Top 3 Ketosis Tips for Success – Dr. David Jockers | Podcast #240

Ketosis is a normal metabolic process that provides several health benefits. It’s a popular weight loss strategy wherein your body converts fat into compounds known as ketones and begins using them as its main source of energy. Ketogenic diets may even have benefits against diabetes, cancer, epilepsy and Alzheimer’s disease.

Read and listen through this podcast as Dr. J and his special guest, Dr. David Jockers discuss the Top 3 Ketosis Tips for Success.

Top 3 Ketosis Tips for Success - Dr. David Jockers | Podcast #240

Dr. David Jockers

In this episode, we cover:

00:43 Ketogenic Diet, Intermittent Fasting

01:10 Importance of Hydration

09:08 Stress Control and Good Sleep

13:54 Keto Adaptations

28:34 Meal Time Strategies

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Dr. Justin Marchegiani: Hey guys, it’s Dr. Justin Marchegiani here. We have a great friend, awesome awesome information dude, Dr. David Jockers. He’s got some amazing information we’re going to talk about today regarding ketogenic diet. David has a phenomenal summit out now called, The Keto Edge Summit. I was a speaker in it. Amazing speakers, amazing information, we’re gonna go over some of the top three Keto tips that David applies with himself and his patients to help improve their health. David, welcome to the podcast. How are we doing?

Dr. David Jockers: Hey always great to be on Dr. J, I love listening to you and Evan. Big fan of the show, so always great when I get to be on. And I love our conversation. So thanks a lot.

Dr. Justin Marchegiani: Yeah well thanks for being here, Doc I really appreciate it. So let’s dive in to it, you’ve been utilizing ketogenic diet, intermittent fasting, these tips these techniques to help improve insulin sensitivity, to help with cellular turnover and healthy aging. So what’s the number one thing right now that you find that patients have a barrier with it, when you make this tweak or you make this adjustment, they get to their next level of health utilizing a ketogenic diet?

Dr. David Jockers: Now I would say the number one thing is hydration. You see, in our brain our, our hypothalamus, our hunger center and our thirst center are right next to each other. And whenever we eat, we stimulate dopamine. It helps us feel good. And I think that’s a great adaptation, because you know it’s like, it’s great to feel good when we eat and it helps drive us to eat to consume food. But what happens is because food so prevalent in our society today, whereas as our ancestors didn’t have access to, you know we didn’t have pantries and refrigerators and things like that in years past. So food is prevalent. We could literally be eating all day long and we’re constantly stimulating that dopamine. And so for many people have become addicted to it, and our hunger and our thirst center are right next to each other in that area of the brain. And so for many people they’ve had these neuroplastic changes where the hunger center has now moved into the thirst center. So they’re really thirsty but they experience it as hunger. So they’re like I need something, I need a dopamine hit. There’s something that I’m missing and there’s food, I’m going to go for the food, and really most people are chronically dehydrated meaning more fluid. We need more water. And so I find that drinking more water, hydrating your body really well especially when you first wake up in the morning, so critical, so critical, for intermittent fasting, so critical for fat burning, for cleansing the body, for energy production, for good mental clarity, and for Keto adaptation. And so getting some good water, I recommend drinking you know, if you’re not used to it start with just eight ounces, OK. But ideally, trying to get 16 to up to 32 ounces of water within the first hour of waking up. So really hydrating your body well because when you’re sleeping overnight you’re breathing out water vapor. So you’re actually losing water throughout the night. So when you wake up in the morning really hydrating well, not only will replace that water, but on top of that it’s also going to help stimulate energy production, you’re going to notice that your energy goes up, the better you’re hydrated, more energy production your body’s going to have, you’re also going to poop better, right. We want to get poop out, want to have good bowel movements early in the morning, you’re at your large intestine is most active. So my goal is always to have two really good solid bowel movements within the first hour of waking, and it’s like my energy is just amazing, my mental clarity- I’m so productive when I’m able to do that. So hydration is number one tip.

Dr. Justin Marchegiani:  I think that’s amazing. I’ve been following that for years. When I first discovered the book, your body’s many cries for water by Dr. Batten and Gila. She talked about that. I’ll add some extra like Redman’s real salt or I’ll use a trace minerals support I’ll add to it. Today, I had a little bit of alcohol last night so I before I went to bed I have a drink, I typically drink mineral water in between each alcoholic beverage to get the extra minerals back in and then I did a lot of glutathione before bed and a lot of vitamin C and extra electrolytes to start my day, and those stretch receptors in your tummy when water comes in, it hits those stretch receptors and allows you to feel more satiated and then naturally have an appetite that’s more calibrated with what their nutritional needs actually are. So that’s a great tip.

Dr. David Jockers: Yes so important, I mean we have that ghrelin hormone. And so when we’re when our stomach is empty, ghrelin going to come out and tell us we’re hungry. So yes the eating a big breakfast in the morning, it’s normal for you to want to eat a big breakfast because you conditioned this response that ghrelin pop out. What if you just start by hydrating your body you’re gonna notice you’re gonna be more satiated. This is a great way to get started with intermittent fasting- you just hydrate your body really well in the morning, and then wait for natural hunger to come after that, to start with the hydration, now allow the natural hunger to come, you know, as it comes naturally after that. Yeah definitely getting the electrolytes and to adding some —

Dr. Justin Marchegiani:  Yes it’s very important. And as insulin levels drop too we tend to pee, pee more because insulin tends to pull sodium. Sodium tends to pull water. So that’s why you know someone does a ketogenic diet and drops their carbs really low they’ll lose three or four pounds the first day it’s not going to be fat it’s going to be water. So yeah I mean that’s that’s a really salient point because we are going to be losing a lot of that water so we have to make sure we get it back. And I would even say the key electrolyte to on keto that I find is really low is potassium. So really upping the potassium and or just really focusing on lots of green vegetables and avocados is another awesome tip for sure.

Dr. David Jockers: Yeah. That is important and sodium too actually. When you lose a lot of sodium, so getting a lot of those salts are really the cool thing is in nature you get potassium, and a lot, you get potassium and sodium and good ratios right. So avocados actually have sodium, celery potassium and sodium, C vegetable. Right. So all these natural foods [inaudible], these broccoli cauliflower got potassium and sodium. So if you’re consuming a lot of those things and then salting your food up to your desired case. I don’t think you need to go beyond that. Not like I’m shoveling salt in your mouth. They just flush you out right. Probably just move your bowels, could you loose stools but instead just salting up to your taste. And even if you’ve been told to be on a low salt diet, it’s kind of like what you were saying there, Dr. J you know, basically once you, once your insulin goes down, you turn a lower carb diet or if you are doing some fasting, your insulin is going to drop down and when you when you drop insulin, you start to excrete sodium. With that sodium comes the water so you need to replace that. So adding in these good trace mineral rich foods, even grass fed meets you’re very rich and in minerals, a lot of good salts and they’re really really good stuff. Dark green leafy sea vegetable, a lot of things we we just talked about, fermented foods, olives, pickles, sauerkraut, all really really good stuff when it comes to trace minerals. So getting those in your diet and then just salting up your desired taste, really good. And then I mean it’s really as simple as this when it when we’re talking about taking Redmond’s real salt or Himalayan salt. Yes a little pinch on your on your finger and put it on your tongue. Specially noticing that you’re just feeling a little bit dizzy or especially a lot of people when they start intermittent fasting or if they start going in a low carb diet, they feel a little bit dizzy, a little bit spacey and oftentimes that’s an electrolyte issue. So just taking a pinch of salt putting it on your tongue, drinking you know, two to four ounces of water and shrinking a little water after that can knock that out right away. I’ve also seen people with allergy symptoms, certain having like a runny nose and coughing things like that, taking a little bit of salt and water actually acts as a natural antihistamine. Dissolution, yeah because histamine actually, one of its jobs in Doctor, Doctor Batman is who I helped in that book he talks about it talks about histamine helps triaged water so we become dehydrated. We triaged water into organ systems that are most vital, like the brain, heart rate. And so therefore the mucous membranes get less of it. So we’re more likely to have allergic type responses right and plus we have elevated histamine in our system. So when we hydrate the body, get the electrolytes in, naturally reduces that histamine response and we get more balanced, more balanced histamine response, therefore, less of the congestion right runny nose things like that.

Dr. Justin Marchegiani:  Yeah, totally makes sense. Love it, love it. and then what’s your favorite brand for a good mineral salt? Redmond’s Real Salt?

Dr. David Jockers:  Redmond’s Salt is great. Absolutely. That’s what I think. I think it’s a little bit lower costs than Himalayan, Himalayan sea salt a great one, Celtic is a good one. So any of those are great.

Dr. Justin Marchegiani: And then just people listening. It’s not just sodium chloride, your typical table salt would be sodium chloride. It’ll be bleached as well. So we’re talking about salt that have you know 60 70 different micro minerals as well as just sodium chloride. So you’re getting a lot more in there. I think that’s phenomenal. What’s number two. Dr. Jockers?

Dr. David Jockers:  Yes. So we talked about the water in the electrolytes obviously we’ve got to start with that. Number two is really controlling your stress and focusing on good sleep. So most people understand this but you know we’re under stress, we’re gonna be elevating our blood sugars, so higher amounts of stress hormone are telling our body we’re in a place of fight or flight and when we’re in place or fight or flight we think we might need to sprint at any moment with survival. Right so our bodies naturally can elevate our blood sugar, and when we do that, then you know if we’re not running, so we’re just stressed out like we’re sitting in traffic, whatever it is, your spouse says something, and we’re stressed out about it ,we’re elevating our blood sugar but we’re not giving the response the body needs which would be to run or lift something, I had to climb a tree so therefore we just end up with this elevated blood sugars in the body towns out some insulin to help lower that blood sugar, high blood sugar can be toxic, can actually cause damage to the nerve system, cause advanced location and products, all kinds of all kinds of oxidative stress, so the body gets insulin up to take the sugar out of the bloodstream and of course, when insulin is up, that’s going to inhibit the production of ketone to burn fat. So insulin being elevated because of the stress response is going to cause you to not be able to burn fat, not get into ketosis, and therefore it’s also going to cause kind of this spiral where you’re going to end up with hypoglycemia, because oftentimes you’ll drop that blood sugar too low. Yeah. And another stress response and this is a vicious cycle, you’ve got to really keep your stress under control. Why I never tell anybody to start intermittent fasting or start a ketogenic diet. If you’re already overwhelmed by stress, like if you would describe your life you’d say, I’m just overwhelmed by stress. Not a good time for you know a ketogenic diet or fast. That’s more for somebody that’s got stress under control. Now these are hacks that are going to really take really improve your body’s ability to be more resilient to stress, to improve your fat burning, improve your brain, down regulate inflammation really powerfully. But first you have to get your stress under control and you’ve got to get your sleep under control because if you don’t sleep well, then you’re you’re naturally going to be under a higher amount of stress. If you get if you’re getting consistent poor nights of sleep, even if you don’t feel stressed out during the day you’re going to have higher stress hormones which is again going to cause that cascade of high blood sugar and high insulin.

Dr. Justin Marchegiani:  Totally makes sense, and I see an email in my inbox that you sent me a couple of days ago for your newsletter and you talked about some of your favorite adaptogens. Yes. Again this is kind of what you probably plug in on the supplements that outside of diet and lifestyle modifications. I imagine you’re probably using some adaptogens to help modulate this stress response. Is that true?

Dr. David Jockers: Oh absolutely. I love [inaudible]. A great one. Magnolia fish [inaudible] reishi mushroom. Yeah. Lemon bomb right. Very good relaxing herbs. If you want more energy, something like Rhodiola. Really good siberian ginseng. Another great one for energy. Right. The great thing about adaptogens is they’re going to help balance you. So if you feel anxious, all right, and jittery, they’re going to help bring you down, if you feel fatigued and lethargic, they’re going to help bring you up. and that’s the great thing about them. They just kind of modulate and help balance you out. Also a huge fan of magnesium too. Know I find that most people are deficient in magnesium some magnesium can be really really powerful for helping modulate the stress response, modulation means balancing. Right. That’s what we want. You know we don’t necessarily want to increase or decrease. We want what the body needs at the moment. Right. We want to help balance it out, so we were able to adapt to the environment adapt to the stressors we’re under and be able to perform at our highest level. So those are those herbs and Magnesium here are key.

Dr. Justin Marchegiani:  That makes sense because people I think forget like, they’re so focused on their diet. Hey I’m trying to keep these carbohydrates down because these eventually will break down into glucose or fructose in my body and have potentially a negative effect at burning fats or cause insulin resistance. People forget that their cortisol levels can create surges of glucose through either protein in their body or just releasing glycogen that’s already in their muscles and that can be the equivalent of having an extra carbohydrate that you wouldn’t want to eat but eat you’re not even eating it, it’s being released internally from these different stores and you can still have deleterious effects, so the adaptogens like you mentioned I think are great, just getting those glute four receptors upregulated on the muscle, these are little fingers that help pull glucose into the muscle and you can do that by movement, by taking a walk after after an hour, or doing some bands or some resistance training to help soak up a lot of that glucose, that’s really good points.

Dr. David Jockers: Yeah absolutely. So important. A third big thing is to you know basically, you want to gradually move into Keto adaptations. So for some individuals I say about 25% percent of the population they can start today. They might have eaten 500, 500 grams of carbs yesterday for twenty five percent of the population. They can go down to 20 carbs and actually feel great within the first week. That’s only 25 percent the population. The other 75 percent is gonna feel really crappy. Yeah. So what we want to do to be on the safe side is, gradually reduce your carbohydrate load. So if you were to take it for example, if you were to take this week or the next three days and just count out how many carbohydrates you’re consuming, right. Subtract the fiber, so your net carbs, total carbs minus fiber that you consume on a daily basis, you keep track of your your macros and you can use like chronometer or something like that. See, see where your carbohydrate load is. Let’s say you’re consuming 250 grams of total carbs, right, in a day. OK great. So for the first week, all you do is you reduce it down by 50 grams. So for the first week, you’re going down to 200 grams of net carbs. So total carbs minus fiber, you replace that with a couple grams of, well not a little bit more than a couple, but roughly about 10 grams of healthy fat. Right. So you eat a little bit, eat a few more olives, you know, a teaspoon of olive oil something along those lines, you just add that and while you take out the carbs, and then you do that each week you drop it down roughly about 50 grams each week. So if you started at 250, you know, by the time you get into the ketogenic range, it’s roughly between 20 grams to 50 grams. It’s about five or six weeks. Right. So you give your body time to start to adapt and build the metabolic machinery to be able to run on a lower carbohydrate diet and use fat for fuel. And I think that’s a big thing. A lot of people try to jump right in, they try to go cold turkey and have a bad experience when you gradually shift into it. So you’re leaning into it, shifting into it. You give your body time to build the metabolic machinery to get more familiar with that with ketones in the bloodstream. Right. So if you’re eating 250 grams of carbs a day, your body has not seen ketones. It doesn’t. It’s not familiar with how to use them for energy. You’ve got to give it some time to see that in the bloodstream then it’s going to up regulate the enzymatic systems to sort to use that for fuel. So that’s a really important strategy. Just keep dropping it down roughly 40 to 50 grams of carbohydrates, replacing that with healthy fat or in some cases, healthy protein if you’re on a very low protein diet, but replacing that until you get into that 20 to 50 gram range. And typically for somebody at sedentary. So if you’re not doing a lot of movement, you’re going to need to get your net carbs down in that 20, is certainly under 30 range and some in some cases under 20 if you’re very insulin resistant, you’re more active. You could find that you’re going to get into a state of nutritional ketosis which is zero point five million miles or higher when you’re testing your blood ketones with, you know, you probably are going to be able to handle up to 50 grams of net carbs and be in that range. And if you’re extremely active high level athlete maybe they’ll take up to 100 hundred and twenty grams in that carbs. So you got to kind of find the right zone for you. So once you get into that zone, I tell you, you know my recommendation is spend 30 days in that zone. I think 30 days in nutritional ketosis is extremely powerful for helping clean up cellular debris reset your systems. I mean ketones, epigenetic modulators. So they help to help your body to express genes are gonna have more anti aging benefits, are going to help upregulate mitochondria and support healthy mitochondria. So you spent 30 days in that and then you find a good carb cycling strategy after that. Right. For some people they like to carb cycle, you know, every other day, for some people it’s you know once every 10 days, where you have a higher carb day where basically you’re.. you’re consuming more carbohydrates roughly somewhere between 50 and maybe up to one hundred and fifty grams of of net carbs depending on you. So if you tend to be more insulin resistance, you might do less. Like for me I tend to be more insulin resistant so I.. For me it’s like a higher carb day might be 70 or 80 grams of net carbs. OK. Whereas for somebody else they may be able to tolerate a little bit more especially if they’re very very active. So you’ve got to kind of find the right zone for you and then you drop back into ketosis. OK, find again, find the right strategy. So for some people they’ll do a feast day once a week, where they’re like one day a week where you know, they’re eating 150 grams or 100 grams net carbs, so just consuming more carbs and for them that works great. Right. And then usually takes them two days or so to get back into ketosis. If you do a high carb day like that and it takes you a week to get back into ketosis, then you really shouldn’t be carb cycling once a week right then you would probably want to carb cycle like once every two weeks once every month. Something along those lines. That way you’re you’re splitting your time right. You want to spend some time where your body is utilizing glucose right for fuel and basically resetting your glycogen stores. You also want to spend time in this state of nutritional ketosis. You got to find the right carbs cycling approach, and the strategy I like to apply is more of a carb backloading strategy. Yeah I like to eat less during the day I eat less food during the day hydrate. I do a lot of hydration during the day, keeps my energy high. It allows me to perform at a higher level because stress is the antagonist to good digestion, meaning that when we’re under stress, we’re not gonna be able to produce as much stomach as–

Dr. Justin Marchegiani: Correct.

Dr. David Jockers: The bile pancreatic enzymes to digest our food well so I like to do more smoothies ,right, things that are predigested during daytime. I’ll throw avocado in my my protein shakes so I get more healthy fats. But the blender is the job of the digestion and then the evening that’s when I feast, right. That’s when I had my big meal meat, right. Vegetables. Healthy fats on there. And I find that that approach works well and especially if you’re going to add in more carbs, doing a lower carb during the day. So if you want to eat solid foods, eggs, right. Maybe like a big chicken salad with olives, and I’ll add avocado and olive oil or something like that where it’s low carb throughout the day and then when you add in the carbs, you do it more in the evening, your sweet potato, right, or your your steamed carrots, beets, if you want grains something like Quinoa or or rice or something along those lines, doing it more in the evening you’re going to notice it. That’s going to get better benefits. A lot of research on that for helping stimulate fat burning, right and supporting the sensitivity.

Dr. Justin Marchegiani:  Some people, one of the side effects with Keto sometimes sleep can deteriorate and that could be from a hypoglycemic kind of episode before bed. So if that’s happening, maybe adding a tiny bit of carbs or even a tablespoon of coconut oil to provide some more of those ketone precursors before bed to keep that blood sugar and add an additional fuel source outside of the blood sugar in your bloodstream.

Dr. David Jockers:  Yeah yeah for sure. Absolutely. And I think if you do the slow keto adaptation approach you’ll notice less of a hypoglycemia. Which will definitely help you. Your bio get better and better at using ketones. But a big thing that I do see is that people aren’t feasting. Right. So if you’re under eating for a certain portion of the day you’re eating a lower amount of calories in the evening. Definitely eat a higher amount of calories right to make up for it. And that is a mistake I see a lot of people make is they reduce the carbs but they don’t they’re not as generous with the fat. And therefore, they end up not just not consuming enough calories which can then cause the hypoglycemic type issues especially for like lean women. I see that a lot of lean women having that issue don’t have as much body fat. The body’s trying to protect the body fat tissue.

Dr. Justin Marchegiani:  I see that all the time. You don’t get enough fat in there to replace some of the carbs that are pulled out, then you could still be in a caloric deficit and that can still create a stress response. So I think that’s really important because the whole goal is we have this kind of fuel partitioning mechanism imagine like an air traffic controller. Right. Planes come in. You point this way, you point that way, imagine an air traffic controller saying, OK go to the mitochondria get burnt up or go back into the fat cells and get burnt up get get stored. So we want to be an air traffic controller shuttling everyone to the mitochondria, to the muscle cell to get burnt and not get stored. And we have to change these cellular enzymes. We need more lipolytic, right, lipo meaning fat, lytic meaning to break down some more lipolytic hormone, sensitive light pace Growth Hormone thyroid hormone versus insulin, lin lipo eugenic hormones on the storing or formation side. So I think what you’re saying these are just basically unregulated that air traffic control, what if they get burnt up and this cellular energy can’t be snapped on and the more insulin resistant you are like you’re highlighting, this may take a few weeks maybe even a month and you’re having a tapering protocol just so it’s not so painful. So you don’t develop this Keto flu type of thing where you’re you’re tired, you’re achy. Correct?

