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The Diary Of A CEO with Steven Bartlett
Insulin Doctor: This Is The First Sign Of Dementia! The Shocking Link Between Keto & Brain Decline!
01:51:51
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- [00:00]
A
It takes a little bit of time to realize this as a founder, but once you do, it's something you can't unsee. That having the right systems in place with your business is critical. One that's helped me across all of my investments is NetSuite, the number one AI cloud financial system and sponsor of today's conversation. Through their streamlined platform, you'll find all of your accounting, finance, management, inventory and HR in one place. And their technology has been a massive unlock for all of my companies, especially for my team at Flight Story as over the last year we've moved out of startup mode into scale up mode. And that's the stage where we found it mission critical to use NetSuite. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and of course the number of errors. Over 43,000 businesses have chosen to future proof their business with NetSuite. So if you'd like to learn how it can help your business right now, get the business guide demystifying AI free at netsuite.com bartlett that's netsuite.com bartlett. Doctor Annette Bosworth, or should I call you Dr. Boz? What is it that you know and believe and understand that you think the general public doesn't know? Believe and understand.
- [03:26]
B
That most of the reasons people come to see me could be reversed if they knew how to make ketones on a regular basis. So I'm an internist. That means 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 puzzles and we do this over long management, chronic disease management. So I've got 25 years of studying chronic problems that deteriorate the quality of life, lifespan, healthspan, both go in the toilet when you're chronically seeing me. And you could abort all of that destiny if routinely you were making ketones.
- [04:06]
A
An intern, it sounds like an intern. I'm trying to understand.
- [04:09]
B
The marketing on this is terrible. It just means you're supposed to take care of very complex answers. Your job, I mean, the buck stops with you. If the internal medicine team can't figure it out, you're gonna die.
- [04:20]
A
So you're basically a chronic illness doctor.
- [04:22]
B
Chronic disease management is absolutely it. You know, I love the way Peter Attia uses medicine 2.0, which is what we are the masters of managing, making sure the prescriptions are there, making sure you are treating all these problems. The internist being one of your best buddies because you're having to see them routinely. You gotta get the meds refilled. You gotta check for the side effects. It's a mill.
- [04:43]
A
What is medicine 2.0 in your definition?
- [04:46]
B
Yeah, so I can keep you from dying from childbirth and infections. And I have an antidote for every one of your symptoms. 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 around the middle. Little things like brain fog. Oh, my eyes are aging. All of these are signals that your body has made more trash than it cleaned up. And there were some rules to humans that you missed.
- [05:14]
A
And for my listeners that have clicked on this conversation, 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 going to be for them in their lives?
- [05:25]
B
Listening to the way I talk to my patients and teach them the steps, how to reverse the medical problems that you've already got on the roster. And by doing that, the freedom is to be the kind of grandparent that you dreamt of, but you've surrendered, can't be there anymore.
- [05:43]
A
And what is the list of predicaments or illnesses that are relevant here?
- [05:47]
B
The most common one is being overweight and a brain that's not working right. What really is behind all of the patients I've seen for 25 years is we're working on peak brain performance. Even if you 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 worry of Parkinson's headed your way. Super Young is 55 years old with Parkinson's. That is a brain that's got too much trash and you don't know it yet. And I mean in the history of Dr. Baz versus Parkinson's, Parkinson's has like 3,500 patients. I have zero. Parkinson's wins every time. And the biggest moment of people who have chronic problems under the hood is they have no idea that it's coming. And once that lands, the reversal is much worse. Seeing it 10 years before it's supposed to be there. This is a gift of saying, 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 most when it doesn't work. And it's linked to all of these things like the arthritis, the weight around the middle, the high blood pressure, the severe to mental approach, meaning you can say depression but people say, oh, I don't have that diagnosis. I'm talking about a brain that doesn't want to engage, that doesn't find joy in their life anymore because it's been too many years 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 life ahead within a year.
- [07:16]
A
So you're going to teach me how to take out the trash?
- [07:18]
B
Yeah.
- [07:19]
A
The trash in my own brain?
- [07:20]
B
Yep.
- [07:21]
A
And if I take out the trash in my own brain, how is my life going to be better?
- [07:24]
B
You live in the 21st century, where there's lots of processed foods and lots of ways that your body did things without telling you. So any injury that you've had, like a joint injury that keeps coming back every time you injure it, it is a little easier to injure the next time. Is there a ring around the middle that's more than pinch an inch? Is there a distance in 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 places where if you did this, if you were able to say, don't stop taking out the trash several times a year, several times a month, if you ask me, then you never have to come into this world. That I just see people, they're in quicksand up to their waist. And getting them out, they need a real lifeline.
- [08:11]
A
And what are the current solutions people are typically offered when they're feeling all the ways that you described there, where they just don't feel good? They have brain fog, they're. They might have chronic pain setting in in various ways. What are the typical solutions that Medicine 2.0 would offer them?
- [08:25]
B
Yeah, especially if they have good insurance.
- [08:27]
A
Yeah.
- [08:27]
B
That doctor is going to be with the covered insurance plan and he's going to say, tell me the symptoms. I have a matching game. I will give you the drugs that will take away that one and take away that one and take away that one. What is always a downside is, well, play that forward for 10 years, play it forward for five years. And are the symptoms gone? No, but it will bridge and hold up the architecture of the body and the human without actually fixing the problem, without actually diving in and saying you got some chemistry problems under the hood that you don't measure and you don't talk about. But if you did, even if you're not perfect, Even if you're 70%, you're gonna find yourself at the age of 54 with vitality and energy and sleeping through the night and not having what every other 54 year old, which is chronic joint pain, a brain that can only for three to four hours without a break, a stamina of endurance and health and joy that falls apart.
- [09:26]
A
So when I'm. You're 54 years old. When I'm 54 years old, I want to be as young and energetic and articulate and cognitively astute as you are. So what should I be doing now to make sure that I don't decline decay in all those areas I described?
- [09:44]
B
Well, what'd you have for breakfast today?
- [09:46]
A
Yeah, I have not eaten breakfast yet.
- [09:49]
B
It's okay, that's not a bad thing. But 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 calorie turns into timing if you eat that food. One bite of food after 6 o' clock 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 also eating's fun if you only get one bite after 6 o' clock and 10 before, move that food towards morning when you're your age. What'd you have for. What's the last meal you ate yesterday?
- [10:26]
A
Yeah, for dinner I had this cod and I had salad. I also had pasta.
- [10:33]
B
Okay.
- [10:34]
A
But I ate pretty late, which is a bit nice.
- [10:36]
B
What did you have the rest of the day before that? Was that your first meal?
- [10:39]
A
Just a big salad.
- [10:40]
B
Was that more towards lunch or noon or.
- [10:43]
A
Probably about 4 o'. Clock.
- [10:44]
B
So waited all the way till 4 o' clock to eat. Very common. This is a really common pattern of people doing what we would say, intermittent or time restricted eating. They put that eating window in this, but it's got that balloon at the end of the day and it really does. I mean, what you're stimulating is an excessive production of insulin and you're going to wake up the next morning. What time did you wake up this morning?
- [11:06]
A
Today I went to bed fairly relatively early for me. I woke up at about 7:30am oh, usually it's later.
- [11:12]
B
And do you have, did you have a solid 7, 8 hours of sleep or how. Yeah, so during that time you finish eating around 10 o' clock then it sounds like, yeah, okay, so then it's seven.
- [11:23]
A
Maybe it later.
- [11:24]
B
Okay, so 11 o' clock and you've got 7:30 in the morning is when you woke up so that's about eight hours since you've eaten. Your insulin is still churning, especially if the meal was large and there was carbs in it. So now you've got these processed foods late at night, and you're at the beginning of the disease, right? You're at the beginning of the chronic inflammatory churn of how do you age faster and faster? You don't do that. You don't have high insulin throughout the night.
- [11:49]
A
So can you explain to me, like I'm a 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, longevity, aging, yeah, for a second. But how does insulin play a role in all of this? And what is insulin?
- [12:02]
B
So insulin insulates, okay? So think of it as it makes you fluffy, it puts the fat on. It's got some other roles too. But we're going to talk about chronic diseases here where it's not a scarcity problem. You make plenty of it. And when it's in excess, it will store energy for when you go through a famine. It will also cause you to grow. Now, grow means get a little fatter, but it also means things like their skin gets a little thicker, they have skin tags. And what I always think about is what's going on in their brain and when that insulin is high for years and years and years, just like yours. Because if you didn't eat the rest of today and then you got up tomorrow morning, it would be about that 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 started from or where we should be in the morning.
- [12:58]
A
For someone that's never heard the word insulin before, there's some context to give in terms of what it's doing. So it's coming out like a transporter and helping put away the sugar will deal with the excess sugar.
- [13:08]
B
Right. So it is what lifts. Yeah, it lifts glucose or sugar from the circulation into a cell. That's its first primary job. But if all the cells are full, their storage is full, it's gonna start to pack it into the liver. Let's say all those stores are full too. This job of insulin, this hormone oozes into every part of your body to say, make sure it's got fuel, make sure it's got that sugar. But most people are like, what I would guess you are. Most of the time, you aren't a shortage of sugar. And so it tops things 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 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 gonna be prepared to live through the famine, but in the meantime, turn it into fat. Make him a little fluffier.
- [14:02]
A
Is that the only consequence? If high insulin is that I'm gonna. I might be a bit more fat?
- [14:07]
B
No, that's just the one people hear about the most. When you look at chronic disease management, it is the growth of the diseases, of the inflammation, it's the making of the trash. So I keep saying, you know, you need to take the trash out routinely. Which means that insulin, which has been smoldering higher than you think it is because you live in today's world, because you eat processed food, because you eat super late at night, you don't go two to three days without eating. You've got storage filled in your body. The high insulin levels in a healthy person hides that the debris is being made. And you don't know it.
- [14:42]
A
It hides it.
- [14:44]
B
Yeah, it's gonna put it in between two cells in your brain. It's gonna put in between the skin cells. The trash doesn't get taken out until the insulin gets lower. And unfortunately, most people have been making buckets of insulin without knowing it.
- [14:59]
A
Why? What are they doing to create buckets of insulin? All the things you said about carbs.
- [15:06]
B
Foods that comes from boxes and barcodes and bags instead of whole foods, instead of a fat forward diet, which would then push that body into making ketones. So you cannot make a ketone if your insulin's high.
- [15:24]
A
Are there any signs that I might have high levels of insulin or insulin resistance?
- [15:29]
B
Abdominal girth is the first thing. That is the first place that the fat goes. So you do this really great part where you don't eat until later in the day. How does that feel during the day?
- [15:39]
A
During the day, I feel really focused. I actually don't even know that I'm not eating.
- [15:42]
B
So that's really good. So what I would love to know is show me what your blood sugars are doing during the day and show me if you make ketones. That'll be the answer is when you have excess insulin, which is this chronic disease maker. It is what makes cancer. It is what makes high blood pressure. It is what makes debris in the brain where call it depression or brain fog or Parkinson's. It's the aging of the brain.
- [16:07]
A
It's linked to all of those things.
