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. Tim, you might be interested in Bimagrumab, a novel monoclonal antibody in development by Novartis to treat pathological muscle loss and weakness. It binds to type II activin muscle receptors stimulating muscle growth by blocking signalling from inhibitory molecules.

  2. Hi Tim!

    Great show, amazing info. I have some questions though. I`d like to incorporate the keto diet with 40g of protein in the morning you advocate for weight loss. Would 40g of whey protein throw me out of ketosis? And what would happen if I took some cinnamon and/or fat with the shake?


  3. Really enjoyed the podcast. Whenever you interview someone who works in the cancer research field please ask them to 2 basic questions. 1) Why hasnt cancer been cured? and 2) How long before cancer will be cured. my wife is a biochemist and I have some molecular biologist friends. I love asking those questions. They always give some form of the answer that we really don’t understand cancer well enough. This seems kind of strange to me with the amount of money going into the research and the level of Biochemistry today. I don’t quite get it. I’m starting to wonder whether or not the problem is really our pharmaceutical science oriented medicine in other words that we know what causes cancer and we know how to cure cancer but we can’t get the cures approved by the FDA because no pharm company is behind it.

  4. Questions for Dom:

    1. Is there any research on the high altitude implications of ketosis? Hypoxia is a large part of high altitude mountaineering and I’m wondering if this might be a parallel situation to your divers.


    2. Where should one look for information or guidelines for a 7 day fast?

    3. What sort of interesting data should be collected on during said fast? I was thinking of weight, blood sugar, keto-stix readings, and mood-logs. Anything else worth monitoring? Are there any citizen-science initiatives that are seeking contributions?

  5. I’ve been eating the sardines every morning and loving it, however eating them plain isn’t enjoyable enough for me. So I’ve been mixing them with about half a cup of lacto-fermented veggies like cortido and it’s actually pretty delicious.

  6. Tim thank you so much for your inquiry and curiosity into living a better life. After this podcast, I’ve been doing a lot of research into the ketogenic diet and Multiple Sclerosis, which my mom has suffered from for over 20 years. It led me to a book on a Paleo-related, low carb diet and lots of testimonials on its effectiveness for treating MS. I just met a girl who has Lyme disease and she described its MS like symptoms, then heard you talk about it on this podcast and I feel like this is meant to be. I will update you with what happens, but regardless of direct effect from the low-carbness of the diet, I know plenty of vegetables and stricter eating will benefit my mom tremendously. You rock, and you have definitely helped push my life into a better place by sharing your own. Thank you.

  7. Loved this episode!

    Gained so much knowledge and tremendous resources.

    I’m curious though about the BCCA Dom recommends having 2 types of chemical sweeteners. Quite surprised about that, and I’m curious what Tim and others think it?

  8. Hi Dom/Tim, When you speak about longer fasts what do you suggest taking while in longer fast. Do you continue on MCT Oil, BCAA’s, or just water or some other regime. So many different uses of word fast so wanted some clarification as to what can kick you out of ketosis. Been doing IM now for over 2 years and have tried a few 2/3 day fasts but always with only water or black coffee.

  9. I absolutely thank you for this episode. I have fasted during spring time to help my body survive the pollen and avoid allergy/asthma and I have been very happy with the results. I am going to fast again this year.

    I am happy to know there are people who are taking a very scientific look at this subject.

  10. You might be interested in interviewing Dr. Jason Fung. He’s a practicing M.D. (nephrology) who is curing Type 2 Diabetes through the use of fasting and low carb/high fat diets. I’m not affiliated with him in any way – I just stumbled across his very impressive blog ( ) while looking up some things discussed in this podcast, and Dr. Attia’s podcast (e.g. fatty liver disease, fasting, insulin response to protein, etc)

  11. I was thinking about trying a 5- to 7-day fast, as Dom recommends. I suppose bulletproof coffee is not permitted during that time, right? 🙂

  12. Great post Tim and Dom, super interested in learning more. I suffer from auto-immune hypothyroidism (Hashimotos) and am wondering if anyone has further information regarding taking supplemental T3 and ketogenic dieting? Seems to be a little info out there but nothing substantial

  13. When your guest is talking about fasting, is that not eating at all and just drinking water for several days?

  14. Hi Tim. Love this episode, even if I am 4 months late. Just wanted to ask

    1) how long should I be in ketosis before I attempt a fast longer than 48 hours?