Dr. David Jockers:  Oh yeah absolutely. So the keto flu is going to be related to hypoglycemia, you know the light imbalances like we talked about and HIPAA axis dysfunction or you know we’ll be college adrenal fatigue. Right. So it’s kind of a combination of all three of those and they all work together. So you’re absolutely spot on and we want to be able to adapt and teach the body to be able to run and use fats for fuel. Right. That’s the key there. Now another caveat to it. And Justin, you probably test fasting insulin on your patients is that correct? Yes. So I test that on all my patients right fasting insulin levels, and so normally if you’re fasting for 12 to 14 hours you finished dinner let’s say 6:00 p.m. You’re doing your bloodwork at 8:00 a.m. something along those lines. Your ideal fasting insulin should be roughly somewhere around three to five right in that range. If you’re on the lower end, they’re like two three. OK, you probably need to do a little bit more carb cycling, you probably need a bump that insulin a little bit more. OK if you’re on the higher end right. There’s a lot of people out there you know they’re they’re insulin levels fasting insulin is 12 14 16. These are people that are going to do better doing fasting, right. Intermittent Fasting, longer fasting, and lower carb throughout the day to get that insulin level down. OK. So that’s another caveat getting your fasting insulin levels tested. That’s going to help you understand your carb tolerance right.

Dr. Justin Marchegiani:  Just kind of piggyback on that, Christopher Gardner did an amazing study out of Stanford in 2007 called, The A to Z Study, and this study was interesting because he compared four different kinds of diets– he compared and Atkins style diet, and Ornish kind of you know higher carbohydrate more vegetarian diet, the Zone diet which is like a 40 30 30 and then I think a standard American diet. So there were four diets and it was interesting because the Atkins group, the lower carb group had the largest amount of success. But then there were still people that were successful in other groups and then they looked at the people and they tried to extrapolate why a lot of people in the act is that great. But why. There were some people in other groups and what they found in the higher carbohydrate groups, the people that did well were the ones that had their fasting insulin below seven. So in other words, the people that were more insulin sensitive, meaning their pancreas made the less insulin, they could tolerate the higher carbohydrates and that threshold was seven anything greater than 7 they could not tolerate the higher carb, and they only got success on the lower carb group because that helped bring their insulin back into balance. And I agree that study this seven I like two to five, I think gets a good point and I think this is really important people listen like you know we’re practitioners so, we understand that there are some people that do well not following that exactly and the question is why? We don’t want to be dogmatic and say no. Everyone has to and it’s a rule it’s tough but we have to understand why there may be some exceptions and that’s I think one of the biggest data points that we can use to say hey these are the people that are going to benefit these you may be able to break the rules a bit and then we can actually have some objective data on that.

Dr. David Jockers: Yeah, absolutely because you do need insulin, you need insulin in particular for converting T four and T three. So you’re active thyroid hormone and if you don’t get that, know this is where we’ll see people start to for example lose hair, when they get really really fatty, they get constipated, they get really really cold, when they’re fasting, or on a ketogenic diet it’s a sign that it probably ban under consuming calories right as a whole. And possibly not carb cycling enough. Right. And that’s really big. So even on a low even on a low carb diet, if you do like a very high calorie meal once a day. OK. So where you’re doing like maybe under eating, lower amounts of calories for a period of time and then of a larger meal, your body is going to still secrete a lot of insulin like on a low carb diet. When you. Eat a lot of food your body’s excrete a lot of insulin. OK. And so you want to get at least, unless you’re like in a period where you’re just doing an extended fast for a specific reason, you want to get a really good shot of insulin at least once a day. I really once no more than twice a day in my opinion. OK. But you want it when you do get it, you want to get a good shot of it. What happens is in our society it’s like people are just continually spiking it because we’re eating all the time right. We’re eating every several hours just continually getting spikes of insulin that promotes too much inflammation right. Insulin is going to activate your inflammatory home right and amplify inflammation throughout your body. But if you strategically get it, once, maybe twice a day. Right, a really good spike of it then that’s going to get. That’s the right amount to activate thyroid hormone to enhance cellular energy production is a lot of good benefits that are going to come from that.

Dr. Justin Marchegiani:  I think that’s great. And what’s your strategy on mealtime and I know we’ve talked about this as, I think for a while you were doing kind of o mad one meal a day. How are you timing your meals and then how do you dial that in for patients exact.

Dr. David Jockers:  So here’s how I do it personally now. I’m about one hundred, one hundred sixty five pounds strong, I’m an 8 percent body fat it’s mostly just muscle tissue, and the way I do it is I workout four days a week, when I workouts very intense strength training, so I’m usually working out for about 45 minutes or so strength training. Monday Tuesday Thursday Friday are typically my spring training days and what I do is on Wednesday, and on Saturday, I only do one meal one meal on those days, usually it’s lunch dates, whatever’s most convenient for me I’m usually eating lunch I find that I just do best at that time. Right so one o’clock, two o’clock, something like that having a really good really good solid lunch and then that’s it, you know just hydrating outside of that and then on the other days, I’m consuming two meals, lunch and dinner, right now typically my dinners are usually my largest meal of the day. I’m consuming a lot of a lot of food right. I mean I’ll easily consume fifteen hundred calories or so, you know a typical dinner. All right. And usually my lunch, if not, I mean I probably could even consume two thousand calories, my dinner and my lunch is usually probably somewhere around five hundred eight hundred calories, somewhere in that range. OK. And yeah that’s how I do it and I function amazing in fact my best sleep. My heart rate variability gets really high on my fasting days so when I’m, when I’m sleeping. Wednesday night and Saturday night it’s like I wake up the next day. I just feel amazing like so good. And that’s why I do it. In fact if I didn’t lose weight. When I would do one meal a day if I didn’t lose weight when I get it. So what happens is I tried that and I started losing muscle. I started losing weight and I’m already very lean as it is, very very thin. Five foot eleven hundred and sixty hundred sixty five pounds so so I feel amazing when I’m fasting but obviously I don’t want to lose weight. So. So that’s why I do the two meals five days a week. One meal two days a week seems to work amazing for me. Now when I do eat, I eat a lot of food. My wife’s always like, wow I’m fond of food. So in order to be able to digest that food effectively at its most effective level. I think a lot of digestive enzymes. OK. From time to time, if I’m under more stress, I’ll take a little bit of stomach acid support it would be THCL. Typically speaking a bunch of digestive enzymes works great for me. OK. And that works well and then I also take a supplement that has Curcumin, Turmeric, right. It’s also got a whole bunch of bitter herbs. It’s called fermented turmeric right. It’s got a bunch of different bitter herbs are really good for stimulating digestive juices production. So I think a combination of those and my digestion is great. OK. And that’s right I feel really good with it. And that’s typically my lunch most days, my lunch is liquid nutrition so usually I’m making a smoothie with Collagen protein. Yeah. Coconut milk, avocado in there. That’s usually my lunch and I might munch on like a cucumber that that I cut up and put some lemon juice on, some salt and some herbs. Right. Or maybe radishes. I’m crunching you know, chewing on some radishes. So it’s usually some sort of raw vegetable. Along with this sort of smoothie. And then for dinner it’s usually a lot of meat. So whether it’s grass fed beef, or we do like grass fed beef hotdogs and I’m familiar with those. Yeah those were great. Lots of vegetables so like steamed broccoli or cauliflower to make up mashed potatoes, and cauliflower all times calling mashed potatoes, broccoli with butter. So we do a lot of that. You know we started using this thing called [inaudible]. Now if you’re familiar with that, it’s hearts of palm, it’s pasta. It’s pasta with hearts of palm and then it’s great. My wife makes this amazing pesto right. We put pesto on that which has got olive oil and avocado and pine nuts and all kinds of stuff like that. So it’s just a scrape,we put chicken with that. So different things, different meals like that. So typically how I’m doing it.

Dr. Justin Marchegiani:  That’s great. Excellent. I did something similar as well typically in my day in day out. I’m having some level of coffee in the morning with some butter at MCT and a little bit of collagen and that’s my breakfast, somewhere at three four hours later, I’ll have a nice glass of celery juice and I’m definitely drinking mineral water throughout the day ,and then my lunch is going to be a big salad typically, it’ll be about four, maybe five servings of vegetables, it’ll be a full avocado maybe six to eight ounces of chicken chicken thigh, or chicken breast with skin on and then an olive oil, olive oil apple cider kind of sea salt pepper type of salad, and then dinner will be some level of non starchy veg if maybe a little bit of starch, in there squash or sweet potatoes, and then mostly meat and vegetables, and then typically my Saturday, is my wife and I will have a date night and we’ll do like a steak restaurant and now I’ll just fast all day and I’ll just that one meal when I go out to eat. Typically that one day it’s nice. I’ll still do coffee with a little bit MCT just to kind of start my day off and get those ketones up and then I’ll just kind of ride that high all day long. And people listening if you have a lot of hormone issues or thyroid issues or blood sugar issues, you have to have some level of one metabolic stamina imbalance before you do it and to have that really good digestion like you mentioned, because now your meal is probably twice as big when you eat at nighttime and you really need the enzymes in the acids and good digestive function to be able to handle that load.

Dr. David Jockers:  Yeah I mean I think that’s really really important is you know, for me for example, I don’t actually get hungry. I don’t feel hungry throughout the day. I don’t get hungry till I start eating. Once I start eating, I’m like OK my body wakes up it’s like, OK I need a lot I need food, right. And that’s actually when I get hungry. So for me it’s very liberating, fasting is so liberating because I don’t I just need to think about food, I’m not hungry I don’t have cravings my body feels great my brain feels amazing feels alive so it’s so good. But you’re right I mean fasting is a level of fitness. It’s kind of like you know if you were just if you, if you’ve never exercised and then you think OK I’m going to do a 5k and I’m going to sprint 5K obviously it’s not going to happen right. You’re going to be so sore and beat up so you’ve got to kind of lean into it right. I always said people start with twelve hours overnight–

Dr. Justin Marchegiani: 12 to 12 is the easiest to start with, you know, 7 to 7 or 8 to 8.

Dr. David Jockers: Simple fast just like that, and then do the water like we talked about in beginning it. Yes. You just hydrate your body well in the morning and allow for the natural hunger to come out, for a lot of people they notice 14 hours easy. Like my kids they finished dinner with us. We’re usually done eating dinner by 6:30. My kids sleep till like 8:30 in the morning. I don’t know if, I don’t know if, if if you’re if your child is like that too.

Dr. Justin Marchegiani:  Same way same way and it’s all nutrition based. Like my son for dinner last night I mean he had a grass fed organic hot dog, a cut of avocado. And then he’s having a hard time with green vegetables. We’re getting green beans with sea salt on an organic green drink no added sugar no fruit juice in there and that will kind of pile that throughout the day and its meal. So yeah. I see kids that wake up. It’s all a lot of it’s blood sugar and it’s not getting enough fat. If that is humanly you gotta have that.

Dr. David Jockers: Yeah. So important got to have the fat so my kids will go well we’ll finish there by 6:30. We get him in bed by 8:30. They sleep till 8:30. They wake up. They take a bath right by the time they get breakfast. It’s usually like 9:30 or so. Right there. I mean they’re getting late and they’re fast growing kids, three and a half year olds. Right. So they’re getting like a 15 hour fast right there. Yes. And that’s because we have and they’re not on a ketogenic diet. They are, they’re definitely consuming carbs. Healthy carbs but they always have the healthy fats and they’re still on a lower carbohydrate template than your typical modern Americans ,or your typical sad diet. And so because of that they have better metabolic flexibility right. They’re able to go 15 hours here without consuming food. So what I find is that for most people 14 hours as long as you hydrate well as long as you’re sleeping well. Right. Doing those things. Not an issue. Right. And then especially if you do feel like you’re overwhelmed with stress or if you tend to be like a very lean woman or a lean woman that’s doing a lot of exercise. OK then one thing we’ll try to do is something called crescendo fasting, I’m not sure if you’re familiar with that now but that’s basically where we do a 16 hour fast. Two days a week. Non consecutive days. So be like a Monday Friday. Right. So fasting is a stressor on the body just like exercise is a stressor. So exercise may you know exercise is great, but if you do exercise five days in a row. Right. It will too stressful on the body. Yeah. I don’t recommend exercising more than two days in a row. After two days. I recommend taking a rest day. Like for me I do upper body. One day and then a lower body the next day and then the next day is always on resting. OK. So unless you’re like a high level athlete I wouldn’t wreck it there’s just no reason you actually the recovery is is where you get the most benefit. Right. You need to recover. So two days in a row. Same thing with fasting especially if you’re new at it or if you’ve been under stress or if you tend to be leaner. Leaner female then not doing it more than two days in a row and ideally a better way to start would be two non consecutive days a week, Monday Friday for example. Or your, your least stressful days like just you’re doing your long fast on a Saturday. Yep. Less stress on Saturday you’re hanging out with the family. Yeah. So it’s easier for you.

Dr. Justin Marchegiani: Exactly. Well Dr. David this is amazing. Lots of great tips. I think people that are listening to a lot of these tips are clinical as well. So we’re in the trenches working with patients so these aren’t theoretical things you know things that actually works out you know take it to heart, try to find at least one thing in this podcast that resonates and try to apply it. I think there’s some great information and for all you out there, head over to DrJockers.com. Make sure you subscribe to his email list. Also Keto Edge Summit, we’ll put a link down below if you guys are listening, just click there. Make sure you sign up to get access to all the great speakers and great content that’s available. Dr. Jockers, anything else you’d like to leave the listeners with today?

Dr. David Jockers: Yeah, I would just I would say, you know, definitely the Keto Edge Summit is great, we talk about all these types of things how to get fat adapted more effectively, how to kind of lean into fat agitation, like I was talking about before how to navigate through you know things like the Keto flu, how to prevent getting it and you know the tremendous benefits that can come from a state of nutritional ketosis. You know I’m a huge fan of diet variation, meaning that you’re not always in ketosis. Well I mean I would say some people probably about 20 percent of the population, 20 25 percent that will do great. Being in ketosis, you’re rounds right. But then you have the other 75 to 80 percent that are not going to do good. Being in ketosis your rounds. They need to cycle in and out. Right. You know for whatever period of time works best for them. So we go through that, Keto Edge Summit, and you know it’s really the goal of personalized nutrition. You know there’s there’s no cookie cutter approach. You got a kind of find what works best for your own unique individuality.

Dr. Justin Marchegiani: Dr. Jockers, thank you so much for all this great information. We’ll be in touch. You take care.

Dr. David Jockers:  Alright sounds good. Thank you.

Dr. Justin Marchegiani: Bye.


References:

https://drjockers.com/

https://justinhealth.com/

https://justinhealth.com/water-pitcher

Audio Podcast:  

http://justinhealth.libsyn.com/top-3-ketosis-tips-for-success-dr-david-jockers-podcast-240

 

Looking Deeper at Your Blood Tests – Podcast # 168

Dr. Justin Marchegiani welcomes Dave Korsunsky, founder and Chief Executive Officer of headsuphealth.com, which is a website about tracking health data. Join them as they discuss about blood sugar levels, ketone levels, blood test and other health-related data that can be integrated with smart devices and the website as a means of analyzing your health.

Know about preprandial and postprandial blood sugar readings and glucose functional ranges. Also, find out more about the Carb Tolerance Test and learn how it can provide value and insight to how your body responds to sugar from different food sources.

Dr. Justin Marchegiani

In this episode, we talk about: 

05:08   Functional Glucose Tolerance

13:45   Body Composition and Postprandial response

18:16   Quick walk through on Headsuphealth

31:51   Heart Rate Variability

35:54   Stress and its associated markers

Youtube-icon

Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. Welcome back to Beyond Wellness Radio! My good friend Dave Korsunsky is in the house. Dave Korsunsky, how we doing today?

Dave Korsunsky: Fantastic, Doc. It’s been far too long since we’ve connected, so happy to be back.

Dr. Justin Marchegiani: Excellent. Love it. So happy we’re connected here, too. Let’s talk about I mean you run the website headsuphealth.com— Heads Up House, phenomenal site where you can track your data. Again, you’re putting lots of new features in there where people can—can plug-in or integrate some of their smart devices, Fitbit, some other ketone or blood sugar reader scales, blood pressure cuffs integrate with lab companies. Lab Corps, coming out soon, you mention Qwest. So great way if you’re kind of like a bio hacker or a health hacker and you want to put everything in one place. Awesome place to look at there. So we have uhm—we have a new feature, where we talked about the new features that are coming up. So we’ll have an affiliate link here below, so if you’re listening to this information and it resonates with you or you want to try plugging it in, we’ll have an affiliate link down below that you can click to get access to some of this information to get your account moving. And again, start integrating some of the features that we’re gonna chat about today.

Dave Korsunsky: Great.

Dr. Justin Marchegiani: Okay. So off the bat, let’s dig in. So, one of the more important things that it’s coming here is we have some newer ketone readers in the market. Uh—one of those readers is called the “Keto Mojo” Cool thing about it is Keto strips are cheaper, which is great. It’s gonna measure ketones along with blood sugar and and it’s also gonna measure hemoglobin and hematocrit. Love it. I’m waiting for just that extra feature of insulin then we got like just freaking lab in the little reader right front of us. Wouldn’t that be amazing?

Dave Korsunsky: Every time I see Dorian the founder, I beat him up to say, “Hey, Dorian, can we get an insulin strip?” Because as you know, that’s— that would be a game changing piece of information that currently there’s no way to do that in a consumer test. But if you can start testing things like postprandial insulin just at home after different meals, it’d be awesome but nonetheless, they’ve put a great product out there and it’s really made ketone testing affordable and accessible to people who perhaps couldn’t have access to this before. So that’s a great one. We’re gonna to talk more about it as we go here.

Dr. Justin Marchegiani: And the reason why insulin is so important is because you have a lot of people that are insulin resistant with their blood sugar looks decent, let’s say 90 or 95 right? But it’s only decent because insulin is compensating and going so, so high. So insulin is shoveling out that blood sugar into the cell, so then the blood sugar looks lower because the insulin is basically the shovel. You got a lot more shovels shoveling that out. So it’s different coz if your blood sugar is here with high insulin, then you’re developing insulin resistance, right? Coz you have more shovels—cons—you know, compensating for that. If we decrease—and your blood sugar’s good, that means you are insulin sensitive.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And we need low insulin to increase ketones, right? Ketones and insular on the scale. So people are like, “Hey, I’m like trying to lower carb or my blood sugar’s low but my ketones are low.” Well, that’s the missing variable is the insulin could be high. So to keep that in mind, we have this little seesaw fat with insulin and ketones. Anything you wanna say about that?

Dave Korsunsky: Yeah. We wrote a blog post exactly on that topic. And we talked about why fasting insulin is one of the most important test your doctor probably isn’t running because you’ll—you’ll get a typical fasting glucose test with no indication of whether or not insulin is artificially inflated, keeping that number down. That’s why it’s important to test both at the same time. So, yeah, I would agree. I think it’s incredibly important. I’d love to see the day we can start testing that at home. But right now, the only way to get an insulin test, whether it’s fasting or postprandial or whatever, is at the lab. And we’re gonna talk about that a little later in this metabolic panel that you have cooked up here.

Dr. Justin Marchegiani: Yeah. Absolutely! And we’re gonna do a screen sharing just a few minutes. The key—we’re gonna kinda just dial a couple of key components here. So let’s say you kinda already transitioned from a Paleo template approach or maybe you’re doing a Keto Paleo where you’re focusing on nutrient dense, anti-inflammatory, anti-toxin foods, right? But you’re keeping the grains, the dairy, the legumes out and such and you’re doing higher-quality fat, but you’re trying a very lower carb version 20 or 30 net grams. Big thing that we can work on integrating today is some of the heads up features looking at that fasting one hour, two hour and three hour glucose tolerance where we called it a functional glucose tolerance. Meaning, we’re not going to drink that 75 gram of glucose artificial sugar crap at the doctor’s office. We’re choosing a real meal not a fake exaggerated meal, but a real meal that we can see how our blood sugar fluctuates over that three-hour period. And you’ve integrated that in there. And why don’t we go to the screen shot on your side and you can kinda just walk us through how that looks. And just for everyone below here, if you listen to this on podcast, the YouTube channel click the affiliate code below we’re gonna have so you can get access to this information.

