National Public Radio podcast examines the connection between a ketogenic diet and mental health. Psychiatrist Chris Palmer and his patient, Dan, are interviewed by host Karen Weintraub. Dan, who has schizophrenia, has been on a ketogenic diet for three years. During this time Dan’s quality of life was greatly improved.

“The good news in all of this is that these things (metabolic disturbances) are reversible. Metabolism can be changed by exercise and what we eat. That is a really exciting area of research.”

Chris Palmer, MD

https://dcs.megaphone.fm/BUR8345063909.mp3?key=812bcd5d8b9493d4a3f6d45474739e49

Podcast show notes

• 0:04 Introduction. The ketogenic diet contains large amounts of healthy fat, moderate amounts of protein, and very few carbohydrates. It has been used since the 1920’s to treat epilepsy.  Now it is also being tested as a treatment for depression, bipolar disorder and schizophrenia.
• 0:35 Karen introduces Dan, Chris Palmer’s patient. Dan talks briefly about his history as a young patient struggling with schizophrenia.
• 1:14 Karen and Dan talk about Dan’s recovery and the medical ketogenic diet he adheres to.
• 1:47 Karen introduces Chris. Chris and Karen talk about the connection between metabolism, diet and mental illness. Mental illness is closely linked with diet and metabolic issues. Metabolism can be positively changed by a ketogenic diet and exercise.
• 3:10 Karen talks about a study being done at Northeastern University: how individual nutrients and chemicals affect the brain. She introduces a computer scientist, Albert-Laszlo Barabasi, and he further explains the study.
• 4:13 Karen and Dan talk about Dan’s recovery again. Dan has been on the ketogenic diet for 3 years. He talks about the positive changes that have occurred in his life. He lost 140 lbs, is on half the medication he used to be on, has an active lifestyle and says he feels great.
• 4:55 – Closing.

Other case reports on schizophrenia and ketogenic therapies

Bibliography – Medical ketogenic diet for metabolic and mental health research

The post NPR Interviews Dr. Palmer and his patient about managing schizophrenia with the ketogenic diet appeared first on Chris Palmer, MD.

Episode 10 “Nutritional Psychiatry, Metabolic Disorders, and Using the Ketogenic Diet as a Medical Intervention for Schizophrenia and Bipolar Disorder with Chris Palmer, M.D.”

Mental Horizons Podcast with Virgil Stucker & Associates’s Stephanie McMahon put together great show notes here.

The post Mental Horizons interviews Dr. Palmer – Using ketogenic medical therapy for schizophrenia, bipolar, and metabolic disorders appeared first on Chris Palmer, MD.

Show notes for Low Carb MD Podcast Episode 49

• 00:00  Welcome to the Low Carb MD podcast with Dr. Chris Palmer. He is a Harvard psychiatrist who has case reports and case studies on mental health and the ketogenic diet.
• 01:23  Nutritional approaches to psychiatric disorders.

Dr. Chris Palmer’s personal health history and metabolic recovery

• 02:19  Dr. Palmer’s story, 20-25 years ago, “I was one of those skinny, metabolically-disordered people.”
• 03:19  Chris’s low fat diet.
• 03:33  Dr. Palmer’s health: “I was pre-diabetic. I definitely had hypertension and I had horrible cholesterol.”
• 05:36  The effect of low-carb diet intervention, “Everything was better. My LDL plummeted. My HDL doubled. And my triglycerides plummeted into a normal healthy range. I was no longer pre-diabetic. My blood pressure was down to a really good, healthy level.”
• 06:02  Twenty+ years on a low-carb ketogenic diet.

Lifestyle intervention

• 09:01  “When I speak to other physicians I often ask how lifestyle interventions are going for their patients? Almost all of them roll their eyes and give a deep sigh of hopelessness and futility. ‘There’s no point. It never works.’ Their perception is that the patients are lazy slackers.”

Change is hard

• 10:01  “Bad advice doesn’t work. Low-carb, high-fat eating goes against everything that we have believed for decades.  Everything that we’ve been taught. Change is hard.”

