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Dr. Nally’s Dementia Protocol

My medical practice is located between the Sun Cities, the beautiful retirement communities on the North West side of the Phoenix Valley.  Over the years my practice has grown with a predominantly large number of patients over 55 years old.  It is a wonderfully diverse group of very dynamic and intelligent people.  Yet, something that has bothered me for many years is the significant risk these patients have for dementia.  One of the most disturbing parts of my job, over the 22 years of my practice, is to see these vibrant patients’ progress down the road to Alzheimer’s dementia. 

To date, there have been over 400 failed clinical drug trials for the treatment of Alzheimer’s Dementia and only a few drugs that showed any mild success at slowing the progression of the dementia. The current medical literature estimates that 30% of these patients will die of Alzheimer’s type dementia.  This statistic has played out in my practice until I started applying the principles of correct diet and lifestyle modification. 

Four Stages of Dementia

There are four stages or phases of dementia that start 20 years before a person ever reaches the diagnosis of dementia. That is important, because this disease can be stopped in it’s tracks:

  • Phase 1 – asymptomatic – abnormal CSF and abnormal PET scans.
  • Phase 2 – Subjective cognitive changes (may last 10 years), symptoms without abnormal cognitive testing. 
  • Phase 3 – MCI – (Mild cognitive impairment) – abnormal cognitive testing, normal activities of daily living (ADLs), 5-10% convert to dementia each year
  • Phase 4 – Final phase of Alzheimer’s disease, ADL’s affected, diagnosis made 20 years after initial biochemical changes.

I’ve been closely following Dr. Dale Bredesen and his protocols in treating and preventing dementia.   To my delight, the following protocols have been very effective at delaying, preventing and actually reversing dementia in my patients.

So, to help you, I’ve written out my protocol (adapted from Dr. Bredesen’s protocol) for dementia treatment and prevention below.

Fat Burning

First, burning fat is crucial. The brain can use two fuels, glucose and fat, but it works better on fat.  Alzheimer’s is associated with a decrease in glucose utilization. A three-pronged approach to begin burning fat includes:

Addressing Insulin Sensitivity

I cannot emphasize this enough. Controlling blood sugar and insulin excess is foundational. Abnormal insulin production dramatically effects the thyroid and all of the sex hormones. Restoring function of the pancreas through diet and the use of Berberine 500 mg twice daily.  If you are diabetic, tight control of blood sugar and using appropriate medications that do not stimulate over production of insulin is essential.

Insulin resistance must be improved (lowering fasting insulin to < 5 ng/dL) and restoring the normal insulin sensitivity is key. This can take up to two years to improve with the correct diet.  Insulin at the correct levels is a key growth factor for neurons.

Insulin sensitivity can be restored by the following:

Health Support

Third, it is important to optimize all nutrient, hormone, and trophic (growth factor) support. This support means we can create resilience, optimize our immune systems, support our mitochondria, and begin to rebuild our brains’ synaptic networks.

Low levels of trophic factors (growth factors) such as vitamin B1 (thiamine), vitamin B12, vitamin D, testosterone, estrogen, and nerve growth factor are all associated with cognitive decline.

Other necessary nutrients for optimal cognitive function include vitamin C, vitamin E, vitamin K2, omega-3 fats, choline, and other neurotransmitter precursors, key metals such as zinc, magnesium, copper, and selenium.

Optimum hormone levels are critical for making and maintaining synapses. Optimal nutrition and lifestyle will lead to optimal hormone production for many of us. Ketones from the diet or used exogenously have been powerfully helpful.

However, other patients will need to support optimal brain function by achieving the healthiest levels of thyroid, pregnenolone, estradiol, progesterone, testosterone, DHEA, and cortisol. These are checked through your doctor and are levels that I monitor every 3-6 months with my patients.

Reducing Inflammation

Fourth, we want to optimize the way the body uses inflammation. It’s important to allow the body to increase inflammation when it’s actually necessary, but also to resolve inflammation when it’s no longer needed. 

Dr. Nally emphasizes minimizing inflammation without a purpose, which is often referred to as “chronic inflammation.” Amyloids often associated with Alzheimer’s disease are part of our body’s inflammatory response. 

Leaky gut is the most common cause of chronic inflammation. This can be caused by:

  • Stress
  • Alcohol
  • Excessive sugar intake 
  • Processed foods
  • Aspirin and related anti-inflammatories
  • Soft drinks with the crappy sweeteners
  • Excessive use of  Proton Pump Inhibitors (PPIs) (used to treat reflux or heartburn)
  • Other damaging agents

We need to know the status of our gut health.

