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Ketogenic

Too much GABA causes a tingling niacin-like flush sensation (in the brain and body). It’s awful and very uncomfortable!

February 18, 2022 By Trudy Scott 104 Comments

too much gaba

GABA, used as an amino acid, helps to raise GABA levels and ease physical tension-type anxiety. There are many misunderstandings on the best and most effective ways to use GABA and this can lead to unpleasant symptoms. One common thing I see is that too much GABA causes the brain and body to react with a tingling niacin-like flush sensation that is very uncomfortable and often described as awful.

Too many people stop using GABA for this reason. And then they lose out on the wonderful calming benefits of this amino acid. Some folks actually push through and continue with the unpleasant tingling sensation because they don’t know better and because they are also getting some of the calming benefits of GABA (I share an example of this below). Neither situation is ideal.

I recently received a GABA question on the blog on this very topic. It was from a licensed acupuncturist in California, USA (let’s call her Dr. M):

When I used to take GABA for my stress, my body/brain reacted with a tingling sensation.

It was so awkward and uncomfortable.

I thought it was only me, but when I prescribed GABA to my patients, they also felt the same sensations.

Can you tell me why this reaction occurred?

Thank you so much for your generosity and deep research.

Because this is such a common question that I get, I’m sharing it and my responses to use it as a teaching opportunity.

Too much GABA can cause this uncomfortable tingling niacin-like flush or sensation

I responded sharing that it can happen when too much GABA is used or if GABA is not needed. I typically hear of this happening when 500mg to 750mg is used to start. It’s also often described as a niacin-like flush. With GABA, 125mg is a typical starting dose and it’s always used as a sublingual or capsule opened onto the tongue. We slowly go up from there based on symptoms and the final dose is unique to each person’s needs. You may end up using 500mg or more but it’s a slow approach to get there.

I asked Dr. M to share which product/s she used, the dosing and let me know if she does better with a lower dose.

As expected she was using too high a dose (and hadn’t done a trial of a lower dose). She responded with this feedback:

The GABA I used for me and my patients is from Pure Encapsulations. This GABA contains 700 mg per capsule, which may be too much for the start.

Which brand would you recommend for practitioner use?

I responded by confirming that 700 mg GABA is way too much to start for most people.

What product and how much to use instead of 700 mg GABA

I like the Pure Encapsulations product but I actually feel the companies are partially at fault for having such high dose products, stating “1 capsule daily, between meals, or as directed by a health professional” on the label, and not educating practitioners and consumers about this issue.

With a product like this I have clients open up the capsule and start with 125 mg GABA powder on the tongue and increase from there as needed.

I also shared the other GABA products I use in case she would prefer to try something like the Source Naturals GABA Calm product I frequently use with clients.

This is a lozenge that contains 125 mg GABA, 5 mg magnesium, 50 mg glycine, 25 mg tyrosine and 20 mg taurine. This is my most popular and most effective form of GABA I use with my clients. [Note: this product is a lozenge with 125mg GABA and is not to be confused with the Source Naturals, GABA Calm Mind, 750 mg tablets]

I’m waiting for feedback from her to hear how using less of the 700 mg GABA (opened up and divided out) or how using another GABA product works for her and her patients.

I do appreciate Dr. M for asking a tough question like this and being open to me sharing so everyone gets to learn.

Where did Dr. M learn about GABA and some resources for additional practitioner education

I did ask Dr. M where she learned about using GABA and if the recommendation was to use a high dose like this. I’m genuinely curious to know so I can help guide further education in the use of GABA.

Of course, I encouraged her to get my book “The Antianxiety Food Solution” and read the chapter on the amino acids. And to consider signing up for the amino acid training for practitioners. There are many nuances and best practices when using the amino acids. And it’s an opportunity to interact with me and other practitioners who are also using the amino acids.

If you’re a practitioner, I’m hoping this question, my feedback and these resources are helpful for you.

Similar niacin-like flush experienced by Holly

As mentioned above this is a very common issue because most GABA products are 500mg and up and folks hear how amazing GABA is for physical anxiety and use a high dose without understanding they need to start low and use only what they need.