Global metabolic and mental disorder epidemic

• 11:44  “In the United States, and around the world, there is something profoundly wrong… Obesity rates are skyrocketing. Diabetes rates are skyrocketing, and my passion, mental disorders, are skyrocketing.”
• 12:30  Other mental disorders are also skyrocketing at the exact same time that we’re seeing these exploding rates of metabolic disorders.

Ketogenic diet as intervention for treatment-resistant depression and weight loss

• 13:40 “I’ve been using it with patients for treatment-resistant depression. And, I’ve been using with a lot of people for weight loss and just for general health improvement.”

Speaking out

• 14:04  Also, I knew I was going against the medical establishment.
• 14:54  “I can’t stay quiet anymore.”
• 15:21  “A schizophrenic patient was on every medication. He suffered every day every day.”
• 16:19  “On psychiatric medication, he gained 150 – 200 lb, he was sedated. He couldn’t function. He couldn’t live alone.”
• 17:03  “I had worked with him for 10 years. We had tried numerous medications.”

Sometimes medication is not enough when treating schizophrenia

• 17:22  “And we couldn’t help him. We’re doing our best. The medications are required. They’re essential.”
• 18:12  “But these medications also made him morbidly obese. These medications are sedating him so that he sleeps 16 hours a day. And these medications are not working for him.”
• 18:45  “Unfortunately, there are literally tens of millions of people just like him all around the world, and this is what the medical field has to offer them.”

Weight loss and psychosis

• 19:02  The patient wants to lose some weight.
• 19:09  “Getting a person with schizophrenia to do a diet though. Everybody thinks that’s impossible.”
• 20:34  But, at the 3-week mark of doing a ketogenic diet, I noticed something distinctly different about him. He’s losing weight. But he is now starting to be more alert. I haven’t changed his meds at all.”
• 21:26  At about 6 weeks, “He spontaneously reports to me: ‘Dr. Palmer, you know those voices that I tell you I hear all the time? I think they’re kind of getting quieter and I’m not hearing them as much, they’re not talking as much anymore…’”

Ketogenic dietary intervention takes time to work when treating schizophrenia.

• 22:01  Another 4 weeks go by, this treatment takes time, he says “Dr. Palmer, you know, I had these delusions? I think maybe that’s not really happening, I think maybe I have schizophrenia and it’s getting better.”

100 pound weight loss and psychiatric symptoms improve

• 23:48  He loses over a hundred pounds at the one-year mark. He is improved psychiatrically, functionally, and socially.

Going off the diet and symptoms return

• 24:57  If he does not follow the diet, he can become acutely psychotic again within 24-48 hours. Just like stopping medication. When he resumes the diet, symptoms abate.

Keto diet is not a stand-alone treatment

• 25:57  Psychosocial and psychoeducational intervention, and sometimes medications, are still necessary. Keto is not a cure-all.

Psychiatric medications

• 27:43  Medications interfere with metabolism, cause weight gain, diabetes, and increases in blood sugar and insulin.

70 year old woman with schizophrenia improves on keto

• 28:25  One of Dr. Eric Westman’s patients had chronic paranoid schizophrenic for 53 years. She couldn’t function in life.

Dr. Eric Westman at Duke University

• 29:24  She had debilitating, disabling schizophrenia and she gained weight up to 330 pounds. Eric Westman, MD treated her at the low-carb weight-loss clinic at Duke University.
• 30:24  Within 2 months her psychotic symptoms were improved.
• 30:32 “She has been off of medications now for 12 years, fast forward 12 years. That’s today. She’s lost 150 lb.”
• 31:14  The patient is symptom-free.
• 31:16  She’s off all medications.
• 31:36  “She is so excited to share her message of recovery using the ketogenic diet.”

Compliance

• 32:21  Compliance is a huge issue.

Food as medicine?

• 35:00  Food can act as medicine?
• 36:11  It’s not a conclusion. It’s a question.

