Dom D'Agostino on Fasting, Ketosis, and the End of Cancer (#117)


“The FDA may see ketones as a drug. I see them as a fourth macronutrient. You have fats, proteins, and carbs. Ketones are an energy-containing molecule.” – Dom D’Agostino

Dr. Dominic “Dom” D’Agostino (@DominicDAgosti2) is an Assistant Professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine, and a Senior Research Scientist at the Institute for Human and Machine Cognition (IHMC).

He has also deadlifted 500 pounds for 10 reps after a seven-day fast.

He’s a beast and — no big surprise — he’s a good buddy of Dr. Peter Attia, my MD friend who drinks “jet fuel” in search of optimal athletic performance.

The primary focus of Dom’s laboratory is developing and testing metabolic therapies, including ketogenic diets, ketone esters and ketone supplements to induce nutritional/therapeutic ketosis. D’Agostino’s laboratory uses in vivo and in vitro techniques to understand the physiological, cellular and molecular mechanism of metabolic therapies and nutritional strategies for peak performance and resilience. His research is supported by the Office of Naval Research (ONR), Department of Defense (DoD), private organizations and foundations.

You can find the transcript of this episode here. Transcripts of all episodes can be found here.

#117: Dom D'Agostino on Fasting, Ketosis, and The End of Cancer

Want to hear another podcast discussing ketosis from a world class scientist? — Listen to my conversation with Dr. Peter Attia. In this episode, we discuss life-extension, drinking jet fuel, ultra-endurance, human foie gras, and more (stream below or right-click here to download):

Ep 50: Dr. Peter Attia on Ultra-Endurance, Drinking Jet Fuel, Human Foie Gras, and More

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QUESTION(S) OF THE DAY: What questions do you have about ketogenic diets that we didn’t discuss in this podcast? Please let me know in the comments.

Scroll below for links and show notes…

Selected Links from the Episode

Connect with Dom D’Agostino:

Facebook | TwitterUniversity of South Florida

Show Notes

  • How Dom D’Agostino responds when someone asks him, “what do you do?” [5:28]
  • Describing the Institutional Review Board (IRB) [9:53]
  • Research on advanced lifters in a state of ketosis [12:13]
  • Thoughts on getting big (hypertrophy) and strong while in a state of ketosis [15:53]
  • Defining ketones and ketosis [20:48]
  • The implications of fasting, nutritional ketosis and/or exogenous ketones for preventing/mitigating the onset of neurodegenerative diseases [28:23]
  • Defining cachexia, sarcopenia, anabolism, and catabolism [30:48]
  • Thoughts on the use of anabolic agents in cancer patients [34:48]
  • The advantage of SARMS instead of pre-existing low androgenic anabolic therapies [38:53]
  • To what extent is it possible to mimic the benefits of pre-chemo therapy fasting with exogenous ketones? [43:23]
  • How to accelerate the induction of ketone projection through use of exogenous ketones[49:18]
  • Ketone esters [56:13]
  • The benefits of eating exogenous ketones while in a carbohydrate attractive environment (for example, when traveling in Italy) [1:16:08]
  • What a traveling ketogenic breakfast looks like [1:20:43]
  • Reasons for using glutamine [1:25:08]
  • Thoughts on being considered a “nutritionist” [1:32:18]
  • The impact of Metformin on the survival rates of animals that have metastatic cancer [1:41:38]
  • If Dom D’Agostino learned that he had advanced cancer, what tools would he use to fight it? [1:46:18]
  • Thoughts on therapeutic fasting [2:03:03]
  • Observations of people who experiment with fasting [2:08:23]
  • Describing the risks and toxicities of consuming a cocktail of exogenous ketones [2:14:33]
  • Unusual foods or beverages that spike ketone levels [2:22:45]
  • Top resources for those seeking to learn about a ketogenic diet [2:41:33]
  • Most gifted books [2:43:13]
  • How to approach fighting Lyme Disease with the ketogenic diet [2:50:18]
  • The effect of ketosis on mitochondria [2:53:18]
  • Healing from use of antibiotics [2:55:53]

People Mentioned

The Tim Ferriss Show is one of the most popular podcasts in the world with more than 900 million downloads. It has been selected for "Best of Apple Podcasts" three times, it is often the #1 interview podcast across all of Apple Podcasts, and it's been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.

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400 Replies to “Dom D'Agostino on Fasting, Ketosis, and the End of Cancer (#117)”

  1. Loving this episode so far! (haven’t finished it yet) but I was wondering if you would consider asking more questions about your guests’ opinions on vegan/vegetarian/plant based diets. I’m an ex-vegan, and often the data that community sites is in direct conflict with other studies, so I think it’d be interesting to hear en educated opinion on going vegan in terms of health and athletic performance. The more I learn about it the more it seems like playing russian roulette with your body (I’m currently recovering from adrenal fatigue likely caused by the vegan diet…), but I’d love to hear a more definitive guess. Thanks so much, I love the show and look forward to it every week!!

    1. Fiona, I’m doing keto version of vegan diet and intermittent fasting and lots of weight training. I’m using different vegan supplements to make my diet work. I do think vegan diet can work but you have to eat so much and best quality of plant foods AND spend lots of time designing your diet, cooking eating…it’s just not doable for 99% of people, even for healthy fanatics like me.

      I’d be so interested in research comparing animal keto diet vs vegan one. And it’s so fascinating for me too that there is so much conflicting data about vegan diet and healthy diet including lots of animal products and not so much of animal products.

    2. Hi Fiona — I appreciate the comment! Typically, I don’t ask this question, as I think the data are definitively in favor of an omnivore diet for athletic performance. There are few scientists I know who would take the plant-only argument, unless they have overriding political or moral arguments influencing their interpretation of the literature. Just my 2 cents.

      1. Vegan versions of the ketogenic diet are implemented by dietitians working with the Charlie Foundation. I have taken what they do and suggested similar diets for athletes. Lacto-ovo is pretty easy, but vegan can be challenging

      2. Vegan version of the ketogenic diet is difficult, but dietitians working with the Charlie Foundation have used it often. I think they have posted guidelines and sample menus on the site. Lacto-ovo ketogenic diet is pretty easy and I know many that follow this.

      3. I do think that some animal products might be very beneficial and necessary because of essential nutrients that are easier to get from animal foods, essential fatty acids is one example. Although I also believe the amount of animal products and food for that matter is overrated. AND those things can be taken as whole food derived supplements anyway AND not necessarily from animal sources. And then nutrition science is still young and it’s discovering new things that work and don’t work all the time. What scientists believe today might be different tomorrow. Nutrition should be personalized, like anything else.

      4. Thank you for the info about Charlie Foundation and their work on vegan version of ketogenic diet Dom! Much appreciated!

      5. First thank you for this! Very interesting. As for a ‘ketogenic’ vegan diet, I don’t think is that difficult at all if you know what to eat (AND HOW). For example nuts are great but unless you eat them as a paste you won’t absorb much fat or nutrients. I did it for some time and felt great but on the long term I have my concerns with ketosis and lack of some good enzymes, same as everybody I guess. MSM, Superfoods high in protein, omegas and minerals (spirulina, chlorella, hemp) then just don’t forget my fave fat out there, CACAO. I have been pretty much living on this miracle food for years and in terms of energy and awareness levels I have never been let down.