Dave Korsunsky: Yeah. I remember when you and I first started working together, doc. And I was your patient and you educated me on what the functional glucose tolerance test actually was versus the oral glucose tolerance. And the functional glucose tolerance being something you could do at home after any meal. And for those who were unclear, the oral glucose tolerance is the formal test we go to the doctor, drink the sugar and you hang around and get the— the postprandial blood glucose test done. Not really that practical in reality. But the functional glucose reference you can test with anything. So I’ve got my screen shared, can you see it here, Doc?

Dr. Justin Marchegiani: I can see it. You’re up.

Dave Korsunsky: Yes. So, this is something we ended up calling initially we called it the functional glucose tolerance test, but it was just a little too wordy to fit in. So it’s really just a carb tolerance test and actually Rob Wolf talks about this in his book as well, where based on some research out of Israel, there was a study done following 800 different people and they found that you could give two people the exact same carbohydrate source whether it’s sweet potato or bread or lentils and they would have very different postprandial glucose responses. So the key take away was that it’s different for everybody. And back to the functional glucose tolerance, where you’re actually having people test their favorite breakfast, test their favorite restaurant meals or meals they’re eating at home. So here’s how this works and you can see on my screen here I’ve got the future called the Carb Tolerance test and you can just click the plus button here. You can test anything you want. So let’s say you test your—your favorite breakfast of Denny’s bacon and eggs. And all you do is just put a name in here, but this could be anything. It could be a muffin, it could be 50 g of Sweet potato, it could be anything that you’re curious about. You say I eat this food regularly, I want to understand how my body— my body’s postprandial glucose responses are going to be. So I’ve called this anything I want. And what I do is I test my blood sugar before I eat that food. So let’s say that my—my pre-prandial for example was 85, and if this was a fasting reading, I could also take it as such. And then what you do is you just test one hour, two hour and three hours after the meal and update this intro info accordingly. You can also record any subjective symptoms and this could help you identify—even though you may have a nice, healthy postprandial glucose response, there’s also the ability to record subjective symptoms. “Did I have an energy crash?” “Did I get brain fog?” Did I feel hungry 30 minutes later?” or “Did I have digestive issues?” And you can save that and then share it with a practitioner like yourself. So I’m gonna answer my pre-prandial glucose reading here and then hit save. And you’ll see this will create a new entry here. And then all I have to do is just update the one hour and a two hour and a three hour after I go. And just to give you an example of what that looks like when it’s completed is here’s what I did at In-N-Out Burger because when I’m traveling, often you don’t have access to all of the healthy, low-carb food to do a home. So I go to In-N-Out, I’ll get two lettuce wrap burgers with—they call it the protein style. And I wanted to see, does—does just a protein burger with no bun have an effect on my glucose?

Dr. Justin Marchegiani: Uhm.

Dave Korsunsky: And here with the results: 90- 106 at one hour; 89 at two hour; and then back to about 95 at the three hour mark. So, maybe I’ll kick it back—back to you, Doc. And you can share more about what you’re looking for in the postprandial glucose curve as you have your patients test different meals and different foods.

Dr. Justin Marchegiani: Absolutely. So, in general, you know, we have this kind of fasting ideally below hundred and 95. Again, we got to be careful in the morning because in the morning and that from when you wake up to 30 minutes later, your cortisol is increasing nearly 50 to 60% in that 30-minute period. And because of that healthy cortisol response, you can actually increase blood sugar and that big spike that’s like, you know, you’re making them over three quarters of your cortisol just in that zero- 30 minutes. So that spike can increase blood sugar and you may think, “Hey, you know, this is partly because of my diet.” And it may or may not be. So just kinda keep it like a little, you know, asterisk next to that and really look at your lunch and dinner ones, especially if you’re seeing an anomaly in the morning. So we like that zero below hundred and 95. We like hour number one, below 140 for extra credit. For extra credit, we like it below 120.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Below 120 and then at two hours, below 120 or close to a hundred and below— at three, definitely, below 100. So, kinda keep that as your— as your kind of your baseline. Remember we went out to eat out like a few months back. We went to a steak restaurant. I think I tested mine one hour after a meal and my blood sugar was 70 or 75, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So you can eat really well and you can choose foods that keep your blood sugar from spiking. And the whole benefit that is when your blood sugar’s not spiking like that, you’re not over secreting insulin; when you’re not over secreting insulin, you’re not gonna develop insulin resistance and all of the effects of that may have with ovarian cyst or cancer cells or inflammation and our blood pressure. So all those things kinda benefit. So, just kinda highlighting on your side, we can plug those in and we can map them and we can put the notes in there regarding what meals. Then you can say, “Hey, protein style In-n-Out.” “The steakhouse where I did” or “The cheat day where I ate this dessert or this crappy food.” Right? And then you can kinda map it out. And that can provide a lot of value and insight of how your body responds and also there’s the immunological qualities that Rob Wolf has talked about where it may not be a carbohydrate thing. It may be a cortisol response to a food allergen that’s getting your immune system wound up that could— that cortisol can increase the blood sugar as a—as a side side effect.

Dave Korsunsky: Yeah. And we—we’ve had several users on Heads Up Health test different foods that they thought were metabolically safe for their body and the results were absolutely shocking for someone will test certain foods that they’ve been eating. And I’ll share some results with me anecdotally and I’ll say, “Wow, I thought this food was safe.” And then they tested and it’s—the blood sugar still skyrocketing at the three-hour mark. It hasn’t started to come down at all. It’s a runaway train. And—and people actually had no idea. So this can be incredibly helpful just to make sure that there’s nothing really sabotaging your efforts. And unfortunately, you do need to test these foods yourself. You can’t just rely on things like the uhm— the guidance from the Diabetes Association or from the uh—glycemic load tables. There’s so much individual variance that this is why postprandial blood sugar testing— even if you’re not diagnosed as having a metabolic disease, even just for your own personal health, it is helpful to test different foods and—and just make sure that you are having a healthy postprandial response. So, that’s the new feature we’ve built into Heads Up Health. You can test anything you want and just make sure it’s metabolically safe. All of these readings will be stored. And actually, you can probably add more here, Doc. But after you’ve been on a clean Paleo eating template for several months, you may actually be able to tolerate foods that you couldn’t tolerate before as your body composition improves, your gut microbiome improved. So, maybe, you can comment on how something that might not be metabolically safe now could potentially be reintroduced at some future point after you’ve made some progress on your health journey.

Dr. Justin Marchegiani: Absolutely. So, of course, if you’re not breaking that food down, not digesting it well, that can create a stressor. It could just be a food allergen kinda like gluten. That could be a stress or dairy or casein, right? People on the Keto community, Keto Paleo community, they are notorious for maybe doing excess casein because you know, “Hey, you can do dairy or cheese or all these things.”
Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you got to be careful with the case in uh—from a Ketogenic perspective because that could be__. And uhm—of course, if you have an infection or SIBO or parasite or H. pylori something that’s driving gastrointestinal permeability or the word “leaky gut” That can get your immune system wound up, too. And of course, if you have you know, low levels of probiotics in your gut that can create issues. Coz probiotics help with the immune function to help reduce B vitamins and vitamin K. And of course, you know, good bacteria eats poop and poops nutrition, right? Bad bacteria eats nutrition and poops poop. Essentially, good bacteria provides more nourishment; bad bacteria provides more toxins and stress in your gut.

Dave Korsunsky: Yup. Exactly. So and—and what about body composition as well? Have you seen for example as you increase your lean muscle mass, for example, that may— does that also have an impact on postprandial response? Because we—we talked to a lot of guys who are bodybuilders and they can go out and need a huge quantity of food and—and postprandial responses are very low. So, I know you mentioned gut microbiome, but what about body composition muscle mass in response to uhm— postprandial glucose?

Dr. Justin Marchegiani: So, number one, if you have more muscle mass, you’re gonna have more glut 4 receptors to soak in that glucose. So, think about it as your kid makes a mess on the table, you go with a tiny little sponge to clean it up. That’s like tiny bit of muscle is a tiny of sponge.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Whereas like a huge—like one of those big sponges you used to kinda wash your car you have more muscles equivalent to a big sponge like that. Lots of glut 4 receptors. You can soak about that glucose just like you can go to your table with your kids mess and you can soak it all up and you didn’t even— didn’t even bat an eye, right?

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: So muscle does that. Also, muscle, if you have more muscle, that means you automatically have less fat, right? So fats and exocrine gland within itself so it will produce estrogen as well.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And what pretty much drives the fat is gonna be insulin. So excess insulin drives more fat; more fat drives more estrogen. So it’s kinda like this vicious cycle. More estrogen can make you more insulin resistant, especially if you’re a guy and then more insulin increases aromatase, which will take your testosterone and bring it downstream to estrogen. So you become more of a female hormonally and with women, it’s actually the opposite. They get more insulin – more insulin will drive the 17,20 lyase enzyme, which then increases androgens and then they get ovarian cyst and then they get more, you know, hair growth, acne. So it’s this vicious cycle our mother nature kinda swaps the roles there.

Dave Korsunsky: Yeah. I talked to a lot of people who are doing everything right in terms of the macronutrient profiles. They are eating low-carb, they’ve got things dialed in there, but— but little to no exercise. And yes, you will— you will lose that to a certain extent body composition will improve, but there’s—it’s also critically important to be building muscle mass, lifting heavy things and sweating. Those are two of the most important ingredients in my own regimen. Making sure I’m building up lots of muscle mass in in the quads, in the back, in the large muscle groups. And I think that’s something that at least in my experience, people I don’t think appreciate as much as they start down this path. They think that diet alone is going to handle it, but lifting heavy even if you’re just starting out starting to learn some of the functional movements that are— that build a lot of core body strength and really hit the big muscle groups. I think that’s perhaps the next level to get to once you have a solid foundation with the diet. Would you agree?

Dr. Justin Marchegiani: Hundred percent. And also, say make sure you get your 10+ thousand steps. Yesterday I got a 14,000 steps. That’s helpful because that— the steps really allow you to start basically cleaning out some of that extra—there’s little bit of extra carbohydrate in there. You can clean some of it out coz you’re constantly moving and the extra steps really help. And of course if your— you know, “ I don’t have a ton of time, so I’ll just jump in and do a couple cattle bells swings to failure, some push-ups to failure.” And that could help because the—the push-ups, right? You know, I have a push a bar so I can go really deeply, so I get a full range of motion push-up all the way down all the way up. I can get the upper body going. I’ll do my TRX Rose to get the posterior side nice and some kettle bell swings as well. And if you have a lot of time, throw a Tabata in there coz that high-intensity gets the growth hormone. And growth hormone is really gonna be stimulating a lot of that—that muscle tissue.

Dave Korsunsky: Yeah. I definitely have a home gym envy, Doc. I’ve been over to your place and I’ve seen your set up. It’s pretty nice, so I definitely would love to have something similar someday in the home.

Dr. Justin Marchegiani: And if you’re on a budget, really simple, TRX that hangs over door.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: You have the adjustable kettle bells on Amazon and get a push-up bar. Push-up bar is optional but I just like it coz you can get really deep coz I would go so deep I bang my head against you know, the floor. So I can go really deep full range of motion and not have to you know make out the floor, so to speak. So that’s a great option for you.

Dave Korsunsky: Those are great. I’d love to maybe see if we can find some of the recommended products on Amazon— the adjustable kettle bells, the TRX stuff and just actually may be included that here in the notes so people know which ones you’ve tested and they can just go out and get that and try it. So I think that would be uhm—yeah, that’d be cool.

Dr. Justin Marchegiani: We’ll get that in the show notes, for sure. Also, let’s just give—we kinda show some of the functional glucose tolerance stuff but you know—you just give us a cursory. Just just give us a quick walk through through Heads Up so someone that they’re gonna click on the link below, they’re gonna get to the site, but then what do they do? How does it work? Give us that like little round up there.

Dave Korsunsky: Yeah this is—this is my—my personal data. So let me just refresh the screen here because uh— some of the information didn’t actually come in on the last load. And as you share screen that’s what I wanted. So the first thing we’ll ask you as a new user is, “Which devices and apps you’re using to measure your health?” And so at least everyone who signs up has at least one of these devices. A withing scale an eye health wireless blood pressure monitor or glucometer, a fit bit, uh— my fitness pal for tracking the macros, Apple Health. These are gonna be able to pull in things like heart rate and blood sugars, sleep, macronutrient profiles. So all of that will flow in so you can connect as many of these sources as you want and then you’ll see were also starting to build some of the more specialized sources as well. The ones I showed first were more of the commercial grade stuff, but you can also see we’re starting to integrate devices like the Oura ring and the level breath acetone analyzer and things like Elite HRV and the other HRV monitors are coming in. So uh—we’re also working on the decks com, CGM device so we want to make it easy for people to build their own custom dashboard because everyone’s tracking different metrics. So this is all completely customizable. So that’s step one. And then you’re allowed to build your own custom dashboard. So I’ve got the carb tolerance test data here, but if that’s not something I’m working on, I can just actually hide it. And you can see my top three metrics are glucose, ketones and the glucose ketone index, which is just a ratio of these two numbers. A lot of our cancer patients and people with serious metabolic dysfunction are tracking the—the index of the two numbers. And then you can see I’ve got my weight and body fat readings those can come from a withing scale. They can be entered manually. This year is my heart rate variability, which actually comes in from the Oura ring and so that’s on here as well. Same as sleep. So that ring gives me a good sleep and HRV reports. So this is all completely customizable, breath ketones, resting heart rate. And then really what people try and figure out is how is this affecting my clinical markers? Are my lifestyle changes lowering my inflammation or not? And the only way to see that is to put the clinical markers in the same system as the light markers. And typically, the doctor has this clinical data. So it’s very difficult to compare lifestyle changes to clinical markers and that’s what we wanted to solve here and make it available for everybody. So I could just jump down and look at things like my inflammation markers and say, “Okay, is CRP coming down as I go on a clean Paleo template?” And we can actually link directly to your medical facility and pull this data out. So all you do is click the connect data button and let’s say that you’re sending patients to Quest Diagnostics. They would be able to just link their quest account to Heads Up and all of that information would flow in or if they’re using a more traditional health system and billing their insurance, you can connect Stanford, you can connect UCLA, you can connect the Cleveland clinic. There’s over 10,000 medical facilities in here and what we’ll do is we’ll take all of that data, clean it up and organize it from oldest to newest so people can actually have the full picture of their health and what we’re seeing is patients can look back into their history five 10-15 years into the past. Maybe even decades before they’ve even started working with their current doctor and see these patterns emerging years before the disease was diagnosed. And the reason you—you can’t do that today is because every time you change doctors, your health record get fragmented but when we put it all together for people, then you can start to see, “Wow, actually that trend was visible 10 years before I even got the diagnosis.”

Dr. Justin Marchegiani: Right.

Dave Korsunsky: But nobody noticed because I moved and my records got fragmented and my doctor can only see back three years, but I can see back 15 years. And that’s where this has the potential to I think really help people uhm— have actually more power and more information on their health. So, there’s a whole bunch of other stuff that goes into the system, Doc, but it’s really meant for patients and then most importantly all I have to do here is go to care team access.

Dr. Justin Marchegiani: Uh-hmm.

Dave Korsunsky: Give you access and you can come in and review all this data whenever you want. And then if I don’t want you have access anymore, I would just disable that access.

Dr. Justin Marchegiani: And if you’re listening to this on iTunes or a kind of an audio version, we’ll put a link down below for the YouTube video version as well. So if you’re trying to figure out like kinda find us, we’ll put the link but Justin health.com/YouTube Y-O-U-T-U-B-E and subscribe there. That way, you can see the videos well and then you can also listen to the audio.

Dave Korsunsky: Yeah. So I just killed the screen share, but that’s a quick walk-through. I wanted to show people the functional glucose tolerance test because it just allows everybody to test their favorite foods, make sure that they are metabolically safe even things you thought might be safe, may not be. So it’s easy to just test and be hundred percent sure and obviously, you can integrate all the other information. So, that’s a little bit about one of the most recent features we just finished up.

Dr. Justin Marchegiani: Love it.

Dave Korsunsky: And actually we uh— we have a debt of gratitude to Dr. J on that one because he was the one who told me about the functional glucose tolerance test. So we took your vision, Doc, and implemented it into our software program.

Dr. Justin Marchegiani: Love it. That’s phenomenal, man. Very cool. I’m also gonna be doing a live right now—a blood sugar test to myself kinda see where I’m at and put it out live on air.

Dave Korsunsky: Well, I can’t get you go solo there, Doc. I’m gonna have my Keto mojo here.

Dr. Justin Marchegiani: 87.

Dave Korsunsky: 87—that’s respectable.

Dr. Justin Marchegiani: And just so you know, that’s an hour and a half to two hours after having three eggs cooked in ghee with sea salt and then some butter coffee with MCT.

Dave Korsunsky: Alright. Let’s see what I got here. So uh—you mention the mojo here it is—uh 99 ketone strip. I’m not gonna do the ketone test right now. I’m just gonna do a is to glucose strip. This is about I don’t know, half an hour after I had breakfast which is really just a chicken breast today. I’m traveling so I don’t have access to all my food and uh—clocked in at 82. Respectable 82. That’s where I wanna be, so, yeah, I’m dialed in.

Dr. Justin Marchegiani: That’s good. Yup. I mean, my ketones are probably around .6 mmol typically is where they are out of, what, like an 80, 80+ percent fat breakfast. I typically get my protein in the morning from collagen. I did some good quality pasteur-fed eggs, but that’s important. And let’s just kinda hit a couple of the other blood sugar markers that we can do. So, I like the functional glucose tolerance. One: because it’s specific to the meals.

Dave Korsunsky: Right.

Dr. Justin Marchegiani: Where if you do kind of a blood test, so you go to Labcorp, it may be helpful, but it’s kinda like a fixed thing—

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: And it’s not something that someone can do all the time. So we can do fasting insulin, which is really nice. And if you’re more insulin resistant, that’s great because your blood sugar may look okay, but it’s nice to see the insulin coming down. And that’s even better coz that tells us that we’re reversing insulin resistance. We can do fructosamine. So, fasting insulin, ideally, below five—the sweet spot.

Dave Korsunsky: So let me—let me jump in on fasting insulin.

Dr. Justin Marchegiani: Yeah, sure.

Dave Korsunsky: A lot of people, probably their doctor might not run it for them because there’s not a diagnostic code. My doctor wouldn’t run it for me and it’s extremely important. As you said, to see glucose and insulin to make sure that one is not overcompensating for the other. And so that’s— sometimes to test that, a patient will have to order on their own and whether they get it from you or whether they go or it themselves online, maybe you can just comment on that. My doctor won’t run that specific test for me and—and how could somebody do that themselves if their doctor won’t run it?

Dave Korsunsky: Yes. So, of course, you want to reach out to a functional medicine Doc like myself. There are others out there because in the realm of functional medicine, we’re not actually treat disease, we’re supporting underlying systems that may not be working optimally. We’re fixing diet and lifestyle and we’re trying to bio hack and kinda maximize optimal performance. So it’s a different mindset and if you’re in the insurance model, things tend to be all disease-based, CD 10 code, CPT attached to it and uhm—it’s just you know, if you’re trying to utilize your insurance for this type of healthcare, it’s typically not gonna work.

Dave Korsunsky: Yup. And so what I did just for myself and my family is we just— we just went on to one of the websites where you can order your own tests. There’s a bunch out there and just ordered our own fasting glucose, our own fasting insulin 70 bucks and just got it done and make sure all numbers were in range. So, at least in the United States, this is not available internationally. But within the United States, we do have direct to consumer lab testing. If you’re concerned and you want to know the numbers and your doc won’t run it, do it yourself and track it in Heads up Health.

Dr. Justin Marchegiani: One hundred percent. And again, a lot of people, they maybe listening concerned about you know, cholesterol, eating this much fat and this much good quality protein, again, I just got approved for the highest life insurance policy you can get from uh—you know, grade wise health and my lipids came back 180-185 for total cholesterol HDL is in the mid-60s Trigs were in the 50-60 range. So again, you know, nearly perfect on everything is wide at the highest rating that you can get for life insurance. But just to show you, you know, you’re concerned about thinking about eating these foods and it jacking up your cholesterol, typically not. The biggest thing that will jack it up will be insulin. Insulin will up regulate the enzyme that makes more cholesterol the uh—Hemo Methyl Glutarate COA Reductase enzyme.

