Podcast #32: Hereditary Angioedema, Lower Blood Ketones, Statins, Healthy Keto Lifestyle

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Stomach Pain & Swelling with Hereditary Angio-Edema (HAE)

Listen to KetoTalk Podcast #32 where we talk about hereditary angio-edema, adequate ketone ranges, statin use while in ketosis and healthy keto questions.  You can listen in by going to KetoTalk.com or you can listen in on iTunes.


“About 40 percent of my older patient population who take statins while eating ketogenic experience some form of myalgia they didn’t have before. And there’s an amplified side effect profile: muscle ache, joint pain, generalized fatigue, liver enzyme elevation, and cloudy headed.” — Dr. Adam Nally


Ketogenic BioHacking Workshop – Online

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How does a ketogenic diet work?

How can it help my metabolism?

What actually occurs in your metabolism when you become a fat burning machine?

How does functioning off of ketones aid and improve disease?

Join Dr.Nally online, via Webex, and learn how to optimize your body and your metabolism.

Ketogenic BioHacking with Dr. Adam Nally
Date: Wednesday, August 24, 2016
Time: 6:00 pm, Mountain Time (Arizona, GMT-07:00)
Session Number: 801 629 053
Registration password: Ketones

To register for this training session click here:

PLEASE NOTE:  Registration for this even must be done on a computer.  Once registered, the WebEx Workshop can be viewed on a computer, iPhone or iPad with.

Once you are approved by the host, you will receive a confirmation email with instructions for joining the session.

To view in other time zones or languages, please click the link here.

Calculating Protein Needs for Your Ideal Body Weight

Schwarzenegger Protein

That’s what he was taught and that’s what most of us did . . .  We did it because of the way we ate.


Even Mr. Schwarzenegger changed his tune on protein. . .

schwarzenegger too much protein

For the body builder that formula is pretty close, but for the average Joe who doesn’t work out for an hour a day 5 days a week, I’ve provided the calculation below:

Ideal Body Weight (IBW) is based on your height:
Males: Protein in g/day of IBW = 50 g (for the first 5 feet of height) + 2.3 g for each inch over 5 feet.  (This lets you calculate the average male needs  that are approximately 1.2 g per kg of ideal body weight per day.)
Females: Protein in kg/day of IBW = 45.5 g (for the first 5 feet of height) + 2.3 g for each inch over 5 feet.  (This lets you calculate the average female needs 1.0 g per kg of ideal body weight per day.)
A 6 foot male’s protein calculation for IBW would be 50 g of protein (for the first 5 feet )+ 27.6 g (2.3 g x 12 inches) = 77.6 g
A 5 foot 4 inch females protein calculation for IBW would be 45.5 g (for the first 5 feet) + 9.2 g (2.3 g x 4 inches) = 54.7 g.
If you are exercising more than 60 minutes 5 days per week then the values above should be multiplied by 1.4 grams per kg for females and 1.6 grams per kg for males.
Heavy Exerciser Protein Calculation Example:
6 foot male’s base protein needs: 77.6 g per day.  
77.6 g x 1.6 = 124.5 g max
5′ 4″ female’s base protein needs: 54.7. g per day
54.7 g x 1.4 = 76.6 grams per day max
If you eat three times per day, then simply divide your protein needed for you IBW by 3 to get the maximum protein you need per meal.
I hope that helps.

Do MORE, Be MORE, Achieve MORE Exogenous Ketones for YOUR LIFESTYLE


Skinny on Sweeteners in 13 Minutes


I am frequently asked about the sweeteners that can be used with a low carbohydrate diet.  There are a number of sweeteners available that are used in “LowCarb” pre-processed foods like shakes or bars, or in cooking as alternatives to sugar.  However, most of them old-man-sour-faceraise insulin levels without raising blood sugar and are not appropriate for use with a true low-carbohydrate/ketogenic diet.  You can see and print the article I published clarifying which sweeteners you can use and which ones to avoid here:

The Skinny On Sweeteners

Of recent note, I’ve been asked about the insulin response that occurs in the study found here quoted by Dr. Jason Fung in his wonderful book, The Obesity Code.

