August 1, 2025 • 18 mins
Could depression be more than a chemical imbalance? In this episode of The Health Pulse, we explore a powerful new lens: depression as an energy crisis in the brain. This emerging field of metabolic psychiatry examines how the brain’s fuel systems—especially in individuals with insulin resistance or mitochondrial dysfunction—can directly influence mood, cognition, and resilience.
We break down how the ketogenic diet, long known for weight loss and epilepsy management, may offer mental health benefits by supplying the brain with ketones—a cleaner, more efficient fuel than glucose. You’ll learn how ketones reduce neuroinflammation, support mitochondrial repair, and help rebalance key neurotransmitters like GABA and glutamate.
From a groundbreaking 2022 study showing improved depression symptoms in just eight weeks to striking case reports of treatment-resistant depression in remission, this episode brings the latest science to light. We also share practical guidance for exploring a therapeutic ketogenic approach, including baseline testing, nutrient-dense planning, and gradual transitions.
If you've struggled with mood symptoms, brain fog, or fatigue—and feel like something deeper is being missed—this conversation might change how you view mental health.
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Disclaimer: The information provided in this podcast is for informational purposes only and should not be considered medical advice. The content discussed is based on research, expert insights, and reputable sources, but it does not replace professional medical consultation, diagnosis, or treatment. We strive to present accurate and up-to-date information, medical research is constantly evolving. Listeners should always verify details with trusted health organizations, before making any health-related decisions. If you are experiencing a medical emergency, such as severe pain, difficulty breathing, or other urgent symptoms, call your local emergency services immediately. By listening to this podcast, you acknowledge that The Health Pulse and its creators are not responsible for any actions taken based on the content of this episode. Your health and well-being should always be guided by the advice of qualified medical professionals.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Nicolette (00:01):
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Rachel (00:26):
So we've all heard the phrase, haven't we?
It's a chemical imbalance.
Oh, yeah, absolutely Fordecades that's been the go-to
explanation for depression andit led straight to treatments
like SSRIs other antidepressants.
Mark (00:40):
Right, the standard approach.
But the thing is, what if thatexplanation, what if it's
actually well incomplete?
Rachel (00:47):
Exactly what if depression isn't just about
brain chemistry, but maybe aboutthe actual energy your brain
uses to function?
Mark (00:53):
That's the really big question isn't it.
And it's driving this whole newfield called metabolic
psychiatry.
It's fascinating.
Rachel (01:00):
Metabolic psychiatry.
So the idea is, mood disordersmight not just be
neurotransmitter levels.
Mark (01:06):
But could fundamentally stem from how your brain
generates and uses its energy.
Think about it.
Things like inflammation, bloodsugar problems, even insulin
resistance in the brain.
Rachel (01:16):
In the brain itself.
Mark (01:17):
Yeah, they're all emerging , as you know, major players in
mental health, and dietobviously hugely influences all
of that.
Rachel (01:24):
Which brings us to something maybe unexpected here
the ketogenic diet.
Mark (01:28):
Right Suddenly.
Keto isn't just about weightloss.
It's a potential tool formental wellness.
Rachel (01:33):
So today, that's our deep dive.
We're going to unpack exactlyhow the keto diet might affect
mood, what the science isstarting to show.
Mark (01:42):
And how this whole functional metabolic approach to
mental health is really gainingtraction.
Rachel (01:47):
Our mission really is to give you a shortcut to
understanding this, well, prettysurprising connection.
Mark (01:53):
Let's start with that traditional view.
The neurochemical imbalance,serotonin, dopamine the usual
suspects.
Rachel (01:59):
Yeah, and that theory definitely led to the rise of
SSRIs and similar drugs.
And look for some people.
They are genuinely lifesaving.
Mark (02:07):
Absolutely.
We have to acknowledge that.
But as we've seen more and morefor a lot of people they're
only partly effective, or maybethe benefits fade over time.
Rachel (02:16):
Which is exactly why researchers started looking
deeper right for otherunderlying causes.
Mark (02:20):
Precisely.
And you have to consider thebrain itself.
It's tiny, like 2% of your bodyweight.
Rachel (02:25):
Yeah, something like that.
Mark (02:27):
But it guzzles over 20% of your body's energy.
It's this incrediblypower-hungry organ running
constantly.
Rachel (02:32):
Like a supercomputer.
Mark (02:34):
Exactly and what studies are starting to show in people
with depression, is this thisreduction in how well they use
glucose, their main fuel,especially in key areas like the
prefrontal cortex?
Rachel (02:44):
Apart from mood focus decisions.
Mark (02:46):
That's the one.
So if the brain isn't using itsprimary fuel efficiently, it's
not just a chemistry issue.
Rachel (02:53):
It's an energy issue.
Mark (02:54):
Wow.
Rachel (02:55):
That really flips the script.
Mark (02:56):
It does and it leads to this newer model.
Maybe depression is, at leastin part, a metabolic disorder of
the brain.
Rachel (03:04):
Okay, and what specific kinds of metabolic problems are
we talking about here?
Mark (03:12):
Well, several things often show up together Mitochondrial
dysfunction.
Basically, your cells aren'tmaking energy properly.
Rachel (03:16):
So the powerhouses are struggling, right.
Mark (03:18):
Then there's neuroinflammation, inflammation
in the brain, messing up signals, insulin resistance, where the
brain itself can't use glucoseeffectively.
