Dhru Purohit Show - How Fasting Can Help You Lose Weight, Prevent Disease, and Increase Longevity with Dr. Pradip Jamnadas

Episode Date: July 4, 2022

This episode is brought to you by InsideTracker and Gut Food. These days, we hear a lot about fasting. Intermittent fasting, time-restricted eating, and water fasting are just some of the many terms being thrown around in support of better health. Which one is best? What does it all mean for our longevity, brain health, and overall wellness? On today’s mini-episode, Dhru sits down with Dr. Pradip Jamnadas to talk about how fasting can troubleshoot our biology, boost our energy, and decrease our risk of disease. Dr. Pradip Jamnadas is the founder and medical director of Cardiovascular Interventions and has practiced in central Florida for over 32 years. Widely recognized for his skill in interventional cardiology, Dr. Jamnadas has been awarded Orlando’s Top Doctor by Orlando magazine consecutively for over a decade. In this episode we dive into:   -Why we get fat -Glucose intolerance and hyperinsulinemia -The number-one cause of hypertension -The top benefits of fasting Listen to the full episode here. For more on Dr. Pradip Jamandas, follow him on Instagram @PradipJamnadasMD, Facebook @PradipJamnadasMD, YouTube @DrPradipJamnadas and @TheGalenFoundation, and through his website, orlandocvi.com. For more on Dhru Purohit, follow him on Instagram @dhrupurohit, Facebook @dhruxpurohit, Twitter @dhrupurohit, YouTube @dhrupurohit, and TikTok @dhru.purohit. Text Dhru at 302-200-5643 or click here.  This episode is brought to you by InsideTracker and Gut Food. InsideTracker provides detailed nutrition and lifestyle guidance based on your individual needs. Right now, they’re offering my podcast community 20% off. Just go to insidetracker.com/DHRU to get your discount and try it out for yourself. Gut Food uses the power of three critical gut-supporting components—prebiotics, probiotics, and polyphenols—and five ingredients at clinically validated dosages to help reduce inflammation, support the growth of beneficial gut bacteria, improve digestion and bloating, and support mood and energy. Check it out at gutfood.com. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hi, everyone. Drew Brode here. On these Monday episodes that we've been featuring, we've been taking some of the top episodes we've had over the last few months, and we're extracting some of the key moments from there, especially for people who don't necessarily always have two hours for a long podcast interview, and my podcast interviews can go along. So today's mini episode is with Dr. Pridip Jan Madas. Now, Dr. Pridip is one of the folks in the last year that has absolutely blown up on YouTube. because of his lectures on fasting. And we're taking my conversations with him and pulling out some of these key moments that are really, you know, the way I explain it to friends when they ask what, you know,

who Dr. Pradip is and what does he stand for? I say he's the hype person. He's the hype man for fasting. He gets you excited about fasting and what its potential is. You know, a little bit about Dr. Pradip before we jump in, just a little background. So Dr. Pradip is the founder

and medical director of cardiovascular interventions, and he's been practicing as a physician in Central Florida for over 32 years. He's widely recognized for his skill in interventional cardiology. He's a cardiologist, by the way, and he's been awarded Orlando's top doctor consecutively for over a decade. On today's episode, we're going to talk a little bit more about how fasting can help you lose weight, prevent disease, and most importantly, increase your longevity. I hope you enjoy this mini episode, and it gives you a chance to get a little taste if you miss this original one. If it gets you excited, you can always go back.

And in the show notes, we have a link to the full episode. Enjoy, and I hope everybody's having a beautiful summer. I can't think of any area that there's more information on than this basic idea of why do we get fat, so to speak. I think there's still a little bit of a misunderstanding in terms of this calorie model and what is known as the hormonal model that's tied into insulin. So can you break that down for the audience that's listening? You're absolutely right. You're absolutely right about this.

You see, the problem is calories, the old calorie theory was that the more calories in, the more you're going to gain weight. And if you don't burn the calories, you're going to gain weight. And we know now from numerous studies that that's absolutely not true. What it is is the hormonal model. So you are absolutely right about the hormonal model. Now, what we're eating and how often we're eating is changing us from a hormonal standpoint. And so you're a hormonally modified human being now.

