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Welcome to the sardine challenge. So, the only thing on the menu for the next 3 days is sardines. I challenge you to
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try and eat three of those cans in a day because that's a hell of a tool to help you get into a ketogenic state. And when
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you're in a ketogenic state, it helps burn fat, muscle mass gets higher, preserved. I've seen patients that have
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reversed their gray hair and that brain performance, concentration, and energy. All of those things improve. And so, I'm
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going to teach you how to do an advanced ketogenic diet. Sorry, the sardine juice has gone on my iPad. Good luck getting that off.
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Dr. Annette Bosworth is the insulin resistance specialist. With over two decades of experience, she's discovered that the key to your
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health isn't more treatments. It's to get into a ketogenic state. Most people have been making buckets of
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insulin without knowing it. But when you have excess insulin, it's a chronic disease maker. It is what makes high
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blood pressure. It is what makes cancer. It is what makes debris in the brain, which is linked to depression, brain
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fog, Alzheimer's, and Parkinson's. And so to reverse the high insulin state, I really push my patients to do the
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ketogenic diet. And what unfolds is your best life ahead within a year. Like I really rescued my mom from the edge of
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death. So where do I start? First thing is quit eating so late at night because you're stimulating an excessive production of insulin. The
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next thing keep the carbs low, put the fat up, more eggs, beef, brisket, ribs, pork belly. But then people often say when you talk
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about the ketogenic diet that it's not sustainable. So you have this idea of this keto continuum consistently. Keto
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for life. Yeah. I mean, I've been on a ketogenic diet for 10 years, and there's 12 steps for it, and you're not going to have to try very hard. So, the first step is
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I see messages all the time in the comment section that some of you didn't realize you didn't subscribe. So, if you
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could do me a favor and double check if you're a subscriber to this channel, that would be tremendously appreciated. It's the simple, it's the free thing
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that anybody that watches this show frequently can do to help us here to keep everything going in this show in the trajectory it's on. So please do
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double check if you've subscribed and uh thank you so much because in a strange way you are you're part of our history
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and you're on this journey with us and I appreciate you for that. So yeah thank you
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Dr. Annette Bosworth or should I call you Dr. Bos. What is it that you know and believe and
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understand that you think the general public doesn't know believe and understand?
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that most of the reasons people come to see me could be reversed if they knew
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how to make ketones on a regular basis. So, I'm an internist. Uh that means uh
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if you go to an internal medicine doctor and we don't know what's wrong, you're going to die. We take care of tough
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puzzles and we do this over long management, chronic disease management.
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So, I've got 25 years of studying chronic problems that deteriorate the
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quality of life. Lifespan, health span, both go in the toilet when you're chronically seeing me. And you could
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abort all of that destiny if routinely you were making ketones.
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An internist sounds like an intern. I'm trying to understand the marketing on this is terrible. It
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just means you're supposed to take care of very complex answers. Your job I mean the buck stops with you. If if the
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internal medicine team can't figure it out, you're going to die. So So you're basically a chronic illness doctor. Chronic disease management is absolutely
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it. You know, I love the way uh Peter Aia uses medicine 2.0, which is what we
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are the masters of managing it, making sure the prescriptions are there, making sure you are treating all these
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problems. The internist being one of your best buddies cuz you're having to see them routinely. You got to get the
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meds refilled. You got to check for the side effects. It's a mill. What is medicine 2.0 in your definition?
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Yeah. So, I can keep you from dying from childbirth and infections. And I have an antidote for every one of your symptoms.
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We are in a world where medicine has answered a lot of problems. Little things like high blood pressure. Little things like it's a few extra pounds
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around the middle. Little things like brain fog. Oh, my eyes are aging. All of
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these are signals that your body has made more trash than it cleaned up. And
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there were some rules to humans that you missed. And for for my listeners that have clicked on this conversation,
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what are they going to get out of giving us their time and staying with us and listening to this? What is the end goal
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going to be for them in their lives? Listening to the way I talk to my patients and teach them the steps how to
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reverse the medical problems that you've already got on the roster. And by doing that, the freedom is to be the kind of
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grandparent that you dreamt of, but you've surrendered can't be there anymore. And what is the list of predicaments or
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illnesses that yeah are relevant here? Most common one is being overweight and a brain that's not working right. What
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really is behind all of the patients I've seen for 25 years is we're working on peak brain performance. Even if you
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don't think about that, that's what I think about. So when you come in and you're 55 years old and I can see the
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worry of Parkinson's headed your way, super young is 55 years old with Parkinson's. That is a brain that's got
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too much trash and you don't know it yet. And I mean in the history of Dr.
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Bos versus Parkinson's, Parkinson's has like 3,500 patients. I have zero. Parkinson's wins every time. And the the
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biggest moment of people who have chronic problems under the hood is they have no idea that it's coming. And once
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that lands, the reversal is much worse. seeing it 10 years before it's supposed to be there. This is a gift of saying,
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"Let me show you how to undo that. Back away from the edge." It's that brain function that you're going to miss the
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most when it doesn't work. And it's linked to all of these things like the arthritis, the, you know, weight around
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the middle, the high blood pressure, the severe uh connection to mental
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uh approach, meaning you can say depression, but people say, "Oh, I don't have that diagnosis." I'm talking about
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a brain that doesn't want to engage, that doesn't find joy in their life anymore because it's been too many years
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since they took out the trash. Let me show you how to take out the trash. And you're going to have to do it a few times, but what unfolds is your best
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life ahead within a year. So, you're going to teach me how to take out the trash. Yeah. The trash in my own brain.
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Yep. And if I take out the trash in my own brain, how is my life going to be better? You live in the 21st century
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where there's lots of processed foods and lots of ways that your body did things without telling you. So any
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injury that you've had, like a joint injury that keeps coming back every time you injure it, it it is a little easier to injure the next time. Is there a ring
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around the middle that's more more than pinch an inch? Is there a uh distance in
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time where you say, "I can focus for this many hours, but I can't do it for this many hours anymore." Those are all
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places where if you did this, if you were able to say, "Don't stop taking out
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the trash." Several times a year, several times a month, if you ask me, then you never have to come into this
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world that I just see people, they're they're in quicksand. They're up to their waist and getting them out. They
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need a real lifeline. And what are the current solutions people are typically offered when they're feeling, you know,
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all the the ways that you described there where they just don't feel good, they have brain fog, they're they might
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have chronic pain setting in in various ways. What are the typical solutions that medicine 2.0 would offer them?
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Yeah, especially if they have good insurance. Yeah, that doctor is going to be with the covered insurance plan and he's going to
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say, "Tell me the symptoms. I have a matching game. I will give you the drugs that will take away that one and take
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away that one and take away that one." What is always a downside is well play
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that forward for 10 years. Play it forward for five years and are the symptoms gone? No. But it will bridge
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and hold up the architecture of the body and the human without actually fixing the problem, without actually diving in
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and say you got some chemistry problems under the hood that you don't measure and you don't talk about. But if you
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did, even if you're not perfect, even if you're 70%, you're going to find yourself at the age
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of 54 with vitality and energy and sleeping through the night and not having what every other 54year-old,
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which is chronic joint pain, a brain that can only focus for 3 to four hours without a break. Uh, a stamina of
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endurance and health and and joy that falls apart. So, when I'm You're 54 years old. When
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I'm 54 years old, I want to be as young and energetic and articulate and
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cognitively astute as you are. So, what should I be doing now to make sure that
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I don't decline decay in all those areas I described? Well, what did you have for breakfast
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today? Yeah. Um, I have not eaten breakfast yet. It's okay. That's not a bad thing. But,
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uh, when you're 54, you should probably put the calories in the morning, not at night. We know that as you age, the cost of a
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calorie turns into timing. If you eat that food, one bite of food after 6:00
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is worth 10 bites of food before noon. So, if you're trying to say, "How do I get the best out of the nourishment, but
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also eating's fun?" If you only get one bite after 6:00 and 10 before, move that
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food towards morning. When you're your age, uh, what did you have for what's the last meal you ate
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yesterday? Yeah. Uh, for dinner, I had this cod and I had
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salad. I also had pasta. Okay. But I ate pretty late, which is
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What did you have the rest of the day before that? Was that your first salad? Just a big salad. Was that more towards lunch or noon or
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probably about 4:00? So, waited all the way till 4:00 to eat. Very common. This is a really common pattern of people doing what we would
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say intermittent or timerestricted eating. They put that eating window in this, but it's got that balloon at the
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end of the day. Yeah. And it really does I mean what you're stimulating is an excessive production
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of insulin and you're going to wake up the next morning. What time did you wake up this morning?
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Today I went to bed fairly relatively early for me. I woke up at about 7:30 a.m. Oh.
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Usually it's later. And do you have did you have a solid seven eight hours of sleep or how?
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Yeah. So during that time uh you finished eating around 10 o'clock then it sounds like Yeah.
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Okay. So then it's 7 bit later. Okay. So 11:00 and you've got uh 7 7:30
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in the morning is when you woke up. So that's about 8 hours since you've eaten. Your insulin is still churning
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especially if the meal was large and there was carbs in it. So now you've got these processed foods late at night and
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you're at the beginning of the disease, right? you're at the beginning of the chronic inflammatory churn of how do you
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age faster and faster? You don't do that. You don't have high insulin throughout the night. So, can you explain to me like I'm a
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12-year-old what insulin is and the role it's playing because you know I guess we're focused here on how to I guess
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longevity aging. Yeah. For a second, but how does insulin play a role in all of this and what is insulin? So, insulin insulates. Okay. So, think
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of it as it makes you fluffy. It makes you it puts the fat on. Uh it's got some
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other roles too, but we're going to talk about chronic diseases here where it's not a scarcity problem. You you make
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plenty of it. And when it's in excess, it will store energy for when you go
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through a famine. It will also cause you to grow. Now, grow means get a little
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fatter, but it also means things like their skin gets a little thicker. They have skin tags. And what I always think
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about is what's going on in their brain. And when that insulin is high for years and years and years, uh, just like
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yours, because if if you didn't eat the rest of today and then you got up tomorrow morning, it would be about that
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long after a late meal last night, that's how long it would take you to say, "Okay, we're back down to where we
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started from or where we should be in the morning." For someone that's never heard the word insulin before, there's some context to give on in terms of what it's doing. So
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it's coming out like a transporter in helping put away the sugar or deal with the excess sugar.
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Right. So it is what lifts Yeah. It lifts glucose or sugar from the circulation into a cell. That's its
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first primary job. But if all the cells are full, their storage is full, it's going to start to
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pack it into the liver. I mean, let's say all those stores are full too. This job uh of the of insulin, this hormone
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oozes into every part of your body to say make sure it's got f fuel. Make sure it's got that sugar. But most people are
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like what I would guess you are. Most of the time you don't you aren't a shortage of sugar. And so it feel it tops things
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off and then it will turn things into fat. It's too much sugar. They can't store it. All the storage is full. So
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you can send the signal out. Make me some more cells. I need some more storage units. This guy's eating more than he thinks he is. And we're going to
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be prepared to live through the famine.
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But in the meantime, turn it into fat. make him a little fluffier. Is that the only consequence of high
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insulin is that I'm gonna I might be a bit more fat. No, that's just the one people hear about the most. When you look at chronic
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disease management, it is the growth of of the diseases of the inflammation.
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It's the making of the trash. So, I keep saying, you know, you you need to take the trash out routinely, which means
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that insulin, which has been smoldering higher than you think it is because you live in today's world, because you eat
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processed food, because you eat super late at night, uh you don't go two to three days without eating. You've you've got storage filled in your body. The
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high insulin levels in a healthy person hides that the debris is being made and
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you don't know it. It hides it. Yeah. It's going to put it in between two cells in your brain. It's going to
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go in between the skin cells. The trash doesn't get taken out until the insulin
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gets lower. And unfortunately, most people have been making buckets of
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insulin without knowing it. Why? What are they doing to create buckets of insulin? all the things you
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said about carbs, um um foods that comes from boxes and barcodes and uh bags instead of
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whole foods instead of a fatforward diet, which would then push that body
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into making ketones. So, you can't you cannot make a ketone if your insulin's
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high. Are there any signs that I might have high levels of insulin or insulin
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resistance? Abdominal girth is the first thing that is the first place that the fat goes. So you do this really great
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part where you don't eat until later in the day. How does that feel during the day?
