The Tim Ferriss Show - #845: How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D'Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment)

Episode Date: January 7, 2026

Dr. Dominic D’Agostino (@DominicDAgosti2) is a tenured associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine and a Visiting Senior Research Scientist at the Institute for Human and Machine Cognition.This episode is brought to you by:Gusto simple and easy payroll, HR, and benefits platform used by 400,000+ businesses: https://gusto.com/tim Seed's DS-01® Daily Synbiotic broad spectrum 24-strain probiotic + prebiotic: https://Seed.com/Tim David Protein Bars 28g of protein, 150 calories, and 0g of sugar: https://davidprotein.com/tim Coyote the card game​, which I co-created with Exploding Kittens: https://coyotegame.com*For show notes and past guests on The Tim Ferriss Show, please visit tim.blog/podcast.For deals from sponsors of The Tim Ferriss Show, please visit tim.blog/podcast-sponsorsSign up for Tim’s email newsletter (5-Bullet Friday) at tim.blog/friday.For transcripts of episodes, go to tim.blog/transcripts.Discover Tim’s books: tim.blog/books.Follow Tim:Twitter: twitter.com/tferriss Instagram: instagram.com/timferrissYouTube: youtube.com/timferrissFacebook: facebook.com/timferriss LinkedIn: linkedin.com/in/timferrissSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hello, boys and girls, ladies and germs. This is Tim Ferriss. Welcome to another episode of the Tim Ferriss show. This particular episode, I think, is probably my most practical, tactical discussion of ketosis. What the benefits are, how to implement it, when the rubber hits the road, what do you do? What do you try to avoid? What are some of the challenges? and this conversation with Dom D'Agostino, I'll describe him in a second, took place about midway through a month-long experiment. I've done a lot of ketogenic dieting. I've experimented with it since probably the late 90s. And my latest bout was one month wearing both a continuous glucose monitor and a continuous ketone monitor. And we basically deconstructed it. And I got Dom's advice on how to tweak it, how to fine-tune it. Now, why would you even want to

consider ketosis. And we also get into exogenous ketones. So supplemental ketones. They've become quite the topic de jure, quite popular among certain athletic populations and so on. But we talk about toxicity with some of these supplements and what to look out for. We talk about ketone dependence and withdrawal. We talk about before and after testing and lots of ways that you can be a bit smarter, a bit more informed about approaching all of this. So the benefits. Why would you even consider this. Why have I myself spent so much time in ketosis, so to speak? Well, there are a few things. Immediately, I will notice once I get to a certain concentration in my blood, and that's generally around, let's just call it 0.7 millimolars measured with a finger prick, and then more

as you get going. I need less sleep. So instead of eight to nine hours, six hours, six and a half hours, I wake up and I am wide awake. So that's another difference. I wake up and I am wide awake alert ready to go. I don't need an hour of booting up and tons of caffeine to get online. I am mentally sharper. My verbal acuity, my ability to think just has a faster turnover. And in the afternoons, I do not have what you would typically associate with, say, a normal diet involving lots of carbohydrates, the afternoon dip. I don't need a nap. I don't need a huge extra cup of coffee around two or three in the afternoon to keep me going. That is just unnecessary altogether. But those all pale in comparison to the mood stabilizing and enhancing

effects. It just takes the ups and downs. And maybe this is peculiar to me, but it preserves the ups, right? I'm not going through crazy manic swings, but it doesn't mute your upside in terms of mood, but it really stabilizes and minimizes the downswings. And that in and of itself makes it worth it to me. And then there are questions around long-term benefits, possible neuroprotection, anti-inflammation, anti-cancer effects. And this conversation with Dom really informed and changed how I think about how I in the future am going to approach ketosis, which will still remain in my quiver is something I use regularly. So, Dom, who is Dom?

I'm going to keep it super short. Dr. Dominic D'Agostino is a tenured associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida, Morsani College of Medicine and a visiting senior research scientist at the Institute for Human and Machine Cognition. He's also a beast of an athlete in his own right. We won't get into that now.

His research focuses on the development and testing of nutritional strategies and metabolic-based therapies for neurological disorders. This includes psychiatric disorders, cancer and human performance optimization. And he has served as a research investigator and crew member on NASA's extreme environment mission operations. His research has been supported by the Office of Naval Research, the Department of Defense, the NIH, and much more. So he is an impressive operator. He walks the talk. He practices what he preaches. So without further ado, please enjoy a very wide-ranging, very practical conversation with Dom D'Agostino.

At this altitude, I can run flat out for a half mile before my hands start shaking. Can I answer your personal question? Now we'll have seen an appropriate time. What if I get the opposite? I'm a cybernetic organism, living tissue over metal endosclerology. Me, Tim Ferriss Show. dumb happy holidays nice to see you great to see you tim so i suggested we hop on the phone because i have been

harassing the living hell out of you with so many questions via text message and i thought you know this must be pretty annoying so rather than answer me once why don't we hop on and record a bunch of the details because the details are so fascinating and for people who are just tuning in who might not know the good doctor to agostino dominic we should establish some basics and i at this point have been quote unquote in ketosis for 18 days now and we'll dig into a lot of questions around that tactical practical practical questions but before we do why would someone and we can talk about what it is and so on but First, let's just give some of the, let's call it established benefits, ideally in human

studies, but could extend to animal models. And then if there's anything on the horizon, say in the next few years, because you're at the cutting edge, if you think there's anything that might plausibly be established as a benefit, what could that be? So what would you put on the bullet list of benefits of intermittently or for extended periods of time being in ketosis. There are many benefits to being in ketosis and a ketogenic diet, if we're going to go there, kind of has the benefits of fasting. And for millennia, we know the benefits of fasting without the baggage, without the metabolic baggage, you know, the muscle loss,

the fatigue, obviously you can't live in a, you know, that level of caloric deficit. But in regards to, you know, the practical applications of it, we know that being in a state of ketosis really quiets the mind. And I think that has major implications. And this was, you know, from centuries we knew this. And now, you know, over the past decades, this has been like a term kind of used. And it's backed up by experimental data to show that there's an elevation of GABA. Obviously, it's silencing a broad array of seizures, independent of the etiology, temporal lobe seizures, you know, Lennox Gusto syndrome, Dravet syndrome, rare forms of epilepsy, the ketogenic diet, quiets the brain, lowers glutamate, and elevates GABA, a brain stabilizing, calming neurotransmitter.

And, you know, that's why people gravitate towards alcohol, right? The GABA-Urgic effect, alcohol and benzodiazepines. So you can sort of, in a very gentle way, transition your physiology to a state of ketosis, which changes the neuropharmacology of your brain to sort of quiet it down. And that, I think, really echoes its broad application for metabolic psychiatry, which is everything from major depression to bipolar, to schizophrenia, to anxiety disorders, to anorexia, nervosa. That's a very interesting and rapidly expanding application of ketosis that's being funded largely by

the bazuki group. Yeah, had David on. And on the physical side, some folks, if they're old enough, may remember the Atkins diet, Not saying that is what we should hold up as necessarily the end-all, be-all of any sense, but why would someone go on this for benefits outside of the cognitive psychiatric? Are there any other benefits that you could list off? I think first and foremost, it's weight loss. So it's very satisfying to go into a state of ketosis because you do see the scale

change pretty dramatically, and that's due in part to some fluid loss associated. with a reduction of fluid volume. It does have a diuretic effect. Ketosis does, ketogenic diets and obviously fasting, and also a natuoretic effect where you dump out some sodium. Your plasma volume, your blood volume will contract a little bit. So if you have high blood pressure, that will likely go down. So if you're on blood pressure medication, you have to think about that.

