What if a dietary intervention could transform the way we manage Post-Traumatic Stress Disorder (PTSD)? A new feasibility study led by Maria Edwards takes a bold step toward answering that question(*). Inspired by her personal journey of putting bipolar 2 disorder into remission using metabolic therapies, Edwards has turned her lived experience into a catalyst for scientific exploration.

While this study was designed to explore feasibility—not efficacy—it has sparked an important conversation: What if the metabolic nature of PTSD offers a new pathway for healing?

For individuals living with PTSD, the shortcomings of conventional psychiatric care are impossible to ignore. By exploring the metabolic roots of PTSD and the science behind ketogenic therapies, we can begin to understand why these innovative approaches may hold promise—and why finding better solutions is a moral imperative.

The Desperate Need for Better PTSD Treatments

Post-Traumatic Stress Disorder (PTSD) affects approximately 10 million people in the United States annually, with nearly 6% of adults experiencing it at some point in their life.

Among veterans, the prevalence is even higher. Data presented by the U.S. Department of Veteran Affairs found that over 10% of veterans receiving VA care were diagnosed with PTSD (*). This figure does not account for the many undiagnosed cases.

Unfortunately, the current treatment options for PTSD often fall short—they can be ineffective, difficult to access, and have low adherence rates. These challenges are particularly evident among veterans. Over the past 20 years, more than 6,000 veteran suicides have occurred annually, with the steepest rise among those aged 18–34(*). These alarming statistics highlight a critical failure in the current care systems, leaving too many without the help they desperately need.

The prevailing treatment model of screening, diagnosing, and prescribing medications has led to an epidemic of psychotropic drug dependence. For many veterans, the cycle of overmedication does more harm than good, exacerbating withdrawal symptoms and leaving underlying issues unaddressed.

The shortcomings of treatment have led to tragic stories like those of Julia Larsen and Andrew Iles. Larsen, a former Navy firefighter, endured PTSD, psychosis, and military sexual trauma, only to be denied immediate care at her local VA clinic. Left without adequate support, she suffered a night of terror that led to the unthinkable—a tragedy that claimed the life of her mother.

Iles, a former Air Force technician, experienced fragmented care riddled with frequent changes in providers and an over-reliance on telehealth. In the grip of a paranoid delusion, he, too, faced a horrifying outcome, fatally harming his mother in a moment of crisis. Both cases reveal glaring gaps in access to care.

These harsh realities call for a new paradigm in PTSD care—one that prioritizes healing over symptom management, addresses the underlying mechanisms of the disorder, and provides veterans with the respect and support they deserve.

PTSD as a Metabolic Disorder

PTSD is often regarded primarily as a psychological response to trauma but emerging research is revealing that PTSD and its symptoms are closely linked to metabolic dysfunction.

One of the key metabolic dysfunctions in PTSD is impaired glucose metabolism in the brain, which itself can alter cognitive function but can also contribute to other hallmark dysfunctions of PTSD. These dysfunctions do not appear to be merely byproducts of the disorder but rather critical contributors to its persistence and severity.

Let’s explore how these metabolic disruptions manifest in PTSD:

• Glucose Hypometabolism: Research shows that PTSD can impair energy metabolism in brain areas like the hippocampus, a region critical to memory processing (*). Dysfunctional glucose metabolism causes an energy deficit in the brain that can impair cognitive function and contribute to downstream effects like neurotransmitter imbalance, oxidative stress, and inflammation

• Neurotransmitter Imbalances: PTSD often features increased dopamine and norepinephrine levels, contributing to hyper-vigilance and anxiety, alongside reduced serotonin and GABA, which can impair stress regulation and increase aggression, impulsivity, depression, and suicidality. Research has also shown that dysfunction in the serotonin system can blunt the effects of certain psychotropic medications and increase reactivity to others (**).

• Oxidative Stress & Inflammation: Research has shown that PTSD can lead to elevated systemic levels of oxidative stress and inflammation, which can damage cells, accelerate brain aging, and disrupt communication between brain regions, further impairing the regulation of stress and emotion (*).

Understanding PTSD through this metabolic lens opens the door to innovative treatment approaches, including ketogenic therapies, that target the brain's energy systems directly.

Ketogenic Therapy & PTSD

A therapeutic ketogenic diet has demonstrated the potential to address key metabolic dysfunctions observed in PTSD. By providing ketones as an alternative fuel source, a ketogenic diet may bypass impaired glucose metabolism to provide sufficient energy to the brain. 

Ketogenic diets have also been shown to help balance neurotransmitter levels, reduce oxidative stress, and mitigate inflammation—critical factors in the neurobiology of PTSD. Research has also demonstrated that gut health may be an important factor in PTSD, another area where a therapeutic ketogenic diet could provide benefits.

Despite these promising mechanisms, no randomized controlled trials (RCTs) have yet investigated the efficacy of ketogenic therapies for PTSD. However, a recent feasibility study led by Maria Edwards and her team marks an important early step in exploring this novel approach (*).

The study included three patients: two who completed four weeks of the ketogenic diet and one who participated for two weeks. For the two patients who completed the full intervention, ketosis was achieved quickly and maintained throughout the study. Importantly, both patients showed improvements in their PTSD Checklist for DSM-5 (PCL-5) scores—a clinical measure of PTSD severity—as well as enhancements in quality-of-life metrics.

However, the study also highlighted potential barriers. Although there were no serious adverse reactions, participants reported some kind of adverse reaction on 70% of intervention days, with headaches and fatigue being the most common. While this does present potential issues with adherence and quality of life on the diet, it’s important to note that these are common side effects for new keto dieters that can often be combatted. If not properly managed through nutrition, low-carb diets can lead to dehydration and electrolyte deficiencies, which can contribute to headaches and fatigue. Additionally, the short duration of the study (4 weeks) may not have allowed sufficient time for full keto-adaptation, which could explain the reported fatigue.

This feasibility study cannot provide definitive conclusions, but it does represent a meaningful step forward in exploring ketogenic therapy for PTSD. For individuals who have experienced the limitations and side effects of conventional treatments, this metabolic approach offers a novel and potentially transformative way to address the underlying biological drivers of PTSD rather than merely managing its symptoms.

Hope and a Call to Action

PTSD takes a tremendous toll on individuals, families, and communities. Everyone living with this condition deserves better care, especially the men and women who have served our country. We owe it to them to explore every possible avenue for healing, including metabolic psychiatry and ketogenic therapies.

Stories like Maria Edwards’ remind us that innovation is possible and is a testament to the power of lived experience in driving scientific progress. Her research offers hope to those living with PTSD and highlights the need for more research. Advocating for improved care is essential to ensuring that individuals with serious mental health conditions like PTSD receive the effective and compassionate support they deserve.

Guest Author: Chris Irvin

Chris Irvin is a metabolic health researcher, content creator, and marketer. On social media he is known as The Ketologist for sharing information regarding ketogenic science and application. He holds a master’s degree in nutrition science from the University of Tampa and currently resides in Florida with his wife and two young children.