In people with severe depression and cognitive decline, brain glucose metabolism has been shown in some studies to decline measurably. Ketone metabolism, by contrast, appears relatively preserved. That single observation is reshaping how researchers think about psychiatric illness.

In this episode, Dominic D'Agostino sits down with Bret Scher, a cardiologist who pivoted to metabolic psychiatry and now leads clinical education and content for Metabolic Mind at the Baszucki Group. Dr. Scher brings a rare dual perspective: deep training in conventional cardiology paired with three years embedded in the research and clinical practice exploring metabolic approaches in psychiatry.

The conversation covers brain energy dysfunction as a potential unifying mechanism across psychiatric disorders, the preserved ketone metabolism documented in work by researchers like Stephen Cunnane, the recently published Delphi consensus paper on metabolic psychiatry, why four-week randomized trials may be inadequate for nutritional interventions, and the case for future diagnostic categories like metabolic depression and metabolic bipolar disorder.

Questions Answered in This Episode:

• Are we underestimating brain energy dysfunction as a potential unifying mechanism across psychiatric disorders?
• What are the two biggest clinical mistakes patients make when starting ketogenic therapy for mental illness?
• Should ketogenic therapy ever be positioned as a first-line intervention for psychiatric disorders?
• What is the single biggest bottleneck preventing wider clinical adoption of ketogenic therapy?
• What has been the most unexpected challenge in moving metabolic psychiatry into the mainstream?
• What does precision, personalized, prescriptive ketone metabolic therapy actually look like in clinical practice?

This conversation reframes psychiatric illness as a question of brain energy alongside neurotransmitter signaling and other biological mechanisms, with implications for how the next decade of research and clinical training will unfold.

Join the Live Q&A with Dr. Bret Scher. Bring your questions directly to Dr. Scher on May 29 at 10:00 a.m. Pacific / 1:00 p.m. Eastern. Register here.

Where to Find Dr. Bret Scher Online:

Metabolic Mind
Coalition for Metabolic Health

Special thanks to the sponsors of this episode:

✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

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Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

A gene mutation that reduces ketone production in the fasted state is associated with sudden infant death in modern populations. But in the ancestral context where it evolved alongside an omega-3-rich diet, it may have been part of what kept infants alive.

Dr. Gideon Mailer and Nicola Hale join The Metabolic Link to present their hypothesis that the CPT1A L479 Arctic variant is not anti-ketogenic but pro-metabolic flexibility, conserving glucose by upregulating ketosis at the fed-state threshold. Their work explains why SIDS rates are dramatically elevated in modern Inuit communities no longer eating the ancestral Inuit diet, and how omega-3 fatty acids counteract the downregulation the mutation produces.

The clinical picture extends beyond infancy. Modern carriers of the variant show lower triglycerides, lower VLDL, slightly higher HDL, and a "healthy obesity" phenotype with favorable fat distribution. But the health advantages seen in traditional Inuit populations disappear with Western diet adoption, as cardiovascular disease and diabetes rates rise to match the general population.

Questions Answered in This Episode:

• How is the mutation associated with SIDS, and why is there a detrimental effect in modern populations?
• How prevalent is the CPT1A Arctic variant in the U.S. population, and does partial Inuit ancestry carry metabolic consequences?
• How do omega-3 fatty acids physically upregulate CPT1A activity and concentration within cell membranes?
• What metabolic markers distinguish carriers of the L479 variant from non-carriers?
• What happens to cardiovascular disease rates in Inuit populations that adopt Western diets?
• What should people take away from the Arctic variant story for their own metabolic health?

A sobering case study in what happens when ancestral genetic adaptations collide with modern dietary environments, and what can be recovered when they are realigned.

Special thanks to the sponsors of this episode:

✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here
✅ ZocDoc - Find and instantly book a top-rated doctor here

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

In a 12-week clinical trial at The Ohio State University, every woman with PCOS who completed the intervention experienced a change in her menstrual status. One participant, who had never had a period in her life, began menstruating within a week. Another saw spotting after five years of amenorrhea while taking only a ketone supplement without adopting a ketogenic diet. These are among the earliest controlled findings linking ketogenic interventions directly to reproductive hormone restoration.

Dr. Madison Kackley is an Assistant Professor of Kinesiology at The Ohio State University and Director of the SHE Is Laboratory. Her work focuses on how hormonal fluctuations shape metabolic flexibility and resilience in women across the lifespan.

In this episode, she explains why a single fasting glucose or insulin measurement is misleading without knowing where a woman is in her cycle, how the luteal phase creates a state of increased energy expenditure and insulin resistance that conventional carb-loading advice may worsen, and why perimenopausal women who jump into intermittent fasting and high-intensity exercise without prior fat adaptation can end up in a high-cortisol catabolic spiral. She also introduces the Renew study, which examines ketone supplementation alongside group exercise for postpartum depression, a condition she frames as an energy-availability problem rather than a purely psychological one.