But first and foremost, it's an effective way to get your body to lower the hormone insulin, if you have insulin resistance, and shift your metabolism. to burning fats, and as we burn more and more fat, that stimulates the production of ketones, ketogenesis. And ketones have a broad array of applications, metabolic, signaling, epigenetic that have real-world applications. And that's why the whole field of exogenous ketones has developed and there's 160 or more registered clinical trials on exogenous ketones. And I could go into each of the applications individually if we want to go there. So, Well, as we talked about before recording, and I have to act as a bit of a referee for my audience

because I know you can go as deep as we want down the rabbit hole into the 17th dimension of biochemistry. So if you get possessed by the organic chemistry demons and start speaking in tongues, I'll rein you in a little bit. However, let me perhaps provide a personal example first for folks because some of this will be familiar to people who've listened for a long time, maybe to other episodes of the two of us. But a lot of it's going to be new. But I want to establish some priors just so people are aware of what this might look like in practice. So I have experimented with the ketogenic diet, also extended fasting. And you can arrive at some similar places. But like you said, Dom, there can be some pretty heavy taxes to pay with extended

fasting. The ketogenic diet I've experimented with all the way back to the 90s. Some of you weren't even born probably who are listening, but some of you will remember the 90s. And I was using it specifically for mood stabilizing. This is towards the end of college, but also to lean out while building muscle on something called the cyclical ketogenic diet. So we're going to get to that later in the conversation, but it was effectively, let's call it, six days of focusing on a ketogenic diet with one day or a half to three quarters of a day of glycogen depletion, and then loading with more carbohydrates, lower fat, et cetera. The reason that the ketogenic diet became doubly interesting to me is that when I had Lyme disease the second time, which came with all

sorts of co-infections like babesiosis and so on. And this isn't chronic fatigue or depression searching for a diagnosis that is external. I feel like sometimes the cottage industry of diagnosing and treating people for quote unquote Lyme disease can be shady at best. But in this case, I'm coming from Long Island. Everybody in my family has had tick-borne disease and was credibly diagnosed. So the second time I had Lyme, I got to a point, I did not see the bullseye rash, assumed I did not have it, which is a mistake because sometimes you don't see the dermatological response and you nonetheless have contracted something like Lyme disease. I ended up weeks later slurring my speech, took me minutes to get out of bed because my joints hurt so much,

forgetting friends' names, and my assistant said, Tim, you really need to see someone. This isn't fatigue. I've seen you sick. I've seen you tired. This is something else. And suffice to say, that turned into several months, even post-antibiotic treatment, which I do think is important, of we could call it pseudo-dementia. I really felt like I was operating at 10% cognitive capacity. And basically at my wits end, I said, well, what can I control? Because a lot has not done the job. And I went into strict ketosis. What does that mean? That means that I'm consuming moderate protein, probably getting at least 50% of my calories from fat and keeping my carbohydrates to less than 20 grams a day probably at that point. And within three or four days, I'd probably say around

day three or four, because I wasn't very fat adapted at the time. My body wasn't well trained to use fat because I wasn't doing intermittent fasting, which we'll come back to. And within three or four days, effectively, all of my cognitive symptoms disappeared. And I stayed in that state through nutritional ketosis for a few weeks, had complete remission of any of the cognitive symptoms, plus the joint pain symptoms, and those never came back. And I recommended that, and this is not a randomized controlled trial, but over the years, due to various factors, we've had ticks growing in population, also expanding to the coasts, and on the West Coast, that is, and elsewhere, had three friends replicate this with ketosis after suffering various symptoms

from tick-borne disease. And we were texting, maybe even talking about this, but I never had a great explanation for why it worked. I said, I don't know the exact mechanism. Maybe I have faulty glucose metabolism that was somehow maybe something was impaired by the ticks and therefore I'm giving my brain this alternate fuel that it really likes ketones but it didn't explain necessarily the durability of the changes in brief do you have a theory or an explanation for why that would work yeah I'm glad you brought that up because quickly dozens if not hundreds of people with tick-borne diseases including Lyme disease and all the tick-borne diseases have communicated with me. And one of the patients is actually Deanna-Todone, who was diagnosed with

ALS prior to 2010 and has basically been stabilized, given three years to live. So I realized that it's underdiagnosed. The test to do that are kind of controversial, you know, with the CDC testing, the two-tier testing and hygienics. So I know I'm going off track a little bit here. But I think it's important to say that the spirochete Borrelia, that spirochete is essentially a hundred percent glycolytic. And when you limit glucose availability and glycolysis, you are targeting the energy systems of that microbe. So that's one thing to think about. And it's well established now. It wasn't three years ago. But a ketogenic diet, in particular, beta hydroxybutary elevated in a blood, stimulates the adaptive immune response. And that's essentially your body's ability

to target foreign invaders and neutralize them. And that has become, a rapidly growing area of interest. University of Pennsylvania, they're doing carty therapy and checkpoint inhibitors because of the ketogenic enhancement of the adaptive immune response. And I think that plays a role. And situationally, I have observed that you go into ketosis if you have an inflammatory process and Lyme disease is inflammatory. But people who have shingles and herpes simplex, things like that, I have an inbox full of

people that do that. And I would like to do experimentally go down that direction to understand why. But I think there's two reasons you're targeting the energy systems and you're augmenting the immune response to keep the spirochet in a dormant stage or maybe eradicating it in some context. It's really incredible on a whole lot of levels. And I'm just lucky that I had the prior experience with the ketogenic diet to even have it occur to me as a last-ach effort. And for people, if it wasn't clear, I mean, you explained it clearly, but glycolytic, I'm simplifying here, but it means that something needs to eat sugar or metabolize carbohydrates to survive, right?

And there are also, Dom, correct me if I'm wrong, but particular cancers that are very sensitive to being starved of glucose as well. And for people who want more on sort of fasting ketosis as it relates to cancer, we may come back to it also, but we've had prior conversations about this and the benefits, some of the incredible effects of fasting prior to cancer treatments of various types. Just a quick thanks to our sponsors and we'll be right back to the show. I have been fascinated by the microbiome and probiotics as well as prebiotics for decades, but products never quite live up to the hype. Now, things are starting to change. And that includes

this episode's sponsor Seeds DSO1 Daily Symbiotic. I've always been very skeptical of most probiotics, but after incorporating two capsules of seeds DSO1 into my morning routine, I have noticed improved digestion and improved overall health. So why is seeds DSO1 so effective? For one, it is a two-in-one probiotic and prebiotic formulated with 24 clinically and scientifically studied strains. But if the probiotic strains don't make it to the right place, they're not as effective. So Seed developed a proprietary capsule and capsule delivery system that survives digestion and delivers a precision release of the live and viable probiotics to the colon. And now you can get 20% off your first month with code 20 tim at seed.com slash tim using code 20 tim, all put together. One more time,

seed.com slash tim code 20 tim. I asked millions of you about Gusto on social media, and I've never seen such overwhelmingly positive responses. It was kind of bonkers, honestly, because I've done this dozens of times. And it makes sense. More than 400,000 small businesses already trust Gusto, and it's been named the number one payroll software by G2 for fall 2025. If you're a small business owner looking to simplify payroll and HR tasks, because why would you want to spend more time on those things, Gusto could be the game changer that you need. Gusto is the all-in-one payroll benefits and HR platform designed specifically for small businesses. They automatically file federal, state, and local payroll taxes, handle W-2s and 1099s.

