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

Picture_USF_Laboratory

“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
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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…

Enjoy!

Selected Links from the Episode

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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 over 400 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.

396 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. 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.

      5. 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.

    1. 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.

  2. 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. 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!

    4. 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 – https://www.youtube.com/watch?v=fuj6nxCDBZ0 – entitled, “The cholesterol conundrum and root cause solution”. Long lecture but well worth the time.

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

    6. 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.

    7. 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”.

    8. 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:

      https://www.dougcookrd.com/2016/01/heart-health-is-more-than-just-lowering-ldl-cholesterol/

      https://www.dougcookrd.com/2014/05/saturated-fat/

      Thanks Tim and Dom for all the great content.

    9. 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.

  3. 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: Strengthsensei.com 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. 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.

    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

  4. 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.

      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. 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.

    4. 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.

  5. 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,

    Mickey

  6. 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?

  7. 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!

  8. 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?

  9. 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.

  10. 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. http://circ.ahajournals.org/content/119/17/2396.full

    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.

  11. 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!!

    D

    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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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….

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

  22. 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?

  23. 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!

  24. 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.

  25. 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

  26. 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.

  27. 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.

  28. 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

  29. 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.

  30. 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!

    Thanks,

    Owen

  31. 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!

  32. 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,

    Jason

  33. 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.

  34. 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.

  35. 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?

  36. 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. 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?

  37. 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.

  38. 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?

  39. 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.

  40. 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.

  41. 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.

  42. 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? ”

      +1

  43. 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.

  44. 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…

  45. 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?

  46. 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.

  47. 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.

  48. 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.

  49. 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!!

  50. 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

  51. 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 ( http://www.econlib.org/library/Bastiat/basEss1.html )

    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.

    Jonathan

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

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

    http://www.ncbi.nlm.nih.gov/pubmed/25686106

    Abstracts on Dom’s Publications

    http://goo.gl/IICq0d

    Website mentioned – Ketogenic Diet Resource

    http://www.ketogenic-diet-resource.com/

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

    Ketosis (What is ketosis? WebMD Definition http://www.webmd.com/diabetes/type-1-diabetes-guide/what-is-ketosis)

    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 http://www.ncbi.nlm.nih.gov/pubmed/19010556

    (If you want Berkeley’s definition https://nature.berkeley.edu/advising/majors/nutritional-sciences-physiology-metabolism)

    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

    Example:

    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? https://www.bulletproofexec.com/what-is-mct-oil-vs-coconut-oil/)

    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.

  53. 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?

  54. 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.

  55. 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.

  56. 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:)

  57. 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

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

    Will definitively listen again.

  59. 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.

  60. 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”!

  61. 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!

    Artur

      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?

  62. 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?

  63. 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.

    thanks,

    Tony B

  64. 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?

  65. 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.

  66. 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?

  67. 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!!

    Christine

  68. 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.

  69. 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. 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!

  70. 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?

        1. 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.

  71. Is there a way to reconcile the ketogenic diet and the use of the 4HBody cheat day? Clearly, a cheat day knocks one out of ketosis and it takes a few days to reenter. I think the inclusion of cheat days increases the possibility of long-term success , but wonder how it lines up with ketogenic thinking.

    1. If you look at the Cyclically Ketogenic Diet, that will give you a good understanding of how/why the ‘cheat’ day can be useful if you are on a keto diet and you are lifting heavy. There are a lot of technical reasons why it helps, so I’ll probably butcher the explanation without going back to the research, but it partially has to do with replenishing muscle glycogen stores, spiking insulin which is anabolic, and up-regulating/normalizing the metabolism via the T3 thyroid hormone.

      It’s important to note that the 4HB diet is the slow carb diet, which is not a Ketogenic Diet (still a great diet IMHO). There are a lot of places to get info/diet plans for strict keto diets – I like the diet plans/recipes on the ruled.me site.

      In my experience, when I am on a strict keto diet – turning the ketostix purple, and do a huge carb up day, all the glucose/glycogen fills up the muscles and liver, and I’m back in ketosis the next day or the day after – so it’s definitely possible to have a ‘cheat’ day and quickly return to ketosis.

      I think it really comes down to objectives and commitment level. If you are on a Ketogenic diet and in ketosis, you can have periodic cheat days and get back into ketosis pretty quickly. If it’s taking you longer than you would like, maybe do intermittent fasting the days after the cheat day. If you are on the slow carb diet, chances are you will not be in ketosis. Get some ketostix and play around with it.

      For me personally, the longer I’m eating a clean, Ketogenic diet, the less I want to get really sloppy on a cheat day – it makes me feel awful.

  72. Tim, great podcast. I love Dom’s demeanor. He’s such an intelligent guy without an air of arrogance. Now how does he feel about strength training or HIIT during these long fasts of 5-14 days? Avoid these workouts entirely or can you do them with some post workout supplementation without breaking the fast? I’m looking at implementing these fasts quarterly like Dom suggested but I wasn’t sure if I should back off training during these periods. I lift 2x per week and do HIIT 2x per week (all workouts on their own dedicated day).

  73. with all the talk about fasting would you recommend doing a fast during the geek to freak workout routine? If so at what time and for how long?

