In this episode I sat down with Denise Potter (RDN, CDCES) to talk about something I really wanted to get right: therapeutic ketogenic diets for epilepsy—especially when medications fail. We dug into what “drug-resistant” epilepsy actually means, why seizure meds can fall short (and why this happens so often in kids), and how ketogenic therapy has been used clinically for over 100 years. Denise broke down the brain-metabolism side in a way that’s practical: ketones aren’t just a weight-loss buzzword—they can change the fuel environment in the brain, and that matters for seizure activity. We also walked through the different clinical versions of keto used in epilepsy care (classic keto, MAD, MCT-based approaches, and therapeutic ketogenic diet frameworks), plus realistic ketone targets, how long kids typically stay on protocol, and what the research shows for seizure reduction. My biggest takeaway: this is not “try keto from TikTok.” This is medical nutrition therapy that needs training, monitoring, and a qualified team—especially for children. If you’re a parent, clinician, or just someone researching metabolic therapy for seizures, this conversation gives you a solid map of what to ask, what to measure, and where to get proper support.