What a pain in the ass, all those can be, and offer straightforward health benefits and 401K options for nearly any budget. Now is the perfect time to choose Gusto to take care of your team and stay compliant. So go to gusto.com slash Tim to see why 9 out of 10 Gusto customers recommend Gusto. Listeners get three months free once they run their first payroll. Again, that's G-U-S-T-O.com slash Tim. Terms and conditions apply. Is it fair to say, do you think most of the benefits that someone would derive from fasting

prior to cancer treatments, they could also get from ketosis, or is it dialed back to a smaller percentage of effect? That's a good question. I think it requires a nuanced answer that we probably don't have time for, But if you are overweight and your BMI, for example, is like, you know, as many cancer patients tend to be like 28, 30, 32, a fasting or a calorically restricted ketogenic diet is the way to go. If a patient is trending towards being lighter, like a BMI, you know, 20, 22, something

like that, a ucholoric, meaning like keeping stable caloric level to maintain your weight is going to be important. And then elevating beta hydroxybutyrate will be important to. get some of the anti-inflammatory effects and also the immune boosting effects and the neuroprotective effects going into cancer therapy because there's people studying ketosis for chemo brain like reversing chemo brain and like managing that so it has a broad array of applications it's targeting the tumor growth and putting a break on it not it's not a cure for cancer and i cringe when people talk about that like online the ketogenic diet curing cancer it does

slow it down, especially if it's highly glycolytic, which 80% of cancers are. And it enhances and augments the response to the standard of care. That's radiation, chemo, and immune-based therapies. So we kind of, we know that now. All right. So why have I been in ketosis for 18 days? And why am I doing it a few times a year? Well, this is, you know, part of how I implement this does hinge and will continue to hinge on some of the answers in this conversation from Tom, because this is very self-interested. But what I have found is that for mood stabilization, and you mentioned metabolic psychiatry,

and you made the introduction, I believe, Chris Palmer out of Harvard on the podcast to discuss this, but there are certain conditions, whether it's depression, but even more squirrely when you're dealing with something like schizophrenia, for instance, or different types of bipolar, people who have been on dozens of medications

who go into, let's call it, remission, or they no longer meet the criteria for the diagnosis of some of these things after being treated on a ketogenic diet of one type or another. It is astonishing. And so for my own mental health, I've noticed complete stabilization

and without subduing the highs, right? I've never had mania necessarily. I'm not talking about that. But I'm not muted. I feel just calm, stable, sharp. And that's one reason in and up itself to do it for periods of time. But I seem to feel a carryover effect also have Alzheimer's and other neurodegenerative diseases in my family of three relatives with rapidly advancing

Alzheimer's at the moment. So maybe we could talk also to how these things might intersect. But my feeling is possibly, and I'd love your input here, if I follow a ketogenic diet for a number of weeks or maybe a month and a half or something like that, I'd love to know the timing you might recommend. Let's say I do that two or three times a year, that there could be enduring effects that have protective carryover. And I also find it much easier now that I started doing intermittent. I've been intermittent fasting pretty much every day for the last six months, which means I'm eating between typically 2 p.m. and like 8 or 9 p.m. and having two meals a day. That's it. Not hungry at all. Like I haven't eaten today.

it's 1230 my time i will not be hungry for another two two and a half hours that by itself completely revolutionized i mean that's an overused word but completely polished my insulin sensitivity and metabolic health on a bunch of levels like my labs have never been better my oral glucose tolerance test has never been better and one question i have for you which is just for timmy tim tim but will apply to other people is is there an argument to be made, and maybe I'm totally off base, but if you follow a ketogenic diet and make it work for a multi-week period of time that you're changing your metabolic machinery or just your body in some way that has carryover effects even after you stop the diet,

or is that me just doing some hand-wavy, fancy footwork as a muggle? I don't know if there's a there there, but what are your thoughts? I would say absolutely. I think the science is still working to clarify that and make it less ambiguous, the benefits that we are deriving from that. But that is kind of like, you know, one of the pitches for the fasting mimicking diet by Dr. Walter Longo, who was one of our keynote speakers at Metabolic Health Summit, and he's presented some really compelling research on that that opened my eyes to that five days of fasting can have, I think he presented a time, even three months of effects on sort of cardiometabolic with biomarkers. In his case, this would be the fast mimicking diet. So a few hundred calories a die.

Yeah, like 600, you know, using his protocol of various foods kind of gravitating towards more of a plant-based lower protein, you know, strategy. And I think that it's promoting metabolic flexibility and ramping up fatty acid oxidation enzymes. And much like muscle memory, I think there's a metabolic memory. So the more you stay in ketosis, the easier it gets and the more benefits you derive from it and the more that you shift your body to being more fat adapted, just like you can build your VO2. When you build your VO2 max or you build up to like, you know, a 400 pound bench press and you take like months off and you go back and you can only do like 225 for a couple reps. It only takes like two or three months to get back, but it took you 10

years to get there. You know, that muscle memory snaps back quick. And everybody, agrees that there's this metabolic memory. And I think there's a lot of things at play, including, you know, gene programs, epigenetic regulation that comes to play. So first and foremost is changing our mitochondrial function and mitochondrial capacity. So the number of mitochondria increase. And then when you take a break and then get that stimulation again, that mitochondria is kind of there and it responds very rapidly. Thank you for that. And I want to bookmark, maybe we come back to this. But if people are trying to think about this, understanding that the science right now is maybe provisional or there's a little bit, you know, hypotheses worth disproving at this point,

but that it seems to make sense, right, from an evolutionary perspective that both muscle memory and metabolic memory would be a thing. Otherwise, it makes sense your body would want to adapt to be prepared for the next famine or whatever it might be. I just want to say muscle memory is metabolic memory. So I gave the analogy of like lifting weights, but someone who runs marathons is the same scenario. They take time off. And then that V-O-2 max quickly establishes again. And it's muscle, but it's metabolic. So I like to use the term metabolic memory. Okay. Yeah, metabolic memory. So just so people know where I am at the moment, actually, yeah, I'll just tell people like what I'm doing because I know they're probably getting itchy

for some just like, what does this look like in practice? And then I want to talk a bit about how ketosis or the ketogenic diet may or may not be helpful for maybe not treating, maybe treating. I've certainly seen some interesting effects in some of my relatives when I give them exogenous ketones where suddenly their sentences are three or four times longer 30 minutes later, which is wild to see. But in terms of prevention or staving off the onset of some of these diseases, I'd love to hear your perspective. But let me tell people what I've been doing for the last few months and especially in the last 18 days. So for the last, whatever it is, I think I mentioned, six months, I've been doing intermittent fasting. And that was after hearing conversation between Dr. Rhonda Patrick, who I'm a big fan of, and Mark Mattson, M-A-T-T-S-O-N, who's done a lot of research related to intermittent fasting.

And the key piece for me, because you see all of these different types of intermittent fasting, all these different ways to do time-restricted feeding. And I am going to paraphrase here. So, Mark, I apologize if I'm getting this wrong or oversimplifying. But in effect, it's important that you fast. This means no calories. We can talk about pure fat, but let's just assume you're not consuming any calories for 16 hours because you want to deplete your liver of glycogen. And once you deplete your liver of glycogen, your body experiences this metabolic switching.

And I've certainly felt this just doing intermittent fasting, where my meals contain carbohydrates later, that around the end of that fasting period, boom, something switches and my mind is sharper. And then when I got to the point of going into the ketogenic diet, this time and also a few months ago, because I was doing the intermittent fasting, and it took me about a week and a half for my body to get comfortable with that, at which point it was no problem, but I was a little pissy, a little irritable for a little while, a little foggy. And then when I went into the ketogenic diet this time, it was the easiest transition I've ever had. I did not have any fogginess. I did not have low energy. I did not have what some people might call the kind of keto flu

adaptive period, which seems to be pretty remediated or dressed with electrolytes for a lot of people. but it was incredibly easy, just straight into the ketogenic diet with no problem, because I was already doing the integrated fasting. Then for 18 days, I've been having two meals a day, and you've recommended a few that sound, frankly, pretty disgusting, but that are actually really easy, like two cans of canned mackerel with about two tablespoons, 30 milliliters of MCT oil plus apple cider vinegar with some salt and pepper. It's actually delicious. I just love mackerel. Oh, there it is. Yeah, you've got your apple cider vinegar right there. Cheap stuff you can get on Amazon. So, yeah.

Yeah, for people who might think, oh, wow, this is what for fancy people who can do all sorts of expensive things in their diet, we're talking about how much does that meal cost? Three bucks? Yeah, a dollar a can for that, chicken of the sea. And literally, you get almost a pound of mackerel. And this is like third party tested very low. Chub mackerel, the little mackerel. So, yeah, you got like $1.50 for almost a pound of mackerel that you, you can get that for it. Like you can't, and the omega-3s are off the charts.