- [16:08]
B
All of those things. And that excess insulin nobody tells you about, but the symptoms are, dang, I feel like I gotta eat every two to three hours. Their debris or their fuel keeps running out. When you say, boy, I can eat 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 your ketones during the day? So when you've got a patient who has done that, their ketones will be 0.7, 1.0, and they're taking out the trash all day long.
- [16:41]
A
So there's these two energy sources. One of them is the glucose. One of them, which is from, like, eating pasta, which I ate last night. So that probably put a lot of glucose in my bed. 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 or when I haven't been eating carbs for a while. And my body's looking for an energy source.
- [17:01]
B
Yeah.
- [17:01]
A
When in terms of these two energy sources, there seems to be a lot of hype around ketones. So why doesn't our body just run off ketones?
- [17:12]
B
It will. As soon as you're done lowering your insulin. And I mean, insulin grew in these patients. They didn't know that it was growing high. They went to their blood test and their glucose looked normal. What nobody checked for years is how much of that insulating hormone did it take to keep the glucose controlled. And that's where chronic diseases are grown in spades. That's where autoimmune disorders.
- [17:34]
A
The insulating hormone being insulin.
- [17:35]
B
Yes. So that excess insulin for the last decade, had you come into my clinic, we'll put a label on it, call it pcos, call it high blood pressure, call it autoimmune problems. All of them are linked to high insulin glucose. When you want to store it, we put it in a fancy string called glycogen. And it's just an efficient way to store glucose. But as soon as your body needs it, it will unlock all that sugar back into your access, back for you. What you don't realize is, well, how much glycogen you got stored over there, how much is there in storage? And that is what high insulin has been doing. Just put it in storage. Put it in storage. And then when you stop eating, you'll know if you emptied out all your stored sugar, which is some of the regular sugar you just ate. But then all this Glycogen, this packaged sugar, how empty are you? I don't know. Have you made a ketone yet? You cannot make a ketone. You cannot burn fat until that tank is empty.
- [18:35]
A
Okay, So I have these glycogen stores which last for a day or two.
- [18:38]
B
Oh, no. Think of it as brown sugar. So you package the sugar really tight, and then you put it in the back of the drawer and it turned crusty because you never lowered your insulin. I have patients that are overweight, and we put them on a ketogenic. We put them on a 20 total carbohydrates per day. So super low carbohydrate. It is 15 days before they make a ketone.
- [18:59]
A
Okay, so it could be a while. It could be up to two weeks, for example, before my glycogen stores are empty. And it's not until my glycogen stores, my glucose stores are empty that my body can start producing ketones.
- [19:10]
B
Correct.
- [19:10]
A
So it's going to exhaust all of those glycogen stores and. And then once it's ran out, it's gonna switch into this ketogenic state.
- [19:16]
B
Right? Yeah. So think of it as your short term, easy to access. Sugar has to decrease, and that means your insulin has decreased that hormone. For insulate. They both run in tangents. You decrease, you're emptying glycogen, your insulin's going down.
- [19:32]
A
So how do I know if I have insulin resistance? What are the key signs? You mentioned skin tags. I've never heard that term before.
- [19:39]
B
Yeah. Skin tags are not moles. So moles, you can feel this bump on your. On your skin. Right. But a skin tag has a neck and like a little mushroom. 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 off. They'll fall off when your insulin's lower. So that's the first place it'll be found. In their armpits or places where the skin rubs. So armpits and their groin. And once insulin starts to grow them, it's like a crop. A crop of little baby cauliflower hanging out in their armpits.
- [20:11]
A
You talked about velvety skin.
- [20:13]
B
Yes.
- [20:14]
A
As well being an indicator.
- [20:15]
B
Velvety skin is this Latin word, acanthosis nigricans, which is a fancy word that means the skin is darker and thicker. So the places it usually happens is the back of the neck. And you'll hear stories of, I tried to wash my neck. It's dirty. All the time. It's not dirt. It is the way the skin is under the curse of high insulin. And you see it in teenagers all the time now. They put on weight and their growth hormones are already doing that teenage thing. Now. You put high insulin in there and they have this dirty neck syndrome or on the creases of their elbow. It's just darker here. That is pathology. That's not normal from high insulin.
- [20:58]
A
You talked about weight changes as well. What's this thing about hairy toes that I was reading about?
- [21:03]
B
Right. So as my patients age, so Most of my 55 year olds that have had high insulin, I will tell them, look at your toes, they're supposed to have hair on them. And when your body has had that high insulin state for a couple of decades now, it will start to say, we don't send resources to a couple parts of the body anymore. And the follicles in their toe are one of them. Like, you just stop growing hair on your toes. And there's an ascending problem with this where the toe starts, then it's the ankles, then it's up to the knees. And they don't have hair anywhere on their lower extremities. It is a process that started from high insulin.
- [21:39]
A
What about aging? You talked about how if you have high insulin, there'll be an impact on your aging. Now I'm thinking about, you know, I'm getting a couple gray hairs down, thinking this is because of my insulin levels.
- [21:50]
B
I have seen patients that have reversed their gray hair on a ketogenic diet. It blew my mind. They asked me for the reason why that happened, and I thought, well, the cells are healthier that are making your hair. That's all I got. Aging is exactly that enemy, which is they are going around the sun with more growing of the trash than they needed. So that high insulin, they don't know about it. They've not produced a ketone in years. And that chronic disease is now difficult to get their, the eye to clean out. It's difficult to get that brain trash removed. And you're supposed to do it every night when you sleep. It's not supposed to be behind this far. You're two decades from taking out the trash in your brain that's aging.
- [22:37]
A
How do I, for a start, even know my ketone blood levels?
- [22:41]
B
Well, when a patient first comes in saying, how do I begin? I want them to tell me what they had for their meal and then say, how many carbs do you think that was? Because this education, like an apple, is 20 grams of carbs. 15 grams of carbs for some of them. And we're gonna ask you in the first six weeks to take your carb intake down to less than 20, 20 total grams of carbohydrates or less is where we begin. And again, I do this in a medical grade. There are people who play with a ketogenic diet, and there's people who try to reverse medical problems with a ketogenic diet in order to do this. It is not a lazy kind of keto. You have to actually be on the same team as me using data to reverse this medical problem.
- [23:23]
A
And how does one measure their blood ketone levels?
- [23:26]
B
Yeah, I think blood is the best. There is a way you can measure them in urine. The burning of fat. If you turn that string of fat into ketones, there are two destinies for that. You either put it into a mitochondria and turn it into energy, or you pee it out. So especially when they're early in a ketogenic journey, they overshoot. Evolution said, don't let them die. Turn that fat into energy. Help them through the famine. So the excess ketones they make end up in their urine. We call them ptone strips, and they're cheap and easy, and we don't have to cross that barrier of somebody pricking their finger at the beginning. So they're gonna pee out ketones every day as long as they're not chronic insulin resistant.
- [24:12]
A
So if I avoid carbs for a sustained 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 to start burning my fat stores.
- [24:23]
B
Yes.
- [24:23]
A
You know, from some of that fat around the mid section, and it's going to start turning that into ketones, which are a different type of energy. Are there any reasons why ketone as a source of energy is better for me in terms of performance, other than the insulin reasons that we've talked about? Like, are there any other parts of my body or my health that benefit?
- [24:46]
B
So ketones, for starters, when you're burning a ketone, there's less trash. Okay. It is a cleaner fuel with less byproduct, especially as you age. So you get the longer energy and you have less debris floating around. You hear the word antioxidants all the time. Well, burning ketones is an antioxidant state. It is a. And it's in the space where you need it, which is inside that cell. You swallow antioxidants and you have no guarantee that they end up where they're supposed to. So, number one, the fuel is reducing trash at a cellular level. It lasts longer and it penetrates through that blood brain barrier to fuel a brain that even if it's insulin resistant, it can use a ketone. So the problem with somebody who's chronic insulin resistance, their brain needs a lot of glucose to stay online. And I can try to get it there, but insulin is constantly fighting that. It's a war to try and keep the glucose in their brain. My hack is ketones will go right around that. It doesn't need the same transporters to get across the blood brain barrier and especially to fuel those cells in the brain. So for performance, I mean, name a game where you don't use your brain. There isn't one. Right. If you're looking at performance, to say, let's begin with the sharpest brains and the most focus, the most discipline, the less impulsivity. All of those things improve when that brain is being fueled with ketones.
- [26:16]
A
So let's focus on the brain part then. So what have you personally noticed as someone who I assume is in the ketogenic diet right now?
- [26:23]
B
Yes.
- [26:24]
A
What have you noticed? The variances between when you're in a keto diet and when you're not. Right.
- [26:29]
B
Well, I've been doing this since 2015, so the onset of it was really messy. But the seasons where I would do a great job and then I would think, ah, I'm fine. I mean, I can tell you, you see 25 patients in a day, and I feel bad for the last five. 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. When you're in a ketogenic state and not in a ketogenic state, the brain power, the concentration, the ability to keep your mood controlled. It is a night and day difference for most people, but I think especially for me, I'm pretty high energy and when it runs out, I get crabby. And that's not a good place to be if you're the patient.
- [27:17]
A
Yeah, I think I've noticed that as a podcaster, But I've also had a lot of very well known podcasters say 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 conversation is night and day when they are in a fasted ketogenic state versus or on a ketogenic diet versus when they are in a higher carb diet. And it's so profound to me that I, that I almost wonder why more people don't.
- [27:41]
B
Oh, it's insane. Like, one of the best things that I've done in 25 years 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 diet for three weeks. It is hardcore. This is not playtime. You're checking your numbers every day and you're comparing them to your classmates. And what you get to see in this class of 200 people going with an extreme ketogenic diet is the testimony. You just said, I cannot believe how good I feel. By the end of three weeks, they're naming babies after me. They think this is a miracle. And I'm like, exactly. I mean, when you do it in a group like that, I don't need to advertise. They tell their friends, they tell their, like, if you want to be on a ketogenic diet, that really wakes up your brain. I didn't think I could do this. I thought I was too old for this level of energy. And it's there within three weeks of doing it. Right.
- [28:35]
A
How long does it typically take on average for someone to feel those brain benefits from doing the ketogenic diet? Typically? How long does it take you?
- [28:44]
B
Me?
- [28:44]
A
Yeah.
- [28:45]
B
I rarely go out of it. Meaning I might 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 anymore. But let's go to when I was overweight. Okay. So you say, who's insulin resistant? Any person who's had a baby. Okay. You have to be insulin resistant to hold that baby for nine months. Okay. So I had three of them and then the weight never came off on that third one. So here is an insulin resistant person at 40 something years old. And I am probably 60 pounds heavier than I am now in the first time. I tried to get into a state of ketosis for like nine months. I was about to give up on like, why can I not pee a ketone? Why 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 because I personally cannot pia ketone. I mean, I was trying to follow 50 carbs, then I tried to do 30 carbs and then I tried to do none, but I just couldn't make it long enough into that ketogenic state. And what had happened is at least a decade of high insulin, three babies, full practice, busy life, you know, on call, those kinds of things that are all dangerous if you're going to try to have a peak brain. I took my kids on a 22 mile hike around the city on Memorial Day in the name of troops as mental health. And I said, if I am not peeing a ketone after walking 22 miles, having fasted for a day, then I'm for sure that this diet is a huy. So that's how much energy it took for me to pee a ketone because I was very insulin resistant. I had been making excess insulin for a decade and I'm a doctor. I should have known that my sugars were fine, my hemoglobin A1C wasn't bad. But that excess insulin, that stored sugar, that stored glycogen, it took forever to get that low. And only after I fasted and then walk 22 miles did I pee a ketone. So when you ask the question, how long does it take? I do a much better job now of telling people how to get there. Cause I almost gave up thinking this is junk science.