Rachel (03:25):
Even if there's plenty of glucose around.
Mark (03:27):
Even then.
Rachel (03:27):
Yeah, and finally oxidative stress, which is like
cellular damage from metabolicbyproducts and insulin
resistance.
We actually think of that withdiabetes or weight right?
Mark (03:39):
Yeah.
Rachel (03:39):
But it affects the brain too.
Mark (03:40):
Directly, yeah, higher fasting insulin, poor blood
sugar control too Directly, yeah, higher fasting insulin, poor
blood sugar control.
They're linked pretty stronglyto increased risk for both
depression and cognitive decline.
Rachel (03:50):
Okay, so that really begs the question if the brain's
fuel system is struggling withglucose what if you change the
fuel?
Mark (03:58):
What if you give it something else entirely?
Rachel (04:00):
And that's what keto comes in.
Mark (04:01):
That's exactly where it fits.
So understanding depression,maybe, as a metabolic issue, not
just chemical, that's a hugeshift in perspective for you,
the listener, to consider.
Rachel (04:11):
Okay.
So if the brain is potentiallyfacing this energy crisis, how
does the ketogenic diet actuallywork?
What's happening at thecellular level?
Mark (04:19):
Right.
So the basics.
Yeah, Keto is very high fat,moderate protein and extremely
low carb.
We're talking typically under,say, 20 to 50 grams of carbs a
day.
Rachel (04:28):
That's very low.
Mark (04:29):
It is, and when you restrict carbs that drastically,
your body shifts gears.
Yeah, that's just a statecalled ketosis.
Ketosis and that means it meansyour liver starts breaking down
fat into molecules calledketone bodies, the main one is
beta-hydroxybutyrate or BHB, BHBokay.
And these ketones then becomethe primary fuel source for your
(04:50):
body and, importantly, for yourbrain, instead of glucose.
Rachel (04:54):
Got it Now.
I've heard ketones described asa cleaner fuel for the brain.
What does that mean inpractical terms?
Mark (05:01):
It's a good description.
Think of it like this, Comparedto glucose when your brain
cells burn ketones for energy,they actually produce more ATP.
Rachel (05:11):
ATP being the cell's energy currency.
Mark (05:13):
Exactly More bang for your buck, metabolically speaking
and, crucially, they generatefewer free radicals in the
process.
Rachel (05:20):
Free radicals cause oxidative stress.
Right that damage we talkedabout.
Mark (05:23):
Precisely so.
Less oxidative stress Forsomeone dealing with depression
who might already havemitochondrial issues or
inflammation.
Rachel (05:30):
Getting a more efficient , less dirty fuel could
potentially help restorefunction.
Mark (05:35):
That's the theory.
It's like cleaning up theengine, maybe letting it run
more smoothly.
That makes sense.
Rachel (05:40):
OK, so that's the fuel source.
What about the brain'scommunication system, the
neurotransmitters?
How does keto affect those?
Mark (05:47):
This part is also really interesting.
Keto seems to have thisbalancing effect.
Studies suggest it can increaseGABA.
Rachel (05:54):
The calming neurotransmitter.
Mark (05:56):
Right and at the same time it can reduce glutamate.
Rachel (05:58):
Which is excitatory, and too much can be harmful.
Mark (06:01):
Exactly, it can be neurotoxic in excess.
So you're boosting the calm,dialing down the excessive
excitation.
It helps stabilize things.
Rachel (06:09):
Like retuning the brain's signals.
Mark (06:11):
Kind of yeah, and this GABA glutamate balance is
actually a key reason.
Keto has been used for epilepsyfor well a century now, since
the 1920s.
Rachel (06:21):
Wow, okay, so it's not just changing fuel, it's
potentially rebalancing thesignaling too.
That seems significant.
Are there wider benefits, maybesystemically?
Mark (06:29):
Definitely.
Keto has pretty powerfulanti-inflammatory effects beyond
the brain.
It can lower inflammatorymarkers like IL-6 and TNF-alpha,
which are often elevated indepression Right.
Plus, it does wonders forstabilizing blood sugar and
insulin levels.
No more sharp spikes andcrashes.
Rachel (06:45):
Which can definitely impact mood and insulin levels.
No more sharp spikes andcrashes, which can definitely
impact mood and energy levels.
Mark (06:49):
Hugely so.
If you put it all together,keto changes the brain's fuel,
potentially leading to morestable mood, better energy,
clearer thinking, all bytackling some of these
underlying metabolic issues.
Rachel (07:06):
This sounds incredibly promising, but are people
actually feeling better?
Is there a real link betweentrying keto and getting relief
from depression symptoms?
Mark (07:10):
Well, anecdotally, we're hearing more and more compelling
stories, people reportingsignificant improvements in mood
, energy, just overallwell-being.
Rachel (07:18):
OK, anecdotes are one thing, but what about studies?
I know you said, large trialsare still ongoing.
Mark (07:24):
Right, the big definitive trials are still needed, but the
early evidence is encouraging.
For example, there was a pilotstudy in 2022 published in
Frontiers in Psychiatry.
Ok, they took people with majordepressive disorder MDD.
Put them on keto for eightweeks and they saw significant
drops in depression scores, plusbetter sleep, better energy
regulation.
Rachel (07:43):
Eight weeks isn't long, but that's still a noticeable
impact.