Questions Answered in This Episode:

• What will we look back on in ten years and realize we got fundamentally wrong about women's health?
• Why are women more susceptible to dementia than men, and what does it have to do with reproductive energy?
• Why might long-term hormonal birth control contribute to infertility, metabolic syndrome, and type 2 diabetes?
• Why can women in perimenopause feel exhausted and still not be able to sleep?
• Should weaning be understood as its own distinct hormonal event, separate from postpartum?

For clinicians, researchers, and women navigating these transitions, this conversation previews the evidence-based framework that female metabolic health has been waiting for.

Special thanks to the sponsors of this episode:

✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

A veteran walks into the clinic with a persistent migraine. Four minutes of vagal nerve stimulation later, the migraine is gone. This is not a one-off result. It is what Dr. Michael Hoffman has been observing for over seven years in the VA hospital system, using non-invasive devices he considers severely underutilized.

Dr. Hoffman is a stroke and cognitive-behavioral neurologist who trained at Columbia University, spent 14 years in the VA system, and has evaluated an estimated 10,000 stroke patients across his career. He now practices at the University of Central Florida, where he integrates ketogenic nutrition, advanced imaging, vagal nerve stimulation, and hyperbaric oxygen into his neurological care.

In this episode, Dr. Hoffman walks through what he calls the "five brain fitness rules," the specific, measurable lifestyle prescriptions he gives every patient, and explains why standard cognitive screening tools like the MoCA and Mini Mental miss the most dramatic behavioral syndromes caused by brain injury.

He also discusses why PET scans and diffusion tensor imaging should be used far more often, and why post-TBI hormonal evaluation is critical but routinely overlooked.

Questions Answered in This Episode:

• What are the five brain fitness rules every neurological patient should follow?
• Why do standard cognitive tests fail to detect some of the most severe brain injury syndromes?
• How is vagal nerve stimulation treating migraines, and why is it so underutilized outside the VA?
• What clinical changes would most improve neurological care today?
• Does the evidence support hyperbaric oxygen therapy for traumatic brain injury?
• Could fungal infections contribute to some long-standing Alzheimer's diagnoses?
• What is the surprising decade when your brain's cognitive function peaks?

Dr. Hoffman makes a case that the gap between what we know about the brain and what we do in clinical practice has never been wider, and that closing it starts with giving clinicians the time and tools to actually examine their patients.

Learn more about Dr. Hoffman on his website here.

Special thanks to the sponsors of this episode:

✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here
✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here
✅ ZocDoc - Find and instantly book a top-rated doctor here
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

You could have elevated levels of contaminants like uranium or arsenic in your drinking water—and not know it. Many of these compounds are colorless, odorless, and undetectable without testing.

Johnny Pujol is a water chemist and the founder of Tap Score, a drinking water testing platform supported by a network of roughly 270 specialized laboratories. His path from electrochemistry research to consumer water testing was driven by a simple realization: the chemistry inside what looks like a clear glass of water is far more complex than most people realize.

In this episode, Dr. Dominic D’Agostino and Johnny break down what’s actually in drinking water, how regulatory standards are set, and where they may lag behind emerging research. They also discuss how chronic exposure to certain contaminants may intersect with metabolic health and long-term disease risk.

Johnny also shares insights from Tap Score’s forthcoming research comparing contaminant profiles in unfiltered tap water, bottled water, and filtered tap water.

Questions Answered in This Episode:

• Why does the EPA action level for lead differ from the ideal target of zero?
• Can certain filtration systems introduce unintended issues, like microbial growth, if not properly maintained?
• How can environmental factors like rainfall impact private well water quality?
• What's the difference between a "first draw" sample and a "representative" sample, and why does it matter?
• Is the health risk from showering in contaminated water meaningful compared to drinking it?
• Why do some water tests cost $600 to $800 while others cost a fraction of that?

Understanding your drinking water starts with recognizing the difference between what’s legally permitted and what may be considered optimal from a health perspective. This conversation explores that gap, and what individuals can do to better assess their own water quality.

Learn more here: https://mytapscore.com/

Special thanks to the sponsors of this episode:

✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here.
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle with the code LINK here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Register for a live Q&A with Dr. Tommy Wood on Wednesday, March 25th.

Decreased glucose uptake in the brain is often considered a hallmark of Alzheimer's disease. But Dr. Tommy Wood asks whether part of that metabolic signature may reflect how little cognitive demand we place on the brain.

He sits down with Dr. Dominic D'Agostino for a nuanced conversation on metabolic health and cognitive function.. Dr. Wood is a neuroscientist, neonatal brain injury researcher, and author of The Stimulated Mind.

This episode follows the metabolic thread through every stage of brain health. Pre-diabetes and type 2 diabetes as predictors of cognitive decline. Neurovascular coupling as the reason heart disease risk factors double as brain disease risk factors. Lactate crossing the blood-brain barrier to drive BDNF production where it actually matters. Creatine as a brain energy distributor that most people still only associate with muscle. Dr. Wood lays out his Three S Model — Stimulus, Supply, Support — and makes the case that cognitive demand drives glucose uptake into the brain the same way muscular contraction drives it into skeletal muscle.

