THINK
Nutritional FoundationTherapeutic
How I build clinical & emotional support & manage medications
My psychiatrist knows little about ketogenic therapy, but he is willing to learn. We are learning together. I’m still mostly left to myself to understand my specific reactions to the lifestyle. We made no changes to my medication when I started. After a few months, I noticed I was hardly reaching for my prn clonazepam anymore. After 4 months, I started noticing what I felt were side effects of my lamotrigine (mainly tinnitus). With my psychiatrist, we lowered my dose from 400mg to 300mg over a 3-month period. My plasma levels were unchanged. Recently, we have started lowering my sleep medication, zolpidem, from 10 mg to 5 mg over 2 months because I do still experience some morning fatigue. The morning fatigue is still an issue, and hopefully I can find some answers here.
Integration
Lab results I track & supplements I take
Understanding electrolytes saved my life! I learned to track symptoms of low magnesium and low potassium. Since I do not have a gallbladder, I also use digestive enzymes like lipase and ox bile. Yes, before I started and at the 6-month mark.
Nutritional
How I eat, incorporate fasting, & approach macronutrients
Strict keto, striving for a 2:1 ratio. I do <10g carbs, ~65g protein and ~145g lipids. I’m mostly on a 16:8 schedule but I am not strict about it. I adjust to social settings by reaching for foods I can eat without getting into details. I rarely fall out of ketosis but when I do it can be challenging, fasting helps.
Ketosis
Target ketone levels & testing methods
Yes Initially I used urine ketone strips then moved to a blood ketone monitor. The ketone monitor is an essential learning tool to correlate diet, ketosis, and mood. My stability range is between 1.0 and 2.0 mmol. Above that, I get hypomanic symptoms.
