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Kidney Stones: The Wicked Step-Child of Gout

While at a medical conference in Tampa, Florida, I started thinking about uric acid.  This lead to remembering the story of a patient who was passing a kidney stone . . .  watch to find out what she said.

Kidney stones are really just gout’s wicked step-child and both are usually found in the insulin resistant patient.  Learn why as we spend a short 10 minutes talking about how both types of kidney stones are formed and why.   Uric acid stones & calcium oxalate stones are siblings with different mechanisms of formation but, oh, how they love hanging out in your kidney.

Interested in learning how to start a ketogenic diet?  Sign up for my Free Six-Part Weight Loss Mini-Course and check out DynamicKetones.com if your interested in jump-starting your ketogenic metabolism.

Atherosclerosis: The Stuff Heart Attacks & Strokes are Made Of. . .

Watch as we talk for a few minutes about how insulin affects atherosclerosis and increases the risk of heart disease.  The higher your insulin, the more plaque you make . . . yes, it is that simple.

Risk for atherosclerosis can be determined by checking your cholesterol and specifically an NMR Lipoprofile with lipids through LabCorp or a CardioIQ with Lipid Panel through Quest Labs.  Additionally, ultrasound testing of the carotid arteries, which we do in my office, or through the cardiology offices, checks risk of vascular disease in the arteries of the neck and a stress test can be completed by the cardiologist to assess risk in the arteries of the heart.

Decrease your plaque risk through the use of a ketogenic diet.  How do you do that?  You can learn the basic principles here:

https://www.docmuscles.com/2016/05/10/principle-based-ketodynamic-lifestyle/

Many people have asked me over the last few weeks how to jump-start this process and get the most effective approach as they apply the principles above.  You can jump-start your ketogenic journey by incorporating Dr. Nally’s favorite ketogenic products below.

ketomaxpacket

ketoessentials3bottle

berberine-plus

The Conundrum of Cholesterol & Ketones

Watch as Dr. Nally discusses how eating more fat actually lowers your cholesterol and your risk for heart disease.  Is a ketogenic lifestyle more effective than cholesterol medication?  Find out as we discuss this an many fascinating cholesterol questions from Dr. Nally’s Periscope watchers from around the world.  He also answers questions about his KetoEssentials Multi-Vitamin, Exogenous Ketones, and Pork Rinds (his favorite are the Pork Clouds brand).

So, mix up a bowel of fluff and grab a spoon while you listen and lower your cholesterol.

 

Hypertension . . . Does Fat Raise Your Blood Pressure?

Watch as we discuss how a ketogenic diet lowers your blood pressure . . . yes, fat drops blood pressure to normal ranges.  We talk about the four mechanisms causing blood pressure to rise and how ketosis improves those mechanisms. . . pull up some pork rinds (Pork Clouds are my favorite) and guacamole and enjoy . . .

Type II Diabetes Mellitus through the Lens of Insulin Resistance

Watch as we discuss Type II Diabetes from the perspective of insulin resistance and how using a ketogenic diet/lifestyle as well as exogenous ketones, KetoEssentials Multivitamin and supplements like berberine play a role in improving your health.

Grab your bacon, butter and pecans, . . . pull up a chair, and enjoy!!

Interested in Exogenous Ketones? Now's the Time to Try . . .

For those of you who may be considering their use, or those who are using exogenous ketones on a regular basis, there is a 15% OFF SALE going on with my favorite exogenous ketone maker, Pruvit©, thru January 29th.  Now is the time to buy and save.

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I’ve become a big fan of exogenous ketones for myself and my patients with a little more challenging insulin resistance.  My clinical experience has been great, both personally and with my patients, in helping people to get into, and maintain, a more successful level of ketosis that drives energy, fat loss, improved mental clarity & focus, and diminished inflammation throughout the body.

I’ve been using a packet 2-3 times a day for the last year, personally, and have found these to be the greatest addition to my ketogenic lifestyle. I’m stocking up right now. . .

