Updated: Mar 30, 2021
I’m writing this article because it’s a pattern I see quite regularly, where exercise or nutrition habits are taken too far, and then some type of hormone imbalance develops. This is usually more subtle than an overt eating disorder, where the imbalance of caloric intake and energy burned is more extreme. There can be too much of a good thing, especially when we’re talking about women’s hormones.
Everyone’s capacity for training and how hard they can push their nutrition varies. Some people may hit metabolic stress at a very normal or average body fat percentage. The symptoms simply reflect the stress your body is under, not necessarily low body fat levels.
The scenario that typically creates metabolic stress includes:
Overtraining – high intensity and/or high duration workouts
Not eating enough calories, or especially enough carbohydrates
Extended fasting windows (intermittent fasting / time-restricted eating)
With a high baseline stress level
HIIT workouts, low-carb diets and intermittent fasting are all still very trendy practices, but your body’s ability to adapt to these stresses largely depends on how high your baseline stress level is in the rest of your life, and how far you push the extremes.
Female hormones are VERY sensitive.
Signs of metabolic stress include:
Period irregularities, and in extreme cases missed periods (irregularities can mean heavier or lighter periods, coming less or more frequently, or missed for months at a time)
Fatigue, especially feeling unrefreshed from sleep
Your athletic performance is going down
Weight gain (that doesn’t make sense based on eating and exercising)
If this pattern of symptoms looks familiar to you, please take a look at your exercise and eating habits. Have you taken on an intense workout program (like a boot camp) or are you training for a long-distance race? Are you limiting carbohydrates in your diet? Have you been fasting for more than 14 hours every night, or doing some longer fasts?
There are tests that we can do to check whether your body is positively or negatively adapting to these stresses. Here is where I would start:
Checking adrenal health – at least testing serum morning cortisol level, and sometimes a full salivary or urine cortisol rhythm
A full thyroid panel (TSH, free T3, free T4 and thyroid antibodies). Low free T3 level is a classic marker for metabolic stress. This is why many of the symptoms that develop look like you have a thyroid disorder.
Estrogen, progesterone, LH and FSH to check hormone levels and test for hypothalamic amenorrhea
If metabolic stress is confirmed based on symptoms and bloodwork, it’s time to start the repair work. I will fully say that this is a slow condition to get out of, especially if your period has stopped, or you have started to gain weight that doesn’t make sense. The reason is that the body remains sensitive to metabolic stress for a while, and an increase in life stress or a sudden increase in training level can cause symptoms to recur.
Steps in treatment:
Address baseline stresses, where possible.
Back off on training significantly. This often means a big reduction training volume and workout intensity. Daily movement like walking, gentle bike rides, yoga, pilates and dancing is encouraged.
When you start building your training back, train smart: this means days off / down-seasons / recovery weeks. Think of yourself as an athlete – you can’t continue to push and build every week without recovery time.
Increase your carbs – most women require 150-200 grams of carbs per day to maintain regular ovulation and hormone balance. (There are exceptions with PCOS and insulin resistance).
Stop fasting – return to no more than 12 hours overnight fasting if you had extended your fasting to longer window. Hormones will not rebalance with extended fasting.
In many cases supplements to support adrenal function, help with thyroid hormone conversion, and help restore sleep quality are recommended.
I want to be clear that I’m not completely against intermittent fasting, lower-carb nutrition plans or intense training. It’s just important to do these things with guidance, and in a smart way. Think of them all as stresses on the body, and your ability to adapt to them will depend on your baseline stress level and current resilience. I do find that after menopause, women are better able to adapt positively to a lower carb lifestyle and longer overnight fasts.
If this pattern of metabolic stress is ringing true to you, or you’re not getting the positive body results you had hoped for from fasting, low-carb eating or intense training, please reach out for help! We can reverse the metabolic stress with a balanced nutrition plan, adjusting how you train, and appropriate supplementation.
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