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One randomized controlled trial including 66 patients with BD admitted to an inpatient setting with mania found that supplementing the probiotics Lactobacillus rhamnosus GG and Bifidobacterium lactis for 24 weeks reduced their hospital stays and readmissions compared with controls.2 Ketogenic Diet Researchers have theorized that the ketogenic diet (KD) may, by shifting the brain’s energy source from glucose to ketone bodies, support better mitochondrial function, which could improve BD.14,15 Currently, limited research on KDs in BD has revealed mixed results, although further studies are ongoing.2,14 In one small retrospective analysis, inpatients with BD provided with a KD (with 5% carbohydrate, 75% to 80% fat, and 15% to 20% protein) showed significant improvements in their well-being and symptom severity.14 Other small studies have found positive effects of the KD on BD symptoms, although most have been case studies or pilot studies.14 There are also potential concerns with following a restrictive KD