Mark (07:46):
It really is, yeah, and other reviews, like one in
neuroscience and biobehavioralreviews, concluded that ketones
themselves might directly tweakinflammation and
neurotransmission in ways thatreduce depressive symptoms.
Rachel (07:59):
Interesting Any other specific examples.
Mark (08:03):
There was a really striking case study in BMJ
Nutrition.
It documented a patient withtreatment-resistant depression,
someone who hadn't respondedwell to other treatments.
Right After six months on keto,with no changes to their meds,
they achieved full remission.
Rachel (08:18):
Full remission Wow, that's powerful, even if it's
just one case.
Mark (08:22):
It is these early findings really do suggest there's a
strong biological rationale herethat needs more investigation.
Rachel (08:30):
Okay, so drilling down into the how what are the main
mechanisms researchers think aredriving these mood improvements
on keto?
Mark (08:37):
There seem to be a few key things working together.
First, reducing thatneuroinflammation we talked
about.
Ketones, especially BHB, candirectly inhibit something
called the NLRP3 inflammasome.
Rachel (08:47):
Which is like a master switch for inflammation in the
brain.
Mark (08:50):
Pretty much, yeah.
So turning down thatinflammatory alarm.
Second, supporting themitochondria, the cell's power
houses.
Better energy production couldcombat that fatigue and brain
fog that's so common indepression.
Rachel (09:03):
Makes sense, what else?
Mark (09:04):
And third, balancing cortisol and blood sugar.
By keeping blood sugar stable,keto helps calm down the HPA
axis, your main stress responsesystem Less cortisol, fewer
stress-driven mood swings andanxiety.
Rachel (09:17):
So it's hitting inflammation, energy production
and stress response.
That's quite comprehensive.
Mark (09:23):
It really seems to be working on multiple levels.
Rachel (09:25):
Given these mechanisms, then who seems to get the most
benefit from trying this?
Is it likely to work foreveryone with depression?
Mark (09:32):
That's a really important question.
It doesn't seem to be auniversal fix.
No, yeah, the biggestimprovements tend to be seen in
people who have clear signs ofunderlying metabolic problems,
such as, well, individuals withdiagnosed insulin resistance or
prediabetes, for sure Alsopeople with that
treatment-resistant depressionlabel we mentioned.
Rachel (09:51):
The ones where standard treatments haven't worked well,
exactly.
Mark (09:55):
Also folks struggling with chronic fatigue, anxiety or
significant brain fog alongsidetheir depression, and
particularly those whose moodseems really tied to blood sugar
swings, you know, gettingirritable or low when they
haven't eaten.
Rachel (10:09):
Hangry, but on a deeper level.
Mark (10:10):
Kind of yeah.
What's fascinating is thatoften the degree of benefit
seems to correlate with how muchmetabolic dysfunction someone
had to begin with.
Rachel (10:19):
So the more metabolically off someone is,
the more potential keto mighthave to help.
Mark (10:24):
It appears that way, it suggests that targeting the
brain's metabolism could be areally crucial, maybe overlooked
factor for a significant subsetof people.
Rachel (10:34):
This is all genuinely exciting, but let's ground
ourselves in the research again.
How solid is the scienceoverall right now?
Can we say this is a clinicallyproven cure?
Mark (10:43):
Yeah, it's super important to be clear here.
No, it is not currently aclinically proven cure for
depression across the board,while interest is booming, most
of what we have right now arethose smaller pilot studies,
animal studies which don'talways translate and those
compelling case reports.
We also borrow insights fromresearch on epilepsy, bipolar
disorder, alzheimer's conditions, where keto has a bit more
(11:05):
history.
Rachel (11:06):
So definitely promising, but still waiting for the big
definitive studies.
Mark (11:11):
Absolutely.
Reviews consistently point thisout.
For instance, one in currentopinion in psychiatry said keto
shows promise, especially ifmetabolic syndrome is present.
But we urgently need largerrandomized controlled trials,
rcts.
Rachel (11:25):
RCTs being the gold standard.
Mark (11:26):
Exactly.
Another study in the Journal ofEffective Disorders reports
echoed this.
The biological mechanisms, themitochondrial support, the
neurochemical shifts.
They're highly plausible but welack the large-scale long-term
human studies to really confirmeffectiveness widely.
Rachel (11:42):
Okay, but you mentioned those case studies earlier and
they do sound incrediblycompelling, especially for
individuals.
Mark (11:47):
They really do.
You read these reports ofpeople with longstanding
depression finally findingrelief or achieving much better
mood stability and bipolardisorder.
People report better focus,feeling more emotionally
regulated.
Rachel (11:59):
And sometimes even reducing medication needs.
Mark (12:02):
In some reported cases, yes, and what often stands out
is that these are people forwhom conventional treatments
just hadn't provided thatlasting breakthrough.
So seeing them respondprofoundly to a metabolic change
is pretty remarkable.
Rachel (12:14):
Right.
So for you listening, thetakeaway here seems to be it's
promising, potentially verypowerful for some, but the
science is still evolving.
Mark (12:22):
That sums it up well.
Keto isn't a proven cure yet,but it's emerging as a really
interesting therapeutic option,particularly if you suspect
underlying metabolic issues,insulin resistance or
inflammation might be playing arole in your symptoms.
The science is early, yes, butit's definitely pointing in a
very interesting direction.
Rachel (12:41):
Okay, so let's get practical.
If someone listening isthinking, this resonates with me
.
I have some of those metabolicmarkers.