    I am considering doing an additional week of the program along with a 5-7 day fast to push into a ultra fat burning start.

  74. Very interesting podcast. Way over my head, but there’s a lot of great stuff in here. Question: I currently follow Slow Carb more or less, with a cheat day on Saturdays. If I tried a Ketogenic diet, would I abandon the cheat day or keep it. If I kept it, how & when would I incorporate it into the week? When would it be best scheduled around intermittent fasting?

  75. Tim-LOVE this episode, love all your episodes but really ate this one up (yes, bad pun intended…)!

    Re: Lyme disease: have you ensured through testing you don’t also have any of the commonly co-occurring diseases? I’m sure you know that most testing stinks. IGeneX is the only lab to use for higher sensitivity testing. (I have no affiliation). Your reference to the neuro systems made me wonder about Bartonella.

    Current theory between me and one of my talented practitioners is that ketosis starves the little bugs and that this is a direct positive healing impact where no other treatment has been fully effective. I wanted to add that in to the additional functions discussed at end of episode in this area. Also, note that we are looking at a ketogenic diet in which protein stays a bit lower than typical in order to avoid the bugs aggressively converting protein over into a glucose form to feed them.

    Also look at Dr. Alan MacDonald’s work connecting Lyme and Alzheimer’s. A pathologist, he has found Lyme spirochetes in 7 out of 10 post mortem Alzheimer brains. That’s crazy, right?? Scary stuff. In an interview I heard him reference Alzheimer’s as a possibly a sort of late stage chronic Lyme form, in part. Zoinks…

    Keep these helpful and informative podcasts coming, thank you so much!

    Also, love 5 Bullet Friday!

  76. What a fascinating episode. I just finished listening to it all in one sitting, literally,as I am a State Trooper and was doing an escort detail listening to the podcast. I am psyched to try a fast, with some exogenous ketones to kick start the effects, before switching into a ketogenic diet. It was great to listen to Dom’s wealth of knowledge. I would be very interested in knowing what his and your input would be as to best start on such a path. A follow-up edisode with Dom would be awesome. Keep up the great work.

  77. Hi Tim,

    Another great one. Thank you for speaking with Dominic about the ketogenic diet. I know you have been playing with this for a while and it’s great to see two podcasts on the subject to expose us to the new information.

  78. Tim, this is one of the best episodes so far! I am going to listen to it two or three times as there a many gems. I have to say, I found some of the potential options in relation to cancer treatment and even prevention to be jaw dropping. And am definitely going to do some N=1 experiments with a Ketogenic diet and some further reading. A follow-up episode would be great!

  79. Question: I currently follow Slow Carb more or less, with a cheat day on Saturdays. If I tried a Ketogenic diet, would I abandon the cheat day or keep it? If I kept it, how & when would I incorporate it into the week? When would it be best scheduled around intermittent fasting?

  80. Hi Tim, I am just finishing this episode and I think this one has a potential to change peoples lives in a massive way. I would pay to get it translated into czech and/or Slovak language if there was a transcript. Is there? I know this one is long, but hey, this is worth it.

  81. Round 2 with Dom D’Agostino? YES PLEASE! It took me 3 days to get through Round 1 but I want more. Dom is funny, smart and excited about his fascinating work. Thanks to both Dom and Tim for investing the time and sharing the fruits with me.

  82. Hi Tim

    Thanks very much for these posts and podcasts on Ketosis – the people you’ve brought on and the stuff you’ve said got me down the rabbit hole, and purchased myself a blood glucose/ketone monitor

    My goal’s to shed a little excess BF – I’m quite lean and athletic but could do with losing a few pounds. Ketosis interwebs information says to stay within 1.5mmol/l – 3mmol/l but, strangely, I’ve found that hasn’t really accelerated fat loss. Instead, I’ve found that around 0.5 mmol/l-1.5 mmol/l in the morning first thing has produced the greatest results in terms of thinking clarity and weight loss. Would you know why that might be? No keto interwebs pages I’ve seen can explain it so was interested in your take on it

    Also what do you think’s a good range for blood glucose readings for fat loss? Again, the interwebs says, on average, that anything between 85-110 is a good range, but I’d be interested to hear what range worked best for you? Is lower better?

    Just wanted to add a big thank you for all the other stuff you do too, I’m a big fan and look out for your stuff because I know it’s going to be well researched and proper – thanks Tim!

    Cheers

    Tom

  83. Awesome episode.

    Curious to hear thoughts on ethanol consumption – AKA and how this is a different animal than nutritional ketosis. Ultimately, beta-hydroxybuturate accumulates however, the redox shifts and associated vomiting may garner a worse milieu than nutritional ketosis perhaps? Interestingly, ethanol is metabolized to acetic acid and was touted to increase insulin sensitivity by Charles Polaquin on a previous episode. Which further peaks my interest as to where ethanol fits into all of this.

    The movie was Gymkata by the way, not GymCaNa. One of my favorite horrible movies to watch on WPIX in the 80’s.