      6. I agree that it’s harder for a human body to get all the nutrients from a plant-only diet in short-term. What diet do you think is best from the perspective of mankind and the future of our planet?

    3. I too am very interested in ketogenic vs for example, The Hippocrates Institute sprout and raw food diet for cancer ( on the East coast of Florida but not a scientific research institute). This podcast made sense and was fascinating however two days prior I sat in on a lecture at the stated institute with testimonies by audience members whom were ” cured” during their stay.

  2. Since BMI is based on weight and height a higher BMI due to increased muscle mass would not result in a “pudgy” woman…

    1. It was just a general response. I dont think he meant it as a blanket allegation towards ALL women at that BMI or higher as being pudgy. Also, BMI is a bullshit and antiquated method.

    2. BMI seems like a fairly pointless measurement as it takes nothing beyond height and weight to compute a ‘value’ – it assumes that weight gain is due to fat only and not to muscle mass, and ignores the possibility of extremes of fat or muscle mass, which would both skew the result. (The BMI ‘ideal’ is really a think and weak individual, imho, and not really ideal at all.) The fact that many organizations (such as police departments, insurance companies, and government agencies) actually use BMI tables to judge applicants shows that in-depth knowledge of what it means to be healthy is severely lacking in many segments of our society.

  3. My boyfriend has been on the keto diet for a few months now but recently stopped after going to a doctor for a checkup – his LDL cholesterol was high (140 when normal range is 100). Any thoughts on that? Also, any chance I could set you two up to meet so you could talk about it in person over coffee or a meal? (:

    1. There’s keto diets and then there’s keto diets.

      I’d be curious to learn more about what your boyfriend was specifically eating during his keto diet. I suspect that if he was eating processed foods or following a commercial meal replacement program (such as those keto bars/shakes etc) they might contain artificial compounds which could disrupt endocrine systems in the body, resulting in abnormal test results.

      All diets, regardless of whether you’re keto, high carb, etc should focus on quality foods from whole food sources. There’s absolutely no point on using highly processed foods in place of real foods.

      A keto diet which basically consists of meat & low carb veggies should not result in any cholesterol or inflammatory markers in any healthy individual. If he was following a very clean whole food keto program – then you might want to suggest he has some other follow up tests done to get to the bottom of this.

      1. A keto diet consist of Fat, you forgot the key Macro. “A keto diet which basically consists of meat & low carb veggies” Saturated fat is included in those fats and other healthy animal fats, which have cholesterol. Please read Cholesterol Clarity.

    2. I would hardly say 140 is “High” LDL. If total LDL was over 240 or so, I think that could be cause for concern. Ratios and other markers are far more important. Listen to Tim’s discussion with Peter Attia.

    3. Please hear the interview portion where Dom speaks of removing dairy from keto diets. This should provide clues.

      1. For those interested that info on ldl’s and cutting out dairy is at 2:30:30 in the podcast

    4. Also Mio, I’m doing keto diet but vegan version. I just feel better this way. Not a moral or religious thing. Maybe try to make you BF eat more plant keto foods instead of animal products? not suggesting going completely vegan just less animal products.

      I would definitely ditch dairy for coconut milk and cream, cashew milk home made is amazing too. Especially if dairy is conventional store-bought. Milk “from grandma” and what you buy at the store these days are completely different things.

      And in general I totally agree with JB and comment below about the quality of food. For example grass-fed beef have different nutrition profile compared to grain-fed, former has much richer essential fatty acids content.

      Those small details here and there can make a HUGE difference!

    5. Way too much is made of the “dangers” of cholesterol. My LDL also increased on LCHF and is considered high by conventional standards (168).

      1. Have the LDL particle size tested. Large particles (denoted A) are associated with lower risk if CVD, while small particles are not desirable.

      2. Then take ratio’s into account. Triglyceride / HDL below 2 mg/dL and Total Cholesterol / HDL below 4.5 is associated with little risk.

      I got this info from Ivor Cummins on youtube here – – entitled, “The cholesterol conundrum and root cause solution”. Long lecture but well worth the time.

    6. Have him read the book Cholesterol Clarity. That is so yesterday with not knowing current science, you BF doctor needs to be re- educated.

    7. Before you worry about Cholesterol, I strongly recommend you get the book, either in print or audio called: The Great Cholesterol Myth by Dr Jonny Bowden MD and Stephen Sinatra PhD.

      The whole Cholesterol thing is a myth.

    8. This is an old comment but: If it were me I’d be more interested in my HDL numbers and small-LDL particle numbers, HDL:LDL ratio, etc. Total number and total LDL don’t really tell anybody anything. I’ve also heard it’s normal for someone’s LDL to go up the first few months of keto or even regular low carb. LDL is the lipoprotein that carries cholesterol from the liver to everywhere else in the body, not just to the arteries. Cholesterol is a structural molecule that among other things makes up part of your cell membranes and is a substrate for your hormones. If your boyfriend’s been eating crap for years and his body’s been on the fritz, this could just be his body trying to heal itself. If it were me in this situation I’d just continue to monitor and see if the LDL drops, especially if HDL is higher, the ratio is good and he doesn’t have small-particle issues going on. (Some small-particle presence is normal, lots is trouble.) I bet his triglycerides have dropped too, which isn’t cholesterol but usually counted as “lipids”.

    9. I recently found myself with the same dilemma. After 6 months on a low carb high fat diet I’ve lost ~17lbs (-12%). Half way into this I discovered 4hb and Tims podcasts and proceed to cut out ALL dairy (except butter in coffee). Consumed essentially all whole foods (organic where possible), used exclusively olive and avocado oil, and lots of whole eggs.

      Last months lipids test showed confusing results:

      Total cholesterol 268

      HDL 73

      Cholesterol/HDL 3.7

      LDL 186 (up from previous test)

      Triglycerides 20

      A couple of these appear to be pretty high but it has been very difficult to interpret since there seems to be current research that contradicts some existing guidelines.

      Dom addresses this question (high LDL) in detail around 1:10 of his q&a podcast (#172) but didn’t really define what “skyrocketing” levels are? And his guidance seemed to suggest that prolonged elevated levels shouldn’t be ignored. Furthermore he clearly took action to bring his own levels back in line and seems to track them regularly.

      Makes me think the jury is still out on this issue, or at least what safe levels or markers actually are.

      I would prefer to continue a LCHF diet but don’t want to compromise cardio health – what to do? I will be looking for some professional advise.

      For anyone interested I found the following articles to be current, detailed and credible support:

      Thanks Tim and Dom for all the great content.

    10. Don’t give a shite about cholesterol levels , unless you have familial hypercholesterolia like for real get n official diagnosis of it. I had a physio prof in med school laugh about the aggresive use of statins and that his opinion is that unless your total cholesterol is 300+ don’t worry about it. Check out a couple of Peter Attia’s lectures on it as well when u can.

  4. It would be nice if you had a show that discussed getting started in the gym. Basic exercises, reps, weights. The stuff a new person would need to know when they walk into the gym for the first time. Also. Free weights vs machines? Is a treadmill useful? Thank you.

