Here’s How to Balance Your Hormones: A Protocol By Dr. Sara Gottfried

By Molly Knauer, MS, RD
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Having worked with many clients in their 40s and beyond, I often hear things like, “I just can’t lose the extra 10 pounds” or “I just don’t feel myself, no matter what I do.” Dr. Sara Gottfried, physician and author of the new book, “Women Food and Hormones,” is on a mission to denormalize hormone imbalances and the symptoms that accompany them.

Women who are between the ages of 35 and 60 have been suffering unnecessarily from hormone imbalances for way too long, according to Dr. Gottfried. Unfortunately, many physicians have not been properly trained how to address these issues at their root cause and have instead been taught to over-prescribe birth control or hormone replacement therapy as the solution, she says.

The full title of Dr. Gottfried’s book, “Women, Food and Hormones: A 4-Week Plan to Achieve Hormonal Balance, Lose Weight and Feel Like Yourself Again,” tells you a little more about her approach. In it, she outlines a step-by-step plan to help women rebalance their hormones and gain control over their energy, moods, weight, and health at large.

Root Causes of Hormonal Imbalances

In a recent podcast with Dr. Mark Hyman, the two physicians discuss the following root causes of these imbalances.

Toxic stress: They highlight how toxic stress causes high or low cortisol and can throw your thyroid into hypo- or hyperactivity (meaning it’s either underactive or overactive).

Reproductive years: The period from postpartum through perimenopause can cause estrogen and progesterone to fall out of the normal range.

Insulin resistance due to a high-sugar and starchy diet can cause that unwanted weight gain in the abdominal area that so many women fight to lose.

Endocrine disruptors: Environmental toxins in plastics, herbicides and pesticides act as endocrine disruptors. The hormones in dairy have also been linked to being a problem.

All of these factors have a negative impact on our hormone’s ability to function properly.

So what is the solution?

Solving Hormonal Imbalances in Women

Dr. Gottfried recommends a ketogenic diet, but tailored for women’s hormones by including carbohydrates from nutrient-dense foods, such as cruciferous veggies. Many women also lack adequate fat in their diet, and fat is the backbone of the sex hormones.

She proposes specifically that for 4 weeks, women subscribe to a diet that consists of 60-70% fat, less than 25 grams of net carbohydrates, and 20% protein.

There should be no feelings of hunger or deprivation on this diet as fat delays gastric emptying, enhancing feelings of satisfaction. While 25 grams of net carbs per day is definitely low, getting these carbs specifically from high-fiber, cruciferous veggies will keep you full while meeting your nutrient needs..

RELATED: How Many Carbs Are Really in Vegetables?

Ketosis and Hormones

This diet will allow your body to enter ketosis, using fat for energy rather than glucose. Besides helping hormones to thrive, nutritional ketosis has benefits of increased energy, brain clarity, better sleep, weight loss and reduced inflammation.

Dr. Gottfried recognizes that this diet is not for everyone and may not be something that women can stick to forever. However, trying it for four weeks allows for metabolic flexibility-enabling your body to switch between using fat and glucose for energy based on what you are eating and the fuel provided.

Strength Training As We Age

Along with diet, strength training is highly encouraged to maintain and grow muscle mass as women age. Dr. Gottfried recommends two thirds of weekly exercise include strength training and one third cardio.

Muscle mass is used as one of the most important markers for overall health and should not be overlooked.

Bottom Line

The unfortunate fact is that women are more vulnerable to hormone imbalances, and society has normalized the uncomfortable and sometimes debilitating symptoms that hormone imbalances cause. With Dr. Gottfried’s prescribed diet and lifestyle alterations, women no longer have to succumb to a passive approach to aging and can take control to live a stronger, healthier, more empowered life.

(Image: Shutterstock)

About Molly Knauer, MS, RD
Molly Knauer is a registered dietitian with her master's degree in clinical nutrition from NYU. Molly works one on one with clients counseling on weight loss, weight maintenance, managing GI diseases, and overall healthy eating. She also works as a nutrition consultant for several brands in the food, wellness and beauty space. You can follow her at @mollysbest and

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