How would I even startexploring a therapeutic keto
approach for mental health?
What's the advice?
Mark (12:53):
Good question, and the key word there is therapeutic.
This isn't just about cuttingcarbs drastically, like for
weight loss.
It's about carefully supportingyour brain's specific metabolic
needs and minimizing anypotential downsides.
Rachel (13:07):
So a personalized approach is vital.
Mark (13:09):
Absolutely essential, and step one ideally is test.
Don't guess, before you makebig changes, get some baseline
lab work done.
Rachel (13:18):
Why is that so important ?
Mark (13:20):
Well, first it helps identify if keto is even
appropriate or if there areother things that need
addressing first.
Second, it gives you objectivedata.
You can track your progress andsee how your body is actually
responding metabolically.
Rachel (13:31):
Okay, what kind of tests are we talking about?
Mark (13:33):
Some key ones would be fasting insulin glucose.
You can calculate somethingcalled HHI from that, which
measures insulin resistance.
H-i-n-b-i-r okay, theninflammatory markers like
C-reactive protein, usuallyHSCRP for higher sensitivity.
Check crucial nutrient levelsfor mood Vitamin B12, folate,
vitamin D.
Rachel (13:51):
Essential stuff.
Mark (13:53):
Definitely Electrolytes too.
Magnesium, potassium, sodiumare really important.
On keto, a full thyroid panel,tsh, free T3, free T4, because
thyroid function impactsmetabolism hugely.
Rachel (14:06):
Good point.
Mark (14:07):
And maybe an omega-3 index which tells you about the
balance of fats crucial forbrain health.
And the good news is, serviceslike QuickLab Mobile actually
offer at-home collection forthese now, making testing much
easier.
That is helpful.
Rachel (14:20):
Okay, so someone gets their baseline test.
What's step two?
Just jump into strict keto.
Mark (14:24):
Generally no.
Rachel (14:25):
Yeah.
Mark (14:25):
Especially not if you're dealing with significant mental
health symptoms.
A gradual transition is usuallymuch better tolerated.
Maybe start by slowly reducingcarbs while consciously
increasing healthy fats.
Rachel (14:36):
What kind of fats?
Mark (14:36):
slowly reducing carbs while consciously increasing
healthy fats.
What kind of fats?
Things like avocado, olive oil,coconut oil, egg yolks, fatty
fish, maybe some grass-fed meat,tallow, ghee, nutrient-dense
fats.
Also, ensuring you get enoughprotein is critical.
Protein provides the buildingblocks for neurotransmitters.
Rachel (14:49):
Right, can't forget protein.
Mark (14:51):
And focus on nutrient density overall.
Rachel (14:53):
Yeah.
Mark (14:53):
Maybe include some organ meats like liver, if you can, or
sardines, pastured eggs, anddefinitely supplement with
electrolytes, sodium, potassium,magnesium, especially early on
to help avoid that keto flu.
Rachel (15:06):
That transition phase adaptation.
Mark (15:07):
Exactly, and maybe a strict keto diet isn't even
necessary or sustainablelong-term for everyone.
A modified keto approach oreven strategically cycling carbs
might work better for somepeople.
Rachel (15:18):
OK, gradual transition, focus on nutrients and fats,
electrolytes.
Then step three must betracking progress.
Mark (15:25):
Absolutely.
You need to track both how youfeel and what the data says.
Subjectively, pay closeattention to things like is my
mood more stable?
How's my sleep?
Is anxiety or irritabilitychanging?
Is that brain fog lifting?
What are my energy levels like?
Rachel (15:39):
The qualitative experience.
Mark (15:41):
Yes, and then objectively repeat some of those key lab
tests after maybe four to eightweeks, see how your home and IR
inflammation markers, et cetera,are changing.
Rachel (15:49):
So you can see the physiological response.
Mark (15:51):
Precisely.
The guiding principle should bedata, not dogma.
Let your own experience andyour lab results guide the
process.
Fine-tune it based on what'sactually working for you.
Rachel (16:03):
Okay, let's try and bring this all together.
Depression is obviouslyincredibly complex, but what
seems really clear from ourdiscussion is this deep
connection to the brain's ownhealth, its energy supply,
inflammation levels, its abilityto adapt.
Mark (16:18):
Exactly, and when you look at it through that metabolic
lens, the ketogenic diet becomessomething much more than just a
fad.
It represents a potential shiftin understanding mood disorders
.
Rachel (16:28):
Seeing them not just as chemical imbalances but as
potential metabolic problemsthat we might be able to
influence directly throughtargeted nutrition.
Mark (16:37):
Right by stabilizing blood sugar, reducing inflammation,
providing that efficient ketonefuel.
This approach might offer realhope, especially where other
treatments haven't been fullysuccessful.
Rachel (16:47):
But and this is the really crucial takeaway it's not
a magic bullet, it's notsomething to just jump into
without thought.
Mark (16:53):
Absolutely not.
A therapeutic ketogenicapproach for mental health
really works best when it'sguided by that objective lab
testing.
We talked about carefulpersonal tracking and, ideally,
professional oversight fromsomeone knowledgeable in this
area, especially if you'realready managing depression or
anxiety.
Rachel (17:10):
So be smart, be guided.
Mark (17:12):
And maybe remember this closing thought your mind runs
on your metabolism and changingyour fuel.
Well, it might just change yourfuture.
