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What mental illnesses can be helped by metabolic therapies?
Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.
Metabolic Mind grew out of the first ever metabolic psychiatry conference hosted by Baszucki Group in May of 2022. Fifty stakeholders gathered to share information and define this rapidly emerging new field. It became clear in the months following the conference that an advocacy effort was critically needed to amplify research, clinical experience and life stories. The Metabolic Mind team is dedicated to filling that gap, and is working toward a vision in which metabolism is understood as a primary driver of human health and well-being.
What is Baszucki Group?
Launched in 2021 by Roblox founder and Chief Executive Officer David Baszucki and best-selling author Jan Ellison Baszucki, Baszucki Group leverages private giving, impact investing, advocacy, storytelling and community building to drive foundational change.
A primary objective of Baszucki Group is to transform mental health outcomes, beginning with bipolar disorder, by supporting initiatives at the intersection of metabolism, psychiatry and neuroscience. Other focus areas include electoral reforms that integrate open primaries and ranked choice voting, and regenerative agricultural practices that restart the cycles of nature to promote healthy soil, nutritious food, and a balanced climate.
What is the connection between metabolic health and mental health?
Many people are surprised to learn that numerous studies indicate that those with poor metabolic health, including impairments like insulin resistance, metabolic syndrome, pre-diabetes, or type 2 diabetes, have a significantly increased risk of serious mental illness such as bipolar disorder, major depression, or schizophrenia.
The correlation holds in the opposite direction as well; those with serious mental illness have a higher likelihood of having metabolic dysfunction. Clinical experience and emerging evidence suggest that improving metabolism through ketogenic diets–as well as smart approaches to nutrient deficiencies, sleep, exercise, and stress reduction–can create mental health. This is the connection we explore at Metabolic Mind.
What are metabolic therapies for mental health?
Metabolic therapies for mental health are interventions or treatments that improve systemic metabolic and mitochondrial function to prevent, reduce, or eliminate symptoms of psychiatric illness. Typical therapies include nutritional ketosis, sleep management, movement/exercise, substance use management, meditation, and mindfulness. In addition, medications that improve insulin resistance are sometimes used to address psychiatric symptoms.
What mental illnesses can be helped by metabolic therapies?
At Metabolic Mind, we are primarily focused on the most serious mental illnesses like major depressive disorder, bipolar disorder, schizophrenia, schizoaffective disorder, and anorexia nervosa. But in his book Brain Energy, Dr. Chris Palmer posits that if mental illness results from metabolic and mitochondrial dysfunction of the brain, then any disorder caused by disordered energy metabolism could benefit from these therapies. According to Dr. Palmer, the scientific literature has identified mitochondrial dysfunction in the following psychiatric conditions:
What is ketogenic therapy for mental illness?
Ketogenic therapy for mental illness is a sustained dietary strategy that improves metabolic function by inducing therapeutic nutritional ketosis to prevent, reduce, or eliminate symptoms of psychiatric illness.
There can be many different components of ketogenic therapy, but it often includes selecting a low-carb dietary strategy (what and what not to eat), establishing a target macronutrient ratio (typically 60% calories or more from fat), measuring ketones daily, and restricting timing of eating (when and when not to eat). Ketogenic therapy can also include tracking metabolic and mental health measures (see our sample lab order here), and supplementing with electrolytes, MCT oil, exogenous ketones, carnitine, Vitamin D, B12, and other nutrients.
What are ketogenic therapies for mental health?
Ketogenic therapy for mental illness is a sustained dietary strategy that improves metabolic function by inducing therapeutic nutritional ketosis to prevent, reduce, or eliminate symptoms of psychiatric illness.
There can be many different components of ketogenic therapy, but it often includes selecting a low-carb dietary strategy (what and what not to eat), establishing a target macronutrient ratio (typically 60% calories or more from fat), measuring ketones daily, and restricting timing of eating (when and when not to eat). Ketogenic therapy can also include tracking metabolic and mental health measures (see our sample lab order here), and supplementing with electrolytes, MCT oil, exogenous ketones, carnitine, Vitamin D, B12, and other nutrients.
What is a ketogenic diet?
Any dietary strategy that lowers glucose and insulin to levels at which the body produces ketones and switches to burning fat for energy.
A ketogenic diet typically lowers carbohydrates enough so your body switches from burning glucose (sugar) for energy to burning fat, either stored body fat or dietary fat. As a result, your liver creates ketones, which your brain and body can use for energy.
Eating between 20 – 50 grams of carbohydrates per day will result in ketosis for most people. Physically active and metabolically healthy individuals may be in ketosis at higher carb levels up to 75 or 100 grams per day.
