High Cholesterol on Keto? Here’s One Psychiatrist’s Approach

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 accounts from individuals whose lives improved with ketogenic therapy, even as their LDL levels rose dramatically. It also follows how they worked with their care teams to better understand their cardiovascular risk and what that approach could mean in your own situation.

🎬 The Cholesterol Code is now streaming on Amazon: https://www.amazon.com/gp/video/detail/B0GS8ZFCYN/

#MetabolicMind #KetogenicTherapy #FoodAsMedicine

Expert Featured:

Lori Calabrese

• https://www.loricalabresemd.com/
• https://www.metabolicmind.org/team/lori-calabrese-md/
• https://www.linkedin.com/in/loricalabresemd

Free CME Clinician Trainings:

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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.