The heavy metals are low. You know, I consume pounds of this stuff and I've gotten my blood and my hair heavy metals tested and it's like super low, like non-detectives. So I wouldn't worry about that. People have questions about cost and heavy metals and that's a non-issue, you know, for me. Yeah. Maybe you could mention, I'll put links in the show notes as well, but since we're on the

topic, any brands that you default to that you like. And that chub mackerel piece for folks, that, that detail is important because they're a mackerel of many different sizes. Yeah, King mackerel is kind of high. This is Chicken of the Sea. So if you want to do the budget, you buy by the case, the more you buy, and then Amazon subscription. And then it goes on sale. You can actually get it for like less than a dollar a can. And I do the same with Chicken of the Sea, Jack mackerel, just chub mackerel or jack mackerel. So they're both small fish. And I kind of like the King Oscar brand, too. There's a little bit more pricey, and Seasons brand is pretty good, too. But it's like as cheap as dog food.

We buy some pretty fancy, like, you know, freeze-dry, we don't buy the kibble stuff. But when you run the numbers, it's very inexpensive. Cases of eggs for like 120 per, you know, if you do like eggs, fish, beef, and also turkey, you can get turkeys for under a dollar a pound, the whole turkey. Yeah. And just for people who are like, oh, my God, I can't believe you guys are eating macrull. mixed with oil and vinegar in a dog bowl. That's not all you can eat. Like, there's more that you can eat. You can have, like, chicken with cheese on it. You can have vegetables. There are certain things you have to watch out for, so you're not whacking yourself out of ketosis. But in my particular case, I don't mind. And the fact of the matter is, when I wrote the four-hour body, people were like, oh, my God, you want us to repeat the same meals over and over again? I'm like,

what did you have for breakfast the last five days? And they ate the same damn thing. You're just swapping out default meals. So my first meal is something typically pretty, small, like the macro I explained. And then I have a big meal. I might have some more protein in between, but it's like yesterday I had lamb chops that were delicious with some vegetables made in an air fire. No problem. And later on, I might have like a rib eye on a big gigantic salad with some other stuff added to it. But that's about it. You have to be careful with the macadamia nuts. Those things will creep up on you. But that is in effect, the diet, right? And I'm doing my training. I'm doing my rehab. I'm doing my zone two. I do find I'm a little, let's say, lower

performance when I'm in ketosis. But what I wanted to talk about is maybe a false negative that I've experienced. And I'll explain what that is. And this is, so how do you know if you're, and I keep putting this in quotation marks, like quote unquote, in ketosis, right? Because people are, most people are, or maybe all people, are producing some level of ketones. So there are different concentrations, right, that you can measure with a finger prick, just like you would look at glucose. And at least with the finger prick, I think that's measuring what you mentioned, earlier as being so beneficial in a lot of studies, the beta-hydroxybutyrate, BHB. I also have, because I wanted to run this tracking, a G7 Dexcom continuous glucose monitor on

one arm, and then a sci-bio, apologies, I'm not pronouncing that correctly, continuous ketone monitor on the other arm, and I'm wearing an aura ring when I sleep to see how all of this affects my sleep architecture and everything else. So I'm gathering all of this, but then I noticed something really weird, which I've texted you about because I keep feeling like I'm failing at keto. I feel great. I feel sharp. And yet, when I look at not just the continuous glucose monitor, but even with the finger prick, because you do have to often calibrate these things, right? Don't assume that your continuous monitors are accurate. You want to calibrate them. But I'm looking at the numbers. And for instance,

my girlfriend freaked out the other night because my phone started screaming. I had earplugs in because I didn't hear it. And it was like critical medical alert or whatever the code red was because my glucose was 69, I suppose. It's gotten quite a bit lower on ketosis, but you know, usually hovers somewhere between like 65 and 80. And my ketones were 0.2 millimolers. Now, when we've talked in prior conversations about what kind of target you might aim for, it seems like between 1.2 and 2 millimolers is anxiolytic, right, lowers anxiety, and then you're looking for this ratio. You could talk about this, but the GKI, there's a ratio, glucose to ketones. And I look at those numbers and I'm like, this makes no sense to me because I'm not getting

enough glucose to function well. And if I'm basing it off of the keto mojo finger prick, even the precision extra from Abbott, or my continuous keto monitor, I'm not getting any ketones either if you're, taking it a face value. So how am I functioning? How would you answer that? Because I don't think I'd be the only person who feels like they're doing something wrong if they run into this. But how would you interpret this? I would definitely say you're running lean. And I think what you've done and your OGT test is really good. I think you had a message. Yeah. And the OGT for folks is just that oral glucose tolerance test where you drink a bunch of dextrous water and then they take your blood every 30

minutes for two hours to see how you're responding to it. The biggest metabolic lever would be you have enhanced insulin sensitivity, and I think that has been the focus. For example, Ben Bickman wrote a book on this and doing hundreds of podcasts on insulin resistance, reversing insulin resistance and low-carb ketogenic, you know, being effective for that. So that, first and foremost, your insulin sensitivity is very high. Your fat oxidation is really high, and your glucose disposal is high.

And if you're in a caloric deficit, your ketone uptake is very high. We see this quite convincingly, you know, in older rats where we like gavage, where we like tube feed the rats and they're older, the ketones get to toxic levels, whereas like a younger metabolically fit rodent will dispose of it very quickly. Same with a couch potato human, same with an elite level athlete. So when you measure ketones in the blood, that's a function of ketone production and ketone utilization. And you could have two to five times higher ketone utilization, you know, with high metabolic fitness. And that's due in part to ketolytic enzymes. You upregulate the MCT

transporters. That could be two or in rodents, two or three times higher. We haven't done that personally. And we have some data in humans. We haven't published yet. But that is a real thing. And I think that you're experiencing also, if you're in a caloric deficit, there's less spillover. I just bought like an antique motorcycle and it's got a carburetor and the float sticks a little bit and it always drips out the carburetor when I'm running it and when I stop and it's like kind of pouring out the carburetor. So there's spillover of fuel. But when I'm running it, it's running lean because I'm using the fuel that's kind of going to the carburetor. And kind of the same analogy here is that if, for example, it might be good to just sit in one spot and relax and

maybe eat a little bit of surplus calories or even eat a little bit of carbs. And what you'll see often is like your ketone spike up. So I remember some of my highest ketone levels ever is when I consumed carbohydrates after I was fasting or in a state of keto. It like jumped up to 5, six, seven. I was like, what is going on here? But the glucose in that context is ketone sparing. But the glucose will also shut off ketogenesis, so it'll tank, you know, after that.

Yeah, afterwards. Yeah. Okay. So it sounds like then because of probably the intermittent fasting in large part, I would think, if my insulin sense. activity is high enough, that can be paired with higher ketone utilization. So if on the assembly line of my body, right, they're producing 10 units of ketones, if I didn't have good ketone utilization, and it was my first rodeo with ketosis, let's just say, or a ketogenic diet,

the finger prick might pick up all 10 of those units. I'm simplifying here, right? But if I have high ketone utilization and my body's quickly using eight of those, especially in a chloric deficit, then it's only measuring two, and I'm getting the false negative that I'm not actually producing ketones in the first place. Is that a fair? Very, very simplified description. And you're not measuring tissue levels of ketones, which we have done too, even in the brain, and that can shoot up, like, really high. So that's also, and I've done this with Peter Attia, too. We were measuring blood and then breath. And it seems like when we were in a caloric deficit fasting, our ketones were like really low in the blood.

Like, you know, low is like one to two, but we're like really deep into fasting, whereas our breath ketones were maxing out the meters. We kind of concluded that after a lot of testing that the breath ketones were almost a better indicator of ketosis, a more accurate, I guess you could say, in a caloric deficit. Because when you're in a caloric deficit,

you just have very high ketone disposal uptake into the tissues. It looks like a breathalyzer, right? So is that measuring, what is it, acetoacetate? No, I'm just trying to repeat words that I've heard once or twice, but it's not B.HB. Acetone. Acetone. God damn it. All right. I know I was close. It was a 50-50. Comes from the spontaneous decarboxillation of acetoacetate, like we'll spit out about 20% of the acetoacetate will kick off to acetone. And then you can measure it. We've measured blood levels of each, and it's very tricky to do that, but we've done it in the lab.