  84. It is sickening that his go to resource for keto diet info is the website of a woman making outrageous claims about the diet, with distance learning degree in “human nutrition” from an unaccredited diploma mill chiropractic college. It’s not like he doesn’t know who is behind that wealth of unsubstantiated medical claims as he sat on a panel with her at AHS 2014. [FWIW, Chef Rachel Albert, the woman on that panel with cancer, has sadly since passed away. I mention this because she talks about how her cancer got away from her and spread because she initially treated it with alternative — read: UNPROVEN — therapies, and it was likely too late by the time she tried anything conventional.] https://vid.me/XJB

    Keto for cancer sounds good until you look past the irresponsible hype. Its track record is nothing short of impressively underwhelming in any of the handful of actual studies on humans with cancer. Keto for epilepsy and rare neuro disorders, check. Exogenous ketones for people eating high refined fat diets in desperate need of quick empty calories, check … but why? Keto for cancer? Not so much. Not yet anyway.

    PS Apologies if this edited/expanded comment is a repeat. WP doesn’t like my WP account so I used Twitter.

    1. Thank you for being the voice of reason here. It’s like the keto telephone game, everyone hears the part they agree with, few are willing to do some research and find quite the opposite information.

  85. phenomenal episode, Tim!

    Curious how you handle alcohol when you are deep into ketosis. I find it makes me a light weight! I get really drunk really quick, could be dangerous if I don’t take care. Do you experience this too?

  86. LOVED this podcast. Thanks Tim & Dom

    One question I’m not sure you got to the bottom of, which I was thinking throughout the interview, was this: “what is the effect if someone takes dietary ketones but does not follow a strict ketogenic diet? ie – if you are in Italy and have a week on the pasta, is taking dietary ketones helpful or unhelpful?

    That’s an extreme example but I imagine that a lot of people might not be disciplined enough to stay in ketosis all the time, so it would be good to know if taking a supplement can help keep us there and if there’s any downside to taking it, if we fall off the carb wagon!

    Thanks a lot,

    Adam

    1. I’m interested in this same thing. I can’t seem to find it again but I’m listening to the podcast again.

      I’m at 2:24 and he’s talking about artichokes and foods to raise ketones.

  87. I love, love this podcast! I have been following you for over a year now and just can’t get enough!

    I have a question about IF on the keto diet. While fasting can you still have fat i.e. Butter cream, mct oil?

    And should you take BCAA’s during your fast to prevent muscle loss?

  88. I have listened to this podcast three times now and it’s starting to sink in. I thoroughly enjoyed this episode and am excited to learn more and do my best to get friends and family to consider updating their eating habits. The bacon grease comment will probably help.

    In the podcast, Dom was trying an experiment and I think xTend(?) was mentioned but without the glutamine, to err on the side of caution, regarding slowing cancer growth. Is that formulation available to the public or is there an alternative? Maybe I’m getting mixed up -there’s so much info in the podcast it’s hard to keep up…

    Sincere thanks Tim- I’ve been following since reading 4hww, Vagabonding and immediately selling all my stuff for my first of many mini retirements. THANK YOU SIR.

  89. Awesome, thanks Tim! I’ve been struggling to stay in ketosis but started testing out the MCT oil a few days ago. Got some nasty carb-flu going on now which I’m gonna try fix with a small bucket of sour-cream keto pudding! I’ve learned more from the TFS this year than all my schooling combined!

    Looking forward to the Alain de Botton episode. Read his book, Status Anxiety at the beginning of the year. Extremely interesting dude.

  90. Great podcast – some questions for a follow up with Dom that I hear conflicting opinions on related to fasting.

    1. Will I break the benefits of the fast by having Butter/MCT(aka Bulletproof coffee) with my coffee in the morning?

    2. Will I break the benefits of the fast by drinking bone or other kinds of meat based broths during a prolonged fast?

    Thanks!

  91. I absolutely loved this episode and learned so much more about the keto diet. I’ve been keto for years now and hearing Dom talk about the many benefits of the diet just confirmed my beliefs even more! Thanks Tim!

  92. What a great episode! Glad you ventured “into the weeds.” I’ve definitely got some research to do on ketosis as I’ll be breast-feeding my third child for another year or so.

    My husband and I started the slow-carb diet (saw amazing results) and transitioned to the “Primal Blueprint”/paleo diet. We are the healthiest we’ve ever been! Our children are thriving as well. We’re planning to take that next step for our health and enter into the world of ketosis. My mom has MS, so she’s been right alongside us in our attempts to attain ultimate health.

    I’d love a Part 2 with Dom. Get out in those weeds, heck, venture into the woods! The physiological explanations and laboratory findings are so interesting! Perhaps you could go more into ketosis and the effets on the immune system (I’d love to see more studies done on autoimmune diseases- is there anything happening there???).

    Thanks Tim!

    Also, I’d love to know where I can ship you some treats for your Molly (my husband makes high-end meat treats).

  93. Wow, awesome podcast! I have a lot more questions I’d love help with if anyone knows the answer or if there is a followup podcast:

    -What is Dr. Dom’s recommendation around doing carb ups? I’d love more in depth details around his diet plan.

    -How do I do and how should I prepare for my first fast? I’ve done 24 hour fasts but nothing beyond that.

    -Does he have any recommendations around not getting constipated on keto?

    -Other sites discuss keto being bad for gut bacteria. How does one prevent this and why is it that keto causes this to happen? This seems a bit concerning that the healthiest diet for someone would be hazardous to gut health.