    1. You might want to check out his interview with Charles Poliquin and then go to his stite: His videos on the site have made all the difference in the world for me (haven’t lifted in three years and probably fifteen seriously) and felt like a newbie again. Good luck!

    2. Grab a copy of the four hour work week or listen to podcast #57 on the Tim Ferris show these are great starts.

    3. Some of the podcasts interviewing various trainers are fairly comprehensive. Good to listen to in bulk if you want to glean info from a range of sources (which is always wise when starting out).

      To answer your questions though – machines and treadmills will NEVER be as effective as picking up a free weight or going for a jog in the fresh air & sunshine.

      All the best with starting out your training, remember – don’t succumb to information overload, keep it simple.

  5. Where can I get quality androgynous ketones ? I’m assuming those raspberry ketone pills/supplements aren’t the real deal.

    1. Stoked to listent to this show! I always love talking to Dr Dom –amazing guy doing critical work in metabolism.

      Aaron, raspberry ketones are NOT the same at all and completely different even though they have the word “ketone” in them. There are some ketones salts on the market as they are a legal over the counter (OTC) supplement. One of them is KetoForce from prototype nutrition. -Mike T Nelson

    2. your assumption is correct. but you dont need exogenous ketones to be in ketosis. you can use fasting for that matter, though it’s much more uncomfortable at first

  6. This stuff really links up with a lot of what Wim Hof was talking about – maybe they are connected? Remember Win saying he ate once a day

  7. Quite a bit of focus on BCAA’s but not much commentary on Essential Amino Acids (EAA’s). I would expect appetite satiating and ketosis acceleration to be even more enhanced via use of EAA’s but curious if Dominic has any opinion on this, if you happen to snag him for a post-podcast Q&A.

    1. I would be interested in that too and off hand, I have not seen any research in that area. From what I have seen, EAAs don’t have much of an insulin release as you know, hence should not decrease ketone production. Good question Ben and I trust all is well with you!

    2. Funny to see your comment here, Ben, as I was thinking of your recent Podcast episode with Denise Minger, who presents the opposite side of the coin: very high carb, low fat. I’m curious of Dr. D’Agostino’s perspective on this – especially Minger’s perspective that carbs + fat are damaging (insulin + fatty acids), but carbs alone or fat alone are not.

      Also, I’m curious about D’Agostino’s thoughts on high LDL cholesterol levels that many people experience while on keto. He mentions that he got his down from reducing dairy fats; that seems to imply that he was concerned by his levels.

    3. Hey Tim (and Ben). Peter Attia (on your podcast) and Ben Greenfield (on his podcast) both talk about the downsides of Ketosis and that perhaps it’s not for everybody. This certainly seemed to apply to me. It would have been interesting to hear some of Dominic’s thoughts on what contributes to the variance and wether exogonous ketones would assist. – Maybe with a post pod cast QandA.

      1. Yes, I had experienced some pretty significant luteinizing hormone downregulation which affected testosterone, and also a big drop in T3. Now mitigating most of that with cyclic ketosis. Would be interesting to do an N=1 with LOWER levels of physical activity combined with ketosis. But then I’d need to become a golfer.

    4. I think EAAs can be helpful pre-workout and with intermittent fasting. Not sure it was mentioned, but I typically blend lysine into my BCAAs powder

      1. You suggest taking Xtend for BCAAS but how do you explain the rational behind taking it when sucralose, Artificial Flavors, and FD&C Yellow and Blue are in there? I would like to take it but how can I justify it when these “other” ingredients are in there.

      2. I think you are going to find that eating healthy balances of macros outweighs the statistically small effects of some sweeteners and food colourings. People need to worry about their macros first to get the biggest changes in their health and then start worrying about small tweeks. If the flavour makes you more compliant with a better macro diet I think it’s just worth it. Like Dom said, if it doesn’t taste good, people are not going to eat it. Once macros are right and you are getting the big changes in your health, then you can search for ways to tweek these small changes in the diet that get you a little closer to the perfect healthy diet. (if there is such a thing) There is always going to be a factor of satiety and I think you just need to choose satiety over heatlh in areas where the statistical relevance of the decision is small.

      3. You can always buy BCAAs in bulk and mix them with water. If I’m going to use them, I prefer that to the artificial colors and sweeteners.

      4. Ben, Xtend has a Raw version of their BCAA product, with no sweeteners, colors or flavors, but it appears to have a “bitterness blocker”, whatever that is.

      5. Dr. D’Agostino, I don’t thing that was discussed on the podcast. What is your usual blend percentage of L-Lysine to Xtend BCAA powder? Thanks for a great interview.

    5. I agree I like EAA’s better than BCAAs plus I’m not a huge fan of using a ton of Leusine to put the mTOR pathway on overdrive. Its not all good to do that without care of downstream consequences.

  8. TimTim! Another great one for the records! Not trying to flatter you, such nonsense is for the weak, but you’re getting pretty damn good at teasing out these golden nuggets of wisdom for us all to put to practice.

    Thanks for the good times,


  9. alert! weird website problem!

    I clicked “click here for transcripts” to get a transcript of D’agostino ketosis transcript.

    Received a big “thank you screen” but no leads to a transcript! ie a deadend screen.

    What gives?

  10. Tim,

    I’ve been on a ketogenic diet for the last three years. As a former endurance road cyclist, it worked wonders for me. The one notable difference I found being in ketosis is that my dreams are vivid at night, since I also supplement with 5 tablespoons of coconut oil daily. These days if I fall out of ketosis, it takes very little time to get back in due to adaptation. Thanks for a wonderful episode. Dom is one smart cookie!

  11. If you do a followup with Dr. D’Agostino, I’m curious of a few things:

    1. You talk about a need for less sleep while on keto in the episode. I too find myself going from 9 hours of sleep with moderate carb, to sub-7 hours with keto. However, I’ve found that it’s noticeably fragmented, and I wake feeling “tired, but wired”. Has he seen this, and if so, does he have any tips?

    2. I’ve noticed my T, Free T & libido all declined while on keto (blood & bedroom tests!). This could be due to the fragmented sleep while on keto, but I’m curious if this has been observed in others, whether clinically or anecdotally. Any thoughts?

    3. D’Agostino mentions that he has decreased his dairy and meat protein intake and replaced it with fish. Is this related to longevity concerns? Insulinogenic properties of dairy/meat? Something else?

    4. Any plans to make an *affordable* ketone ester or ketone salt?

  12. If you anyone in community knows what is essentially “allowed” during fasting for the five days per Tim or Dr. D’Agostino please reply. I listened twice at least and didn’t pick that up.

  13. Among the best so far from my perspective. The problem for me is these episodes that have diet, nutrition, science of any kind are the squirrel to my inner dog… puts me into a 3-4 day research binge. Thank God and Tim for Evernote; I’m learning to file the research for future reference. Thanks Tim for another great time.

    Mio, your boyfriends high LDL by itself, is only part of the story. I worry if his triglycerides are also high; does he have positive family history, ie. father or brother suffer from heart disease before age 55, mother before age 65. Your boyfriend needs an expanded assay for blood lipids. Most primary care physicians can do this if they know about it. Otherwise, he’ll need a Cardiology consult.

    High LDL is further broken down into small and large particles. Some studies have the smaller LDL particles positively associated with cardiovascular disease risk. You can dig deeper for understanding here.