- [30:52]
A
If you were to eat a high carb meal now and take a couple of days off, how long would it take you to get back into a ketogenic state where you have those brain benefits now?
- [31:01]
B
I could probably flip back in within 12 hours.
- [31:04]
A
So that's how long it roughly takes for someone who's got in better metabolic shape, it will take a couple of days. Is there a downside to living in ketosis the whole time? Because people often say when you talk about the ketogenic diet that it's not sustainable.
- [31:20]
B
Yeah, I hear that a lot. But I have thousands of patients that have been doing it for years. And what happens is as soon as they exit from the ketogenic diet and they start to feel the trash build up again, meaning the joints that didn't hurt forever now hurt. The vision that was super clear is now foggy again. The brain that wasn't irritable and depressive is back to doing those things again. I mean, it is within a week or two that I mean, I like to think of when you're in a ketogenic state, you wring 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 sugar back in, the swelling goes back into their brain. Insulin and water flood the body and it's almost like a minor concussion. And their brain is not working right and they now know it.
- [32:11]
A
And is there any other benefits to being in a ketogenic state? You mentioned strength briefly.
- [32:17]
B
Yeah. So when you're looking at, do you do weightlifting?
- [32:20]
A
Yeah.
- [32:21]
B
Okay, so when you weightlift, how grade your soreness on the day after your lifting day?
- [32:29]
A
If I've been using that muscle consistently, there's no real soreness.
- [32:33]
B
Good. So let's just take a day where you're pushing it harder, you're deadlifting harder, and you've got a strain in those muscles. One of the key components for repairing that as quickly as possible is to be in a ketogenic state to take that inflammation way down. And you probably didn't need the help of repairing that muscle when you were 18, 22. But as you get into the 30s and especially into the 40s, the amount of inflammation that tries to help you repair that, it overshoots. And that's where the chronic pain's from. That's where the delay in repair comes from. So when I look at power and muscle training, the first place I talk to my patients about it is how many days does it take you to get back to feeling good after you've had an injury? Let's be on the side of a ketogenic setting where your inflammation is super low. And when you tear something, which you're going to tear things when you're lifting heavy, the repair part is so quick, the power is a little hard to talk about. If you want me to go there, I can.
- [33:35]
A
Yeah. So is there going to be any impact on my ability to train? 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?
- [33:46]
B
So we looked at this in military people. It's one of my favorite ones where they are all insulin 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 ketogenic state, they've lost weight, but their power and time didn't do 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 did another big check. And by golly, they've lost even more weight and their power is about 20% more than their counterparts. When they get to 18 months of a ketogenic diet, their power is almost 50% more than what their counterparts were. So let me explain that. As you're looking at a muscle, it 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 going to use glucose first to fuel. But if you can train it to use fat in that training, it's a longer, better fuel with less inflammation, and especially in a state where it will use both fuels quickly, that takes time. 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 six months. But if you're trying to run a marathon and we're only three to four weeks out, you should not start a ketogenic 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.
- [35:13]
A
And is there a link between some of these cognitive degeneration diseases like Alzheimer's, dementia, et cetera, and the ketogenic diet? Because I know that there's been some research that's underway and has been done to try and establish causality. Is there a link here?
- [35:31]
B
Yeah, you know, it's one of the saddest places where if you look at what patients regret in life, they come into the clinic and they're already starting to say, I was driving the other day and I got lost. And when I hear that we are 15 years too late, it is 15 years of building up trash in that brain that we have to clean out that debris. And I had the privilege of an amazing story that taught me I don't have the gift of seeing into the future. Am I going to reverse these Alzheimer's before they show up? We don't have the research for it, but I have a lot of clinical experience saying, boy, they are so much better. I don't know if their memories going to stay this good. We're only three years into a ketogenic diet, but it's way better than when it started. And then I had a Down syndrome patient at 40 years old in my practice. So her mother came to see me first. She said, I want to try this ketogenic diet. I've been helping my daughter, who has down syndrome. We've lost £100 because the doctor said that she might do better if we lost some weight. And it's not an uncommon thing to see. They have advanced insulin resistance and advanced Alzheimer's earlier in life. So it's a great place to study Alzheimer's because they have a more rapid onset of it. So the woman comes, she's lost £100, and during that time her mental cognition got Worse. So now she's got £100 down, but none of those brain things are better. And I said, all right, if we're gonna do this with your daughter, we're gonna make sure we're pricking your finger. It's not gonna be fake. We're gonna do a real ketogenic diet. So the mom starts on a ketogenic diet, and I think both her and mom are genetically superpowered to make ketones. Cause they have ketones of like three within a couple of days, which is.
- [37:26]
A
The average would be like one.
- [37:28]
B
If they hit one in a few days, I'm thinking, good job. And the mom calls me at the end of the week saying, do you think it could possibly. She is, she's, you know, 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 most profound thing just happened. I've taken care of this girl for 41 years. 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 was giving her instructions to do this. Go around here and put it over there on the. Give her a little job. And she said, do you understand? And the girl replied, I understand. I said, what's the big deal? And the mother said she had never said a three syllable word in her whole life. Two syllables is all her brain could ever put together for the first time in her whole life. Three weeks onto a ketogenic diet. And this Alzheimer's diagnosed patient, who had down syndrome, now had a brain that was not only working great, it was doing the best mom 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 again because her brain, which had Alzheimer's, no longer had that diagnosis.
- [38:44]
A
I was looking at some of the supporting studies around this around the impact that can have on the brain. And studies show that in dementia, especially in Alzheimer's, the brain struggles to use glucose efficiently. Ketones provide an alternative, cleaner fuel source. Ketogenic diets can boost mitochondrial function and energy availability in brain cells. Keto lowers systemic inflammation, which is linked to slower cognitive decline. Ketones may protect neurons from damage and promote the growth of new neural connections. And Alzheimer's is something called type 3 diabetes, which I've had a lot. And keto improves insulin insensitivity, potentially reducing this risk. And lastly Small studies show temporary improvements in memory and cognition in people with mild cognitive impairment or early Alzheimer's. But the evidence is early stage. Long term adherence can be hard and the diet isn't suitable for everyone. For example, underweight people and people with certain medical conditions. Right, so how do I measure my blood ketone levels? Is that what these devices are here on the table?
- [39:42]
B
When I look at giving patients the freedom to say, don't come to me for the things that you can do at home, first thing is be willing to check data. 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?
- [39:58]
A
Yeah.
- [39:59]
B
Okay, so you want to go first?
- [40:01]
A
Okay, so what I'm going to do here is I have a finger prick here which is going 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 blood onto and within a couple of seconds it's going to tell me how many ketones I currently have in my body right now.
- [40:18]
B
And so we're going to look at that at the same time as your blood sugar, which is how you can measure insulin. It's the best proxy for saying how high is his 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 ketones and a brown one's going to measure your glucose.
- [40:37]
A
Okay. And this device, how much does it cost if people want to buy it at home and start pricking their own fish?
- [40:41]
B
Yeah, I think there's a kit that comes with about 50 strips. So you can have ketones and glucose at the same time. I'm guessing it's around 70 bucks or maybe it's 60 to $70. They have quite the. Put it all in. There you go. And so they'll still lights on the other one too, Right? Perfect. Okay, so now prick your finger. Best to do it on the side of your finger because there's less nerves there. There you go. Good job.
- [41:04]
A
Okay, so going to put my blood onto this one, which is the keto reader.
- [41:09]
B
And it'll count down.
- [41:11]
A
I think it's. My glucose is 86, takes more blood for the ketone and my ketone levels are 0.9.
- [41:24]
B
Okay, so that's a Dr. Baz ratio of 86 divided by 0.9, which is probably like 95 or something like 95ish. Right.
- [41:33]
A
So my glucose level's at 86. Is that high or low?
- [41:36]
B
That's good. So I would say that's not low, it's just good.
- [41:40]
A
Okay. And my ketone levels are 0.9.
- [41:42]
B
Right. So when you look at them in comparison, like, you want to have a blood sugar that's not triple digit. So that's very good. And the closer. The higher you are above 0.5, the better the result. So that's a pretty good number.
- [41:55]
A
So if I'm in ketosis, what reading would I have on this ketone meter?
- [42:01]
B
0.5 or greater. But it would be also that you have that reading without a triple digit blood sugar. So when I look at the combination of them, I do a little math and say your doctor bowels ratio is like 95. So you are burning fat right now.
- [42:14]
A
Okay.
- [42:15]
B
Okay. So that's a good sign. When I am trying to help people who are trying to undo cancer or autoimmune or brain injuries, they have to have a better Dr. Bowels ratio than that.
- [42:26]
A
Let's do your readings to see where you're at.
- [42:30]
B
All right. Drumroll.
- [42:33]
A
83 and 1.7. How are you at 1.7? What have you done?
- [42:39]
B
So I've learned that I would 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 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 night. Now, you're still in a season where you get to just kick your heels and enjoy youth. But at my age, you cannot do that. I can eat in the morning, I can have good calories of high fat and good protein in the morning, and I've learned to stop eating somewhere around three o' clock in the afternoon. In fact, if I. Yeah, I know.
- [43:15]
A
3:00 in the afternoon, you stop eating.
- [43:17]
B
That's usually the case. What's really hard, though, is how much of your life is social. Like you said. Oh, there was this dinner party last night, and I had pasta. And you're like, yep, 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 at night if you want your insulin to not do that debris thing. And boy, when their memory isn't going well, when their friends are dying of memory problems, I don't like using fear tactics. I don't think they last Very long. But it is such a reality of poor performance that I can't do that. I cannot eat at 10:30 at night.
- [43:56]
A
What is it about being asleep that causes the sort of deregulation? Like, what is it about it doing it at night?
- [44:04]
B
So now it's going to take that metabolic curve and in order to store all of the part that gets stored and then turn the part into fat that needs to be tucked away, get back to baseline. It's gonna be eight hours at least eight hours, which is fine, right?
- [44:17]
A
Because I don't eat till. I'm probably not going to eat until 2pm today.
- [44:20]
B
Right? Well, you missed one part. The sun will rise. When the sun rises, even if you're in solitary confinement, you cannot see the sun. Your brain knows that the sun just went up and cortisol rises.
- [44:32]
A
Okay.