Dave Korsunsky: Yup. So, yeah, we–-and that’s great. And you were just actually also, we were talking about a panel we’re gonna put together which is going to be a fasting glucose fasting insulin A1C and fructosamine. So uh— some people may not be familiar with fructosamine and A1C so maybe comment on those and then we’ll will put the panel together on the website people can just go do it themselves, Quest or Lab Corp and we’ll put the functional ranges in the show notes because the conventional ranges are misleading sometimes. So what do you think about those numbers in general?

Dr. Justin Marchegiani: Yes. So fructosamine, typically is a 10-14 day window. So in the lower, 200 is gonna be great.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: A1C in the lower fives—

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Lower 5’s is gonna be great. Of course, glucose, it depends upon the timing. But fasting you know, below hundred, below 95 is great, you know, we got shot it in the 80’s which is excellent. Insulin below five below six is really good from a fasting insulin closer to two or three is—is—is great, too, as well. And again, if we go really low in the insulin, we have a lot of fatigue issues. We do need insulin to help convert thyroid hormones. So we could be driving insulin too low, which could be creating some other metabolic issues. So keep that in the back of your head if you’re Keto, Paleo and you’re still having some symptoms you may need to actually raise the insulin a bit especially if your body comps are already pretty good. So keep that in the back of head. That could be a little something we have to tweak down the road.

Dave Korsunsky: And that is actually something you help me with last time I was in Austin where I had extremely low carb for a really long time. Potentially, it was even keeping insulin too low and I was seeing some elevated cortisol responses and just having some uh— post exercise uhm— insomnia type issues. And I was able to just dial it back a little bit and over time, quickly correct those. So that was one of the things I learned just from my own personal experience was to cycle out every once in a while and—and dial back up the—the carbs maybe from below 25 to 50 or something around there. I know you’d target 100, you’ve mentioned before. So, I think variance is good, basically. And uhm—I I know I personally may have stayed low carb too long I didn’t need to be I was actually— my body composition was good, but that’s a good point. It’s actually being too low can also have some downstream effects on the insulin side as well. Correct?

Dr. Justin Marchegiani: Hundred percent. And again, for me, I always default to go in low coz it’s easier to start low.

Dave Korsunsky: Absolutely.

Dr. Justin Marchegiani: Kind of stabilized and then move up.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: Coz if you’re kinda in the middle, then which way that you gotta go. There’s more variables that you have to move through; but if you start lower, then you start to move one direction.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And you know, then you’re okay. Then if you hit a point, you know, you got, you got—so to speak, some uh—you have a direction that you just got to go the opposite to get back to where in case you just start having a negative reaction.

Dave Korsunsky: Yup, cool. Okay, perfect.

Dr. Justin Marchegiani: So we talked about those couple of markers there. That’s perfect. We hit those things. Also, let’s chat about the HRV a bit. So I see HRV, your heart rate variability, which is the unevenness between the hearts uh—you know, the heartbeat in each second. It’s not a consistent beat, there’s some level of unevenness, which basically is a parasympathetic response. So the more the parasympathetic nervous system is activated, that’s a great sign of being able to heal anabolic hormones, being able to recover, build, back up, recycle neurotransmitters, build muscle. That’s really good. So we have some devices that we can utilize I mean you can do the Amway device by HeartMath. Uhm—I like the just the Fit bit, making sure sleep looks pretty good. Uhm you can check in with the Oura ring. So let’s dial in with some of the things that you use to help improve heart rate variability.

Dave Korsunsky: Yeah. That sounds good, Doc. Give me one second here. Can you hear me, okay?

Dr. Justin Marchegiani: Yeah. You sound great.

Dave Korsunsky: Alright. So, starting to see a lot of individuals who are starting to look at heart rate variability. I think there’s still a lot of people who aren’t quite sure what is. They’re starting to hear that term, HRV. You might not know exactly what it is. I’ve only recently started introducing it into my regimen. Initially I started by very simple—just purchasing a heart rate monitor— a polar heart rate monitor that you can get on Amazon for 30 bucks and it’s a chest strap. So in the morning you would—you’d put it on and you would fire up an HRV app. And in my case, I was starting with the lead HRV. There’s a number of them out there you can pick one that you like and it will just ask you to sit—sit still for two or three minutes in the morning and it will start doing what’s called a readiness score and it will start measuring that variability. The—the time between each heartbeat and looking at the variance and then it will be able to give you a—a measurement of your level of recovery. How well recovered your body is on a given day and it just can help you inform how hard you should push yourself on your training. So some of the popular apps out there that I’ve come across are lead HRV, bio force and the one I’m using now is actually the Oura ring, which is here and this one actually will measure a number of different metrics. It will measure HRV, body temperature, sleep cycle analysis and give you a readiness score based on all that information. But for those who are not familiar with it, HRV is an excellent measurement to start assessing your level of personal stress, sympathetic versus parasympathetic, your level of recovery from physical training on a given day. And it can be a very helpful metric to understand just—just the level of stress in the body that can have implications for inflammation, can have implications for your blood sugar levels. So for those who aren’t familiar with it, starting to look into doing some basic HRV measurement I think is increasingly becoming a very popular metric that we’re seeing requests for from our users.

Dr. Justin Marchegiani: Love it. Excellent.

Dave Korsunsky: Are you testing? Have you tested HRV? Have you use any products there? do you have your patients measured at all?

Dr. Justin Marchegiani: I don’t do a lot of testing with it. I just—I haven’t found something that I’ve been streamlined with because there’s many things out there. So like the bigger things for me are like functional glucose testing. I like the Fit bit. If people aren’t gonna be going to the gym, making sure they’re getting enough steps.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: There’s a cool one that’s out there I’m liking. Coz I see a lot of people poor posture. It goes on your spine.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: And then there is an app and that it tells you how straight your spine is.

Dave Korsunsky: Yeah.
Dr. Justin Marchegiani: So you put it on for optimal posture and then if you start moving, there’s a screen alert and it shows you where your posture is. So it’s instantaneous biofeedback for your posture.

Dave Korsunsky: Yeah.

Dr. Justin Marchegiani: That’s—

Dave Korsunsky: Yeah. It’s called—I forgot the name of it. It’s Lumo Back or something like that.

Dr. Justin Marchegiani: Yes. I’m liking that to a certain degree coz if people sit all day, I think it provides a lot of awareness that, “Hey, your posture is pretty bad maybe get a stand desk.” I stand 5-6 hours a day and have a walking treadmill that I slide into my desk and I walk about you know 5 to 10 miles a day while I’m seeing patients. That’s I think helpful. So I don’t go crazy on that, but I think it’s something that I will look more into. I— I wish that Fitbit would integrate and have a heart rate variability aspect, too. I think some of the more expensive ones do, but I like the Flex for the Fitbit. It’s just a little more durable.

Dave Korsunsky: So this is something that I think would be uh— helpful—helpful to a lot of users on our system who are managing autoimmune disorders. They are managing metabolic diseases. They are managing cancer, for example. And if HRV is a proxy measurement for stress and perhaps underlying cortisol and elevated sympathetic nervous system response, maybe it’s not specifically to HRV, but can you share how things like stress can affect autoimmune, specifically, gut disorders and other autoimmune diseases and how measuring and lowering stress can improve symptoms and associated markers.

Dr. Justin Marchegiani: So, of course, we have stresses –is in a couple different areas, right? We have like when people think of stress, it’s typically emotional stress, right? It’s work, families, relationship, finance. Like that’s one element to you know, emotional stress.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Also things are like blood sugar. Having your blood sugar swing up and down because you’re eating too much carbohydrate or you’re skipping meals and you’re not getting enough nutrition and B vitamins and minerals at the meals coz you’re burning that stuff up, the more stressed you are, right?
Dave Korsunsky: Got it.

Dr. Justin Marchegiani: Think of you driving a car. You gas it on the highway. You’re going faster, you’re making fast turns. Well, you go through gasoline at higher rate.

Dave Korsunsky: Uh-hmm.

Dr. Justin Marchegiani: Well, the same thing happens with people when they are skipping meals, right? And they’re under a lot of stress. They don’t have the gasoline and the take. The difference is our body just starts shifting in the catabolic physiology where it starts breaking down other tissue. The difference in a car is once you’re on empty, right? That Seinfeld episode, how low can you go? Well, eventually, you just—the car just stops. The difference is if the car was equal to our physiology, we’ll start metabolizing the bumper or we’ll start metabolizing the internal uh—gas, you know, the internal oil and fluids and such, right? The car is not quite like us. Once it’s on, once it’s out of fuel, it stops.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: We don’t stop. We break down other tissues and hormones and neurotransmitters and that creates disease because we’re breaking down, we’re getting chronically inflamed. So cortisol is gonna break down of course more neurotransmitters. It’s gonna create— it’s gonna a breakdown gut tissue, which is gonna create more leaky gut and create more immune stress. The more immune stress there is, the immune system sucks up a lot of resources, a lot of energy and of course, when the gut is impaired, when the gut is inflamed, we’re not gonna be able to absorb a lot of those nutrients. So, let’s say you start shifting your diet back to up to a Paleo template or an autoimmune template and you’re not getting better, that’s probably why. Is your sympathetic nervous system is so turned on we have to work on that. We need to support the gut integrity. And there’s probably some infections that have come because your immune system has been shut off. So basically, you left your door in uh— unlocked and now you get five homeless people sleeping your house when you get home, right? That’s the equivalent of you know these parasites. You got to come clean them up, right. You gotta go do all the stuff you need to do in the functional medicine program to get them all dial back in.

Dave Korsunsky: Yes. So my take away from that is heart rate variability is actually a way that people construct to quantify stress because—

Dr. Justin Marchegiani: Another way to monitor it, right? Like heart rate variability is not “tell me what to do” but it tells me that what I’m doing is actually working.

Dave Korsunsky: That’s exactly right. So if someone is suspecting that they’re doing everything right and they’ve got an autoimmune condition, they’ve got some other condition going on, they know that they have some stress in their life that’s probably exacerbating things. Starting to get some HRV measurement can actually give you some hard data because otherwise stress is just as nebulous thing. “Yeah I’m stressed out. It may be affecting my markers, my symptoms. I don’t really know how to quantify it.” And I think that’s where learning HRV can become extremely helpful especially getting that morning HRV readiness score, where it just says, “you got a great sleep” “your HRV numbers look good” “you can push yourself today” or you can say “Your HRV numbers are terrible. Take today focus on rest and recovery.” And it actually gives you a number of quantifiable, accurate number that can be used to start to calibrate lifestyle, actually understand how stressed your—your system is. And then make adjustments and have some data to work with instead of this nebulous “I’m stressed” term. The HRV can give you real numbers to work with. And there’s some great tools out there. The Oura ring is one. The elite HRV readiness score is another. Not difficult to measure and that can help you start to move the needle in terms of stress response. So, I guess that’s my take away from why I recommend HRV, why I test it personally.

Dr. Justin Marchegiani: And what’s your favorite device again?

Dave Korsunsky: Well, right now I’m using the Oura ring. It’s a pricey device that’s the thing, but it incorporates a lot of different things into the uhm— stress response score. It includes a lot of data from your previous night’s sleep. Deep, light, REM, uh— bedtime, wake time, resting heart rate. Things of that nature. So that’s the device I’m using. I also have a Polar heart rate chest strap which I bought on Amazon. I think it was $29 and the elite HRV app is free. So that’s another one. And I know that there’s other HRV apps out there. Pick one you like. Maybe test a couple. Start getting some basic HRV measurements and then it can be just another helpful data point to help you try to assess and measure and improve metrics associated with stress, elevated sympathetic nervous system, poor sleep quality could also contribute to poor HRV numbers. So those are the products I currently am familiar with.

Dr. Justin Marchegiani: Love it. Excellent. Well, I have to get them to sponsor the show here, Oura Ring, phenomenal. Alright, Dave, hey, phenomenal show. We’re gonna put links here kinda link to get access all this material here for you guys.

Dave Korsunsky: Yup.

Dr. Justin Marchegiani: Get people over there. We’ll put some of the material and things we talked about in the show notes section underneath. So if you’re listening to iTunes or YouTube, we’ll be able to give you access some of those information there and some of those tools. Anything else you want to share that you think is really important before we wrap it up.

Dave Korsunsky: No. I think it’s always good to—to be on here and just –my whole thing is data-driven health and using having access to your numbers and learning how to figure out what works for you and it’s also great to speak with you and get the clinical perspective on how to interpret these numbers as well. So it was just great to be back. We’ve always got a lot of stuff we can talk about. We could probably go on forever but I think we recovered some good information here so uh— it was it was fun as always, Doc. I’ll be seeing you at Paleo f(x) Not to— not too far from now. Always a fun time so I’m sure we’ll have an opportunity to have some fun and uh yeah, otherwise, it’s just great to be on the show.

Dr. Justin Marchegiani: Love it. Great to be here, too. And also you’re listening to this, sharing is caring. Give us a share. Give us the thumbs up. We appreciate it. Spread the word. Uh again, it really fires me up when I see more people getting healthier so make sure you give that a share. Dave, thanks a lot. Great having you here today.

Dave Korsunsky: Okay, great.


REFERENCES:

HeadsupHealth

Adjustable Kettlebells

TRX suspension trainer

Push up bar

Keto Mojo

Lumo Back App

Fitbit

Oura Ring

Elite HRV readiness

Jimmy Moore – The Complete Guide to Fasting – Podcast #132

Dr. Justin Marchegiani welcomes his special guest, Jimmy Moore, in today’s podcast about fasting and nutrition. Listen to them as they engage in a very energizing and interesting discussion on how to do intermittent fasting for a therapeutic reason.

Learn about how fasting benefits and affects our bodies in many ways and be able to apply the guidelines involved in a successful fast. Get valuable information on supplements supporting the Ketogenic diet and know more about cholesterol issues, including the testing involved and its possible root cause.

In this episode, we cover:

07:21   Fasting

11:40   Thyroid Function during fasting

18:43   MCT oil, Ketones, and other supplements

27:27   Ketones and Neurological Conditions

34:50   Lipid Panel: Cholesterol

 

itune

 

 

youtuve

 

 

Dr. Justin Marchegiani: Hey there! It’s Dr. Justin Marchegiani. We have my good friend, Jimmy  Moore. And one of the biggest podcasts on the Internet here. He is a—he’s one of the guys that I look to for inspiration, kinda how I MC kinda my podcast coz Jimmy is— does it so right. Jimmy, how you doing today?

Jimmy Moore: Hey! What’s up, Justin? I love how enthusiastic you get. We all have our radio boys when we come on.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: We’re just talking to each other then, “Hey, hey, guys we’re back here on the Justin Marchegiani show.”

Dr. Justin Marchegiani: Hahaha. Well I always love how you exit your podcast. You say the person’s name, you’d say, “His name is Jimmy Moore” And I love that exit. It was just so great.

Jimmy Moore: I still do that.

Dr. Justin Marchegiani: I love it. I love it. It’s so great. I’m gonna do it today, too, as a little tribute for you.

Jimmy Moore: That’s cool.

Dr. Justin Marchegiani: But Jimmy, how have you been?

Jimmy Moore: I’ve been good, man. Just like us Tony before we came on the air. It’s just busy busy all the time and it’s the way I like it.

Dr. Justin Marchegiani: Excellent. I know you had a book that just came out recently on fasting. Let’s dig in. How’s that going? I know you did that book with Dr. Jason Fung.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: Talking about fasting and how to do it therapeutically. Just kind of any listener that’s trying to get some more information on fasting, why should they get that book?

Jimmy Moore: Well, we wrote the complete guide to fasting, Dr. Fung and I, uhm— because when I was looking for a resource on doing some longer facet done some intermittent fast pretty naturally, when you’re ketogenic, you know it’s extraordinarily easy to intermittent fast. I mean, if you go longer than or—or shorter than eight hours without eating between meals, you’re not doing it right. So intermittent fasting was very easy for me and I was even finding that pushing it to say 36-ish hours which is basically an alternate day fast also was pretty easy. So I want to try to push the envelope a little bit and do these longer fast. Well I met Dr. Fung of all places in Cape Town, South Africa he and I shared

Dr. Justin Marchegiani: Wow.

Jimmy Moore: — the stage together at a big low-carb conference that happen there a few years ago. And I went up to him after hearing his talk. I’d never heard of him before and he was talking about fasting as, “Oh, here’s somebody that does something about fasting.” And so, I said, “You know I’m looking for a good resource on doing some longer fast. What is out there?” And he said, “Nothing.”

Dr. Justin Marchegiani: Alright. So we’re back. So the last question we were talking about the fasting book and you mention you did it with Dr. Jason Fung, so tell me about kind of how that started?

Jimmy Moore: Yes. So he when he and I decided we wanted to collaborate on a book, I decided to start fasting myself. Again, I’ve been doing some— some intermittent fast but I wanted to push the envelope and see, “Okay, let’s see how I do with a little bit longer fast— no, context here.” I used to think fasting was the stupidest thing in the world. Why would you purposely starve yourself? It just made no sense to me. But that was under the thinking that I was starving myself. Once I realized it’s not really starving yourself. You’re doing this for therapeutic reason. That’s when fasting started to make a little more sense, especially when it was spontaneously happening on an intermittent level. Really, all you’re doing is just extending it a little further than that to give your body the benefits that you’re looking for. So I did a—a goal in September 2015, to go 21 days in a row of fasting. Now the longest I’ve ever made, it was like 6 1/2 days. And that one, I told this uh—story in the book, The Complete Guide to Fasting, that I— I took communion on the seventh day of a fast. And I was planning on going seven days on that one and to communion that day at church, got home from church and you know what happened, Justin. I crashed so hard.

Dr. Justin Marchegiani: So hard.

Jimmy Moore: And so my blood sugar got down to low 50s which in and of itself isn’t a horrible thing when you have higher ketone levels.

Dr. Justin Marchegiani: Right.

Jimmy Moore: But I wasn’t testing blood ketones at that time. And I was definitely in hypoglycemia because I was so hungry, and I was just curled up in the fetal position. And my wife’s like, “Please eat something.” And I was like, “I’m four hours away.”

Dr. Justin Marchegiani: Oh my gosh.

Jimmy Moore: I did in the beating uh—and—and breaking that fast, but that was kind of my horror story of fasting. So when I came to this one, I said, “Jason, will you kinda pay attention to me. I will not take communion this time. God will forgive me. Uh—and – and –

Dr. Justin Marchegiani: So you’re thinking with the communion, it created like a reactive hypoglycemic spike? Is that what you’re thinking?

Jimmy Moore: It really did.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Because I had gone, like I said, over six days without eating.

Dr. Justin Marchegiani: Wow.

Jimmy Moore: Suddenly I introduce this in—

Dr. Justin Marchegiani: Even a tiny bit. Anybody that has ever had communion, its’ just a tiny little wafer and a tiny little cup of juice. Uh—I mean very tiny and just that little bit, Justin push me over the edge in a hypoglycemia. Now that wouldn’t happen under normal hospices uh— if I just taken that in—in a fed state.

Dr. Justin Marchegiani: Exactly.

Jimmy Moore: But in a fully fasted state, uh— and my body just wasn’t ready for even that little bit of carbohydrate. So anyway, 21 days—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I attempted and September 2015, I made it 17 1/2 days in a row which was almost triple what I had done my longest before. So I was pretty happy about that. The only reason it ended was Christine and I were actually on vacation and I was having a good time. And that was stress and I found that stress for me as a very insulin resistant man, hits me harder probably the most people. And so, I couldn’t continue with the fast. Now some people said, “Well fasting itself is a stress and it can be early. But I think the longer you do it, the longer you stay on it, you actually find that it’s very sustainable beyond the first three days. The first three days can be pretty tough and we talk very openly about that. I definitely tell people day two is gonna really suck, worse than anything. But if you get through day two, it’s nirvana after that.

Dr. Justin Marchegiani: Awesome. Can you step uh—half a step to your right. Perfect. Now I got your whole beautiful face in there. Awesome. Love it.
Jimmy Moore: I’m trying to balance where I’m in. I ‘m in my bedroom so it’s like I –I’m like we’re doing st—

Dr. Justin Marchegiani: You look perfect right there.

Jimmy Moore: So the question I have for you is, what was the big difference between being able to go 30 days versus 7? I know the reactive hypoglycemia thing but it sounds like you’re at 7. Seven so, long way from 30. What was the different things that Dr. Fung was uh—coaching you on that was helping?

Jimmy Moore: I never actually made it 30 days. Uh—

Dr. Justin Marchegiani: Okay.

Jimmy Moore: The longest I’ve done is 28 days in January last year.