Chronic inflammation with or without a leaky gut may also be caused by periodontitis, gingivitis from suboptimal dentition, or an infection of a root canal in your mouth.

In fact, chronic periodontitis, an inflammatory condition of the gums, may be a direct link to Alzheimer’s disease.

Other causes include chronic sinus infections, or ongoing infection with pathogens such as Borrelia, or metabolic syndrome (insulin resistance, high blood pressure, high triglycerides, and inflammation, often accompanied by obesity).

There are also cases of chronic inflammation due to ongoing exposure to air pollution or mold toxins. Determining the root cause of inflammation is just the first step.

Next, the inflammatory agent or cause should be removed. Once that’s resolved, preventing further inflammation is essential. Several excellent anti-inflammatory alternatives to drugs (NSAIDs) include curcumin, fish oil or krill oil (omega-3 fats), ginger, and cinnamon.

Treating Pathogens

Fifth, we must treat chronic pathogens. Chronic undiagnosed infection can be a contributing factor in cognitive decline. It needs to be identified and targeted. We all live with more than a thousand different species of microbes.

Even the brain may harbor bacteria, viruses, spiral bacteria, fungi, or parasites. Our brain’s protective response to these pathogens causes the very changes we call Alzheimer’s disease. The goal here is to reach and maintain a balance of these microbes.

Addressing Toxin Exposure

Sixth, we emphasize the need to identify and remove toxins. Metals such as mercury, organics like toluene and benzene, and biotoxins like mold toxins (mycotoxins) can lead directly or indirectly to cognitive decline.

Optimizing Sleep

Dr Nally’s Protocol necessitates ruling out sleep disorders and optimize sleep. The amount of oxygen saturation in our blood as we sleep can plummet, which affects our brain’s optimum functioning. Oxygen saturation can be a significant contributor to cognitive decline.

Thankfully, it’s also easily addressed. A dental device APAP or CPAP device can improve oxygen intake through the night. On the other hand, simply reducing inflammation or weight can improve many people’s oxygen saturation and cognition.

That’s why it’s necessary to have a personalized program implemented by a qualified practitioner based on individual lab and other testing results. 

Identifying and targeting the various contributing factors, even down to genetics, with a plan for removal, resilience, and rebuilding can tip the scale in preventing and even reversing Alzheimer’s disease. Early identification and treatment show the greatest promise.

This protocol is based on 40 years of research and the Amyloid Hypothesis, which has found that beta-amyloid accumulates and finds its way into synaptic clefts. This protein interferes with synaptic communication. 

The amyloid then collects, forming plaques that activate enzymes. This leads to the formation of neurofibrillary tangles (NFTs) inside the neuron. NFT formation activates immune cells called microglia surrounding plaques, promoting microglial activation and local inflammatory response and contributing to neurotoxicity.

The Six Alzheimer’s Subtypes Identified by Dr. Bredesen

  • Type 1 Alzheimer’s disease is inflammatory, or hot
    • Ongoing or chronic inflammation puts you at greater risk for developing Alzheimer’s
  • Type 2 Alzheimer’s disease is atrophic, or cold
    • Sub-optimal levels of nutrients, hormones, trophic factors (cell growth factors like NCF, nerve growth factor) increases your risk for Alzheimer’s disease.
  • Type 1.5 Alzheimer’s disease is glycotoxic, or sweet
    • High blood sugar or high fasting insulin levels increase your risk for Alzheimer’s disease. It is termed Type 1.5 because it has features of both Type 1 and Type 2. High cholesterol may also come into play.
  • Type 3 Alzheimer’s disease is toxic, or vile
    • Exposure to toxins such as mercury, toluene, or mycotoxins (made by certain types of mold) leads to an increased risk for Alzheimer’s disease. Although we all experience this exposure to a greater or lesser degree, the key is to minimize it by identifying and removing or minimizing exposures.
  • Type 4 Alzheimer’s disease is vascular, or pale
    • If you have cardiovascular disease, you are at an increased risk of Alzheimer’s disease. Vascular leakiness is one of the earliest changes identified in Alzheimer’s disease.
  • Type 5 Alzheimer’s disease is traumatic, or dazed
    • A history of head trauma — from accidents, falls, or repeated sports-related head injuries — increases your risk for Alzheimer’s disease.