You're no longer the same human being from four generations ago. And your hormones are changing because of what you're eating, the type of food you're eating, the processed foods, how often you are eating. So that's what's happened. And the reason why we've come to this is, look, every day you're bombarded by advertisements. You're bombarded by people who tell you that, you know, you've got to eat five meals a day, that you get in the car, you've got to have your drink and your food. you've got to eat on the motion. And so every day, you know, your instinct of saying that,

you know, I'm not hungry, but you still eat. And there's so much pressure for you to eat. Because people are, everything is being pushed on you, the advertisements, the snacks, the, the, everything just points towards consumption, consumption, because we need to break out of it. Because otherwise, we are going to suffer. See, we are addicted because we've been made addicted. And then, of course, the medical profession, but also government forces have not really helped us because they've told us dietary advice that was not entirely correct. So we were told it was all fats, fats, fats, fats. But now we know it's not all about fats. We know that it's also about sugar and carbohydrates and processed foods and what that does to us and changes our physiology.

And these foods are addictive. So we've moved to a calorie-rich addictive diet. And that's why addiction is such a huge part of everything I talk about to my patients. And I've got to get them out of the addiction so that they can make changes in their life. So it's not just about just eat this, eat this, it this. No, I have to recognize that these people are addicted. And this addiction is a serious addiction. It's as serious as being addicted to morphine or any other drug.

And it's that serious. and people look at me and my patients look at me and say, you mean to say I'm a junkie? I said, yes, you're a junkie now. You really are. And I see it every day. I see it every day in my clinic. This is my clinic and I run my practice every day. I do surgery.

This morning I did angioplasty. I did a stent. So I'm a day-to-day cardiologist. And when I speak to my patients in the clinic in the afternoons, it's addiction. You know, one day and they go, oh, my God, I was breaking out in a sweat and I felt my sugar was getting low, so I had to go and eat and I felt better. And I said, and did you take your sugar level? And they said, yeah, and it was 100. Well, then it's not hypoglycemia. Pure addiction. It's pure addiction. So that's what's happening. We've moved away from eating real food to

addictive substances. These are not foods, by the way. These are substances. So should we be consuming substance or should be consuming real food? That's the issue. We're moving away from real food to substances, chemicals, addiction. And the combinations of these foods is also a problem. So you see, fasting is also about what type of food you? Look at the combinations. It's high sugar and high fat. And of course, there's lots of salt in it too.

That combination is not found in nature. So when that gets into our body, it causes these hormonal changes. And the biggest hormonal problem I found was insulin. So there's a condition called, glucose intolerance. That means your sugar level is a little high, but not high enough to make a diagnosis of diabetes. So I found that at least half of my patients in whom I didn't have a diagnosis of diabetes actually at slightly elevated sugar levels. And then that got me thinking that why is this happening? And right around that time, we were realizing that insulin levels are

really high in these patients and that type 2 diabetes is a case of hyperinsular anemia. Let me just explain that a little bit for the audience. So what happens is that in these patients, they do up high insulin levels, which keeps the sugar level down. So when you do the glucose to honest, it doesn't look too bad. And you look at the blood test called a hemoglobin A1C, which is a test to see what your blood sugar has been doing over the last few weeks. They also stay nice and low. But the problem is the insulin level is so high. and I found that on my patients that the insulin levels were so high for 10 years, 12 years before they become diabetic.

So it's finally when the insulin just can't keep the sugar down, the sugar starts going up. He's said, oh, now you have diabetes. But guess what? He's already had high insulin for by at least 10 to 12 years. And right then my curiosity really got there. I said, you know what? There's something going on here. And then as the more research came out and other researchers also came in, I realized that it's insulin resistance.

And now, almost routinely, almost every patient gets an insulin level. Now, the problem is we were not doing insulin levels before. No one was measuring it. If you go to your family doctor and say, I want to measure my insulin levels, he says, no, you don't need it. He's just a glucose tolerance test. And you do a glucose tolerance test, and it tells you nothing. It tells you that your sugar is all okay, and you've got a pattern on the back and say,

go home. But in reality, behind the scenes, you've got this really high insulin level. So I think that this is a time when we need to be educating our medical profession also that we need to be looking at the insulin levels because I'm finding that when I find these high insulin levels and then I chase that and I bring it down through methodologies which we'll talk about in the second. Now I'm making an impact on those patients who have heart disease and all of a sudden I started noticing the patients were getting better. when I bring their insulin levels down and the way I brought it down, there's no magic pill to bring insulin levels down, as you know. There's no injection to bring your insulin level down. So that's when I got interested in fasting because I realized how am I going to bring this

insulin level down? How? How am I going to? Okay, okay. We're going to change the diet. Don't eat sugary things. Don't eat carbs. Don't eat simple stuff.