    2.) would ingesting MCT oil break the fast, or do you do a strict no calorie fast?

    2.) I’m shopping around MCT oil and I stumbled on to this,, they say it is edible, but being primarily a carrier oil, is it different from the MCT oil supplement?

    Really appreciate it if I can get a response. thanks 🙂

  15. 1 cup of sour cream/coconut cream (healthier choice)

    1 tbsp dark chocolate powder

    1 pinch of salt

    Sweeten with stevia to taste

    Add a handful of blueberries or whipped cream if you like

    At about 2:35:00

  16. Tim,

    I’m about to do a 5 day fast after being on a keto diet for 4.5 days. I have done very detailed tracking of diet, blood glucose, beta hyrdoxybutyrate, and urine ketones, and will continue. Based on my research here and elsewhere I will take the following during the fast and am looking for feedback and offering my data. I chose to do the keto diet beforehand to get past the keto transition that happens in 2-3 days fasting before fasting, so the fully fasted ketosis state is longer.

    Ursolic Acid (UrSpray) 2X /day

    BCAA 5g 2X/day

    1 cup bone homemade bone broth in the AM, full fat

    10 capsules biotest curcumin

    Elysium Health Basis

    5k IU vitamin D

    1 cap vitamin K

    Optional that I’m thinking about and need to research:

    Pareto Nutrition PAGG

    4 caps Biotest fish oil


    1. Sounds like you have really thought it through. Good luck. In Joel Furhman’s Eating and Fasting for Health, he emphasizes the need to only drink water (distilled) while fasting to truly get the underlying benefits from the fast.

    2. Also, Tim, do you know that BCAA’s and any protein (in bone broth) or carbs will stop autophagy, one of your primary goals for fasting. I believe you used both in more recent fasts. Does that mean you’re more interested in the fat loss and muscle maintenance over longevity? It would seem that is not your primary goal.

  17. Thanks, this is a really good podcast packed with information.

    In my view, Francis Collins (NIH director) is a living contradiction. His “faith” is completely unfounded based on available evidence. He has been unable to overcome his childhood brainwashing and face the reality of life C.S. Lewis is another religious fanatic. Yes, this has little to do diet, but one should chose role models carefully. Dom is clearly a smart and dedicated scientist and I would recommend that he apply this approach to the poison of religion.

  18. Nice job on the interview! You can tell your listening not asking questions only. Thanks for not dumbing it down, your making me stretch and that’s good.

  19. Tim / Dom:

    What are your thoughts on the anabolic / metabolic diet by former Olympian powerlifting Dr. Mauro Di Pasquale? Basically the ketogenic diet with a weekend carb load phase to increase muscle glycogenic uptake for putting on mass and increasing strength?

  20. Hey, I am new follower of the Ferriss machine. Fun stuff. Questions regarding Dom’s periodic (a few times a year) fasting:

    1. Do you still train during the fasted week, or dial it back? (I am generally a crossfiter 5x wk, mod Atkins/keto-lite, 16/8 IF, bulletproof mornings – but not as extreme as all this sounds as evidenced by the 3ish% more BF than my vanity desires).

    2. During the fasted week, are you still supplementing with ketones, BCAAs, MCTs etc?


  21. Hey everyone,

    I’ve seen a lot of people asking about the MCT powder Dom mentioned in the podcast. Specifically people have asked where to get it and if substitutes work. For those of you who don’t also subscribe to Rhonda Patrick’s podcast (highly recommend), Dom mentions that the MCT powder by Quest nutrition is “pretty close” to the supplements he is working on. He also says the specific MCT/ketone supplements he mentioned will be out within 6 months to a year. I’m guessing Mr. Ferriss will put out a post via some medium when they come out.

    1. That is a myth. The argument is that cortisol is raised to upregulate gluconeogenesis. But what the science shows is that normally the body uses glucagon, not cortisol, for this purpose. The only time sustained high cortisol levels have been seen in a keto diet study was when sodium was insufficient. This is often a problem in the adaptation phase, and for some people that can take longer. But it’s easily remedied. That is why so many people supplement electrolytes on the keto diet, at least initially until the body rebalances.