First, it is essential to note that both the crystalline form of Stevia and the aspartame used in the form of Equal, also a crystal, contain either dextrose or malto-dextrin as the crystallizing agent.  Both dextrose and malto-dextrin have a known insulin spike equal to table sugar.  You can see that in my article link above. Watch the video and we’ll discuss which forms of Stevia and aspartame don’t raise insulin and haven’t been a problem with myself or my patients in the last 10 years.

Men’s Hearts Failing Them for Fear

I am always fascinate when religious or spiritual topics collide with medical evidences and/or disease.  I am convinced that “the natural man” has trouble recognizing that all things are spiritual unto God (1 Corinthians 2:14).  Unfortunately, training in medicine often attempts to “educate the spirituality out of you.”

However, this week,and in church today, I’ve been reading about “signs of the times.”  Of interest, and something that I’ve been pondering, is the statement made in Luke 21:25-26 where the Savior, Jesus Christ, specifically foretells the signs of His Second Coming. Among the perplexities and distress outlined, one statement stands out this week and has been the food of much thought, “Men’s hears failing them for fear,…” (Luke 21:26).

heart failure help

This food for thought is actually what directed me to this verse, as I’ve had a number of people express notable fear and worry over whether their diet is correct, because so much miss-information abounds in society today. Argument, stress and fear over diet, apparently, is not new and was something that even Paul noticed and wrote about in his Epistle to the Romans (Romans 14:1-3).

Stress and fear are two of the biggest hindrances to health and weight loss in my office.  The most common non-food cause of failing to maintain ketosis while living a ketogenic lifestyle is stress.   Stress is often due to fear.  Men, and women alike, become fearful because they seem to:

  1. Forget their Purpose
  2. Forget their Identity

When heartache arise from illness, injury, disability, death, divorce, wayward children and the other innumerable causes, stress and fear abound.  Worry about diet and health, in a time when so much contradictory advise is at our fingertips, adds to that fear.

I dont careWhen we forget our purpose and our identity, three symptoms arise both physically and spiritually:

  1. Apathy toward some or all parts of life (“It’s just going to change again so why even care . . ?”)
  2. A mental slumber due to temporal or carnal pacification (“I can just eat and/or drink my problems away”)
  3. Fear of change and the pain or effort it may take to make a change (“I don’t have the will-power to change anymore.”)

The scriptures call this “weak hands & feeble knees” (Isaiah 35:3), and we in medicine refer to this as dysthymia, the first step in progression toward chronic depression and/or anxiety.

These symptoms all increase chronic levels of cortisol and Ponderinginsulin.  Amplified “brain fog,” weight gain, and inflammation are physical responses to the mental fear that is chronically unresolved.  These symptoms just add to the apathy, mental slumber and fear of pain that was already present.

The problem is that over time, this progressive triad lead down the hormonal path to what we now call atherosclerosis, narrowing of the blood vessels, increasing the risk for heart attack, heart failure and stroke.   This was seen in Hippocrates day as “sudden death related to episodes of chest distress” (Leibowitz, 1970).  The Italian anatomist Giovanni Morgagni (1682-1771) described it in his day as “the force of the heart decreases so much more in proportion as the greater number of its parts becomes tendonous instead of being fleshy.”


First, realize that the problems you are facing have been faced by millions of human beings and you are not alone.  But, to paraphrase Irene Dunne, if you don’t stand for something, you will fall for anything.

I no longer believe in coincidence.  Whether you have thought about it or not, every interaction you have with others (even our interaction . . . your reading this blog), are not by coincidence. There is a reason.  Whether you believe it or not, everything around us testifies that God exists; the Hand of Providence can be seen from the rotation of the earth, planets and stars, the precision of the seasons, the balance of the atmosphere allowing for the perfect pressures and concentration of elements to sustain a life giving breath, to the perfect replication of DNA within billions of cells throughout the body.

I’m not trying to get religious, and, no, I can’t prove this through the scientific method . . . But, that is just the point.  Hands are weak because of lack of faith.  Faith is the substance of things hoped for, the evidences of which are not yet seen.  Even though we do not see the evidences, we can discern the light and that gives hope.  Hope is a substance that gives purpose.  I can strengthen hands by sharing a little light and stabilize knees through friendship and fellowship (Romans 14:1).