- [44:33]
B
Cortisol leaves. Your brain, goes to the liver and says, you know that stored sugar, that glycogen release? You make glucose first thing in the morning. How much glucose depends on how insulin resistant you are. So you're gonna have an uneaten meal. When you wake up in the morning, glucose has been stored for this purpose. It's gonna wake you up. It's gonna give you the energy when sun rises to fuel you. If you got a bunch stored, you're gonna have a high blood sugar.
- [45:01]
A
Can we to Jack's ketone levels? I'd like to know where Jack is at.
- [45:03]
B
Ooh, let's do that. What's Jack do for his?
- [45:07]
A
We're about to find out.
- [45:09]
B
I don't think I'm gonna be. No, wait a minute. Is Jack the one that did the VO2 Max with Peter Attia and you? Well, you know, peak brain performance is my thing. And one of the hardest brains to heal are chronic runners. That trauma thing is real. Like, it's so hard to explain to them, too. If you're a vegan who runs. Ooh, you're in trouble.
- [45:28]
A
95% of vegans that listen to this podcast frequently don't subscribe.
- [45:32]
B
Oh, yeah, well, all right. So glucose is 88. Not too bad. Ketones, Boo. Absolutely. Yeah. That's an example of. He is making trash. There's no trash going out.
- [45:43]
A
So his keto level is what, 0.1?
- [45:46]
B
And his blood sugar is 88. So if you take 88 divided by 0.1, it's like, what, a thousand or something. It's really high. 888, probably. That is a lot of trash being made. When that doctor Boss ratio is high, you can't take it Out.
- [46:01]
A
Do you want to say that to his face? I mean, I feel like.
- [46:05]
B
I just think that when Peter Attia did that and said, oh, I had no idea. I'm like, you could have just checked this first thing in the morning for five days. If you have that kind of a Dr. Baus ratio, you're insulin resistant. You're insulin resistant. You have to be hitting that in a routine, regular interval in life to not have those problems. To have osteoporosis at such a young age, a ketogenic state would not allow that. You would be using resources much better.
- [46:31]
A
He actually did a test that turns out he doesn't have osteoporosis.
- [46:33]
B
Oh, good. That was shocking.
- [46:36]
A
Yeah.
- [46:36]
B
I was like, you shouldn't have osteoporosis at your age.
- [46:38]
A
No, I think that was a misreading because of the scanner, but.
- [46:41]
B
Right.
- [46:42]
A
But on this point in particular, his ketone levels are 0.1, so he's basically running off glucose, all glucose.
- [46:48]
B
And so why is that happening? Okay, whatever he ate, the insulin went up. So let's say he was your exact same eating pattern. He ate last night. He had the six, eight hours of sleep. The cortisol said, oh, the sun's rising, and it rose his blood sugar a little bit. Okay. When the sugar's high, you can't. Your insulin's gonna be high, too. You're not making ketones.
- [47:09]
A
When I did this keto test with most of the team here, they were all around that region. They were in the region of 0.1 ketones in their blood to 0.3.
- [47:19]
B
Welcome to my clinic. In 10 years, that is trash being made, never being taken out.
- [47:24]
A
And so you'd say to them, you need to do some fasting. You need to.
- [47:28]
B
You need to cut scarves. Yeah. I mean, if you're looking for a quick. Okay. If they're in their 20s, I mean, I have three kids, right. And they have heard this chirp for 10 years. I mean, how I got into this was my mother was very sick, and she was sick because of a high insulin problem that caused cancer. So 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 in their young twenties, and for the first time, they're actually listening to, say, gosh, Mom. One of them's at Georgetown. 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, I Can't keep the focus. And I said, well, how are you doing that? At first he tried some of the supplements. Okay. But what really happened was he cut the carbs down and said, I can say no to that because of the sustained 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 you made ketones and that return on your dividends is you won't be seeing me in 25 years.
- [48:29]
A
So you have this idea of this keto continuum. What is the ketone continuum? I read about it. I mean, it's a book here that I have, which you published in 2020 called the ketone Consistently Keto for Life.
- [48:44]
B
Right.
- [48:44]
A
So the keto continuum is this 12 step process to get into a consistent keto consistently keto.
- [48:51]
B
Yeah, you're constantly taking out the trash. The first part is the beginner.
- [48:54]
A
Okay. So the first part, the beginner section, has four stages to it.
- [48:57]
B
Right.
- [48:59]
A
What are those four stages?
- [49:00]
B
Well, I like to tell patients that you never fall all the way off of the continuum. So the first step is really not keto, but it is that they're eating every two to three hours. 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 keeping their carbs less than 20. Step two is cut your carbs to 20. That's the only thing I need you to measure. And you're gonna be able to use a ptone strip, you know, measure ketones in your urine. And that will ride, you'll ride a wave. And that ketone production is happening. The fat based hormones in your body are starting to resurrect. They're starting to do the things that they need to do. And there will be this magical moment in the not too near future where you skip a meal.
- [49:47]
A
And this, that beginning stage, how long does that last? I'll put this on the screen so everybody can see the continuum. How long does that initial beginner stage.
- [49:56]
B
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 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 average person that's like, they're not 100 pounds overweight, they're hitting menopause and they've put on 25 pounds. When they drop their carbs to 20, they're peeing a ketone by the end of the week and they are missing their first meal by day 10.
- [50:24]
A
Okay, so day 10. And then it says when we get to stage five in the keto continuum, it says 1680, 16, eight. Is that.
- [50:32]
B
Yeah. So then we start to use time restricted eating where I want. We're gonna. Your body will 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 reversing this problem and you'll know you have the right step if the ketones are still present in your blood. Your body will adapt, though. So we start to say, all right, we're gonna learn some new behaviors. We're gonna learn what the nothing burger looks like at least for 16 hours out of the day.
- [51:02]
A
What does that mean?
- [51:03]
B
You do not eat a thing in those 16 hours. Now, I give them a little hedge because most people come in like you, they don't start eating until 2 o' clock in the afternoon and then they eat until 10 o'.
- [51:14]
A
Clock.
- [51:14]
B
And I want them fat forward, I want lots of fat going in because insulin resistance, that high insulin state, means they've locked or they've insulated their fat on their body.
- [51:26]
A
And then we get to stage seven where it says 23 one. Is that fasting for 23 hours a day? Yeah, and eating for one hour a day.
- [51:33]
B
And there's a little bitty line between 16, 8 and 23 and 1, but there's a whole bunch of life there. Meaning we don't actually have patients go from 16 hours of fasting to 23. We have them 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, quit eating so late at night.
- [51:54]
A
And then the last stage here, so step nine, 10, 11 and 12, is prolonged fasting between 36 and 72 hour fasting.
- [52:04]
B
Right. So those folks that have high insulin for 20, you know, 15, 20 years, 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 metabolism. And although you look at other folks saying, oh, you should never do that if you're a woman, you 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 insulin over time.
- [52:28]
A
On that point between men and women are There metabolic differences that need to be mentioned here because, you know, when I sometimes when I do ketogenic fasting, my girlfriend, she takes much longer than me to get into a ketogenic state. And I'm wondering if her body is in some way trying to defend the switch.
- [52:44]
B
Have you ever seen the reality show Alone?
- [52:47]
A
Oh, no, I'm not.
- [52:49]
B
I'm not either. But they drop these 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, the fat just melts off of them. And the women, they do what your girlfriend does. It just holds onto them that we are designed to have that fat on them. So asking them to do a ketogenic state, you'll hear people say, oh, it's gonna ruin your hormones. Oh, it's going to. You can't do that. And I would say you can have all those conversations once their insulin is normal. I have lots of women in childbearing years that are excessive producers of insulin. And their vitamin D is low, their estrogen is low. They have hair loss on the top of their head. They have skin tags throughout their. Or maybe the first sign was they had pcos. Okay? All 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 have a baby, carry a baby, have the weight come off after you've gestated a baby, have weight, not be your enemy. During menopause, you have to be making ketones at a routine and regular interval. And start with the food, start with the menus in the kitchen. Don't run to the gym first.
- [54:02]
A
I've noticed in women in my life that they've told me that their menstrual cycles become more synced up when they are in a lower carbohydrate diet.
- [54:11]
B
Right. Their hormones can hear each other. I mean, when insulin is high, insulin dictates what that sugar does, but it also is the dictator for every morsel of fat. And estrogen, testosterone, vitamin D, they're all a derivative of fat, of cholesterol, and they are. They're put into the fat cells. If you biopsy an obese woman and say, can I see? Is there any vitamin D hidden in there? Is there any estrogen? Is there any. Yes, they're all in those fat cells. You start to lower their insulin and the fat mobilizes. So the hormones that are naturally communicated between women, they can actually hear them again. I mean, that tribal thing, if a.
- [54:50]
A
Woman were to stay in a ketogenic state permanently. Would there be any disruption to her metabolic health?
- [54:58]
B
You mean like me?
- [54:59]
A
Yeah, like, you know, her menstrual cycles. Her. Yeah. Anything?
- [55:04]
B
No, I think it's. You're gonna find people that. It shouldn't be extreme. Meaning. I've been on this for 15 years. The ketogenic phase is at least 20 out of 30 days in a month. The first few years I was on it. Now at 55, menopause in the last year, I'm like, without a ketone, my brain doesn't work right now. Without a ketone, my energy goes to pot. And I've been walking women through menopause for 25 years. It is not a fun story when they're insulin resistant. So prepare. Have the flexibility of that mitochondria to use both ketones and glucose. And that's what a ketogenic state is.
- [55:46]
A
We have 12 cans of sardines here. And I wondered why you brought sardines with you.
- [55:53]
B
Well, yes. That's a hell of a tool.
- [55:57]
A
Why?
- [55:58]
B
So when you're trying to help patients change behavior.
- [56:05]
A
Sorry, the sardine juice has gone on my iPad.
- [56:08]
B
Good luck getting that off. Yeah. Sardines rank for the worst smelling, but they're not the worst tasting. When it comes to bitter in fish, they don't have the bitterness that tuna does.
- [56:20]
A
So tell me about sardines. Why should I be eating sardines?
- [56:23]
B
When you're trying to teach patients those stats that you read off a minute ago, they don't care. They need a very clear step on how do I begin? And when you're working with 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 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 affordable for everybody under the sun.
- [56:48]
A
Okay, so do you do like a sardine fast?
- [56:51]
B
Yeah. So in fact, that 21 day. 21 day is that three week course where I say, I will teach you how to do an advanced ketogenic diet where everybody will be peeing or making abundant ketones on day six, I say, all right, the only thing on the menu for the next three days is sardines. There's no eating window. You can eat as much as you want. There's no limit to the amount. And what I'm pushing them to do is not only eat a nutrient dense food, but I want them to feel satiety. I want them to feel full.
- [57:23]
A
Do I need to be consuming a lot of fat as well?
- [57:25]
B
There's plenty of fat in there.
- [57:26]
A
But I mean, generally, because this is one of the things that always puzzles me is I'll go say I went a week without eating carbohydrates sometimes. I'm still not in ketosis. And I think I heard somewhere that it's because my fat isn't high enough.
- [57:42]
B
Yeah. So again, at the time, 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.
- [57:51]
A
Yeah.