Rachel (17:21):
That's a powerful thought and, just before we
finish, a very importantdisclaimer the information
shared in this deep dive isstrictly for educational and
informational purposes.
Mark (17:29):
That's right.
It is absolutely not intendedas a substitute for professional
medical advice, diagnosis ortreatment.
Rachel (17:35):
Please always consult with your doctor or another
qualified healthcareprofessional before making any
decisions about your health,changing treatments or starting
or stopping any medications.
Mark (17:45):
Engaging with this content does not establish a
doctor-patient relationship.
Your health situation is uniqueand personalized.
Medical guidance is always thesafest and most effective.
Path guidance is always thesafest and most effective path.
Nicolette (18:02):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
No-transcript.
Welcome to the Health Pulse, your go-to source for
quick, actionable insights onhealth, wellness and diagnostics
.
Whether you're looking tooptimize your well-being or stay
informed about the latest inmedical testing, we've got you
covered.
Join us as we break down keyhealth topics in just minutes.
Let's dive in.
Rachel (00:26):
So we've all heard the phrase, haven't we?
It's a chemical imbalance.
Oh, yeah, absolutely Fordecades that's been the go-to
explanation for depression andit led straight to treatments
like SSRIs other antidepressants.
Mark (00:40):
Right, the standard approach.
But the thing is, what if thatexplanation, what if it's
actually well incomplete?
Rachel (00:47):
Exactly what if depression isn't just about
brain chemistry, but maybe aboutthe actual energy your brain
uses to function?
Mark (00:53):
That's the really big question isn't it.
And it's driving this whole newfield called metabolic
psychiatry.
It's fascinating.
Rachel (01:00):
Metabolic psychiatry.
So the idea is, mood disordersmight not just be
neurotransmitter levels.
Mark (01:06):
But could fundamentally stem from how your brain
generates and uses its energy.
Think about it.
Things like inflammation, bloodsugar problems, even insulin
resistance in the brain.
Rachel (01:16):
In the brain itself.
Mark (01:17):
Yeah, they're all emerging , as you know, major players in
mental health, and dietobviously hugely influences all
of that.
Rachel (01:24):
Which brings us to something maybe unexpected here
the ketogenic diet.
Mark (01:28):
Right Suddenly.
Keto isn't just about weightloss.
It's a potential tool formental wellness.
Rachel (01:33):
So today, that's our deep dive.
We're going to unpack exactlyhow the keto diet might affect
mood, what the science isstarting to show.
Mark (01:42):
And how this whole functional metabolic approach to
mental health is really gainingtraction.
Rachel (01:47):
Our mission really is to give you a shortcut to
understanding this, well, prettysurprising connection.
Mark (01:53):
Let's start with that traditional view.
The neurochemical imbalance,serotonin, dopamine the usual
suspects.
Rachel (01:59):
Yeah, and that theory definitely led to the rise of
SSRIs and similar drugs.
And look for some people.
They are genuinely lifesaving.
Mark (02:07):
Absolutely.
We have to acknowledge that.
But as we've seen more and morefor a lot of people they're
only partly effective, or maybethe benefits fade over time.
Rachel (02:16):
Which is exactly why researchers started looking
deeper right for otherunderlying causes.
Mark (02:20):
Precisely.
And you have to consider thebrain itself.
It's tiny, like 2% of your bodyweight.
Rachel (02:25):
Yeah, something like that.
Mark (02:27):
But it guzzles over 20% of your body's energy.
It's this incrediblypower-hungry organ running
constantly.
Rachel (02:32):
Like a supercomputer.
Mark (02:34):
Exactly and what studies are starting to show in people
with depression, is this thisreduction in how well they use
glucose, their main fuel,especially in key areas like the
prefrontal cortex?
Rachel (02:44):
Apart from mood focus decisions.
Mark (02:46):
That's the one.
So if the brain isn't using itsprimary fuel efficiently, it's
not just a chemistry issue.
Rachel (02:53):
It's an energy issue.
Mark (02:54):
Wow.
Rachel (02:55):
That really flips the script.
Mark (02:56):
It does and it leads to this newer model.
Maybe depression is, at leastin part, a metabolic disorder of
the brain.
Rachel (03:04):
Okay, and what specific kinds of metabolic problems are
we talking about here?
Mark (03:12):
Well, several things often show up together Mitochondrial
dysfunction.
Basically, your cells aren'tmaking energy properly.
Rachel (03:16):
So the powerhouses are struggling, right.
Mark (03:18):
Then there's neuroinflammation, inflammation
in the brain, messing up signals, insulin resistance, where the
brain itself can't use glucoseeffectively.
Rachel (03:25):
Even if there's plenty of glucose around.
Mark (03:27):
Even then.
Rachel (03:27):
Yeah, and finally oxidative stress, which is like
cellular damage from metabolicbyproducts and insulin
resistance.
We actually think of that withdiabetes or weight right?
Mark (03:39):
Yeah.
Rachel (03:39):
But it affects the brain too.
Mark (03:40):
Directly, yeah, higher fasting insulin, poor blood
sugar control too Directly, yeah, higher fasting insulin, poor
blood sugar control.
They're linked pretty stronglyto increased risk for both
depression and cognitive decline.
Rachel (03:50):
Okay, so that really begs the question if the brain's
fuel system is struggling withglucose what if you change the
fuel?
Mark (03:58):
What if you give it something else entirely?
Rachel (04:00):
And that's what keto comes in.