    Here’s the deal. I’ve played around with diet for years causing these lipid panel numbers to literally jump rope. Let your food be your medicine.

  14. Tim, I am enjoying your site and look forward to exploring and listening. While I admittedly, I haven’t read much, and have only heard a few of your interesting guests and podcasts, am impressed by the variety, and your style – you really do a great job (and Terry Gross is my fav ;). I do have a question, I hesitate to ask as I’ve explored to little. Being of the female persuasion, so much research and info information is geared toward men, (yes I know you are a guy … ). I understand lots of info works for both genders, but some does not. I know it’s a tall order, but I would be grateful to to see and hear future episodes and information as applied to women.

    I sure hope this is taken in the spirit intended!! Keep up the GREAT work!!


    1. Lots of women do keto Sally. It’s esp. useful if you have PCOS or PMS, as it fixes those problems for most practical purposes in just a few months. So it’s great when you want to get preggers. You’ll also grow great hair & nails if you make sure to eat adequate calories – undereating on keto will lower your thyroid. So be sure to eat at least 1500 calories, minimum a day. When measuring your ketones on the blood meter, note that during your period your ketones will vary. They will very likely measure lower for a bunch of complicated reasons having to due with fertility. But a couple of days after your period, they’ll rebound. The metabolisms of pre-menopausal women are different than men’s in important ways, so treasure that. 😀 While some women really benefit from fasting, others find when they do hormone tests that it lowers their hormones & could interfere with ovulation. Your body wants to ensure you have the resources to carry a baby so it won’t ovulate or implant if it senses you’re in an energy-poor environment. So experiment with fasting if you want, but test your hormones to make sure you’re not compromising your fertility or losing your period.

  15. I checked the referenced BCAA product Dom recommends from Scivation. It has sucralose, artificial flavors, and artificial dyes. Really???

  16. Fabulous! Yes to Part II. Thank you both so much. Thanks, Tim, for asking the “What would you do . . .?” question; I have friends dealing with stage IV cancer and I’ve been advocating much of the same things (even the DCA, which I learned from Cancer Compass), unfortunately to little avail, as the oncologists poo-poo what they don’t understand. In any event, I appreciated the affirmation, if nothing else. And it is affirming of my choices, having been in NK for over 2 years (running 1.3 to 1.8 mmol., typically), female, 61, no meds, very healthy (HDL 118, triglycerides 30, etc.). So this is one of my favorite topics, and I hadn’t heard Dom since AHS ’14, so thanks again.

  17. Wow! Great podcast! Dom is loaded with wonderful insights! More, please. I am trying to manage my prostate cancer and very much appreciate so much to consider.

  18. I would like to know if physiological insulin resistance is a significant consequence of long term keto genie diets and if so, how long it should take I reverse this.

    1. My personal experience with ketosis is that if I keep it up long enough I become a lot more sensitive to sugar intake. Like, drinking just one 12oz can of full-sugar soda (real sugar or HFCS, doesn’t matter) would make me sick. But when I’m high-carbing it I’m way too tolerant of that stuff and wind up overloading on it. And once upon a time it was taken for granted that if a person overindulged on sweets they would make themselves physically ill, something we don’t hear a whole lot about anymore. Given that I have more IR when I’m eating high carb and not making myself sick from it, I’m not sure how I could hold on to it in ketosis and then have this physical backlash when I indulge. Something interesting is going on there.

      And face it, as long as you’re absorbing amino acids into your muscles you’re doing pretty well anyway.

      1. +Dana. I have experienced this same effect but I generally stay in ketosis all of the time now since I feel so good on it. I basically follow the Wahls protocol (modified whole foods based ketogenic diet with MCT oil and a lot of vegetables (6 cups per day or thereabouts). I get great lean muscle gains on this approach as well as a host of other positive benefits.

  19. Tim, there is a technical issue on the page. When you click: “Click here to access the transcripts”, it takes you to the popup that asks me for my email address and then after I do it, it does not take me to the transcripts. It is frustrating.

  20. Your podcasts raise the bar everytime when it comes to broadening my horizons, keep up the good work! I was also wondering: Would taking an antioxidant stack whick targets the mitochondria(Idebenone + PQQ + Shilajit) somewhat blunt the hormesis effect of a keto diet? Any answer would be greatly appreciated since I’ve had great results with this stack while NOT being in keto but I would possibly consider dropping it if keto could help me achieve similar results as regards mitochondrial health.

  21. Awesome interview Tim!

    I would love to know your opinion on whether it’s ok to use stimulants while doing fasting. If you have any knowledge on this topic. To be specific do you think there is any problem with drinking coffee while fasting ? Or taking low dose (20-30mg) of amphetamine for example ? I’m planning to do 10-14 days fast, starting from ketosis (at least 2mmol/l bhb levels) and this is probably last thing I’m curious about.

    Thanks a lot 😉

    ps: Huge fan, for a long time.

  22. regarding fasting (and can you do a full show on it) – can I drink diet coke while fasting? How about green tea?

    Can I still take a multi-vitamin while fasting? Salmon oil? Vit D?

    Is fasting just zero calories for a set amount of time, or do I need to exclude everything but water?

    1. Not to be critical but diet coke is one of the worst things you can put in your body bar none. It is highly acidic and many common artificial sweeteners are proven carcinogens. Just drink lots of Electrolyzed Reduced Water ideally from an Enagic ionizer machine. Also avoid RO water since it will leach minerals.

  23. Hello Mr. Ferriss I’m a high school student who would like to ask you a few question on leadership and your definition of the word and what has shaped that definition in your life for a research project. You can contact me via email [Moderator: email address removed]. Thank you have a good day.

  24. Unfortunately the interview with Dom is simply too long for my attentions span. It was be greatly appreciated if you would summarize it with bottom line take aways for the ketogenic lifestyle, i.e. diet, etc

    1. +Brian — Interesting as I would have preferred the interview to last for at least another hour. So much great information here….

  25. When Tim and Dom use the word “Fast” does that mean eating absolutely nothing, eating nothing but fats, or eating nothing but ketones?

  26. I was wondering what Tim and Dom’s definition of fasting is. I always thought it simply meant eating nothing. I have heard some people talk about eating solely fats to maintain a fasting state. So my question is does fasting mean eating absolutely nothing, eat nothing but fats, or eating nothing but ketones?

  27. I thoroughly enjoyed this interview with Dr. D’Agostino. I have been on a Ketogenic Diet for about 8 months now and I am always looking for new information; I must say that this interview delivered the goods. I learned a lot of new information concerning dichloroacetic acid, metformin and new dietary information, especially fasting. I really enjoyed learning about how Dr. D’Agostino nourishes his mind and body on an average day. His cutting edge research and knowledge is very exciting. Thanks!

  28. Tim, Would love to see more of this content – but from a female perspective. Because there seem to be some important differences with how ketosis affects women compared to men.

    1. Agreed!! I feel like keto is such a boys’ club at the moment. And while I loved this whole episode to bits, I was nonetheless a bit thrown by his comments about women, especially on women and fasting. Obviously men and women have different responses to both keto and fasting, and these should be looked at rather than cackled at in a throwaway comment.