- [57:51]
B
Okay, so why didn't the fat get to your mitochondria? Excess insulin. Okay. You had been in a high insulin state. So if you swallow the fat, then you can turn it into ketones. Right now all your fat's locked 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.
- [58:10]
A
So what you're saying. You're saying that I need to eat the fat?
- [58:13]
B
Yeah. So if you put the sardines in oil, that's a great high fat, high protein. It's also a little easier to masticate the meat. And you'll have high fat, high protein, and you'll have beautiful ketones by 48 hours, maybe 72.
- [58:28]
A
And what is the composition of my diet in terms of protein, fats, and carbohydrates when I'm trying to get into a ketogenic state?
- [58:35]
B
Yeah. I don't let people get distracted by this. Right. I say, look at your finger. If it's got a high ketone, you have got enough fat and enough protein and low enough carbs. What most people have is the story you told. I've been doing this for five days. Why don't I make any ketones? And the answer is, what is hidden behind the chemistry is too much insulin you've got to have. And so that's a great place to say, put the fat up. Keep the carbs low, and the ketones will come.
- [59:04]
A
When you say put the fat up, you mean 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 and stay there, I would have.
- [59:14]
B
Yeah. One of my favorite things is pork belly, more eggs, beef brisket, ribs, avocado. Avocado have a beautiful marketing team, but they do have carbs in them, and I've had people overeat them like I Have four avocados today. I'm like, that's. You're on the wrong bandwagon there. Avocado makes the list, don't get me wrong. But it's not a diet of mostly avocado with a sprinkle of chicken 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 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. I've said eat butter for a day. That's 100% fat.
- [59:55]
A
Okay, so you can just have. Increase the butter.
- [59:57]
B
Yeah, you could have that. Okay, so that.
- [59:59]
A
Are there carbs in here?
- [60:00]
B
No, no, no. It's just fat. And it's not awful, but it is a great social experiment where they haven't felt what satiety feels like in a while.
- [60:12]
A
People talk about net carbs. They say, you know, an avocado has 12 grams of carbs in, but it has 10 grams of fiber. So the net carbs is 2.
- [60:23]
B
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 game. It's gotta be total carbs. Fiber is for farting.
- [60:33]
A
Do you recognize this photo of this lady?
- [60:37]
B
Oh, yes.
- [60:39]
A
Who is she?
- [60:39]
B
Why, she is just a great story. Jane had. She had pathology with how she thought about food. Like many patients, she had food as the way she coped with a lot of things. And as long as she was clearing her plate and using that food, it comforted a lot of wounds. When you start to address some of these things, I mean, the ketogenic diet doesn't fail if you just follow the chemistry. The ketogenic diet fails when you have humans who've had wounds, who've had a history, who have stress, who don't sleep. And Jane was a great story where all the goodness in the world couldn't undo some of that relationship she had with food. So the first time, she's one of the coaches that I used for that 21 day. And she just has the best outcomes because she was doing a strong ketogenic diet for those three weeks twice a year. And she decided that after, I think, the third class, she was going to do sardines only 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 some of those demons associated with why she would eat what she would eat, and then life hit again, and she put on some of the weight again. She'd used sardines intermittently. And she called me and said, all right, I think I'm gonna do this again. I'm gonna just go on sardines and really have some come to Jesus moments on why it is that I 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 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 with Joe Rogan. He has said some inappropriate things about sardines, like they're arsenic 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 arsenic, selenium, and a few other things. And she starts on her sardine challenge, her sardine journey. And she goes 100 days. 100 days of only sardines. And not only does she. First 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 to just maybe over 100, 108 or something. Her selenium didn't do anything naughty. Her arsenic did not do anything naughty like Joe Rogan said it would. And she was able to not only shed the pounds, but really say some truths about why she was eating so much. And she confronted the pathology about why. Why is she using food for those other things? You know, I do this thing in the 21 day where I ask them to find their best day in their life. And I'm trying to just get them to think about, what does that feel like? What did that look like? And then we go to the worst day in their life. And Jane wrote something that really touched me. She said, I don't think I've ever had the best day of my life. This was probably the third or fourth time we'd done that exercise. So she'd done it in a way where it didn't bring any extra attention. But she spoke a truth that just said, I've had this fear for so long that for the first time, I'm gonna say out loud that I'm looking for the best day of my life. And I feel like I have the freedom to do it. That's what happened after 100 days of sardines.
- [63:55]
A
So if she eats sardines for 100 days, she's probably not gonna get, like, the Gut microbiome.
- [64:03]
B
She has the best gut microbiome.
- [64:06]
A
Doesn't she need to be eating plants to.
- [64:08]
B
Oh, no. Fibers for farting. So you're looking at a gut biome. Right. And so tell me what you think that is.
- [64:17]
A
Lots of bugs that have been feeding on plants.
- [64:21]
B
Okay, yes. Putyrate has part of that equation. So gut biome is this slime layer inside your gut. It's where the critters live, it's where they set up homes. And if you have a really good slime layer, it's squishy, it's dense, it's not moth eaten, it's not aqueous or water like it's squishy. And when you put plants in there, when you put fiber in there, it's tears that down. And you say, well, fiber's needed for this because some of those bugs eat up on the fiber and they put out some butyrate and that helps these other bacteria to grow. You're like, yeah, that's one way to get a good microbiome. But we haven't been fiber eaters forever. And when you look at many of my carnivore patients, especially when they've got some of those little fish scattered into that carnivore diet, their symptoms of irritable bowel, of chronic diarrhea, of, you know, bloody ulcers, reverse. Why? Because that gut biome got a lot stronger and a lot healthier.
- [65:24]
A
So the things that, from doing this podcast for a long time, the things that I'd be concerned about if I just ate 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 about. And then all the other things that are just not in sardines. I mean, vitamin C. Yeah.
- [65:42]
B
You still get a good vitamin C. So vitamin C has different rules when you go carnivore.
- [65:45]
A
What about magnesium?
- [65:46]
B
Yeah, lots of that. Magnesium I still think is one supplement we all need.
- [65:50]
A
What about sodium overload? Because these are very salty. Right?
- [65:53]
B
Your sodium churn. How well you use sodium is dependent on how well you've eaten in the last week. So when you increase the sodium, those receptors get better. When you decrease the sodium, those receptors shut down. That is an adjustment that everybody will make.
- [66:07]
A
What about things like mercury and other.
- [66:09]
B
Sort of metals, toxins, little fish, little problems. You've got the right one for mercury again. We tested that for her too. 100 days, no problem.
- [66:17]
A
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 microplastics, microplastic toxins, et cetera.
- [66:25]
B
I think you're majoring in the minor leagues there. The amount of benefit that people get from sardines versus whatever might be in those. In that. Can I tell patients not to worry about it?
- [66:38]
A
And then the last point I said was about digestive and mood issues because the gut microbiome is so, so linked to brain.
- [66:44]
B
Absolutely.
- [66:45]
A
Serotonin, isn't it?
- [66:46]
B
I mean, serotonin's in the gut, but it's a huge part of like a GLP1 GIP. They're all produced hormones in the gut that are hugely impacting your brain. And when you want GLP1 to be made have a strong, thick microbiome, you do not need fiber to do that. You need butyrate. Butyrate is that 2 carbon fat that comes from Akkermansia chewing up the fiber. Right. Or beta hydroxybutyrate in your blood. That's that ketone thing you got over there.
- [67:20]
A
Oh, these things?
- [67:22]
B
Yeah, all of them.
- [67:23]
A
Hashtag add.
- [67:24]
B
There you go. Yes, it's a. Beta hydroxybutyrate is what that is going to turn into your circulation. Butyrate is a fat chain that's two carbons long. That's what you're asking that microbiome to say here, this long string of fibers coming along and that little bug is going to eat a piece of it and make butyrate. Two carbons of fat. That's one of these things that you're talking about. You need to have butyrate. You need to have butyrate. That's what every. Why are you even fighter? You got to have butyrate.
- [67:53]
A
All these experts come on my show and they talk about the importance of having a diverse.
- [67:56]
B
I know, I've watched a bunch of them. Diverse microbiome. Yes. And what I think.
- [68:01]
A
So it's not gonna be diverse if I'm just eating one thing.
- [68:03]
B
Oh, yes, it will. So that's the whole point of a microbiome is diverse enough to be supportive. I mean, diverse enough to have the two chain fat that you want to have in there. I mean, go back and look at when our bodies were just eating, you know, fish or carnivore. The beauty of a microbiome is how much it does adjust in every patient.
- [68:33]
A
What about supplementation? What are the key supplements that you don't live without on a daily basis?
- [68:40]
B
Vitamin D turns out to be a really important one. If I'm eating sardines. Four or five cans a week. I probably don't need vitamin D, but.
- [68:48]
A
Why is it so important? Vitamin D?
- [68:50]
B
Yeah. It's a hormone, right? A hormone that goes and talks to every one of the cells in your body, and it tells that cell to be its best version of itself. That hormone goes to the nucleus, and it makes that skin cell do something different. It makes your brain cell do something different. It makes your heart cell do something different. You read all the benefits about vitamin D and you think it's like. It's like it does everything. Like, how can I do all of these things? And the reason why is it is not just a vitamin. It's a hormone that changes how the cell functions. Unfortunately, it's made of fat. So if you have high insulin, it gets stuck, parked in your fat cells, and it didn't get to the cell.
- [69:30]
A
Is there a link between vitamin D and ketosis and weight loss and insulin?
- [69:35]
B
Yeah. It's actually why I pointed out that when Jane did that hundred day. She's been struggling with her vitamin d in the 30s or 40s.
- [69:43]
A
Right.
- [69:43]
B
But for the best brain, we want it to be of 50. So she starts on the sardine challenge. It's in the 30s or 40s, and she's supplementing. She's taking as much as she can. But what's happening? Her 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, 108, something like that. So you can see the experts say, don't go above 100. But I don't. I don't have any worry about hers being 108. What happened was she lowered her insulin, and now fat can 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. She looks.
- [70:21]
A
Like 20 years younger.
- [70:22]
B
Isn't it amazing? You should see how joyful she is. That's the part that you're like, what? Unlocked during those 100 days of. You can say food restriction. But vitamin D went up, insulin went down. And she really said, how many things am I gonna comfort in my life from food? And let's tackle that demon.
- [70:42]
A
Did it stick?
- [70:43]
B
Yeah, that's the cool part.
- [70:46]
A
The world of business looks entirely different today than it did 15 years ago. Back then, building a brand meant having huge budgets, warehouses, office space, and lots and lots of staff. But now you can start a business with your laptop, an idea, and the right Tools. And I would know more so than anybody else, because that's exactly what I did. Shopify is one of our long standing sponsors on this show and they're a brand I often refer people to when they're starting their businesses because it's a tool that contains many more tools within itself. And when you're starting out, everything is everywhere. It's messy and it's confusing. So having everything in the same place is incredibly useful. Shopify puts store, design, payments, inventory, shipping, and even AI tools all in one place. And you can sell directly from your website or on social media, essentially wherever your customers spend their time. It's truly a brilliant business tool. So if you want to give it a go, head to shopify.com bartlett and sign up for your $1 per month trial period. That shop. What about the other supplements that you would not live without?