Mark (04:01):
That's exactly where it fits.
So understanding depression,maybe, as a metabolic issue, not
just chemical, that's a hugeshift in perspective for you,
the listener, to consider.
Rachel (04:11):
Okay.
So if the brain is potentiallyfacing this energy crisis, how
does the ketogenic diet actuallywork?
What's happening at thecellular level?
Mark (04:19):
Right.
So the basics.
Yeah, Keto is very high fat,moderate protein and extremely
low carb.
We're talking typically under,say, 20 to 50 grams of carbs a
day.
Rachel (04:28):
That's very low.
Mark (04:29):
It is, and when you restrict carbs that drastically,
your body shifts gears.
Yeah, that's just a statecalled ketosis.
Ketosis and that means it meansyour liver starts breaking down
fat into molecules calledketone bodies, the main one is
beta-hydroxybutyrate or BHB, BHBokay.
And these ketones then becomethe primary fuel source for your
(04:50):
body and, importantly, for yourbrain, instead of glucose.
Rachel (04:54):
Got it Now.
I've heard ketones described asa cleaner fuel for the brain.
What does that mean inpractical terms?
Mark (05:01):
It's a good description.
Think of it like this, Comparedto glucose when your brain
cells burn ketones for energy,they actually produce more ATP.
Rachel (05:11):
ATP being the cell's energy currency.
Mark (05:13):
Exactly More bang for your buck, metabolically speaking
and, crucially, they generatefewer free radicals in the
process.
Rachel (05:20):
Free radicals cause oxidative stress.
Right that damage we talkedabout.
Mark (05:23):
Precisely so.
Less oxidative stress Forsomeone dealing with depression
who might already havemitochondrial issues or
inflammation.
Rachel (05:30):
Getting a more efficient , less dirty fuel could
potentially help restorefunction.
Mark (05:35):
That's the theory.
It's like cleaning up theengine, maybe letting it run
more smoothly.
That makes sense.
Rachel (05:40):
OK, so that's the fuel source.
What about the brain'scommunication system, the
neurotransmitters?
How does keto affect those?
Mark (05:47):
This part is also really interesting.
Keto seems to have thisbalancing effect.
Studies suggest it can increaseGABA.
Rachel (05:54):
The calming neurotransmitter.
Mark (05:56):
Right and at the same time it can reduce glutamate.
Rachel (05:58):
Which is excitatory, and too much can be harmful.
Mark (06:01):
Exactly, it can be neurotoxic in excess.
So you're boosting the calm,dialing down the excessive
excitation.
It helps stabilize things.
Rachel (06:09):
Like retuning the brain's signals.
Mark (06:11):
Kind of yeah, and this GABA glutamate balance is
actually a key reason.
Keto has been used for epilepsyfor well a century now, since
the 1920s.
Rachel (06:21):
Wow, okay, so it's not just changing fuel, it's
potentially rebalancing thesignaling too.
That seems significant.
Are there wider benefits, maybesystemically?
Mark (06:29):
Definitely.
Keto has pretty powerfulanti-inflammatory effects beyond
the brain.
It can lower inflammatorymarkers like IL-6 and TNF-alpha,
which are often elevated indepression Right.
Plus, it does wonders forstabilizing blood sugar and
insulin levels.
No more sharp spikes andcrashes.
Rachel (06:45):
Which can definitely impact mood and insulin levels.
No more sharp spikes andcrashes, which can definitely
impact mood and energy levels.
Mark (06:49):
Hugely so.
If you put it all together,keto changes the brain's fuel,
potentially leading to morestable mood, better energy,
clearer thinking, all bytackling some of these
underlying metabolic issues.
Rachel (07:06):
This sounds incredibly promising, but are people
actually feeling better?
Is there a real link betweentrying keto and getting relief
from depression symptoms?
Mark (07:10):
Well, anecdotally, we're hearing more and more compelling
stories, people reportingsignificant improvements in mood
, energy, just overallwell-being.
Rachel (07:18):
OK, anecdotes are one thing, but what about studies?
I know you said, large trialsare still ongoing.
Mark (07:24):
Right, the big definitive trials are still needed, but the
early evidence is encouraging.
For example, there was a pilotstudy in 2022 published in
Frontiers in Psychiatry.
Ok, they took people with majordepressive disorder MDD.
Put them on keto for eightweeks and they saw significant
drops in depression scores, plusbetter sleep, better energy
regulation.
Rachel (07:43):
Eight weeks isn't long, but that's still a noticeable
impact.
Mark (07:46):
It really is, yeah, and other reviews, like one in
neuroscience and biobehavioralreviews, concluded that ketones
themselves might directly tweakinflammation and
neurotransmission in ways thatreduce depressive symptoms.
Rachel (07:59):
Interesting Any other specific examples.
Mark (08:03):
There was a really striking case study in BMJ
Nutrition.
It documented a patient withtreatment-resistant depression,
someone who hadn't respondedwell to other treatments.
Right After six months on keto,with no changes to their meds,
they achieved full remission.
Rachel (08:18):
Full remission Wow, that's powerful, even if it's
just one case.
Mark (08:22):
It is these early findings really do suggest there's a
strong biological rationale herethat needs more investigation.
Rachel (08:30):
Okay, so drilling down into the how what are the main
mechanisms researchers think aredriving these mood improvements
on keto?
Mark (08:37):
There seem to be a few key things working together.
First, reducing thatneuroinflammation we talked
about.