Quackery?

• 36:42  Quackery… skepticism.
• 37:54  “We have more basic science research and knowledge and understanding of the effects of this [ketogenic] diet on the human brain than we do any other dietary intervention and than we do for most psychiatric medication.”
• 38:14  “Thousands and thousands of studies published in some of the best medical journals neurology journals.”

Keto for epilepsy

• 39:14  Twenty to 30% of treatment resistant people treated with the ketogenic diet are seizure-free. “These are the worst of the worst. They’ve tried everything they suffered for years or decades and nothing is working for them. And this diet can make 20 to 30% of them seizure-free.” But, some can’t stay on the diet.

Cochrane review

• 39:50  “The Cochrane review on the ketogenic diet for pediatric epilepsy in particular, and it is unequivocal in its conclusion: The ketogenic diet is an effective treatment for epilepsy.”

“Off-label” treatment

• 40:59  A ketogenic diet is shown to work for epilepsy. Every anti-epileptic medication is used in psychiatry. “We use benzodiazepines, Depakote, Lamotrigine and Tegretol. We use all of it. Every anticonvulsant medication is used in psychiatry sometimes on label, sometimes off label.”
• 42:45  “When we combine two psychiatric medications, that’s off-label.”
• 43:41  “We use every epilepsy treatment in psychiatry. We often treat patients off-label in psychiatry… why should I even consider using the ketogenic diet today in a patient with a treatment-resistant mental illness? [It is] because it’s a proven treatment for treatment-resistant epilepsy and you’re going to use it off label. So the way I look at it is, I am using an off-label established treatment for epilepsy in psychiatric disorders.”

Time with patients

• 47:15  “…one of the great things about being a psychiatrist is that we are probably the last of the medical professionals who still get to have a relationship with our patients. Who still get to talk about whatever we think is important to their health.”

The mental-metabolic connection

• 51:24  “We have hardcore epidemiologic data… obesity affects diabetes and diabetes control affects cardiovascular disease.”
• 51:59  Sleep and metabolism.
• 53:59  Bipolar disorder.
• 54:43  Treatment-resistant depression. “Dramatic Improvement in mood disorders and anxiety symptoms…”
• 55:23  Caveats: Keto adaptation-keto flu is a serious medical risk. People may get worse initially, before they get better.
• 56:13  Transition from utilizing glucose for fuel to using fat for fuel takes time and the process initially deprives cells of energy.
• 57:48  Metabolic disorders and energy deprivation.
• 58:56  Medical monitoring necessary for people with serious disorders.
• 59:52  Medical risk, powerful intervention.
• 1:02:47  “Mental health and metabolic disease are intimately related.”

Other articles you might find useful

Start here

• Medical ketogenic diet bears burden of popularity despite being a useful therapy
• Keto resources for mental health and psychiatry
• Ketogenic providers

Information about specific diagnoses

• The relationship between the ketogenic diet and psychiatry
• Schizophrenia – Ketogenic diet brings new hope for the treatment resistant
• Might the ketogenic diet help fight Alzheimer’s Disease?
• Can a ketogenic diet successfully treat Bipolar Disorder?

Success Stories

• Doris’s chronic schizophrenia put into remission bringing hope to many
• Ketogenic diet helps young Ecuadorian twins improve their schizophrenic symptoms

The post Low Carb MD podcast with Drs. Tro and Brian Lenzkes – Treating schizophrenia with a ketogenic diet appeared first on Chris Palmer, MD.

Part 1: Episode 63 – Keto Naturopath by Karl Goldcamp interviews Chris Palmer

Show notes – Addiction and ketogenic diet

This podcast discusses behavioral disorders and a ketogenic therapeutic intervention.

 Diet and addiction

• 3:20  Nora Volkow, MD. Director National Institute on Drug Abuse. Research implies some foods activate the same reward pathways as addictive substances.
• 6:02  Alcohol and insulin resistance.
• 7:02  Study of ketogenic diet and alcoholism.
• 13:25 Alcohol converts to acetone and fuels the brain. (The big three ketone bodies are beta-hydroxybutyrate, acetoacetate, and acetone.)