      1. In the sense that most people who are doing, and discussing keto (online), and researching keto… are men.

  29. Is the brand correct for the Dom’s favorite oysters? I can’t find either King Oscar or Wild Planet oysters on the links or using the google.

      1. Used the link above to get oysters on Amazon – the Crown Prince Oysters – PHENOMENAL!! Who knew canned oysters could be so good? Even my son ate a bunch of them.

        I think this is officially my most re-listened to episode. So much good information. Thanks Tim and Dom

  30. Wim Hof said he normally eats 1 meal a day. Do you believe his fasting (and subsequent ketosis) contribute to his iceman powers? Seems likely to me.

  31. For anybody interested in further exploring the intellectual evidence for the existence of God, I can’t recommend Norman Geisler and Frank Turek’s book “I Don’t Have Enough Faith to Be an Atheist” highly enough. Using only logic, scientific evidence, and historical facts, it proves how we know truth exists, how we know God exists, and how we know he is the God of the Bible. It may not make you a believer, but it will convince you that believing in God is not silly or anti-intellectual. It absolutely destroys the moral relativism that permeates popular culture and underpins much of secular academia.

    1. Tim is a self declared athiest and should read that book. I would love to hear an inbetween-a-sode of his anti beliefs and reasoning. Guarantee it’d be controversial and create a firestorm that he loves. This is one topic he seeems unwilling to attack at least publicly. Feeling uncomfortable about it? Yes, what Neil Gaimen says.

  32. Man oh Man – This was one of my favorite episode so far. I’ve heard Dom on a few other interviews and this is no doubt the best. MCT powder, Ketogenic Cows – WTH. I know that you’ve been talking about writing an article on Keto, but honestly, this episode covers all the bases. Good Job Tim – Keep up the great work!

    1. Right around 2hr 26min 30sec

      Keto-Mousse or Keto-Ice Cream

      – 1-2 Cups Sour Cream or Coconut Cream (optionally mix both)

      – 1 Tablespoon Extra Dark Chocolate Baking Powder

      – Dash of Cinnamon

      – Pinch of Salt

      – Pinch of Stevia (as desired)

      Stir until thick.

      Put in Freezer for ~30min

      Other options:

      – Add 1/3 to 1/2 Cup Blueberries

      – Add Tablespoon of Coconut Oil with Frozen Blueberries in it

      1. @Mike Eads, minor timecode correction. Keto-Mousse/Ice Cream begins at 2 hr 36 min 21 sec and ends at 2 hr 41 min 36 sec.

      2. Just at made and ate this Keto Mousse ice cream – amazing! I do love the way the coconut oil takes like little chips. Very good.

  33. Are the links for Dom’s favorite oysters correct? Neither links lead to an oyster product and a googling of king’s Oscar and wild planet doesn’t yield any oysters.

  34. Hey Tim,

    Really great talk with Dom. One thing I wish you would have touched upon is fasting for athletes. I’m a climber, and train hard 6 days per week. I’d love detailed info on fasting for athletes in training.

    Keep up the great work!



  35. Wonderful interview! I would love to listen to a “Part 2” with Dominic D’Agostino. I have a question about glutamine. Thomas Seyfried also warns against it for a ketogenic diet for cancer. I’m following the anti-CA form of a ketogenic diet due to a CA diagnosis – above 80% fat, a much smaller amount of protein (2 – 3 oz of protein per meal, which for me is typically 2 meals a day) and very low carb (9-11 grams per day). I recently checked food sources of glutamine and found that mushrooms are high in glutamine. Bastyr, a naturopathic university in my area, recommends Turkey Tail (Trametes versicolor) mushrooms as part of its oncology protocol. I know that Turkey Tail mushrooms enhance the immune system, but since mushrooms are high in glutamine and also would seem to be a source of saccarides, should they be limited or avoided? Thanks!

  36. I’ve been a loyal podcast listeners since the very first episode. Listen to every minute of every episode, until today. This episode got so far into the weeds, I couldn’t understand what the hell was going on. I made it to 1 hour 7 minutes, then just had to shut it off. Tim, you are generally awesome at getting your guests to translate there Martian language along the way, but in this particular episode, you were speaking the same Martian language as the guest. Note, this was a fantastic episode for scientists! For laymen like myself, you will be completely lost! To stick with the theme of the 4 hour books, this entire podcast belongs in the boxes in the 4-hour body where you would explain the nitty gritty details for people that actually cared, while providing the basics/instructions for people that only want that.

    With love,


  37. A thoroughly enjoyable and very interesting episode, I shall definitely be listening to it again soon, so much info in there. You mentioned the option for a repeat interview, I would be very interested in this, as I’m sure many other would be.

  38. A fascinating podcast. Technically a bit over my head, but I would rather it have the technical info than not. Thank you Tim for asking about that particular cancer. I have a friend diagnosed about a month ago with it. She is still fighting it. (surgery and radiation did not work) I am hoping that she will survive it. She is a young woman of 24 and has shifted her care to a hospital Seattle. Thanks for the wonderful podcast.

  39. From this blog on Ketosis and such I found “The Tim Ferriss Experiment” but am having problems locating in itunes. Is it not available in Canada? If so when you click on link in browser it asks you to launch itunes. When I click ‘launch” it simply opens itunes but does not populate any “Tim Ferris” material. When I search all it yields is the podcasts. Advice?

  40. Very cool. I wonder if fasting actually helps with weight lifting on a physiological level, or if any observed benefits are simply tied to better mental focus?

  41. Can you point me in the right direction for signing up to the Friday email you talked about at the end of the podcast? Not seeing where to click.

  42. Maybe I missed this but you and Dom talked repeatedly about being at a certain millimole level for something. I have two questions around that.

    1) What were you measuring?

    2) How were you measuring it (and is there a way to do so that is accessible)?

    1. Millimolar blood concentration of ketones (specifically BHB). Tested using a finger prick with the Abbot PrecisionXtra device.

      1. Interestingly the Precision Xtra doesn’t appear on the Australian Distributors website, but all the lower models have ketone testing listed as features but the Abbot website only lists that for the Xtra. Is it that the hardware is different in different markets or that they try to up sell in the US by leaving out a feature on the cheaper units?

  43. Fantastic episode!!

    This episode is going to require a few replays to take it all in. Dr. Dom gives us a wealth of information, and he speaks with clarity of thought, which makes it easy to follow . BTW this dude is HUGE!

    Thanks Tim!

    Hopefully you can land another drop 5 director and/or screenwriter soon.

  44. Lately I’ve seen a number of new MLM companies touting what appear to be exogenous ketones. Is Dom familiar with these and are any of these worthy of a 2nd look?

  45. Great episode! One that will need to be replayed to get all the info that was packed in. If you were to get Dominic back on the show (which would be awesome) I’d like to get his take and/or yours on a couple of things, the first being, when approaching the keto diet how do you know when you have reached your limit and secondly, how is the diet being adopted in the medical field for both oncology and general practice? Keep up the good work Tim. One of the few podcast out there where you can come away with knowledge and a lot of times, a better understanding of something meaningful.