If you haven’t tried exogenous ketones, now is the perfect time.  Buy yours now before this special ends.

 

How Does Ketosis Affect the Diseases of Civilization?

Listen and watch as we talk about how ketosis, or the absence thereof plays a role in the formation of the Diseases of Civilization (It’s not rocket science, or maybe it is?)

We touch on non-alcoholic fatty liver disease, carbohydrate restriction, the use of protein and even exercise (Did you say “eggs are sides . . .” or exercise?).   So pull up a piece of string cheese and spend 20 minutes that may just change your life.

You can find the vitamin supplements that Dr Nally developed and uses himself and with his patients at KetoLiving.com.

You can find exogenous ketones referenced in the video at DynamicKetones.com

You're Doing It Wrong: Can 50 Years of Nutritional Advise Really be that Wrong?

Listen in as Dr. Nally discusses how we got to be the fattest and sickest country in the world after 50-60 years of bad science influenced by the media and politics.  How can a ketogenic diet help the diseases of civilization?  Listen in and then click the link in the menu above to get my six-part mini course instruction.

We also discuss Dr Nally’s daily diet and his use of exogenous ketones.

Why Be In Ketosis – Part X: PPAR-alpha

Benefit #10 in my 25 part series on “Why Be In Ketosis?”

This evening we briefly discuss PPAR-α, a powerful hormone that is stimulated by the ketogenic state.  It has a number of known benefits.  A number of great questions also popped up that we answered.  Listen and watch as we discuss them here:

Stay tuned for more great content on Facebook Live, Periscope and Instagram.

Why Be In Ketosis? Part IX – Memory

Ketosis plays a major role in lowering blood glucose, insulin and notably improving memory in those with Mild Cognitive Impairment and risk for Alzheimer’s Disease (1).  Watch this short 5 minute segment on how a ketogenic lifestyle helps.  You can learn about a Ketogenic Lifestyle by reading my blog post: A Principle Based Ketogenic Lifestyle.  And you can ramp up your blood ketones in less than 30 minutes by getting exogenous ketones at DynamicKetones.com.

Enjoy!!

References:

  1. Krikoria R et al. “Dietary ketosis enhances memory in mild cognitive impairment.” Neurobiology of Aging. Feb 2012, Vol 33:2 p 419-425.

Why Be In Ketosis? Part VII – cGMP (Making Fat Burning Efficient)

Many people ask me, “Dr. Nally, why should I always be in ketosis even if I burn fat and lose weight without restricting carbohydrates as much as you do?”

The answer is fat burning efficiency.  Shifting into ketosis changes your ability to burn fat, and do it efficiently by turning on cGMP in the adipocyte.  I explain how below:

Enjoy!!  You can click the link below to ramp up your ketosis through the use of exogenous ketones at DynamicKetones.com.  Yes, I make a profit from the sale of exogenous ketones, but I just gave you the magic bullet for opening up the adipocyte for FREE!

Merry Christmas!

Why Be in Ketosis? Part VI -Blood Pressure, Headaches & Nitrous Oxide

How does being in ketosis and living a ketogenic lifestyle lower your blood pressure, decrease risk of kidney stones and gout?  Listen in to the way nitrous oxide is raised by being in ketosis . . . Enjoy!

Ketogenic Interview with Vicki Fitch: A Fresh Perspective

I had the chance to appear for an interview on Vicki Fitch’s podcast last night: A Fresh Perspective.  We talked about bacon, ketogenic diets, hypoglycemia, sweeteners, food cravings, #FitchSlaps, exogenous ketones and we answered a bunch of great questions from the Facebook Live audience.  You can see video of the show below:

Had a great time.  Let me know what you think. Thanks, Vicki!!