Ketones, especially BHB, candirectly inhibit something
called the NLRP3 inflammasome.
Rachel (08:47):
Which is like a master switch for inflammation in the
brain.
Mark (08:50):
Pretty much, yeah.
So turning down thatinflammatory alarm.
Second, supporting themitochondria, the cell's power
houses.
Better energy production couldcombat that fatigue and brain
fog that's so common indepression.
Rachel (09:03):
Makes sense, what else?
Mark (09:04):
And third, balancing cortisol and blood sugar.
By keeping blood sugar stable,keto helps calm down the HPA
axis, your main stress responsesystem Less cortisol, fewer
stress-driven mood swings andanxiety.
Rachel (09:17):
So it's hitting inflammation, energy production
and stress response.
That's quite comprehensive.
Mark (09:23):
It really seems to be working on multiple levels.
Rachel (09:25):
Given these mechanisms, then who seems to get the most
benefit from trying this?
Is it likely to work foreveryone with depression?
Mark (09:32):
That's a really important question.
It doesn't seem to be auniversal fix.
No, yeah, the biggestimprovements tend to be seen in
people who have clear signs ofunderlying metabolic problems,
such as, well, individuals withdiagnosed insulin resistance or
prediabetes, for sure Alsopeople with that
treatment-resistant depressionlabel we mentioned.
Rachel (09:51):
The ones where standard treatments haven't worked well,
exactly.
Mark (09:55):
Also folks struggling with chronic fatigue, anxiety or
significant brain fog alongsidetheir depression, and
particularly those whose moodseems really tied to blood sugar
swings, you know, gettingirritable or low when they
haven't eaten.
Rachel (10:09):
Hangry, but on a deeper level.
Mark (10:10):
Kind of yeah.
What's fascinating is thatoften the degree of benefit
seems to correlate with how muchmetabolic dysfunction someone
had to begin with.
Rachel (10:19):
So the more metabolically off someone is,
the more potential keto mighthave to help.
Mark (10:24):
It appears that way, it suggests that targeting the
brain's metabolism could be areally crucial, maybe overlooked
factor for a significant subsetof people.
Rachel (10:34):
This is all genuinely exciting, but let's ground
ourselves in the research again.
How solid is the scienceoverall right now?
Can we say this is a clinicallyproven cure?
Mark (10:43):
Yeah, it's super important to be clear here.
No, it is not currently aclinically proven cure for
depression across the board,while interest is booming, most
of what we have right now arethose smaller pilot studies,
animal studies which don'talways translate and those
compelling case reports.
We also borrow insights fromresearch on epilepsy, bipolar
disorder, alzheimer's conditions, where keto has a bit more
(11:05):
history.
Rachel (11:06):
So definitely promising, but still waiting for the big
definitive studies.
Mark (11:11):
Absolutely.
Reviews consistently point thisout.
For instance, one in currentopinion in psychiatry said keto
shows promise, especially ifmetabolic syndrome is present.
But we urgently need largerrandomized controlled trials,
rcts.
Rachel (11:25):
RCTs being the gold standard.
Mark (11:26):
Exactly.
Another study in the Journal ofEffective Disorders reports
echoed this.
The biological mechanisms, themitochondrial support, the
neurochemical shifts.
They're highly plausible but welack the large-scale long-term
human studies to really confirmeffectiveness widely.
Rachel (11:42):
Okay, but you mentioned those case studies earlier and
they do sound incrediblycompelling, especially for
individuals.
Mark (11:47):
They really do.
You read these reports ofpeople with longstanding
depression finally findingrelief or achieving much better
mood stability and bipolardisorder.
People report better focus,feeling more emotionally
regulated.
Rachel (11:59):
And sometimes even reducing medication needs.
Mark (12:02):
In some reported cases, yes, and what often stands out
is that these are people forwhom conventional treatments
just hadn't provided thatlasting breakthrough.
So seeing them respondprofoundly to a metabolic change
is pretty remarkable.
Rachel (12:14):
Right.
So for you listening, thetakeaway here seems to be it's
promising, potentially verypowerful for some, but the
science is still evolving.
Mark (12:22):
That sums it up well.
Keto isn't a proven cure yet,but it's emerging as a really
interesting therapeutic option,particularly if you suspect
underlying metabolic issues,insulin resistance or
inflammation might be playing arole in your symptoms.
The science is early, yes, butit's definitely pointing in a
very interesting direction.
Rachel (12:41):
Okay, so let's get practical.
If someone listening isthinking, this resonates with me
.
I have some of those metabolicmarkers.
How would I even startexploring a therapeutic keto
approach for mental health?
What's the advice?
Mark (12:53):
Good question, and the key word there is therapeutic.
This isn't just about cuttingcarbs drastically, like for
weight loss.
It's about carefully supportingyour brain's specific metabolic
needs and minimizing anypotential downsides.
Rachel (13:07):
So a personalized approach is vital.
Mark (13:09):
Absolutely essential, and step one ideally is test.
Don't guess, before you makebig changes, get some baseline
lab work done.
Rachel (13:18):
Why is that so important ?
Mark (13:20):
Well, first it helps identify if keto is even
appropriate or if there areother things that need
addressing first.
Second, it gives you objectivedata.
You can track your progress andsee how your body is actually
responding metabolically.
Rachel (13:31):
Okay, what kind of tests are we talking about?
Mark (13:33):
Some key ones would be fasting insulin glucose.
