Ketone bodies are three different biochemicals that are produced as by-products when fatty acids broken down for energy.Two of the three are used as a source of energy for the brain. Neurotransmitters (such as serotonin and dopamine) work by changing these membrane potentials in various ways. Neurotransmitters can open ion channels, allowing sodium to enter the cell and causing a wave of electrical impulse that travels along the neuron. This is the problem in bipolar patients, especially with the neurotransmitters of seratonin and dopamine. The synapse region does not allow a message from one neuron to pass to another neuron correctly, making one react to a situation in an inappropriate manner, sometimes with little inhibition.
When a person is in a ketogenic state, the electrical impulses that pass from one neuron to another are opened up by the mediation of sodium. It allows extracellular calcium to pour into the cell, which leads to the release of the neurotransmitters of seratonin and dopamine into the synapse region. Then, it can be released to the next neuron to generate an appropriate response, like excitement or inhibition, depending on the situation.
The Ketongenic Diet and Macronutrients
The three macronutrients are protein, fat, and carbohydrates. Ketogenic diets restrict your carbohydrate intake to 20 grams or less per day. Each carbohydrate gram has four calories, each protein gram has four calories, and each fat gram has nine calories. This results in the vast majority of your caloric intake coming from proteins and fat. Ketone bodies are made from fat, which is used by your brain for fuel instead of glucose from carbohydrates. The ketone bodies, acetoacetate and beta-hydroxybutyrate, are acidic. The protons can be pumped into neurons in exchange for sodium, acting somewhat like lithium, which is a common drug prescribe for bipolar patients. The extra protons outside the cell help do things such as reduce the excitability of the neurons and reduce the activity of the excitatory of the serotonin and dopamine neurotransmitters.
Limitations of the Ketogenic Diet for Bipolar Patients
On the internet, you can find several blog posts and articles by people who have use ketogenic diet plans to improve their bipolar symptoms. Unfortunately, there are no scientific studies that fully support the findings of using a ketogenic diet for treating bipolar patients.
A ketogenic diet similar to one used for epilepsy was found to have stabilizing and antidepressant effects, much like you would find in bipolar patients. And Standford Medical School attempted a study using a ketogenic diet protocol on bipolar patients. Unfortunately, due to the inability to attract subjects, the trial was never started. But, this proves that they felt a study was warranted.
Another limitation is the restriction of carbohydrates in the diet. If one is limited to 20 or fewer grams of carbohydrates per day, then they must choose vegetables low glycemic index scale. The glycemic index is a numerical scale used to calculate how fast particular food raises blood sugar. So, foods low on the GI must be incorporated like broccoli, spinach, and iceberg lettuce, which only contain one or two carbohydrates per cup. And all complex carbohydrates must be avoided like grains, pastas, and breads. Just one slice of bread can have more than 20 grams of carbs. This can make staying on the diet a difficult task given the restrictive amount of carbohydrates allowed, which does limit food choices.
While scientific evidence has lagged in showing empirical findings that a ketonic diet works well for bipolar patients, there has been enough evidence that it is gaining attention, like at the Standford Medical School. And scientific evidence does show that it does similar things to the neurotransmitters in the brain, like lithium does, which is a common bipolar patient medication. While further research is certainly warranted, several bipolar patients have already begun prescribing to this diet and proclaiming that it does help with their symptoms. So, if you are a bipolar patient, utilizing a ketogenic diet might be worth trying to see if it helps alleviate the symptoms of your disorder.