism
Low-carb eating is one of many tools that can help support metabolic and hormonal health. As with any dietary intervention, personalization is key. Factors such as activity level, stress load, energy needs, medical history, lifestyle and metabolic status all influence individual response. Consider patient-specific goals when determining dietary interventions to support sustainable, long-term outcomes.