Here's another practical, tactical question for you, because I've gone. back and forth on this and Uncle Chat GPT has confused the shit out of me. So maybe you can help resolve it. Gluconeogenesis and protein intake. So you consume, what is it between like 200 and 240 grams of protein a day, something like that? On active days, on like less active days, if I'm just behind my computer all day, maybe closer to 180, 200, but yeah. Yeah. And people might have picked up when Dom was casually throwing around like, you know, when you've been squatting 400 and you take a break and then you go back and you can only get squat 300 pounds. Tom's a pretty big guy who's also deadlifted 500 pounds for like 10 reps before after fasting for a week. So he and I are not the same size.

But nonetheless, I'm trying to figure out on one hand how much protein I can eat without my liver taking excess protein amino acids and turning it into glucose. And depending on what I look at, and I have looked at sources outside of chat GPT, on one hand, there are folks who say, don't worry about it. If you're consuming enough fat, you really don't have to worry about it. And then there are other folks who are like, watch out, watch out. If you consume more than X number of grams at a given meal, you can very easily knock yourself out of ketosis, which would, if that's true, be maybe an alternate explanation for why I'm getting these low readings. If I'm having a small meal around three and then a gigantic meal later on, how should I and

how should listeners think about this? If you were to consume protein in the, the form of liquid, for example, like weigh or something like that, then the rapid entry of amino acids into your bloodstream from your small intestine will shut off ketosis. So fat and fiber and salt, because your pyloric sphincter will basically be pretty tight until you're... Talking dirty, dumb. Is that where your stomach connects to your small intestine, if you have a very fatty, salty, high fiber meal, that entryway, we call that the sphincter, it's the pyloric sphincter, will remain shut until like the contents of your stomach become isotonic, which means that your body

has to kind of give up water and it's got to churn it and break it down. So you could delay gastric absorption simply with fat, fiber, and salt is pretty good too. You could do ketone salts or just salt electrolytes. So that will delay the entry of amino acids or protein into the small intestine and thus amino acids into the bloodstream. And that's the major regulator of ketosis, you know, having an impact on insulin and also having impact on gluconeogenesis to that rate of entry. And if you can slow that down, you see nothing on the CGM and your ketosis levels can basically stay.

You could further augment that by using MCT oil with the protein and the fiber. So if you have long chain fats from like a fatty steak and MCT oil, and then fiber, and that could be insoluble fibers, pretty good to soluble and insoluble. That can slow the entry of amino acids and essentially buffer the gluconeogenic response. Just a quick thanks to our sponsors and we'll be right back to the show. I am always on the hunt for protein sources that don't require sacrifices in taste or nutrition. And that's why I love the protein bars from today's sponsor. David, they are my go-to protein source.

on the run. I throw them on my bag whenever I am in doubt that I might be able to get a good source of protein. David has 28 grams of protein, 150 calories, and zero grams of sugar. And on top of that, David tastes great. Their bars come in six delicious flavors. They're all we're trying. Protein is also the most satiating macronutrient. What does that mean? It means that protein, out of carbohydrates, fat and protein inhibits your appetite while also feeding all the things you want to feed, which helps you consume fewer calories throughout the day. You're less. inclined to eat garbage. All of that contributes to fat loss and reducing the risk of various diseases. And now, you guys, listeners of the Tim Ferriss show, who buy four boxes

get a fifth box for free. You can check it out. You can also buy one box at a time. Try them for yourself at Davidprotein.com slash Tim. Learn all about it. That's Davidprotein.com slash Tim to get a free box with a four box purchase or simply learn more. Check it out. Davidproteen.com slash Tim. Hey folks, Tim here. My best-selling card game, Coyote, which I made with the amazing team at Exploding Kittens, just won the Pop Insider, Best Geeky Game of 2025, and also Best Stocking Filler in the Made for Mums Toy Awards 2025. It is on sale everywhere. It's cheap. It's fast to learn. Has 4.8 stars out of five. People are loving it. Coyote Game.com will take you to all the retailers, but you can find it everywhere. It is a game of thinking fast and laughing faster. Think charades meets hot potato meets

a bunch of brain fun. It's good for your head. It's perfect for families with kids age 10 plus or adults who are kids at heart or don't take themselves too seriously. A lot of adults love this game. And as I said, it's available everywhere. Amazon, Walmart, Target, 8,000 plus retail locations, you name it. So please check it out. I loved making it. People are really enjoying it. It has 300 or 400 million plus social views of gameplay online, and try it, enjoy it this holiday season. Check it out, coyotegame.com one more time. That's coyote game.com or anywhere you buy your games. Now, back to the episode. So let's say I was stuck in San Francisco late. I'm just taking a rare trip over here, which is pretty exciting time to be here with all of the mania with AI going on.

I mean, everyone's kind of drunk on the Kool-Aid, but that's a lot. separate story. I got trapped downtown because didn't want to deal with traffic and blah, blah, blah, blah, blah. So I ended up having a huge bunless double cheeseburger, like gigantic. This thing, I did not expect it to be as big as it was. And so I go online to try to figure out what the protein content of this thing might be. And it's like 80 grams of protein. But plenty of fat, certainly, tons of fat, salty A.F, plenty of salt. Not a lot of fiber, we'll give that one a pass. Should I be worried about something like that

knocking me out of ketosis? I think you need to measure. So I'm kind of default back to like everybody's a unique metabolic entity. But if you eat that and kind of your activity level is high and you're in a bit of a caloric deficit and you were to have that and sort of not overdo it on the total calories, I know my body. I know my body. I could stay in ketosis. But if you have that over satiated feeling. So we have, we have neurons, we have neuronal pathways to and from the liver and two and from the gut. We call that aphrent and efferent signaling, right, and the enteric nervous system. And a big meal will basically tell your brain that you had a big meal. And independent, I talked about the amino acids going into the bloodstream, kind of kicking you out of ketosis.

But there's also like when you have stretch receptors and you have a big full meal in your gut, then that could actually tell your brain to activate the sympathetic nervous system. And then that, by virtue of spilling out catecholamines, can basically, like, we're talking adrenaline, epinephrine, things like that, that can further augment and enhance gluconeogenesis. Okay. Let me just translate that for a second. So people wake up, the cortisol has developed this, like, bad reputation among a lot of, like, online influencers, but it's like, you really need cortisol. So when you wake up in the morning and you see a bit of a glucose spike, like, it's actually important to get your ass up and moving.

If you're in ketosis, it's a different thing, right? So if I'm hearing you correctly, right, outside of how people think about digestion, blood sugar, insulin, et cetera, that just based on stretching your stomach, et cetera, right, with these mechanoreceptors taking the inputs, that that signals to the brain. It's go time. So let's basically get things moving with the, hormones and that could in and of itself then trigger the liver to produce more glucose or liberate more glycogen I guess it can it's above and beyond what you normally eat like

if you train your body to that size meal but it also activates other like gut hormones like colicinin that's called CCK and other things that can then activate the parasympathetic nervous system that comes in a little bit after at the same time it's sort of kind of bifurcates but then the paris sympathetic nervous system is sort of relax digest so that kind of comes in after so you might see a blip and sort of might feel kind of stimulated also all the salt if it's a salty meal it's going to expand your plasma volume your blood volume will increase and that can increase your blood pressure a little bit and that can activate your sympathetic nervous system so it's always good to go take a walk after a big meal. Yeah, yeah, I do that. Not like go squat and deadlift,

but just yeah, even a 10, 15, ideally like a 20 minute brisk walk is really good after a big meal. Let me ask you this on the walk timing. So when I have a big meal, and I will say I think I have trained my body to have big meals and what the exact response is, I can only give you subjectively what I feel and I can give you what the monitors show. But I typically feel pretty good. However, if I have a big meal, whether this is in ketosis or otherwise, I don't see the biggest spike until something like, depends on the meal, right? But 60 to 90 minutes later, that's when I see the spike. So should I do the walk at 60 to 90 minutes or should I do the walk right after the meal? When should I actually time the walk? So you eat a meal, you go walk and then

you see the rise 60 to 90 minutes after or is that independent of the walk? Independent of the walk. okay so you're not walking but you see the rise 60 to 90 minutes later so i'm saying that you might not see that rise 60 or 90 minutes later if you did it right after the meal yeah just because a little bit goes a long way so just like walking actually doing like some stretching and walking too it activates the glucose four the glut for transporters so that's an insulin independent so less insulin is dumped greater glucose uptake and you're also using sort of uh the sympathetic nervous system mobilization of glucose through gluconeogenesis during that walk. So it then attenuates the buffering of ketogenesis. Like a very short walk can go a long way. Yeah. Okay, cool.