  94. Hello Tim, I get that these factors are important. It would be awesome if you were to key into one of the very most important ones…the kind of light exposure we receive every day! Not enough during the day and way too much at night and of the wrong type. Talk about macro nutrient.

  95. did they give a protein:fat:carb ratio that one should strive for in a ketogenic diet? it sounded like they were about to and then they got caught up in the weeds and then shifted focus

  96. Tim, given the focus on maximum performance in life, would you consider doing an episode on structural/orthopedic issues and the ways to deal with those? I’ve had 1/3 of my foot bone removed, had a bone graft and a stem cell procedure to attempt to get back to a place where I can do some of the fun and healthy things I want to do. I have used PDTR and various other spooky sciences to help myself get more out of life. I would love to hear you tackle the issues that are not diet related that most of us encounter during a life well lived.

  97. Tim, Please have your friend Ray Cronise on the show soon. He just completed a 23 day fast, has helped many find health through plant based diet along with Dr. Fuhrman and is writing a book about the science of it all which is on Kickstarter for next year.

  98. This interview inspired me to try incorporating a ketogenic diet. I was previously on a diet that mirrored that in the 4 hour body and was heavy on legumes. It seems that legume consumption would be difficult on a ketogenic diet based in its carb content.

    Can anyone explain if it is ok to eat legumes on a ketogenic diet and if so, why those are ok as opposed to other carbs?

    Thanks.

  99. As a long time listener, this was one of my favorite podcasts. Wanted to thank Tim / Dominic for the awesome show. Made me want to hop on the ketogenic diet ASAP. Used to be on a low carb diet a couple years ago, then felt as if it wasn’t really necessary for my health or performance.

    So right now I aim for simply the highest quality foods and a balanced diet – mostly protein based. I engage in powerlifting 4 days per week, and usually do a lot of walking – I find that carbs are enjoyable and don’t seem to compromise my performance. However, in regards to cancer prevention, the carbs may be a good idea to minimize (after hearing this episode).

    Am very interested in testing some of those exogenous ketones for rapid induction of ketosis. Would be interested to hear Tim/Dom’s thoughts on Oxaloacetate as a supplement. On a side note, a related podcast episode you may want to check out featuring Dr. Thomas N. Seyfried of Boston College (he was referenced in this podcast) is here: http://smartdrugsmarts (Dot) com/ketosis-vs-cancer/.

    Tim, if you’re reading this comment – I’d especially dig a round #2!

  100. I really loved this interview. I have been experimenting with a keto/ modified atkins and low carb diets and have felt great. I want to get pregnant soon and am curious to find actual data and research pertaining to ketosis and low carb eating and pregnancy. I have read that a lot of people say this is not good, but they don’t seem to have much to back it up. Have there been any studies as to the amount of carbs needed during pregnancy and breastfeeding?

  101. I absolutely loved this episode. Thank you so much Tim for getting Dom on the show, and thank you Dom for all the interesting and valuable insight! I look forward to the follow up episode! I have listened to this one more than once already and still can’t get enough.

    All I know my whole life is that I crave chocolates and biscuits and never felt satisfied. I was constantly thinking about my next meal. Since I heard this, I only adjusted my diet by cutting sugar and refined starch, and adding coconut oil to my tea in the morning (I normally take Green Mate, Russian blend, which if I recall correctly is a black tea or Pomegranate White) and already after one week I noticed that I am not hungry all the time. I am going to order a few books to read more how to fully implement a Ketogenic diet.

    Second to this I am interested in the effects that Ketones might have on anxiety combined with extremely low Gamma waves and extremely elevated Alpha 2 waves (QEEG test was performed), if any. Especially after the short discussion of how being on a ketogenic diet helps the GABBA Glutamate balance.

    Am I correct in assuming that being in a state of ketosis will also promote Seritonin / 5HTP levels as Ketones has not only the ability to bridge the blood-brain barrier but also has restorative effects in the brain and neurotransmitters. (Apologies if I do not get it completely right, I am not a doctor or anything of the sorts).

    Lastly I was interested to test the effects of a Ketogenic diet on my trigger finger (ring finger), which is a secondary complication to my primary injury (Ruptured FDP and FDS of my index finger). The reason for this is that surgery was planned to cut the A1 pulley after I failed 2 cortisone injections and oral anti-inflammatory drugs. I do manage the trigger currently by restricting sugar which makes me wonder how many patients can potentially benefit from following a ketogenic diet struggling with inflammatory diseases. I even wondered if Crohn’s Disease, Ulcerative Colitis and rheumatoid patients might benefit being in a state of ketosis.

    This was so insightful and inspiring and I definitely want to hear more.

    Thanks for the great work and bringing it to us!

  102. Thanks Tim, an interesting episode. I would like to know more about ketogenic diets in relation to endurance athletes. I’m going to +1 the comments about wanting more information regarding plant based nutrition. I understand that the general consensus is that it is not optimal for athletic performance however I have concerns regarding the diets being used/tested in that many vegan/vegetarian diets can be high carb through things like breads, fruit, rice etc. instead of a focus on leafy greens, avocados etc (I guess similar to what they encourage in the ketogenic diet resources page). I also have increasing concern over the environmental effects of supplying all the animal products to our increasing world population. So I guess I’m looking for what would be best for an athletic body but has the least impact to the planet.