A ketogenic diet supplies adequate protein, usually between 15-30% of calories, and the rest of the calories come from fat.
You can achieve ketosis with multiple types of diets, including vegan, vegetarian, Mediterranean, omnivore, and carnivore.
Is a ketogenic diet safe for long-term use?
While we do not have longitudinal randomized controlled trials demonstrating that staying on a ketogenic diet for the long term is better or worse than other dietary strategies, we do have 100 years of evidence of safety and efficacy in the field of neurology. And as Gary Taubes demonstrates in his new book, Rethinking Diabetes, ketogenic diets were understood to be the most effective treatment for diabetes before the advent of insulin. Although ketogenic diets have long been criticized for increasing cardiovascular risk, there is emerging evidence in the scientific literature that the opposite may be true. Check out Dr. Bret Scher’s Metabolic Mind playlist for videos on various aspects of the safety of nutritional ketosis: Is Keto Safe? Plus Keto News and Views – YouTube
What is therapeutic nutritional ketosis?New Question
Ketosis is a physiologic state where your body burns fat for energy rather than glucose (sugar). This can mean burning either stored body fat or the fat you eat.
Some clinicians define ketosis as at or above 0.5mmol, but emerging evidence suggests that brain benefits can be achieved even at very low levels of ketosis for some people. Others may see the most improvement at higher levels of ketosis, for example above 2.0mmol.
You can achieve a state of ketosis by eating a diet very low in carbohydrates or fasting.
Ketosis is a safe and natural state that has likely been present throughout evolution. When our ancestors didn’t have enough food or couldn’t find any fruits or vegetables, they maintained their energy and focus through ketosis.
What is a low-carb/ketogenic lifestyle?
What low-carb and ketogenic diets can I choose from?
Many different dietary strategies can lead to improvements in mental health. Strategies we commonly hear about from our community include:
How does ketosis impact the brain?
Being in a state of ketosis can improve metabolic health and allow the brain to use ketones for energy, both of which directly contribute to improved brain function.
The beneficial impact of ketosis has been known in epilepsy for over a century, with decades of supporting research and clinical experience.
Emerging research and clinical experience in both dementia and mental illness demonstrate improvement in symptoms and reduced need for medications.
What is metabolic health?
Clinically speaking, metabolic health is defined by optimal levels of five markers: blood glucose levels, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and waist circumference—without using medication. These markers can help measure levels of insulin sensitivity indirectly. In addition, fasting insulin levels can be measured directly. This is important, since abnormally high insulin levels can precede high blood glucose by decades in some people. So measuring your blood glucose may not be enough to tell you whether you have insulin resistance.
What is insulin resistance?
Insulin resistance, or “pre-diabetes,” is when the cells in your body become resistant to the master signaling hormone insulin, wrecking metabolic havoc in your body. Here’s a great post from Levels describing what insulin does and calling for it to be tested more often:
https://www.levelshealth.com/blog/what-are-normal-insulin-levels-and-why-dont-we-test-it-more
Learn more in these videos from Dr. Bret Scher and Dr. Georgia Ede about testing for insulin resistance and how it impacts mental health:
Ketogenic Diets for Mental Health | Dr. Georgia Ede | Metabolic Link Private Feed Episode
What is metabolic syndrome?
Metabolic syndrome is defined as a constellation of features of deranged metabolism, including high blood pressure, high blood glucose, excess body fat around the waist, and abnormal HDL cholesterol levels. Together, these conditions increase your risk of heart disease, stroke, type 2 diabetes, and other health problems.
What is the definition of serious mental illness?
Psychiatry generally defines “serious mental illness,” or SMI, as schizophrenia spectrum disorders, bipolar disorders, major depressive disorder, and anorexia nervosa.
Can I use metabolic therapies for “milder” conditions like anxiety, ADHD and brain fog?
We don’t have robust evidence demonstrating the effectiveness of ketogenic therapy for anxiety, ADHD and brain fog, but clinical experience suggests that in fact these conditions might benefit significantly from ketogenic and metabolic therapies. Early results from clinical trials for other diagnoses show that improved attention, clarity of thought, and decreased anxiety are common beneficial outcomes.
What are the best books to read on metabolic approaches to mental health?
Brain Energy by Dr. Chris Palmer and Change Your Diet, Change Your Mind by Dr. Georgia Ede are the two books we recommend most for anyone interested in metabolic approaches to treating mental disorders. Drs. Palmer and Ede are pioneers of the metabolic psychiatry movement, and have both been treating patients with ketogenic and metabolic strategies for decades. You can find other favorites on our Go Deeper page.