I shared my discussion with Dr. M in a Facebook post and Holly responded with what happened to her when she switched from GABA Calm (which has 125 mg GABA) to a 750 mg GABA product:

I experienced the niacin-like flush when I tried to go from GABA Calm [mostly dissolved in my mouth] to a pill form and didn’t realize the dosage would be way too high all at one time. The pill was 750 mg GABA [and swallowed with food], so it wasn’t going to work well anyway.

The flush lasted about 15-20 minutes. It was awful. I was sure I was going to throw up every time.

It took me a couple of weeks to figure out the cause.  My therapist recommended your website and book and those helped me understand when to take it and why it would help.

When I eliminated the 750 mg GABA  pill the symptoms completely went away.

Now I stick to GABA Calm. I take one in the morning and one before bed and sometimes one midday.

I appreciate Holly for sharing and I’m glad her and her therapist figured it out.

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acids GABA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms)

In case you’re new to the low GABA-type of anxiety, with low GABA levels you may experience physical-tension and stiff-and-tense-muscles, panic attacks, more physical tension in certain settings like public speaking or driving. You will often have the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods.

Insomnia can also be caused by low GABA and you’ll experience physical tension in bed at night rather than the ruminating thoughts which is the low serotonin type of insomnia (although it’s not uncommon to experience both.) GABA also helps with muscle spasms and pain relief when muscles are tight.

If you suspect low levels of GABA or low serotonin and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the GABA products that I use with my individual clients and those in my group programs.

Get guidance in the GABA QuickStart Program

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program.

We have an active and engaged community in the private Facebook group and there are 2 live Q & A calls with me.

One of the recent participants shared this lightbulb moment after starting with GABA Calm in the day and then shifting to 250 mg GABA at night only:

Listening to the GABA Quickstart made me realize something about the Source Naturals GABA Calm with the bit of tyrosine. I bought the NOW GABA powder and last night took 250mg (1/8 tsp and I have tiny measuring spoons) and woke up great.

I think I found my dose of GABA and I don’t think after my trial I’m a GABA in the day girl.

Have you used a high dose of GABA to start (or switched to a higher dose like Holly did) and experienced this unpleasant niacin-like flush?

How much caused this tingling sensation for you and how unpleasant was it? Did you push through and continue using the high dose? Or did you figure it out and use less? How long did it take you to figure it out?

Maybe you quit using GABA because of something like this – do you now feel inspired to try again?

If you’ve had success with using GABA please do share too.

If you’re a practitioner where did you learn about using GABA and was the recommendation was to use a high dose like 500 mg or 750 mg to start?

Feel free to ask your questions here too.

Be sure to share which product you used, how much you used and if you have low GABA symptoms.

Filed Under: Anxiety, Diet, GABA Tagged With: anxiety, bizarre, GABA, grain-free, horrible, intrusive thoughts, keto, Ketogenic, LCHF, low carb/high fat diet, microbiome, nutritional psychiatry, OCD, paleo, postpartum, serotonin, tryptophan, zinc

A lifetime of horrible and bizarre intrusive thoughts eliminated by a low carb/high fat diet (not as strict as keto) – a case study and research

February 11, 2022 By Trudy Scott 26 Comments

intrusive thoughts and low carb high fat diet

Intrusive thoughts are a symptom of anxiety, are more common than you’d expect and it’s not just you who experiences them. Today’s case study illustrates the power of diet: a low carb/high fat diet (not as strict as keto) completely eliminated a lifetime of horrible and bizarre intrusive thoughts for one woman. Read examples of her actual intrusive thoughts below and check out the supporting research and other case studies.

Ruthie suffered from intrusive thoughts as a child and most of her adult life, and assumed everyone did too. As a child, she would share some of her bizarre thoughts with other children, and they would stare at her and tell their parents. Her own parents became extremely concerned believing she might do one of these bizarre things. Her husband would sometimes look at her in horror when she asked certain questions. As an adult, she was told she was “unusual in a nice sort of way-haha!” This is how she described some of her intrusive thoughts:

They took the form of either myself or family members doing horrible/bizzare things or I would get in the car to go someplace and imagine one of the other drivers on the road doing something bizarre and my mind would follow it right through to the end result of what the individual caused to happen. I would arrive at my destination not remembering any part of my drive, my mind was so busy.