Most patients with Alzheimer’s disease have more than one type and present multiple risk factors.

Get Screened and Get Optimized

In our office we screen for dementia with regular labs looking at all the factors above, MRI scans and a yearly COGNITRAX mental status test.  This is covered by insurance and by Medicare.  In fact, they recommend it yearly with your annual wellness visit.

Second, we perform autonomic nervous system testing yearly that looks for metabolic causes of inflammation and stress.

The key markers that I have found essential to balance in this population are:

  • HS-CRP
  • HbA1c
  • HOMA-IR
  • TG:HDL ratio
  • small dense LDL particle
  • Fasting Insulin
  • Homocysteine
  • Vitamin D
  • MRI with grey matter volume measurements

This multi-factorial seven tiered approach has been tremendously effective the delaying and treating progressive dementia. If you have any risk for dementia, get in to your doctor and get your brain checked. Or, call my office and schedule a comprehensive dementia evaluation.

Obesity, Anxiety and The Divided Mind

In past posts, we’ve discussed how to effectively and efficiently lose weight and open the gates of the fat cells.  We’ve talked about the keys to the back doors of the fat cells that must be opened to create effective lipolysis (releasing of fat from the fat cells) and weight reduction.

I want to focus, today, on another key found in the brain.  The brain neuropeptides play a huge role in metabolic balance of the body and have direct relationships to anxiety, stress and post-traumatic stress disorder (PTSD).  In the last few years, research into the hormones of the brain (neuropeptides) and body demonstrates that the “autonomic nervous system” plays a very significant roll in losing weight.

The autonomic nervous system is the part of the nervous system responsible for “fight or flight responses.”  If a bear rises up in front of you while you are strolling in the woods, and begins to chase you, the autonomic nervous system kicks in to speed up the heart rate, shunt blood to the muscles and turn down the processing of food in the gut while you run from or fight the bear.  This autonomic nervous system is also the system that links emotions (like happiness, sadness, stress, anger, depression) between the conscious and subconscious mind and creates the attachments of these emotions to specific memories.

The Divided Mind and Disease

A disconnect or poor communication between our conscious mind and subconscious mind wreaks havoc in the balance between memory, emotion, cognitive function, endocrine glands and immune system.  One example of this is the onset of panic attacks for no reason.  Another example is chronic fatigue and many symptoms found in autoimmune diseases.  This same autonomic nervous system, when malfunctioning, plays a significant roll in our ability to lose weight.   The subconscious mind triggers the autonomic nervous system without the conscious mind’s involvement.

Thanks to the work of John E Sarno, MD, and Candace B. Pert, PhD, the link between our subconscious mind and the autonomic nervous system is much more clear.  This opens the door to our understanding how the subconscious mind can have a profound effect on obesity.

This field of research requires one to understand a concept about the psyche initially outlined by Dr. Sigmund Freud and his colleague Dr. Josef Breuer (the Father of Psychoanalysis) in the 1880’s.  Misconceptions regarding the basic drives of the human psyche aside, they identified through their clinical evaluations that the human psyche is made up of three parts, the subconscious (the id), conscious (the ego), and the super-conscious (the superego).  They identified an essential concept that the subconscious is a more primitive and childish component of the mind functioning much more instinctually,  and that the ego and super-ego house the intelligent, ethical, and moral consciousness.  They also identified that a split or division can arise between these two partitions causing physiological conflict to arise (i.e. – onset of a panic attack for no reason).

Autonomic Nervous System is made up of two parts: Sympathetic and Parasympathetic divisions. These divisions act like a gas pedal or brake for various organs and functions.

It is important to understand, as Freud pointed out, that you cannot divide the mind into neat compartments suggested by these three divisions.  The mind acts as a single unit.  However, understanding the “id” and it’s instinctual functions being tied to the autonomic nervous system is central to understanding how subconscious can derail weight loss.

Freud and Breuer identified in their Studies on Hysteria that a simple subconscious idea or instinct could be strong enough to exert powerful physical responses without  sufficient intensity to become conscious thought recognized by the individual. This means that a physiologic motor response in the body could be stimulated without being conscious of the reason for the stimulus.  They, along with Jean-Martin Caharcot, Alfred Alder, Franz Alexander and Allan Walters, witnessed this multiple times clinically.  They came to the conclusions that pain and other nervous functions could originate and could actually be created by the mind.