Yeah, is it glut for, glute four? How do you pronounce that? I don't know. How do people say that? I always say glute four. Okay. All right, glue four. Yeah, for the OGs in the audience, go back and look for glute four in our body. It's in there. So the other measurement question I want to ask you about, which is, you know, these continuous glucose and keto monitors are not designed for someone like me. They're developed presumably, I don't know about the keto monitor, but in the case of glucose, to help people with serious conditions not end up in very serious situations, right? So when I am looking at my ketone levels, right? Like right now, I feel very sharp. I had some keto start. You know this well. Exogenous ketone salt-based product not too long ago.

It's just in hot water with a little bit of MCT oil. This was, I guess, an hour, hour and a half ago. But I'm at 0.4 millimolers. And I guess what I'm saying is whether I have a huge meal or I'm fasting as I am right now, my range is basically 0.1 to 0.4, 95% of the time. There are a few outlier cases. If I'm just doing like a yolo, you know, as many grams as possible exogenous ketone party, then maybe I could goose it, but we can talk about this. Like once it gets past a certain point, then I might spike insulin and like have a subsequent crash. But I guess what I'm trying to say in brief is my range for the most part is 0.1 to 0.4,

regardless of whether I'm fasting or eating a gigantic double cheeseburger. So I'm not really sure how to determine what effect it's having. I can watch the glucose, but right now I'm 0.4 millimolors of concentration on the side bio. And as we've talked about, maybe the precision extra would give me an extra 0.1 or 2. But they've been pretty close so far. And then ever since my cheat meal, we had this experiment. I wanted to see if I did a workout and then had one or two cheat meals last Saturday. It is now Thursday, but my glucose right now is 103, which is higher than the week prior. But it goes around. It moves around, right? Like last night, it was probably 70-something. Do you have any suggestions for how to read the tea leaves, or is it mostly just subjective feel? Still thinking about the size of the meal. But I guess what I'm saying is if my device is telling me, as it is right, right now, right? Zero point four. Fat not burning. You're almost not burning fat at the moment,

not in ketone. Like, it's very chastising. So if I'm to believe this by the letter of the law on the screen, I'm failing at ketosis. Any thoughts on how to kind of read the tea leaves here? I would kind of ignore that. I think that's sort of an app in the process of being sort of developed that fat semium. So you need like whole body metabolomics to really answer that question if you're in fat burning or do a metabolic cart and look at respiratory quotient or whatever. But subjectively, if you feel good, we have seen like an athlete, especially more advanced athletes that, and we do a very strict, you know, strict keto macros and everything that basically with a bunch of athletes with like 0.8 is about as high as we get. And that's the

average across. Sometimes you get guys like 2.5, 2.6 and like every day. And the same guy with the same, you know, essentially metabolic phenotype will be running 0.4, 0.3, he could potentially just have greater ketone utilization. So I think it would be important to measure your blood. So a continuous ketone monitor measures interstitial. That can be different. The side bio, I think it's a great device. It's very versatile. I can kind of, you know, jump in and out of salt water. The thing stays on me. It's almost like more reliable than a CGM. But I did notice, and I've probably, probably use about 50 of these devices that the first week is pretty accurate and then it tapers off, the sensitivity.

And this is a known limitation of the technology is that essentially the enzyme-based sensor system tends to just D. And you could get around that conceivably just by having the ability in the app to calibrate it. So if you were to measure it and the continuous ketone monitors measuring 1.0, but your blood ketones is 2.0, that you should be able to calibrate it like you can with a Dexcom. So they acknowledged that at the company, and they said, yes, we realize that that would fix the problem, but that's not a feature of the app yet. They do have in events, they have blood ketone on the bottom right.

I don't know if it actually calibrates it. It may just record the blood ketone at this point. It does not have the ability to calibrate it to my knowledge. I inputted one measurement on the Quito Mojo, and it didn't seem to change it, right? The number stayed the same. So I think it's just logging it because you can do that with a glucometer. Well, you can do it with Dexcom, but not Abbott. So that's a problem with the Abbott freestyle, too, and that's the feedback I gave them

because I put these devices on, it's reading me like 130, but I measure my, I'm like 80. It's literally like 50 because if you are lean and it's stuck in your muscle instead of your adipose tissue, issue. Oh. The group of those are going to be higher, especially like when you work out and stuff. So I've noticed this. So that's why the Dexcom is very nice because I can calibrate it to. And I consistently show that.

And that was a major issue I had. Yeah. Let me hop in also and just tell folks, this is not going to be very quantifiable. But for what it's worth, part of my reason I avoided intermittent fasting for so long is that I thought I would not be able to get sufficient protein or caloric intake and that I would a bunch of muscle mass. I was dead wrong about that. I was very, very wrong. If anything, it seems to have enhanced my ability to put on muscle kind of per calorie or per gram of protein ingested. So I admit I was totally wrong about that. Furthermore, on this ketogenic diet

where I've historically found it pretty hard to put on muscle or, I mean, I shouldn't say keep muscle, because I'm only doing it for a few weeks. But I have been astonished by having one small meal, like I'll have some ox tail soup after this with some veggies and obviously ox tail. It's a whole separate story. And then I'll go out and have another meal probably in like three or four hours, which will be a much bigger meal. And just with that, and I am watching some of the grams of protein intake and so on, but I have not, looking in the mirror and looking at the weights that I'm putting up in the gym, I don't feel like I have lost any muscle and I feel like I have leaned out. Some of that's losing fluid, but I've been really

impressed with how little relative to what I used to do in college, like taking weight gainers and just all this garbage, like how little it actually takes to at least maintain muscle mass. But I do have a question for you, which I've never really been able to answer to my satisfaction, and it kind of relates to rabbit starvation. So for people who don't know what that is, you could probably give a better description. But if you've ever watched the show alone, alone is probably the only reality TV show that I'd love to watch. Season six and seven in particular are outstanding for folks. But what you will notice is that if people are trying to survive in the wilderness to outlast everyone else, that's what the show is. You get to pick a handful of items. You get dropped off.

You don't get to choose where you're dropped. And then you just need to survive for as long as possible. Sometimes it's 100 days. Sometimes it's last man or woman standing. If somebody is only eating lean protein like rabbits, they will waste away. They will not last. They will have to get yanked out for medical reasons. And that might seem strange to people. My question, though, is on a ketogenic diet specifically, can you just consume leaner protein and then rely on body fat for the fat? And some people are like, yeah, everybody knows that doesn't work. But I really want to understand why that's the case, right? Because I understand dietary fat, sort of damp insulin response, or at least that's my understanding. Maybe there's a rate limiting step in

how much body fat you can break down and use, right? And who knows if that's mediated by the kidneys or who the hell, liver, I don't know, right? I guess it would probably be liver. But I'd love to hear your take on it because certainly in the past, I and lots of people reading the four-hour body have been able to lose more body fat than they're told they are capable of losing, as measured through Dexa scans and other things. Can you do a moderate fat or low fat protein-based keto diet if your goal in part is to lose body fat, or does that backfire? Just not indefinitely.

So when I was, did the keto diet for a year, I was cruising about 300 to 320 grams of fat, sometimes 350 grams of fat per day. And then just experimenting, I would throw in a two days per week. week of protein veggies with about 50 to 100 grams of fat. And in those days of dropping to 300 plus grams of fat to 50 to 100 grams of fat, after two days, like I swore, like I lost like 2% body fat, like in that. And I would just transition back. So I would just periodically throw in protein veggie days. I would cruise on keto and then periodically titrate in the protein veggie days to assist body composition alteration. If I kept that,

going, I could get pretty dramatic, almost scary lean to where it happened very fast. It's almost keto trains your fat metabolism. And then if you just start titrating in, it's just pulling fat out. And I think my body really liked, like throwing in the veggies with the fiber, seemed to help with gut health. And I would do that twice a week. And it's pretty dramatic. Why not do it seven days a week? What happens when you try to do it for more?