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During the day I feel really focused. I actually don't even know that I'm not eating. So that's really good. So what I would love to know is show me what your blood
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sugars are doing during the day and show me if you make ketones. That'll be the answer is you when you have excess
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insulin which is this chronic disease maker. Uh it is what makes cancer. It is
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what makes high blood pressure. It is what makes debris in the brain where call it depression or brain fog or
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Parkinson's. It's the aging of the brain. It's linked to all of those things. All of those things. And that excess
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insulin nobody tells you about. But the symptoms are, dang, I feel like I got to eat every two to three hours. Uh their
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debris uh or their fuel keeps running out. When you say, boy, I can eat uh
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once at the end of the day and I'm pretty good. My focus stays really good. What I want you to prove is what are
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your ketones during the day. So when when you've got a patient who has done that, their ketones will be 7 1.0
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and they're taking out the trash all day long. So there's these two energy sources. One of them is the glucose. One of them's
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which is from like you know eating pasta which I ate last night. Um so that probably put a lot of glucose in my my
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blood. I probably had a high glucose spike and then insulin came out to deal with that. And then there's ketones, which start to appear when I'm fasting
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or when I haven't been eating carbs for a while and my body's looking for an energy source. Yeah. When in terms of these two energy sources,
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there seems to be a lot of hype around ketones. Mhm. So, why doesn't our body just run off
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ketones? It will as soon as you're done lowering your insulin. And I mean, insulin grew
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in these patients. They didn't know that it was growing high. They went to their blood test and their glucose looked
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normal. What nobody checked for years is how much of that insulating hormone did it take to keep the glucose controlled.
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And that's where chronic diseases are are grown in spades. That's where autoimmune disorder the insulating hormone being insulin.
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Yes. Okay. So that excess insulin for the last decade had you come into my clinic.
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We'll put a label on it. Call it PCOS. Call it uh high blood pressure. Call it
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um autoimmune problems. All of them are linked to high insulin. Glucose, when
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you want to store it, we put it in a fancy string called glycogen. And it's just an efficient way to store glucose,
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but as soon as your body needs it, it will unlock all that sugar back into your access back for you.
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Mhm. What you don't realize is, well, how much glycogen you got stored over there?
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How much is there in storage? And that is what high insulin has been doing. Just put it in storage. Put it in
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storage. And then when you stop eating, you'll know if you emptied out all your
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stored sugar, which is some of the regular sugar you just ate, but then all this glycogen, this packaged sugar. How
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empty are you? I don't know. Have you made a ketone yet? You cannot make a ketone. You cannot burn fat until that
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that tank is empty. Okay. So, I have these glycogen stores which last for what, a day or two? Oh, no. Think of it as brown sugar. So
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you package the sugar really tight and then you put it in the back of the drawer and it turned crusty because you
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never lowered your insulin. I have patients that are over overweight and we put them on a ketogenic we put them on a
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20 total carbohydrates per day. So super low carbohydrate. It is 15 days before
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they make a ketone. Okay? So it's it could be a a one it could be up to two weeks for example
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before my glycogen stores are empty. And it's not until my glycogen stores my glucose stores are empty that my body
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can start producing ketones. Correct. So, it's going to exhaust all of those glycogen stores and then once it's ran out, it's going to switch into
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this ketogenic state, right? Yeah. So, think of it as your shortterm easy to access sugar has to
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decrease and that means your insulin has decreased. That hormone for insulate.
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They both run in tangents. You decre you're emptying glycogen, your insulin's going down. So, how do I know if I have insulin
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resistance? What what are the key signs? You mentioned skin tags. I've never heard that term before. Yeah, skin tags are not moles. So moles, you can feel
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this bump on your on your skin, right? But a skin tag has a neck and like a little mushroom.
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And it's the most annoying thing when patients come and say, "Well, I just tried to cut them all off, but they kept bleeding." I'm like, "Do not cut them
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off." They'll fall off when your insulin's lower. So that's the first place. It'll be found in their armpits
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or places where their skin rubs. So armpits and they're growing. And once insulin starts to grow them, it's like a
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crop. a crop of little baby cauliflower hanging out in their armpits. You talked about velvety skin.
00:19:03
Yes. As well being an indicator. Velvety skin is this Latin word aanthosis nigraans which is fancy word
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that means the skin is darker and thicker. So the the places that usually
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happens is the back of the neck. And you'll hear you know stories of I tried to wash my neck. It's it's dirty all the
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time. It's not dirt. It is the way the skin is under the the curse of high
00:19:28
insulin. And you see it in teenagers all the time now. They put on weight and their growth hormones are already doing
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that teenage thing. Now you put high insulin in there and they have this dirty neck syndrome or on the creases of
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their elbow. It's just darker here. Uh that is pathology that's not normal from
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high insulin. You talked about weight changes as well. What's this thing about hairy toes that I was reading about?
00:19:53
Right. So, as my patients age, so most my 55year-olds that have had high insulin, I will tell them, "Look at your
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toes. They're supposed to have hair on them." And when your body has had that
00:20:05
high insulin state for a couple of decades now, it will start to say, "We
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don't send resources to a couple parts of the body anymore." And the follicles in their toe are one of them. Like, just
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stop growing hair on your toes. And there's an ascending problem with this where the toe starts, then it's the
00:20:21
ankles, then it's up to the knees. and they don't have hair anywhere on their lower extremities. It is a process
00:20:28
that started from high insulin. What about aging? You talked about how if you have high insulin, there'll be an
00:20:34
impact on your aging. Now, I'm thinking about, you know, I'm getting a couple gray hairs now. I'm thinking, this is because of my insulin levels. I
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I have seen patients that have reversed their gray hair on a ketogenic diet. It blew my mind. They asked me for the
00:20:46
reason why that happened, and I thought, well, um the cells are healthier that are making your hair. That's all I got.
00:20:53
Um, aging is exactly that enemy, which is they are going around the sun with
00:21:00
more growing of the trash than they needed. So that high insulin, they don't
00:21:05
know about it. They've not produced a ketone in years. And that chronic disease is now difficult to get their
00:21:13
the eye to clean out. It's difficult to get that brain trash removed. And you're
00:21:19
supposed to do it every night when you sleep. is not supposed to be behind this far. You're two decades from taking out
00:21:24
the trash in your brain. That's aging. How do I for a start even know my ketone
00:21:30
blood levels? Well, when when a patient first comes in saying, "How do I begin?" I want them to
00:21:36
tell me what they had for their meal and then say, "How many carbs do you think that was?" Because this education like
00:21:42
an apple is 20 gram of carbs, 15 grams of carbs for some of them. And we're
00:21:47
going to ask you in the first six weeks to take your carb intake down to less than 20. 20 total grams of carbohydrates
00:21:54
or less is where we begin. And again, I do this in a medical grade. There are people who play with a ketogenic diet
00:22:00
and there's people who try to reverse medical problems with a ketogenic diet. In order to do this, it is not a lazy
00:22:06
kind of keto. You have to actually be on the same team as me using data to reverse this medical problem.
00:22:12
And how how does one measure their blood ketone levels? Yeah, I I think blood is the best. There is a way you can measure
00:22:19
them in a in urine. The burning of fat if you turn that string of fat into
00:22:26
ketones, there are two destinies for that. You either put it into a mitochondria and turn it into energy or
00:22:31
you pee it out. So, especially when they're early in a ketogenic journey, they're they overshoot. Evolution said,
00:22:38
"Don't let them die. Turn that fat into energy. Help them through the famine." So the excess ketones they make end up
00:22:46
in their urine. We call them ketone strips and they're cheap and easy and we don't have to cross that barrier of
00:22:52
somebody pricking their finger at the beginning. So they're going to pee out ketones every day
00:22:59
as long as they're not chronic insulin resistant. So if I avoid carbs for a sustained
00:23:05
period of time, which could be a couple of days, it could be up to two weeks, eventually my body's going to say, "Listen, we need energy." So it's going
00:23:11
to start burning my fat stores. Yes, you know, from some of that fat around the midsection, and it's going to start
00:23:17
turning that into ketones, which are a different type of energy. Are there any
00:23:23
reasons why ketone as a source of energy is better for me in terms of performance
00:23:29
other than the insulin reasons that we've talked about? Like, are there any other parts of my body or my health that
00:23:35
benefit ketones? For starters, when you're burning a ketone, there's less trash. Okay? It is a cleaner uh fuel with less
00:23:43
byproduct especially as you age. So you get the longer energy and you have less debris floating around. You hear the
00:23:48
word antioxidants all the time. Well, burning ketones is an antioxidant state.
00:23:54
It is a and it's in the space where you need it, which is inside that cell. Uh you swallow antioxidants and you have no
00:24:02
guarantee that they end up where they're supposed to. So number one, the fuel is
00:24:07
reducing trash at a cellular level. It lasts longer and it penetrates through
00:24:13
that bloodb brain barrier to fuel a brain that even if it's insulin
00:24:18
resistant, it can use a ketone. So the problem with somebody who's chronic insulin resistance, their brain needs a
00:24:26
lot of glucose to stay on online. and I can try to get it there, but
00:24:31
insulin is constantly fighting that. It's a war to try and keep the glucose in their brain. My hack is ketones will
00:24:39
go right around that. It doesn't need the same transporters to get across the bloodb brain barrier and especially to
00:24:44
fuel those cells in the brain. So, for performance, um I mean, name a game where you don't use your brain. There
00:24:52
isn't one, right? you're you're gonna if you're looking at performance to say let's begin with the sharpest brains and
00:24:57
the most focus, the most discipline, the less um impulsivity.
00:25:02
All of those things improve when that brain is being fueled with ketones. So, let's focus on the brain part then.
00:25:08
So, what have you personally noticed as someone who I assume is in the ketogenic diet right now?
00:25:13
Yes. What have you noticed the variances between when you're in a keto diet and when you're not? Right. Well, I've been doing this since
00:25:20
2015. So, um, the onset of it was really messy, but, uh, the seasons where I
00:25:25
would do a great job and then I would think, h, I'm fine. Uh, I mean, I can
00:25:31
tell you, you see 25 patients in a day and I feel bad for the last five. Uh,
00:25:36
they've got a they've got a sluggish brain. I don't care how much coffee you've got in you, you can't keep that focus for that length of time. um when
00:25:44
you're in a ketogenic state and not in a ketogenic state, uh the the the brain power, the concentration, the ability to
00:25:51
keep your mood controlled is is just it is a night and day difference for most people, but I think especially for me
00:25:58
like uh and pretty high energy and when it runs out, I get crabby. Uh and that's
00:26:04
not a good place to be if you're the patient. Yeah, I think I've noticed that as a podcaster, but I've also heard a lot of very well-known podcasters say
00:26:11
the same thing, which is the variance in their ability to speak and articulate themselves and think and sit here for three to four hours having a
00:26:17
conversation is night and day when they are in a fasted ketogenic state versus or on a
00:26:22
ketogenic diet versus when they are in a higher carb diet. And it's so profound to me that I that I
00:26:29
almost wonder why like more people don't Oh, it's it's insane. Like one of the best things that I've done in 25 years
00:26:35
was I went out on a limb and said, "I'm going to try and teach 200 people at once how to do this intense ketogenic
00:26:42
diet for 3 weeks." Uh it is hardcore. This is not playtime. You're checking your numbers every day and you're
00:26:48
comparing them to your classmates. And what you get to see in this class of 200 people going with an extreme ketogenic
00:26:55
diet is the testimony you just said. I cannot believe how good I feel. By the end of three weeks, they're naming
00:27:02
babies after me. They they think this is a miracle. And I'm like, exactly. I
00:27:08
mean, when you do it in a group like that, I don't need to advertise. They tell their friends. They tell their like
00:27:14
if you want to be on a ketogenic diet, that really wakes up your brain that I didn't think I could do this. I thought
00:27:19
I was too old for this level of energy. And it's there within 3 weeks of doing it, right? How long does it typically
00:27:26
take on average for someone to feel those brain benefits from doing the ketogenic diet?