  22. Great podcast. Giving the ketogenic diet a go but have some concerns as I have heart disease in family and have had elevated tri, ttl cholesterol and low hdl.

    I came across this link in my research and wanted to see if this guy is credible. Ben Greenfield seems to say that a ketogenic diet doesnt provide any of the benefits discussed in this podcast but lots of risks. Would love to hear Dom or any others thought on ketogenic diet and how it effects blood panels.

    1. My personal experience and lab reports with LCHF over the past 13 months says Greenfield is wrong. Suggest you follow the people doing the research in performance sports. In addition to Dominic, there is the “Muscle Professor”, Dr. Jacob Wilson, Professor Tim Noakes and Professor Jeff Nolek, to name a few. LCHF is amazing.

  23. I’ve listened to this podcast a couple of times since it’s original posting to absorb as much as possible. This is by far the most informative podcast with Dom. Thank you for your point of clarifications throughout the episode Tim. As a hard charging long course triathlete, I’ve been playing with the Keto CaNa and KetoForce products as an alternative to the limitless sugar based hydration and Carb based nutrition products during long distance exercise. I’ve trained and raced with these products with added Lime and Nuun tablets to introduce citric acid to help with absorption. So far, I’ve been really impressed with the shorter 2 hr or less results with the product, but am feeling a caloric deficiency after about 3 hrs of hard work. I believe it gets to a point where glycogen is going to be used and I’m in that hard place where I don’t know if I should resort back to all the glucose based products on the race course or hold my ground and tough it out. I’m wondering if adding MCT powder is a smart move to give me the extra calories I need to maintain high level of aerobic bordering anaerobic exertion and staving off glycogen metabolism as long as possible. It’s a dream end goal to replace the sugar and carb based nutrition plans with this 4th metabolite. Thanks guys and gals!

  24. Has anyone done a one week fast? Would you take BCAAs, MCTs or any other supplements during the fast? Also, would you continue to train, or would you dial back the activity?

  25. Dom, thanks for the great info. I am intrigued by using MCT powder and KetoCaNa to jumpstart ketosis, either in general or as a pre-fast plan. Curious– do you ever take some more of those products (one, the other, or both) during a fast? Or during the first stages of a fast? Or is that “cheating”?

  26. Hey Tim! I’ve got a random one for you, but maybe you have had similar questions from other women interested in the ketogenic diet. I have found that it has a significant effect on my hormone levels and menstruation – yes very personal, I know. But, this podcast introduced me to the ketogenic diet and I have been experimenting ever sense. Do you know, or can you point me to someone who might be able to answer some very pointed questions for me about the effect of ketosis on the efficacy of progesterone based birth control? Unfortunately, the doctor I see didn’t have the faintest clue… and while the numerous reddit threads I’ve been through have been entertaining, they have also been a complete waste of time. Thanks in advance!

  27. I’ve just started doing what I’m calling DIF, or Deep Intermittent Fasting. My liver has struggled with the fat content of the pure ketogenic diet, so I’m going to try doing the slow carb (with even lower carbs) diet Friday night through Monday night, then strict water fast Monday night to Friday night, so I’m basically eating 3 1/2 days a week and fasting 3 1/2 days a week…hopefully emulating what our ancestors did to get into ketogenesis…first week results were good and man, did I enjoy Friday dinner!

  28. I’d like to know if type 2 diabetics have

    Had great success with ketogenic diet.

    And how do they have to adapt to it

    differently than others who use this approach?

  29. Hey Tim,

    What Ketone test kit do you recommend? Also, in a given day, what supplements are you taking and have you had any negative effects on your liver from long term supplement usage?

    Just want to say that I absolutely LOVE your podcast. Its wonderful finding someone else as curious about things as I am out in the world.

    Thank you


  30. hi guys, the 1 meal a day fasting, is there any data or case studies on if this can, loose body fat and retain muscle. the one meal a day would be great for me living in a area with, very poor quality food, sleep , and living environment.

    does body types come into this? #stooped Endomorph body.