  103. Outstanding podcast (which is pretty normal for you!). This is near the center of my interests and I would love to extend the interview with Dr. D’Agostino. A particular question I would like discussed is nutritional ketosis and gut health: effects, maintaining….

    On a more general note, what I particularly like about your podcast is that it stretches me. I hear ideas and speakers that I would otherwise have to knowledge (or interest) in. Keep it up.

  104. Tim,

    I love that you’re using your resources for a greater good. Thanks for making them so accessible.

    Quick question – do you, or anyone here have a good coconut cream that you recommend? So many of them are runny, or rock solid.

    Thanks!

    1. Rick, I am nuts about the Unsweetened Organic Coconut Cream Premium from Native Forest. I buy in the 5.4 oz cans & add 20 drops of liquid stevia per can. For a special evening treat also add a jigger of Jack Daniels.

  105. Hi All! Great podcast. I find that both work and my hobby, ultra-running, benefit from being in ketosis, and I actually really love the food. I have not measured bio-markers, but have not seen any negative effects after spending much of the last two years in ketosis (certainly no mucus problems that seem to be the focus of scaremongering). I do worry though whether there would be any deleterious effects of “over-using” gluconeogenesis in the long-term. Any thoughts?

  106. Looking at the comments there is definitely a desire for a part 2 interview. Even if I don’t have a specific question I too would like more with Don.

    The part that I found most interesting in this episode was that cows are ketogenic by nature and that there are certain vegetables that helps retaining ketosis. I am fasting from time to time and believe that the science supports a ketogenic diet but before listening to this episode I were conflicted about this. Because lately there has been a large amount of research showing the importance of the microbiome. Dr. Perlmutter (I think he would be an excellent guest for your show) who previously wrote the Grain Brain came out with a new book named Brainmakers were he cites the latest research showing how the Microbiome can be used to reverse and/or cure all kinds of modern diseases. The problem has just been that if you should develop a healthy microbiome then you need to eat vegetables to fuel the good gut bacteria. And before this episode I avoided vegetables since they contain carbs and would break the ketosis. Now I can see a way how to eat so I can develop a healthy Microbiome at the same time as I keep my ketosis. Thank you Tim, this really changed my thinking. If you have the possibility I would love to know more in a later post or podcast about which vegetables to use, how to use them etc. from a ketogenic and microbiome point of view combined.

    Lots of love from Sweden, you are doing an amazing job. Keep up the good work.

  107. I’m trying to find anyone who can shed light on this situation … I’ve always been interested in LCHF diets, dabbled on and off with them. About a month ago, I ran across Dr. Fung’s fasting work and at the same time, an exogenous ketone drink. The ketone drink made it easy to slip into a 7 day fast (water, salt, a little bit of bone broth, and some vitamins) and I felt stronger and more energetic than I had in years. I stopped the fast and for about a week, stuck to an LCHF/IF regimen (no ketone drink). I went out of town and had a typical fast food meal for lunch (one meal won’t hurt, right?)–chicken sandwich, french fries, coke. Thirty minutes later, I had a full-on tonic-clonic seizure. I was taken to the ER, stabilized, and put on an anti-epileptic drug which is making me crazy. I am now dealing with the side-effects of the drug (exhaustion, psychosis, brain fog, depression, anger), trying to take care of my four little kids without driving for six months (thank goodness I wasn’t driving when it happened), and trying to get into a neurologist in the small town I live in–the wait is currently over 3 months.

    Of course everyone who knows I fasted for a week blames the fasting, but it doesn’t make sense to me since fasting and ketogenic diets were used as the treatment for seizures before drugs were available. It’s hard to not think there was a link though. I do have a history of seizures–one tonic-clonic 25 years ago as a freshman in college during finals after pulling an all-nighter and one after 18 hours of hard labor with no food, no sleep, and no pain medication during the birth of my first child. I’ve had 3 children since then with no problems, and multiple EEGs with no findings. I have one or two deja vu experiences a year that may be mild simple partial seizures–so mild that I’ve been speaking to a large audience and no one in the audience knew that anything was happening, even though I did. These have been going on since I was 13.

    Does anyone have any ideas? I would like to continue fasting/LCHF/IF, but am nervous about triggering another seizure.

  108. This was one of my favorite episodes. I need to study Dom’s go-to resource to make sense of it all, though. This is a great addition to all of your 4 Hour Body and Slow Carb resources.

    Additionally, I want to point out that the Keto Pet link appears to be dead.

  109. Great podcast-thanks for the tip from Dr Newport (5bullet Friday) I am very interested in nutrition and optimizing health through nutrition (am an RN). I listen to your podcast while driving from home to work (2.5hr). It is amazing how many people are basically saying the same things-but nice to have the research to back it (i.e. Dom, Hof,) You have been having amazing guests. Keep it up! Regards Linda P

  110. Tim – I just finished this podcast, which kind of overwhelmed me with all the fancy terminology and acronyms you guys kept throwing around. “Fasting” was probably the most often mentioned word in the entire 3-hour conversation, so I wonder what kind of fasting you really meant? I’m assuming this was pure fasting, with water only (not fruit fasting, lemon water fasting, or any other kind of fasting)? Have you ever done any research on dry fasting? I just completed a 9 + 3 day dry fast (no contact with or intake of water or any other liquid) in September in the Altai mountains of Russia, and the healer supervising the fast there (Dr. Filonov) kept mentioning ketosis as well. What are your thoughts on dry fasting, and have you ever discussed it with the likes of Dom D’Agostino?

