How Women Should Really Use Keto with Thomas Hemingway, M.D.
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In this insightful episode of the Healthful Pursuit Podcast, host Leanne Vogel sits down with Dr. Thomas Hemingway to discuss the evolving role of the ketogenic diet for women, emphasizing metabolic flexibility over rigid adherence. Vogel shares her personal journey of losing her menstrual cycle for eight years and how adopting a ketogenic lifestyle helped restore hormonal balance. She reflects on her extensive experience with keto—from writing three bestselling books to touring globally—before transitioning to a more flexible, cyclical approach that aligns with hormonal rhythms. The conversation explores the science behind ketones as a cleaner, more sustainable fuel source compared to glucose, the importance of electrolyte balance during keto adaptation, and the dangers of over-relying on strict protocols. Key themes include carb cycling tied to the menstrual cycle, strategic fasting windows, and the critical role of adrenal health during perimenopause. Vogel stresses that the goal isn't perfection or high ketone numbers, but rather long-term functionality, energy, and resilience. She advocates for listening to the body, avoiding the 'evil triad' of processed grains, sugars, and seed oils, and embracing real food over dogma. Ultimately, the episode champions adaptability, self-awareness, and holistic wellness over rigid dietary rules.
Metabolic flexibility—switching between burning fat and carbs—is more important than strict ketosis for long-term health.
Women should time carb intake around their cycle: lower carbs early in the cycle, increase them around ovulation and the luteal phase.
Fasting should be aligned with hormonal phases—avoid prolonged fasts during ovulation and premenstrual phases when hunger is natural.
Adrenal health and liver support are critical during perimenopause, and women should consider testing (like Dutch tests) before age 40.
Ketone levels are not a reliable indicator of success; focus on how you feel and your ability to function, not numbers.
…and 2 more takeaways available in PodZeus
Introduction: A Shift in Perspective on Keto
“I've talked it to death. I have nothing else to add to the conversation on keto. I covered it from 2014 to 2021.”
Personal Journey: From Amenorrhea to Hormonal Restoration
“After 30 days, I decided I'd never go back to the way I was eating. And fast forward a year and a half, I got my cycle back.”
The Science of Metabolic Flexibility
“You could burn on a really, really dirty fuel. Or you could burn on something super clean and great, not only for your body, but the environment.”
Navigating the Keto Transition: Tips for Success
Vogel shares practical advice for starting keto, including gradual carb reduction, electrolyte supplementation (especially with pink or gray salt), hydration, and using exogenous ketones. She warns against going too hard too fast and stresses the importance of patience and self-compassion during adaptation.
Carb Cycling and Hormonal Alignment
“If you start in the morning, you're going to want to have more and more carbs throughout the day. But if you eat them at night, you're sleeping through your fast.”
“If my ketones are not too, can I still run around with my grandkids? You know, like reframe our mindset.”
“After 30 days, I decided I'd never go back to the way I was eating. And fast forward a year and a half, I got my cycle back.”
“If you start in the morning, you're going to want to have more and more carbs throughout the day. But if you eat them at night, you're sleeping through your fast.”
Host
Guest
keto diet
other
metabolic flexibility
other
menstrual cycle
other
Leanne Vogel
person
Dr. Thomas Hemingway
person
parasites
other
mold illness
other
Dutch test
other
LMNT
product
Borrelia
other
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