  31. Tim,

    I’m curious as to your exposure/opinion of the experts and their research surrounding a documentary called The Truth About Cancer. It seems that this episode with Dom dives into and around some of the broader generalizations of the possible root causes and or solutions to eradicating cancer and the idea of lessening, if not eliminating the need for conventional protocols i.e. surgery/chemo/rad therapies. It seems there are multiple paths to more plausible answers as to the ‘Why’ it (cancer) happens and ‘Where’ it’s stemming from and Dom seems to be onto one of them. It seems that if there was efficacy to the above experts in said documentary that maybe you would have mentioned or referenced some of their work? Or maybe there is inherent bias in your opinions? If so could you please elaborate.

    Truly and equally fascinated. Thanks for translating along the way..

  32. Hey Tim (or Tim friends who know!), I’ve had a lot of success with ketosis and maintaining a healthy weight/ body fat percentage, but I get really frustrated with the first two-ish weeks because I become a raging bitch. I’m working on being healthy AND maintaining my relationships so I’m trying to find the podcast where you mention taking something to ward off irritability, but I can’t find it. Was it exogenous ketones? If so, the same brand that Dom suggests from these show notes?

  33. Hi Tim. I have been on Keto (in and out) for around 6 mths. Just had Blood test and ApoB was 150. Lp(a) and

    TGs were Ok. Doc for some reason didn’t check

    HDL and LDL. Any ideas?

  34. 1) I am curious about how ketosis influences thyroid hormone. I noticed my thyroid markers are normal except for a drop in T3. I was going to take some supplements (or do some carb cycling) to support the conversion of T4 to T 3 and then I read that the lowering of T3 is actually adaptive and helps spare lean tissue. Thoughts?

    2) Can you shed some light on the effect of ketosis/ hflc diet on the intestinal microbiome. Any research (or thoughts) on that topic? Dom spoke a little about soluble fiber, but what about resistant starch? Does, for example, green banana or potato, starch have a place here? How would it be incorporated?

    PS. I did the potato hack (only cold potatoes) for three days and went to higher levels of ketones. It was probably about 600-700 kcal/day, but really painless. (I have been regularly IF-ing and low-carbing for a couple years.)

    I loved this interview… Particularly for my friend who is going through chemo. Wish this information was, at minimum, provided to cancer patients. I would love to hear more.


  35. Hi All!

    In addition to glucose and ketones and igf1, does anyone know what are the blood exams one should take prior and after the first 5 day fast?

  36. Keto O/S. Pruvit. Been taking for 2 weeks while I change my diet over to fats. Feel great. Plan on fading the supplements out when my own Ketones Are at the right level.

  37. Tim,

    I’ve heard you mention that keto appears to affect your breathhold time (increase) and sleep need (decrease). I experience this as well and was wondering what mechanism may be and if the following idea has any merit. I’d love to hear your thoughts, as well as Dom D’Agostino, Peter Attia, or anyone else with expertise in this area (Note: I have minimal background diet and metabolism science. Forgive me if any terms are used incorrectly).

    From what I understand, with HFLC diets, the volume of food required to meet energy requirements is significantly less (9cal/g lipids vs 4cal/g CHO). Therefore, is it fair to assume that the expected byproduct or waste per energy unit generated would be less as well, particularly at the cellular level? Two sources initiated my thought on this:

    1) In Josh Waitzkin’s 2nd interview at 11:30 ( he stresses that it’s CO2 buildup that gives you the urge to breathe and not O2 deprivation.

    2) In this TED talk (, the main argument for needing to sleep is that it’s the brain’s chance to clean up its metabolic waste product.

    Could the apparent increased breathhold time and decreased sleep need when following the keto diet be related to a reduction in the need to eliminate metabolic byproduct as a function of the higher energy efficiency of the ketogenic diet? If not, any other theories as to why this occurs? Thanks!

  38. Hey Tim,

    Just wanted to see if you’d entertained the notion that the “neurodegenerative disease that runs on both sides” of your family is in fact Lyme disease.

  39. Tim, Dom, I have a question I am really hoping you can help with, as the research I am finding is not really pointing me in the right direction.

