Q&A: Does Keto Harm Thyroid Function? Bone Health, Ketones & More

Can a ketogenic diet affect your thyroid? What about bone health, uric acid, cannabis use, or ketone supplements?

In this Metabolic Mailbag episode, Dr. Bret Scher and Dr. Georgia Ede answer your most pressing questions about ketogenic therapy and how it interacts with real-world health concerns.

From thyroid function to mental health, this conversation highlights how nuanced and individualized metabolic therapies can be.

You’ll learn:

• How ketogenic diets influence thyroid hormones, and why lower T3 doesn’t necessarily mean hypothyroidism
• When to monitor thyroid function more closely, especially with pre-existing conditions or medications like lithium
• What the evidence says about protein intake, uric acid, and bone health
• Why temporary changes during the adaptation phase (like uric acid fluctuations) may not reflect long-term outcomes
• How cannabis use may affect appetite, cravings, and adherence to a ketogenic diet
• Whether exogenous ketones and MCT oil provide the same benefits as nutritional ketosis

Dr. Ede also shares a key principle: context matters. Lab values, symptoms, and individual biology all need to be considered together, especially when using ketogenic therapy for mental health or metabolic conditions.

The key takeaway: ketogenic therapy is not one-size-fits-all. It’s a dynamic, personalized approach that often requires thoughtful monitoring, adjustments, and collaboration with a knowledgeable clinician.

🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.

Expert Featured:

Dr. Bret Scher

• https://x.com/bschermd?ref_src=twsrc^google|twcamp^serp|twgr^author
• https://www.linkedin.com/in/bret-scher-08baaa102/

Dr. Georgia Ede

• https://www.diagnosisdiet.com/
• https://www.linkedin.com/in/georgiaedemd
• https://www.facebook.com/GeorgiaEdeMd/
• https://www.instagram.com/georgiaedemd/?hl=en

Experts Mentioned:

Dr. Jeff Volek

• Website: https://lowcarb.osu.edu/
• https://www.linkedin.com/in/jeff-volek-b3944092

Dr. Stephan D. Phinney

• https://www.linkedin.com/in/stephen-phinney-631467/

Dr. Dom D’Agastino

• https://secure.instagram.com/dominic.dagostino.kt/

Resources Mentioned:

• National Osteoporosis Foundation study on protein and skeletal health - https://pubmed.ncbi.nlm.nih.gov/28404575/

Free CME Clinician Trainings:

Are you a clinician who would like to learn more about the science behind these therapies and how to implement them in practice? Earn CME with our growing library of courses from some of the top experts in the field including Dr. Chris Palmer, Dr. Georgia Ede, Dr. Matthew Bernstein, Dr. Mariela Glandt, Dr. Deanna Kelly, Dr. Julie Milder, Dr. Zoltan Sarnyai, and Dr. Bret Scher with more coming soon.

Our courses have been made FREE by grants from Baszucki Group, so we can spread these powerful therapies as widely as possible. Earn CME/CNE credits: https://www.metabolicmind.org/for-clinicians/trainings-courses/?utm_medium=organic-social&utm_source=youtube&utm_campaign=cme-yt

Follow our channel for more information and education from Bret Scher, MD, FACC, including interviews with leading experts in Metabolic Psychiatry.

Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/

About us:

Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them.

Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.