Nicolette: 0:01

Welcome to the Health Pulse, your go-to source for quick, actionable insights on health, wellness and diagnostics. Whether you're looking to optimize your well-being or stay informed about the latest in medical testing, we've got you covered. Join us as we break down key health topics in just minutes. Let's dive in.

Rachel: 0:26

So we've all heard the phrase, haven't we? It's a chemical imbalance. Oh, yeah, absolutely For decades that's been the go-to explanation for depression and it led straight to treatments like SSRIs other antidepressants.

Mark: 0:40

Right, the standard approach. But the thing is, what if that explanation, what if it's actually well incomplete?

Rachel: 0:47

Exactly what if depression isn't just about brain chemistry, but maybe about the actual energy your brain uses to function?

Mark: 0:53

That's the really big question isn't it. And it's driving this whole new field called metabolic psychiatry. It's fascinating.

Rachel: 1:00

Metabolic psychiatry. So the idea is, mood disorders might not just be neurotransmitter levels.

Mark: 1:06

But could fundamentally stem from how your brain generates and uses its energy. Think about it. Things like inflammation, blood sugar problems, even insulin resistance in the brain.

Rachel: 1:16

In the brain itself.

Mark: 1:17

Yeah, they're all emerging, as you know, major players in mental health, and diet obviously hugely influences all of that.

Rachel: 1:24

Which brings us to something maybe unexpected here the ketogenic diet.

Mark: 1:28

Right Suddenly. Keto isn't just about weight loss. It's a potential tool for mental wellness.

Rachel: 1:33

So today, that's our deep dive. We're going to unpack exactly how the keto diet might affect mood, what the science is starting to show.

Mark: 1:42

And how this whole functional metabolic approach to mental health is really gaining traction.

Rachel: 1:47

Our mission really is to give you a shortcut to understanding this, well, pretty surprising connection.

Mark: 1:53

Let's start with that traditional view. The neurochemical imbalance, serotonin, dopamine the usual suspects.

Rachel: 1:59

Yeah, and that theory definitely led to the rise of SSRIs and similar drugs. And look for some people. They are genuinely lifesaving.

Mark: 2:07

Absolutely. We have to acknowledge that. But as we've seen more and more for a lot of people they're only partly effective, or maybe the benefits fade over time.

Rachel: 2:16

Which is exactly why researchers started looking deeper right for other underlying causes.

Mark: 2:20

Precisely. And you have to consider the brain itself. It's tiny, like 2% of your body weight.

Rachel: 2:25

Yeah, something like that.

Mark: 2:27

But it guzzles over 20% of your body's energy. It's this incredibly power-hungry organ running constantly.

Rachel: 2:32

Like a supercomputer.

Mark: 2:34

Exactly and what studies are starting to show in people with depression, is this this reduction in how well they use glucose, their main fuel, especially in key areas like the prefrontal cortex?

Rachel: 2:44

Apart from mood focus decisions.

Mark: 2:46

That's the one. So if the brain isn't using its primary fuel efficiently, it's not just a chemistry issue.

Rachel: 2:53

It's an energy issue.

Mark: 2:54

Wow.

Rachel: 2:55

That really flips the script.

Mark: 2:56

It does and it leads to this newer model. Maybe depression is, at least in part, a metabolic disorder of the brain.

Rachel: 3:04

Okay, and what specific kinds of metabolic problems are we talking about here?

Mark: 3:12

Well, several things often show up together Mitochondrial dysfunction. Basically, your cells aren't making energy properly.

Rachel: 3:16

So the powerhouses are struggling, right.

Mark: 3:18

Then there's neuroinflammation, inflammation in the brain, messing up signals, insulin resistance, where the brain itself can't use glucose effectively.

Rachel: 3:25

Even if there's plenty of glucose around.

Mark: 3:27

Even then.

Rachel: 3:27

Yeah, and finally oxidative stress, which is like cellular damage from metabolic byproducts and insulin resistance. We actually think of that with diabetes or weight right?

Mark: 3:39

Yeah.

Rachel: 3:39

But it affects the brain too.