    I am a CrossFit athlete (6x regional individual athlete) and have a high volume of training (2-3 sessions/day) which includes lots of strength work, both in powerlifting and olympic lifting styles, aerobic work and anaerobic/power work. I consume 40% of my calories through carbohydrates to properly recover and fill up glycogen stores.

    My question is this: will exogenous ketones taken pre workout improve performance, even on a relatively high carbohydrate diet?

    I am thinking that it should, especially pre “Aerobic” workouts, but I have no data or studies to support that.

    Thank you! Amazing content by the way! Bought like 10 of your new books to go around, excited to read it!

  40. I was wondering if you or Dom can help provide a daily routine on how to consume the products introduced in the podcast? Assume I will do the breakfast / dinner routine and no lunch. How and when should we consume the following: exogenous ketone supplement, mct oil, scivation xtend, denovo utopian…. He mentioned SARMs as well and some meg foreman? All of these are so over my head. by the way we are also having coffee with bulletproof brain octain oil….

    Also, my husband who is 6’3″ 250lbs is wanting to get serious about a ketogenic diet and working out. He’s starting with diet because he feels too heavy to workout. Right now we don’t know what we are doing and I think he lost about 15 – 20 lbs just eating a low/no carb diet, but he’s definitely in ketosis and not consuming that much fat. He’s feeling weak and cold sometimes….

    I’m 8 months pregnant. I know you’re not supposed to do this while pregnant but I was wondering if Dom is doing any research on ketogenic while pregnant or while lactating? I’d be interested in participating….

  41. Hey Tim, can you share the benefits of Elysium Basis: Metabolic Repair & Optimization? If any? What are the pros and cons?

  42. Hey guys, how effective would exogenous ketones be for sports performance ON a high carb diet? Specifically, CrossFit competition. Would it add in performance fuel? Or would it take away by some how delaying the carb fueling, which is the dominant fuel for the sport?

  43. hey time! I am currently undergoing a seven day water fast. i have done an eleven day water fast before. This time, i would like to push the boundaries of physical activity while fasting. I’m thinking of supplementing with bcaa’s and some form of exogenous ketones. I’ve never used exogenous ketones. I have followed the veto diet for about 3 months, although that time period was not leading up to this fast. would love to here your thoughts and opinions about this

  44. Is it (generally) safe to consume a full can of sardines/day? And a half can of oysters? I did my best to search through the comments but wasn’t able to find an answer. I was unclear on whether or not this is what was being recommended or if it was more so every other day or just at will etc. The Wild Planet sardines are my new addiction. Mahalo!

  45. This was a fascinating conversation, thanks for sharing Tim.

    Did you ever listen to or read Dead Dr’s don’t lie by Joe Wallach ? He approached many healthy problems from a nutritional perspective, coming out of veterinarian medicine. It’s older material so I’m not sure where the science has gone since, but this podcast reminded me of it. I think you would get a kick out of his sense of humour, anyways.

    It was also very interesting learning about the scientific benefits of fasting, as it is a practice that has been embraced by religions and traditions the world over, at various times. Great to know there are some tangible benefits to the practice – think of how cool this makes Ramadan. It makes attempts to introduce a billion ish people to the benefits of the fast. It will be great once science allows the appeal of fasting I become more universally communicated (given that the efficacy of any cultural /religious explanation for fasting is typically limited to members of that culture or religious group)

    I wonder if you have read Gandhi’s autobiography ? In addition to the so many other things he did, he was an avid experimenter with diet and nutrition, and I believe you would find his writings on the subject interesting. His understanding will be less refined, of course, but perhaps his experiences through trial and error will add something to your own .

    Cheers! I am a newcomer to your material, only a few in so far, but easily one of my favorites. You deserve the strong reviews

  46. Where’s Don’s amazing sounding keto fat bombs/desserts? I was really interested in having a replacement to ice cream.

  47. This episode has helped me make an interesting connection.

    My diet is largely ketogenic. Sounds a lot like how Dom described his own in this episode, but the bottom line is that I am in mild ketosis probably 3-4 days out of 7. I cross the line so often I hardly notice it any more.

    I also meditate daily. Started with HeadSpace, maxed out the 20-min sessions, and then got tired of listening to Andy blabber and switched to a timer (the Insight Timer app for iOS is awesome btw).