But then I, as I started peeling that onion, I realized that it's not just that. it's also processed foods. It's also certain combinations of foods. And then I realized that, oh, my God, we're eating too often as well. That's when I came and I said, you know what? There has to be one thing that will help all of this. And that has to be fasting. And I looked at my insulin responses.

It was fascinating that if you don't eat all day long and then have only one meal, you're going to make less insulin for that one meal than had you eaten that same meal after having had two previous meals that day. So what that tells me is that your sensitivity to insulin changes on a day-to-day basis, or hour-to-hour basis. So even your own circadian cycle, as you know, makes you insulin resistant at certain times of the day. You know, like when you're waking up in the morning, you're going to be a little bit more insulin resistant at that time.

things like that. So as I read more and more, I got lost in this field. I said, oh my God, this is so amazing stuff. And how come we do anything about this? So that's how I got into fasting. So you can see it was a little roundabout way that I got into fasting. Yeah. It was a roundabout way, but really at each intersection, you're asking yourself, okay, what's deeper? Okay, what's deeper than this? Okay, what's deeper than this? And that's what brought you to a place of, wow, this one thing, this insulin, which plays so many different roles inside of the body, you know, one of them being, you know, keeping your blood sugar, you know, down, is so central to all these conditions. You know, you mentioned one, which is people

having their arteries clogged. What are some other conditions, symptoms, issues, challenges that people are going through because often sometimes people hear this and they're like, well, I don't have any history of diabetes in my family. Okay, I might be a little bit more overweight, but I'm not having a diagnosis of diabetes. I'm not sure if this is something that I should pay attention to. But talk about all the things that this is connected to beyond just diabetes, beyond just, you know, somebody worrying about their arteries being clogged. What else is insulin and having too much of it in your body connected to? So this insulin doesn't just affect the condition of your arteries in your heart. Because ultimately, remember, when you're born,

that bud comes out of your heart and then all the arteries grow out, the arteries in your heart grow out, and then the arteries, your aorta, your carotid arteries, and then down to your kidney arteries, your leg arteries. These are all blood vessels. And what we've done in medicine is we've compartmentalized everything. And then we break it up into different organs. So we don't see that there's a universal connection. So whether if you have kidney disease, for example, what's wrong with your kidneys? Now, there are many different types of kidney disease, but the number one thing is still macrobascular disease in your kidneys. So when you have high insulin levels, the tiny blood vessels in your kidneys are not going to work very well. They lose their ability to vasodalate.

So insulin blocks nitric oxide production. Nitric oxide is a vasodilator, as you know. So when your nitric oxide is not that you can't vasodalate. And the body is, supposed to have this vasodilitary capacity. You're supposed to be vasodilate and vaso constrict, and you're supposed to have that flexibility. But you immobilize all your tiny blood vessels and caprives when your insulin levels high. So in your kidneys, you're not going to get adequate kidney function. In the brain, you're not going to have adequate brain function. You're going to develop major arteries. It will also clog up your carotid's, your peripheral vascular disease. So insulin affects every organ, because every organ has blood supply, and you are as

old as your blood supply. I mean, William Osler said that, right? You're as old as your arteries. So the manifestations of high insulin are widespread. So I'll give you an example. Some of my older patients come in and say, you know, I'm getting a little demented. I'm getting very forgetful. And the spouse will say the same thing. And I will find hyperinsulinemia. And when I treat them and I change their diet, and I'm not, I'm just the cardiologist. But I tell them, look, you've got to do the following things. The wife will come back and say, you know what? His memory so much better now. He's functioning better. And we now know that when you do magnetic resonance imaging studies in the brain and look at functional studies, that it's the vasodilation,

vasodiliction that occurs in your brain, in different parts of your brain. And you basically immobilize all that when your insulin levels are high. And insulin is a growth factor. That's something else that people need. So how does it cause hardening of the arteries? Well, the walls of your arteries have smooth muscles. Okay. That's why they can vaso constriction and vasodilate. And What insulin does is that it causes that smooth muscle proliferation. So it causes it to thicken. So the walls of the arteries become thicker as well. So it's a growth factor.