She goes on to share some of her postpartum experience with intrusive thoughts:

Everyone thought I had postpartum depression with my first child but it was the intrusive thoughts that had put me into a panic regarding her care. It was wonderful when a therapist told me it was the intrusive thought component of OCD and I could put a name to it.

It was the greatest delight of my life, when both children grew bigger and stronger than me so I knew, even though I knew I would never hurt them, they had the chance to defend themselves!

For her, eating high fat/low carb has eliminated her lifetime of intrusive thoughts:

Fast forward to discovering the low carb/high fat (LCHF) eating plan (not as strict as keto) and my intrusive thoughts have been gone for almost 2 years now (unless I become overtired).

It is a simply horrid disorder to have. I am just glad now it is well known but it really upsets me that it is being treated with dangerous psychotropic drugs that can do more harm than good when diet changes could be the solution.

I asked if she had ever used GABA or tryptophan (covered in part 1) or any other nutrients during any of the really bad periods and if any of it had helped. She shared that tryptophan gave her dreams that were too vivid and “by the time I was aware of GABA as a possibility, I had changed my diet and my problems had basically been resolved.”

She also confirmed her LCHF diet is predominantly gluten/grain free except the occasional splurge. I suspect these splurges may contribute to her feeling overtired and factor into her intrusive thoughts showing up again.

These are powerful results and I’m thrilled for her. I also appreciate her willingness to share and for allowing me to include her story.

A low carb/high fat (LCHF) / Ketogenic diet study

Most of the LCHF diet research focuses on weight loss and improvement of metabolic markers for conditions like diabetes. However, there is some promising new research on mental health.

This 2020 paper is one example – Ketogenic Diet: A Dietary Modification as an Anxiolytic Approach?

Diets with low amounts of carbohydrate consumption (low-carb) seem promising both for weight mass optimization among mentally ill patients and for their possible anxiolytic effect.

A diet is characterized as being low-carb high-fat (LCHF) when fat comprises >70% of the daily calorie consumption, with sugars [or carbs] being 5–15%, and the rest of the calorie intake being made up of proteins.

This paper discusses anxiety and the role of serotonin, GABA/glutamate imbalance, hypothalamic-pituitary-adrenal axis and elevated cortisol, inflammation and oxidative stress, the microbiome and leaky gut.

It also covers some ways LCHF diets may reduce anxiety: via impacts on the microbiome (with GABA being produced by good bacteria in the gut), by reducing inflammation and oxidative stress, and by providing omega-3 fatty acids and healthy oils (such as olive oil). The inclusion of real whole foods (i.e. no processed junk foods) with quality protein and zinc-rich foods such as oysters, low glycemic index carbohydrates and leafy greens as a source of magnesium, all contribute too.

The authors do mention canola oil which I do not recommend. And contrary to their mention of egg whites, I recommend the entire egg.

Their conclusion includes these statements:

In our mind, the LCHF diet is a promising, well-accepted diet regimen which has an impact on anxiety disorders…

The evidence mentioned in this paper should encourage psychiatrists to recommend LCHF diets as advice somewhere between psychotherapy and pharmacology, or as an add-on to those two.

And I’ll add this: let’s consider LCHF instead of psychotherapy and pharmacology. As you heard Ruthie share above and as you’ll read below, diet changes alone can have profound effects.

Dietary changes alone can be profound for many folks

I’ve blogged extensively about diet in the past: ketogenic diets, the omnivore or Paleo diet and grain-free diets. Diet provides the foundation of any anxiety nutritional program but many people don’t realize or acknowledge that dietary changes alone can be profound for many folks.

I’ll typically hear something like this: “My anxiety [or depression or intrusive thoughts] are too severe for only diet to make a difference. I’m someone who really does need medication.”

As you’ll see below, diet alone can make a huge difference and is often the only thing that needs to change:

  • Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss

Two schizoaffective patients of Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss. As well as losing weight, they experienced reductions in auditory hallucinations and delusions, had a better mood and had more energy. I review the 2018 study and offer my insights in this blog.