00:27:32
Typically, how long does it take you? Me? Yeah. I rarely go out of it. Meaning I I might
00:27:37
have a couple of days where I fly to LA and have a fancy meal and then I need to be back on it. It just doesn't feel good
00:27:42
anymore. So, but let's go let's go to when I was overweight. Okay. So, you say, who's
00:27:48
insulin resistant? Any person who's had a baby. Okay. You have to be insulin resistant to hold that baby for nine
00:27:54
months. Okay, so I had three of them and then the weight never came off on that third one. So here is an insulin
00:27:59
resistant person at 40 something years old and I am probably 60 lbs heavier
00:28:05
than I am now. In the first time it it I tried to get into a state of ketosis for
00:28:12
like nine months. I was about to give up on like why can I not pee a ketone? Why
00:28:17
does every I mean I'm a doctor. I'm trying to use this for my brain patients, but I'm afraid to tell them about it cuz I personally cannot keep
00:28:24
pee a ketone. I mean, I was trying to follow 50 carbs, then I tried to do 30 carbs, and then I try to do none. But I
00:28:31
just couldn't make it long enough into that ketogenic state. And what had happened is at least a decade of high
00:28:37
insulin, three babies, full practice, busy life, you know, on call, those kinds of things that are all dangerous
00:28:43
if you're going to try to have a peak brain. I took my kids on a um 22-mile hike
00:28:50
around the city uh on Memorial Day in the name of troops as mental health and
00:28:56
I said if I am not peeing a ketone after walking 22 miles having fasted for a day
00:29:03
then I'm for sure that this diet is a hoie. So that's how much energy it took for me to pee a ketone because I was
00:29:09
very insulin resistant. I had been making excess insulin for a decade and I'm a doctor. I I should have known that
00:29:15
my sugars were fine. My hemoglobin A1C wasn't bad. But that excess insulin,
00:29:20
that stored sugar, that stored glycogen, it took forever to get that low. And
00:29:26
only after I fasted and then walked 22 miles did I pee a ketone. So I when you
00:29:32
ask the question, how long does it take? I don't make a I do a much better job now of telling people how to get there
00:29:38
cuz I I almost gave up thinking this is junk science. If you if you were to eat a high carb meal now and take a couple
00:29:45
of days off, how long would it take you to get back into a ketogenic state where you have those brain benefits now?
00:29:50
Uh I could probably flip back in within 12 hours. So that's how long it roughly takes for
00:29:55
someone who's got a bit in better metabolic shape. It will take a couple of days. Mhm. Um
00:30:02
is there a downside to living in ketosis the whole time? Because people often say
00:30:07
when you talk about the ketogenic diet that it's not sustainable. Yeah, I hear that a lot, but I have thousands of
00:30:13
patients that have been doing it for years. And what happens is uh as soon as
00:30:18
they exit from the ketogenic diet and they start to feel the trash build up
00:30:23
again, meaning the joints that didn't hurt forever now hurt, the vision that was super clear is now foggy again. The
00:30:30
brain that wasn't irritable and depressive is back to doing those things again. I mean, it is within a week or
00:30:35
two that I mean, I like to think of when you're in a ketogenic state, you ring
00:30:41
out that inflammation and trash in their brain and the brain is like crisp. It is doing a great job. And when you put the
00:30:48
sugar back in, the swelling goes back into their brain. Insulin and water flood the body and it's almost like a
00:30:55
minor concussion and their brain is not working right and they now know it. And is there any other
00:31:03
benefits to being in a ketogenic state? You mentioned strength briefly. Yeah. So when you're looking at uh do
00:31:09
you do weightlifting? Yeah. Okay. So when you weightlift uh uh how
00:31:14
grade your soreness on the day after your like lifting day? Um if I've been using that muscle
00:31:21
consistently, there's no real soreness. Good. So uh let's just take a day where you're pushing it harder. You're
00:31:26
deadlifting harder and you've got a strain in those muscles. One of the key components for repairing that as quickly
00:31:32
as possible is to be in a ketogenic state to take that inflammation way
00:31:37
down. And you probably didn't need the help of repairing that muscle when you were, you know, 18, 22. But as you get
00:31:45
into the 30s and especially into the 40s, the amount of inflammation that tries to help you repair that, it
00:31:52
overshoots. And that's where the chronic pain's from. That's where the delay in repair comes from. So, when I look at
00:31:59
power and muscle training, I the first place I talk to my patients about it is
00:32:04
how many days does it take you to get back to to feeling good after you've had an injury? Uh, let's let's be on the
00:32:10
side of a ketogenic setting where your inflammation is super low and when you
00:32:15
tear something, which you're going to tear things when you're lifting heavy, the repair part is so quick. The power
00:32:22
is a little hard to talk about. If you want me to go there, I can. Uh, yeah. So, is there is there going to be an impact on my my ability to train?
00:32:29
Yeah. If I'm in a ketogenic diet, am I going to be impacted in terms of endurance or strength or power or anything like that?
00:32:36
So, we looked at this in um in military people. uh is one of the my favorite ones where they are all insulin
00:32:42
resistant and we put them on a ketogenic diet and so they're trying to meet their standards and at a month of being in a
00:32:50
ketogenic state, they've lost weight, but their power and time didn't do
00:32:55
anything too sexy. Then you look at those same soldiers at a year or I think it was six months was the next time they
00:33:01
did another big check. uh and by golly, they've lost even more weight and their power is about 20% more than their
00:33:10
counterparts. When they get to 18 months of a ketogenic diet, their power is
00:33:15
almost 50% more than what their counterparts were. So, let me explain that. As you're looking at a muscle, it
00:33:22
will choose which fuel it wants to use. And when you've been glucose using when you're on a non- ketogenic diet, it's
00:33:28
going to use glucose first to fuel. But if you can train it to to use fat in
00:33:33
that training, it's a longer, better fuel with less inflammation. And um
00:33:39
especially in a a state where it will use both fuels quickly. That takes time.
00:33:45
I mean, it takes and what I tell patients is you'll love me in 18 months. You'll think I'm pretty great at 6
00:33:51
months, but if you're trying to run a marathon and we're only 3 to 4 weeks out, you should not start a ketogenic
00:33:56
diet. You're going to think it's the worst thing ever. It's meant to train muscles to use fat and that takes time.
00:34:03
And is there a link between some of these cognitive degeneration diseases
00:34:09
like Alzheimer's, dementia, etc., and the ketogenic diet? Cuz I know that
00:34:14
there's been some research that's underway and has been done to try and establish causality. Is there a link
00:34:21
here? Yeah. You know, it's one of the saddest places where if you look at what patients regret in life, they come into
00:34:27
the clinic and they're already starting to say, "I was driving the other day and I I got lost." And when I hear that, we
00:34:33
are 15 years too late. It is 15 years of building up trash in that brain that we have to clean out that debris.
00:34:41
And I had the privilege of an amazing story that taught me I don't have the gift of, you know, seeing into the
00:34:48
future. Am I going to reverse these Alzheimer's before they show up? We don't have the research for it. Um, but
00:34:54
I have a lot of clinical experience saying, "Boy, they are so much better. I don't know if their memory is going to
00:35:00
stay this good. We're only three years into a ketogenic diet, but it's way better than when it started." And then I
00:35:07
had a Down syndrome patient at 40 years old uh in my practice. So her mother
00:35:16
came to see me first. She said, "I I want to try this ketogenic diet. Um, I've been helping my daughter who's has
00:35:23
Down syndrome. We've lost 100 pounds uh because the doctor said that she might
00:35:28
do better if um if we lost some weight and it's not an uncommon thing to see.
00:35:36
They have advanced insulin resistance and advanced Alzheimer's earlier in life. So, it's a great uh
00:35:43
place to study Alzheimer's because they have a a more rapid onset of it. So, the woman comes, she's lost 100 pounds, and
00:35:50
during that time, her mental cognition got worse. So, now she's got 100 pounds
00:35:55
down, but none of those brain things are better. And I said, "All right, if we're going to do this with your daughter,
00:36:01
we're going to make sure we're pricking your finger. It's not going to be fake. We're going to do a real ketogenic diet." So, the mom starts on a ketogenic
00:36:07
diet. And I think both her and mom are genetically superpowered to make ketones cuz they have ketones of like three
00:36:14
within a couple of days, which is the average would be like one if I if they hit one in a few
00:36:19
days. I'm thinking, good job. And the mom calls me at the end of the week saying, "Do you think it could possibly work this fast? She is she's, you know,
00:36:26
doing the little jobs that she used to do around the house." And I said, "Well, call me again in a week. Let's see how she's doing." And the mom goes, "The
00:36:33
most profound thing just happened. I've taken care of this girl for 41 years.
00:36:39
And I asked her the other day if she was doing something. She wanted to go to the church with me, which means she left the house and she was at the church and she
00:36:46
was giving her instructions to do this, go around here and put it over there in the give her a little job. And she said,
00:36:52
"Do you understand?" And the girl replied, "I understand."
00:36:58
I said, "What's the big deal?" And the mother said she had never said a
00:37:03
three syllable word in her whole life. Two syllables is all her brain could ever put together. For the first time in
00:37:10
her whole life, three weeks onto a ketogenic diet. And this Alzheimer's
00:37:16
diagnosed patient who had Down syndrome now had a brain that was not only working great, it was doing the best mom
00:37:23
had ever seen it. And on a ketogenic diet, not only did she lose about 15 to 20 more pounds, but her world opened up
00:37:30
again because her brain, which had Alzheimer's, no longer had that diagnosis. I was looking at some of the supporting
00:37:36
studies around this around the impact can have on the brain and studies show that in dementia, especially in
00:37:42
Alzheimer's, the brain struggles to use glucose efficiently. Ketones provide an alternative, cleaner fuel source. Um,
00:37:47
ketogenic diets can boost mitochondrial function and energy availability in brain cells. Keto lowers systemic
00:37:53
inflammation which is linked to slower cognitive decline. Um, ketones may protect neurons from damage and promote
00:38:00
the growth of new neural connections. And Alzheimer's is something called type 3 diabetes which I've heard a lot. Um, and keto improves insulin in sensitivity
00:38:07
potentially reducing this risk. And lastly, small studies show temporary improvements in memory and cognition in
00:38:12
people with mild cognitive impairment or early Alzheimer's. But the evidence is early stage long-term adurance can be
00:38:19
hard and the diet isn't suitable for everyone. Uh for example, underweight people um and people with certain
00:38:25
medical conditions, right? So how do I measure my blood ketone levels? Is that what these devices are
00:38:31
here on the I mean when I look at um uh giving patients the freedom to say don't don't
00:38:36
come to me for the things that I that you can do at home. First thing is be willing to check data. Okay.
00:38:42
Okay. So, blood way better than any other way to measure this. We're going to be able to see. Should we have a contest? Which one's better?
00:38:48
Yeah. Okay. So, you want to go first? Okay. So, what I'm going to do here is I have a finger prick here which is going
00:38:54
to take some blood. It's going to prick my finger. Then I have this little reader. And I also have this little strip here which I'm going to put my
00:39:00
blood onto. And within a couple of seconds, it's going to tell me how many ketones I
00:39:06
currently have in my body right now. And so we're going to look at that at the same time as your blood sugar, which is
00:39:12
how you can measure insulin. It's the best proxy for saying how high is his
00:39:17
insulin. So put both of them in there before you go because then you don't have to prick yourself twice. Okay. So a blue one is going to measure the
00:39:23
ketones and a brown one's going to measure your glucose. Okay. And this device, how much does it
00:39:28
cost if people want to buy it at home and start pricking their own? Yeah, I think there's a kit that comes with about 50 strips so you can have
00:39:35
ketones and glucose at the same time. I'm guessing it's around 70 bucks or maybe it's 60 to $70. I They have quite
00:39:41
the Yeah. Put it all in. There you go. And so they'll still little lights on the other one too, right? Perfect. Okay. So now prick your finger. Best to do it
00:39:48
on the side of your finger because there's less nerves there. There you go. Good job.
00:39:54
Okay. So I'm going to put my blood onto this one which is the keto reader.
00:39:59
And it'll it'll count. Uh let's see. I think it's um
00:40:05
my glucose is 86. Takes more blood for the ketone.
00:40:10
And my ketone levels are.9. Okay. So that's a Dr. B's ratio of 86
00:40:17
divided by 0.9 which is probably like 95 or something like 95ish,
00:40:23
right? So my glucose levels at 86. Is that high or low? That's good. Uh so I would say that's
00:40:29
not low, it's just good. Okay. and my ketone levels are 0.9. Right? So when you look at them in
00:40:34
comparison, like you want to have a blood sugar that's not triple digit. So that's very good. And the closer the
00:40:41
higher you are above 0.5, the better the result. So that's pretty good number. So if I'm in ke ketosis,
00:40:47
Mhm. what reading would I have on this ketone meter? 0.5 or greater. But it would be also
00:40:53
that you have that reading without a triple digit blood sugar. So when I look at the combination of them, I do a
00:40:59
little math and say your Dr. ratio is like 95. So you are burning fat right now.
00:41:04
Okay. Okay. So that's a good sign. When I am trying to help people who are trying to undo cancer or autoimmune or brain
00:41:12
injuries, they have to have a better Dr. Boss ratio than that. Let's do your readings, okay, to see where you're at.