The Mind has the Power to Create Disease

Dr. Pert’s research over the last 40 years has been able to clearly identify a communication system between the brain, the endocrine system and the immune system.  Dr. Pert’s research identified that memory and/or subconscious idea is directly tied to emotion through the brain hormones called neuropeptides that, when triggered, reproduce stored memory, emotion physical autonomic responses (like changes in heart rate, dry mouth, dilation or constriction of the pupils, sweating of the palms or trunk, chest pressure, etc) and even auto-immunity.

Memory, Emotion & Storage Controlled by Neuropeptides

Neuropeptides also participate in memory sorting, storage and recall .   In his recent book, Beyond Order, the clinical psychologist and professor Dr. Jordon Peterson explains that the miracle of memory is not that we remember, the miracle of memory is that we forget and that we only remember what is necessary.  The miracle of memory is that we only remember those things that are important and teach us meaning.  Because we can forget, we don’t drag the horrible details of the past along with us.  Our memories allow us to get free of the past.  All you need is three sleepless nights in which you cannot dispense with the past and you would understand that life would be a literal hell if we cannot dispense with the day, the memory and the emotions of each day. We must renew ourselves in this cyclical unconsciousness we call sleep and resetting of the memory.   It is during this time that memory, emotion and neurohormones are tied together.

Our memories are tied to emotions through neurochemical synapses created in the brain by the neuropeptides.  Forgetting and remembering are very complex and sophisticated cognitive processes.  Our subconscious reduces the memory, emotion and experience to it’s significance.  The significance is then recorded as memory with it’s associated emotion, then our brain lets go of the details.
If you think about it, we boil our lives down to the “jest” of the story and then we remember only the significance of that story with attached emotion.  This process saves us from being crushed by days, years and decades of the gory details of day to day experience.

Anxiety Provoking Memories are Experiences that Still Need Unpacking

If memories from 18 months or older are still bothering you, if they produce negative emotions, that is a sign that that memory has not been correctly or completely unpacked by the complex processes of the brain. It is essential that the brain unpack wisdom from the past that learning can occur and it can be applied to the future.  This process occurs so that you don’t do the same stupid thing over and over again.  Or, it is there so that you can repeat things that worked well.  That is the purpose of memory.  Not recollection, our memory is the extraction of wisdom for the lesson of life from vast experience.
If you have a memory that is still hurting you, making you anxious, causing, fear, guilt or shame, you have not undertaken the complex process of analyzing that memory, pulling out from it the moral, and dispensing with the details.   This is why writing down these specific memories is so very important.
You must write the bad memory out.  You must write out all of the details you remember and the emotions of that experience.  It allows the mind to do the complex processing of identifying wisdom and social moral barriers of uncertainty, anxiety, threat, fear and panic that are bothering you.  This is what therapy does when talking about and discussing the past.
If journaling and writing out the memory is not effective in resolving the anxiety or if you are unable to identify the memory causing the anxiety, you may want to consider hypnotherapy and directed meditation.  This has been very effective with many of my patients having anxiety relating to childhood experiences improperly tied to strong emotions.
W. Dennis Parker does a wonderful job in his book, Spiritual Mind Management, elucidating how our subconscious mind inappropriately ties emotion to simple experiences and memory, and how these can cause anxiety. For those with resistant anxiety to journaling and therapy, hypnotherapy has been very effective.