KetoTalk 34: Short-Term Ketosis Benefits, Exogenous Ketones, Upper Abdominal Pain, Cheating On Keto

KEY QUOTE: “For those of us that are insulin resistant, which is two-thirds of the patients in my practice, you really have to use the ketogenic diet to see the true effects of the exogenous ketones as an adjunct to the diet.” — Dr. Adam Nally

 

abdominal-pain

 

You’re not going to want to miss this one, listen in by down loading KetoTalk on your IOS device or here at iTunes.  Or, you can use your computer to listen on KetoTalk.com to hear Dr. Nally & Jimmy Moore talk about the benefits of Ketones, Abdominal Pain and Ketones, & “To Cheat . . . or Not To Cheat.”

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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.

Statin.jpg

“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

Ketogenic BioHacking.png

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

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To register for this training session click here:
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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

Too much protein, too little protein?  How do you know how much protein to eat?  This has become a very confusion question for many of my patients in recent years.  There a a large amount of “mis-information” in the ketogenic world about the effect of protein of gaining and losing fat.

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For the person exercising 5-6 days a week, 1 gram of protein per pound of ideal body weight is the formula that works quite well.  However, for the average Joe or Mary who doesn’t work out for an hour a day 5 days a week, I’ve provided the calculation below.  This calculation is a baseline starting point.  It is the basic amount of needed protein to maintain muscle on a ketogenic or carnivorous diet:

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.  Then multiply the number you found by 1.2 (multiplier for sedentary male). [This lets you calculate the average male needs  that are approximately 1.2 g of protein per kg of ideal body weight (IBW) 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.)
Example:
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 x 1.2 = 93.2 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 (IBW calculated number before using the multiplier).  
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.

 

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.”

SO, WHAT DOES ONE DO?

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?

Yes.

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.

KetoOS

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:

Breakfastofchampions

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!

References:

  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.

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

Giant Pizza Slice

LISTEN AND DOWNLOAD AT ITUNES

LISTEN ON YOUR COMPUTER AT KETOTALK.COM

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 podcaster 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.

Admit It . . . Your Problems Went Away for a Moment

I want you to think about bacon for a minute . . .  here are some images to help:

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Now admit it . . . your problems went away for just a moment  . . . didn’t they!?  That’s the power and influence of ketones on your brain.

See, your brain loves ketones.  Bacon is the bearer of ketones.  Bacon contains saturated, polyunsaturated and monounsaturated fat.  Fats that have the ability to be converted to ketones in the short run, in a couple of hours and 4-5 hours from now. Isn’t that exciting?

I know my brain feels a little kick start just thinking about it.

MacronutrientKetoneUse
Triglyceride conversion to ketones in the hepatocyte (The KetoDynamic Antidote©)

As long as you are putting that bacon into the system without the stimulus due to an insulin surge from carbohydrates, you’ll do fantastic.

This is the same feeling I get when I use exogenous ketones like Keto//OS. If you haven’t tried them, you’re missing out.

So, if your feeling a little foggy today, stop and think about bacon wrapped avocado fried to a crispy golden brown in coconut oil for a moment, and while you’re making them . . . drink a Keto//OS . . .

There . . . doesn’t that feel better?

(Yes, I just used pictures of bacon to advertise for exogenous ketones, but really,  . . . . you feel better don’t you!?)

KetoTalk: Episode 27 -Mailbox Blitz, Low Energy, Headache, Stomach-Ache, Breast-Feeding While On Keto

Mailbox desert

Listen in today as Jimmy and Adam blaze through a bunch of listener questions in Episode 27 of KetoTalk with Jimmy and the Doc!