  • An “omnivore” like diet or Paleo diet is associated with reduced anxiety and depression

This type of diet is also referred to as a cave-man type of diet. Even though this 2018 study was only showing associations and not a cause-and-effect, it’s still very encouraging to see new research in the field of nutritional psychiatry, further supporting the results we see in clinical practice.

  • Paleo and grain free diets: anxiety and depression success stories

I share many success stories in this blog. Here is an example from one woman: “Three days after I stopped eating grains, my chronic depression lifted and has never returned (it’s three years later now).”

  • Integrative Medicine Approach to Pediatric Obsessive-Compulsive Disorder and Anxiety

I write about a 2016 study where gluten was found to be the cause of a childhood case of obsessive-compulsive disorder (OCD). Intrusive thoughts are common with OCD and a gluten-free diet (and some other interventions) led to a “marked reduction of OCD symptoms and anxiety along with marked improvement of social behavior and school work.”

This is a small selection of many similar articles on the blog.

Other nutritional and hormonal solutions

This blog is part 2 of my deeper dive into intrusive thoughts and as a follow-on to part 1 where I cover low GABA, low serotonin, low zinc, low vitamin B6 (and pyroluria) and hormone imbalances as root causes for some individuals.

  • Many people “did not realize intrusive thoughts were a ‘thing’ a symptom of something” and thought it’s just something that happens to them
  • A definition of intrusive thoughts from The Anxiety and Depression Association of America and the fact that “Unwanted intrusive thoughts can be very explicit, and many people are ashamed and worried about them, and therefore keep them secret.”
  • The article that inspired these blogs on intrusive thoughts: The Debilitating Anxiety Symptom No One Ever Talks About
  • How to address low GABA, low serotonin, pyroluria (low zinc & vitamin B6) and hormone imbalances as possible causes (and examples from folks with these causes, plus supporting research)

As I mentioned in part 1, my purpose is to share actual examples from real people so you can see how varied these intrusive thoughts can be. And recognize that they are a thing and that you are not alone if you experience them.

And, of course, to create awareness that there are nutritional solutions.

My book as a resource if you are new to nutritional psychiatry

If you are new to nutritional psychiatry, do read this blog: Nutritional medicine in modern psychiatry: position statement by ISNPR.

If you do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading the chapters on diet, sugar and blood sugar control, gluten and grains, and caffeine/alcohol so you have the foundation in place. Who knows, it may be the only changes you need to make to eliminate your intrusive thoughts and other anxiety symptoms!

Be sure to share it with the health team you or your loved one is working with.

If you are new to using the the amino acids GABA or 5-HTP/tryptophan as supplements, I cover this and pyroluria in part 1: Intrusive thoughts are a thing with anxiety: low GABA, low serotonin, pyroluria (low zinc & vitamin B6) and hormone imbalances as possible causes. Be sure to read the many comments and especially Kimberly’s feedback – she combined everything in the above blog and saw wonderful results.

As I mentioned in part 1, let’s talk about intrusive thoughts so we don’t have to feel alone and so we can find solutions. And share your success with nutritional solutions when something works for you. Share it with your friends, your health practitioner, researchers and on this blog.

Did you know intrusive thoughts are a thing, or did you think it was just you? And what kind of intrusive thoughts have you had?

Are you surprised that a LCHF/keto or similar diet could have such a profound impact?

Has a dietary approach alone helped you eliminate your intrusive thoughts or other anxiety symptoms?  Or has diet, in conjunction with amino acids such as GABA and tryptophan helped?

What else has helped eliminate or reduce your unwanted intrusive thoughts?

Feel free to ask your questions here too.

Filed Under: Anxiety, Diet, GABA Tagged With: anxiety, bizarre, GABA, grain-free, horrible, intrusive thoughts, keto, Ketogenic, LCHF, low carb/high fat diet, microbiome, nutritional psychiatry, OCD, paleo, postpartum, serotonin, tryptophan, zinc

The ketogenic diet for mental health, weight loss, inflammation and disease prevention

May 2, 2018 By Trudy Scott 6 Comments

I wasn’t aware until recently that “KETO”, “Ketones” “Keto diet”, “Ketogenic lifestyle”, “Ketosis” and “Ketogenic diet” are some of the MOST SEARCHED terms on the internet today.

