Could Ketones Help Mental Health?

When it comes to metabolism, the brain is a heavy weight. The brain makes up only about 2% of human body mass, yet consumes a whopping 20% of its oxygen and energy [1]. Given this, it’s no surprise that when the brain can’t get energy to meet its high demands, it starts to suffer. We’ve spoken about this phenomenon in the past in the context of Alzheimer’s disease. Now, let’s look at some new evidence suggesting the same applies in mood and anxiety disorders. 

Unfortunately, these mental health issues are becoming remarkably common, particularly in younger people [2]. There are myriad medications that are prescribed to treat anxiety and depression, but while they have very limited and mixed benefits, they often have meaningful negative metabolic effects, including substantial weight gain [3]. Not surprisingly, the weight gain can make a person feel even worse about life. For all of these reasons and more, we should be open minded to natural (side effect free!) interventions that improve mood disorders. In a newly-published report, scientists identify an oft-overlooked role for a ketogenic diet – treating depression and anxiety [4]. 

By scouring the published literature, this manuscript highlights the cumulative effects, and the authors concluded that “…studies suggest possible beneficial effects.” Among several possible mechanisms, this could be due to a molecule called gamma amino-butyric acid (GABA). GABA is very often low in people with mood disorders, and interventions that increase GABA (such as benzodiazepines) are go-to medications to improve symptoms. However, as usual with drugs, sometimes it just doesn’t help. This could be where ketones come in – ketones increase GABA levels [5], all without the side effects so common to drugs.

Additionally, ketones could simply make up for a fuel problem. In mood disorders, as with Alzheimer’s disease, the brain is less able to access glucose as a fuel [6]. In this case of mild starvation, the brain suffers, potentially manifesting as depression and anxiety. This certainly increases the reliance (even necessity) to provide the brain access to its other fuel–ketones. Unlike glucose, whose access to the brain is partly regulated by insulin, ketones have unfettered entrance into the brain; if there are ketones in the blood, the brain greedily pulls them in for energy. 

Of course, depression and anxiety are serious and should be discussed carefully. However, because the main outcome of a diet that restricts processed carbohydrates and increases proteins and fats is simply weight loss, if that same diet improves anxiety and depression, it should be presented and discussed as a very real therapeutic option for people struggling with mood disorders. 

So, as a metabolically-minded Marie Antoinette might have said: Let the brain eat ketones!

References

1. https://pubmed.ncbi.nlm.nih.gov/12149485/
2. https://www.nature.com/articles/s41398-023-02315-7
3. https://pubmed.ncbi.nlm.nih.gov/10926053/
4. https://pubmed.ncbi.nlm.nih.gov/37066662/
5. https://www.sciencedirect.com/science/article/pii/S0278584621000166
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125423/