Dr. Justin Marchegiani Wow.

Jimmy Moore: 28 out of the 31 days uh—so wasn’t 28 in a row, but it was 28 of the 31. Again, travel rears it— reared it its ugly head and uh—kick me in the tail. Christine had to make uh— emergency trip to go see her family in Virginia. So I hop in the car and what does the stomach start doing? (growl sound) Great.

Dr. Justin Marchegiani: Oh, man.

Jimmy Moore: So I end the fast. But that—that—But that’s self-awareness.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You gotta know. You got fit fasting within your life. And so if life happens, and life happen that day, and of course we had to drive home from that. When life happens, you just have to deal with it and not fight back. Uh— listen to your body and I’m sure you preach this pretty often to your listeners, listen to your body and pay attention and respond accordingly. Don’t fight those signals that tell you something’s wrong.

Dr. Justin Marchegiani: Yeah. I totally agree. Now when you mentioned not fat—not eating for 28 days, so what does that look like? Is it just simple as you’re just not eating? Or are there certain things that you’re doing with hydration or minerals?

Jimmy Moore: Great question.

Dr. Justin Marchegiani: What else is there?

Jimmy Moore: Yes. So when I first started doing these longer fast, Justin, I thought, “Okay, I’m going to need something.” Because anybody that knows my history, you know, really eating literally all the time. Uh— it’s kind of funny to think, “Oh, not eating at all? What—what?” So, I decided I’m going to do it with bone broth, with some sea salt so that gives you a little bit of uh—nutrition there—minimal.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Coz I’m only having a cup or two a day and this may be like 80 calories for 2 cups of bone broth and really minimal nutrition. I also did a little bit of Kombucha but I’ve since cut that out. I found it was actually tearing my gut up pretty bad. Because I thought that I would need it to preserve gut health during the fast. What I’ve found is my gut health has actually done extraordinarily well without the Kombucha because of the fasting. And so we definitely into that coz I know that’s kinda your heart and soul, too.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You talk on gut health. So uhm— so I did that and of course, as you mentioned, hydration, hydration, hydration. I didn’t really count how much water I was drinking but I was drinking quite a bit of water. And— and the interesting thing is people sometimes they will just do water only. I would say do salt water in there as well.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: Because that helps to balance out the electrolytes and if you’re using something like pink Himalayan sea salt, you’re getting those trace minerals of the potassium and—and the other things that are gonna keep your electrolytes in balance. That’s a concern a lot of medical professionals have about these longer fast, is where do you get your electrolytes? That’s how you can balance that out. And I’m a big fan, so was Dr. Fung of, kinda adding in that salt from time to time as well.

Dr. Justin Marchegiani: Yeah. I think when you’re under stress and you’re in a stress response, one of the big things that happens is that hormone aldosterone can go loaded and that cause you to pee out a lot your minerals.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: So it that sounds like adding in the extra minerals, electrolytes, and also some—some little bit of amino acids in there, really made a difference for you.

Jimmy Moore: And speaking of elimination—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You wanna get down and dirty.

Dr. Justin Marchegiani: Oh yeah, let’s hear it.

Jimmy Moore: So you actually do pee quite a bit, and—and that’s natural especially if you’re coming from a non-ketogenic state. You’re suddenly flooding your body with ketones by not eating anything. And so, when that happens, all the glycogen? Pheww— right outta you. And so what happens? You pee your brains out. And even if you’ve been ketogenic, you’re gonna have that as well. And those are kinda gross, but it’s real life, people. So here we go—

Dr. Justin Marchegiani: That’s cool. Keeping it real.

Jimmy Moore: But then the thing that come—comes out the other end, though, that’s the most interesting thing to me. Coz you think, okay, after a few days you’ve not eaten, all that’s gone. Uh-uh— I’ve gone really long times without eating and by day 12, day 15, you’re still seeing stuff come out the back side. And it—it freaked me out coz I’m going, “What else is in there?” It—it just it’s amazing we don’t realize just how much gunk is still in there. And you can definitely explain maybe why that stuff’s still in there that deep into a fast when you’re drinking plenty of water every day, you’re getting adequate salt which would ostensibly make things move along pretty—pretty good as well. Why would there be stuff still in there, 12, 15 days later?

Dr. Justin Marchegiani: Oh, I think some of that, too, is if you look at the composition of your stool, half of it is gonna be bacteria-based. So It just could be bacteria that’s replicating in the gut just kinda having this kind of passing its lifecycle. That could be one aspect.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: It’s definitely not the fibers in the food aspect.

Jimmy Moore: No.

Dr. Justin Marchegiani: That part is not there. But the other half of your stool is gonna be the bacteria so that make sense. So that’s good that you are having regularity there.

Jimmy Moore: Oh, yeah. Definitely regularity. I would say the the—the uhm—the normality of the stool was gone by day 5. In other words, it was all kinda soupy.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: After day five. And–and from what you just said that make sense.

Dr. Justin Marchegiani: Yeah. Totally. Now the big concern that I have with patients—coz I have a lot of patient with blood sugar issues and adrenal issues—is that when you–you cut calories, you know, one of the big things you’ll see in the research is— just type in, “hypocaloric diet” and “low thyroid” or “low T3”

Jimmy Moore: Yes.

Dr. Justin Marchegiani:– or “triiodothyronine” is we see the thyroid kinda down regulate. We see the body temp go down. We see the reverse T3 go up. We see the free and total T3 go down. What did you evaluate your thyroid function during the fast and all?

Jimmy Moore: Here’s the most exciting part I think about fasting. When you’re doing it deliberately as a therapeutic uh—resource, and let me give the caveat, I don’t think everybody needs to do really long fast.

Dr. Justin Marchegiani: Uh-hmm.

Jimmy Moore: I think most people probably could get most of the benefits of fasting just from doing uh— like a 16-8 or 18-6 type of—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —fast. If you did that, I think probably most of the population would do well. This is for those people that are the type II diabetic that are the very insulin resistant that do have a lot of obesity that they want to try to deal with. Uhm—this is uh— who it’s for. Now you mention hypocaloric diets. Here is the thing. Hypo caloric diets can be very detrimental to you. So let’s say, 5,6,700 calorie a day type of diets. That will actually slow your metabolism down. People worry about, “Oh, I’m gonna ruin my metabolism. It’s gonna slow —

Dr. Justin Marchegiani: Right.

Jimmy Moore: —my basal metabolic rate.” And all this, yada, yada, yada that you hear. And the research definitely bears it out. We’ve seen it with the biggest loser contestants.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: Here’s the thing. When you eat no calories at all, which I’m defining as that bone broth and the Kombucha, anything like less than maybe a couple hundred calories, that actually is a far different creature than a hypocaloric state of 5,6,700 calories. Fasting actually revs up your metabolism and gives you a lot of health benefits and impacts those hormones in a different way than even eating just a little bit which blows people’s minds. So thinking, “If I just eat a little bit, then that’s better than not eating at all.” No. Actually it’s a lot better to not eat anything at all again defined as 200 calories—

Dr. Justin Marchegiani: Interesting. Yeah.

Jimmy Moore: — than to have even a little bit calories. And your body thinks it starving and it’s gonna hold on to everything, whereas fasting releases it all and lets this cascade of really cool hormonal effects are to happen.

Dr. Justin Marchegiani: Interesting. Now what about people that have blood sugar issue, would they tend to go hypoglycemic? How do you address that on —when you’re going to do a fast?

Jimmy Moore: So if there’s concerns about that, obviously keep a very close eye on that and obviously this should go without saying, let uhm— medical professional follow you.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —while you’re going through this. Uhm— so don’t willy-nilly do a fast on your own especially if you have known issues like hypoglycemia. But what we’ve seen and what Dr. Fung has seen— he seen well over 1000 patients in his intensive dietary management plan uh— in Toronto, Ontario Canada and he actually has had some hypoglycemic patients come on and it actually regulates their hypoglycemia. So it doesn’t mean that their blood sugar doesn’t go down —it does. When you fast, it goes down. But the cool thing is, you have a corresponding rise in the blood ketones.

Dr. Justin Marchegiani: Ketones.

Jimmy Moore: — which then steps in the place of that. So that yes, you have lower levels of blood sugar, but it— but you’re completely asymptomatic of hypoglycemia.

Dr. Justin Marchegiani: Now what do you think about adding in synthetic ketones while doing the fast. Like the betahydroxy butyrate calcium salts. Are you concerned that if you do that while you fast, you may go up into that ketoacidosis rate? What’s your experience there?

Jimmy Moore: So I have used it uh— in the early days and I would say, use it for the first maybe two, maybe three days, but Justin, by the time you get today 3-4, you’re seeing betahydroxy butyrate levels of 4,5,6 very easily without exogenous ketones. So I would say, it’s probably a good idea in those first couple days especially day 2 where it’s hell—haha—

Dr. Justin Marchegiani: Tough to cravings.

Jimmy Moore: —to take it then for that purpose to kinda get through that period coz you’ll feel the effects that you’re in the fully fasted state because of the extra ketones. But then once your ketones naturally go up on their own, you can back off and completely eliminate those exogenous ketones. So I think as a beginning uh —part of the fast, absolutely. As you go higher, know and—I— I don’t think ketoacidosis would be a concern because you have to get extraordinarily high level—

Dr. Justin Marchegiani: 25, right? 20’ish—

Jimmy Moore: of blood ketones. Yeah. 20+ milli molar and I think the highest I’ve ever seen, and this was without exogenous ketones, was 7.6 Very naturally, again, it was early on when I started keto and I started kinda really doing this. Your body levels out over time, but blood sugar at the same time as 7.6 was like in the 50’s and so I wasn’t worried about it in the context of a lower blood glucose level. And if you’re fasting, your blood glucose level is gone drop like a rock.

Dr. Justin Marchegiani: Got it. Okay. And I’ve seen a lot of people do the therapeutic fasting with severe insulin resistance. It can be a game changer of turning that insulin resistance around right away.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And get them back on, you know, the right type of guy whether it’s a paleo, low-carbish, you know—

Jimmy Moore: Sure.

Dr. Justin Marchegiani: 60 carb, 20 protein, 10—10—or 20 protein uh—10 carb. Whatever that macro rain—

Jimmy Moore: Right.

Dr. Justin Marchegiani: You figure it out with your clinician and work on that. I think it’s a great starting point. My issue is with the low-calorie. I always see a lot of patients just automatically they tend to go lower calorie to begin with. And it’s hard to see if their fatigue is from a low-calorie issue.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: —or adrenal, thyroid issue. And the calories you can be driving all of the above.

Jimmy Moore: It could be both exactly where the one is feeding it to the other. And— and I do a Thursday podcast called, “Keto Talk” and my cohost on that one is a practitioner out of Arizona, Dr. Adam Nally and he sees 10, 15,000 patients a year. And so he’s seen literally everything come through the office and he says, “The biggest issue that he sees time and time and time again especially among women is they’re not eating enough calories when they go keto.” And so you gotta have adequate calories or it’s just a moot point.

Dr. Justin Marchegiani: Yeah. Definitely the fasting is therapeutic coz we— we need nutrition to run our body and we won’t be getting those nutrients in a fasting state. But when will be doing some severe uh —U-turns with our physiology when it comes to insulin resistance for sure.

Jimmy Moore: Absolutely. That’s why you do it.

Dr. Justin Marchegiani: Also, I had a little flashback when you’re talking about the constipation thing.

Jimmy Moore: Uh-oh.

Dr. Justin Marchegiani: I flashback to one of your podcast a few years back when I— you are interviewing— not Ornish, when uh — Mc Dougall.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: And he kept on referring you to Mr. Moore—

Jimmy Moore: Ho-ho—how’s your constipation, he told me.

Dr. Justin Marchegiani: Yeah. He kept on saying, “How’s your constipation, Mr. Moore?” “How is it?” So I kept on having those flashbacks there. That was an excellent interview that I think uh —everyone should partake in. It was just a uhm—amazing.

Jimmy Moore: It was fun. Hahaha—

Dr. Justin Marchegiani: —just you showing your patience on being able to stay calm. That was unbelievable. You’re a saint.

Jimmy Moore: What’s funny is behind the scenes, my wife could hear what was going on.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: She heard it very quickly took a turn for the worse. And she— I mean I had on mute and she was like, “Don’t let him run over you.” I’m like, “I got this—I got this.” Hahaha—

Dr. Justin Marchegiani: That was probably one of the podcast— one of the best podcast that I’ve ever seen. It was great. Love it.

Jimmy Moore: You gotta have fun in podcasting and sometimes talk to people that you don’t agree with and they can hang themselves.

Dr. Justin Marchegiani: Totally. Well, we’ll put that topic behind us. Uhm— literally and figuratively.

Dr. Justin Marchegiani: So you—

Jimmy Moore: See ya.

Dr. Justin Marchegiani: I know. Next— what’s your experience using MCT oil or other types of ketone precursors to help to kinda push yourself into a higher level of ketosis?

Jimmy Moore: Yeah. I think they’re great adjuncts. Like we said a moment ago—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —with the exogenous ketones in the beginning of a fast, I think anything that’s gonna give you even a psychological boost, I know that physiologically you should be getting a boost in your ketones because MCT is a precursor to that. But I think anything that’s gonna make you feel better about what you’re doing and how you’re fueling your body and—and the end goal of—of feeling better and getting healthier, is a good thing. So just be careful if you do add any of these products like MCT oil, specifically. I remember first time I was gonna—

Dr. Justin Marchegiani: Loose stools.

Jimmy Moore: —two big tablespoons full of this stuff—

Dr. Justin Marchegiani: Oh, yeah.

Jimmy Moore: And two hours later, I can’t get off the pot. So—

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: Hahaha—
Dr. Justin Marchegiani: Love it.

Jimmy Moore: So you gotta—It’s beware at that point and—and be prudent about it. Obviously, listen to podcasts like these. Uh— it’s gonna help you, you uhm—you know, and read up before you kinda jump full-fledged. I think sometimes a little bit of knowledge is dangerous, Justin. Because people think, “Oh well, I can do this on my own.” And you probably should not do it on your own.

Dr. Justin Marchegiani: Yeah. I hundred percent agree. Now you mentioned that certain people the fasting may not be the best thing for, especially when there’s a lot of active stress.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And is that because of the stress hormones affecting blood sugar and insulin levels?

Jimmy Moore: Blood sugar and just how you feel in general. I— I think all of those things uhm— it’s just not a good idea. I mean obviously, if you’re malnourished and underweight, you shouldn’t be fasting either coz you’re gonna lose weight. Uhm— if you’re pregnant, obviously you should not be uh— fasting because you’re basically trying to build a little one inside you.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: You’re going to needing to, you know, feed you and that baby. Uhm —I think if someone comes from an eating disorder, like uh—anorexia or bulimia, get that under control first. Uhm— and just— and children. If you’re under age, and you’re still developing and growing, probably not a good idea to fast unless the only caveat I’d give to the children is unless they’re very severely—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: — obese and diabetic and this is something that could be therapeutic for them. But again, in general, children probably should not be fasting.

Dr. Justin Marchegiani: Got it. Would you say if you also have like an active thyroid or adrenal issue, would you say get that under control before trying that?

Jimmy Moore: Yeah. You definitely want to get those things under control. Uh— it might help those things, it might— but I think getting those under control through nutrition first, and then as an adjunct in the process of your healing, adding in a few times a fasting just to see how you do, is definitely there is no downside to trying it uh —a time or two, just to see how it impacts you. And— and that’s the theme song, we say again and again with what I like to refer to as the other “F word”.

Dr. Justin Marchegiani: Nice.

Jimmy Moore: With fasting is you just gotta try it. And if it works for you, great; If doesn’t work for you, great. Move on back to your Paleo diet, your ketogenic diet and be happy with where you are.

Dr. Justin Marchegiani: Love it. And I spoke at 2015 low-carb cruise, and one of the things I talked about was thyroid function and insulin resistance. So, if you are insulin resistant, that can definitely affect thyroid function. And fasting may be a good short-term modality to help get that insulin resistance which would thus, help with thyroid T4 to T3 conversion, too.

Jimmy Moore: And see, it’s all related.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: People like to say, “Well, I have uh— heart disease, I have diabetes, I have cancer.” Guess what guys, they’re all metabolic diseases, they’re all cut from the same cloth. Uh— thyroid disease, the same thing. They are all cut from the exact same cloth and—and knowing that, keeps you so much more knowledge and power than probably most medical professionals.

Dr. Justin Marchegiani: Totally, 100% agree with that. So looking at some of the supplements that you’re using, I know you’ve up with your own line with Dr. Adam Nally there on your Keto podcast.

Jimmy Moore: Yup.

Dr. Justin Marchegiani: Let’s talk about some of the—the core or the big three so to speak. Uhm—what are those and then where do you—where do you stand on synthetic ketones, too?

Jimmy Moore: So uh— big three in terms of what the big uhm— supplements are?

Dr. Justin Marchegiani: Yeah. Exactly. What are those big three supplements that you’re doing?

Jimmy Moore: The big three—like—haha

Dr. Justin Marchegiani: Haha—

Jimmy Moore: We have two uh—two products in the line. Currently, one is multivitamin that’s very specifically uh —targeted to people on a ketogenic diet. We call it Keto Essentials. And we literally load that bad boy up with all kind of stuff uhm —and so in six pills, you get like all the vitamin D that most people would need. I believe we have 2000 IU of the vitamin D in there. We have biotin. We have uh—just a lot of things, K2, that you don’t usually see in a lot of multivitamins. You definitely can’t find this formulation in like uh— vitamin shop or anything like that. So uh— we worked hard and this is one that Dr. Nally actually uses specifically with his patients that he puts on a which is like 99% of the people that come through his door, he puts on a ketogenic diet. And then uh— uh—the other one is blood sugar tends to be an issue a lot of people deal with. And so Berberine Plus is the name of the product that we came out with there and it’s for Berberine, Banaba leaf and chromium all known to help lower and modulate your blood sugar levels. And the cool thing about that one is when you lower blood sugar, guess what also happens, you raise in the context of a low-carb, high-fat diet, you raise ketone levels. And so it helps you get into ketosis. Uhm— I would think that fish oil probably is a third one that’s really essential work we’re—we’re kinda looking into what we can do from an omega-3 standpoint. But I think getting that right balance of Omega 3’s is so essential. I personally just love cod liver oil.

Dr. Justin Marchegiani: Love it.

Jimmy Moore: And use it pretty often and definitely high quality pharmaceutical grade. Don’t buy the ones that are, you know, Walgreens or whatever.

Dr. Justin Marchegiani: Absolutely.

Jimmy Moore: No offense but just they’re just—they’re rancid, they’re nasty.

Dr. Justin Marchegiani: Yup.

Jimmy Moore: And—and when you fishy burp, that’s a really bad sign—

Dr. Justin Marchegiani: Yup.

Jimmy Moore: that you got a bad one.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: So— and then you asked about exogenous ketones, I’m still kind of— I’m still kind of filling that out because there’s a lot of companies out there really trying to get on this bandwagon with exogenous ketones. Uh— I think I was telling you before I came in the air, I don’t like to way some of them are being marketed.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Into ketosis within 45 minutes or less—No, you don’t.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: You get ketones in your blood system.

Dr. Justin Marchegiani: Totally.

Jimmy Moore: But you’re not in ketosis. You’re not keto adapted and then some of the other marketing is like, “Well, eat all the carbs you want, just take exogenous ketones and you’re in ketosis.” I’m like “No. No. There’s some dangerous implications there where you’re raising your blood sugar with these carbs you’re eating and then suddenly you’re raising blood keto levels. That would be a concern for ketoacidosis at some point if you go overboard.

Dr. Justin Marchegiani: Big time.

Jimmy Moore: So I’m very leery about this, Justin. And very open about it I do think exogenous ketones have a role in the Keto community where people that are struggling may be just starting off and they want to kinda feel some of the effects of having ketones in their blood system. This will do that for them and again, a psychological effect of, “Oh, well I already have ketones in my system, now it motivates me to go do it endogenously while I’m doing it exogenously. I think that can be—that can be a good use for them. But just these people that are pushing it and eat your carbs and have ketones at the same time, no— don’t do this. Don’t do that anymore.

Dr. Justin Marchegiani: I totally agree. I see a lot of these companies. They do that and they don’t really emphasize the dietary aspect of pus your physiology into nutritional ketosis by making the right diet and lifestyle changes. They’re just like “Hey, let’s forget that let’s just take this magic pill and get in the ketosis.” But we’re saying maybe do both. If you do some of that and then you make the diet changes than you can have a really beneficial effect.

