Episode
High Cholesterol on Keto? Here’s One Psychiatrist’s Approach
- Podcast
- Metabolic Mind
- Published
- Apr 20, 2026
- Duration seconds
- 1556
- Processing state
not_requested- Canonical source
- https://metabolicmind.org/
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Summary
We’re seeing increasingly compelling results from ketogenic therapy in serious mental illness, including schizophrenia, bipolar disorder, and major depression. But what happens when a potential concern emerges along the way? In this conversation, Dr. Bret Scher sits down with psychiatrist Dr. Lori Calabrese to walk through a real patient case that highlights both the promise and the complexity of metabolic treatment. A young woman with longstanding schizophrenia experienced dramatic improvements in her mental health, metabolic markers, and quality of life after starting a ketogenic intervention. But alongside these gains, her LDL cholesterol rose significantly, raising important clinical questions. Rather than defaulting to extremes, either stopping the therapy or ignoring the lab values, Dr. Calabrese takes a thoughtful, patient-centered approach: Investigating deeper cardiovascular risk markers Exploring potential underlying causes, including familial hypercholesterolemia Collaborating across specialties, including cardiology Prioritizing both psychiatric recovery and long-term health This case illustrates a critical principle in metabolic psychiatry: context matters. Lab values don’t exist in isolation, and neither do patients. It also highlights a broader shift in medicine where clinicians are increasingly called to step beyond traditional silos and consider the full metabolic picture when treating brain-based conditions. At Metabolic Mind, we believe these nuanced conversations are essential. The goal isn’t to ignore risk or to abandon effective therapies, but to better understand both so individuals can make informed decisions alongside their care teams. You can learn more about this conversation in the documentary The Cholesterol Code . The film shares firsthand…