Other Hormones associated with Anxiety and Obesity

Over the last two decades, I’ve found that two other hormones play a huge role in handling stress, anxiety, brain repair and play a very large role in sleep.  Both of these hormones are derived directly from cholesterol.  Low fat, vegan and vegetarian diets lead to low cholesterol availability and I commonly see low levels of the following hormones in both men and women.
The first of these is Pregnenolone.  Pregnenolone is the precursor sex hormone derived from cholesterol in the blood stream.  When serum pregnenolone level is lower than 50 mg/dL anxiety, insomnia, hair loss, poor recovery from exercise and difficulty with concentration become chronic.  The cognitive cloudiness that occurs with low pregnenolone levels make the unpacking of traumatic experiences and the sorting of wisdom from day to day experience difficult due to poor sleep.  I have been amazed that just the simple supplementation of pregnenolone nightly reverses anxiety, improves sleep, stops chronic migraine headaches, increases cognition and frequently allows people to “feel normal again.”
The second hormone is Progesterone.  Interestingly progesterone is derived directly from pregnenolone.  If large amounts of mental or physical stress are occurring, pregnenolone is used to make DHEA, Cortisol and Cortisone.  Little is left to make progesterone which is necessary for further hair growth, sleep, focus, memory, the healing effects from stress and trauma in the brain.  Progesterone often acts like a “brain steroid” healing both brain and spinal cord from stress and trauma.
Any evaluation for anxiety, insomnia, PTSD or stress must include screening both of these hormones, because without them, I’ve seen patients suffer for years with failure of the standard approaches.
One other molecule that has hormonal activities in the arena of anxiety and weight loss is that of methylated folic acid.  Folic acid is converted into L-Methyl Folate within every cell of the body.  This is accomplished by and enzyme called methytetrahydrofolate reductase (MTHFR).  About 60-65% of the patients I see in my office with insulin resistance, impaired fasting glucose or diabetes have a deficiency in one or both of the MTHFR genes leading to poor conversion of folic acid to the methylated form.   This is detrimental as methylated folic acid is essential in using Vitamin B12 within every cell of the body.
Lack of effective MTHFR enzymes leads to neuropathy, anxiety, depression, obesity and in severe cases elevated homocysteine levels and schizophrenias.  You can learn more about that by reading my blog article on Folic Acid here and a youtube video on it here.

The Search for Individual Meaning is The Deepest of Human Instincts

The human psyche is stabilized by the search for and the experience of individual meaning within life. The subconscious instinct for understanding our individual meaning is the deepest thing about us as humans.  It is innate and is part of our survival instinct.  What if the instinct understanding or experiencing meaning meaning goes wrong?  Pathologizing or lying about that individual meaning causes one to become “lost.”  Understanding that the instinct for meaning can be distorted or lied about is the most frightening thing upon this planet.  If you pathologize that individual meaning with deceit, you will be in the hands of things you do not want to contemplate.  If you have no theory of good and evil, if you’ve never been exposed to malevolence and someone malevolent touches you, you’re done for.
Being true to one’s self or truthful with your understanding of individual meaning helps to properly orient a person in the world, and find middle ground between complete chaos on one side of life and rigid totalitarianism on the other.   Finding and living in that middle ground requires one to rely upon individual instincts founded in truth.   If you want to live in harmony with yourself and your instincts, and live in a middle ground between a life of chaos and one of totalitarianism, don’t feed yourself or surround yourself with indigestible lies, half-truths and deceit.  You certainly shouldn’t try to warp the world around you by intentionally sharing deceitful meaning.

Anxiety Arises from Naivete

The sheltered soul or naive person is raised with the mindset that “all people are innately good.”  The thought or concept that people are “fundamentally good” is a complete misconception.  Being “good” is very difficult.  It is by no means the default position of the natural man and the subconscious mind. Entropy, catastrophe, tragedy, malevolence and death is the default position of human nature and the subconscious mind.  Good struggles up against this continually.
The people who are most prone to post-traumatic stress disorder (PTSD) are usually naïve people who have been sheltered from malevolence – sheltered from those who are truly spiteful, hostile, vicious, malicious, malignant, vindictive, pernicious, vengeful, hateful, rancorous, and evil-minded.  This is a well known clinical fact and can be found throughout the psychology literature.  There is nothing about this fact that is questionable.  The naïve world view is that you believe the world is fundamentally good – you believe that good behavior is rewarded with good in return – and you don’t really believe that there is any such thing as evil, and you encounter someone who is malevolent (and often you encounter this in yourself).  That sheltering is general throughout our society.  Death no longer occurs at home, it usually occurs in a hospital.  People live in cities and are rarely exposed to the death of animals and the cycle of life seen 100 years ago in farm and ranch life.
Often in those with PTSD, people who have been sheltered from these things, do something, or are required to do something, so morally reprehensible that it damages them psycho-physiologically. Until their psychological framework of good and evil changes, it is very difficult to recover.   These people have no framework in which to conceptualize violent death, evil or the reprehensible act.  They are unable to balance the conscious and subconscious memories and emotions attached to reprehensible emotional guilt, and it destroys them.  This is very common among soldiers.  It’s not always what they saw, it’s what they did or what they were a part of.
Telling and teaching people that humans are innately good (which has been part of our school system teaching for decades) and that evil doesn’t really exist makes them ripe picking for the malevolent and there is nothing about that which is positive.  It leaves tremendous anxiety and psycho-physiological scars in the wake.  This sheltered outlook is cowardice masquerading as virtue.  We see it more and more in our society.
This is why a teenage boy or girl in a traditional Christian or Jewish school is wiser and happier than the 50 year old professor of philosophy in a secular college.  The person who innately understand that good and evil exist within the world have a much easier time coping with and handling stress and trauma that will cross all of our paths.