It also causes left ventricular hypertrophy. Big word. Basically, the heart muscle gets a little fat when you put the patient on insulin or you have high insulin levels. So it's a growth factor. Growth factors also affect cancer and cancerous cells in the body. So a growth factor is something you want when you need it, but when you have an inappropriately high insulin level, you don't want those growth factors to be there. So take blood pressure.

Now, Drew, I'm going to tell you something about blood pressure. I've been dealing with blood pressure since the day I graduated from school, and I was told that hypertension is essential. Well, there's no such thing as essential hypertension. There's always a cause for hypertension. And the number one cause that I have found in the last 10, 15 years, it's a hyperinsulinemia. So I'll give you a typical example. Young guy like you comes to the office, he's got no other problems. He says, my blood pressure is high.

I bet you you've got insulin resistance. And I measure his insulin levels, this guy high. Bring his insulin levels down. So now he says, my doctor told me I have to be on blood pressure medications forever. I was one of those doctors. Then you have to be on blood pressure medicines forever. you can't come off because you got hypertension. And I have realized that that's absolutely not true.

If you find a patient who has essential hypertension, I now look for hyperinsulinemia. And invariably, I do find it, bring it down through dietary changes and lifestyle changes, and the blood pressures go away. And I've done that to hundreds and hundreds of patients in my office. So insulin causes hypertension because I just totally have vasoconstriction and it doesn't allow your blood vessels to dilate appropriately,

and that causes hypertension. So when you look at metabolic syndrome, part of it is hypertension. And this is how it works. It's all because of hyperinsuliniaemia. So it causes hypertension. It causes hardening of the arteries in all your organs, and then you're going to feel the symptoms of that organ,

whether it's your brain, your kidney, or your heart, or even your peripheral asclature, or even endothial dysfunction, causing erectile dysfunction. So as a cardiologist, I don't see those patients, but my urology friends and I have now got this rapport going, that, hey, you see those patients with irritable dysfunction, they have endothel dysfunction. If they have endothel dysfunction, there's something going on. You should be looking at the insulin levels.

And it's been very exciting because we've actually restored endothel dysfunction in these types of patients by appropriate dietary interventions and British insulin. So you can see that it has ramifications beyond what we imagine because it just depends which organ is being affected by the dysfunction due to the hormonal imbalance of hyperinsulinemia. You know, you said, I believe it was one of the talks. It was like, there is no drug out there on the planet that can do the same thing that this not doing of something,

not eating, can do in our body. So talk about some of the science that's out there that you came across that really helped you connect the dots in terms. And in addition to your own experience with your patients and seeing the improvements with their health, talk about some of the studies or some of the general research that's out there that really helped you connect the dots around fasting. Yeah. Yeah. So when you're not consuming calories, right? When you're not consuming calories, the insulin levels obviously drop.

because insulin only is produced when you're taking in calories. So your insulin will drop. And I found through all the research that so what happens now is the body, through all its chemicals and changes, realize that, hey, I need an alternative source of energy. Well, guess what? You do have it in the form of fat because you stored it away for a rainy day. Well, the rainy day has come because you haven't eaten. So when you don't eat and you're fasting, now the rainy day has come and your body has to start mobilizing the fat stores. But the problem is that all of us are hyperinsulinymic.

So so long as your insulin level is high, those fat stores are locked away. You cannot mobilize them. But when the insulin levels start coming down because you're fasting, now those fat stores, because they get hormone sensitive lipase and other hormones. As a result, the fats start mobilizing. The fats now come in the form of triglysis to your liver. Your liver will start producing some ketones. And the ketones can be utilized by the body as an alternative energy source. So fasting unleashes a whole new metabolic pathway of energy production through ketones.

And you and I do that or supposed to be doing that naturally because it's built in our system to do that. Because you are not supposed to be eating every two hours. and our physiology is such, we were about more than 10,000 years old. And our genetic engineering is from that time when you eat now, and you may not eat again for another day or two. And therefore, during those times, you have an alternative source of energy. And we just didn't realize that we thought there was only one energy source, and it was all sugar, sugar, sugar, and glucose only. But no, these are the pathway available to us. So what is the advantage of having that alternative pathway?