00:41:20
All right, drum roll. 83
00:41:25
and 1.7. How are you at 1.7? What have you done? So, I've learned that I would
00:41:33
love to be 33 again and be able to eat that late at night. You said that I'm like, "Oh, it's been a while since I've
00:41:39
eaten that late at night." It's probably the hardest thing to teach my patients, too, is like, you don't appreciate how much insulin you make that late at
00:41:45
night. Now, you're still in a season where you get to just kick your heels and enjoy youth. But at my age, you
00:41:53
cannot do that. I can eat in the morning. I can have good calories of high fat and good protein in the morning
00:41:59
and I've learned to stop eating somewhere around three o'clock in the afternoon. Um, in fact, if I Yeah, I
00:42:05
know. 3:00 in the afternoon, you stop eating. That's usually the case. You know what what's really hard though is how much of
00:42:11
your life is social. Like you said, oh, there was this dinner party last night and I had pasta. And you're like, yep.
00:42:17
Uh, that would be something I have to teach my patients. You have to say no to that. You cannot be eating at 10 o'clock
00:42:23
at night if you want your insulin to not to not do that deb breathing thing. And
00:42:29
boy, when their memory isn't going well, when their friends are dying of u memory problems, you know, it's I don't like
00:42:36
using fear tactics. I don't think they last very long. But it is such a reality
00:42:41
of poor performance that I can't do that. I cannot eat at 10:30 at night. What is it about being asleep that
00:42:48
causes the sort of deregulation? Like what is it about it doing it at night?
00:42:53
So now it's going to take that metabolic curve and in order to store all of the
00:42:59
part that gets stored and then turn the part into fat that needs to be tucked away and get back to baseline, it's
00:43:04
going to be 8 hours. At least 8 hours, which is fine, right? Because I don't eat till I'm probably not going to eat till 2 p.m. today.
00:43:10
Right. Well, you you missed one part. The sun will rise. When the sun rises,
00:43:15
even if you're in solitary confinement, you cannot see the sun. Yeah. Your brain knows that the sun just went
00:43:21
up and cortisol rises. Okay. Cortisol leaves your brain, goes to the liver and says, you know, that stored
00:43:26
sugar, that glycogen release. You make glucose first thing in the morning. How
00:43:32
much glucose depends on how insulin resistant you are. So, you're going to you're going to have an uneaten meal
00:43:38
when you wake up in the morning. Glucose has been stored for this purpose. It's going to wake you up. That's going to
00:43:43
give you the energy when sun rises to to fuel you. If you got a bunch stored,
00:43:49
you're going to have a high blood sugar. Can we do Jack's ketone levels? I'd like to know where Jack is at. Let's do that. What's Jack do for a for
00:43:57
his? We're about to find out. I don't think I'm going to be No. Wait a minute. Is Jack the one that did the V2 max with Peter Aia and you
00:44:05
Well, you know, peak brain performance is my thing and one of the hardest brains to heal are chronic runners. That
00:44:10
trauma thing is real. Like it's so hard to explain to them, too. If you're a vegan who runs, you're in trouble.
00:44:18
95% of vegans that listen to this podcast frequently don't subscribe. Oh, yeah. Well, all right. So, his
00:44:24
glucose is 88. Not too bad. Ketones. Boo. Absolutely. Yeah. That's
00:44:29
an example of he is making trash. There's no trash going out. So, his ketone level is what the
00:44:35
0.1 and his blood sugar is 88. So, if you take 88 divided by 0.1, it's like what? 1,000 or something. It's really
00:44:42
high. 888 probably. Uh that is a lot of trash being made when that Dr. Bos ratio
00:44:49
is high. You you can't take it out. Do you want to say that's his face? I mean I feel like
00:44:55
I just think that when Peter did that and said, "Oh, I had no idea." I'm like, "You could have just checked this first
00:45:01
thing in the morning for 5 days." If you have that kind of a Dr. Boss ratio, you're insulin resistant. You're insulin
00:45:07
resistant. You have to be hitting that in a routine regular interval in life to
00:45:12
not have those problems to have osteoporosis at such a young age. Uh a ketogenic state would not allow that.
00:45:18
You would be using resources much better. He actually did a test and it turns out he doesn't have osteoporosis but
00:45:23
Oh, good. That was that was shocking. Yeah, it was like you shouldn't have osteoporosis at your age.
00:45:28
No, I think that was a misreading because of the scanner, but um Right. but on this on this point in particular,
00:45:34
his keto levels are 0.1. So he's basically running off glucose, all glucose. And and so why is that
00:45:39
happening? Okay, whatever he ate, the insulin went up. So let's say he was your exact same eating pattern. He ate
00:45:46
last night. He had the 6, eight hours of sleep. The cortisol said, "Oh, the sun's
00:45:52
rising." And it rose his blood sugar a little bit. Mhm. Okay. When the sugar's high, you can't you you can't your your insulin is going
00:45:58
to be high, too. You're not making ketones. When I did these this keto test with most of the team here, they were all
00:46:04
around that region. and they were in the region of 0.1 ketones in their blood to 0.3. Welcome to my clinic in 10 years. That
00:46:11
is trash being made, never being taken out. And so you'd say to them, you need to do
00:46:16
some fasting. You need to you need to cut scarves. Yeah. I mean, if you're looking for quick, okay, if
00:46:22
they're in their 20s, I mean, I have three kids, right? And they have heard this chirp for 10 years. Uh, I mean, how
00:46:28
I got into this was my mother was very sick and she was sick because of a high insulin problem that caused cancer. So,
00:46:36
we put her in a ketogenic state and everybody in the family got on board. So, here's three little boys who no longer have candy around. Now, they're
00:46:42
in their young 20s and for the first time they're actually listening to say, "Gosh, mom, one of them's at Georgetown.
00:46:47
He has to read for long periods of time for Georgetown Law School." And he's like, "If I'm not in a ketogenic state,
00:46:53
I can't keep the focus." And I said, I said, 'Well, how are you doing that? At first, he tried some of the supplements.
00:46:59
Okay, but what really happened was he cut the carbs down and said, I can say no to that because of the sustained
00:47:06
brain power. I mean, it's really easy in your early 20s to do this. Cut the carbs even to 50, but prove to yourself that
00:47:13
you made ketones and that return on your dividends is you won't be seeing me in 25 years.
00:47:19
So, you have this idea of this keto continuum. Mhm. What is the ketone continuum? I read
00:47:26
about it. I mean, it's a it's a book here that I have which you published in 2020 called the ketone continuum.
00:47:32
Consistently keto for life, right? So, the keto continuum is this 12step
00:47:37
process, right, to get into a consistent keto. Consistently keto. Yeah. That you're constantly taking out the trash. The
00:47:43
first part is the beginner. Okay. So, the first part, the beginner section has four stages to it, right?
00:47:48
What are what are those four stages? Well, I I like to tell patients that you never fall all the way off of the
00:47:53
continuum. So, the first part the first step is really not keto, but it is that they're eating every two to three hours.
00:47:59
And if they fall off the wagon, that's usually where they land. So, that's what most people start at. They're eating every two to three hours. They are not
00:48:05
keeping their carbs less than 20. Step two is cut your carbs to 20. That's the
00:48:10
only thing I need you to measure. And you're going to be able to use a ketone strip, you know, measure ketones in your
00:48:17
urine. Uh, and that will ride you you'll ride a wave. And that ketone production
00:48:22
is happening. The fat-based hormones in your body are starting to resurrect.
00:48:27
They're starting to do the things that they need to do. And there will be this magical moment in the not too near
00:48:33
future where you skip a meal. And this that beginning stage, how long
00:48:40
does that last? I'll put this on the screen so everybody can see. Sure. The continuum. Um, how long does that
00:48:45
initial beginner stage last for people if they've been severely insulin resistant? This is the ones where I've said they took their carbs to 20 for for
00:48:54
two weeks before they peed a ketone. So, I use some other steps if that's how severe that is. But let's just take the
00:49:00
average person that's like not they're not 100 pounds overweight. They're hitting menopause and they've put on 25 lbs. when they drop their carbs to 20,
00:49:08
they're peing a ketone by the end of the week and they are missing their first meal by day 10.
00:49:14
Okay. So, day 10 and then it says when we get to stage five in the keto continuum, it says 168 168. Is that
00:49:22
Yeah. So, then we start to use timerestricted eating uh where I want I mean we're going to your body will
00:49:28
adapt. People say you can't stay on the keto diet because they go to step four and then they think that that's all they needed to do. There are several steps to
00:49:35
reversing this problem and you'll know you have the right step if the ketones are still present in your gut in your
00:49:41
blood. Your body will adapt though. So, we start to say, "All right, we're going to learn some new behaviors. We're going
00:49:47
to learn what the nothing burger looks like at least for 16 hours out of the day." What does that mean?
00:49:53
You do not eat a thing in those 16 hours. Now, I I give them a little hedge
00:49:58
because most people come in like you. They don't start eating until two o'clock in the afternoon and then they eat until 10 o'clock. And I want them
00:50:05
fat forward. I want lots of fat going in because insulin resistance uh that high
00:50:12
insulin state means they've locked or they've insulated their fat on their body. And then we get to stage seven where it
00:50:18
says 231. Is that fasting for 23 hours a day and eating for 1 hour a day? And the there's a little bitty line
00:50:25
between 168 and 23 in1, but there's a whole bunch of life there. Meaning, we
00:50:30
don't actually have patients go from 16 hours of fasting uh to 23. We have them
00:50:36
slide it down by an hour, slide it down by an hour, and then we do that harder thing, which is move it towards sunrise.
00:50:42
Quit eating so late at night. And then the last stage here, so so step 9, 10,
00:50:48
11, and 12 is prolonged fasting between 36 and 72-hour fasting.
00:50:54
Right? So those folks that have high insulin for 20, you know, 15, 20 years,
00:50:59
they're going to have to do a nothing burger for 36 hours in most of them to really give a good reset of their
00:51:04
metabolism. And although you you look at other folks saying, "Oh, you should never do that if you're a woman. You
00:51:10
should never do that over the age of 50." I'm saying you have too much insulin in your body. You have to do that to get the pancreas to make less
00:51:17
insulin over time. On that point, between men and women, are there metabolic differences that need to be mentioned here? Because, you
00:51:23
know, when I sometimes when I do ketogenic fasting, my girlfriend, she takes much longer than me to get into a
00:51:29
ketogenic state. And I'm wondering if her body is in some way trying to defend the switch.
00:51:34
Have you ever seen the the reality show Alone? Oh, no. I'm not show guy. No, I'm not either. But they drop these
00:51:40
people off in the middle of nowhere and they starve them to death. And you watch the fat come off of them. And the men,
00:51:46
the fat just melts off of them. And the women, they do what your girlfriend does. It just holds on to them. That we
00:51:53
are designed to have that fat on them. So asking them to do a ketogenic state,
00:51:58
you'll hear people say, "Oh, it's going to ruin your hormones. Oh, it's going to you can't do that." And um I would say
00:52:05
you can have all those conversations once their insulin is normal. What I have lots of women in childbearing years
00:52:11
that are excessive producers of insulin and their vitamin D is low, their estrogen is low, they have hair loss on
00:52:18
the top of their head, they have skin tags throughout their body, or maybe the first sign was they had PCOS. Okay, all
00:52:25
of these are a sign that insulin came in and it's too high in their body. So lowering it has rules and if you want to
00:52:32
have a baby, carry a baby, uh have uh the weight come off after you've
00:52:37
gestated a baby, um have weight not be your enemy during menopause. You have to be making ketones at a routine and
00:52:44
regular interval and start with the food. Start with the menus in the kitchen. Don't run to the gym first.
00:52:52
I've noticed uh in women in my life that they've told me that their menstrual cycles become more synced up when they
00:52:58
are in a lower carbohydrate diet. Right? Their hormones can hear each other. I mean, when insulin is high,
00:53:04
insulin dictates what that sugar does, but it also is the dictator for every
00:53:10
morsel of fat. And estrogen, testosterone, vitamin D, they're all a
00:53:16
derivative of fat, of cholesterol. And they are they're put into the fat cells. If you biopsy an obese woman and say,
00:53:23
"Can I see is there any vitamin D hidden in there? Is there any estrogen? Is there any?" Yes, they're all in those
00:53:28
fat cells, you start to lower their insulin and the fat mobilizes. So, the
00:53:34
hormones that are naturally communicated between women, they can actually hear them again. I mean, that that tribal
00:53:39
thing. If a woman were to stay in a ketogenic state permanently, would there be any disruption to her
00:53:46
metabolic health? You mean like me? Yeah. like her, you know, her menstrual cycles, her uh yeah, anything.