- [71:45]
B
Well, I think the whole world's low on magnesium. I wish I could.
- [71:48]
A
Magnesium.
- [71:49]
B
Yeah. So magnesium is required for every little. It's like the spark plug in our 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 in it, our soil is low on it. You just gotta replace it. I use magnesium supplements, but I also have my patients go for a magnesium float.
- [72:11]
A
What's that?
- [72:12]
B
Ever seen pictures of people in the Dead Sea?
- [72:15]
A
No.
- [72:15]
B
They're floating, right? The salinity or the salt level is so high. And it stinks, right? It's a stinky place. It's magnesium. So they go in there, they soak in the magnesium, and you're like, oh, my gosh, I feel so much better. Like, that's gotta be junk science, right? Well, it turns out it's not. So you can get magnesium absorbed through your skin and just like, I don't know, in the 1990s, you'd go rent time in a tanning bed. You can rent time in a magnesium float.
- [72:40]
A
Any of this.
- [72:41]
B
So Omega 3, if you're not doing fish, you can't go wrong with Omega 3. And you know, Steven, I really push my patients to have ketones around.
- [72:52]
A
When you say ketones, you mean exogenous ketones.
- [72:55]
B
Yeah.
- [72:55]
A
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 that's probably worth saying ketone iq. You've got some other ones here which are. What's this?
- [73:07]
B
That's ketone salts. So this one is just beta hydroxybutyric acid. My husband is deathly allergic to stevia, so I said, I'll make this one for you, honey. It's just liquid ketones, okay? No sweeteners, no fillers, nothing.
- [73:20]
A
And is there a difference between taking external ketones through a drink or through the salts or whatever else versus actually being in the ketogenic state? Because of your diet, when you make.
- [73:31]
B
It, it is much more abundant. But when you do what people do, they fall off the wagon or they're very insulin resistant, so their body is trying to catch up to equilibrate. You want ketones put back in circulation because it will spark their liver to make ketones. So it really is a jump start for patients with chronic insulin resistance, chronic problems. We got about six years of getting them to the healthiest version of themselves, as long as they 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 ketones. And by putting ketones in their circulation like that, by checking their blood, the liver will make ketones. So it's not just a fuel. They will feel better. It's a signal for the liver to make more ketones.
- [74:18]
A
But I'm not going to be burning fat then, am I?
- [74:20]
B
You will. I mean, again, ketones beget ketones. When you are making ketones, your body makes more ketones. So if you jumpstart it by swallowing some, you get better tomorrow. Get better tomorrow. And usually if somebody's fallen off the wagon, I'll have them do ketones for like three days. And the fourth day they are on their own again, and they'll stay steady for a couple of weeks, and then they'll have pasta.
- [74:43]
A
That's why I invested in this company, because I'm actually k owner of the business now and because I saw the benefits of having exogenous ketones on a regular basis.
- [74:53]
B
Right.
- [74:53]
A
So if anyone wants to try them, go to ketone.com and your brain will.
- [74:57]
B
Use it like that.
- [74:58]
A
Yeah, it's super fast.
- [74:59]
B
Beautiful, right?
- [75:00]
A
When I use my ketone reader, it appears in about 15 minutes or 20 minutes or so. So.
- [75:04]
B
And their liver then makes more ketones for the next 12 hours. That's the part that I. Especially for my cancer patients or people who are really. I mean, 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 the time. So let me help you. And there's nothing better than going into that chemotherapy, going into that radiation With a bunch of antioxidants in circulation coming right out of your liver.
- [75:29]
A
Explain why that matters. I mean, I've got a photo here.
- [75:32]
B
Of a Grandma Rose.
- [75:34]
A
Grandma Rose?
- [75:36]
B
Yeah, that's my mother. Yes, she is the reason I'm here. It's been five years. Yeah. 2015, the most stubborn patient walks through the door after 10 years of the best health care I know how to give. And she's gray, she looks like a zombie, and she's got big lymph nodes in her neck. You don't need to be a doctor to know that she's dying. Cancer is back again. And we go to see the oncologist, and he says, you need chemotherapy. And she says, like hell. The last two times you did that to me, I didn't know what a sewing machine was. And she made all of my clothes until I was the age of 10. And she's nervous because she has six months to live if we don't do something. And she asks me a question that lots of patients have asked me this question, and I just sometimes lie. She said, if it was you, what would you do? That's a really emotional question. Because there's guidelines, there's rules. Here's what you're supposed to do as the doctor. Oh, and it's your mom. And I saw what chemotherapy did to her. It was terrible. She didn't know the grandkids. It was terrible. And we just got her back to functional again. And so I had been reading about the ketogenic diet on brain injuries, and I'd come across a couple of studies on what it can do to a cancer patient, especially an insulin driven cancer patient like she was. I said, mom, do you trust me? Like a fool, she said, with my.
- [77:34]
A
Whole life.
- [77:38]
B
We were standing there in the. In the waiting room of the hospital. One way was to schedule the chemotherapy, and the other way was the front door. I said, mom, let's get in the car together. I left my car there. I drove to my family farm, which is 100 miles away, and explained to my mother what a ketone was. And her brain wasn't working right, so she didn't quite remember. And we went to the house. We threw out every carbohydrate and man. At six weeks, with chemotherapy, her numbers were supposed to drop by 30% of her cancer. We didn't tell the doctor. We just put her on a ketogenic diet and said, we'll come back in six weeks. So she's walking through the door of the hospital. It's six weeks from there. And it is like God has just. The holy spirit is rising out of her. She looks amazing. So we go to get her blood drawn. We're sitting in the waiting room for the cancer doctor. And he's my friend, he's known me for 10 years, so I'm scared to tell him what we're about to do. 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. 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. Because I don't know what to tell him. And he walks in and he slides the piece of paper over to me and says, how did you get her numbers to drop by 70%? There's no drug on the market that would do that.
- [79:11]
A
When you say numbers, her cancer numbers.
- [79:14]
B
So the chemo would have dropped it by 30%, and the ketogenic diet dropped it by 70% in six weeks. And she went from a 70 year old that looked 100 to a 75 year old who looked 40.
- [79:32]
A
How did your mother get on from that point onwards?
- [79:34]
B
Yeah, she. She lived her best life. I mean, I talk about her being from this little town of 800 people. She was mary poppins. I mean, like, you don't have a ladies aid Unless you're part of the ladies aid in the little small town. You don't have a Sunday school teacher unless you're doing the Sunday school. She was in every aspect of this little town, and she went back to doing all of it. And the pandemic hit, and there's a thrift store that she would volunteer at because, well, it's just a good place to put your time, and the community needs it. And while she was at the thrift store, she got Covid. And her cancer was of the T cells, which means it's going to be the first line of defense against Covid and her T cells failed.
- [80:28]
A
Some of the science behind this talks about how cancer cells often rely heavily on glucose for energy, A phenomenon known as the wahlberg effect. The keto diet drastically reduces carbohydrate intake, Forcing the body to produce ketones for fuel instead of glucose. Healthy cells can use ketones efficiently. Many cancer cells cannot. So in theory, keto could starve tumors while supporting normal tissue. And they've done some animal studies that show it can slow tumor growth in some cancers, especially brain cancers like glimoblastone glioblastoma.
- [80:57]
B
Yep.
- [80:58]
A
Enhance response to radiation or chemotherapy in certain models and reduce inflammation and oxidative stress, creating a less cancer friendly environment. However, results are mixed. They may also benefit muscle mass and weight stability in patients. Losing muscle from treatment may improve energy levels and mental clarity for some people and could reduce insulin and IGF1 levels. Hormones linked to cancer growth may improve quality of life when used alongside standard treatments like chemotherapy. There's also a list of potential risks which I'll throw up on the screen. And I guess the summary here is Keto may help by lowering glucose and insulin, reducing inflammation and supporting metabolism, but it can be risky if it leads to malnutrition, fatigue or worsened treatment tolerance.
- [81:38]
B
When patients. I get a lot of people calling and saying, is it going to help my cancer? Is it going to help my cancer? Steven, I go back to the same thing. The amount of trash that you've not been taking out, we have to start. And when you put them in a ketogenic state, I mean, it really helped her cancer. It really did that Warburg effect. She was a new human within three weeks, 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 and it really did return and restore her to health. When I look at patients now who say, you know, 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.
- [82:14]
A
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, with a lot of diseases there is a causal element where the way we eat and our lifestyle does create the disease.
- [82:26]
B
Right.
- [82:27]
A
But also when that disease arrives, what like environment is your body and to deal with it. And I think a lot about this, I think in part because of the pandemic where for the first time in my fairly young life, I saw that your current physiological environment, so your current, the current state of your body was the single biggest predictor of your outcomes.
- [82:46]
B
Amen. Oh, it was terrible.
- [82:47]
A
So I said 30 years old. And it's like, well, if you're currently overweight, your chance of dying from COVID is really, really high. And so I think that was one of the big sort of protagonists in me getting into shape was realizing that, you know, disease is probably going to happen to me, but how my body responds to it is to be determined.
- [83:06]
B
And I look at how much when you're asking an elder person to lose weight and you just read something really important there, which is when those ketones are in circulation, it is a signaling agent to make more ketones. But it also signals the body to say, don't use muscle mass as a resource. Go for the fat. So you can see this protective. I mean, you take people through chemotherapy and they have, you know, they shed way too many pounds, right? You put them in a ketogenic state and their muscle mass gets higher, preserved their brain function, their ability to handle this. You know, one of life's most enormous fears is death and that mood stability and muscle mass protection because they've got ketones in circulation, boy, that's the gift that they need right now in high numbers.
- [83:53]
A
What is. I've heard you talk about methylene blue for brain health.
- [83:57]
B
Ever done that?
- [83:58]
A
No.
- [83:58]
B
Oh, my goodness.
- [83:59]
A
What is it?
- [84:00]
B
Well, it's old as dirt, so nobody's making money on it. But it is a dye, and so if you swallow it, you'll pee blue. But it's also a bridge for how to help mitochondria move fuel along. So one of the worst parts, you asked me this question about supplements and I really have a tough time saying which supplements actually get to the cells that the patients are looking for. There is a really great fact about methylene blue that when you swallow it, it actually was used for malaria treatment or anti malaria for soldiers. And they would check compliance by making sure that their pee was blue. But when they died at autopsy, they had blue brains and blue hearts. It would dye these organs blue. You say, my gosh, that's so strange. But, you know, that tells me it got to the cells that it was advertising it was going to get to. 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 read about it and 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 take it for a couple weeks. It was amazing. It was amazing. Like, I was floored at how well that little turkey worked. So there's no money to be made on it. It's been around as long as dirt. But it's a powerful brain energizer. Like, it helps the electrical stimulus of the mitochondria in your brain keep energy high. And especially for, like, high energy brains. I love it. I'm like, I put that in my morning coffee, which is where The April Fool's joke, because nobody can see it in their coffee, but they definitely pee blue.
- [85:44]
A
And do you take creatine as well?