Mark: 3:40

Directly, yeah, higher fasting insulin, poor blood sugar control too Directly, yeah, higher fasting insulin, poor blood sugar control. They're linked pretty strongly to increased risk for both depression and cognitive decline.

Rachel: 3:50

Okay, so that really begs the question if the brain's fuel system is struggling with glucose what if you change the fuel?

Mark: 3:58

What if you give it something else entirely?

Rachel: 4:00

And that's what keto comes in.

Mark: 4:01

That's exactly where it fits. So understanding depression, maybe, as a metabolic issue, not just chemical, that's a huge shift in perspective for you, the listener, to consider.

Rachel: 4:11

Okay. So if the brain is potentially facing this energy crisis, how does the ketogenic diet actually work? What's happening at the cellular level?

Mark: 4:19

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: 4:28

That's very low.

Mark: 4:29

It is, and when you restrict carbs that drastically, your body shifts gears. Yeah, that's just a state called ketosis. Ketosis and that means it means your liver starts breaking down fat into molecules called ketone bodies, the main one is beta-hydroxybutyrate or BHB, BHB okay. And these ketones then become the primary fuel source for your body and, importantly, for your brain, instead of glucose.

Rachel: 4:54

Got it Now. I've heard ketones described as a cleaner fuel for the brain. What does that mean in practical terms?

Mark: 5:01

It's a good description. Think of it like this, Compared to glucose when your brain cells burn ketones for energy, they actually produce more ATP.

Rachel: 5:11

ATP being the cell's energy currency.

Mark: 5:13

Exactly More bang for your buck, metabolically speaking and, crucially, they generate fewer free radicals in the process.

Rachel: 5:20

Free radicals cause oxidative stress. Right that damage we talked about.

Mark: 5:23

Precisely so. Less oxidative stress For someone dealing with depression who might already have mitochondrial issues or inflammation.

Rachel: 5:30

Getting a more efficient, less dirty fuel could potentially help restore function.

Mark: 5:35

That's the theory. It's like cleaning up the engine, maybe letting it run more smoothly. That makes sense.

Rachel: 5:40

OK, so that's the fuel source. What about the brain's communication system, the neurotransmitters? How does keto affect those?

Mark: 5:47

This part is also really interesting. Keto seems to have this balancing effect. Studies suggest it can increase GABA.

Rachel: 5:54

The calming neurotransmitter.

Mark: 5:56

Right and at the same time it can reduce glutamate.

Rachel: 5:58

Which is excitatory, and too much can be harmful.

Mark: 6:01

Exactly, it can be neurotoxic in excess. So you're boosting the calm, dialing down the excessive excitation. It helps stabilize things.

Rachel: 6:09

Like retuning the brain's signals.

Mark: 6:11

Kind of yeah, and this GABA glutamate balance is actually a key reason. Keto has been used for epilepsy for well a century now, since the 1920s.

Rachel: 6:21

Wow, okay, so it's not just changing fuel, it's potentially rebalancing the signaling too. That seems significant. Are there wider benefits, maybe systemically?

Mark: 6:29

Definitely. Keto has pretty powerful anti-inflammatory effects beyond the brain. It can lower inflammatory markers like IL-6 and TNF-alpha, which are often elevated in depression Right. Plus, it does wonders for stabilizing blood sugar and insulin levels. No more sharp spikes and crashes.

Rachel: 6:45

Which can definitely impact mood and insulin levels. No more sharp spikes and crashes, which can definitely impact mood and energy levels.

Mark: 6:49

Hugely so. If you put it all together, keto changes the brain's fuel, potentially leading to more stable mood, better energy, clearer thinking, all by tackling some of these underlying metabolic issues.

Rachel: 7:06

This sounds incredibly promising, but are people actually feeling better? Is there a real link between trying keto and getting relief from depression symptoms?

Mark: 7:10

Well, anecdotally, we're hearing more and more compelling stories, people reporting significant improvements in mood, energy, just overall well-being.

Rachel: 7:18

OK, anecdotes are one thing, but what about studies? I know you said, large trials are still ongoing.