  46. Hey Tim,

    Fascinating stuff – I could have listened to another 3 hours. I’ll be on the lookout for round two! I’d like to hear how Dom manages his micronutrient intake (does he take a multi? Does he feel that greens are sufficient?); and also whether he’s got an answer to those who argue that low/no carb diets compromise gut barrier (the so-called “sugar wall”) integrity and GI health in general (the beneficial butyrate-producing bacteria that Dom mentions are crowded out by gram-negative bacteria on a long-term ketogenic diet – something I’ve been able to test personally. He did mention that his exogenous ketone supplement had added fiber, so I’m guessing he’s aware if this). Also of concern is the fact that the ketogenic diet is anti-inflammatory in part because cortisol is produced in excess of baseline for ketogenesis.

  47. Question:- if a ketogenic diet is anticancer, where does last weeks warning that bacon and other processed meats and probably all red meat are carcinogenic come from?

    1. different mechanisms – keto = no glucose = no food for cancer to grow. red meat = maybe causes DNA mutations = causes cells to become cancerous.

      keto doesn’t fix DNA damage, it just causes damaged cells to grow more slowly or not at all.

  48. Best podcast yet and I’ve listened to all of them. Will be listening to this one twice to improve comprehension & retention. Would be fascinated to learn more about 1) hyperbaric oxygen 2) whether the BCAA that Dom uses daily include or exclude glutamine 3) dors he recommend any of the powdered MCt products that are currently on the market, or just this new as yet unobtainable product? 4) what are the downsides to ketosis? Any rebuttals to the ray peat / danny roddy school of thought re; metabolism generally and hair loss specifically?

    1. “3) Does he recommend any of the powdered MCT products that are currently on the market, or just this new as yet unobtainable product? ”


  49. Is there a good guide on a full ketogenic diet protocol, as well as the exogenous supplementation? This had some really good info, but didn’t seem to give the full picture to get started with a ketogenic diet.

    1. In a previous 5-bullet Friday Tim recommended the book Keto Clarity by Jimmy Moore. It’s a quick read, and while it leans a bit in the evangelist direction, it’s got a lot of excellent and practical information in it.

  50. Tim, certainly one of my favs out of all your podcasts to date and I listen to them all. Could have been another couple of hours longer! Better do a part two…

  51. Loved every minute of this!!! Thanks so much.

    Really nice to hear about a massively successful keto “dieter” who doesn’t eat much red meat or dairy. Unfortunately the alternative – oysters and sardines – also sounds disgusting, but hey, at least there’s hope!

    So much I would follow up on, but I would love to hear more on using keto prophylactically to prevent Alzheimer’s and other diseases, and whether it would work for someone to take exogenous ketones instead or go in and out of the keto diet (thinking of my parents, not myself).

    Also, more info on the hyperbaric therapy, scuba divers (just for the cool factor) and whether fasting is really necessary – and how to evaluate if it’s right for you (speaking as a woman who freaks out without food). What value does it add if you are already on a ketogenic diet full-time? And lastly, was he really implying that people in the future might be able to take exogenous ketones with a standard American diet and experience all the benefits of ketosis?!

    1. We find oysters and sardines deliciuous in Spain!! Oysters, mussels… are perfect for a romantic dinner. We eat sardines with our own hands, cooked in a barbacue at a further distance than meat and covered with some lemon juiced… some parsley suits also very well. At home, the best way is ‘papillote’, as you don`t want your neighborhood smelling what you are having for dinner 😉

      Great podcast Tim! waiting for a 2nd part, and… any advantages of olive oil for being into ketosis?

  52. Hey Tim,

    If you haven’t checked it out yet, visit [Moderator: link removed] the work of Sports Scientist Prof Tim Noakes. Im new to the Ketone world, but its working for me, thanks to intro from Tim Noakes. Thanks for the podcast.

  53. Thank you for the incredible podcast, such in depth questions much more than the average questions. Look forward to more.

    Been doing the Ketogenic diet and using Exogenous Ketones with great success.

  54. Really interesting stuff here. I never heard of the keto diet before, but I’m definitely going to try it. I hope you invite Dom for a second podcast in the future. This guy has many fascinating insights.

  55. Amazing episode, filled with so many gems. Is there a website where we can buy ketones to take? I saw some brands on amazon but didnt know if they were valid.


  56. Also, on the off chance someone can weigh in on this — I’m scheduled to undergo a thyroid operation (lobectomy) under general anesthesia next Friday and the hospital staff here in the Netherlands have never heard of keto and have all given one big shrug whenever I mention I’m on the keto diet. The information online is of two minds (what a surprise), can anyone give me any info on whether I need to come out of ketosis before the surgery and if so how far in advance?

    And if anyone knows about whether I will screw up my thyroid recovery by staying on keto… Would be also very helpful.

    Thanks in advance for any advice!!

  57. Tim,

    I loved this episode. This was perfect for me as a powerlifter and researcher. It confirmed many of my feats of strength as of late. 570 X 5, 595 x 5 on my deadlift at a BWT of 165. Just did 605 X 4 off a three inch block. Going from the floor once I hit 5 reps. I am shooting for 640 at the AAU World Championships. This show also aligned well with my second doctorate. I am studying the benefits of the ketogenic diet in improving performance as well as treating certain pathologies. In particular, my interest lies in the treatment of COPD patients with a ketogenic diet. I would recommend dividing this one into three separate podcast and paired with the transcript. I enjoyed all of it but some might want to skip the weeds.

    Bill Croft

  58. Thank you for this interview Tim.

    I worry that as in other complex domains like this, say economics, there is the seen and the unseen ( )

    We see benefits from Ketosis as really well explored in your podcast but we don’t see, yet, any problems. I suspect that before we understood much about insulin it seemed obvious that muscles use glycogen therefore we need to eat carbs, or that heart attacks happened to people with furred arteries so we stopped eating cholesterol but, as time went by, we discovered the system is much more subtle and complex than we at first thought.

    I know you asked the question about downsides of ketosis but sticking a bunch of mice on a massive dose for a few weeks is only likely to reveal short term issues. A lifetime on ketosis, who knows?

    I respect a premise of the Paleo community that the burden of proof should be on those suggesting anything that recommends a behaviour that deviates far from what we would ever have evolved to do. It may be that ketosis has all the upsides mentioned on the podcast and there are no downsides but it would be surprising that we evolved as omnivores that might have occasionally been ketonic but all along would have been better to deliberately only use that pathway.


  59. Fascinating conversation. Thanks for clarifying those technical terms!

    Paper Mentioned – Published Diet on ketone bodies in the body- YALE (read abstract)

    Abstracts on Dom’s Publications

    Website mentioned – Ketogenic Diet Resource

    Benefits of Fasting and examples – start listening to audio at 1:59

    Ketosis (What is ketosis? WebMD Definition

    Preventive Chronic Age Disease

    Helps reset the body = therapeutic immune system

    Causes metabolic stress on cancer cells + purges precancer cells

    (My personal – easy to read recommendation- The Miracle of Fasting: Proven Throughout History for Physical, Mental, & Spiritual Rejuvenation [Moderator: link removed]

    What is metabolic physiology?

    Metabolic system analysis + human systems biology

    (If you want Berkeley’s definition

    Dom’s Recommendations

    Foods that can enhance ketosis? Good sources of fiber?

    Artichoke, spinach, kale, asparagus (top of list)

    Celery or any green leafy vegetables.

    A lot of Olive oil.

    Mix your food, vegetables with a source of fat.