00:53:54
No, I think it's you're going to find people that it shouldn't be extreme. Meaning, I've been on this for 15 years.
00:54:01
The ketogenic phase is at least 20 out of 30 days uh in a month. The first few
00:54:09
years I was on it. Now, at 55, menopause in the last year, um I'm like without a
00:54:15
ketone, my brain doesn't work right now without a ketone. uh my energy goes to pot and I have been walking women
00:54:21
through menopause for 25 years. It is not a fun story when they're insulin resistant. So prepare uh have the
00:54:29
flexibility of that mitochondria to use both ketones and glucose and that's what a ketogenic state is.
00:54:36
Well, we have 12 cans of sardines here and uh I I I wondered why you you
00:54:41
brought sardines with Well, yes. That's a hell of a tool.
00:54:47
Why? So, um, when you're trying to help patients change behavior,
00:54:55
sorry, the sardine juice has gone on my iPad. Oh, good luck getting that off. Yeah, sardines rank for uh the worst smelling,
00:55:04
but they're not the worst tasting. When it comes to bitter in fish, they don't have the bitterness that tuna does. So,
00:55:10
tell me about sardines. Why Why should I be eating sardines? When you're trying to teach patients, those stats that you read off a minute ago, they don't care.
00:55:17
They need a very clear step on how do I begin. And when you're working with
00:55:22
somebody who cannot seem to get their ketones to rise, and I give them a whole list of menus that's too noisy, let's
00:55:28
take it down to one food that is high in fat, high in some of the best fats, high in protein, it's whole foods, and it's
00:55:35
affordable for everybody under the sun. Okay. So, you do you do like a sardine
00:55:41
fast? Yeah. So in fact that that 21 day I mean 21 day is that three-week course where I
00:55:47
say I will teach you how to do an advanced ketogenic diet where everybody will be peeing ke or making abundant
00:55:52
ketones. On day six uh I say all right the only thing on the menu for the next
00:55:57
three days is sardines. There's no eating window. You can eat as much as you want. There's no limit to the
00:56:03
amount. And what I'm pushing them to do is not only eat a nutrient-dense food
00:56:08
but I want them to feel satiety. I want them to feel full. Do I need to be consuming a lot of fat
00:56:14
as well? There's plenty of fat in there. But I mean, generally, because this is one of the the things always puzzles me is I I'll go
00:56:21
let's say I went a week without eating carbohydrates. Sometimes I'm still not in ketosis. And
00:56:28
I think I heard somewhere that it's because my fat isn't high enough. So yeah. So again, you at the time you went
00:56:34
you went seven days without eating hardly any carbs, right? And you still didn't make a lot of ketones. Okay. So you had fat on your body.
00:56:41
Yeah. Okay. So why didn't the fat get to your mitochondria? Excess insulin. Okay. You had been in a
00:56:47
high insulin state. So if you swallow the fat, then you can turn it into ketones. Right now all your fats locked
00:56:54
under this insulin bed. If you kept going, it would eventually hit. But that's painful. I mean, I have patients who do it for two weeks.
00:57:00
So what you saying? You're saying that I need to eat fat. Yeah. So if you put the sardines in oil,
00:57:05
uh that's a great highfat, high protein. Uh, it's also a little easier to masticate the the meat and you'll have
00:57:12
high fat, high protein, and you'll have beautiful ketones by by 48 hours, maybe
00:57:18
72. And what what is the the composition of my diet in terms of protein, fats, and carbohydrates when I'm trying to get
00:57:24
into a ketogenic state? Yeah. I don't let people get distracted by this, right? I say look at your
00:57:29
finger. If it's got a high ketone, you have got enough fat and enough protein
00:57:35
uh and low enough carbs. What most people have is the story you told. I've been doing this for five days. Why don't
00:57:41
I make any ketones? And the answer is what is hidden behind the chemistry is too much insulin. You've got to have And
00:57:49
so that's a great place to say put the fat up, keep the carbs low, and the ketones will come. When you say put the fat up, you mean
00:57:55
eat more fatty foods. Give me an example of the type of shopping list that if I was trying to get in a ketogenic state
00:58:02
and stay there, I would have. Yeah. My one of my favorite things is uh uh pork belly, more eggs, beef brisket,
00:58:10
uh ribs, avocado, avocado have a beautiful marketing team, but they do have carbs in them and I've
00:58:17
had people overeat them. Like I have four avocados today. I'm like that's you you're on the wrong bandwagon there.
00:58:24
Avocado makes the list, don't get me wrong, but it's not a diet of mostly avocado with a sprinkle of chicken
00:58:29
breast. That's not going to get you into ketosis. The fat has to be higher than that. Most of the time when I'm really
00:58:35
struggling with a patient who just can't seem to make ketones, can't seem to make ketones, and they won't do the sardines,
00:58:41
I've said, "Eat butter for a day. That's 100% fat." Okay. So, you can just have increase the
00:58:47
butter and Yeah, you could have that. Okay. So, that Are there carbs in here? No. No. No. It's just fat.
00:58:53
Mhm. And it's not awful, but it is a great social experiment where they
00:58:59
haven't felt what satiety feels like in a while. People talk about net carbs. They say, you know, an avocado has 12
00:59:07
grams of carbs in, but it has 10 grams of fiber. So, the net carbs is two.
00:59:13
If you've never had insulin resistant, you can do it that way. My patients have had high insulin, and I don't play that
00:59:18
game. It's got to be total carbs. Fiber is for farting. Do you recognize this photo of this
00:59:25
lady? Oh, yes. Who is she? Why, she is just a great story. Jane had
00:59:32
uh she had pathology with how she thought about food. Like many patients, she
00:59:39
she had food as the way she coped with a lot of things. And as long as she was
00:59:45
clearing her plate and using that food, it comforted a lot of wounds. When you
00:59:50
start to address some of these things, I mean, the ketogenic diet doesn't fail if you just follow the chemistry. The
00:59:55
ketogenic diet fails when you have humans who've had wounds, who've had a history, who have stress, who don't
01:00:02
sleep. And Jane was a great story where all the goodness in the world couldn't
01:00:07
undo some of that relationship she had with food. Uh so the first time she's one of the coaches that I used for that
01:00:13
21day and she just has the best outcomes because she was doing the a strong ketogenic diet, you know, for those
01:00:19
three weeks twice a year. and she decided that after I think the third class she was going to do sardines only
01:00:26
for 30 days and she writes me at the end of the 30 days can't believe how great she feels and really kind of addressed
01:00:33
some of those demons associated with why she would eat what she would eat and then life hit again and she put on some
01:00:39
of the weight again um she'd used sardines intermittently and she called me and said all right I think I'm going
01:00:44
to do this again I'm going to just go on sardines and really have a some come to Jesus moments on why it why it is that I
01:00:51
do some of the things I do. I mean, it's a really vulnerable moment where you can hide those moments. You can never tell a
01:00:57
soul what's really going on through your mind. And she was going to address them. And I said, "Well, I have a bone to pick
01:01:04
with Joe Rogan. He has said some inappropriate things about sardines, like they're arsenic
01:01:11
poisoning. So, I'd like to check a few blood levels in you before you start." So, we check her vitamin D, we check her
01:01:16
arsenic, selenium, and a few other things. and she starts on her sardine challenge, her sardine journey, and she
01:01:22
goes a 100 days, 100 days of only sardines. And not only does she, first
01:01:29
of all, her vitamin D, she did not take any vitamin D. She stopped her vitamin D. It went from like the 30s and 40s up
01:01:35
to just maybe over 100, 108 or something. Uh, her selenium didn't do anything naughty. Her arsenic did not do
01:01:42
anything naughty like Joe Rogan said it would. and she was able to um not only
01:01:49
shed the pounds but really say some truths about why she was eating so much
01:01:56
and she confronted the pathology about why why is she using food for those
01:02:01
other things. You know, I do this thing in the 21day where I ask them to find their best day in their life and I'm
01:02:09
trying to just get them to think about what does that feel like? What what did that look like? and then we go to the worst day in their life. And Jane wrote
01:02:15
something that really touched me. She said, "I don't think I've ever had the best day of my life."
01:02:22
This was probably the third or fourth time we'd done that exercise. So, she' done it in a way where it didn't bring any extra attention, but she was she
01:02:28
spoke a truth that just said, "I've had this fear for so long
01:02:34
that for the first time, I'm going to say out loud that I'm looking for the best day of my life, and I feel like I
01:02:40
have the freedom to do it. That's what happened after 100 days of sardines.
01:02:45
So if she eats a sardines for 100 days, she's probably not going to get like the
01:02:51
gut microbiome. She has the best gut microbiome. Doesn't she need to be eating plants to
01:02:58
Oh no. Fibers for farting. So you're looking at a gut biome, right? And so
01:03:04
tell me what you think that is. Uh lots of bugs that have been feeding on plants.
01:03:11
Okay. Yes, Pututyrate has uh has part of that equation. So, gut biome is the
01:03:16
slime layer inside your gut. It's where the critters live. It's where they set up homes and they if you have a really
01:03:22
good slime layer, it's squishy. It's dense. It's not moth eaten. It's not
01:03:28
aquous or waterlike. It's squishy. And when you put plants in there, when you
01:03:33
put fiber in there, it tears that down. Uh, and you say, "Well, fiber is needed for this because some of those bugs eat
01:03:41
up on the fiber and they put out some butyrate and that helps these other bacteria to to grow." You're like,
01:03:47
"Yeah, that's one way to get a good microbiome." But we haven't been fiber eaters forever. And when you look at
01:03:54
many of my carnivore patients, especially when they've got, you know, some of those little fish scattered into
01:04:00
that carnivore diet, um, their symptoms of irritable bowel, of chronic diarrhea,
01:04:06
of, you know, bloody ulcers reverse. Why? Because that gut biome got a lot
01:04:13
stronger and a lot healthier. So, the things that I from doing this podcast for a long time, the things that I' I'd be concerned about if I just ate
01:04:19
sardines for a prolonged period of time or really any diet, I guess, for a prolonged period of time, a narrow diet would be the fiber issue we talked
01:04:27
about. Um, and then all the other things that are just not in sardines, I mean, vitamin C. Yeah, you still get a good vitamin C.
01:04:33
So, vitamin C has different rules when you go carnivore. What about magnesium? Yeah, lots of that. Magnesium, I still
01:04:38
think is one supplement we all need. What about sodium overload? Because these are very salty, right? your sodium
01:04:45
churn. How well you use sodium is dependent on how well you've eaten in the last week. So when you increase the
01:04:50
sodium, those receptors get better. When you decrease the sodium, those receptors showed down. That's a that is an
01:04:55
adjustment that everybody will make. What about things like mercury and the sort of metals toxin? Little fish, little problems. You got
01:05:01
the right one for mercury. Again, we tested that for her, too. 100 days, no problem.
01:05:07
Oh, especially in the can as well. I think I've got a bit of an issue with canned food these days because I've heard so many
01:05:12
microplastics, microplastic toxins, etc. I think you're majoring in the minor leagues there that the the amount of
01:05:19
benefit that people get from sardines versus whatever might be in those in
01:05:25
that can. I tell patients not to worry about it. And then the last point I said was about
01:05:30
digestive and mood issues because the gut microbiome is so so linked to brain. Absolutely. Serotonin, isn't it? the the
01:05:36
I mean serotonin is in the gut, but it's it's a huge part of like a GLP-1 the GIP they're all produced hormones in the gut
01:05:43
that are hugely impacting your brain. And when you want GLP-1 to be made, have
01:05:49
a strong thick microbiome. You do not need fiber to do that. You need butyrate.
01:05:54
Butyrate is that twocarbon uh fat that comes from acromancia you
01:06:01
you know chewing up the fiber, right? or beta hydroxybutyrate in your blood.
01:06:08
That's that ketone thing you're got over there. These things. Yeah, all of them.
01:06:13
God. There you go. Yes. It's a beta hydroxybutyrate is what that is going to
01:06:18
turn into your circulation. Butyrate is a fat chain that's two carbons long. That's what the
01:06:25
you're asking that microbiome to say here this long string of fibers coming along and that that little bug is going
01:06:31
to eat a piece of it and make butyrate. Two carbons of fat. That's one of these
01:06:36
things that you're talking about. You need to have butyrate. You need to have butyrate. That's what every every Why are you even in Viterate? You got to
01:06:42
have butyrate. All these, you know, experts come on my show and they talk about the importance of having a diverse I know. I I've I've watched a bunch of
01:06:48
them. Diverse microbiome. Yes. And what I think so it's not going to be diverse if I'm just eating one thing.