If the Big Bang started the universe, what started the Big Bang?  Where did the first atom or molecule or particle of dust come from?  I have a very difficult time accepting that you and I are here by accident, by a chaotic explosion that created order.  That implies that there must be a plan, and that plan had to have been set in motion by a Creator.  You and I have a place in that plan.  That also implies that that Creator placed solutions to our challenges, including the diseases of civilization, within our grasp and available to those seeking the solutions upon the earth today.

PleasurePrincipleSecond, today’s society teaches the Pleasure Principle.  This is the human instinct to seek pleasure and avoid pain, including avoiding painful recollections.  We often define ourselves by those things that bring us pleasure.  We each go through personal tests, failures and triumphs. Some of us harness all of those experiences for good, others find worsening mental paralysis due to fear of them. We often hide from the painful experiences and attempt to bury or forget them.  Food is often involved with many of the experiences of life, and for a significant number of people, the endorphin release from eating a meal, sometimes just the act of chewing, may be the only pleasure one experience in a day, in a week or a in a year. Many people hide from painful recollections behind the simple pleasure produced by the eating of “comfort foods.”  Food, and our opportunities to experience pleasure from it’s various flavors, textures and physical stimulus, begin to define us.  However, hiding from life’s painful memories with momentary pleasures usually prolongs or makes the problem worse. The ingestion of simple foods containing glucose and fructose, their effect on the liver, and the hedonistic hormonal response is the basis of addiction, and simple carbohydrates provide the perfect fix.

Fascinatingly, when fructose is metabolized in the liver, in the presence of glucose (the basic structure of sugar – one fructose molecule bound to a glucose molecule), the byproduct has a hedonic (pleasure experiencing) effect on the exact same pleasure receptors in the brain that bind to morphine.   Yes, that’s why the M&M’s make you forget your troubles and why the Jolly Rancher is so jolly.  And, its the same reason you crave another do-nut two hours after you ate the entire baker’s dozen.

Healing can only occur when one is willing to confront and talk about the reasons, the real reasons you’d rather experience the endorphins from the do-nuts with your family instead of acknowledge your weakness, stresses, and fears.  Many of us are so afraid of where we might be, we avoid acknowledging where and who we are.  It takes courage not to take the easy path.  And I will be the first to admit, pizza is the easy path and it’s scenic views are decorated with french fry palms and sunset clouds of apple fritters.

Third, many cultures and most forms of religion or spirituality incorporate the use of fasting to one degree or another.  Why fasting?  Well, it removes the effect of the pleasure principle for starters.

Fasting is also a simple and inexpensive method of shifting the body’s metabolism to one of ketosis.  Spiritual, physical and mental clarity are more prominent in the ketotic state.  Finding your identity and purpose are often encouraged while fasting.  In fact, a whole chapter in the Old Testament’s Book of Isaiah is dedicated to the powerful effects of fasting and the ketogenic state it produces (Isaiah 58:3-12).

Your life is never without meaning. Keep it real by recognizing that diet alone may not compete your answer for physical health.  Having courage and faith allow you to see and embrace the truth that is right in front of you. The  Alcoholics Anonymous’ 12 step program only becomes successful when one realistically and courageously applies their faith to align with the truth they have felt all along.  For any long-term lifestyle change to take place, one must connect and live the principles before one truly knows they are true.  In this way the Ketogenic Lifestyle becomes real and men’s hearts are less likely to fail them.  You can start here: The Principle Based KetoDynamic Lifestyle.

Is Your Oatmeal is Killing You?

“Doc, if I don’t get my testosterone up, I’m just going to die!”

I’ve been hearing that statement from men more and more often lately.   And, the answer isn’t what you’d think.

If you’ve watched late night TV recently, you’ve probably seen the many advertisements for testosterone supplements for low testosterone in men or what is now being called “Low T” Syndrome.   It seems like this is the new advertising trend so much that patient’s use the term “Low T” as part of their conversations.

Watch the four minute short below about how your testosterone and sense of fatigue is being driven by your oatmeal or breakfast cereal . . .