- [85:46]
B
I do take creatine, yeah. Yeah. That's great. That brain supplement is awesome. You do?
- [85:49]
A
I do. But my doctor the other day, I think he was suggesting that I might have taken too much.
- [85:53]
B
Why?
- [85:54]
A
Some liver scan I had and he was saying that.
- [85:57]
B
Liver scan or kidney scan?
- [85:58]
A
Kidney scan.
- [85:59]
B
Kidney scan. So that's a trick. Don't fall for that. I mean, I've done a couple of big shows on this where creatine is what you're gonna measure. Kidney funct. When your doctor 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 how clean is your blood. That's what kidneys do.
- [86:15]
A
You just did a blood test.
- [86:16]
B
Okay, well, even the blood test, the trash was looking like it was a little higher. Because the trash we're measuring is creatine, creatinine, which is made from your supplement. So you put the supplement in and it looks like there's more trash around. But that's just the supplement. It's falsely elevated. It's not true. Your kidneys did not get hurt by that. I 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 measured your kidney that would not have been manipulated by that supplement. What it does for brain function, especially if there's any adhd, man, they love it. They just focus for a long period of time. I mean, it's got other great findings. Like how often do you fly over to London?
- [87:01]
A
I fly a lot.
- [87:02]
B
Yeah. That's the best part about it, is that the jet lag part of it, there's really good studies on this. Like, your reset of sleep is going to be augmented if you take like 20 grams of it after the flight. 10 in the morning, 10 at night. And those are great studies. Like Navy Seals sleep deprived. Watch what happens when you add creatine.
- [87:25]
A
A lot of women don't take creatine because they've historically thought of it as like a bodybuilder thing.
- [87:29]
B
Right. It's a brain thing.
- [87:30]
A
And you take creatine every day. How much do you take?
- [87:33]
B
So two scoops every single day? Every single day, seven days a week. I put my methylene blue in it too. Down at first thing in the morning. I got blue dyed creatine. I mean, those Two supplements are just. They blew my mind with the amount of research out there. And then I did them. I mean, I'm not a big bodybuilder. I do some crossfitty kind of stuff three times a week, so there's that. But I do it for the brain stuff. The brain stuff is really impressive.
- [87:58]
A
At the moment in society, people are talking a lot about GLP1s and a Zempec and all this kind of stuff. And I was wondering if there's any harms or downsides in your view of using these Azempeq, Wegovy, GLP1 protagonists. Antagonists.
- [88:16]
B
Agonists.
- [88:16]
A
Agonists. And if there's a natural version for those of us that are looking to have less cravings. But we don't want to take GLP1s. We don't want to be injecting ourselves.
- [88:28]
B
Yeah. So those hormones are powerful. I mean, if you think that weight loss isn't a hormonal problem, show up at a medical clinic. They are powerful hormones that hijack people into a healthier, or at least a weight loss stage. But when you're looking at using this powerful hormone, okay, and use it for a short time, use it for a long time, what are the rules? These are brand new. One of the analogies I use for patients is, Stephen, if you wanted to have legs with no hair on them, how would you accomplish that?
- [88:59]
A
Shave them.
- [89:00]
B
Right. Because that would be short term, easy and reversible. You would not take chemotherapy. The most powerful, amazing there'll be. Every hair on your body will be off in the next two weeks. In the short term, they'll come back. 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 where I like to begin when I talk about GLP1s, it's amazing. You will lose fat.
- [89:27]
A
And what do I do instead then?
- [89:29]
B
So there's great ways to lower GLP1s or great ways to raise GLP1s. Right. For starters, when you're overweight, it 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 lift naturally, the GLP1s.
- [89:48]
A
Is there other ways to suppress? Well, suppress. I was going to say suppress my appetite, but more to just get rid of the cravings.
- [89:55]
B
Well, you'll suppress the appetite by raising those hormones. So you put in allulose. That's a great little boost to that you put in butyrate, whether or not that's the bug that you were talking about or the supplements. Butyrate increases and stimulates GLP1.
- [90:11]
A
And butyrate, just for those that might not know that word again.
- [90:15]
B
Right. That is what a ketone looks like floating around your blood.
- [90:18]
A
Okay.
- [90:19]
B
Yeah. So a ketogenic state will raise those hormones and suppress appetite.
- [90:23]
A
I've seen a bunch of studies on that that show that when people are high in ketones, ketones, they have a suppressed appetite.
- [90:29]
B
Right. And that is linked to the production of some of these hormones, these really great hormones. But you make them naturally. And so it's not the addiction part. It's the natural way to make it.
- [90:37]
A
I do find that. Anyway. I find that when. 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 things that I once craved, like, I don't know, like carrot cake or cinnamon rolls, they just completely seem to vanish.
- [90:52]
B
That's the same thing that happens when you give them that shot, too.
- [90:55]
A
Oh, really? When you give them GLP1?
- [90:56]
B
Yes.
- [90:56]
A
Okay.
- [90:57]
B
And, I mean, the beautiful part is you're young, you'll make a lot of GLP. You've already made healthy GLP1. You'll hijack and suppress it by being overweight and high insulin. So constantly delivering ketones to your blood, that's how you keep it high and you don't end up on the shot, which is expensive and very powerful.
- [91:16]
A
I always think, you know, when we give people advice on things like weight loss, there's always a part missing, which is this part about, like, discipline and motivation or whatever one might call it, which is the. Is gives somebody the sort of activation energy to even stick to it. Do you think about this much in your patients? Do you think about motivation?
- [91:34]
B
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 repair. Well, all of that is true. And I can get them motivated for a little while, and then we have the long game. You look at that story with 100 days of sardines, okay? That's two years into her journey where she finally says, okay, there's this demon that keeps coming about, and I keep falling off for all the wrong, you know, all the reasons everybody else does. And so she commits to this 100 days, and what happens is a whole bunch of things go right her Hormones go up and she has an amazing story. But most people are not going to do that. So in my practice, I do say the smallest dose of these hormones. I'll help you when you're struggling. I want you in a ketogenic state before we begin. I 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, 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 prescription. And I need it to be you that succeeds. Here, I'll lift you a little bit.
- [92:38]
A
So what do you. Is there any tricks to get someone to be motivated? Is there any. Do you have to focus them on their why?
- [92:44]
B
Yeah, exactly. Right? You're right. That first trick is get out of crisis mode. Okay? Crisis is what brings them in. But to stay the course and you have to get to a very serious moment where you say, what motivates me? What at the deepest heart am I most insecure about that I'm gonna do when all else fails, when everybody else gives up, I'm gonna find something that I'm this little farm kid from the middle of nowhere who was, you know, third grade stinky girl. I was a farm 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 gonna carry that insecurity with me until the day I die. What has that done? It makes me work really hard when everybody else gives up. Now, finding that for them and using that, using that harness to say, your biggest failure, your biggest insecurity can be your power by reframing it. That why we work on that every time we do that 21 day. Jane, she did that four times before she really got to the corner core center. Why do you keep doing this? That's how people stay motivated. It's a truth serum.
- [93:56]
A
All I had to do was brain dump. Imagine if you had someone with you at all times that could take the ideas you have in your head, synthesize them with AI to make them sound better and more grammatically correct, and write them down for you. This is exactly what whisper flow is in my life. It is this thought partner that helps me explain what I want to say. And it now means that on the go, when I'm alone in my office, when I'm out and about, I can respond to emails and slack messages and whatsapps and everything across all of My devices just by speaking. I love this tool. And I started talking about this on my behind the scenes channel a couple of months back. And then the founder reached out to me and said, we're seeing a lot of people come to our tool because of you, so we'd love to be a sponsor. We'd love you to be an investor in the company. And so I signed up for both of those offers and I'm now an investor and a huge partner in a company called Whisper Flow. You have to check it out. Whisper Flow is four times faster than typing, so if you want to give it a try, head over to whisper flow.AI/doac to get started for free. And you can find that link to Whisper Flow in the description below. Have you ever heard about this before? This thing I'm holding in my hands now, this is called Ketone IQ. The website is ketone.com. 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 highly restricted diet. And the reason I do that is plentiful. One of them is I spend hours and hours talking to people for a living, so I want to make sure my brain is firing in an optimal way. And the other reason that I do the ketogenic diet is because I just feel better. So when I discovered this, which is what they call an exogenous ketone product, where you can drink it and it increases your blood's ketone levels, I was blown away. I contacted them, I met them, I invested extremely heavily into their company, and I've become a co owner of the company accordingly. And they sponsor this show now. So if you want to try this, this out for yourself, I recommend you try it. Just visit ketone.com stephen and you'll get 30% off your first subscription order. You'll also get a free gift with your second shipment. That's ketone.com Stephen, I was reading about what happened to you in 2011, 2010, 2011, when you reached what you referred to as your breaking point in corporate medicine.
- [96:05]
B
Yeah.
- [96:05]
A
And you had some issues because you were, I think, helping some people who were homeless.
- [96:13]
B
Yep.
- [96:14]
A
What do I need to know about that and how has that shaped you?
- [96:17]
B
Corporate medicine has lots of flaws and you get tired of answering the same question over and over and over again. So you put some stuff up on YouTube and you start to say, here's the education I wish I could give you. And this starts to work. But that's not the path. If you're into corporate medicine. You're going to ruffle feathers. You're going to tick people off. Well, I left corporate medicine, started my own thing and I'm living out a two year non compete. Do you know what that means?
- [96:45]
A
That you can't do medicine for two.
- [96:47]
B
Years in that same market where they recruited me and they had advertised for me. 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 you can see Medicaid.
- [97:00]
A
Medicaid being the government funded medicine program, low income.
- [97:04]
B
So I said, they don't know me very well. Those are just as much my people as anybody else. I'm taking care of some Native Americans. They were the ones in the shelters. They're the ones with the low income. And those teenagers were overweight and they were eating kitty litter. They were eating toilet paper. Their iron was so low the machine couldn't measure it. So they're super malnourished. I started doing what I would do if you had all the money in the world. I took care of these patients. I gave them IV iron.
- [97:33]
A
So you gave them iron, which was expensive.
- [97:35]
B
It caused a ruckus. I got put on the radar of somebody that did not like that. So this is the budget. The whole state gets a budget for how much you're gonna spend on each patient. Yeah, I mean, by expensive, it was like 350 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 envelope from the state capitol. Stop doing Cadillac medicine. Yeah.
- [98:00]
A
So you were sued eventually.
- [98:02]
B
Oh, they call it Medicaid fraud.
- [98:04]
A
Okay.
- [98:05]
B
They thought I was wasting Medicare's numbers because I was giving IV iron. And I said, no, I didn't bill for it, I paid for it. And when I paid for the medicine for these impoverished patients, they said, well, that's Medicaid fraud. So the government tried to sue me for that and they lost. But now they're ticked off. They've brought me to court and they lost. And what happened next is a lot worse. I don't know if you want to hear that. You want me to go there?
- [98:33]
A
Of course, yeah.
- [98:34]
B
Okay. So when you are being investigated for Medicaid fraud, all income stops.
- [98:41]
A
Yeah.