Well, when you use that alternative pathway, you're getting rid of the fat from the body. So you don't develop the obesity that we're getting nowadays. But more than that, more than that, the body makes you stronger because you're going in that pathway. Why? Because the body wants you to survive. So when you're in a survival mode, you're going to come back stronger and better than before. Because, look, if you don't have calories, you think you're just going to crawl into a cave and die over there and just become weaker and weaker and just become, I can't think anymore. And you just go, no.

Nature wants you to come back, stronger, become brighter, smarter, stronger than before. Go out and get your food so that you can get back. And that's what this ketogenesis is all about. This new pathway is not just providing energy to you. It's actually bringing you back better. bringing you back better. So the research that I found is that when you allow this to happen, it's a kind of hometic stress that you're creating on yourself.

Homantic stress means that you're creating a stress on the body, which is going to bring you back better. So when you do this fasting, there's so many benefits. Number one, I'll tell you. I'll just rattle them off, basically. There's a thing called brain-derived neurotropic factor that is released. And that makes your brain brighter, smarter. You can actually grow new cells and neuroplasticity as well, which is fascinating.

We never thought that this was possible, that our brains can actually grow, grow back. So, you know, brain-teref neurotrophic factor. And then when you do feed yourself afterwards, there's a release of stem cells into your bodies. These things don't happen under normal circumstances when you're constantly eating. So this stem cell mobilization is fascinating information. Growth hormone, during fasting, you get growth hormone. You get more growth hormone production during fasting than at any other time. So your growth hormone allows you to maintain your muscles and repair.

That's fascinating stuff that's going on inside your physiology when you are in the fasting mode, which you wouldn't at other times. and then there's this thing called autophagy. And I know there are a lot of people talking about autophagy, and you know all about autophagy, but for your audience, I'm just going to tell you, when you're running out of fuel and substances not coming in, you're going to take all your intracellular redundant parts of your cells

and say, you know what, I'm just going to use these for energy. Because I need energy, right? So under the circumstances of fasting and some ketone production, you're going to take your intracellular organelles that are redundant, and you're going to basically package them into lysosomes and basically export them out of the cell so that the body can utilize them. Now what you've just done is you've cleaned up your intracellular debris, as it were. And same thing with old mitochondria. You're going to get rid of your old mitochondria because the body is now saying, you know, know what? I'm out of fuel here in the house. My fire is getting down. Well, you know, there's this old piece of furniture. I'm going to burn this old piece of furniture. That's what it's doing. It's

getting rid of redundant furniture. It's going to be. Now, when you feed yourself again, those parts are going to be replaced. So the science is now showing that when you clean up your mess in your cells, and then you do feed yourself again, you're going to get new mitochondria. you're going to get better intracellular functions, and energetics is going to get better in the cell. So I have found, especially right now with everything that's going on with post-COVID and the end of the patient's coming on no energy whatsoever, and I tell them to do fasting, the energy gets better. Why is that? It's because they're getting mitophagy, their mitochondria getting better. They're getting new, better mitochondria.

So the fasting process is not just about losing weight. It's about changing your entire cellular mechanisms. And we're supposed to have that. That's what keeps us young. Our telomeres also get longer when we're doing this. They don't shorten so fast, I should say. So there are so many biochemical changes. It's crazy that we didn't take advantage.

advantage of this pathway before. So everybody gets into a ketotic state at a different level of their fasting. It just depends on what your diet has been before, how much sugar you've been consuming in your diet. But let's say that, like, I eat once a day. That's what I do. So for me to get into ketogenesis very easily, I start spilling some ketones very quickly. By about 16 hours, I'm already got some ketones in my urine. So I know that. that I'm in that pathway. Others may take them a little bit longer, but then slowly it becomes shorter and shorter and shorter,

so you start producing. So one thing is that you need this metabolic flexibility to become healthier and to heal some of the bad things that have happened as a result of our lifestyle and diet. So fasting has, to me, as you said in the beginning, you know, as a cardiologist, I realized that when you first start your fast,

fasting, you're going to get rid of your addictions. It's going to be a tough, tough process for a couple of weeks. Then you start fasting one day a week. Skip one meal a day, maybe for three, four days, and then skip two meals a day for the next week or two weeks so that your body is getting used to it. Look, I didn't die. Nothing happened. I missed two meals, but I'm still here. I felt okay. And it empowers the patient to say, you know, I can do better. And then the next time, They say, you know, evening came about. It was supposed to be my meal. I'm not hungry.

