Will these medications for PCOD inhibit weight loss on a keto diet?


Will these medications for PCOD inhibit weight loss on a keto diet? How can you build muscle on a low-carb diet? And is Bulletproof tea OK?

Get the answer to these questions in this week’s Q&A with the fertility specialist Dr. Fox:

Medications for PCOD along with keto – will they inhibit weight loss?


I have been on the keto diet for the last three weeks and for the first time in my life I have lost 5 kg (11 lbs) so rapidly. My gyno has prescribed Mirena coil and Finasteride for irregular periods, facial hair and acne due to PCOD. I am nervous to start on either as I am scared it might hinder weigh loss. Will either of them hinder my weight loss on keto?


Dr. Fox:

This answer is not supported anywhere in the medical literature, so here is my opinion: Finasteride is fine but I personally worry about Mirena IUD’s. If you have read some of my answers, low estrogen can be bad for insulin resistance (IR) and progesterone (in the IUD) is also bad for IR. The progesterone lowers estrogen and thus worsens IR and can slow changes in metabolic improvement.

You are justified in your concern in my opinion. The average practitioner will not understand this rationale since Mirena has been lumped into the acceptable contraceptive bucket and is routinely prescribed without any thought about what we are speaking of. Unfortunately this is true of most of the contraceptive agents out there including birth control that has some estrogen but not enough for many people skewing them in a progesterone direction and causing further metabolic dysfunction.

If your practitioner supplemented with estrogen to normalize, then you would be OK but finding someone that would buy into this will be difficult. Using a non-hormonal IUD is fine but it is probably better to use an oral contraceptive or nuva ring and possibly add estrogen to that regimen.

Best of luck.

Building muscle

How can I build muscle on a ketogenic diet?


Dr. Fox:

Being a thin less-muscularized person myself, I subscribe to the idea that maximal muscle strength can be achieved at some level but limited by genetics. The only way to look like Schwarzenager is to take anabolic steroids (growth promoting).

With muscle strengthening, you might increase your protein intake slightly from 1.2-1.7 g/kg ideal body weight to 1.5-2 g/kg. The Slow Burn Fitness Revolution by Fred Hahn is the appropriate way to maximal muscle strength. Other protocols can be dangerous to your joints and don’t really result in maximal muscle fitness. Hope this helps.

Ketogenic diet is perfectly appropriate for this approach. Look also at the pictures of the natives in Westin Price’s 1936 book, Nutrition and Physical Degeneration.

Bulletproof tea?


Because I’m pregnant, I stopped drinking coffee and I was wondering if I could drink herbal tea instead with coconut oil and butter?

Thank you!

Dr. Fox:

If you read any of my information, you know I’m against caffeine. If it is caffeine free… have at it!!

More questions and answers

Questions and answers about low carb

Videos with Dr. Fox



How to reverse PCOS with low carb


  1. Sharon
    Hello. I can not eat Butter. Can I replace the Butter with olive oil.
  2. Jihad
    Does the oat bread stop weight loss?
  3. Sony
    Good day. I am 49 years on the lchf for almost 6 years now. Since 2014 until around Sep last year I lost about 13.8 kg and dropped from 78.9 to my goal weight of 65
    kg - sometimes even less. I always suffered iron deficiency as a result of heavy menses and in Aug last year my iron levels dropped to 6. My gynae suggested the mirena. Mirena was inserted in Aug 2019 and that is when I started having trouble with weight gain. Still following the bsntjng lifestyle, but picking up weight instead of losing. I also suffered a shoulder injury on Nov last year and am on and off on anti-inflammatories for a frozen shoulder for about 2 months now. So I'm currently weighing 69 sometimes 70 kg, cannot really exercise due to my injury. I am so confused in terms of my weight gain. I am still trying very hard to stick to my lchf lifestyle and find myself eating even less. Could the weight gain be a combination of mirena hormonal changes, water weight caused by the anti-inflammatories and menopause approaching? Please advise. I came too far to pick all of this unwanted weight!

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