But there is a good reason for this and host of  The Keto Edge Summit (which runs from May 7-13, 2018), Dr. David Jockers shares this:

The goal of the ketogenic lifestyle is to adapt the body to utilize FAT as its primary fuel source instead of SUGAR.

For our ancestors, eating three meals a day just wasn’t a thing. Instead, they’d hunt and forage for the foods they could find. When there wasn’t food, they wouldn’t eat.

Sometimes they’d go for days without food. To sustain life during times of scarcity, the body is thought to have developed the ability to utilize fat as an alternative fuel source.

Today, there’s an abundance of food available to most of us at all times. We regularly eat three meals per day with intermittent snacking between them.

This kind of frequent eating, along with an overemphasis on carb-rich and sugary foods, causes a REDUCED ability to burn fat. Because we don’t have to hunt or forage for food; we’ve become “sugar burners.”

As these sugar-laden foods damage our bodies, we rely MORE on sugar and lose the ability to produce ketones – as a result, massive blood sugar spikes, inflammation, hormone imbalance and ultimately many of the chronic diseases that plague us today.

In a traditional nutrition course, you’d learn that sugar is the body’s PRIMARY fuel source, while fat is secondary. What we’ve learned now (and so much research is supporting this) fat can be a healthier and more sustainable source of energy.

Ketones help you burn fat for energy, powerfully reduce inflammation and show promise in preventing and eradicating diabetes, cancer, autoimmune and neurodegenerative diseases like Alzheimer’s and Parkinson’s, and they can even play a role in alleviating symptoms in mental health conditions like anxiety, depression and schizoaffective disorder.

One of the amazing speakers on the summit is Dominic D’Agostino, researcher and Associate Professor at the University of South Florida. I attended the Bioceuticals conference in Melbourne this past weekend and had the pleasure of hearing him present on this topic live and all I can say is wow! I don’t want you to miss out and now you don’t have to when you tune in via the Keto Edge Summit.

Here is one of the slides where he shares the many proven and emerging applications of nutritional ketosis:

The applications of nutritional ketosis are extensive – including epilepsy, type 2 diabetes, weight loss, NAFLD, mitochondrial disease and inflammation, with emerging evidence for acne, PCOS, wound healing, cancer, autism, ALS, MS, Alzheimer’s, the brain and anxiety.

(anxiety and depression fall under brain on the right and also under inflammatory disorders on the left)

I shared these case studies a few weeks ago in a blog post – Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss. Two schizoaffective patients working with Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss:

  • After four weeks on the ketogenic diet, the female patient had resolution of her delusions and lost ten pounds.
  • The male patient experienced similar results with “dramatic” reductions in auditory hallucinations and delusions, as well as better mood and energy. He also lost weight, losing 104 pounds over the course of a year.

There is also research reporting the following results:

  • Therapeutic use of carbohydrate-restricted diets in an autistic child; a case report of clinical and 18FDG PET findings

the patient’s behavior and intellect improved in regard to hyperactivity, attention span, abnormal reactions to visual and auditory stimuli, usage of objects, adaptability to changes, communication skills, fear, anxiety, and emotional reactions

  • Exogenous Ketone Supplements Reduce Anxiety-Related Behavior in Sprague-Dawley and Wistar Albino Glaxo/Rijswijk Rats

ketone supplementation may represent a promising anxiolytic strategy through a novel means of inducing nutritional ketosis.

As Dr. Jockers states:

The GREATEST health discovery of this century may ALREADY be inside your body!

During this health summit, you’ll discover:

  • What is ketosis (and how does it work)?
  • Myths, and how to separate fact from fiction!
  • How to overcome the challenges of being “keto adapted.”
  • Whether you should start a keto diet (or not!).
  • How to shop, live and eat on a ketogenic lifestyle.

The Keto Edge Summit is online and available at no-cost from May 7-13, 2018! Register here

I will be in learning mode with you for the Keto Edge Summit. I’ve been following Dr. David Jockers for awhile and I’m very excited about the applications of a ketogenic diet for anxiety and depression, given what we’ve learned so far. It’s going to be a great educational opportunity for all of us.

Have you experienced benefits from a ketogenic diet? If yes please do share what benefits?