01:06:53
Oh yes, it will. Measuring. So that's the whole point of a microbiome is what what you know diverse
01:07:00
enough to be supportive. I mean diverse enough to have the the two chain fat
01:07:06
that you want to have in there. I mean go back uh and and look at when our
01:07:12
bodies were just eating um you know fish or carnivore. Uh the the beauty of a
01:07:18
microbiome is how much it does adjust in every patient.
01:07:23
What about supplementation? What are the key supplements that you don't live without on a daily basis?
01:07:30
Vitamin D turns out to be a really important one. Like if I'm eating sardines uh four or five cans a week, I
01:07:36
probably don't need vitamin D. But why is it so important? Vitamin D. Yeah. It's a hormone, right? A hormone
01:07:42
that goes and talks to every one of the cells in your body. and it tells that
01:07:47
cell to be its best version of itself. That hormone uh goes to the nucleus and
01:07:53
it makes that skin cell do something different. It makes your brain cell do something different. It makes your heart
01:07:58
cell do something different. You read all the benefits about vitamin D and you think it's like it's like it does
01:08:04
everything like how can it do all of these things and the reason why is it is not just a vitamin. It's a hormone that
01:08:10
changes how the cell functions. Unfortunately, it's made of fat.
01:08:15
So, if you have high insulin, it gets stuck parked in your fat cells and it didn't get to the cell.
01:08:20
Is there a link between vitamin D and ketosis and weight loss and insulin? Yeah, it's actually why I pointed out
01:08:26
that when Jane did that 100 day, uh, she's been struggling with her vitamin D
01:08:32
in the 30s or 40s, right? But for the best brain, we wanted to be of 50. So, she starts on the sardine challenge.
01:08:37
It's in the 30s or 40s, and she's supplementing. She's taking as much as she can, but what's happening? her
01:08:43
insulin was putting it in her fat. She goes on sardines which have vitamin D in them. By the end, her vitamin D was 105,
01:08:52
108, something like that. So, you can see the experts say don't go above 100, but the I don't I don't have any worry
01:08:59
about hers being 108. What happened was she lowered her insulin and now fat can
01:09:05
move around in her body like it's supposed to. And part of that fat isn't just her estrogen, it was her vitamin D.
01:09:10
She looks like 20 years younger. Isn't it amazing? You should see how joyful she is. That's the part that
01:09:16
you're like what unlocked during those 100 days of you can say food restriction, but vitamin D went up, uh
01:09:22
insulin went down, and she really said, "How many things am I going to comfort
01:09:28
in my life from food?" And let's let's let's tackle that demon. Did it stick?
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period. That's shopify.com/bartlet. What What about the other supplements
01:10:33
that you would not live without? Well, I think the whole world's low on magnesium. I wish I could. Magnesium.
01:10:39
Yeah. So, magnesium is required for every little It's like the spark plug in our
01:10:44
bodies. It's a little metal and it's how ATP gets recycled and you need it for almost every enzyme. But our food is low
01:10:51
in it. Our foods, our soil is low on it. You just got to replace it. I I use magnesium supplements, but I also have
01:10:58
my patients go for a magnesium float. What's that? Uh, ever seen pictures of
01:11:03
people in the Dead Sea? No. Uh, they're floating, right? This the salinity or the salt level is so high
01:11:09
and it stinks, right? It's a stinky place. It's magnesium. So, they go in there, they soak in the magnesium and
01:11:15
you're like, "Oh my gosh, I feel so much better." Like, that's got to be junk science, right? Well, it turns out it's
01:11:20
not. So, you can get magnesium absorbed through your skin. And just like, I don't know, in the 1990s you'd go rent
01:11:26
time in a tanning bed, you can rent time in a magnesium float. any of this.
01:11:31
So, omega-3, if you're not doing fish, uh you can't go wrong with omega-3. And you know, uh I Stephen, I really push my
01:11:40
patients to have ketones around. What? When you say ketones, you mean external exogenous ketones. Yeah.
01:11:45
So, the word exogenous means external externally consumed. And there's some on the table here. I'm an investor in this company actually, so
01:11:51
that's probably worth saying. Keton IQ. Um there you've got some other ones here which are what's this? It's like a
01:11:57
that's ketone salts. So, this one is just beta hydroxybuteric acid. My husband is definitely allergic to
01:12:03
stevia, so I said, "I'll make this one for you, honey. It's just liquid ketones, okay? No sweeteners, no fillers, nothing."
01:12:10
And is there a difference between taking external ketones through a drink or
01:12:15
through the salts or whatever else versus actually being in the ketogenic state because of your diet?
01:12:21
When you make it, it is much more abundant. But when you do what people do, they fall off the wag again or
01:12:27
they're very insulin resistant, so their body is trying to catch up to to equilibrate, you want ketones put back
01:12:34
in circulation because it will spark their liver to make ketones. So it really is a jump start for patients with
01:12:41
chronic insulin resistance, chronic problems. We got about, you know, six years of getting them to the healthiest version of themselves as long as they
01:12:47
don't fall off the wagon. So when they are doing okay and now they need to get back on track, give them a dose of
01:12:54
ketones and by putting ketones in their circulation like that by checking their blood, the liver will make ketones. So
01:13:01
it's not just a fuel. They will feel better. It's a signal for the liver to
01:13:07
make more ketones. But I'm not going to be burning fat than am I? You will. I mean again ketones beget ketones. When you are making ketones,
01:13:13
your body makes more ketones. So if you jump start it by swallowing some, you get better tomorrow. they'll get better
01:13:19
tomorrow. And usually if somebody's falling off the wagon, I'll have them do ketones for like 3 days and the fourth
01:13:25
day they are on their own again and they'll stay steady for a couple of weeks and then they'll have pasta.
01:13:33
I I that's why I invested in this company because I'm actually a owner of the business now. Um because I saw the
01:13:39
benefits of having exogenous ketones on a regular basis, right? So if anyone wants to try them, go to
01:13:44
ketone.com and your brain will use it like that. meaning super fast, right?
01:13:50
When I use my ketone reader, it appears in about 15 minutes or 20 minutes for so and their liver then makes more ketones
01:13:56
for the next 12 hours. That's the part that I I especially for my cancer patients or people who are really I mean
01:14:03
we need ketones high for their they got chemo tomorrow. They can't afford to say go fast for 48 hours. They don't have
01:14:08
the time. So let me help you. And there's nothing better than going into that chemotherapy, going into that
01:14:14
radiation to with a bunch of antioxidants and circulation coming right out of your liver. Explain why that matters. I mean, I've
01:14:20
got a photo here of her. Grandma Rose. Grandma Rose.
01:14:25
Yeah. That's my mother. Yes. She is the reason I'm here.
01:14:32
It's been five years. Yeah. 2015. the the most stubborn
01:14:38
patient walks through the door after 10 years of the best health care I know how to give.
01:14:46
And she's gray and she looks like a zombie and she's got big lymph nodes in her
01:14:51
neck. You don't need to be a doctor to know that she's dying. Her cancer was back again.
01:15:01
And we go to see the oncologist uh and he says, "You need chemotherapy." And she says, "Why Cal, the last two times
01:15:08
you did that to me, I didn't know what a sewing machine was." And she made all of my clothes until I
01:15:14
was the age of 10. And she's nervous because she has 6
01:15:20
months to live if we don't do something. And she asks me a question that
01:15:28
lots of patients have asked me this question. I just sometimes lie.
01:15:34
She said, "If it was you, what would you do?" That's a really emotional question
01:15:39
because there's guidelines. There's the rules. Here's what you're supposed to do as the doctor
01:15:46
when it's your mom. And I have I saw what chemotherapy did
01:15:52
to her. It was terrible. She didn't know the grandkids. She It
01:15:57
was terrible. And we just got her back to functional again.
01:16:03
And so I said I had been reading about the ketogenic diet on brain injuries and I'd come across a couple of studies on
01:16:11
what it can do to a cancer patient, especially an insulin driven cancer patient like she was.
01:16:16
I said, "Mom, do you trust me?" I'm like a fool.
01:16:23
She said with my whole life. We were standing there in the in the
01:16:29
waiting room of the hospital. Well, one way was to schedule the chemotherapy and the other way was the front door.
01:16:36
Said, "Mom, let's get in the car together." I left my car there. I drove to my family farm, which was 100 miles away,
01:16:43
and explained to my mother what a ketone was. And her brain wasn't working right, so she didn't quite remember.
01:16:49
And we went to the house. We threw out every carbohydrate. And man, at 6 weeks
01:16:55
with chemotherapy, her numbers were supposed to drop by 30% of her cancer.
01:17:00
We didn't tell the doctor. We just put her on a ketogenic diet and said, "We'll come back in 6 weeks." So, she's walking
01:17:06
through the door of the hospital. It's 6 weeks from there. And it is like God has
01:17:14
just the Holy Spirit is rising out of her. She looks amazing.
01:17:21
So, we go to get her blood drawn. We're sitting in the waiting room for the for the cancer doctor. And he's my friend.
01:17:26
He knows he's known me for 10 years. So, I'm scared to tell them what we're about to do.
01:17:33
So, we're sitting in there waiting and they come and draw our blood again, which either means it's really good or it's really bad.
01:17:40
And so, I get really nervous at the end. We've been in that room for about an hour and I said, "Mom, if he asks you what you're doing, just shut up cuz I
01:17:47
don't know what to tell him." And he walks in and he slides the piece
01:17:53
of paper over to me and says, "How did you get her numbers to drop by 70%.
01:17:58
There's no drug on the market that would do that. When you say numbers, her cancer numbers, so the chemo would
01:18:05
have dropped it by 30% and the ketogenic diet dropped it by 70%. In 6 weeks
01:18:12
and she went from a 70-year-old that looked 100 to a 75year-old who looked 40.
01:18:22
How did your your mother get on from that point onwards? Yeah, she she lived her best life. I mean, I talk about her being from this
01:18:28
little town of 800 people. She was Mary Poppins. I mean, like, you don't have a
01:18:34
lady's aid unless you're part of the lady's aid in in the little small town. You don't have a Sunday school teacher
01:18:41
unless you're doing the Sunday school. She was in every aspect of this little town.
01:18:46
And she went back to doing all of it. and the pandemic hit and there's a
01:18:54
thrift store that she would volunteer at because well it's just a good place to put your time and the community needs
01:19:00
it. And while she was at the thrift store she got CO
01:19:07
and her cancer was of the tea cells which means it's going to be the first line of defense against CO
01:19:14
and her her tea cells failed. Some of some of the science behind this talks
01:19:20
about how cancer cells often rely heavily on glucose for energy, a phenomenon known as the Wahberg effect.
01:19:25
The keto diet drastically reduces carbohydrate intake, forcing the body to produce ketones for fuel instead of glucose. Healthy cells can use ketones
01:19:32
efficiently. Many cancer cells cannot. So in theory, keto could starve tumors while supporting normal tissue. And
01:19:39
they've done some animal studies that show it can slow tumor growth in some cancers especially brain cancers like
01:19:45
glimoblastto glyobblastoma. Yep. Enhance response to radiation or chemotherapy in certain models and
01:19:51
reduce inflammation and oxidative stress creating less a less cancer friendly environment. However, results are mixed.
01:19:58
Uh it may also benefit muscle mass and weight stability in patients losing muscle from treatment. may improve energy levels and mental clarity for
01:20:05
some people and could reduce insulin and IGF-1 levels, hormones linked to cancer growth, may improve quality of life when
01:20:11
used alongside standard treatments like chemotherapy. Um, there's al also a list of potential risks which I'll throw up
01:20:17
on the screen. And I guess the summary here is keto may help by lowering glucose and insulin, reducing inflammation, and supporting metabolism,
01:20:23
but it can be risky if it leads to malnutrition fatigue or worsen treatment tolerance. When patients I get a lot of people
01:20:29
calling and saying, "Is it going to help my cancer? Is it going to help my cancer? Stephen, I go back to the same thing. The amount of trash that you've
01:20:35
not been taking out, we have to start. And when you put them in a ketogenic state, I mean, it really helped her
01:20:41
cancer. It really did that war effect. She was a a new human within 3 weeks.
01:20:47
But she had a lot of trash to take out. This was a year and a half before she got to be the best version of herself.
01:20:52
And it really did return and restore her to to health. When I look at patients
01:20:57
now who say, you know, can is I am I going to reverse my cancer with a ketogenic diet? I'm like, no, but you are going to deal with it a lot better.