Jimmy Moore: Yeah and unfortunately, I think a lot of these companies are just in it for the book.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: For the trend and, you know, Keto is very, very hot right now. I wrote Keto Clarity three years ago, and it’s still under a 1000 on Amazon. It just blows my mind how help long that book is just lasted. But it’s because so many people are truly interested and I’d— I don’t want anybody to get confused that Keto— exogenous ketones is anything close to being exactly the same as endogenous doing it through a low-carb, moderate protein, high-fat diet.

Dr. Justin Marchegiani: Got it. And what’s your take using endogenous ketones for like neurological disorders? Whether it’s epilepsy or whether it’s Parkinson’s or neurological conditions. What’s your experience with that did?

Jimmy Moore: Did you say endogenous or exogenous?

Dr. Justin Marchegiani: Uhm— I’m sorry I would be talking about exogenous.

Jimmy Moore: Okay.

Dr. Justin Marchegiani: So extra ketones. So let’s assume—

Jimmy Moore: Coz I heard you say endogenous—Wait a minute, uh—eat low carb and then—haha—

Dr. Justin Marchegiani: So endogenous is what’s happening inside. That’s the low-carb—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: —that moderate protein diet—

Jimmy Moore: Right. Right.

Dr. Justin Marchegiani: And then exogenous what we’re putting into our bodies. So what’s your take with that with some of those neurological conditions?

Jimmy Moore: Oh my goodness. I think these are the people that that was made for that. O-o—other than like the Navy Seals which I know Dominique D’ Agostino’s been kind of leading the way of creating these things for the Navy Seals to kind of help, you know, enhance their mental performance.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: While they’re out there. And plus they do a lot of fasting as well.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: So they do a lot of the endogenous ketones that way. So, yeah. Absolutely. These are the very people that I think they’re trying to reach this really cool ratio of glucose to— to ketone and if they’re doing it endogenously and—and working voraciously even more so than just someone just trying to heal insulin resistance, they’re going upwards 85-90% fat and then the rest is protein, carb. They’re doing really hardcore trying to get those ketone levels up for a therapeutic purpose. So don’t misunderstand me as, “Oh, I’m gonna go eat 90% fat. Jimmy Moore said it was okay.” No, I didn’t. For the purposes of Parkinson’s and—and some of the things that you mention, I think it, along with exogenous ketones, can be very uh —very therapeutic for those people because quite frankly, the brain— your fat head, by the way, Justin—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: And so am I. We all are. We’re all like we have— was at 70% fat—

Dr. Justin Marchegiani: Yup.

Jimmy Moore: —in our brains. And there are some glucose uh— functions in the brain but your body makes all the glucose you need endogenously. So you don’t have to eat, you know, uh— extra glucose in order to get it into the brain. So the brain’s gonna be fine. The brain’s actually going to be more than fine. It’s gonna be optimal when you start eating low-carb, moderate protein, high-fat. And then adding in these exogenous ketones, the brain just goes wild when you’re in a ketogenic state.

Dr. Justin Marchegiani: Totally. And you talked about brain here just one second ago. Now we are— we are 70% you know, fat in the brain. Uh— Tom —Tom Naughton uh— his video, “Fat Head” a few years back.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: It was just absolutely great. It was really emphasizing that. But in our brain, right? We look at some of the enzymes that are active in our brain. There’s one enzyme called insulin degrading enzyme. And that enzyme’s really unique because that enzyme’s also the enzyme that mops up insulin and also mops up plaque. So imagine someone spilled a whole bunch of insulin on your floor, right? And yet Mop comes in, and mops up that insulin but there’s some plaque on the other side of the floor because the mop’s so saturated it can’t mop up the plaques. In other words, that mop can only mop up so much gunk in the brain. The more insulin that’s there from the excess sugar and carbs, you have less of that mop’s utilization for the plaque. And that’s part of the mechanism of Alzheimer’s and some of these Dementia brain conditions.

Jimmy Moore: Alright. I wanna see an illustration of that on your website now. So—

Dr. Justin Marchegiani: Haha—

Jimmy Moore: The mop that’s dripping with insulin can’t get the plaque—Haha—

Dr. Justin Marchegiani: I’m gonna do it. I’m gonna do it. I’m gonna do a chalk talk later this week. You got it.

Jimmy Moore: Cool.

Dr. Justin Marchegiani: It will be uh —dedicated to you, Jimmy.

Jimmy Moore: Cool. There you go.

Dr. Justin Marchegiani: So we talked about the insulin piece, that’s important. What’s been your experience with fasting or using very— like you know, 200-500 calorie diets? And I know you said below 200. I had some experience using hCG. Some of the hCG protocols—

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: The Human Chorionic Gonadotropin. And using that to basically tap into your body secure fat sources and kinda having this appestat, you know, the appestacin or the brain kinda re-regulating that. What’s been your experience with that, if you have any?

Jimmy Moore: Can I be honest about hCG?

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I’m extraordinarily skeptical uhm— I know it’s helped a lot of people actually uh —know a lot of patients that have gone through that. I have not personally done that. Uhm— and I think the thing that scares me the most about it and maybe you can acquiesce my fear, is the— is the very, very low calorie. I think I find more benefit from being under the 200 than being at 500 with hCG. And it could just be my naïveté and not knowing enough about it, but I’m— I’m just extraordinarily concerned anybody that goes through that. Because once you go through the round of hCG and you go back to eating somewhat normally again, maybe a ketogenic diet, I haven’t really seen anybody continue to sustain the benefits from that. So that would be my only caveat concern about this.

Dr. Justin Marchegiani: Yeah. I’ve done it with a couple dozen patients. I’ve done it myself personally. My wife tried it a few times as well. And it has worked profoundly if you do it right.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: Couple of caveats, there’s a lot of homeopathic’s out there— homeopathic drops—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Don’t recommend that. If you do an hCG, you should do it the injection—

Jimmy Moore: You do the injection.Yeah.

Dr. Justin Marchegiani: You should do the injection.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And the easy way to do it as you should know because if you get a pregnancy test, you should test positive. It’s a great way to freak out your husband, by the way. Okay.

Jimmy Moore: Test positive— Will a guy test positive for pregnancy as well?

Dr. Justin Marchegiani: I —I think they will because that’s still gonna spill out—some of it will spill out in the urine.

Jimmy Moore: I so wanna do that to freak out Christine.

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: Hahaha—

Dr. Justin Marchegiani: But I tried it with a sublingual and I tried it with a homeopathic—

Jimmy Moore: Yes.

Dr. Justin Marchegiani: You will not get a positive pregnancy test. And again, my wife has tried it, not me. I’ve done the injection but I haven’t tried it yet.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But I’ve seen it work phenomenal. It took her about one year to gain the weight back.

Jimmy Moore: Wow.

Dr. Justin Marchegiani: And she felt great. Going— that— In the first five days was tough, but you are able to keep it off. And again, you know ,the quick—the key is what do you go back to?

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: You go back to a really good diet.

Jimmy Moore: That’s right.

Dr. Justin Marchegiani: She’s kind of a Paleo, low-carb.

Jimmy Moore: Sure.

Dr. Justin Marchegiani: That’s where she—she lives. Uhm— but again, the key is don’t go back to a crappy diet. But the science behind that is the hCG is tricking the body. And this makes sense more with the female physiology.

Jimmy Moore: Right.

Dr. Justin Marchegiani: Not so much the male. You’re tricking the body that you are pregnant and your body is tapping into secure fat stores coz it’s trying to pull calories out so the baby can be nourished and fed. So the whole idea is you’re tapping into those secure fat stores. That’s the stores you normally wouldn’t tap into if that hormonal level wasn’t there. And there’s been a study at __was the British endocrinologist—

Jimmy Moore: Right.

Dr. Justin Marchegiani: —that came up with this in the 60’s.

Jimmy Moore: Right.

Dr. Justin Marchegiani: There’s a study in the Lancet where you have two group: one without the hCG, low-calorie diet; one with the hCG. And the group with the hCG loss more calories and also kept it off longer as well. So just kinda—that’s from my experience and pretty good.

Jimmy Moore: Yeah. I’ve interviewed a few people about hCG on the “Livin La Vida Low Carb Show” over the years. So I’m curious the 500 calories is key. You’ve gotta keep it down so basically you don’t overfeed your body because you’re tapping into the body fat stores to make up for the rest of calories that you need. Is that the theory?

Dr. Justin Marchegiani: Yes and no. I— I’ve modified it over the years where I still boost the calories up a little bit more upto —

Jimmy Moore: You do. Okay.

Dr. Justin Marchegiani: — thousand. I played around with that coz you still get—

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: —similar results. And also adding in— they recommend no fats but the only exception is been for me is MCT Oil.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And I find it boost up the ketones the more helps with the appetite.

Jimmy Moore: I would be willing to try a 1000 calorie one with the hCG injections that— that sounds a little more prudent. I think the 500 was what just freak me out. Every time I saw that it—

Dr. Justin Marchegiani: I’ve had so many good experiences with it with people that already have healthy diets, healthy everything.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: And that’s like my go to with patients that are like at their wits end with their diet. Everything else is right— exercise, lifestyle, supplements, gut. That’s kind of my last go to. So I’d be curious to see your— your take on that.

Jimmy Moore: Yeah maybe will give it a go.

Dr. Justin Marchegiani: I love it. Very cool. So we talked about the ketone, we talked about some of the supplements which I think are really good. Now we talk about you— you talked about it before in Keto clarity kinda looking at your lipid panel Can we talk more about lipids when you’re— when someone’s reading their lipid panel, is there cut off for you? With your cholesterol so high that they should worry at all? What does that look like for you?

Jimmy Moore: Total cholesterol is that you’re referring to?

Dr. Justin Marchegiani: Total cholesterol. Correct.

Jimmy Moore: Yes. So I was just talking to this lady that was going in at the mail place I’d take books every day to the mail and this lady was there, and I don’t know how it came out, but her —her total cholesterol she just shared it with me. I guess she knew what I did for a living. And so, you have 620 total cholesterol and I’m like, “Okay, that’s high. I’m not really worried about total cholesterol in general, but that’s really, really high.” And so I said uhm— “So usually when your blood lipids are that high, do you have, you know, something else going on? Do you have like maybe infections in your teeth or something?” She’s like, “Oh, yeah.” and she pulls out the bottom of her teeth.

Dr. Justin Marchegiani: Ohh— Oh, man.

Jimmy Moore: She had six all pulled out that— that probably had infections in there from root canals that she’s had done. And this was the bad part. This was the part that just broke my heart, Justin. She just spent over $10,000 mercury amalgam galore all in her teeth. And I’m going, “I’m sorry to be the bearer of bad news, but that’s why your blood cholesterol has gone up so extraordinarily high.” So I think in the context of knowing why it’s high, it does matter. Uh—but it’s not the high number, I told her. I said, “You should be very thankful that you have that very high cholesterol because that’s the only thing that’s saving you from dying right now because of the inflammation.” And so it kinda startled her. “I just spend all this money” and like, “I know but total cholesterol can be an interesting marker if it starts to go up because it should clue you when something is going on somewhere in the body and it’s usually an inflammatory response somewhere. And teeth is a big one for a lot of people. I actually have four root canals done when I was in my early 20s, mercury amalgams.

Dr. Justin Marchegiani: Argh—

Jimmy Moore: And 2013, actually wrote a book, “Cholesterol Clarity” and an in preparation for that book, I thought well, I learned that infections in your teeth can be a big player in your total cholesterol. So I went and got them all cleaned up. I went to a holistic dentist down the road from here, he took all the mercury amalgam— amalgams and put good stuff in there and he cleaned up all of the root canals and the infections that had taken place. I can literally taste the infection that’s how bad it was.

Dr. Justin Marchegiani: Oh—

Jimmy Moore: So he cleaned all that up, and Justin, and in one year, my total cholesterol jumped a 100 points just from doing that. No other changes, just from doing that. And so it can be uh—uh —kinda your first telltale sign something serious might be going on. So that’s the only weight that I really give total cholesterol. I think looking at triglyceride – HDL ratio gives you a whole lot better indication.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: You know, any, maybe necessarily cardiovascular issues uh—and NHS CRP to kinda see you like the inflammatory response. There’s a lot of inflammatory uh —numbers I know that you run.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Uhm—in—in your office. And so I think cholesterol helps to a degree, but not to the degree that most mainstream medical professionals think it does.

Dr. Justin Marchegiani: I think you’re a hundred percent right. Anytime I see like, you know, over—over mid 300 cholesterol, the first thing I always go to rule out is make sure it’s not a hypercholesterolemia issue with it.

Jimmy Moore: Right.

Dr. Justin Marchegiani: It’s just a genetic issue with the—

Jimmy Moore: Right. And I had that tested, by the way. I have a 5% chance that I have familiar hypercholesterolemia which is, no, I don’t.

Dr. Justin Marchegiani: Right. Exactly.

Jimmy Moore: And that—And then it lead to—“Hey, maybe there’s something— oh yeah, had all these root canals, I had the mercury and that— that was the thing.” And now my— my blood sugars uh — or blood sugar — blood cholesterol is still pretty high. It’s in the 200’s but that’s not abnormal.

Dr. Justin Marchegiani: No, that’s not an issue at all.

Jimmy Moore: And we can talk about the context of uh— of a ketogenic diet, that’s not abnormal.

Dr. Justin Marchegiani: Yeah. I don’t worry until they’re into the mid 300’s.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But any than that

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: —to—where’s the HDL—where’s the HDL at?

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Just curious.

Jimmy Moore: Yeah. HDL 75.

Dr. Justin Marchegiani: That’s beautiful.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: So your ratio right there still under—It’s still under 4. That’s still beautiful. And at 3 ½, you have the risk factor.

Jimmy Moore: And—and 360, so yeah, exactly.

Dr. Justin Marchegiani: That’s less than 1. That’s beautiful.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: I don’t have an issue with that. But uh— you know, but if there is an issue, we’ll run the LDR receptor, the P—PCKS9 test, look at the genetic markers there and if those aren’t there, we’re doing all the things that you mentioned. Also looking at thyroid function.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: Because low thyroid function cause— can cause—

Jimmy Moore: Will raise cholesterol—

Dr. Justin Marchegiani: to creep up.

Jimmy Moore: Yup. Do you run an NMR at all?

Dr. Justin Marchegiani: Uhm— Yeah. I do run an NMR. I was using the VAP before.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: But then after they got shut down.

Jimmy Moore: Yes.

Dr. Justin Marchegiani: So I’ve been doing more of the NMR to look at the LDL number.

Jimmy Moore: NMR is like the only game in town now. HDL Labs is gone now, and VAP is gone.

Dr. Justin Marchegiani: How about—how about the Cardiac IQ, is that still there?

Jimmy Moore: Yeah, it is. But I think NMR has a little more prominence.

Dr. Justin Marchegiani: Yes.

Jimmy Moore: It’s got legs coz they’re like only game in the— in the subfraction game, so to speak. That I think more and more doctors are accepting that one. Although I will tell you my own medical doctor just down the road from here in South Carolina, he stopped running them. And I’m going, “Can I please have an NMR run coz I want to keep around small dense LDL particles” “Well, you’re gotta have pay for it out-of-pocket.” So insurance won’t even pay for it anymore.

They don’t have a code for it anymore at my local doctors office. So I run it on my own anyway I can— I can do it NMR for about— about 50 and done and done. And in that way, I know where I am.

Dr. Justin Marchegiani: Yeah. That’s so smart. And again, I’m imagining the main reason why they’re not running it is because there’s no modality that they can do to change it.

Jimmy Moore: Well, they don’t know what to do with it. That—mainstream medicine they even run the standard lipid panel. They don’t know what to do with it. So that— that’s we’re getting deep into an issue with the mainstream medical system. They run so many numbers that they just don’t know what to do with it. “Okay, you’re normal.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: And it’s like normal of what?

Dr. Justin Marchegiani: What?

Jimmy Moore: Sick people.

Dr. Justin Marchegiani: Yeah. Exactly. And also the fact that uhm— also when you’re looking at those test, typically the prescriptions gonna be a statin.

Jimmy Moore: Yeah.

Dr. Justin Marchegiani: The statin won’t touch particle size and won’t touch LDL number per se.

Jimmy Moore: Right. Well kudos to this uh— this postal lady coz she said, “They tried to put me on this medicine. I told them, I ain’t taking that ever.” It’s like, “You go girl.” Uh—so she was—she was really— do have a fasting story regarding uh—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: —cholesterol when I did that September 2015 fast, 17 ½ days, I tested all of my blood markers uh —cholesterol before and then did it after. Do you know when that 17 ½ days my total cholesterol dropped a hundred points. And my LDL-P which was on the NMR like profile test, it dropped a thousand points.

Dr. Justin Marchegiani: Whoa.

Jimmy Moore: And small LDL was pretty low already but it even dropped another hundred or so points. Uhm— triglycerides obviously went down as well. HDL slightly went down which you’re not eating food, that make sense coz—since dietary fat tends to help your HDL go up. I wasn’t eating anything so uh— really interesting markers. And then the uh— really advanced lipid marker lipoprotein little-a actually was in the 400’s. I’ve always had really high lipoprotein little-a, like 423, and it dropped down to like 130 in 17 ½ days.

Dr. Justin Marchegiani: Wow.

Jimmy Moore: Nothing moves that. No drug moves your numbers that quickly. So uh— I was pretty impressed by the— just the therapeutic fasting. Just that little bit of fasting how profound it move those cholesterol numbers.

Dr. Justin Marchegiani: What If you’re someone that was going to their conventional position. Could just fasting for a day or two make— move the needle in the right direction so you’d be out of that danger zone?

Jimmy Moore: You know I didn’t test after a couple days. That— this will be a fun test to do.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: Like uh— I like do daily NMR’s or whatever—

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I just see when that— that dramatic shift takes place. I don’t think it would in that very short amount of time.

Dr. Justin Marchegiani: Right.

Jimmy Moore: Uh—I know some people they try to get like good health insurance or life insurance policies based on the cholesterol numbers.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I never get those preferred rates because I can’t get my numbers down that good. Uh— although, uh—you could do it with uh—you know, 10-day fast to try to get those numbers down. Get the good rate and go back to eating, it would go back up again. But, yeah, it’s uh— you know, I haven’t tried that but, that— would—If I could uh—make a little—If I can sell a few more books maybe I’ll do that daily NMR just to kind of keep an eye on what’s exactly happening.

Dr. Justin Marchegiani: That’s great work. Kinda doing the circle run here. We hit the fasting book, fasting clarity; hit the Keto clarity; we hit the cholesterol clarity; Are there any other key topics within those three books to give out now, that you wanna hit on? That you just feel is really important to address?

Jimmy Moore: Yeah. I mean, we’ve hit all the—the key points with that. Uhm— I’m obviously still writing books and still continuing to— to try to get information out there. The next book that I’m—I’m working on is kind of a sequel to Keto Clarity uh— coz all these people read that it was meant to be an entry-level book. I get some weird reviews on Amazon top uh—uh.com sometimes for Keto Clarity like, “It’s too simple.” Like, “Yeah. That was the point, dude.” Hahaha— I wanted it to be entry-level coz keto can be a little complex. You start talking about gluconeogenesis and ketoacidosis.

Dr. Justin Marchegiani: Gluconeogenesis. I love it.

Jimmy Moore: Yeah. Exactly. Oh, you remember that. Uh —And so I uh— wanted to go a little bit deeper and so Dr. Nally, uh—my keto talk co-host and I are actually working on a book called, “The Keto Cure” which will take all the major disease states uh—that a ketogenic diet helps with and show you the metabolic pathway of why it works, supplements you can take that would correspond with the ketogenic diet. And as a very last resort, any medications that might be an adjunct for that particular condition. So we’re really excited to get that book out in September uh—like a settl— kind of a long-awaited sequel to Keto Clarity. Uhm— and then another piece that’s not being talked about a lot, Justin, is the whole uh— mindset. The whole uh— getting your brain in the right— uh and loving yourself in the process.

Dr. Justin Marchegiani: Yeah.

Jimmy Moore: I guess it’s a long time to say a lot of people give you the “Here’s the how to” “Here’s the practical” And some people say, “I just hate how I look.” “I just don’t know” They don’t love themselves. And so I’m teaming up with a registered holistic nutritionist named, Meg Doll. Uh— was Meg on the cruise the year you came?

Dr. Justin Marchegiani: She may have been. Sounds familiar.