I feel good. I'm just going to skip it. I'll go to tomorrow morning. You just did a 36-hour fast. So that's how I empower them to gradually get into it. Because if we just go straight to fasting, they fail. They fail. They fail miserably and they feel terrible.

And then they won't come back to you. They'll say, oh, I can't do this fasting stuff. You've got to do it gradually. You've got to just learn to skip meals. and know what to expect, you're going to get some cravings. And these are all part of your addictions in the beginning. Then you're going to get some, besides the cravings and the addiction symptoms, you might get electrolyte imbalance.

That's why you go to drink lots of water. Because as your insulin levels come down, you'll find that you'll have a diureasis. You'll have much more urine output. So you need to replace sodium. Because with insulin, when your insulin levels are high, you hold on to salt and water. When your insulin levels come down, you start mobilizing all that. So you start having a diariesisic. I'm making so much urine and you're losing salt.

So if you get cramps, you're getting cramping in your legs and arms, I tell them to take some little bit of salt with the water and they start getting better. So now all of a sudden they say, you know, I feel good. Yes, Doc told me about my cramps. I took salt. He told me about my cravings and my behavior. I'm just going to have to work my way through that because I'm a junkie. He called me a junkie.

So I'm a junkie now. So I'm getting out of it. So it'll take me two weeks to undo all that. And after two weeks, they feel empowered. I did it. And then they start feeling better. You know, the mental fog is gone. They're sleeping better.

Their memory is better. and at the end of the day, they just feel so much energy inside them. And they say, you know, Doc, I never felt so much energy before. And they go and they work out in the gym. They're actually holding on to more muscle as well because their growth hormone levels are higher as well. So they come back and they tell me all this. I feel great, Doc. I don't know what it is, but this fasting stuff is very working with me.

And if they're really obese, once they've reached this stage, then I make them do a three-day walk. fast. So first you got to do all this. You got to graduate. You can't just go to university. You first got to go through high school and get through all this stuff. So I make them go through all this and then say, okay, now you're ready. You're going to do a three-day water fast. And then it's just water for three days. And then we get better results. Yeah. One clarifying question that I have is that for example there, because I know a lot of people are paying attention, watching this on YouTube or listening on the podcast, for those that might find themselves in that same category, would you say, you know, generally, you know, time

restricted eating, you know, not having food between a certain, you know, period of time, having like an earlier dinner and a little bit of a later breakfast, doing a basic practice that would fall under the world of fasting of time restricted eating. I think generally, you know, most people would regard that now. Even mainstream medicine would say, like, that's safe, you know, that's all good to go. Then there's like the longer fast that are there. There's the intermittent fasting and then people working themselves up to like a 24 hour fast. And you've done some great videos on this and we'll link to those as well. Would you say in the category of a three day water fast that's something that people can navigate on their own or should they really have some connection to a medical

professional like yourself or somebody else that's out there? Do you have any opinions on that? That's a great question. So if you are on insulin, this is very, very important. If you're on insulin and you're fasting and you're still taking insulin, you're going to get hypoglycemic. Now, that means that your sugar levels are going to drop because you're not taking any calories and you're taking your insulin. So you are going to be in grave danger of getting hypoglycemia and you can get a seizure and you can even die or get a heart attack. So when you are fasting and you're going to do a three-day water fast, for example, you really, even, even the, 24-hour fast, you really need to have a medical professional that is going to oversee that if you're

taking medications. So what are my general advice is as follows. If you're on insulin, you really need to talk to your provider because you should not be taking insulin when you are fasting. And even when you do the 24-hour fasts, you need to cut back on the amount of insulin. So what I tell my patients typically is that the long-acting insulin you can stay on, but the short-acting insulin that you're taking for meals, you shouldn't have. You still need your background insulin. But the goal here is to get you off insulin. So I'll tell you right now, I've taken about 150 patients off insulin in the last few years.

So they've come to me there are tons of insulin. So I think that when you're fasting, you do need medical supervision if you're a diabetic and you're taking insulin. Now, if you're taking oral agents for diabetes, for example, then what should you do with those on the days that you're fasting? You shouldn't take them. You shouldn't take them if you're fasting for 25 hours or more. So on the three-day water fast, I tell them, don't take it.