    So in an effort to keep my head clear during meditation, I count: slow counts to 8 or 10 or 12 on the inhale, again on the exhale. And I found very quickly that I could slow my breathing simply by slowing or extending the count. Slower is better… there comes a point where maintaining the cadence is the only thing I can focus on, which puts me where I want to be.

    So there came a day when I hit a new level… I just checked out, and when the bell rang 20 min later, it felt like almost no time at all had passed. Great sit. But what really astonished me was what happened to my breathing rate… took a couple days to figure out how to time it, but when I’m down there I’m averaging about one breath cycle per MINUTE.

    That’s insane… it’s like twice the period generally characterized as “deep meditation” on the inner tubes. And no gasping, dizziness, nothing. Just sitting and breathing.

    So I’ve been pretty impressed with myself. Figured I was half a step from achieving enlightenment and living the rest of my life rent-free in my own navel. But now I’m guessing my meditation experience may be significantly fueled by my ketogenic diet and its effects on O2 absorption.

    Which is also cool, even if I’m not the Buddha after all. 🙂

  48. keto diet flat out works for a while I was doing paleo then heard Dom podcast about 2 1/2 months ago seemed to make total sense and jumped right in best decision I’ve made in a long time never got the keto flu so after this is going so well I decided to go for a 7 day fast and now I am on day 6 and feel great and no downturn on any day seems easy as I’m not fasting at all and fat it falling off but now that I’m to this point I have not found anything about coming out of the fast has anyone seen info on this

  49. Hey Tim, great episode and I have learned a lot. I would like to ask if I could take creatine during fasting? Would it interfere with ketone production or it has no effect whatsoever?

    kind regards


  50. Great episode, Tim. I wonder if a thousand people already mentioned this, but the best documentary on this subject, The Science of Fasting, is on Amazon Prime. It’s only an hour long but packed with great information. I did a fast after watching it with amazing, and some unexpected, results.

    [Moderator: additional text and link removed.]

    1. I’ve been in nutritional ketosis for 4.5 years and, sadly, find that nutritionists tend to be the least knowledgeable about the latest nutrition science. Most people’s cholesterol levels improve on a keto diet; a small subset (typically those with one or two ApoE4 alleles) have their LDL particle numbers increase, though usually with concomitant increases in HDL and decreases in triglycerides and other improvements that may make the LDL increase unimportant. Look at Dave Feldman’s work. Fiber is a non-issue. There is fiber in avocados, for example. And it may even be that fiber is only necessary to enable humans to digest grains and other plants and that a lot less fiber is needed on a keto diet. Look at Amber O’Hearn’s work. Muscle mass also isn’t a problem for most, as it’s a misconception that ketosis causes the body to “feed” on its own lean body mass. A well formulated keto diet, with enough protein (which may take some tinkering, especially if you’re an athlete) and plenty of healthful fats, will support your muscles. Experiment. Read Volek and Phinney. Ignore nutritionists. Good luck!

      1. Agreed! I’ve been in keto for about three years, minus the odd day out, and my bloodwork has never been better. Re muscle mass… you might see a little less as a consequence of the caloric restrictions intrinsic to keto. But that little bit less is gonna be RIPPED, assuming you’re actually working out and not just relying on a diet. Not a bad trade-off at all if what you really want is to look good naked. 🙂

  51. Thanks this great episode-some really exciting changes in medicine in the future. I’ve been on a strict keto diet for a couple months and have been training a lot as well. I heard Dom mention BCAAs and the Xtend product linked, but looking at them I don’t see any without glutamine like he was describing. Was that something custom for Dom to test or are the non glutamine products available? I’ve had an astrocytoma so really want to be careful about the BCAAs but getting keto levels up as high as possible. So far so good and feeling better than ever.

    1. According to most of the literature: yes, enthusiastically!

      According to the rest, you will die with your hair on fire just minutes after announcing your intent to adopt a keto diet. Eat a cookie NOW.

      You sort of have to choose.

  52. Two questions I didn’t remember hearing: Can you do a vegan version of keto, and when you do the extended fasts, are you just drinking water, or can you have something like bulletproof coffee?

  53. 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!!