Jimmy Moore: Yeah. So I— Anyway, she and I are collaborating on a book called, “Keto Freedom” coming out in December. And then I just signed the contract as of the recording of this, like today, uh —for my next book after that called, “Weight Loss White Lies” There are so many shysters in the weight loss industry and I’m so sick and tired of seeing them on television and in print magazines. And people believe the garbage that’s put out there about what they need to do lose weight. And so, “Weight loss White lies” is gonna come in 2018 and I’ve already asked my publisher, “Can I please just rail against everybody?” So they don’t let me do that and uh— really excited to get that out there. Constantly working on new projects trying to uh— help other people, keep doing my podcasts. I do five podcast a week now between the three shows. So stays busy.

Dr. Justin Marchegiani: That’s great. You are the major podcast guy over the last 10 years. Now you’re into the whole authorship field. You’re doing great. Any of those book hits uh—hit New York Times best seller?

Jimmy Moore: You know, Keto Clarity came so close.

Dr. Justin Marchegiani: Aww—

Jimmy Moore: It was 22 the week it would’ve hit. And—and some of the behind-the-scenes games people may not know about. There’s publishers that actually pay their way to get on the list.

Dr. Justin Marchegiani: It’s hard.

Jimmy Moore: And so—You know publishers pay their way to get on the list the week I would’ve it. Uhm— and so I missed it by two on that one. The Ketogenic Cookbook hit 21.

Dr. Justin Marchegiani: Aww— one away.

Jimmy Moore: But “Ketogenic Cookbook” did hit International Bestseller status as did the uh—the book after that one uh— was “The Complete Guide to Fasting” that came out on October uh—we originally called it “Fasting Clarity” but then we got into writing it and, “Oop, we need to change the title.” Coz he didn’t want to necessarily stick with the same form as the clarity books. And so “Complete Guide to Fasting” also it sold out in six hours on Amazon.

Dr. Justin Marchegiani: Wow. Unreal.

Jimmy Moore: The day it came out.

Dr. Justin Marchegiani: Everyone listening, let’s help Jimmy get to number one here on his next book.

Jimmy Moore: Hahaha—

Dr. Justin Marchegiani: Well, thank you. And yeah, we’re really excited about “The Keto Cure” and yeah, we’re gonna keep doing our thing, man. Getting the message out to think we’re all passionate. All of us in this community are passionate just about educating people and helping them change their lives.

Dr. Justin Marchegiani: We’ll put the links below to all the Amazon— all the Amazon links to the books of people can easily access that. Awesome. And if you want to get in touch with Jimmy, livinlavidalowcarb.com livinlavida pod —livinlavidalowcarb podcast, and as well as the Keto talks, right, with Adam McNally?

Jimmy Moore: Adam Nally.

Dr. Justin Marchegiani: Adam Nally.

Jimmy Moore: Yeah. He’s been called McNally. He’s been called worse, so—

Dr. Justin Marchegiani: Hahaha—

Jimmy Moore: that’s just from Jimmy Moore. Like Keto Talk with Jimmy Moore & the Doc on Thursdays. And then I have a brand new podcast that started with Dr. Fung in January called, “Fasting Talk” so that’s also out there, as well, fastingtalk.com

Dr. Justin Marchegiani: Love it, man. Excellent. And last question I asked all my guests here. If you’re stuck on a desert island and you can only bring one supplement with you, what would it be, Jimmy?

Jimmy Moore: Well, I wouldn’t need vitamin D if I’m on a dessert island so—

Dr. Justin Marchegiani: No. You wouldn’t need that.

Jimmy Moore: One supplement— I— I would bring MCT oil.

Dr. Justin Marchegiani: I knew you were gonna say that. That would myself ahead of time.

Jimmy Moore: Hahaha—Or coconut oil, either one—

Dr. Justin Marchegiani: Something to increase uh— ketones naturally. Love it, Jimmy.

Jimmy Moore: Or to be fuelled, you know, coz if you’re—because you’re probably gonna have to fast quite a bit. So if I’m fasting, I want some fat in my body.

Dr. Justin Marchegiani: Totally makes sense. And you’d be a pro at that. I mean 28 days, man. Coz me and you in a dessert island, I think you may have me beaten, man.

Jimmy Moore: Well, I’ve got a little more uh—uh— meat on my body as well. I would survive a little longer.

Dr. Justin Marchegiani: I hear you.

Jimmy Moore: Awesome, Jimmy. Hold on, I’m gonna do it. His name is Jimmy Moore. Thanks Jimmy. I appreciate everything.

Jimmy Moore: His name—is Jimmy Moore.

Dr. Justin Marchegiani: I love it.

Jimmy Moore: Thanks so much for joining us here today on the Justin Marchegiani Show.

Dr. Justin Marchegiani: I love it. And again, thank you for being an inspiration on the podcast. I listen to your shows for a lot inspiration and just kinda how do I captivate the crowd and just be a really good host and kinda like prod for those good questions and that good uh—interactive feedback. So I appreciate that, Jimmy. I think the spontaneity helps and—and when you’re good friends with the person you’re interviewing, that also helps a lot. Uhm— and yeah, behind-the-scenes, I try to mentor a lot of podcasters. People don’t realize that I’m talking to a lot of these people that are coming on new and I’m happy to do that. I’ve done this a very long time and I love every minute of it.

Dr. Justin Marchegiani: Love it, Jimmy. We’ll get you back on as soon as that book comes out.

Jimmy Moore: Thanks, bud.

Dr. Justin Marchegiani: Thanks so much, Jimmy. Take care.


References:

http://www.livinlavidalowcarb.com/

http://ketotalk.com/

https://ketoliving.com/

http://www.fastingtalk.com/

http://www.fathead-movie.com/

The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting

Cholesterol Clarity: What The HDL Is Wrong With My Numbers? 

The Ketogenic Cookbook: Nutritious Low-Carb, HIgh-Fat Paleo Meals to Heal Your Body

Autoimmune Paleo Cookbook & Action Plan: A Practical Guide to Easing Your Autoimmune Disease Symptoms with Nourishing Food

 

Using ketosis to lose weight and improve your health – Podcast #109

Dr. Justin Marchegiani and Evan Brand dive into an in-depth discussion about nutritional ketosis and what benefits you can reap from it. This is a podcast episode where you’ll get valuable information about a Ketogenic-Paleo diet, what to eat (and when!) to get the best results.

ketosisLearn why insulin needs to be kept low and the ketones high. Find out how you can keep your diet in check and avoid wasting money when you’re taking exogenous ketones. Discover why carbohydrates are better consumed during night time.

In this episode, topics include:

03:38   What is Ketosis? Who is it for?

08:35   Kinds of ketones

09:50   Ketone supplements

17:36   Using ketones beneficially

28:45   Ketoacidosis vs ketosis

itune

 

 

youtuve

 

 

 

Dr. Justin Marchegiani:  Evan, it’s Dr. J! It’s a Monday. How’re we doin’?

Evan Brand:  Hey, I’m doin’ great. What’s up with you?

Dr. Justin Marchegiani:  Hey, it’s good that you survived the weekend.

Evan Brand:  Yeah, it was extremely exciting weekend with the baby—getting a lot of trouble with the baby.

Dr. Justin Marchegiani:  Nice. What’d you guys do?

Evan Brand:  Just hanging out at the park, hanging out outside.

Dr. Justin Marchegiani:  Nice. That’s awesome.

Evan Brand:  You get—you get stopped by a lot of people when you have a baby.

Dr. Justin Marchegiani:  Oh, I know. I just a got a dog a month or two ago and I just—I’ve never realized how many people are dog lovers, but man, we get so much attention when we have our dog. It’s crazy.

Evan Brand:  Yeah, if you were single. That would be the easiest way.

Dr. Justin Marchegiani:  I told my wife that. I said, if I ever—like if something ever happened where I can go back in time—if I were to do it all over again. I would’ve got a dog like right off the bat, like just a really cute, small dog but it’s all good. I’m happy where I’m at.

Evan Brand:  Yup, cool.

Dr. Justin Marchegiani:  But I wanted to say, we were talking pre-show there that I got a crown today and I go see a holistic dentist in Austin. Her name is Dr Joan Sefcik. I’m gonna actually have her on the podcast real soon. We’re gonna talk about root canals, cavities, crowns, all those things, but I had an issue with my tooth where I needed a crown. About 16 years ago I split my tooth in half when I was really young, just eating a whole bunch of sugar, eating a whole bunch of gluten. Hadn’t really got the message back then about health. Split my tooth but I was actually able to keep it together with some cement, and obviously changed my diet and never had anything like that happened with my tooth again, but I had those—the long-term consequence of that tooth being unstable so we put a crown on it and we actually did some testing, too, to figure out what the best material was and we actually—I think we ended on a cubic zirconia. So right now I have an acrylic crown that’s a temporary one and we got a cubic zirconia one coming in. We had it muscle tested and we called the lab. We—we chose the top 3 materials that test the best based on blood chemistry and then we muscle tested the top 3 and I tested great for all of them which was great, and then the doc said, “Well, you know, this is the one I have the best success with, and because you tested great with all three, we’re gonna go with this one.”

Evan Brand:  So I’m sure people wanna know with holistic dentistry, that’s all cash no insurance for that?

Dr. Justin Marchegiani:  A little bit. I mean, we have some dental but I—you know, I paid that I think out of pocket. I think it ended up costing me like a thousand bucks for the crown–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  And if I didn’t have insurance, it would have cost me $1500. Something like that.

Evan Brand:  Oh, okay. So insurance kinda works for holistic dentistry.

Dr. Justin Marchegiani:  A little bit. I mean, the thing is what’s holistic is the material we’re using, right? We’re not using the standard-based crap. I think it’s nickel a lot of times–

Evan Brand:  Yeah, it’s horrible.

Dr. Justin Marchegiani:  Which can screw up with, you know, the conduction of nerves in the body. So that’s the big thing and also she used a lot of ozones as she go in there. She’d use ozone and get in there, like a lot of essential oils. So it was really targeted to kill a lot of the bacteria and crap that could be in there even though she—I actually asked her, she said it was great, which is good. It’s testament to you know, good, clean—clean eating. So we’re gonna have her on the show real soon to talk more about healthy teeth and oral hygiene, so that that’ll be fun.

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  So I’m doin’ pretty good. Not bad. I get to go get my cubic zirconia tooth. My wife was texting me, it’s like, “Is that gonna look like one of those fake diamonds?”

Evan Brand:  Is it?

Dr. Justin Marchegiani:  In your mouth? No, I don’t think so. I asked. It’s gonna look, you know, it’s gonna look cosmetically in sync with my other teeth. So it’ll be alright.

Evan Brand:  Awesome.

Dr. Justin Marchegiani:  Yeah. So we talked about doing something on ketosis. I’ve had Jimmy Moore on the podcast. I’ve spoken on Livin’ La Vida Low Carb Cruise. We did a podcast a few months ago on Keto OS which is a synthetic ketone supplements and look forward to digging in a little bit more on ketosis.

Evan Brand:  Yeah, there’s a lot of benefits. Ketosis in my opinion is not for everyone at every point in their life. It has a lot of incredible benefits for weight loss but if you have adrenal issues in my experience, some people feel worse. Maybe there is that adjustment period but I find that if people are just they’re afraid of carbs, they can tank out even more. What’s—what’s your experience with adrenal issues and—and ketosis?

Dr. Justin Marchegiani:  So I think ketosis is phenomenal for most people that are out there, especially if you’re dealing with metabolic syndrome, meaning there’s a level of insulin resistance and you’re body is having a difficult time tapping into fat for fuel, ketosis is phenomenal because what you’re doing is imagine fat is like this big branch and we’re trying to throw that branch into the wood chipper and then out of that wood chipper comes these things called ketones, and these ketones can be used by different tissue in the body and the thing is, glucose actually burns dirty. Right? It’s like a diesel fuel. You kinda sm—it’s smells. It’s stinky. If you ever drive by in a diesel car, at least the older ones. But ketones they burn really clean and when I say burn really clean, you don’t get a lot of reactive oxygen species or free radicals afterwards. So it burns really clean like that and also you don’t get the effects of glycation, which is basically all the proteins or tissue in your body gets sugar-coated and that creates basically a m—a magnet for free radicals. So we like ketones because of the stability they give people, right? With sugar, we get this up and down reactive hypoglycemic effect with a lot of people that are doing refined sugar or just higher glycemic foods, meaning they get into your bloodstream really fast. We don’t quite get that with ketones. So the big issue is most people who have metabolic syndrome, big waist, high blood pressure, lots of inflammation, lots of insulin and blood sugar, they can’t get the sugar into their cells and utilize it for fuel optimally. So they can’t—their cells are—are very resistant so they start—one, they get reliant on sugar to burn but two, their cells don’t wanna take it in a lot and actually burn it so they get very tired and a lot of that that gets put in gets stored as fat. So it’s a double edged sword. They’re tired. They don’t wanna exercise. They get cravings. They create more sugar and then when your insulin levels are high, it basically blocks fat from being burned so you’re primarily burning sugar but you can’t get a lot of it to the cells so you’re tired.

Evan Brand:  Right. I’ve heard recently which I’ve read. I can’t remember what I was reading. There’s this kind of—there’s kind of a myth that’s perpetuated where people who are only a fat burner or only a sugar burner and that’s not the case. It seems that most people have the ability to do both and if you wanted to survive in primal times then you would have, you better have that ability to be able to burn glucose or ketones to survive. But I think the goal of that is you just wanna be primarily a fat burner, not primarily a sugar burner which is what would you say, 90% of the population is probably primarily glucose—glucose driven?

Dr. Justin Marchegiani:  Yeah, I would say at least 75%, and we talk in generalities, right? We’re talking like, “Hey, you know, you’re primarily burning sugar for fuel or primarily burning fat for fuel.” That’s—that’s the thing that we’re kinda get across there and most people, you know, when we talk about calorie partitioning, their partitioning, right? You know, imagine you got a police officer and his siphoning people through, “Go that way. Go that way.” You got all these calories that are going through and the police officer is saying, “Hey, go this way into the fat cell. Get stored as fat and a small amount will actually get burned. So we’re not shunting those calories. “Hey, go to the mitochondria. Get burned. Create energy.” While you’re creating energy, you’re building muscle because you’re doing something that’s creating resistance in the body which builds muscle, whether it’s the piezoelectric effect and you’re building calcium into the bone or whether you’re putting muscle into the muscle belly. So we wanna essentially use that you know, traffic policer officer or that you know, flight tower attendant that’s telling the planes which direction to go. We want tell those calories, “Hey, go to the mitochondria. Get burned versus get stored in the fat cell.” And one the biggest ways we can do that especially with people that have this insulin resistance metabolic syndrome is getting into ketones by cutting carbs.

Evan Brand:  Yup, so–

Dr. Justin Marchegiani:  Typically down to 20-30g is a great starting point for most people. Go ahead.

Evan Brand:  Now, the people actually need to count? I mean, I’m probably in ketosis now at this point because I haven’t had much today. I had some—I had a bison burger and also I had some bison—or no, what did I have for breakfast? Had some kinda meat and—and I can feel that. I know because you can feel your breath start to stink a little bit more. That’s how you know. That’s like the first sign of ketosis or one of the first signs.

Dr. Justin Marchegiani:  Well, yeah, you get the acetone but I mean, if you’re only at like .5 mmol, I mean that’s not a ton. So maybe your breath gets a little bit fruity, that’s the acetone. So there’s 3 kinds of ketone. There’s acetone. There’s beta-hydroxybutyrate and there’s acetate. So like if you look at the breath meters. The breath meters are really measuring the acetone in the breath and then the blood is measuring the beta-hydroxybutyrate–

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  In the blood.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Right? And then some will actually measure the ketones in the urine, not that efficient because if you’re burning ketones, well, that means if you’re burning them they may not end up in the urine, right? So if you get someone who’s in ketosis, they’re spitting out a whole bunch of ketones but they’re burning them up efficiently they may not pee a lot out. Does that make sense?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  So early on you get a lot of people that are in ketosis but they’re body’s not efficient at burning those ketones so those ketones go in the urine to start.

Evan Brand:  Well, let’s–

Dr. Justin Marchegiani:  But then later on as they get more efficient, you won’t see them in the urine. That’s why I got my ketone meter right here. I use the Abbott Precision Xtra or Precision Xtra and it’s—I got blood sugar on there as well as ketone strips, too.

Evan Brand:  Yeah, I’ve done the breath. It was by Ketonix.

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  I’ve done their breath one. That one was pretty good. I find that I had like a low level of ketones all of the time. Let’s clear something up though. When people hear about ketones, they’ve likely been in the grocery store or Walgreen’s or somewhere and they’ve seen the raspberry ketones as a weight loss supplement. They became very popular over the last probably 5 years. First off, raspberry ketones, they’re not even derived from raspberries when you see those. Most of the time when I’ve looked at the ingredients, a lot of times there’s synthetic chemicals in there. There’s artificial colors, sometimes artificial sweeteners in these raspberry ketones. So I do not recommend them. I don’t actually know enough about what’s actually in there to know what’s actually going to happen but generally just looking at some of the ingredient list on ketones, it—it’s garbage.

Dr. Justin Marchegiani:  Yeah, raspberry ketones aren’t necessarily ketones. I mean, if you look at what’s in there, there are these phenolic compounds that aren’t your typical beta-hydroxybutyrate whether it’s calcium or sodium beta-hydroxybutyrate salts. Like if you look at a lot of the ketone products, there’s Keto OS. There’s another one, a Keto Sport I think, and they’re using the beta-hydroxybutyrate salts, calcium or sodium. Those are like the gold standard. Now you can use precursors, right? Kinda like how we use maybe pregnenolone for adrenal support precursors. You can use precursors like medium chain triglycerides which are gonna be primarily C8 and C10. Like the, you know, the brain—the brain ketones are more C8, right? Octanoic acid or I think that’s maybe caprylic, there’s two names. I like the octanoic because it’s more descriptive. The oct–, octo–, octagon, that’s 8—8 carbons. So typically we’ll do ketones that are C8 and C10 because you get the brain effects of ketones but you also get the metabolic effects. So like typically in the morning after I have either a good clean collagen shake or some eggs and I do my butter coffee with high quality MCT oil. I’ll get my ketones up within an hour or 2 to—to .5, .6 mmol and I feel great.

Evan Brand:  Do you measure that?

Dr. Justin Marchegiani:  I measure it, yeah. Now the thing is with the Ketonix, it’s more qualitative. So like that number like let’s say you’re—you’re a different color or light on that variant. That light that you hit one day, you may hit it the next day but your number may have been different if you were measuring it in mmol of ketones. So it’s a good indicator to—to say if you’re in ketosis. It’s not a good quantitative indicator of what exactly were you.

Evan Brand:  Yeah, the other brand that I’ve seen before. I’m looking—trying to find the ingredients right now is Kegenix. So I’m trying to see what’s in here. It’s $200 for a 4-week supply.

Dr. Justin Marchegiani:  Yeah, they’re kind of expensive. My biggest thing off the bat is number one, get your diet dialed in. So you talked about carbs. So the first thing is as a macro percentage of nutrients is you wanna get your fat up. Most people screw up in ketosis because they go too high in protein. They’re eating like you know, 30-40% protein. It’s hard to do that much in protein unless you do two things wrong. Number one, you eat lots of lean meat and number two, you do excessive protein powders. So those are the 2 things. Now you can get away, going higher on protein if you’re doing a lot of resistance training, alright? But if you’re not doing a whole bunch of resistance training, you want your macros up around 60-70% fat as a pretty good starting point. So what I recommend is just throw your foods into a MyFitnessPal and if you’re using a Paleo template, so that means you’re gonna be getting most of your meats from animal products. Your carbohydrates, you’re gonna choose obviously more from a non-starchy vegetable sources. A really easy thing is you’ll typically be good around 20-30g and you can just throw in your carbohydrates, a cup of broccoli, a cup of spinach, a cup of kale, maybe you’re doing some asparagus, maybe you do another salad for dinner or lunch. Throw all the vegetables that you do in there, you’re probably find that you sit around 30g of carbohydrate once you factor out the—the fiber, 20-30 is pretty good unless you’re doing a ton of juicing or ton of veggies. You’ll probably be around 20-30 net carbs. That’s a pretty good place to be. So that’s a good starting point and then from there, depending on whether you wanna stay in ketosis—I like to—to keep myself around 40-70 carbs a day and I keep—I get my ketones up to .5 and I feel phenomenal–

Evan Brand:  So you’re—you’re–

Dr. Justin Marchegiani:  At around .5.

Evan Brand:  So you’re basically in some level of ketosis most days.