    Eat protein with fat + high fiber


    Chicken breast alone = no ketosis

    Chicken breast + olive oil + vegetable = ketosis

    Dom’s Daily Routine

    Coffee and half a stick of butter + 2 scoops MCT powder (Dom uses MCT oil and MCT powder)

    50 grams of protein per serving – and AFTER workouts 70-80 grams

    Fatty proteins with meals

    Vegetable cooked in coconut oil, or butter.

    (Helpful article on Coconut Oil vs. MCT Oil vs. Lauric Acid: What Is MCT Oil Really?

    Bottom line – derive more energy per oxygen molecule per ketone metabolism.

    Thank you, thank you… great conversation.

    The Screwtape Letters is one of my favorites.

      1. Why does chicket breast unadorned with fats kick one out of ketosis?. Isn’t a chicken breast more or less just protein and small amount of fat? I guess I don’t understand role of pure protein in a ketogenic diet.

  60. Thank you very much for having Dom on the podcast. YES please have him back for another round of questions! The title of this podcast should be called “Temporal Distortion” as the 2 hours literally felt like 30 minutes.

    Wow, very interesting to hear about the Navy Seals and rebreather ops during Ketosis. Would be interested to see a study done on fighter pilots under high G environments using Ketosis. Might help in preventing G-LOC deaths during BFM engagements. Also wonder what effect NKD would have on high O2 intake during high altitude flights above 25K feet AGL.

    QOTD- does being on a ketogenic diet affect one’s sex drive?

  61. Tim,

    Can’t thank you enough for this episode. My father is currently battling stage IV colon cancer and the standard of care options have made me question our entire healthcare system (did I mention I hate chemo?). There’s a lot of interesting alternative treatments out there, but Dom did an excellent job explaining the mechanisms behind each treatment discussed (he would mentally (and physically) Hulk smash the average oncologist). My father has been on an alkaline diet in addition to other natural treatments, but cachexia is clearly kicking in, so I was very intrigued about the suggestions Dom mentioned about BCAA’s for maintaining weight. Definitely worth investigating all of the material discussed further so huge thanks to both of you!

    BTW, I literally yelled “F*$& YEAH TIM” when you asked Dom what he would do if he was diagnosed with terminal cancer.

    Things I’d be interested in for Round 2:

    1) The ketogenic diet cuts off the cancers fuel source, but a topic not covered was detoxification of the body, which is also a very common naturopathic treatment (the Gerson Method focuses primarily on this). Would be interested to hear Dom’s take on treatments such as coffee enema’s, juice cleanses, high dose Vit C (intravenously), IR Sauna’s, etc., and whether there would be a synergistic effect doing these with a ketogenic diet.

    2) Dom mentioned his wife processes carbs better than he does. What tests could you do to quantify this?

    Again, awesome episode Tim, and thank you Dom for sharing your expertise and latest research.

  62. This episode is sensational. A lot of dense material. What I wasn’t left with was a clear idea of what a non cancer patient might look at for a program of exogenous ketones when on and not on a ketonic diet. Just the practical stuff. What should I take? How much? Brands? Also I’m looking for the MCT Powder but I can’t find it. Any help?

    This entire topic of using food and timing of intake as a tool for health and performance is one I hope you continue to spend time on as frequently as you can. Have Dom back and do more on specific items like what a regular guy wanting to be superhuman should try if he wants to experiment on himself. Thanks Tim. Keep up the great work.

    1. I agree. I’ve listened to this episode twice in order to absorb all the information and find it fascinating. I’ve done intermittent fasting and had great benefits and am now eager to focus more on a modified Adkins diet all the time. I’d really appreciate some help selecting a maintenance exogenous ketone supplement. There were so many options thrown around on this program with only a few commercially available. Also, I’d like to make sure its applicable to someone like me – early 50s, female, post-menopausal, athletic, no need to lose weight — just looking to optimize mental clarity and energy.

  63. Possibly the most interesting podcast so far and would love a part 2!

    Q: Why do mild stimulants like coffe seem so much more effective when in ketosis? And also for me the same goes for magnesium, seems more effective vs muscle cramps while in ketosis than on a regular diet.

    The use of “Flux” and “Free radicals” in the same paragraph makes my inner geek happy:)

  64. Question re ketosis and prolonged military selction/operations

    During selection for many units the participants will enter ketosis from lack of food, what are your and Doms’ thoughts on preparing for this? Would it be beneficial to already be in a state of ketosis from the get go? Also small amounts of food is often provided to keep the sense of hunger going (wonderful mind fcuk..), would it be better to abstain from this and stay fasting to ensure you stay in ketosis?

    How do you deal with the smell from workout clothes while in ketosis? ( Non nano silver infused clothing,) ?

    1. Sustaining nutritional ketosis and periodic intermittent fasting will make you far more resilient when challenged with lack of food. High protein makes me smell whereas in ketosis I have not experienced an issue

  65. Great and very insightful interview. Transcript would be nice to have, although it would probably look more like a book 🙂

    Will definitively listen again.

  66. Great podcast! A few questions if there is a part 2.

    Dom says he eats 60g of protein at dinner – is this pure protein? I got the impression he was talking total volume of animal meat, not pure protein.

    If you add in his brekky he is eating about 100g a day of pure protein (rough estimate, put your calculators away 😉 ), pretty low for a guy that weighs over 100kg. He must have a pretty solid endocrine system, would that be a major factor in long term success on keto diet?

    When fasting, are amino acids considered acceptable? Or is it just water and ketones?

    When eating mostly fat, bcaas and protein with just one serve of greens per day, im assuming you need to supplement with additional B vitamins?

    Would cycling a keto diet periodically give additional potential cancer prevention benefits to the quarterly fast? If so, what would the minimum effective period be?

    Are there any standard blood tests that someone should get before having a serious crack at keto diet?

    Thanks again for the excellent show.

  67. This is a great interview. I’ve read Dr. Seyfreid’s book and it was an epiphany. Thanks,Tim,for going deep with Dr. D’Agostino. I’ve also followed his work. He’s truly a “bright bulb”!

  68. Hey Tim,

    thanks for this gem! Love it!

    I am on my way to try out the ketogenic diet and already read a couple of books like keto clarity.

    There is one questions which bugs me though. You and Dom touched the idea of cycling in and out of ketosis. I am wondering, how a cheat day fits into the ketogenic diet. Do you have some experience in regular (lets say one time per week) cheat days, with heavy carb and sweet eating like on the slow carb diet and then going back to ketosis?

    Thanks for the work you do!

    Greetings from Germany!


    1. i am against “cheat days” because people tend to go crazy. Occasional cheat meals (with limitations) can be a good thing, especially following heavy training sessions

      1. Dom (or anyone!), are there any resources that you recommend for fasted weight training and minimizing muscle lot during a 5-7 day fast?

  69. I was fascinated by the detail that Dom provided about ketogenic metabolism. If there is a follow up, I would love to hear some strategies for mitigating insulin responses from protein at the bigger meals (breakfast, dinner). In the four hour body you talked about cinnamon as an effective insulin mitigator: assuming that I stick to coconut oil and other MCTs between meals could cinnamon or other additives help keep me in ketosis when I eat more macronutrient complete meals?

