The Metabolic Classroom with Dr. Ben Bikman

How Ketones Help the Brain Recover From Concussions

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Nov 3, 2025

The podcast explores how concussions trigger a metabolic energy crisis in the brain, impacting glucose use and leaving neurons deprived of essential energy. Discover how ketones can provide a powerful alternative fuel source, improving energy production and reducing oxidative stress. The discussion includes evidence that ketogenic diets and exogenous ketones can enhance brain recovery and even serve as a preventive measure for athletes. Additionally, learn about the exciting potential for ketones to promote neuroplasticity and overall brain health.

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INSIGHT

Concussion Is A Metabolic Energy Crisis

A concussion creates a metabolic energy crisis by impairing the brain's ability to use glucose.
This metabolic failure can persist for days and worsens inflammation and oxidative stress.

INSIGHT

Glucose Pathways Are Blocked After Injury

Concussion reduces GLUT1/GLUT3 expression and inhibits glycolytic enzymes like hexokinase and PFK.
Pyruvate dehydrogenase is also inhibited, producing a glycolytic bottleneck that lowers ATP production.

INSIGHT

Brain Readily Uses Ketones Over Glucose

Ketones (BHB and acetoacetate) serve as efficient alternative fuels and cross the blood-brain barrier via MCTs.
When both fuels are present, the brain can derive more than two-thirds of ATP from ketones.

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In this mini lecture Dr. Bikman explores how concussions cause more than just structural damage to the brain—they create a serious metabolic energy crisis.

A concussion reduces the brain’s ability to use glucose by impairing glucose transporters and glycolytic enzymes, leaving neurons starved for energy just when demand spikes. This disruption persists even after initial symptoms fade and can worsen inflammation and oxidative stress, further harming brain function.

Fortunately, ketones provide a powerful alternative energy source. Unlike glucose, ketones can bypass the damaged pathways and fuel the brain directly via mitochondria, improving ATP production, reducing oxidative stress, and modulating inflammation.

Both ketogenic diets and exogenous ketones (like goBHB) can dramatically improve brain recovery after a concussion and even provide preventative protection for athletes and others at risk of head injuries.

Animal and limited human studies confirm that after injury, the brain increases its ability to use ketones, especially when they are available immediately. Studies show improvements in mitochondrial function, reduced lesion volume, and even increased neuroplasticity and antioxidant gene expression. Whether through fasting, dietary restriction, or supplementation, making ketones available may be a crucial part of supporting the injured brain.

Show Notes/References:

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IMPORTANT NOTE: The information presented is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Dr. Bikman is not a clinician—and, he is not your doctor. Always seek the advice of your own qualified health providers with questions you may have regarding medical conditions.

Exogenous ketones—especially beta-hydroxybutyrate (BHB), the most effective and bioavailable form—can provide an immediate and practical energy source for the brain and body, particularly during times of increased demand. A high-quality option is the NSF-certified goBHB from Clean Form Nutrition, where you can use the code BEN10 for a 10% discount: https://cleanformnutrition.com/products/go-bhb

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