About this episode

Dr. Bret Scher and psychiatrist Dr. Lori Calabrese discuss the complexities of ketogenic therapy in mental health treatment, focusing on a case of a young woman with schizophrenia and rising LDL cholesterol levels.

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…

People in this episode

Host: Bret Scher

Guest: Lori Calabrese

Topics covered

• ketogenic therapy
• mental health
• cholesterol
• psychiatry
• metabolic treatment

Keywords

• ketogenic diet
• cholesterol
• mental illness
• psychiatry
• metabolic health

Mentioned in this episode

Organizations: Metabolic Mind, cardiology

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• My LDL Went Up On Keto. Should I Stop? Cardiologist Explains · April 17, 2026 · 17 min
• DGA vs AHA: Why Nutrition Guidelines Disagree · April 15, 2026 · 11 min
• Metabolic Psychiatry in Practice: Ketogenic Therapy for Mental Health Care · April 13, 2026 · 28 min

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