What does anxiety, chronic stress and PTSD have to do with obesity and weight gain?

Signals in our environment from very stressful life experiences on a daily basis, chronic underlying stress, chronic anxiety, radiation exposure, infectious organisms (such as bacteria and viruses), xenobiotic chemicals, allergens, intestinal bacterial metabolites and food-derived bioactive substances (including phytochemicals), all have influence on messages received by our genes that then influences their expression. Gene expression can turn on and off neuropeptides.  This can effect the autonomic nervous system turning the metabolism up or down.  The expression of our genes in turn controls our health and disease outcomes.  This is one of the reasons COVID-19 seems to effect some people more dramatically than others.

The hormonal counterbalance of blood sugar is regulated, in part, by the autonomic nervous system.  Changes to this system increase or decrease cortisol & glucose production, thereby affecting production of insulin and other weight mediating hormones.  Changes in neuropeptides from stress or anxiety can act just like eating a meal.

As blood sugar falls, the autonomic nervous system responds to balance the blood sugar.  If this system is dysfunctional or under chronic stress, cortisol and adrenalin will cause higher blood sugars due to the stress response and can trigger increased hunger inappropriately.

This is why chronic stress, poor sleep, or even getting cut off while driving in traffic is the equivalent of eating a donut to your hormone responses.  If you’re not exercising, theses hormones will cause weight gain without any change in your diet, and even with caloric restriction.

How Do You Combat Chronic Stress or Anxiety?

  1. Exercise – Because these hormones are released subconsciously, the only way to help control them is regular and consistent physical activity or exercise.  Exercise, 20-40 minutes 3-6 days per week, is often the only way my patients have been able to combat the weight gain from chronic stress, anxiety and PTSD.
  2. Adequate Protein – Recent studies have demonstrated that hitting protein thresholds in men ( > 150 grams per day) and women ( > 90 grams per day) increased growth hormone and decrease insulin, helping to offset the negative effect of stress and anxiety.  This is a key component of a ketogenic or carnivorous lifestyle.
  3. Sleep -Lack of sleep has been implicated in difficulty with weight loss and weight gain.  Lack of sleep places the body into a state of chronic stress. This elevates cortisol, lowers testosterone, increases insulin (there’s that insulin problem, again) and increases the other inflammatory hormones. This perfect storm of stress, driven by lack of restful sleep, plays a big role in fat loss. My average patient needs at a minimum of 6-7 hours of restful sleep to maintain and lose weight. This is where untreated sleep disorders like sleep apnea play a big role. If you have sleep apnea, get it treated. What else can you do to help improve sleep?
    • Remove the computer, iPad and cell phones from the room.
    • Lower the room temperature. Men sleep better around 68-70 degrees F and women sleep better when the temperature is <70 degrees F.
    • Close the blinds or shades to add or darken the room.
    • Don’t study or watch TV in the same room you sleep in. Your body gets used to doing certain activities in certain rooms of the house. The bedroom should be reserved for sleep.
    • Go to bed at the same time
    • Get up at the same time. 
  4. Journaling – Daily journaling of experiences is one of the most powerful keys to helping the brain sort powerful emotions related to anxiety and memory.
  5. Meditation – I’ve created a 23 minute relaxation/meditation audio file that you can listen to for 30 days to help change your subconscious script on weight loss.  You can find it here.
  6. Some people need additional help through hypnosis.  Talk to your doctor about a certified hypnotherapist near you.  If you are a patient of Dr. Nally’s, he offers these services. Set an appointment today.
  7. Additional Resources – If this information is helpful, you may find additional interest in the following books:
  • “Loving What Is ” by Byron Katie
  • “Overcoming Worry and Fear” by Paul A Hauck
  • “The Joys of Living” by Orison Swett Marden

What to Expect

It may take your body and body’s biorhythm 3-4 weeks to adjust to changes you make around exercise, journaling, protein & sleep habits. Be patient with yourself.

Knowing that these challenges plague people on and off throughout the year, and, seeing people get hung up on these issues, I’ve created the Ketogenic Lifestyle 101 Course.  This program gets you jump-started into ketosis and gives you the tools to overcome the individual hurtles you will experience on your health journey.