  111. i think dom mentions at one point that he’s consuming something like 300g of fat? i’m 200lbs and trying to consume ~185g of fat. 300g seems like it would be a real lot.

    1. The urine strips only work for awhile, and then the urine concentration of acetoacetate levels off. There are breath testers (for acetone), if you are blood averse, but the Precision Xtra blood meter is my preference and very easy to use. The test strips for ketones can be pricey, but they are available from Canada online.

  112. Wow! SOOO enjoyed this episode! What are your thoughts about early morning (5am) HIIT/CrossFit workouts while on a ketogenic diet? I’ve struggled with energy during the workout and attributed it to a lack of fast acting glycogen. As well as recovery post workout that I attributed to a drop in blood sugar.

    Thoughts? Suggestions?

  113. As usual, this podcast was fun and exciting to listen to. Great nourishment for the head! Like Dr. Attia, Dr. D’Agostino is articulate, interesting and knowledgeable, and I like the N=1 personal experience too.

    At his website I ran into his interview with Dr. Mercola. I’m just not sure what to think about this guy. Science Based Medicine has a very low opinion of him (AIDs denialist, anti vacc?).

    While at SBM I looked up the ketogenic diet and there is an entry there (focusing on Dr.Seyfried). It’s basically just a bit of restraint, as I (feebly) read it. One thing I like about Dr. D’Agostino’s view is that puts things in context – for example the keto diet can complement other more traditional approaches and even though some chemo is in fact carcinogenic, it can have its place.

    But sheesh, it can be hard for a layman to know who to believe sometimes on nutrition. I know I know, swim at your own risk. I guess what I’m running into is how to assess risk (in terms of quackery or not).

  114. Hey guys, recently listened to 4-Hour Work Week, loved it. Was wondering where I could find all the templates and reading recommendations mentioned in the book?

  115. Great show…..keep it up and would love a part 2!!! In regards to the mct powder. There’s a product called pruv-it and they have a powder they suggest to take once or twice a day. Does Dom recommend this product for the ketogenic diet. Thanks in advance for the response.

  116. Dom briefly covered what supplements he takes in the morning but I’m having a tough time finding the spot in the podcast where he covers that. Tim, can you please list out what supplements Dom is taking and at what dosage? Thanks! I’m looking to start my Keto diet AFTER thanksgiving!

  117. Dom mentioned what supplements he takes every morning in addition to taking ketone powder. I am having a tough time finding where in the podcast he mentions this. Tim, could you list out all of his supplements and the dosages he takes? I’m looking to start my Keto diet and am also interested in these additional supplements. starting my diet AFTER thanksgiving, of course. Thanks Tim!

  118. Would love to hear some feedback from the community: After hearing this podcast and in light of Stan McChrystal podcast (http://fourhourworkweek.com/2015/07/05/stanley-mcchrystal/),I’m ready to take a guinea pig leap and try doing one meal a day for 30 days. I love to work, like to eat, and have some stuff I want to do get done.

    I’m thinking of going down to about one meal a day for a while. Lots of water until about 2:00, then a shake made of Amazing Grass, PB Fit, Strawberries and Blueberries, more water then a “normal meal” (protein, carbs, veg, etc.) for dinner.

    Would love to hear any feedback the group might offer.

    Thanks,

    Adam

  119. Amazing podcast. I listened to the entire thing twice and will be going back for a third time so I can understand it all. I have also gone to the recommended website (keto diet resource) and it is very helpful. I know that Dom does not specifically recommend or sell supplements, etc, but I am interested in decent resources for exogenic ketones and a good dried MCT oil. In the podcast, Dom said that he used a dried MCT oil sprayed with a probiotic and it was not available for purchase yet however when I search for dried MCT oil, I can find a couple and I wonder if they are decent quality or not?

    I would really like to see a follow up with Dom and it would be great to speak about the specifics of how to determine the amount of protein and fat needed on a daily basis and how to deal with “cheat days” effectively.

    Personally, I am interested in 1) ketosis for weight loss in the short term and 2) ketosis for brain health in the long term.

    Again, thanks for an amazing podcast, can’t wait for the follow up interview!

  120. Far out – so much new information to take on board, thanks a lot guys! Will need to listen again for sure. Mum has metastatic breast/bone cancer and the oral chemo tablets seem to be mostly only maintaining a low cancer cell count. So while they may be inhibiting cancer cell growth, pretty sure they are taking out a bunch of healthy cells too… Will be looking into modifying her diet further and mine – we mostly follow the Blood O diet as a general guiding principle on food we eat.