Mark: 7:24

Right, the big definitive trials are still needed, but the early evidence is encouraging. For example, there was a pilot study in 2022 published in Frontiers in Psychiatry. Ok, they took people with major depressive disorder MDD. Put them on keto for eight weeks and they saw significant drops in depression scores, plus better sleep, better energy regulation.

Rachel: 7:43

Eight weeks isn't long, but that's still a noticeable impact.

Mark: 7:46

It really is, yeah, and other reviews, like one in neuroscience and biobehavioral reviews, concluded that ketones themselves might directly tweak inflammation and neurotransmission in ways that reduce depressive symptoms.

Rachel: 7:59

Interesting Any other specific examples.

Mark: 8:03

There was a really striking case study in BMJ Nutrition. It documented a patient with treatment-resistant depression, someone who hadn't responded well to other treatments. Right After six months on keto, with no changes to their meds, they achieved full remission.

Rachel: 8:18

Full remission Wow, that's powerful, even if it's just one case.

Mark: 8:22

It is these early findings really do suggest there's a strong biological rationale here that needs more investigation.

Rachel: 8:30

Okay, so drilling down into the how what are the main mechanisms researchers think are driving these mood improvements on keto?

Mark: 8:37

There seem to be a few key things working together. First, reducing that neuroinflammation we talked about. Ketones, especially BHB, can directly inhibit something called the NLRP3 inflammasome.

Rachel: 8:47

Which is like a master switch for inflammation in the brain.

Mark: 8:50

Pretty much, yeah. So turning down that inflammatory alarm. Second, supporting the mitochondria, the cell's power houses. Better energy production could combat that fatigue and brain fog that's so common in depression.

Rachel: 9:03

Makes sense, what else?

Mark: 9:04

And third, balancing cortisol and blood sugar. By keeping blood sugar stable, keto helps calm down the HPA axis, your main stress response system Less cortisol, fewer stress-driven mood swings and anxiety.

Rachel: 9:17

So it's hitting inflammation, energy production and stress response. That's quite comprehensive.

Mark: 9:23

It really seems to be working on multiple levels.

Rachel: 9:25

Given these mechanisms, then who seems to get the most benefit from trying this? Is it likely to work for everyone with depression?

Mark: 9:32

That's a really important question. It doesn't seem to be a universal fix. No, yeah, the biggest improvements tend to be seen in people who have clear signs of underlying metabolic problems, such as, well, individuals with diagnosed insulin resistance or prediabetes, for sure Also people with that treatment-resistant depression label we mentioned.

Rachel: 9:51

The ones where standard treatments haven't worked well, exactly.

Mark: 9:55

Also folks struggling with chronic fatigue, anxiety or significant brain fog alongside their depression, and particularly those whose mood seems really tied to blood sugar swings, you know, getting irritable 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 that often the degree of benefit seems to correlate with how much metabolic dysfunction someone had to begin with.

Rachel: 10:19

So the more metabolically off someone is, the more potential keto might have to help.

Mark: 10:24

It appears that way, it suggests that targeting the brain's metabolism could be a really crucial, maybe overlooked factor for a significant subset of people.

Rachel: 10:34

This is all genuinely exciting, but let's ground ourselves in the research again. How solid is the science overall right now? Can we say this is a clinically proven cure?

Mark: 10:43

Yeah, it's super important to be clear here. No, it is not currently a clinically proven cure for depression across the board, while interest is booming, most of what we have right now are those smaller pilot studies, animal studies which don't always translate and those compelling case reports. We also borrow insights from research on epilepsy, bipolar disorder, alzheimer's conditions, where keto has a bit more history.

Rachel: 11:06

So definitely promising, but still waiting for the big definitive studies.

Mark: 11:11

Absolutely. Reviews consistently point this out. For instance, one in current opinion in psychiatry said keto shows promise, especially if metabolic syndrome is present. But we urgently need larger randomized controlled trials, rcts.

Rachel: 11:25

RCTs being the gold standard.

Mark: 11:26

Exactly. Another study in the Journal of Effective Disorders reports echoed this. The biological mechanisms, the mitochondrial support, the neurochemical shifts. They're highly plausible but we lack the large-scale long-term human studies to really confirm effectiveness widely.