    1. that would make a good discussion. fat and fiber play a big role in helping reduce this. there are also a few supplemental agents that could be discussed

  70. loved this podcast. thank you!

    Any recommendations for cooking and eating artichokes? I only know of boiling or steaming for long time, then pulling individual leaves off one-by-one to dip in butter and eat.


    Tony B

  71. When should women fast, relative to their menstrual cycles?

    Are there any pros/cons for being in ketosis relative to different points in the cycle?

    Or for women in general, in order to maintain a good hormonal profile?

    1. This is a good question that we don’t have an answer too. Menstruation can kick some women out of ketosis, at least based on feedback I’ve gotten.

  72. Great episode…. Tim, it’s time to start doing the “round twos” you keep talking about! Keep the new episodes coming, but go back and talk to the great guests you’ve had on so far, especially in the early days of the podcast.

    I’ve gotten something (many things) from nearly every episode, whether I was previously familiar with the guest or not.

    Two comments on technique (well, three really): Your interviews have gotten better with every episode, kudos, you started as “very good” and are now “great”. The “rapid fire” questions – well, they’re not really rapid fire, in either the question or the response. Minor pet peeve, perhaps, “random questions” 😉 Also, I preferred the earlier form of the question, “What book influenced you the most” rather than “gifted” because there are different purposes in reading than gifting. Perhaps combine the question – “What book have you gifted the most, or a book you’ve read that has had the most impact on you?” One of the guests even commented that he doesn’t give books as gifts because the act of giving a book reflects more on the giver…this was a great point.

    Keep the terrific shows coming, Tim! I look forward to each one.

  73. Tim,

    I have been a powerlifter for 37 years and I am 53 years of age. During the last 27 years, I was a hardcore vegetarian. Yes, this is an oxymoron to some. Nevertheless, I was determined to live the lifestyle while excelling in my sport. During the last 14 years, I won over 70 AAU World or International Powerlifting titles and set 74 World and American Records in the deadlift, squat and total in 165Lb class. I am reluctant to mention this since it seems like self-aggrandizement to me. It is what it is. I should mention that I set no records prior to being a vegetarian. Based on my long career in powerlifting and my graduate degrees in health and nutrition (MS, Med, PhD, and EDD-ABD), I was familiar with every diet in the media and those not in the media. I was biased towards vegetarianism based on my results. Multiple digestive issues with my gut, gradual weight gain and skin issues prompted me to change to Banting Diet or LCHF (low carb, high fat) or ketogenic diet. I was not happy with my bodyweight relative to my body fat. I was still 165 but noticed my cuts were no longer visible. My journey into a new version of the LC diet was different from the past since now I was going to 60% fat. Health conscious and brainwashed by too much education caused me to hesitate. I pressed on and made the leap in April. More importantly, I also added seafood back to my diet for one practical reason. I needed and additional protein source that would replace soy. Previous versions of LC dieting had left me starving and weak. I clearly had a great deal at stake. Would I get stronger or weaker? Would it harm my chances at claiming the World title once again? Ok, this is not as important as my health. Since April 2015, my gut issues are completely gone. However, other result came quickly that I did not expect including skin tags disappearing, dry flaky and itchy skin resolved, and my rhinitis seemed to disappear, so no more nasal steroids. Energy levels were definitely higher. With my years of training, I know my body so I can tell what a high level or low level of energy is. In addition, my waist dropped down 3-4 belt loops holes so about 3 inches. My arms are growing again, which is unusual at my age but I am loving that part. My weight is still 164-167, which means that I am adding muscle while losing fat. What about my lifting? Hold on…This is what impressed me. I was not losing strength and I had just as much energy at the end of my work as I did in the beginning. This is harder to prove but the weights speak volumes. Here are my lifting results over the 6 weeks leading up to the IPB National in October: Deadlift 405 X 5, 455 x 5, 505 x 5, and 555 x 5. 10 days out from the IPB Nationals, I pulled 570 for 5 reps. During the meet; I pulled a rather easy 605 lb.

    The point is that my results are consistent with Dom’s research. He confirmed my suspicions on the why behind the results. This was a great podcast.

    1. “Ketosis is a disease state”

      Yes and the only way to cure a woman of hysteria is to cut out her uterus. Thus the medical term ‘hysterectomy’. Wait, this is the year 2015 and not 1815? Time to update the science with actual experiments rather than relying on erroneous correlations and associations. Thank you Dr. Dom for doing exactly that.

      To tie it all together: what are the keto implications for pregnant/breastfeeding women?

  74. Can you discuss the effects of drinking spirits or wine whilst trying to remain in ketosis?

    Can it be done?

    If so, how?

    Thanks for such an intriguing discussion!

    You guys have really knocked my socks off again!!


  75. Thanks for the great podcast! It sounds like a ketogenic diet might have a positive effect on Endometriosis as well. Could you please raise the question to Dom in case of a follow-up.

  76. Might there be a follow up post on these super long fasts? I’m very intrigued but need more details/tips. You guys didn’t seem to nail down how often to do them for lasting benefit. You mentioned quarterly, he said once or twice a year I think.

    By the way, this was probably my favorite podcast you’ve ever done. It was dense with the jargon but that’s good from time to time. Best content on the Internet!

    1. would love to expand more on this topic and give specific protocol recommendations based on some of the emerging science and my personal experience

      1. Hi. Just wanted to say that I would also be very interested in a follow up on longer fasts with more specific recommendations about that. I’m a little crazy, so after hearing the podcast episode and doing a bit of reading, I went ahead and tried a 7-day fast (just water and coffee/tea a couple times) in December with no idea what I was doing. It was an interesting experience and surprisingly not unpleasant! Anyway, I am thinking about doing the same thing again in March, and I would love to hear any suggestions from Dom or Tim about how to carry out a fast safely and how to get the most benefit from it. Thanks—I’m grateful that you’re putting this information out there!

  77. This practice is very interesting and I would like to incorporate it into my lifestyle. However, I am a type 1 diabetic. I take insulin 24/7 with my pump and I typically treat low blood sugars with glucose. As diabetic ketones and ketoacidosis have always been “bad words.” I am constantly monitoring my blood sugar levels and administering insulin to prevent diabetic ketoacidosis. I am curious if there is a way that I can still incorporate ketosis and its benefits as a type 1 diabetic. With my situation would it still be possible to achieve an effective state of ketosis and if I could/did would it present any dangers/challenges unique to a type 1 diabetic? I would appreciate any feedback. Thanks!

    1. I have a PhD student that is a T1D. He switched to low carb/keto and reduced his insulin requirement by 60-80%. He’s 6’4 250, lean and trains faily high volume. Also, See “ketogenic diet resource” for a book on this subject written by a T1D that is also a medical doc

      1. Hi is that glucose monitor able to tell you how much ketones are in your blood or is that determined based on blood sugar levels?

      2. Sean, you would get the Ketone meter that is referenced above, in the Show notes. It is called the “Abbott Precision Xtra Glucose Monitor” but if you order the Ketone test strips for that meter, then it will measure ketones in your blood directly. However, if your blood glucose level goes down and the ketones excreted in urine rises, that will also help you determine if you are in ketosis, but not directly. Dr. D’Agostino stated recently (paraphrasing) that if blood glucose level is 75 or below, then you are in ketosis. Good luck.