Chris and his father’s success stories

• 16:55  How Chris Palmer discovered low-carb dieting and his own metabolic dysfunction.
• 23:45  Chris’s father’s story of diabetes and recovery.
• 39:11  Chris’s personal diet and exercise plan.

Part 2: Episode 64 – Keto Naturopath by Karl Goldcamp interviews Chris Palmer

Exercise

• 8:05  Karl – Hard to encourage exercise to the non-athletic.
• 8:42  Chris – Growing up with poor diet and no exercise

On a ketogenic diet people feel more energetic and want to start exercising

• 10:33  Mental and emotional changes with ketogenic diet

Metabolic – mental connection

• 13:36  Mental disorders
• 14:35  Stigma of mental illness
• 15:49  Mental disorders as metabolic disorders
• 16:36  Diabetes and insulin resistance in mental disorders
• 16:55   At onset of mental illness patient’s weight is normal. But their insulin resistance is already measurable.
• 19:39  bidirectional relationship between mental and metabolic disorders

Ketogenic diet as a therapeutic intervention

• 23:14  Ketogenic diet can stop seizures
• 24:37  Epilepsy treatments are commonly used in psychiatry
• 25:22  Metabolic defects in mental disorders
• 28:15  More research needed
• 30:00  Off-label treatments
• 32:24  My hope is to better understand this metabolic-mental overlap
• 33:29 Metabolic interventions don’t work for everyone. I wish they did. I’m using them to help those with serious, treatment-resistant illnesses.
• 33:46  New schizophrenia research by Chris Palmer, MD
• 35:46  Dream of a residential treatment program
• 39:02  Hopeful that this is a game-changing way of thinking about and addressing these disorders

Part 3: Episode 65 – Keto Naturopath by Karl Goldcamp

Like-minded researchers and clinicians around the world

• 16:41  Others currently investigating the ketogenic diet for mental illness.
• 18:45  Many clinicians unwilling to use the ketogenic diet with the most serious. disorders. For example, bipolar, schizophrenia and chronic-disabling depression. Using the medical-ketogenic diet as a treatment requires a multi-faceted approach.
• 20:40  I desperately want to improve the lives of psychiatric patients
• 21:40  I want to motivate other mental health clinicians to learn about the ketogenic diet.
• 22:40  It is going to take a movement to spur change.

Mechanisms of Action

• 25:16  Medical practitioners require a mechanism of action
• 25:57  History of ketogenic diet
• 25:57  Better understood than any other dietary intervention
• 27:49  Neurologist have been studying this since the 1970s
• 28:23  Probably 20 different mechanisms of action have already been elucidated. They suggest why the ketogenic diet can stop seizures .
• 29:19  Increasing GABA, a primary inhibitory neurotransmitter in the brain.
• 31:24  This diet also increases activity of Adenosine.
• 33:10  The ketogenic diet helps repair mitochondria.
• 34:19  The ketogenic diet stimulates some pathways that result in anti-aging.

Fasting and the origin of the ketogenic diet

• 37:39  Fasting and the ketogenic diet both significantly change metabolism.
• 38:15  Fasting has a long history
• 40:16  The epilepsy world put it to some rigorous tests and they found it actually works for a real brain disorder, and you know they have been using it for a hundred years.
• 41:08  Does not stop seizures 100%
• 42:08  Some are skeptical of it because it doesn’t work immediately.

Lab testing

• 44:19  Lab monitoring
• 46:39  Cortisol.

The post Karl Goldcamp interviews Dr. Palmer for Keto Naturopath – Addiction and keto appeared first on Chris Palmer, MD.

Come hear Chris speak at the Metabolic Health Summit during the 2020 conference.

The post Metabolic Health Summit’s Victoria Field interviews Dr. Palmer appeared first on Chris Palmer, MD.