01:21:04
I guess that's really what it comes down to. It's like creating a better environment so that if disease does arrive, obviously there is a, you know,
01:21:10
with a lot of diseases, there is a causal element where the way we eat and our lifestyle does create the disease,
01:21:16
right? Um, but also when that disease arrives, what like environment is your body in to
01:21:22
deal with it, to manage it? And I think a lot about this I think in part because of the pandemic where for the first time
01:21:27
in my fairly young life I saw that your current physiological environment so your current the current state of your
01:21:33
body was the single biggest predictor of your outcomes. Amen. Oh it was terrible. So I think 30 years old and it was like
01:21:39
well if you're currently overweight your ch chance of dying from COVID is really
01:21:44
really high. And so I think that was one of the big sort of protagonists in me getting into shape was realizing that,
01:21:50
you know, diseases are probably going to happen to me, but how my body responds to it is to be determined. And I look at
01:21:57
how much when you're asking an elder person to lose weight. And you just read something really important there, which
01:22:02
is when those ketones are in circulation, it is a signaling agent to make more ketones, but it also signals
01:22:08
the body to say don't use muscle mass as a resource. Go for the fat. So you can see this protective m I mean you take
01:22:14
people through chemotherapy and they have you know they shed way too many pounds right you put them in a ketogenic
01:22:21
state and their muscle mass gets higher preserved their brain function their ability to handle this you know one of
01:22:27
life's most enormous fears is death and that mood stability and muscle mass
01:22:34
protection because they've got ketones in circulation boy that's the gift that they need right now in in high numbers.
01:22:43
What is um I've heard you talk about methylene blue. Oh. For brain health. Ever done that? No.
01:22:48
Oh my goodness. What is it? Well, it's old as dirt, so nobody's making money on it. But it is a dye. And
01:22:56
so if you swallow it, you'll pee blue. But it's also a bridge for how to help
01:23:03
mitochondria move fuel along. So, one of the worst parts, you asked me this
01:23:08
question about supplements and I really have a tough time saying which supplements actually get to the cells
01:23:14
that the patients are looking for. There is a really great fact about methylene blue that when you swallow it, it
01:23:20
actually was used for malaria treatment or antimmalaria for soldiers and they
01:23:26
would check compliance by making sure that their pee was blue. But when they died at autopsy, they had blue brains
01:23:34
and blue hearts. it would dye these organs blue. You say, "My gosh, that's
01:23:40
so strange." But you know what that tells me? It got to the cells that it was advertising it was going to get to.
01:23:46
So you look at methylene blue, it's supposed to supercharge your brain. And I'm like, "Yeah, yeah, yeah. I've heard this before." So I I read about it and
01:23:53
I'm like, "Wow, there's a lot of literature on this." And then I did what I normally do, which is, "Well, let me
01:23:58
take it for a couple weeks." It was amazing. It was amazing. Like
01:24:04
I I was floored at how well that little turkey worked. So there's no money to be made on it. It's a It's been around as
01:24:10
long as dirt, but it's a powerful brain energizer. Like it helps the mito the
01:24:16
electrical stimulus of the mitochondria in your brain keep energy high. And
01:24:22
especially for like high energy brains, I I love it. I I'm like I put that in my
01:24:27
morning morning coffee which is where the April Fools joke because nobody can see in their coffee but they definitely
01:24:33
pee blue. And do you take creatine as well? I do take creatine. Yeah. Yeah. It's great. That brain supplement is awesome.
01:24:39
Do you do I do but my doctor the other day I think he was suggesting that I might have taken too much. Why?
01:24:44
Some liver scan I had and he was saying that liver scan or kidney scan? Kidney scan. That was kidney scan. So that's a trick. Don't
01:24:50
don't fall for that. I mean, I've done a couple of big shows on this where creatine is what you're going to measure kidney function with. When your doctor
01:24:57
checked your kidneys, he probably had you pee in a cup and check your blood. Yeah. Yeah. So, he's looking at what did you pee out and what how clean is your
01:25:04
blood? That's what kidneys do. He just did a blood test. Okay. Well, even the blood test, it the trash was looking like it was a little
01:25:10
higher because the trash we're measuring is creatine, creatinin, uh, and which is
01:25:16
made from your supplement. So, you put the supplement in and it looks like there's more trash around, but That's
01:25:22
just the supplement. It's falsely elevated. It's not true. You your kidneys did not get hurt by that. This I
01:25:27
answer this question probably 30 times a week. I have a standard email saying, "Here's what happened. Don't measure that." There's other ways he could have
01:25:33
measured your kidney that would not have been manipulated by that supplement. Uh what it does for brain function,
01:25:39
especially if there's any ADHD, man, they love it. They they just focus for a long period of time. I mean, it's got
01:25:46
other great findings like if you how how often do you fly over to London?
01:25:51
I fly alone. Yeah, that's the best part about it is that the the the jet leg part of it.
01:25:56
There's really good studies on this. Like your reset of sleep is going to be augmented if you take like 20 grams of
01:26:04
it after the flight, 10 in the morning, 10 at night. Uh and those are great studies like you know, Navy Seals
01:26:12
sleepdeprived. Watch what happens when you add creatine. A lot of women don't take creatine because they've historically thought of
01:26:17
it as like a bodybuilder thing, right? It's a brain thing. And you take creatine every day. How much do you take?
01:26:23
So, two scoops. Yeah. Every single day. Every single day. Seven days a week. I put my methylene blue in it, too. Down
01:26:29
at first thing in the morning. I got blue dyed creatine. I mean, those two supplements are just
01:26:34
they they blew my mind with the amount of research out there. And then I did them. Uh I mean, I'm not a big
01:26:39
bodybuilder. I do some CrossFitty kind of stuff three times a week. Um, so
01:26:44
there's that, but I do it for the brain stuff. The brain stuff is really impressive. At the moment in society, people are
01:26:50
talking a lot about JLP1s and a Zmpeek and all this kind of stuff. And um, I
01:26:55
was wondering if there's any harms or downsides in your view of using these
01:27:00
amp WGO JLP1 protagonists antagonist agonist.
01:27:06
Agonist agonist. And if there's a natural version for those of us that are looking to have less cravings,
01:27:14
um, but we don't want to take GLP1s. We don't want to be injecting ourselves. Yeah. So, those hormones are powerful. I
01:27:19
mean, you if you think that weight loss isn't a hormonal problem, uh, show up at a medical clinic that that they are
01:27:27
powerful hormones that hijack people into a healthier uh, or at least a
01:27:33
weight loss stage. But when you're looking at using this powerful hormone, okay, and use it for a short time, use
01:27:39
it for a long time. What are the rules? These are brand new. One of the analogies I use for patients is, uh,
01:27:44
Stephen, if you wanted to have legs with no hair on them, how would you accomplish that? Shaving them,
01:27:50
right? Because that would be short-term, easy, and reversible. You would not take chemotherapy, the most powerful,
01:27:57
amazing, they'll be every hair on your body will be off in the next two weeks. and it's short term they'll come back
01:28:04
but there's a price to pay when you're using a really powerful unit to do something for a vanity reason. So it's
01:28:11
where I like to begin when I talk about GLP1s. It's it's amazing. You will lose fat and
01:28:17
what do I do instead then? So there's great ways to lower GLP1s or
01:28:23
great ways to raise GLP1s, right? Uh for starters um when you're overweight it
01:28:29
suppresses it a lot. So getting the weight off is a huge part of it. That's why this ketogenic diet is so powerful. Will get the weight off and that will
01:28:36
lift naturally the GLP1s. Is there other ways to suppress um well suppress I was going to say suppress my
01:28:42
appetite but more to just get rid of the cravings? Well, you'll suppress the appetite by raising those hormones. So you put in
01:28:49
alulose. That's a great little boost to that. You put in butyrate. Whether or not that's the bug that you were talking
01:28:55
about or the supplements, butyrate increases and stimulates GLP1
01:29:01
and butyrate just for for those that might not know that word again, right? That's a that is what a ketone
01:29:07
looks like floating around your blood. Okay. Yeah. Uh so a ketogenic state will raise those hormones and suppress appetite.
01:29:13
I've seen a bunch of studies on that that show that when people are high in ketones, ketones, they have a a suppressed
01:29:18
appetite, right? And that is linked to the production of some of these hormones, these really great hormones. But you
01:29:23
make them naturally. And so it's not the addiction part, it's the natural way to make it. I I do find that anyway. I find that when
01:29:29
um I guess it could be something to do with my dopamine receptors as well in my brain, but I find that when I'm in a ketogenic diet, my cravings for the
01:29:35
things that I once craved, like I don't know, like carrot cake or cinnamon rolls, they just completely seem to
01:29:41
vanish. That's the same thing that happens when you give them that shot too. Oh, really? When you give them JLP1? Yes.
01:29:46
Okay. And I mean the beautiful part is you're young. You'll make a lot of GLP. You've already made healthy GLP-1.
01:29:53
You'll hijack and suppress it by being overweight and high insulin. So constantly delivering ketones to your
01:30:00
blood, that's how you keep it high and you don't end up on the shot, which is expensive and very powerful. I always
01:30:06
think, you know, when we give people advice on things like weight loss, there's always a part missing, which is
01:30:11
this part about like discipline and motivation or whatever one might call it, which is the is gives somebody the sort
01:30:18
of activation energy to even stick to it. Do you think about this much in your patients? You talk about motivation.
01:30:24
It's huge. I mean, again, most people show up because there's been a recent crisis. Somebody died, they had a diagnosis, something broke, they didn't
01:30:30
repair well. All of that is true and I can get them motivated for a little while. And then we have the long game
01:30:37
and you look at that story with a hundred days of sardines. Okay, that's two years into her journey where she
01:30:42
finally says, "Okay, there's this demon that keeps coming about and I keep falling off for all the wrong, you know,
01:30:47
all the reasons everybody else does." And so she commits to this 100 days and what happens is a whole bunch of things
01:30:53
go right. Her hormones go up and she was has an amazing story. But most people
01:30:58
are not going to do that. So, in my practice, I do say these the smallest
01:31:04
dose of these hormones, I'll help you when you're struggling. I want you in a ketogenic state before we we begin. I
01:31:10
can use much less that hormone. And then you have ownership of this because if I come in and do all of the work again,
01:31:17
that's like every other thing I've been doing for the last 20 years. Here's your symptom. Here's my diagnosis. Here's the
01:31:22
prescription. And I need it to be you that succeeds here. I'll lift you a little bit. So what do you is there any
01:31:29
tricks to get someone to be motivated? Is there any do you have to focus them on their why? Yeah. Yeah. Exactly right. You're right. Uh
01:31:35
that that first trick is get out of crisis mode. Okay. Crisis is what brings them in. But to stay the course, you
01:31:43
have to get to a very serious moment where you say, "What? What motivates me? What at the deepest heart am I most
01:31:50
insecure about that I'm going to do when all else fails? When everybody else gives up? I'm gonna find something that
01:31:57
I'm this little farm kid from the middle of nowhere who was, you know, third grade stinky girl. You like I was a farm
01:32:03
kid. I was a hog farmer's daughter. I wasn't the smart one. I wasn't the, you know, the best one. I'm going to carry
01:32:09
that insecurity with me until the day I die. What has that done? It makes me work really hard when everybody else
01:32:15
gives up. Now finding that for them and and using
01:32:21
that using that harness to say your biggest failure your biggest insecurity
01:32:26
can be your power by reframing it and that why we work on that every time
01:32:32
we do that 21day Jane she did that four times before she really got to the core center why do you
01:32:39
keep doing this that's how people stay motivated it's a truth it's a truth
01:32:44
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You've heard me on this podcast talking about the fact that I stay much of the year in a ketogenic state, which is a
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01:34:04
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01:34:10
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01:34:47
I was reading about what happened to you in 2011 2010 2011 when you reached what you you referred to as your breaking
01:34:53
point of corporate medicine. Yeah. And you had some issues because you were, I think, helping some people
01:34:59
who were homeless. Yep. What What do I need to know about that?
01:35:05
And how has that shaped you? Corporate medicine has lots of flaws and you get tired of answering the same
01:35:11
question over and over and over again. So, you put some stuff up on YouTube and you start to say, "Here's the education
01:35:17
I wish I could give you." Uh, and this starts to work, but that's not the that's not the path. If you're into
01:35:23
corporate medicine, you're going to ruffle feathers. You're going to tick people off. I left corporate medicine, started my
01:35:30
own thing, and I'm living out a two-year non-compete. Do you know what that means?
01:35:35
But you can't do medicine for two years in that same market where they recruited me and they had advertised for me.
