Turn Setbacks into Comebacks: Troubleshooting on Keto for Mental Health

The ketogenic diet is emerging as a powerful, root-cause-focused therapy for mental health. Backed by research and lived experience, it supports brain chemistry balance by addressing systemic inflammation, oxidative stress, and metabolic function—foundational drivers of many psychiatric symptoms.(1)

By maintaining consistently low insulin levels and staying in ketosis, the body enters a healing mode that reduces inflammation, lowers oxidative stress, and may facilitate deep cellular repair, though its intensity varies based on factors like age, activity level, metabolic flexibility, overall health status and more.(2) However, achieving this often requires long-term commitment.

That said, being in ketosis long term doesn’t have to feel “hard” or “restrictive”—not when compared to the benefits many report: improved and more stable mood, deeper sleep, consistent energy throughout the day, enhanced cognitive function and more.

One of the keys to long-term success is learning how to troubleshoot. Especially in the early stages of keto adaptation, and until someone becomes more attuned to how their body responds to different factors influencing insulin and ketone levels, a more structured and consistent dietary approach is often necessary. But knowing what to do to get back into ketosis as soon as possible, whether in the early adaptation phase or later on, is critical for long term success.

TOP 3 STRATEGIES

1. Fasting + Exercise + Higher Fat Ratio Regimen (MCT oil based) is by far the best strategic combination to get back to ketosis as soon as possible.
2. Fasting is one of the quickest ways to reduce blood glucose and insulin levels enough to trigger fat-burning mode. A 24- to 36-hour fast should support burning off stored glycogen in the liver and trigger production of ketones. If you have not done prolonged fasting, building up slowly to 24 hours can be safe and effective.
3. Exercise can be extremely beneficial by helping to burn off excess glucose in the blood or stored in the muscles and liver as glycogen.

Once those two strategies have been implemented, you can resume your ketogenic diet, preferably at a 2:1 or higher ratio of fat: protein + carbohydrates for a few days or as long as needed. To achieve an additional ketosis boost, MCT oil can represent up to 50% of total fat intake, if needed.

Additional Strategies to Consider

Macro Mistakes to Watch For:

🧁Too Many Carbs?

• Switch to tracking total carbs instead of net carbs, and aim for 20–30 g/day
• Read labels carefully (especially sauces and condiments)
• Cook at home when possible to avoid hidden sugars

🍗 Excessive Protein?

• Stay in the range of 0.5–0.7 g per pound (1.1-1.5 g per kilo) of ideal body weight
• Avoid very lean meats and processed protein powders

🧈 Too Much Fat?

• Track intake: excess fat, especially with carbs, can spike insulin
• Calories still matter—too much can halt ketosis

Additional Troubleshooting Tips

• Consider a ketogenic version of the 30-day carnivore elimination diet—focusing exclusively on meat, seafood, and healthy animal fats for a clean, deeply anti-inflammatory reset
• Eliminate caffeine and alcohol for a reset
• Reduce or cut dairy (goat/sheep may be better tolerated)
• Remove all sweeteners
• Review medications for those that affect blood sugar/ketones
• Address inflammation: illness, injury, and high stress can raise glucose levels
• Prioritize sleep and hydration—both are critical for ketone production

A question I frequently ask my clients—and one I continually revisit myself—is: “How good do you want to feel?”
And the answer, more often than not, is “As good as possible… as long as it feels sustainable and not overwhelming.” With the right tools, mindset, and support, that vision is absolutely achievable, even in the face of serious mental health challenges.

Healing is rarely linear, especially when it comes to mental health. But when you approach your body as a complex, integrated system that has the innate wisdom and ability to heal itself, when given the right conditions, real transformation is possible!

REFERENCES

1. The Relationship of Ketogenic Diet with Neurodegenerative and Psychiatric Diseases: A Scoping Review from Basic Research to Clinical Practice, Nutrients, 2023

2. Metabolic Insights into Neuropsychiatric Illnesses and Ketogenic Therapies: A Transcriptomic View, International Journal of Molecular Sciences, 2024

This blog is provided for informational purposes only and should not be considered a replacement for professional medical advice, diagnosis, or treatment. If you have any questions about a health condition or concerns related to your well-being, always consult with your physician or another qualified healthcare professional.