    Pivoting again to Ketogenic diet appears to be mostly moving around quantities of what we already eat and cutting the remaining things we still indulge in 😛 Have a feeling though as we take up the Ketogenic diet the cravings for these sugary & salty foods will go down/away anyway…

    Looking forward to part 2 Tim & Dom 😉

  121. This was your most interesting podcast yet! I would love to hear more like this. I’m planning on starting the Ketogenic diet and would love to know the brand of ketones you take to help me get into ketosis sooner rather than later. I’ve been following the Slow Carb Diet for a little over a month, so I don’t expect it to take me very long as my carb ingestion is already minimal. Thanks for all of your research on so many levels. You’re one of the most interesting people I follow!

  122. I’ve been guinea pigging myself with ketosis for a bit over a year now. And on my second listen through with this podcast. Dang, it goes by in hurry. Great stuff here.

    One of the issues I have with the ketogenic diet is that it is quite restrictive. I enjoy the superpowers it bestows, such as higher tolerance to hunger, a certain clarity of mind and long sustained energy between meals. But a bit too much carb, and the wheels come off.

    So it is with great interest I listen to Dom talking about the use of exogenous ketones and a modified Atkins diet. Just the ticket as far as I’m concerned. But, there is one thing I’m not quite grasping here. From listening to the podcast it sounds like exogenous ketones both keep the ketone bodies high enough to stay in ketosis, and reduce blood glucose. But I don’t understand HOW they reduce blood glucose.

    As I understand it, once glucose hits the blood stream it either needs to be taken up by cells and burned for energy, or converted in the liver to either glycogen or fat.

    Just how do exogenous ketones reduce blood sugar? This one is a real puzzle to me.

    One other annoying question– In addition to being interested in the various benefits of a ketogenic diet, I’m also thinking that a diverse and health gut biome is essential to wellbeing. But, the ketogenic diet is (as I understand it) is pretty low in fiber and the kind of carb that can make its way into the large intestine for the bacteria there to do their thing.

    It raises the question in my mind of how to both nourish the bugs in the gut, and keep the blood stream percolating along with enough millimolars of ketone bodies to derive the benefits of powering our mitochondria with ketones instead of glucose.

    Tim, again, thanks for this podcast. I’ve enjoyed all the ones I’ve listened to, and this one in particular dials down on some questions that I’m currently noodling on.

  123. Tim,

    It amazing how fast you have progressed into such a professional interviewer. Thank you very much for providing amazing content from so many different people. It would be great to have a part 2 with Dom.

  124. Ketosis positive impact on post-surgical recovery?

    Based on this audio interview. I decided to (and did) eat / fast prior to my full knee replacement surgery on November 23rd in order to achieve Ketosis, which I believe I accomplished, though I did not do any blood testing to verify this. My results, based on feedback from the nurses and physical therapists, seem to be sufficiently unusual that I am referencing those here in case this might be of interest to others. Within two days of surgery I was walking without any aid (walker, crutch or cane) with the approval of my physical therapist. My flexion was measured at 105% and and extension was measured at < 10%. If you are having surgery, such as this, perhaps entering a state of Ketosis could be beneficial.

  125. Wow! What an episode! Very informative and exciting.

    If you ever do a follow-up, I’d be curious to know what are Mr. D’Agostino’s thoughts on artificial sweeteners in a ketogenic diet. He mentioned Stevia, which is a natural “fake” sweetener, but what about all the more industrial ones?

    Oh, and in a potential cancer therapy, how would CoQ10 (or its apparently much stronger relative, MitoQ) fit, considering the beneficial effects it has on mitochondria?

  126. WOW. Really enlightening podcast Tim.

    My question has to do with the ketogenic diet and health risks. With an 80% fat diet, aren’t cholesterol and LDL elevations a major concern? I know Dom mentioned a little that his LDL has spiked from time to time, but my first thought is “Man, there is gonna be a lot more fat floating around in those arteries” What about long term cardiovascular risks?

    Guy

  127. Great episode, they touched on severe lower back pain on fasting, every time I fast this hits me on day 3 and I can’t sleep, I usually give up pushing through at this point. I would like to do a quarterly 7 day fast. Does anyone know how to negate this back pain? Would eating Keto before the fast help? Or is there anything else I could do? Also I use water Kefir, as this is made from sugar water (although most gets eaten by the Kefir grains) i’m guessing this will be no good for a Keto diet. Does anyone know if milk Kefir would be better, or am I just opening the bad ass door of adding dairy in my diet that I could really do without.

  128. Awesome Podcast. Your link led me to “Tripping Over the Truth” which is an amazing book. Any chance you could get either Pedersen or Ko on the show to talk about 3BP how it appears to be the cure to cancer by attacking the metabolic effects of cancer? At least the author of the book – Travis Christofferson. Can’t believe that the results of their treatments haven’t been more mainstream. Any attention to getting 3BP to market could save millions of lives.

  129. I’ve been doing the ketosis thing about 90% and have noticed my skin is no longer dry like it always gets in PA about this time of the year. And it’s crazy, but I no longer crave food of any sort. First time in my life I have no weaknesses for pizza, or anything else. It’s not that I can resist it, it’s that it’s just…gone. Crazy

  130. First off love the podcasts!

    Couple of thoughts:

    1) Could you do something about fasting, I do a version of the 5:2 diet meets the 4 hour body and would be really interested in anything that makes my fasting more effective.