If the idea is to stay in ketosis, it was like, really hard for me to sink ketosis if I do like protein veggies. Like after two days, I would kind of be out, but my metabolism would be cranking. Mechanistically, why is that the case? Why doesn't your body just break down more body fat? Yeah, because, well, it's taking body fat exogenously and endogously. And I think the more fat going to the liver, you know, and the more fat that's in circulation gets sort of shuttled to the liver. And then that's sort of stimulating beta oxidation in the liver. You just have a greater fat pool. But actually, I think the day that I would do protein veggie days and then the day I would jump back into ketosis, I would see this big ramp up

in ketones like that day. Whereas if I did like a cheat day and just ate a lot of carbohydrates, it took me like two or three days to get back into ketosis. But if I just did like protein and veggies and cruise back into ketosis, then I would rapidly get back into ketosis and just gave my body a break from the fat. But I think just that short amount of time really stimulates mobilization of fat from your body because your body is used to getting it exogenously and then you're just pulling more fat off. But yeah, I think on the protein veggie days, I'm getting higher amounts of calories from protein. So that has a bit of an anti-ketogenic effect. And then shifting back into ketosis on that third day, I always had probably the best, you know,

ketone numbers for the week. I don't want to beat this. dead horse too long, but I'd love to just hear you riff on this a little bit more because I guess in my mind, I'm thinking, well, on your protein veggie only days, if you're getting enough protein, not enough protein to satisfy all of your resting metabolic rate, you're hypokaloric, but you're getting enough protein to not lose muscle, why wouldn't the body just break down the fat that it needs to continue producing? reducing ketones. So I'm trying to avoid the gluconeogenesis problem where you're having like 200 grams at a meal with no fat to offset it. But if you're having smaller amounts that are

slowly digested, but it's just enough to keep you from losing muscle mass, maybe you're doing some weight training to help with that or whatever, then I guess what I'm trying to figure out is why the dietary fat is so important. Because I think of the body, right? It's like each pound of stored body fat is what? 3,600, yeah. All right, so 3,600 calories, that's a decent amount of calories, right? And for somebody who's, let's just say here, 150 pounds, 10% body fat, okay, you got 15 times 3,600, you got plenty of body fat to go around.

So it would seem to be enough to do a few weeks of ketosis that is low fat, higher protein, but not enough protein to necessarily be hammering your liver with gluconeogenesis if you're dividing it up, slowly digested protein. Some people are going to be really annoyed with me dragging this out so long. But why is dietary fat so important? Because, I mean, that's the fuel that you are using. You coax your body into using. And I should probably add a little bit of context to my protein veggie days.

So I would go from like 125 grams of protein to like 300 grams of protein. Right, right. That's a pretty big bolus of protein. That's a lot, yeah. If one was to go 100 grams of protein. protein or whatever and then bump it up to like 170 or 200 or something they may not kick out of ketosis but I remember just lower ketones but not out of I was still in ketosis but typically how I think I did it like that my protein veggie days were following like a heavy

deadlift or squat workout so the thinking was that I'm recovering for those two days and the extra amino acids and proteins and mTOR activation is sort of assisting in recovery and regeneration skeletal muscle protein synthesis and then I I would kind of go back to. I kind of calculated it in that way. So yeah, I like double the protein on the protein veggie days, but my calories were about the same or maybe a little bit lower. Yeah. I need a side bio if you're listening. Please allow me to calibrate this with a finger prick because I need a little more range. I need a little more range than 0.01 to 0.04 for me to be able to read this type of thing effectively, right? Because technically, if I'm believe I'd like,

if I'm reading this as it is, like I'm never in ketosis. I shouldn't say never, that's not true. In any case, it would be nice to be able to calibrate. Let's come back to something I promise that I would ask about, which is neurodegenerative disease, Alzheimer's, et cetera, could the ketogenic diet benefit people with these conditions? And just as important, certainly for me personally, is it plausible there as a mechanism by which the ketogenic diet regularly done could help delay the onset of any of these diseases, or am I just Pollyanna hoping for a pie in the sky?

I think that's a question we don't have an unambiguous answer to, but I think all the science points into the direction that if you improve upon and optimize your cardiometabolic, I like to say cardio-immunometabolic biomark, instead of cardio metabolic biomarkers, because if you can lower, for example, your insulin and keep that between 2 to 6, and if you lower your HSCRP below 0.6 and then optimize your hemoglobin A1C or glucose, and I think also, and I've talked about this with Rhonda Patrick and other people too, that if you measure your omega-3 fatty acids and look at your omega-3 to 6 ratio, I think that's going to be a biomarker that's probably,

going to end up in standard blood work because it's so compelling the data behind it. And you also measure your B12 too. I think that's important. People coming into the Alzheimer's Center that can present as flat out Alzheimer's disease and then you correct their B12. A B12 deficiency will cause brain atrophy. And that could be reverse with B12. So the things that if you're following ketone metabolic therapy, it's impacting the things that we know, are driving age-related chronic diseases, and then, you know, obviously one of them is Alzheimer's. So the level of inflammation, HSCRP now is probably more atherogenic than LDL. There's probably people selling statins that don't want to hear that. But we know that the data has emerging on that now. So

lower insulin, lower inflammation. And that's an inflammatory marker, right? The C-reactive protein. What does the H.S. stand for? High sensitivity, C-reactive protein. High sensitivity. Yeah. So it measures in that lower range. And I used to trend to like two to three, like my early CRP, HSCRP when I was like on a high carb. I only had it measured twice when I was like on a like a high carb diet. But, you know, since I've been keto, it's like either non-detectable or like 0.2 or when I did extreme environment research on myself, you know, then I could bump it up a little bit. And when I had a bacterial or viral gastroenteritis, it shot through the roof because it activated. your immune system. But generally that HSCRP is a big driver. I used to laugh at it and be like,

ah, it's this non-sensitive thing. But now, like, all the data is pointing to the direction that we need to add that to that. And your omega-3 status, your B-12, make sure you don't have any deficiencies because that could lead to sort of rapid progression to Alzheimer's disease, your magnesium levels. But also, just in general, like exercise, the biggest metabolic lever and your body weight, body composition, get dexas scans. I know it might be good for you to do a dexas scan with your keto experiments too. I was getting once a year, but now I end up doing like three or four times a year because I do these many experiments to see how acutely some of the things are impacting my body

composition. I just get antsy for like an answer to that. But it's a long-winded explanation to just basically say that your metabolic health is tightly linked to your brain health and can dramatically delay the onset of Alzheimer's disease. Not that you're going to get it or reverse it altogether before something else gets you in the end. I mean, the metabolic health piece, just to underscore that, I mean, one of my relatives in question, APOE33, I understand that's not the only risk factor, but something just seemed

to be missing, right, because the decline was so precipitous. It didn't map to any patient data or clinical data that number of doctors who are also researchers I was working with had seen. Also because this person, this relative had been assessed four or five years prior and did not show any indication of predisposition to a rapid decline. I'm ApoE3-4, again, recognizing there are other factors at play. But when she just kind of disintegrated, there are a few things that came to light. Number one is her local GP had basically missed severe metabolic dysfunction for years. And I can't remember the reference range, but like insulin, let's call it, upper bound of 12. I'm making this up,

but you'll get the idea. And she was like 43, right? It was just absolutely atrocious. Body weight and just general, like, composition. I mean, poor body composition. Yeah, poor body composition, very little exercise, despite my best efforts, misbehaves horribly, dietarily, not morbidly obese, but certainly. Smoking alcohol, other drugs? No smoking or alcohol. But here's the other piece that, so she had been diagnosed, stage one, breast cancer, had a lumpectomy, was removed. Late 70s was put on an estrogen, I think it's an estrogen blocker called Letrosol. And I looked at this, and I spoke to a friend of mine who was a radio oncologist, and she said, it is very poorly tolerated by most women from a cognitive

