Uploaded August 2026 | Updated September 2026, 4 hours ago
The questions around ketogenic therapy keep getting more layered, and your latest submissions reflect that. In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard tackle some of the most common questions about insulin resistance, ketosis, bone health, and a fun rapid-fire round on popular ketogenic products and practices.
In this discussion, you'll learn:
- The difference between pathologic and physiologic insulin resistance and why insulin levels matter most
- Why someone in deep ketosis may fail a glucose tolerance test and how to interpret it
- How metabolic health affects how strict your ketogenic approach needs to be
- Why some people can stay in ketosis at 75 grams of carbs while others need under 25
- Why claims about ketogenic diets causing bone loss don't hold up under scrutiny
- The role of protein intake, resistance training, and walking in supporting bone density
- A rapid-fire round covering MCT oil, electrolytes, caffeine, diet sodas, keto bread, creatine, exogenous ketones, intermittent fasting, and artificial sweeteners
This conversation captures the nuance that ketogenic therapy and metabolic health really call for, while keeping the practical realities of everyday life in view.
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#KetogenicTherapy #MetabolicMind #MetabolicPsychiatry
*Expert Featured:*
Dr. Bret Scher
- Baszucki Group Medical Director
- https://x.com/bschermd
*Resources Mentioned*
- youtube.com/watch?v=3m6Fm0nXaMQ&t=2s
*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:
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 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.
*Timestamps:*
0:00 - Intro & How to Submit Questions to Metabolic Mailbag
1:36 - Deep Ketosis & Insulin Resistance: Is It Something to Worry About?
2:35 - Physiologic vs. Pathologic Insulin Resistance Explained
4:25 - Low Insulin Levels: The Key Distinction for Metabolic Health
7:05 - Trouble Reaching Ketosis & Individual Carb Tolerance
10:49 - Ketogenic Diet & Bone Density: Acid-Base Myth Debunked
13:39 - Lightning Round Begins: MCT Oil & Electrolyte Powder Ratings
14:57 - Coffee, Caffeine, Coke Zero & Keto Bread Brands
17:45 - Creatine for Muscle & Mental Health, Plus Exogenous Ketones
18:10 - Quest Bars in a Pinch & Intermittent Fasting Nuance
19:58 - Artificial Sweeteners, Monk Fruit, Allulose & Final Thoughts
The questions around ketogenic therapy keep getting more layered, and your latest submissions reflect that. In this Metabolic Mailbag episode, Dr. Bret Scher and producer Erica Gerard tackle some of the most common questions about insulin resistance, ketosis, bone health, and a fun rapid-fire round on popular ketogenic products and practices.
In this discussion, you'll learn:
- The difference between pathologic and physiologic insulin resistance and why insulin levels matter most
- Why someone in deep ketosis may fail a glucose tolerance test and how to interpret it
- How metabolic health affects how strict your ketogenic approach needs to be
- Why some people can stay in ketosis at 75 grams of carbs while others need under 25
- Why claims about ketogenic diets causing bone loss don't hold up under scrutiny
- The role of protein intake, resistance training, and walking in supporting bone density
- A rapid-fire round covering MCT oil, electrolytes, caffeine, diet sodas, keto bread, creatine, exogenous ketones, intermittent fasting, and artificial sweeteners
This conversation captures the nuance that ketogenic therapy and metabolic health really call for, while keeping the practical realities of everyday life in view.
🔎 Have questions about how to apply metabolic therapies effectively? Submit them at metabolicmind.org/questions to be featured in a future Metabolic Mailbag episode.
#KetogenicTherapy #MetabolicMind #MetabolicPsychiatry
*Expert Featured:*
Dr. Bret Scher
- Baszucki Group Medical Director
- https://x.com/bschermd
*Resources Mentioned*
- youtube.com/watch?v=3m6Fm0nXaMQ&t=2s
*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:
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 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.
*Timestamps:*
0:00 - Intro & How to Submit Questions to Metabolic Mailbag
1:36 - Deep Ketosis & Insulin Resistance: Is It Something to Worry About?
2:35 - Physiologic vs. Pathologic Insulin Resistance Explained
4:25 - Low Insulin Levels: The Key Distinction for Metabolic Health
7:05 - Trouble Reaching Ketosis & Individual Carb Tolerance
10:49 - Ketogenic Diet & Bone Density: Acid-Base Myth Debunked
13:39 - Lightning Round Begins: MCT Oil & Electrolyte Powder Ratings
14:57 - Coffee, Caffeine, Coke Zero & Keto Bread Brands
17:45 - Creatine for Muscle & Mental Health, Plus Exogenous Ketones
18:10 - Quest Bars in a Pinch & Intermittent Fasting Nuance
19:58 - Artificial Sweeteners, Monk Fruit, Allulose & Final Thoughts