Rachel: 11:42

Okay, but you mentioned those case studies earlier and they do sound incredibly compelling, especially for individuals.

Mark: 11:47

They really do. You read these reports of people with longstanding depression finally finding relief or achieving much better mood stability and bipolar disorder. 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 for whom conventional treatments just hadn't provided that lasting breakthrough. So seeing them respond profoundly to a metabolic change is pretty remarkable.

Rachel: 12:14

Right. So for you listening, the takeaway here seems to be it's promising, potentially very powerful 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 a role in your symptoms. The science is early, yes, but it's definitely pointing in a very interesting direction.

Rachel: 12:41

Okay, so let's get practical. If someone listening is thinking, this resonates with me. I have some of those metabolic markers. How would I even start exploring 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 cutting carbs drastically, like for weight loss. It's about carefully supporting your brain's specific metabolic needs and minimizing any potential 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 make big 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 are other things that need addressing first. Second, it gives you objective data. You can track your progress and see 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 something called HHI from that, which measures insulin resistance. H-i-n-b-i-r okay, then inflammatory markers like C-reactive protein, usually HSCRP for higher sensitivity. Check crucial nutrient levels for mood Vitamin B12, folate, vitamin D.

Rachel: 13:51

Essential stuff.

Mark: 13:53

Definitely Electrolytes too. Magnesium, potassium, sodium are really important. On keto, a full thyroid panel, tsh, free T3, free T4, because thyroid function impacts metabolism hugely.

Rachel: 14:06

Good point.

Mark: 14:07

And maybe an omega-3 index which tells you about the balance of fats crucial for brain health. And the good news is, services like QuickLab Mobile actually offer at-home collection for these 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 usually much better tolerated. Maybe start by slowly reducing carbs 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 enough protein is critical. Protein provides the building blocks 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, and definitely 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 sustainable long-term for everyone. A modified keto approach or even strategically cycling carbs might work better for some people.

Rachel: 15:18

OK, gradual transition, focus on nutrients and fats, electrolytes. Then step three must be tracking progress.

Mark: 15:25

Absolutely. You need to track both how you feel and what the data says. Subjectively, pay close attention to things like is my mood more stable? How's my sleep? Is anxiety or irritability changing? 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 eight weeks, 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 be data, not dogma. Let your own experience and your lab results guide the process. Fine-tune it based on what's actually working for you.

Rachel: 16:03

Okay, let's try and bring this all together. Depression is obviously incredibly complex, but what seems really clear from our discussion is this deep connection to the brain's own health, its energy supply, inflammation levels, its ability to adapt.

Mark: 16:18

Exactly, and when you look at it through that metabolic lens, the ketogenic diet becomes something much more than just a fad. It represents a potential shift in understanding mood disorders.

Rachel: 16:28

Seeing them not just as chemical imbalances but as potential metabolic problems that we might be able to influence directly through targeted nutrition.

Mark: 16:37

Right by stabilizing blood sugar, reducing inflammation, providing that efficient ketone fuel. This approach might offer real hope, especially where other treatments haven't been fully successful.

Rachel: 16:47

But and this is the really crucial takeaway it's not a magic bullet, it's not something to just jump into without thought.

Mark: 16:53

Absolutely not. A therapeutic ketogenic approach for mental health really works best when it's guided by that objective lab testing. We talked about careful personal tracking and, ideally, professional oversight from someone knowledgeable in this area, especially if you're already 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 changing your fuel. Well, it might just change your future.

Rachel: 17:21

That's a powerful thought and, just before we finish, a very important disclaimer the information shared in this deep dive is strictly for educational and informational purposes.

Mark: 17:29

That's right. It is absolutely not intended as a substitute for professional medical advice, diagnosis or treatment.

Rachel: 17:35

Please always consult with your doctor or another qualified healthcare professional 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 unique and personalized. Medical guidance is always the safest and most effective. Path guidance is always the safest and most effective path.

Nicolette: 18:02

Thanks for tuning into the Health Pulse. If you found this episode helpful, don't forget to subscribe and share it with someone who might benefit. For more health insights and diagnostics, visit us online at wwwquicklabmobilecom. No-transcript.