GetAdaptBars

KEY QUOTE: “Children are born in ketosis, so ketones are perfect for babies. The level of fat in breast-milk is essential for them to maintain their health and their growth.” — Dr. Adam Nally

Here’s are the 12 questions Jimmy and Adam answered in this special Keto Talk Mailbox Blitz extended podcast today:

– Testimonial from someone who learned his lesson why it’s important to stay ketogenic all the time
– Three-decade study confirms saturated fats are bad for health
– Is increased testosterone from a ketogenic diet a bad thing for women?
– Why am I still struggling with low energy and low ketones after months of being in ketosis?
– Can being in nutritional ketosis above 1.0 mmol cause painful headaches?
– Do artificial sweeteners and stevia raise insulin?
– Is my ketogenic diet causing me to cramp up before and during my half marathon racing?
– Is MCT oil a better fat to use on a ketogenic diet than other fats like coconut oil, cream, or butter?
– Why do I have a constant stomachache while I’m on a ketogenic diet?
– Do you have to be in ketosis to burn fat?
– Does being in ketosis lead to daily spotting and extended periods?
– Are ketones in my baby’s breastmilk safe for her to consume? And why did my milk supply drop when I went keto?
– What is the impact of the supplement creatine on ketones, blood sugar, and insulin levels?
– Can I ease into ketosis as a way to avoid the dreaded “keto flu?”

KEY QUOTE: “If you’re not feeling energy after that adaptation period of 2-4 weeks at the very most, then you’re doing something wrong. Let that be your wakeup call to change something.” — Jimmy Moore

KetonesKETOOS

Listen in here at KetoTalk.com or you can download the episode for free on iTunes.

How Fat Lowers Your Blood Pressure

Hypertension (elevated blood pressure) is one of the triad symptoms of metabolic syndrome.  Most of the hypertension that I see clinically is driven by insulin resistance as Blood Pressure Surprisethe underlying cause.  I see this problem in a very large majority of the people in my office and I am seeing people younger and younger show up with continually increasing blood pressure.
In medical school, we were taught to treat “borderline” or “slightly elevated blood pressure,” through “lifestyle changes” which was another way of saying exercise, caloric restriction  & hold the salt.  But most physicians today will tell you that exercise, salt & caloric restriction doesn’t work.  When asked why the 34 year old male in my office suddenly has elevated blood pressure, the only explanation we had was it is a “genetic problem,” or “blood pressure naturally goes up as we get older,” or “you’ve been eating too much salt,” and they are started on blood pressure medication and sent on their way. But, as time went on, I found that I had to keep adding more and more blood pressure medication to control the continually rising blood pressure of the patients in my practice.

Most of these people will have a progressive elevation in blood pressure over time, and these blood pressure (anti-hypertensive) medications are/were continually raised until the person is on four or five different blood pressure pills at maximal doses.  Again, when questioned why, their genetics are blamed and that is the end of it.  Or is it?!Time Changes Everything

What shocked me was that when I took patients off of salt & caloric restriction, and placed them on low carbohydrate high fat diets (and yes, I gave them back their salt), their blood pressure normalized. I noticed that as their fasting insulin levels began to fall, their blood pressure began to return to normal.

What?!  Blood pressure rise is caused by insulin?!

Ummm . . . Yes!

I am a prime example.  During the first few years of my medical practice and reserve military service, we had routine vitals checkups. I was working out 3-5 days a week with weights and running 3-5 miles 2-3 times a week and restricting my calories to 1500 per day.  So, I thought I was in pretty good shape.  However, it was not uncommon for for the nurse to raise her eyebrows at my blood pressure readings in the 140-160 systolic and 85-98 range diastolic.  “Oh, it’s the lack of sleep last night,” or “it’s the caffeine I had this morning,” would be my excuse.  But I was making a lot of excuses, and in light of those excuses, my caloric restriction, exercise and salt restriction, I was also still gaining weight.

Nally 1998 Expanding Waist

 

By the 5th year of my medical practice, I weighed 60 lbs heavier than I do today and I struggled to keep my blood pressure under 150/95.  I was violating my own counsel . . . don’t trust a fat doctor for nutritional advise. (Or, was that advise from Dr.House?)