- [98:42]
B
Yeah. So I have to come home to my husband and say, I just can't. I can't give in. I think we need to fight this. He said, okay. He, God bless him, he said, okay, let's fight it. Have you ever tried to Fight the government. That's very expensive. So they hold off. When you're under a Medicaid fraud investigation, you get no paychecks. So we have no paychecks to pay payroll, to pay house payments, to do anything for about nine and a half months. Actually, it lasted longer than that. During that time, we started doing things like we sold the lake cabin, we sold the boats, we sold the extra car, we sold our own house. We moved into a donated RV.
- [99:25]
A
You moved into a car, an RV?
- [99:28]
B
Yep. In South Dakota, where there's 50 below zero weather with three little kids. We actually used. We took our wedding rings in for the last paycheck. I just can't give in. And then I won. Okay, so Medicaid fraud wasn't there. But in the midst of that, I said this was when Obamacare was really happening. And I got asked to run for US Senate. There's only 100 of those in the country. I run for US Senate, and I did really good. I raised insane amounts of money saying, I am a doctor that serves the poor. I am a physician that runs their own company. I think I am a great voice to send to Washington, D.C. to make policy about patients and care as opposed to the other opponents. But that same Attorney general, his best buddy, was running against me. And when I am in a mission trip in the Philippines, that has nothing to do with it, but I was on a mission trip in the Philippines and I left a petition. I don't know how you do it in London, but a petition means if you're going to run for office, you got to get some people saying they believe in you. So we needed 2,000 signatures, and we got 6,000 signatures. We submitted them to the state. We think there's no problem. But then the quarterly earnings come back for a campaign raising. And my opponent had about 70 donors at about $10,000 a pop and had something like $740,000. I put my earnings in, and they were $780,000. So I outraised him. You have to report to the government whenever somebody gives you more than $200. So his donors are right there on the list. My list is empty because the average size of the donation was $45. And they know they can't win with that. I have a grassroots behind me, and that's when the black cars started showing up in my life. It sounds like I've got a tinfoil hat, but it was real.
- [101:44]
A
The black what?
- [101:45]
B
The state card started to show up outside my house. They started to say, find something on her And I am the first person in the history of the United States of America to be investigated for not witnessing a signature on those petitions.
- [102:02]
A
Okay, so there was these petitions. You had to get 2,000 of them signed, and you had to witness them. So you had to be there when they were signed by people.
- [102:10]
B
Well, that's what it says. And you're right. It says, I bear witness. So as I'm. I left them in my clinic, my staff signed it, the preachers in my clinic signed it, and those signatures were collected while I was in the Philippines.
- [102:26]
A
And so you signed to witness them when you were back from the Philippines?
- [102:29]
B
Right, So I didn't witness them. I just vouched that. That's my sister. That's the preacher. I know who these people are.
- [102:36]
A
And so they charged you for. They realized that you were in the Philippines at the time, so you couldn't have witnessed them based on the dates or something.
- [102:43]
B
Yep.
- [102:43]
A
And then they arrested you.
- [102:47]
B
12 felonies. They give you 12 felonies and 24 years in prison.
- [102:53]
A
That's what they charged you for, or.
- [102:55]
B
That'S what they charged me with. 12 felonies. Six counts for each of the six petitions. Six. So there's 12 felonies, there's six mistakes, but each mistake counts for two felonies. I mean, if you're gonna make a mistake, there's one felony when you're trying to make a statement. There's 12 felonies, and you're the first one in the history of the United States of America to ever have this charge, let alone brought to trial and then found guilty. The trial didn't happen in my state, my town. It happened in the state capitol, where everybody knew that attorney general. Everybody knew the opponent.
- [103:34]
A
So they tried to get you to serve 24 years in prison?
- [103:37]
B
Yeah, they sentenced me to 24 years in prison.
- [103:40]
A
They sentenced you to.
- [103:40]
B
Yeah, My kids are sitting behind me. You are guilty of 12 felonies and 24 years in prison. And then he says, but the stack of papers in front of me might be the biggest. He'd been a judge for 20 some years. And I had patients who had written in saying, this is the best doctor I've ever seen. I didn't ask them to write that. They just sent them in.
- [104:02]
A
That moment when you hear that you're going to be in prison for 24 months, 24 years.
- [104:07]
B
Oh, God. It is the lowest moment of my life, because, I mean, I do not like that that story cost the state of South Dakota any money. But I also don't like that when you oppose the political giants and you stand there with all of the right intentions, that if they need to find something on you, they will. Six petitions and we had a thousand extra signatures. There was nothing. This was a nothing burger. But it was enough. And that attorney general said, prosecute her to the fullest extent. And I'm not a martyr. I do things that aren't right. And if there was a mistake that I made, I would take full ownership. And to that judge I made. I took full ownership that the attorney general was. He won. I got sentenced.
- [105:07]
A
But you didn't have to serve the 24 years.
- [105:09]
B
He said, I'll probate that. I will suspend that. With. The highest number of service hours ever in the state of South Dakota was 500 community service hours serving the poorest patients in the state. And when he said those words, I thought, oh, my God, you don't know who I am. That's what I've been doing. I was already working in Pine Ridge.
- [105:29]
A
How do you feel about all of this?
- [105:30]
B
I mean, I think of it as a test. It was a test of. I mean, most marriages aren't going to make it through that. If you've got kids, they'll end up in rehab without much stress. And I didn't want that life. I didn't want that to be my ending. I framed it different. I said, all right, God, you're testing me. You're testing to say, can I be? Can I stay true to who it is that you've called me to be? That our marriage was incredibly. That's a lot of pressure. I mean, I was the number one news story in the whole damn state for three years, running by a mile. I can't go anywhere without. That's her. That's her. My parents were ashamed. My kids would say, this is the woman that takes me to Haiti. She is Mother fricking Teresa. And now she's on the front page of the newspaper as a 12 time felon. And your teachers at school say, I write about your mom in the newspaper. I mean, I said, oh, it should have crushed me.
- [106:39]
A
But it didn't.
- [106:39]
B
It did not.
- [106:41]
A
When did your life begin to turn upwards from that point onwards? When was the moment where things were.
- [106:49]
B
Well, the first thing is we appealed that to the Supreme Court. That's where the big legal bills come from. Like when you're fighting an attorney general. That's where. And the Supreme Court said that that attorney general abused his power for at least six of them. And then that judge said, I'll Erase all these because of the work you've done. So the 12 felonies went away during all of them. All of them. I think on the edge of that story, I work to resurrect people's health back to a place where they get their best life. And yes, ketones are a really big part of that. But as you look at the relationships you've got around your life, take the core ones and nurture them to a place where your best life comes out of those relationships. Find the purpose that you've been designed for and take those relationship with you as you seek that. I know that's what happened to me. I cared about the ones on the inner circle and I had a one track of this is what I'm designed to do.
- [107:51]
A
We have a closing tradition we're gonna ask leaves a question for the next. And the question left for you is, do you have a daily practice to find deep inner peace when you are emotionally triggered? And if so, please share it with the audience.
- [108:08]
B
Yeah, I have a devotion that I do every morning that centers me, keeps me in line with my faith. And it's not that you do it on the bad days, it's that you've got the foundation for doing it on the good days. And there are a daily devotion like upper room is a. This is spiritual devotion for my church.
- [108:34]
A
What does that look like? Is it a prayer?
- [108:36]
B
Yeah, it's a prayer.
- [108:37]
A
And how does that sound?
- [108:39]
B
Yeah, it's usually a scripture and then it's a prayer that has been paired with that scripture. And again, it's easy to not do it routinely, but when you practice it on the good days, it's what lifts you on those really tough days. And sometimes you forget you're not the first person to run through these problems. But there are thousands of generations that have taught you how to do life and get through those hard places. And I'm going to use their rules, I'm going to follow what that scripture says and lead for my best life.
- [109:17]
A
Dr. Boss, thank you.
- [109:19]
B
Very good.
- [109:20]
A
We are done. I really think, I really appreciate so much about you. I appreciate your personality. Well, I. Incredibly engaging, but I also just. I appreciate that you've taken the time to make so much content over on your YouTube channel, which I'm gonna link on screen and below now to sort of demystify and break down some of these really complicated subjects that people struggle with. And they're looking for someone who they can trust, who has a bit of personality, who can communicate some of these very complicated things to Them. And on your channel you talk about everything from the ketogenic diet to many things we talked about today, to the creatine stuff, to cancer more broadly, this idea of autophagy and fasting and lots 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 would like to learn more. It will be linked below. And you've written some wonderful books, some of them that we've referenced. We've got the Keto Continuum, which I'm going to link below as well, this wonderful book called any way you can, A beginner's guide to ketones for life, which talks a lot about rose and has some wonderful photos of rose in that book. And we have the Keto Continuum workbook, which is a much more practical.
- [110:29]
B
Yeah, it goes hand in hand with the other one. And it's what I give my patients in the clinic because they got to go through that workbook.
- [110:34]
A
I think a lot of people are looking for 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 a way holds them accountable, which is exactly what the workbook does. Thank you so much. You're helping millions of people. You've had a fucking rough ride. It's like 12 felonies and 24 years in prisoners for something as little as what you did, I think is bizarre, quite frankly. But it's a story of inspiration that it didn't hold you back. And you've risen like a phoenix and created so much incredible work. Therefore, that's benefit so many. So please do keep going.
- [111:06]
B
God bless you. Thanks for having me here. I'm really excited to be on your show.
- [111:09]
A
Thank you so much, Dr. Buzz. This is something that I've made for you. I realized that the Diavisio audience are strivers. Whether it's in business or health, we all have big goals that we want to accomplish. And one of the things I've learned is that when you aim at the big, big, big goal, it can feel incredibly psychologically uncomfortable because it's kind of like being stood at the foot of Mount Everest and looking upwards. The way to accomplish your goals is by breaking them down into tiny, small steps. And we call this in our team, the 1%. And actually this philosophy is highly responsible for much of our success, success here. So what we've done so that you at home can accomplish any big goal that you have is We've made these 1% diaries and we released these last year and they all sold out. So I asked my team over and over again to bring the diaries back, but also to introduce some new colors and to make some minor tweaks to the diary. So now we have a better range for you. So if you have a big goal in mind and you need a framework and a process and some motivation, then I highly recommend you get one of these diaries before they all sell out once again. And you can get yours now@thediary.com where you can get 20% off our black Friday bundle. And if you want the link, the link is in the description below. It takes a little bit of time to realize this as a founder, but once you do, it's something you can't unsee that Having the right systems in place with your business is critical One that's helped me across all of my investments is NetSuite, the number one AI cloud financial system and sponsor of today's conversation. Through their streamlined platform, you'll find all of your accounting, finance, management, inventory and HR in one place. And their technology has been a massive unlock for all of my companies, especially for my team at Flight Story as over the last year we've moved out of startup mode into scale up mode and that's the stage where we found it mission critical to use NetSuite. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and of course the number of errors. Over 43,000 businesses have chosen to future proof their business with NetSuite. So if you'd like to learn how it can help your business right now, get the business guide demystifying AI free at netsuite.com bartlett that's netsuite.com bartlett.