Questions Answered in This Episode:

• Does the brain respond to energy demand the same way skeletal muscle does?
• What role does creatine play in brain energy distribution, and what do the clinical trials show?
• Can heavy resistance training produce the same brain-relevant lactate response as HIIT?
• How should exercise be dosed after a concussion or traumatic brain injury?
• Is cognitive decline in your 50s, 60s, and 70s actually inevitable, or is that a statistical artifact?
• Why are pre-diabetes and metabolic syndrome among the strongest predictors of dementia?

The mechanistic throughline here is demand-driven metabolism. Dr. Wood makes the case that the same principles governing glucose uptake in skeletal muscle apply to the brain — and the conversation gets into what that means for how we interpret FDG-PET data, design lifestyle interventions, and think about neurodegeneration itself.

Find more at DrTommyWood.com

Special thanks to the sponsors of this episode:

✅ Fatty15 – Get 15% off a 90-day Starter Kit with code METABOLICLINK here

✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here

✅ Toups and Co – Get 15% off your first order with code METABOLIC here

✅ ZocDoc - Find and instantly book a top-rated doctor here

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Get free access to our new Ketogenic Metabolic Therapy ebook here.

Could changing your metabolism reduce alcohol cravings, ease psychiatric symptoms, and even make cancer immunotherapy more effective? The science is pointing to yes, and the mechanisms are fascinating.

In this Journal Club episode, co-hosts Victoria Field, Dr. Dominic D'Agostino, and Dr. Angela Poff break down five peer-reviewed papers from their newly released Ketogenic Metabolic Therapy ebook (Volume 4). From a French preclinical study showing ketogenic diet enhances PD-L1 immunotherapy response in kidney cancer, to an NIH/UPenn trial using machine-learning-derived fMRI signatures to measure reduced alcohol cravings during ketosis, to Stanford's pilot trial demonstrating notable metabolic and psychiatric improvements in schizophrenia and bipolar disorder, this episode covers the cutting edge of metabolic therapy research.

Questions Answered in This Episode:

• Why does the brain crave alcohol in people with alcohol use disorder, and how might ketones help?
• How might a ketogenic diet affect a tumor’s response to immunotherapy?
• Can insulin resistance in the brain contribute to psychiatric symptom severity?
• How does the ketogenic diet compare to the Mediterranean diet for autoimmune inflammation?
• Does timing of ketogenic diet initiation matter for chronic pain relief?
• Is it realistic for people with serious mental illness to adhere to a ketogenic diet?

Whether you're a clinician, researcher, or someone looking to understand the latest science, this episode reveals just how far-reaching ketogenic metabolic therapy has become, spanning oncology, psychiatry, addiction, autoimmune disease, chronic pain, and much more!

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Dr. Mark Tarnopolsky's VO2 max was once 87.6 ml/kg/min — an elite-level mark few humans have reached. He's competed at three world championships in three different sports. He's also had three cardiac ablation surgeries, bled from his bowels after races, and watched his vision tunnel to a speck crossing a finish line. His story is a master class in where the line falls between peak performance and self-destruction.

Now 63, Tarnopolsky is a neurologist, neuromuscular disease specialist, and supplement formulator who has channeled decades of elite athletic experience and hundreds of published studies into the idea that keeping metabolic throughput high is what protects us as we age.

In this conversation with Dom D'Agostino, he shares practical strategies anyone can apply: why resistance training three times per week is non-negotiable after 50, why post-exercise nutrient timing improved performance in a simulated training camp with identical calories, why he says creatine belongs in nearly everyone's regimen, and why he personally takes his mitochondrial supplement stack situationally after hard efforts rather than daily.

Questions Answered in This Episode:

• What is the only intervention proven to extend human lifespan — and by how much?
• At what point does endurance exercise become pro-aging — and what are the warning signs?
• What simple nutrient timing strategy improved performance with zero extra calories?
• How did a bodybuilder bar conversation lead to a published discovery about growth hormone and collagen?
• What muscle and bone costs of Ozempic aren't getting enough attention?
• Why did elite endurance athletes need nearly as much dietary protein as bodybuilders — and why were bodybuilders massively overconsuming?

This conversation reframes the longevity debate around what's actually been proven in human clinical trials — not Petri dishes, not animal models, and not social media influencers.

Special thanks to the sponsors of this episode:

✅ Troscriptions – Get 10% off your first order with code METABOLICLINK here.
✅ Toups and Co – Get 15% off your first order with code METABOLIC here.
✅ iRestore – Get a huge discount on the Elite and the Illumina bundle here.
✅ MudWtr – Get up to 43% off + free shipping and a free rechargeable frother with code METABOLICLINK here.

In every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!

You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!

Find us on social:

• Instagram
• Facebook
• YouTube
• LinkedIn

Please keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.