You can calculate somethingcalled HHI from that, which
measures insulin resistance.
H-i-n-b-i-r okay, theninflammatory markers like
C-reactive protein, usuallyHSCRP for higher sensitivity.
Check crucial nutrient levelsfor mood Vitamin B12, folate,
vitamin D.
Rachel (13:51):
Essential stuff.
Mark (13:53):
Definitely Electrolytes too.
Magnesium, potassium, sodiumare really important.
On keto, a full thyroid panel,tsh, free T3, free T4, because
thyroid function impactsmetabolism hugely.
Rachel (14:06):
Good point.
Mark (14:07):
And maybe an omega-3 index which tells you about the
balance of fats crucial forbrain health.
And the good news is, serviceslike QuickLab Mobile actually
offer at-home collection forthese now, making testing much
easier.
That is helpful.
Rachel (14:20):
Okay, so someone gets their baseline test.
What's step two?
Just jump into strict keto.
Mark (14:24):
Generally no.
Rachel (14:25):
Yeah.
Mark (14:25):
Especially not if you're dealing with significant mental
health symptoms.
A gradual transition is usuallymuch better tolerated.
Maybe start by slowly reducingcarbs while consciously
increasing healthy fats.
Rachel (14:36):
What kind of fats?
Mark (14:36):
slowly reducing carbs while consciously increasing
healthy fats.
What kind of fats?
Things like avocado, olive oil,coconut oil, egg yolks, fatty
fish, maybe some grass-fed meat,tallow, ghee, nutrient-dense
fats.
Also, ensuring you get enoughprotein is critical.
Protein provides the buildingblocks for neurotransmitters.
Rachel (14:49):
Right, can't forget protein.
Mark (14:51):
And focus on nutrient density overall.
Rachel (14:53):
Yeah.
Mark (14:53):
Maybe include some organ meats like liver, if you can, or
sardines, pastured eggs, anddefinitely supplement with
electrolytes, sodium, potassium,magnesium, especially early on
to help avoid that keto flu.
Rachel (15:06):
That transition phase adaptation.
Mark (15:07):
Exactly, and maybe a strict keto diet isn't even
necessary or sustainablelong-term for everyone.
A modified keto approach oreven strategically cycling carbs
might work better for somepeople.
Rachel (15:18):
OK, gradual transition, focus on nutrients and fats,
electrolytes.
Then step three must betracking progress.
Mark (15:25):
Absolutely.
You need to track both how youfeel and what the data says.
Subjectively, pay closeattention to things like is my
mood more stable?
How's my sleep?
Is anxiety or irritabilitychanging?
Is that brain fog lifting?
What are my energy levels like?
Rachel (15:39):
The qualitative experience.
Mark (15:41):
Yes, and then objectively repeat some of those key lab
tests after maybe four to eightweeks, see how your home and IR
inflammation markers, et cetera,are changing.
Rachel (15:49):
So you can see the physiological response.
Mark (15:51):
Precisely.
The guiding principle should bedata, not dogma.
Let your own experience andyour lab results guide the
process.
Fine-tune it based on what'sactually working for you.
Rachel (16:03):
Okay, let's try and bring this all together.
Depression is obviouslyincredibly complex, but what
seems really clear from ourdiscussion is this deep
connection to the brain's ownhealth, its energy supply,
inflammation levels, its abilityto adapt.
Mark (16:18):
Exactly, and when you look at it through that metabolic
lens, the ketogenic diet becomessomething much more than just a
fad.
It represents a potential shiftin understanding mood disorders
.
Rachel (16:28):
Seeing them not just as chemical imbalances but as
potential metabolic problemsthat we might be able to
influence directly throughtargeted nutrition.
Mark (16:37):
Right by stabilizing blood sugar, reducing inflammation,
providing that efficient ketonefuel.
This approach might offer realhope, especially where other
treatments haven't been fullysuccessful.
Rachel (16:47):
But and this is the really crucial takeaway it's not
a magic bullet, it's notsomething to just jump into
without thought.
Mark (16:53):
Absolutely not.
A therapeutic ketogenicapproach for mental health
really works best when it'sguided by that objective lab
testing.
We talked about carefulpersonal tracking and, ideally,
professional oversight fromsomeone knowledgeable in this
area, especially if you'realready managing depression or
anxiety.
Rachel (17:10):
So be smart, be guided.
Mark (17:12):
And maybe remember this closing thought your mind runs
on your metabolism and changingyour fuel.
Well, it might just change yourfuture.
Rachel (17:21):
That's a powerful thought and, just before we
finish, a very importantdisclaimer the information
shared in this deep dive isstrictly for educational and
informational purposes.
Mark (17:29):
That's right.
It is absolutely not intendedas a substitute for professional
medical advice, diagnosis ortreatment.
Rachel (17:35):
Please always consult with your doctor or another
qualified healthcareprofessional before making any
decisions about your health,changing treatments or starting
or stopping any medications.
Mark (17:45):
Engaging with this content does not establish a
doctor-patient relationship.
Your health situation is uniqueand personalized.
Medical guidance is always thesafest and most effective.
Path guidance is always thesafest and most effective path.
Nicolette (18:02):
Thanks for tuning into the Health Pulse.
If you found this episodehelpful, don't forget to
subscribe and share it withsomeone who might benefit.
For more health insights anddiagnostics, visit us online at
wwwquicklabmobilecom.
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