01:35:42
Okay. Okay. So, you can't compete with what we just put money into for two years. And they said, "You can see the homeless and
01:35:49
you can see Medicaid." Medicaid being the like government funded med medicine program, low income. So I said, "They don't know
01:35:55
me very well. Those are just as much my people as anybody else. I'm taking care of some Native Americans. They were the
01:36:00
ones in the shelters. They're the ones of the low income. And those teenagers
01:36:06
were overweight and they were eating kitty litter. They were eating toilet paper. Their iron was so low the machine
01:36:14
couldn't measure it. So they're super malnourished." I started doing what I would do if you had all the money in the
01:36:19
world. I took care of these patients. I gave them IV iron. She gave them iron, which
01:36:24
was expensive. It caused a ruckus. I got put on the radar of somebody that did not like that. So, this is a budget. The
01:36:31
whole state gets a budget for how much you're going to spend on each patient. Yeah. I mean, by expensive, it was like 350
01:36:36
bucks per person. That's not that expensive, but it was. And nobody else was doing it. And I got a sticky note inside an
01:36:44
envelope from the state capital. Stop doing Cadillac medicine.
01:36:49
Yeah. So, you you were sued eventually. Oh, they they call it Medicaid fraud.
01:36:54
Okay. They thought I was wasting Medicare's numbers because I was giving IV iron. And I said, "No, I didn't bill for it.
01:37:01
Bill for it. I paid for it." And when I paid for the medicine for these
01:37:06
impoverished patients, they said, "Well, that's Medicaid fraud." So, the
01:37:11
government tried to sue me for that and they lost. But now they're ticked off. They've brought me to court and they
01:37:16
lost. And what happened next is a lot worse. I don't know if you want to hear
01:37:22
that. You want me to go there? Of course. Yeah. Okay. So, when you are being investigated for
01:37:29
Medicaid fraud, all income stops. Yeah. Yeah. So, I have to come home to my
01:37:35
husband and say, "I just can't I can't give in. I think we need to fight this." He said, "Okay."
01:37:43
He he God bless him. He said, "Okay, let's fight it." Have you ever tried to fight the government? That's very
01:37:49
expensive. So they hold off you you when you're under a Medicaid and fra fraud investigation, you get no paychecks. So
01:37:56
we have no paychecks to pay payroll, to pay house payments, to do anything for about 9 and a half months. Actually, it
01:38:02
lasted longer than that. During that time, we started doing things like we sold the lake cabin, we sold the boats,
01:38:09
we sold the extra car, we sold our own house, we moved into a donated RV. You
01:38:16
moved into a car, an RV. Yep. In South Dakota where there's 50 below zero weather with three
01:38:23
little kids. We actually used we took our wedding
01:38:28
rings in for the last paycheck. I I just can't give in.
01:38:34
And then I won. Okay. So, Medicaid fraud wasn't there. But in the midst of that, I said I This was when Obamacare was
01:38:42
really happening. and I got asked to run for US Senate. There's only a hundred of those in the country.
01:38:49
I ran for US Senate and I did really good. I raised
01:38:56
insane amounts of money uh saying I am a doctor that serves the poor. I am a
01:39:02
physician that runs her own company. Uh, I think I am a great voice to send to
01:39:07
Washington DC to make policy about patience and care as opposed to the other opponents.
01:39:15
But that same attorney general, his best buddy was running against me. And when I
01:39:20
am in a mission trip uh in the Philippines, that has nothing to do with it, but I was on a mission
01:39:26
trip in the Philippines and um I left a petition behind. I don't know how you do
01:39:31
it in London, but a petition means if you're going to run for office, you got to get some people saying they believe
01:39:36
in you. Mhm. So, we needed 2,000 signatures. And we got 6,000 signatures. We submitted them
01:39:42
to the state. We think there's no problem. But then the quarterly earnings come
01:39:48
back for a campaign raising. And my opponent had about 70 donors at about
01:39:53
$10,000 a pop and had something like $740,000.
01:40:01
I put my earnings in and they were $780,000. So I outraised him. You have to report
01:40:08
to the government whenever somebody gives you more than $200. So his donors are right there on the list.
01:40:15
My list is empty because the average size of the donation was $45 and they know they can't win
01:40:23
with that. I have a grassroots behind me and that's when the black cars started
01:40:29
showing up in my life. It sounds like I've got a tinfoil hat, but it was real. The black what?
01:40:35
The state card started to show up outside my house. They started to say, "Find something on her."
01:40:42
And I am the first person in the history of the United States of America to be investigated for not witnessing a
01:40:51
signature on those petitions. Okay. So, there was these petitions. You had to get 2,000 of them signed and you
01:40:56
had to witness them. So, you had to be there when they were signed by people. Well, that's what it says. And you're
01:41:02
right. It says, "I bear witness." Uh, so as I'm I left them in my clinic, my
01:41:07
staff signed it, the preachers in my my clinic signed it, and those signatures
01:41:14
were collected while I was in the Philippines. And so you signed to witness them when you were back from the Philippines.
01:41:19
Right. So I didn't witness them. I just vouched that that's my sister, that's the preacher, I know who these people
01:41:26
are. And so they charged you for they realized that you were in the Philippines at the time, so you couldn't
01:41:31
have witnessed them based on the dates or something. Yep. And then they arrested you. 12 12 felonies.
01:41:38
They give you 12 felonies and 24 years in prison.
01:41:43
That's what they charged you for or that's what they charged me with 12 felonies. Six
01:41:48
counts for each of the six petitions. Six. Uh so there's 12 felonies. There's six mistakes, but each mistake counts
01:41:55
for two felonies. I mean, if you're going to make a mistake, there's one felony. When you're trying to make a
01:42:01
statement, there's 12 felonies and you're the first one in the history
01:42:06
of the United States of America to ever have this charge, let alone brought to trial and then found guilty. The trial
01:42:15
didn't happen in my state, my town. It happened in the state capital
01:42:20
where everybody knew that attorney general. Everybody knew the opponent. So they they tried to get you to serve
01:42:26
24 years in prison. Yeah. They sentenced me to 24 years in prison. They sentenced you to? Yeah. My kids are sitting behind me. I'm You
01:42:33
are guilty of 12 felonies and 24 years in prison. And then he says, "But this stack of
01:42:40
papers in front of me might be the biggest." He'd been a judge for 20ome years. And I had patients who had
01:42:46
written in saying, "This is the best doctor I've ever seen." I didn't ask them to write that. They just sent them
01:42:51
in. That moment when you hear that you're going to be in prison for 24 months, 24 years.
01:42:57
Oh god. It is the lowest moment of my life because I mean I do not like that the
01:43:04
that that story cost the state of South Dakota any money. But I also don't like
01:43:09
that when you oppose the the political giants
01:43:16
and you stand there with all of the right intentions that if they need to find something on you, they will.
01:43:24
six petitions and we had a thousand extra signatures.
01:43:30
There was nothing. This was a nothing for her, but it was enough. And that attorney general said
01:43:37
prosecute her to the fullest extent. And I'm not a martyr. I do things that
01:43:42
aren't right. And if there was a mistake that I made, I I would take full ownership. And to that judge, I made I
01:43:48
took full ownership that the attorney general was he won.
01:43:55
I got sentenced. But you didn't have to serve the 24 years. He said, "I'll probate that. Uh I will
01:44:01
suspend that with um the highest number of service hours ever in the state of South Dakota was 500 community service
01:44:08
hours serving the poorest patients in the state." And when he said those words, I thought, "Oh my god, you don't
01:44:13
know who I am. That's what I've been doing. I was already working in Pineriidge. Well, how do you how do you feel about all of
01:44:20
this? I mean, I think of it as a test. It was a test of I mean, most marriages aren't
01:44:26
going to make it through that. If you got kids, they'll end up in rehab with that much stress.
01:44:32
And I didn't want that life. I didn't want that to be my
01:44:37
ending. I framed it different. I said, "All right, God, you're testing me.
01:44:42
you're testing to say, "Can I be can I stay true to who it is that you've called me to be?"
01:44:49
That our marriage was incredibly uh that's a
01:44:54
lot of pressure. I mean, I was the number one news story in the whole damn state for 3 years running by a mile.
01:45:01
I can't go anywhere without That's her. That's her. My parents were ashamed. My
01:45:07
kids would say, "This is the woman that takes me to Haiti. She is Mother freaking Teresa and now she's on the
01:45:13
front page of a newspaper as a 12-time felon. And your teachers at school say,
01:45:20
"I read about your mom in the newspaper." I mean, it's
01:45:25
it should have crushed me. But it didn't. It did not.
01:45:31
When did your life begin to turn upwards from that point onwards? When was the the moment where
01:45:37
things were Well, the first thing is we appealed that to the Supreme Court. Yeah,
01:45:42
that's where the big legal bills come from. I mean, you're fighting an attorney general. That's where And the Supreme
01:45:48
Court said that that attorney general abused his power for at least six of them. And then that judge said, "I'll
01:45:55
erase all these because of the work you've done." So, the 12 felonies went away during all of them. All of them.
01:46:01
I think on the edge of that story, um I work to resurrect people's health back to a place where they they get their
01:46:09
best life. And yes, ketones are a really big part of that. But as you look at the relationships
01:46:16
you've got around your life, take the core ones and nurture them to a place where uh your best life comes out of
01:46:23
those relationships. find that purpose that you've been designed for and take
01:46:29
those relationship with you as you seek that. I I know that's what happened to me. I cared about the ones on the inner
01:46:36
circle and I had a one track of this is what I'm designed to do.
01:46:41
We have a closing tradition where the last guest leaves a question for the next and the question left for you is do you have a daily practice to find deep
01:46:49
inner peace when you are emotionally triggered and if so please share it with
01:46:55
the audience. Yeah, I have a a devotion that I do every morning that um that centers me,
01:47:04
keeps me in line with my faith. And it's not that you do it on the bad
01:47:10
days, it's that you've got the foundation for doing it on the good days. And there are generations
01:47:18
a daily devotion like upper room is a is a spiritual devotion for my church.
01:47:24
What What does that look like? Is it a prayer or Yeah, it's a prayer. And And how does that sound? What is
01:47:29
Yeah, the it's usually a scripture and then it's a prayer that has been paired with that scripture. And again, it's
01:47:36
easy to not do it routinely. But when you practice it on the good days, it's
01:47:41
what lifts you on those really tough days. And sometimes you forget you're not the first person to run through these
01:47:47
problems. But there are thousands of generations that have taught you how to do life and
01:47:55
get through those hard places and I'm going to use their rules.
01:48:00
I'm going to follow what that scripture says and lead for my best life.
01:48:07
Dr. Boss, thank you. Very good. We are done. I really think I really appreciate so much about you. I
01:48:13
appreciate your personality. Well, I incredibly engaging, but I also just um I appreciate that you've taken the time
01:48:18
to make so much content over on your YouTube channel, which I'm going to link on screen and below now, um to sort of
01:48:25
demystify and break down some of these really complicated subjects that people struggle with, and they're looking for
01:48:30
someone who they can trust, who has a bit of personality, um who can communicate some of these very
01:48:36
complicated things to them. And on your channel, you talk about everything from the ketogenic diet to many of the things we talked about today to the creatine
01:48:42
stuff to cancer more broadly, this idea of autophagy and fasting, um, and lots
01:48:49
of other things. I mean, everything we've talked about today and much, much much more. So, I highly recommend people go and check your channel out if they
01:48:54
would like to learn more, it will be linked below. And, um, you've written some wonderful books. Um, some of them
01:49:01
that we've referenced, we've got the Keto Continuum, which I'm going to link below as well. um this wonderful book called Any Way You Can, a beginner's
01:49:08
guide to ketones for life, which um talks a lot about Rose and has some wonderful photos of Rose in that book.
01:49:14
And we have the keto continuum workbook, which is a much more practical um yeah, it goes hand inhand with the other
01:49:20
one and it's what I give my patients in the clinic is they got to go through that workbook. I think a lot of people are looking for
01:49:26
exactly that. They're looking for something that they can follow step by step which gives them a framework for progress and I guess in in a way holds
01:49:32
them accountable which is exactly what the workbook does. Thank you so much. You're you're helping millions of people. You've had a rough ride
01:49:38
if I'm being like 12 felonies in 24 years in prisoners for for something as as little as what you did I think is is
01:49:45
bizarre quite frankly. But you know it's a story of inspiration that it didn't hold you back and you've risen like a
01:49:51
phoenix and created so much incredible work therefore that's benefited so many. So, please do keep going. God bless you. Thanks for having me
01:49:57
here. I'm really excited to be on your show. Thank you so much, Dr. Buzz. [Music]
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