    2) From what he said would a 5 day fast four times a year taking Dichloroacetic acid clear out from your system pre-cancer cells? Get them out of your system before they cause trouble.

    Couple of people to interview:

    Dan Harris – 10% happier

    Todd Sampson – Hack My Brain

    Enjoying 5 bullet Friday by the way.

  131. Hey, at about what point in the episode was he talking about his “fat bomb” dessert? Or does anyone here remember the simple recipe?

    I don’t mind listening to the whole episode again… but if someone could tell me now, that would be hugely helpful!

  132. Hi Tim,

    I have been doing some reading on fasting. There is a book by Upton Sinclair called “the fasting cure”. I wanted to get your thoughts on the following in connection with fasting; bad breath, enemas and breaking fast.

    Tnx

  133. Hi Tim & Dr. Dom, Long time podcast listener, but first comment/question. I heard Dr. Dom start talking about keto diet and efficacy for anxiety, before Tim pivoted with another question, and would love to hear the rest of that thought… has Keto shown signs of being effective for anxiety treatment? Cheers, Chuck

  134. For those fighting cancer, I think that green tea can lower glutamine levels. Google it and read up on it. I am absolutely no expert on this, but maybe someone can elaborate.

  135. Would anyone know where exogenous ketones can be purchased? Also any recommendations for brands?

    I am looking into getting into ketosis, but as I understand the transition period can be hard if not supplemented with exogenous ketones.

    Thank you.

  136. This was full of great information and great conversation. Tim or Dom, do you think there would be much benefit to taking a well rounded western diet and adding in some exogenous ketones? I ask because I feel good on my nutrition plan and meet my athletic goals, but I am interested in the benefits of ketones. It makes me wonder if one could take the caloric value of a certain amount of ketones and add them in the place of some of the current carbohydrate or fat intake. If so, would there be a threshold dose you need to take in order to achieve any meaningful health benefits?

  137. I absolutely loved this show and look forward to more please!!! I am in ketosis and never want to go back!! This was one of the most educational interviews I have ever listened to 🙂 Thank you so much!

  138. In this world of dumbed down, bullet point, 5 ways to… it’s so great to listen to something that I will happily listen to again with a pen in my hand. Thank you, Tim and Dom.

    I’m preparing (mentally) for my first at home 5 day fast. I have NOT prepared physically for this at all since it’s Dec 26th. Clearly I am a lunatic, but a lunatic with pluck and a sense of adventure. I’m excited…

  139. You should interview Atom Bergstrom. Been in the health food game for a long time and he is a regular on one radio network and has a blog. Might be a little out there but I know him personally and he is the smartest person I know. He is you 40 years ago. [Moderator: link removed]

  140. Thank you for your podcasts! Having read “Tripping over the Truth” after learning of it on your podcast, I would be delighted to hear you interview Travis Thristofferson and/or thomas Seyfried. Specifically it seems that 3BP could be a “magic bullet” for cancer therapy but progress seems stymied by the NCI/NIH bureaucracy and the fac that 3BP cannot be patented. You have enough wealthy listeners who care about this that you could help drive funding for this research. (I would make a donation if I had confidence in the recipient.)

  141. Question: Loves the talk, thanks for this interview and all interviews. My question/request if that when you are talking with your guest especially about the body, is it possible to add in to the conversation/questions to your guests about how it would effect women? I love the articles and I know you interview based on your own curiosity but was hoping to get a bit more info if the topic has a slightly different take for women.

    Thank you Tim! Love it!

    Lasca Weiss

  142. 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.

  143. 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?

    Thanks!

  144. 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.

  145. 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?

  146. 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.

  147. 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.

  148. 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?

  149. 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.

  150. 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.

  151. 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 (https://intensivedietarymanagement.com ) 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)

  152. 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? 🙂

  153. 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

  154. 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, http://www.purenature.co.nz/shop/Carrier+Oils/M-O/MCT+Oil-2/x_sku/MCT.html, 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 🙂

  155. 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

  156. 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

    Jamie

    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.

  157. 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.

  158. 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?

  159. 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?

    Thx!

  160. 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.

  161. 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. http://blog.wellnessfx.com/2014/01/07/ben-greenfield-4-dangers-low-carb-high-fat-diet/

    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.

  162. 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!

  163. 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?

  164. 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”?

  165. 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!

  166. 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!

  167. 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?

  168. 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

    Tanika

  169. 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.

  170. 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..

  171. 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?

  172. 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?

  173. 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.

    THANKS!

  174. 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?

  175. 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.

  176. 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 (http://fourhourworkweek.com/2016/03/23/josh-waitzkin-the-prodigy-returns/) he stresses that it’s CO2 buildup that gives you the urge to breathe and not O2 deprivation.

    2) In this TED talk (https://www.ted.com/talks/jeff_iliff_one_more_reason_to_get_a_good_night_s_sleep?language=en), 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!

  177. 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.

  178. 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!

  179. 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….

  180. 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?

  181. 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

  182. 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!

  183. 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

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

  185. 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. 🙂

  186. 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

  187. 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

    Vigo

  188. 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. 🙂

  189. 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.

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