Dr. Justin Marchegiani:  Absolutely. Absolutely. And then like if you listen to guys like Jimmy Moore, Jimmy is around 1, maybe—maybe 1-2. And again, you don’t have to worry about ketoacidosis until you get to about 20. Ketacidosis is potentially what could happen to diabetics type 1 primarily and/or alcoholics that have cirrhosis, with that—they have messed up livers. Essentially ketoacidosis is when your insulin levels are high and your blood sugar’s high. Okay, that typically hard to do because when the insulin goes high, blood sugar goes low.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Alright, so insulin’s high. Blood sugar’s high in the bloodstream but what’s happening is we can’t get the—we can’t get the—the calories or the blood sugar into the cell so the cell’s starving and what happens is the body is trying to generate energy so it spits out a whole bunch of ketones.

Evan Brand:  Yeah, so–

Dr. Justin Marchegiani:  Does that make sense?

Evan Brand:  Yeah, so I was looking at the ingredients here. Basically what this is, it is the beta-hydroxybutyric acid, that’s literally what’s your supplement— supplementing with. That along with some medium train—medium chain triglycerides and then leucine, lysine and isoleucine. That’s it. And then erythritol, some Stevia, some color, things like that. So you’re literally just taking—you’re taking ketones. That’s what it is, right? The—the beta-hydroxybutyric is one type of ketone?

Dr. Justin Marchegiani:  Yeah.

Evan Brand:  Is that right?

Dr. Justin Marchegiani:  Correct. I wanna go back and correct myself. I misspoke. So regarding the ketoacidosis, it’s the insulin is low. Insulin’s low.

Evan Brand:  So you can’t deal with the blood sugar.

Dr. Justin Marchegiani:  Blood sugar is high so you can’t get it–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Remember insulin’s the lock or the key that goes into the lock. The—the keyhole is receptor site, whether it’s a GLUT4 key which is that’s allowing sugar into the muscle or whether it’s on the liver and an—various different GLUTs. So imagine the GLUT’s the lock and insulin’s the key. So you can’t use the key to get into the cell. So what happens is all the sugar accumulates in the bloodstream because insulin’s low. So everything I said before is correct except it’s because of low insulin. Think, right? Type 1 diabetics have an issue with low levels of insulin because their—their islets cells in their pancreas, the beta cells have been destroyed by autoimmune attack. So they can’t get that sugar in there, so the body’s freaking out. It’s saying, “Where the heck am I gonna get energy?” So it starts ramping out a whole bunch of ketones. Ketones have an acidic ash to it or an acidic foundation to it so it shifts the pH because of instead of being a nutritional ketosis at .5 mmol or 1 or maybe 2, they are 20-10 x higher and that shifts the pH down. When the pH goes down, they can go into a diabetic coma.

Evan Brand:  Wow. Yeah, I—you said that quickly otherwise, I probably would have caught that. That makes a lot more sense. So insulin’s low, sugar’s high. That’s when you don’t wanna do it and like the supplement says that you cannot use it with type 1 diabetics for that reason.

Dr. Justin Marchegiani:  And I—exactly. And I was listening to a lecture just yesterday talking on the topic and he did the same thing I just did and I—I got his bad habit from it. He said the exact thing I said the first time.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So I got the bad habit by osmosis, but we corrected it here. So think low insulin, high sugar, the cells are starving.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  The body freaks out and it tries to go and generate a whole bunch of ketones but shifts the pH. Now how do we use ketones beneficially? So we can use exogenous precursors like we mentioned, okay? Obviously the diet’s gonna be foundational. Now for some people, there’s a couple of ways of doing it. You can live in ketosis. That can be great for some people. If you have cancer, lot of great studies especially over at Boston College, Dr Veech, NIH guy. He went to school—he studied under Dr Hans Krebs, I mean the guy invented the Kreb cycle, alright? He discovered it, which is how the body generates you know, energy via NA—NADH and FADH redox—redox reactions which then generate ATP in the—in the Kreb cycle as well as the electron transport chain, but this is how our body generates energy and this guy studied with this doctor that created or discovered this stuff. So moral of the story is this is another way the body can generate energy and ketones are really important part of the Kreb cycle and they are really important part of starving out cancer cells. So cancer’s primarily—primary fuel if you look at Otto—Otto Warburg or Otto Van Warburg, a German scientist in the 30s and 40s who got 2 Nobel prizes discovering this physiology around cancer cell metabolism and he found that cancer cells primarily survive on glucose and if you can starve the cancer cells of that metabolic fuel—remember it burns dirty—if we can use ketones, we can essentially starve that type of cell.

Evan Brand:  Yeah, so—I mean, basically you and I both touch in to ketosis. Now I do do some sweet potatoes and things in the evening so I likely pull myself out of that so this is something that this is gonna depend on the person but you can touch in to ketosis—you do some carbs, don’t you? Do you do sweet potatoes with dinners?

Dr. Justin Marchegiani:  I cycle in and out. I cycle in and out. Typically at dinners, I’ll do after a dinner as a treat. I’ll do a handful of berries and maybe some cream.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Or I’ll do some high quality, 90% dark chocolate that’s you know, organic and you know, obviously gluten-free. So it depends. Like this week I did buy some sweet potatoes so at one night, I’ll have that. I mean, you get different diets out there like a cyclical ketogenic diet.

Evan Brand:  Right.

Dr. Justin Marchegiani:  There’s also Jason Seib’s stick on the AltShift Diet, which is I think a 3 days—I think it’s a 5-day low carb, 3-day high carb kinda stick as well. So there’s different things out there where you can cycle in and out and those I think tend to be really good for most people. If you’re more metabolically damaged, ketones, ketosis at that 20-30 induction phase can be pretty good. It depends. Some people I see if they’re in ketosis long-term will start to develop some of those hypothyroid symptoms, losing hair, hair loss, outer third eyebrow, cold hands, cold feet, mood stuff.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And then would just add in just a little bit carbs, small amount, and they’re doing better, so–

Evan Brand:  That’s what I had to do.

Dr. Justin Marchegiani:  Yeah, so some people–

Evan Brand:  I crashed.

Dr. Justin Marchegiani:  Do better so I’m not dogmatic at all. There are people out there that do great on that diet and because they’re not clinically oriented, meaning they’re not working with patients that we are, they—they just think well, because they did good on it, the other person out there that’s having a bad response or not as good response must not be doing it wrong.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  I’m sorry, must not be doing it right.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Because they’re doing it wrong essentially. So we always just make sure the fat macros are up, the protein macros aren’t too high, and then just make sure the carbs are there and that’s a pretty good sign off the bat and then we can always measure it. Get to a .5 to 1. 1 is pretty good. Cut off. So we can customize it and then we can figure out. Okay, you’re at ketosis. You’ve been there for 2-3 weeks. You’re stabilized now. Okay, you’re already at a healthy weight. You’re feeling good. Your markers look good. Let’s just taper up some of those carbohydrates a little bit, just a little bit. And this is where it’s cool that you can play around with these exogenous ketones, the beta-hydroxybutyrate salts like the calcium and the sodium. This is great to try. Be careful though. Don’t make the mistake of adding these synthetic ketones and eating a whole bunch of sugar. The body is programmed when insulin goes up, typically ketones never should be there, right? Because think about it, right? Insulin has to be low for ketones to be high. Because if high insulin’s present, the body will block fatty acid synthesis. What are fatty acids? That’s the tree branch going into the tree chopper. Out comes the ketones, right? So we wanna keep insulin low so if we eat a whole bunch of sugar, take some exogenous ketones, insulin’s high, guess where those ketones are going, you know?

Evan Brand:  Well, hopefully it’s gonna help go into the mitochondria.

Dr. Justin Marchegiani:  Well, if insulin’s high and sugar’s high, you’ll actually pee it out. So if you use exogenous ketones, you wanna keep the insulin low still.

Evan Brand:  So if you—so if you’re eating high sugar or you’re eating high carb and then you take ketones, you’re saying waste of money.

Dr. Justin Marchegiani:  Waste of money. And again a lot of the marketings out there because frankly, a lot of these ketone companies, they don’t care if you do it right or wrong.

Evan Brand:  Right.

Dr. Justin Marchegiani:  Because they’re getting—they’re getting paid either way.

Evan Brand:  Exactly.

Dr. Justin Marchegiani:  Not saying that’s bad. There’s education that comes into play. So if you’re using exogenous ketones which I think can be great from a performance, neurological standpoint especially if you have issues with Alzheimer’s, things like that. That can be phenomenal because then if you have the right diet in place and then you add some ketones, it’s like bada-bing! You’re there. You know, we call it therapeutic ketone therapy. You know?

Evan Brand:  So basically, don’t waste your money. If you’re gonna do this thing then get the diet straightened out always but then get the—get the cyclical Ketogenic Diet or experiment with that first before you buy ketones.

Dr. Justin Marchegiani:  Experiment.

Evan Brand:  That—that’s expensive. That’s $200 and that’s a—a way to waste it.

Dr. Justin Marchegiani:  And you may not have to be you know, full out ketosis. You know, I sit around .5 to 1 and that feels pretty good. I think just spit out some ketones.

Evan Brand:  Okay.

Dr. Justin Marchegiani:  Get to a pretty good place. See if you can test it. Get down to .5 or 1. See how you feel. Stabilize and then taper in some carbs. You know, start off with a little bit of lower sugar, lower fructose fruit, and handful of berries. It’s a pretty good place and then you can always try adding in a little bit of safe starch, sweet potatoes, squash, yams, plantains. Do it at night. Because your body doesn’t need the extra sugar during the day because cortisol’s already there, mobilizing and conducting sugar out of the—out of the glycogen, out of the muscle tissue, or out of the liver. So the glucose is already going where it needs to go because of the high cortisol. Do your carbs at night where that cortisol isn’t as present.

Evan Brand:  This is fun.

Dr. Justin Marchegiani:  Yeah, you having a good time here?

Evan Brand:  Yeah, this is fun.

Dr. Justin Marchegiani:  Awesome.

Evan Brand:  Well, just because you know, there—there’s so many different ways to go about this and there’s never—I—I think when people download these episodes, they think there’s gonna be like a single and that’ll be all answer, and that’s never going to exist especially for this ketosis discussion here.

Dr. Justin Marchegiani:  Plus we’re clinicians, so if it were that easy, you know, every patient would be a home run, right?

Evan Brand:  Yeah, exactly.

Dr. Justin Marchegiani:  So we have to put on our clinician cap, you know, so to speak. And we look at the diet, we customize it. So if you’re an endomorph, right? Larger, bigger, you know, wider hips, bigger belly, you know, those type of things, you put on fat easier–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it’s harder for you to burn, then you know, you’re gonna really benefit by starting out with a Ketogenic Diet and then customizing and then stack your carbs. When it’s time to stacking your carbs, stack your carbs on at night.

Evan Brand:  Here’s another thing I wanted to mention though, too, that we haven’t brought up yet. And you and I talked about Kalish’s talk I think a few weeks ago together, where if someone has a bigger waist and they have this excess body fat. Even if they go into a ketogenic approach, they may not lose weight because of those toxins that are stored in the fat cells could still disrupt the metabolism, right?

Dr. Justin Marchegiani:  Yeah, so the fat cells are a toxic reservoir for toxins essentially. A lot of our toxins go into the fat cell. They’re–

Evan Brand: So what do we do then if—if you’re going, you’re trying to go super low carb and yet you still just maintain your heavy weight, you cannot burn fat?

Dr. Justin Marchegiani:  Well, that’s where seeing a good functional medicine practitioner helps so we’d look at organic acids. We would look at how you’re detoxifying via pyroglutamate and sulfate and a lot of these organic acids that look at phase 1 and phase 2 liver detoxification. Phase 1 is taking fat-soluble toxins, right? It’s already there. They’re lipid-soluble. I mean, they’re in the fat cell. We’re liberating them and turning them into water-soluble toxins primarily via B vitamins, antioxidants, and then we facilitate the transfer of these water-soluble toxins out the urine, out the stool, out the breath or skin, right?

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And we do that with sulfur amino acids, right? We’re supporting methylation and—N-acetylation, hydroxylation ,right? Glucuronidation, glutathione, all of these pathways that are shooting it out. So phase 1 is more B vitamin and antioxidant induced. Phase 2 is more sulfur amino acid induced. And then also some people because amino acids make carnitine, carnitine’s a really important compounds that shuttles fat into the mitochondria. It’s literally called the carnitine shuttle. You can Google it. It’s shuttling fat in the mitochondria to be burned so some people will see low carnitine. We’ll see some mitochondrial defects and then we’ll see some detox issues. So that can be something that we–

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Incorporate into someone’s metabolic functional medicine program to help enhance it. So we get the diet dialed in non-dogmatically. Again, if you’re overweight, default to a Ketogenic Diet. That’s pretty safe. A Ketogenic Diet on a Paleo template. Right? Atkins create the—or Atkins made that ketogenic term famous except he used a lot of crappy foods, you know, didn’t differentiate with soy protein, added aspartame and artificial sweeteners. Didn’t care about grass-fed or chemicals or pesticides or Roundup so he kinda stumbled on it by accident–

Evan Brand:  Right.

Dr. Justin Marchegiani:  Because he was just looking at it from a sugar and carbohydrate standpoint. He didn’t look at it from the qualitative standpoint of phytonutrients and pesticides and chemicals and—and inflammatory foods and excitotoxins like MSG and aspartame. So we know more. So we kinda add like a—a Ketogenic-Paleo template on to it and then we have tools like the Precision Xtra by Abbott and get it on—I think get it on eBay and buy the strips on eBay. There’s a company out of Australia. You can get a much cheaper—they’re expensive. They’re like $1 or $2 a strip but if you buy them here, they’re like $2 to $3. So you can get them like 50% off. I bought like 100 strips and I just test my ketones a couple times a week to see where I’m at and I pretty much know where I’m at based on what I eat because I’ve tested so many meals. I see a pattern.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  So if I’m eating like good, clean eggs or a good clean collagen shake with some good fats, MCT and butter in the morning, I’m sitting around .5.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And I feel pretty damn good with that.

Evan Brand:  Yup, so I know we’re running out of the time but some of the benefits you can expect—I notice mental clarity goes up if I’m pushing towards ketogenic. Weight loss can happen which I don’t need to lose any weight but I am less hungry. I’m able to go little bit longer between meals. I don’t feel like I’m crashing like I was when I was doing more starch. There’s a few benefits for me. Did you wanna say anything on that part?

Dr. Justin Marchegiani:  I think you touched upon it really well. I think a lot of people will hear this especially if they’re medically oriented. People get confused between ketoacidosis and ketosis. So I already kind of touched upon the people that ketoacidosis happens to and typically you’re looking at over 20 mmol/L is gonna be what happens in ketoacidosis and ketosis, you’re gonna you know, .5, 1, that’s totally fine. Now there’s nutritional ketosis which is what we’re focusing on, right? We’re doing it by nutritionally eating an adequate amount of calories because you can go on ketosis by starving and fasting.

Evan Brand:  Yeah.

Dr. Justin Marchegiani:  Right? Because you still drive down your insulin levels because there’s no calories. If there’s no calories, remember insulin’s the door that opens up the cell for the calories to go in. Whether it opens up the mitochondria or the muscle or the fat cell, that’s dependent upon how much insulin is coming in. But you can lower insulin by just going low calorie. So you can be in ketosis via starvation, too. The difference is we’re doing it nutritionally, meaning we’re actually eating foods. They’re real whole foods and we’re getting enough calories so you’re body’s not gonna be eating away lean tissue.

Evan Brand:  Yes.

Dr. Justin Marchegiani:  Most people confuse it and they think, “Oh, you’re gonna be ripping up your body. You’re destroying your muscle.” It’s like—well, my body’s not stupid. It rather burn the nutrients that are in it versus taking away lean tissue, right?

Evan Brand:  Yeah, so—so don’t starve. This is not starvation–

Dr. Justin Marchegiani:  They’re confusing the physiology.

Evan Brand:  Yeah, totally.

Dr. Justin Marchegiani:  They’re confusing it and that happens all the time.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  And it drives me nuts so people need to really understand ketoacidosis and nutritional ketosis, and they need to understand ketosis vs fasting vs ketosis vs adequate calories and also ketosis at the acidotic level because of cirrhosis or type 1 diabetes.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Well, I think that’s pretty good there. If you would have sum it up, what’s the take home, Evan?

Evan Brand:  Well, take home. Try it out. Make sure you’re eating enough food. It’s easy to undereat if you’re basically cutting out, not almost, not an entire food group but essentially, so make sure you are getting enough good fats, enough good proteins, your coconut oils, your avocados, your avocado oils, your good meats, your good veggies. You know, your leafy greens are excellent. Stay away from the chemicals. If you start to crash, if you notice your outer one-third eyebrows going away, if you notice hair loss, if you feel like you’re a little bit more sluggish, you feel like hands and feet are getting cold like you alluded to, get some tests run. You can get some blood panels run for thyroid. You could get your adrenals tested to see if you’re just tanked out. Maybe you can’t go super ketogenic. Maybe that puts an extra stress on the body and you’re—you’re just not ready for that right now. So make sure your adrenals are healthy. Make sure your gut’s healthy and I think you’re gonna be—you’re gonna be on your way to—to weight loss if that’s a goal which is why many people go to—to ketogenic approaches.

Dr. Justin Marchegiani:  So who should do this? Cancer patients, Alzheimer’s patients, anyone with metabolic syndrome, right? Waist size 35 or bigger for a woman, 40 for a man. Blood pressure, you know, in the 140s or up. Any bit of inflammation, chronic pain, any of those symptoms. A good therapeutic trial of a Ketogenic Diet, Paleo style, Paleo template is a great starting point and again if you enjoyed this show and you’re applying the information and loving it, sharing is caring. Also give us a 5-star review. We appreciate it and click below this screen and you can help us out.

Evan Brand:  Yup.

Dr. Justin Marchegiani:  Evan, it’s been real, brother.

Evan Brand:  You, too. Take good care.

Dr. Justin Marchegiani:  You, too. Bye!

Evan Brand:  See ya! Bye!

Why Is Your Brain Starving?

Why Brain Is StarvingBy Dr. Justin Marchegiani

Alzheimer, dementia  and other neuro-degenerative diseases are on the rise with no real end in site.  Many people aren’t aware that you don’t get Alzheimer, Dementia or neruo-degenerative disease in your 60’s, 70’s and 80’s.  These are conditions that start in your 20’s and 30’s, and once enough damage and degeneration has occurred, the tell tale symptoms finally begin to manifest.

There are a few underlying patterns that tend to exist with conditions of this nature.  The first being insulin resistance, and in some circles it has even been refereed to as Type III diabetes.  The second being auto-immunity driving neuro-degeneration in the brain. The third underlying factor is environmental toxicity including heavy metals like aluminum, mercury and lead.  Most of today’s blog will be on the insulin resistance component.

It is a scientific fact that the brain only represents about 5% of our body weight yet consumes nearly 25% of our nutrition and oxygen.  As we consume excess carbohydrate and refined sugar past what our bodies can handle, our brain becomes less capable of being able to utilize the glucose in the carbohydrate for energy.  The insulin resistance that builds up from the excess glucose essentially keeps the glucose trapped in the blood stream where the cells can not receive it, which then causes our brain to starve over time.  If the brain is starving for glucose, the fuel needed to power our higher brain function is no longer accessible.

Optimize brain health by clicking here.

I know what you are thinking, we just need more glucose, glucose is good, right?  It’s important to remember that it is the excess glucose that has caused this whole problem.  Excess glucose in the blood causes (advances glycation end products) AGES, which are free radical magnets that damages our DNA and sets us off in the fast path for accelerated aging (AGES causes wrinkles too).

brain

What the most up to date research is showing is that our brain can adapt to burning fat or ketones for energy. Essentially 80% of our brain can run off of ketones, so other areas that were perhaps starving, now have access to a new fuel that can bring to life parts of the brain that may have been a sleep.  One of the most popular fats that are being used are MCT’s (medium chain triglycerides) which are abundantly found in coconut oil.  These fats are unique because they are easily digested and converted into ketones which become brain food rather quickly.

Next time your sitting down to a meal, it’s a wise choice to avoid the excess sugar and refined junk and eat organic whole foods especially vegetables, healthy fats and proteins.  The solid portion of your brain is 70% fat, so make sure you get an extra serving of healthy grass-fed meat, wild salmon and coconut oil.  This will help your brain function at the highest level possible and help prevent the occurrence neuro-degenerative disease in your future.

Click here for more ways to improve brain health and functioning.

Ways to Improve Brain Healthand Function


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.