Nally 2016
A much slimmer, healthier and happier Dr. Nally (center) in 2016

After cutting out the carbohydrates (I’ve kept my carbohydrate intake < 20 grams per day), moderating my protein intake and eating all the fat I am hungry for each day, my recent physical examination at the beginning of June 2016 revealed my blood pressure at 112/64.  I don’t remember ever having blood pressure that low. And to be honest, I didn’t sleep well the night before my exam due to a number of middle of the night patient calls.

Loegolas Blood Pressure

When I first started treating the insulin resistance problem in the human, rather than the blood pressure problem, I began to see immediate reductions in blood pressure within one to two weeks.  So much of a reduction that if I didn’t warn the patient that they should Himalayan Saltbegin to back down their blood pressure medications, they would experience symptoms of dizziness, light-headedness, headache and a few patient’s nearly passing out.   On a low-carbohydrate, high-fat (ketogenic) diet you need salt (sodium, potassium, & magnesium).
The process of burning fat as fuel causes you to lose increased amounts of sodium & potassium, and you have to replace these electrolytes.  A number of my patients begin a low-carbohydrate, high-fat diet and are afraid of increasing their salt intake.  Not replacing these electrolytes while on a ketogenic diet can also lead to low blood pressure, dehydrate and dizziness.

 

I often wondered why applying a ketogenic diet had such a profound effect on blood pressure so quickly.  Dr. Robert Lustig helped answer that question for me.

In order to understand how the Standard American Diet (we call it the SAD diet in my office) raises your blood pressure, it is important to understand how the body processes the basic sugar molecule.  Sugar is one glucose molecule bound to a fructose molecule.  This is broken down in the body and 20% of the glucose is metabolized in the liver, the other 80% is sent on to be used as fuel throughout the body. Fructose, however, is where the problems arise.  100% of the fructose is metabolized in the liver, and the by product of fructose metabolism is increasing the liver’s production of MORE glucose and the byproduct of uric acid. Uric acid is produced and this inhibits the production of nitric oxide. The diminished nitric oxide in the presence of an increased level of glucose (stimulating increased insulin production due to eating starches) constricts the blood vessels and raises blood pressure.   Yes, that donut you just ate raised your blood pressure for the next 12 hours. GetAdaptBars

The mechanism that fructose containing carbohydrates, sugars and starches raise blood pressure, cholesterol and cause weight gain can be seen in the really complex diagram found in Dr. Lustig’s 2010 article:

Metabolism of Fructose

 

So, how do you lower your blood pressure through diet?

First, cut out all the simple sugars. These include anything with table sugar, high fructose corn syrup and corn syrup.  (This is why people with any change in diet see some improvement in weight and blood pressure as they remove the simple sugars like candy, sugared drinks and pastries from their diet.)

Second, limit your overall intake of other sources of carbohydrates including any type of bread, rice, pasta, tortilla, potato, corn and carrots.  Realize that carbohydrate in fruit is fructose, and when taken with other forms of glucose can have the same effect as table sugar – it can and will raise your blood pressure, as well as halt or cause weight gain.

Third, if you are taking blood pressure medications for hypertension, see your doctor about close monitoring of your blood pressure as it can and will drop within 2-4 weeks of making these dietary changes.

Maintaining ketosis is really important for weight loss and blood pressure or hypertension control. I am very much an advocate of using real food for this process, but I have also found that the use of exogenous ketone salts aid significantly in maintaining ketosis.  I have found that exogenous ketones are the next step in bridging the difficulty of day to day maintenance of ketosis.

It isn’t making the mistakes that’s critical; it’s correcting them and getting on with the task that’s important.  If you’ve been calorie restricting and exercising to lower you blood pressure, don’t fret.  A simple change in your diet focused on restricting starches and carbohydrates has been demonstrated in my office to be more powerful than many of the blood pressure medications we’ve used for years.

Learn how to get started on a low carbohydrate, high fat (ketogenic) diet here.  You can also read about the basic principles in my recent articles  The Principle Based Ketogenic Lifestyle – Part I and Ketogenic Principles – Part II.