Featured article | November 2025
Ketosis and the Optimal Carbohydrate Diet: A Basic Factor in Orthomolecular Psychiatry
Richard A. Kunin, M.D., Orthomolecular Psychiatry, Volume 5, Number 3, 1976, Pp. 203-211
This article explores how fluctuations in blood sugar, which often stem from carbohydrate intolerance or reactive hypoglycemia, can contribute to irritability, anxiety, fatigue, and other psychiatric symptoms. Dr. Kunin uses short-term ketosis as a clinical method to assess each patient’s carbohydrate tolerance, shifting the body to ketone metabolism to observe when symptoms reappear.
The goal is not prolonged ketosis but determining each patient’s optimal carbohydrate level, where mood, energy, and cognitive function remain stable. Carbohydrate management often enhances outcomes when combined with orthomolecular nutrient therapy.
Discussed in this article:
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Psychiatric and emotional symptoms may arise from blood sugar instability and adrenal overstimulation in carbohydrate-sensitive individuals.
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Short-term ketosis helps reveal a patient’s carbohydrate tolerance by resting the glucose system
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Emotional regulation and mental clarity often improve when carbohydrate intake stays below the individual threshold.
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Early ketosis may cause temporary symptoms such as fatigue, weakness, nausea, headache, or palpitations.
Intervention methods described in the article:
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Zero-carbohydrate induction for up to 5 days to initiate ketosis
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Potassium salts administered to reduce weakness or palpitations
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Gradual reintroduction of carbohydrates, with ketone levels tracked using Ketostix
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The patient’s optimal carbohydrate intake is the point at which ketones disappear while symptoms remain stable
“Ketosis, in the form of fasting, has been known in the treatment of epilepsy for at least two thousand years.”
“…the Ketostix method of monitoring ketone bodies in the urine provides an alternative mode of behavioral reinforcement and reward for obese patients who otherwise must depend on the vagaries of weighing their progress with the bath-room scale.”