But they can take all the other medications. So there may be on medications for cholesterol or gout or anything else. Fine, you can stay on those medications. But nothing that's going to lower your blood sugar. So you've got to be a little cognizant of that. And then same thing for blood pressure medications. You will notice that your blood pressure goes down when you are fasting. So watch your blood pressure.

So what I typically do is two things. I tell all my patients get a blood pressure cuff. You need to monitor your blood pressures on the days that you're fasting or starting this whole program. Number two, if you're on insulin or if you're a diabetic, you should get continuous glucose monitoring. The device that you put on your hand. I think that's amazing because that'll empower you to know that your symptoms you're having right now are not due to low blood sugars. And you can basically be confident that you're not hurting yourself and you get more confidence. And yes, the sugar may go up because you don't take your insulin shot.

So it goes up from, let's say, 150 to 200 or 250. That's not going to bother me that much because that temporary increase in your blood glucose level is not going to harm you that much because it's temporary. And then it'll come back down again. So if you look at the effects of glycation due to high sugars, that effect, that detrimental effect on your proteins through the glycation end products is not as deleterious as having that high insulin level and inflammation in your body. So I kind of let the sugar run a little bit higher and make sure that they don't become hypoglycemic

because that's the problem. So when you are starting this program and you start skipping meals, it's a little bit easier without supervision. But once you start getting a little serious and you're only eating once a day or doing a fast more than 24 hours, I think you really need to have a doctor or somebody who knows a little but about this involved in your case. And it's kind of hard these days because a lot of people are still not on board with this fasting issue.

But that's a great question. I think that generally speaking you do. Now, I tell you, I got a patient that came to see me from South Florida, and he was on his 83rd day of fasting. Only water. 83 days. Drew, I looked at this guy, and he looked amazing. And he felt amazing.

And he didn't have all that skin, you know, all over his face and under his arms and everything else. So, and that's because when you do this type of fasting, you lose weight and mostly fat, but also your skin shrinks. So it's a different type of weight loss than when you're losing weight by eating five small meals a day and doing caloric restriction. I've definitely seen a difference in the way the patients present. But this guy was 83 days, and I was shocked.

I said, this is amazing. And so I have a blood lab. Immediately did his electrolytes in the office, normal. Wow. CBC, normal. Are you on any medications now? No, I was on diabetes medication, and I was on blood pressure medications. He's on nothing.

The guy looked amazing. So he weighed 385 pounds. He was down to 230 pounds. So I said, okay, so according to the scale, I want you to come down to about 190. I think that that'll be the perfect weight for you. And he just called me, he broke his fast. So I told him to take some bone broth and broke his fast gently. And he's doing wonderful.

Now, he's not going to go back to eating five times a day or three times a day. He knows what to eat, how to eat, and he's going to start eating only once a day. And he says that I'm happy doing that. So here's a guy who came off all his medications. But I think that people are looking for help and where are you going to find these practitioners. is. It is a bit of a problem, Drew, right now. There's more and more that are coming out each day. A lot of younger people who are into like working out or CrossFit, like my brother-in-law, he's a cardiologist at Kaiser in San Diego. And, you know, he practices his lifestyle and he'll

work with his patients and try to support them in fasting and other aspects. So there's more and more people, and there's places like the Institute of Functional Medicine or Integrative Centers that are out there or A-4-M. If you dig a little bit, you can try to find some doctors that are out there or some practitioners that can guide you. And I think that, you know, what you just shared, by the way, that's an astonishing story. And I think there's a couple layers of it. Number one, for people who listen and are immediately shocked, like, whoa, can somebody even survive 83 days just on water?

Here you have a medical doctor telling you that he's had firsthand experience with somebody who did. And on top of that, you know, it sounds like, did you formally accept him as a patient? So was he working with you? Yeah. So he's also now a patient. So it's not that you're saying that this is something that everybody should be considering out there. You're really highlighting what's possible and how this fear, especially for individuals that might be classified in the obese category or extremely overweight category where there's a lot of extra storage that's there that the body can use.

You're really highlighting what's possible when we allow our body to do what it's. needs to do best. And then within that, everybody can personalize their own approach on how to tap into the power of fasting.