If you’ve had challenges being on a ketogenic diet please share those challenges too, so we can all learn.

Filed Under: Diet, Events, Ketogenic diet Tagged With: anxiety, brain, Dominic D'Agostino, Dr. David Jockers, Inflammation, keto, Ketogenic, Ketogenic diet, ketosis, The Keto Edge Summit, weight-loss

Ketogenic diet: reductions in auditory hallucinations and delusions, better mood and energy, and weight loss

April 6, 2018 By Trudy Scott 5 Comments

Two schizoaffective patients of Dr. Chris Palmer, a psychiatrist from Harvard’s McLean Hospital in Belmont, Massachusetts, tried a ketogenic diet for weight loss. As well as losing weight, they experienced reductions in auditory hallucinations and delusions, had a better mood and had more energy.

Here is additional information about these remarkable results, published late last year in this letter to the editor – Ketogenic diet in the treatment of schizoaffective disorder: Two case studies.

The male patient: lost weight, reductions in auditory hallucinations and delusions, better mood and energy

The male patient, diagnosed with schizoaffective disorder, with a prior psychiatric history of attention deficit hyperactivity disorder and major depression, experienced “dramatic” reductions in auditory hallucinations and delusions, as well as better mood and energy on the ketogenic diet. He also lost weight, losing 104 pounds over the course of a year.

He weighed 322 lb and wanted to lose weight by following a ketogenic diet, typically consisting of coffee with medium chain triglyceride (MCT) oil and butter (“bulletproof coffee”), eggs, meat, fish, poultry, spinach, kale, and olive oil. Within 3 weeks, he had lost 15 lb, but also noted a dramatic reduction in his auditory hallucinations and delusions, and improvement in his mood, energy, and ability to concentrate. For the past year, he has largely remained on this ketogenic diet and has lost 104 lb.

His functioning has improved and he has become more independent:

He completed a certification course, successfully participates in an online college program, has friends, began dating, and moved from his father’s home into an independent apartment.

The female patient: lost weight, resolution of her delusions

After four weeks on the ketogenic diet, the female patient, also diagnosed with schizoaffective disorder, and with a prior psychiatric history of major depression and anorexia nervosa, had resolution of her delusions and lost ten pounds:

she wanted to lose weight, and went on a ketogenic diet, consisting mostly of coffee, eggs, poultry, and lettuce. Within 4 weeks, she lost 10 lb and noted that her delusions were no longer present, and that her mood and energy were much better. After 4 months, she lost a total of 30 lb and her PANSS score decreased to 70 [down from 107]

In both instances their symptoms returned when they stopped the diet, but then improved again when back on the ketogenic diet.

In case you’re not familiar with the ketogenic diet here is a quick summary:

The ketogenic diet is a high-fat / low carbohydrate [and low protein] diet that has been used since the 1920’s to treat childhood epilepsy, with some studies suggesting that over 50% of patients experience significant reductions in seizure frequency. The ketogenic diet results in ketone bodies, instead of glucose, being used as the primary energy source in the brain.

There simply is no psychiatric medication available with the power to accomplish these results

I had the pleasure of meeting Dr. Georgia Ede, MD  last year at the ISNPR conference. She is a Harvard-trained psychiatrist and nutrition consultant practicing at Smith College, and writes about these two schizoaffective cases in her article – Low-Carbohydrate Diet Superior to Antipsychotic Medications:

These outcomes are truly remarkable: improvement by dozens of points on the PANSS, significant weight loss, and better quality of life. There simply is no psychiatric medication available with the power to accomplish these results.

I agree with Dr. Ede especially when we look at the medications these patients had trialed. These medication trials for the male patient: methylphenidate, amphetamine salts, dextroamphetamine, bupropion, sertraline, paroxetine, buspirone, lamotrigine, lorazepam, clonazepam, gabapentin, haloperidol, perphenazine, aripiprazole, olanzapine, quetiapine, and clozapine. The female patient had a similarly long list of medication trials and she also received 23 electroconvulsive therapy treatments. For both of them, positive and negative symptoms persisted.

