Therapeutic
As a researcher, I can recommend participating in a clinical trial as one excellent way to try ketogenic therapy - you'll get lots of support from a psychiatrist and dietitian, and you'll have the opportunity to contribute to scientific understanding of the condition. Therapeutic ketosis is very different to the popular versions of the ketogenic diet you can find online, and this is best done with the proper support. There are now many clinical trials taking place worldwide, you can find these listed on the Metabolic Mind website. We will begin recruitment for an RCT in the UK in 2026, please do get in touch if you would like to learn more about the trial.
Integration
A few things I have found helpful in maintaining ketosis:C8 MCT oil (occasionally as needed), ketone salts, intermittent fasting (one meal a day). 10k steps per day has also been very helpful in controlling my blood glucose.
Nutritional
- I tend to eat more animal-based fats on a ketogenic diet, which I find work best for me personally in terms of satiety and maintaining ketosis. But there are many variations like vegetarian and vegan versions of the ketogenic diet, which also achieve ketosis.
- I generally feel best when I fast until dinner and eat one meal for dinner. This allows me to get into higher levels of ketosis. I listen to how my body feels each day and will add in breakfast and/or lunch as needed.
Ketosis
- Ketosis is not the result of a "fad diet” as you will sometimes hear online, it's an ancient biological state which has been around for millions of years across diverse forms of life. It's been an essential state of human physiology for survival, allowing humans to tap into fat resources when carbohydrates are scarce. Humans can store around 25000 calories from carbohydrate as glycogen and well in excess of 100,000 as fat. So ketosis is really an essential mode of human metabolism.
- What's fascinating about ketosis as someone living with bipolar, is the effects it has on the brain: reducing hyperexcitability, reducing glutamate levels (an excitatory neurotransmitter and neurometabolite), fighting inflammation and ameliorating seizures in epilepsy. Several important medications for bipolar were originally developed for epilepsy, and we are just beginning to learn about the broad range of effects ketosis has on the brain in bipolar disorder. Our pilot study showed significantly reduced glutamate levels in bipolar patients after a 6-8 week ketogenic diet.
