Is keto good for women in perimenopause?

Nikkiey gives keto real credit. Cutting carbs reduces insulin spikes, and she calls that short-term improvement in insulin sensitivity real and valuable. The problem is what happens over months. She explains that when glucose stays low, your body produces cortisol to turn protein and fat into fuel for your brain. For a woman in perimenopause or menopause, whose cortisol she says is already running hotter because estrogen isn't buffering it, that is stacking stress on stress. In her view, the stubborn midsection fat many women notice after months of keto is cortisol doing its job. She also says your thyroid needs some carbohydrate to convert T4 into active T3, so chronic keto can slow your metabolism. If thyroid or hormone questions apply to you, those are worth raising with your doctor.

The other issue is protein. Nikkiey points out that the standard keto template most women follow is not protein forward, which makes it harder to hold on to muscle after 40. She describes a WarriorBabe client, Chris, who combined keto with five or six days of hard training and got puffier, more inflamed and more exhausted, doing more work for fewer results. That is not a willpower failure. It is a plan working against her physiology. Add a high dropout rate, and Nikkiey's total score for keto is 14 out of 30.

What she recommends instead is a slightly higher fat intake, because fats directly support hormones, while keeping enough carbs and plenty of protein to build muscle. On Ep. 67 she shares a split of 35% protein, 27% carbs and 38% fat. Another video uses 32/30/38. The numbers differ slightly, but both are clearly not keto, which she says would be closer to 10% carbs. In one client example, Nikkiey kept calories the same, shifted the fat and carb ratios, and the client lost abdominal fat and gained muscle definition.