Is it that men have just stopped making testosterone?  Suddenly, everyone’s testosterone is low and men are complaining about fatigue, libido, and erectile dysfunction . . . or are they?

It’s actually the oatmeal . . . and the breakfast cereals.  Clinically, when a man cuts the cereals and oatmeal out of his diet, he actually increases testosterone by 50-150 points within 1-2 months.

If you practice medicine long enough, you’ll see a trend that seems to have arisen as our waistlines have expanded.  About half of the men in my office with insulin resistance, pre-diabetes or diabetes have low testosterone levels.  But this shouldn’t be a surprise.  Type II diabetes, metabolic syndrome and insulin resistance are all driven by an over production in insulin in response to a carbohydrate load in the meal. Patients with these conditions produce between two to ten times the normal insulin in response to a starchy meal. A number of studies both in animal and human models demonstrate that insulin has a direct correlation on testosterone suppression in the blood. This has been demonstrated in both men and women.  In fact, glucose intake has been shown to suppress testosterone and LH in healthy men by suppressing the gonadal hormone axis and more predominant testosterone suppression is seen in patient with insulin resistance or metabolic syndrome.

Image Credit: http://www.townsendletter.com/July2012/metsyndrome0712.html

In fact, to put it simply, insulin increases the conversion (aromitization) of testosterone to estrogen in men (it does the opposite in women by interacting with the hormone FSH).  Interestingly, leptin resistance has a similar effect.  I tend to see the worst lowering of testosterone in men with both insulin and leptin resistance.

What that basically means is that your breakfast cereal or oatmeal decreases your ability to maintain testosterone by up to 50% (1), lowers your ability to stabilize muscle (2), increases your risk for heart attack and stroke and makes you fat!

Death by oatmeal  . . . really?


How to you improve your testosterone?  Supplemental testosterone has been shown to help, but it comes with some risks, including prostate enlargement and stimulating growth of prostate cancer.  The most natural way to improve your testosterone is to change your diet.

A low carbohydrate or ketogenic diet turns down the insulin production and allows the testosterone to be available for use by the body. A ketogenic diet has the effect of reducing leptin resistance as well through weight loss.  A simple dietary change of this type is frequently seen in my office to increase testosterone by 100-150 points.


What is a ketogenic diet?  It is a diet that restricts carbohydrates to less than 30 grams per day, thereby causing the body to use ketones as the primary fuel source.  So, for breakfast tomorrow morning, hold the oatmeal (1/2 cup of Quaker Instant Oatmeal is 31 grams of carbohydrates) and have the bacon and eggs.  And, rather than have the cheesecake for desert this evening, have an extra slice of steak butter on your rib-eye and hold the potato.

Or, you might consider using a high fat shake with exogenous ketones.  This is my breakfast each morning:


Exogenous ketones mixed in sparkling water, 2 tablespoonfuls of coconut oil and my multi-vitamin and I’m usually full until after noon.

Either way, get rid of your breakfast cereals or oatmeal . . . it’s killing ya!


  1. Ballester J et al., J Androl. “Insulin-dependent diabetes affects testicular function by FSH- and LH-linked mechanisms.” Sept-Oct 2004; 25(5): 706-19.
  2. Manninen AH, Nutr Metab (Lond). “Very-low-carbohydrate diets and preservation of muscle mass.” Jan 31, 2006; 3:9.

KetoDynamic BioHacking Workshop

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Come join us on August 4th at 7pm for an evening of fun filled learning about health, diet and how ketones play a role in a healthy lifestyle.  Get a chance to talk with Dr. Nally and try out a sample of exogenous ketones.

You can register for the event here.

The Sign of a Good Doctor . . .


Pizza & Family Gatherings, Is A Carb A Carb, Cataracts, & Hyperinsulinemia On Keto

Giant Pizza Slice



If you are interested in the low-carb, moderate protein, high-fat, ketogenic diet, then this is the podcast for you. We zero in exclusively on all the questions people have about how being in a state of nutritional ketosis and the effects it has on your health. There are a lot of myths about keto floating around the blogosphere, and our two amazing co-hosts are shooting them down one at a time. Keto Talk is co-hosted by 10-year veteran health pod-caster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona osteopath and certified obesity medicine physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday.


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