I do still have questions about the ketogenic diet

The research in epilepsy is extensive and the research in mental health is growing. I am really impressed with the results, but I do still have questions about the ketogenic diet. Perhaps you have some similar questions and concerns. Here goes…

  1. If this particular nutritional psychiatry approach works so well for severe mental health disorders such as schizophrenia and psychosis, how will it work for less severe conditions like anxiety and panic attacks? Are these severe cases like the “canaries in the coal-mine” paving the way and teaching us about the benefits of this way of eating?
  2. Should you use a ketogenic dietary approach as the first approach or consider it as a last resort once the other dietary approaches have been implemented and you’re not seeing full symptom resolution? In other words, should you start with a real whole foods diet, then implement a gluten-free diet, then a grain-free diet, then remove dairy (if it’s an issue), then incorporate low FODMAPs if needed and only then implement a ketogenic diet? (low oxalate, low salicylate and low histamine would be incorporated as needed earlier in the process, based on each person’s unique needs).  If we look only at schizoaffective disorder,  there is growing evidence of the role of gluten  in some individuals with this paper “suggesting that an antigliadin IgG positive population of schizophrenia could be a distinct subgroup.” This 2 person pilot study reports the benefits of a gluten-free diet: “this potential mechanism is exciting and may provide improvement for up to one-fourth of patients (antibody-positive) who suffer from this devastating disorder.”
  3. How do we clearly define a ketogenic diet and communicate this definition to practitioners and to those who choose to implement this way of eating on their own? I’ve had feedback from many people who tell me they have been on a ketogenic diet (and it’s worked well for them or maybe it hasn’t worked so well for them), only to discover they are not really eating a true ketogenic diet. How do we simplify this way of eating and make it easy for individuals to understand and then stay in ketosis?
  4. How do we create a ketogenic diet that is nutrient dense and also offers the benefits seen in this research. I have major concerns about long-term nutritional deficiencies with a diet of coffee, eggs, poultry, and lettuce (as eaten by the female patient in this case study). It should ideally include plenty of leafy greens, non-starchy vegetables like broccoli, cauliflower, asparagus etc. and healthy fats like avocado, grass-fed butter and coconut oil, together with fermented vegetables and bone broths. I’m also not convinced that coffee should be part of the ketogenic diet, especially if coffee increases your anxiety and affects your sleep.

  1. How do we help individuals make the switch to this way of low carb eating and help them maintain so they don’t feel deprived and are not relying on willpower alone? As you can see from these 2 cases, the diet can be challenging to sustain and slip ups are common. If you are eating enough health fats (and it’s a lot more than you’re used to eating), this typically helps with cravings. If you still have cravings and feel you are deprived and missing out on treats, the targeted individual amino acids offer powerful results: tryptophan (for afternoon cravings), GABA (for stress eating), DPA (for comfort eating), tyrosine (when there is low motivation) and glutamine (for low blood sugar cravings).
  2. Is the ketogenic diet the next big fad or weight-loss trend as we’re hearing in the media? Based on the above research it truly does have impressive therapeutic benefits beyond only weight-loss. So can we see similar benefits with a modified ketogenic diet, using intermittent fasting and/or cycling in and out of ketosis, and even adding in a ‘feasting day’ of carbs?
  3. Who shouldn’t adopt a ketogenic diet? For example: those with the APOE4 gene, women with adrenal and hormone issues, and individuals with thyroid issues and no gallbladder? The question then becomes this: of those suffering with anxiety and depression or another mental health disorder, who doesn’t have one of these issues? And how do we address the keto rash, constipation, fat malabsorption, fatigue, mineral deficiencies and other issues some people experience on a ketogenic diet?

Right now, this is my thinking: as with any nutritional or functional medicine approach, I would say there is no one-size-fits all for who should implement a ketogenic diet (we need to consider the unique biochemistry of each person) and there is no one set ketogenic diet (it will need to be customized for each person).

Please do share if you’ve adopted a ketogenic diet and the benefits you have experienced, and if you experienced any issues. Be sure to share what a typical day’s diet looks like for you.

Filed Under: Anxiety, Diet, Sugar addiction Tagged With: anxiety, coffee, delusions, depression, diet, Dr. Chris Palmer, energy, hallucinations, Ketogenic, mood, schizoaffective, weight-loss

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