perspective, like they get smashed by and large. Guys do, by the way, guys, guys that take Alomatase inhibitors, yeah, for like TRT and things like that. Okay, yeah, it's not a good thing to do. Yeah. Yeah. Yeah. Yeah. So I was looking at it, and I mean, it's upsetting that I'm the one who has to kind of find these things. But it's like, okay, well, we think about the oncologist's role. It's to prevent my mom from dying of cancer. That's the directive, right? But if she were 30 and had later stage cancer that was really aggressive, it's one thing. But she's late 70s, stage one. all cancer removed. And so got her off of the lettrosol with the cooperation and after discussions with doctors and almost saw an immediate turnaround within a handful of weeks after the washout period and everything. But it seems to, I mean, look, I'm not an MD. I don't

play one on the internet, but it seems to have done some real damage. I mean, there's the metabolic piece that is very non-trivial, but the acceleration of decline was just so. so absurd over the course of a handful of months, terrifying to see. But I guess I'm laying this all in, not necessarily to explore this particular case, because I've got a lot of people on it for all of my relatives. But it's just to say that I am not going quietly into the night with something like Alzheimer's. And so what I'm trying to figure out for myself, I'd be curious to hear your perspective. I will be honest. I find keto pretty goddamn boring. Like I don't find it to be the most diverse diet in the world. I don't really want to do it all year round. I also have some

maybe compromising cardiac elements. I'm a cholesterol hyper-absorber, so I do, I use, again, guys, talk to your doc, don't just copy me. But it's like I'm using rapatha, taking a Zetamide. I have been also taking Naxil-Zep, but that might end up being redundant, the Bambinoic acid with the rapatha. That is a long way of saying, like, I got to keep an eye on the heart stuff, because neurodegenerative disease and cardiovascular disease is what kills everybody in my family. So for a lot of reasons, I don't want to do keto all year, but I'm trying to figure out, like, what is the sort of minimal effective dose that, and I know we're going to have to probably take a couple of speculative leaps here, but just as a working hypothesis, right, like what does a minimum

effective dose of following a strict ketogenic diet look like for me? Assuming the rest of the time. I'm still doing intermittent fasting. I'm not eating a lot of refined carbohydrates. But how might you suggest that I think about that? Right? Because I don't know what the durability of kind of keto memory, like metabolic memory is. So I'm trying to figure out like, can I get away with two, three to four week periods a year where there's some carryover of like cancer protective. You know, our last conversation we kind of talked about thinking about ketones as hormones. But in terms of neuroprotective, anti-inflammatory, you. yada, yada, yada. What are your thoughts? I think in your context is hard to say, like,

you know, to give absolutes, but I would say you can get 80% of the benefits with a low carb diet, low carb, count meaning, you know, 100 grams a day, just fibrous, non-starch, non-sugar, carbs, low-carb Mediterranean, if you want to call it that. And then periodically, maybe one week out of a month, get into a deeper state of ketosis. And higher is not better. And higher is not better. we know that from the research. When ketones get into that two, three, four, five millimolar range, that creates energy toxicity and something we call reductive stress. And that is not good.

I did not know this before getting into this kind of research. But the sweet spot seems to be between one and two for therapeutic ketosis unless you're metabolically managing a disorder that's highly responsive to a ketogenic diet like neurometabolic diseases and some of the things that we actually study need to be in the two to three millimolar. And oxygen toxicity needs to be like four to five because it's a very powerful seizures. But one to two seems to be the sweet spots for metabolic management of many different things and also just general metabolic health. And I think what you'd be doing, just doing low carb and periodic ketosis is just enhancing your metabolic flexibility and maybe increasing the

diversity of food that you're eating to prevent micronutrient deficiencies to. I am of the opinion that, you know, plants are good for you to eat, broccoli, asparagus, salads, colorful vegetables, things like that that kind of fit into a pattern of eating that we've known. Even things like lentils are probably good. Lentals actually have like zero CGM response to me. Really? Yeah, lentils seems to like skyrocket other people that I know. I'm like completely flat. I'm like somewhere in between. Like completely flat. I don't know. Maybe it's the time a day that I have them at dinner, then I always go take a walk. But it's like no bump at all in my CGM. And I think that's where CGM comes into play. We can do a personal precision engineered diet,

if you will. And it gives us insight into the types of foods and the amount of foods that we can eat. And I think that's going to be really important information. And I know there's a lot of people harping on because another study came out on CGMs provide no benefit in all to the non-diabetic. And I've had this conversation with people actually at a big event. and people that were type 2 diabetics, and I asked them just flat out, I just went around the table and just saying, if you're type 2 diabetic, when you were diagnosed like three years ago, if you were to be giving a CGM, you know, five years before that, or even one year before that, do you think you would have been diagnosed with type 2 diabetes?

And they said, no. They said, once they got type 2 diabetes and got a CGM, it gave them the awareness. So just, I mean, you can ask anyone who has flat out over type 2 diabetes and just, to ask them the question, hey, if you were given a CGM a year or two in advance and you understood the impact of foods. So I think a CGM is going to be important for delaying that Alzheimer's disease. And if you have loved ones, you know, Tim and your family that I think you would encourage them to slap on a CGM and get some insight into what they're eating. But it's also forcing them to exercise because, you know, we're talking about diet here. But just getting out and doing a brisk

walk, you know, 20, 30 minutes a day can go a long way. Resistance exercise, I'm a little biased towards that. But muscle is like an endocrine organ that produces, you know, hormones and various molecules that are neuroprotective. And muscle is tightly linked to brain size. And of course, your waist and your visceral fat, I'd also encourage them to get a dexas scan and gamify it and say every year I'm going to get a dexas scan. And every year, like I do, I just kind of like it, create like a lot of stress for myself to like beat my dexas scan every year and get their friends involved make it like a social event everybody goes and gets your dexia and then every year you go back and just try to beat you know beat your scores yeah these are low hang fruit kind of things

people should be doing i think probably fair to say make sure you consistently hydrate for any of these things like a dexas scan i do have a follow-up question so also on the exercise piece people can look up something called clotho k-l-o t-h-h-o there's a lot more that comes of exercise like BDNF and all these various things. There's a book called Spark that covers some of it, but it's very outdated. But check out cloth, though. There are a lot of good reasons to exercise thinking of muscle like an endricon organ. That's a really good way to put it. My question to you was, you mentioned, say, one week per month going to more of a lower carb or catotic state. How would you think about the benefits of one week per month, assuming that the rest of the time

I'm behaving most of the time with a lower carbohydrate Mediterranean diet, let's just say. Okay, one week per month every three months or three weeks, three contiguous weeks, once a quarter. Do you feel like one of those is superior to the other? Not really. I think whatever pattern works best, I think you would gain benefits for both. That would be an interesting experiment to do. I'm just thinking about the lead time to get into a properly ketogenic state.

If I'm going from some carbohydrate to ketosis, I'm just, we could talk about things that might accelerate it, but like if it takes me two days to get there, three days, and then I only have kind of four days in the sweet spot, these are things running through my mind. I'm just curious to get your take. The one week intervention for the month, my kind of opinion is that it could be pretty aggressive. Like you cut calories 50% the first two days and then cruise into it so you're really cranking ketones by the end of the week.

And then you're also cruising into it from what should be like a low carb diet. So you should have that metabolic flexibility to kind of seamlessly transition into that ketosis state. And you could do intermittent fasting with mild caloric restriction for the first two days to ramp up ketones. Alternatively, if your schedule permits and like, you know, you work soon, you have like three weeks where you need to really dig deep into a research project or something.

And ketosis seems to give you. that cognitive flow or boost, then that might situationally fit into your schedule. And I definitely have periods of time where I do that, especially like if my wife is traveling or something like that or on a research project or something, I just like, okay, I clean the house of certain foods. And then I just prepare, I mean, simple things like that too, I know just from the clinical ketogenic world is that if you have a family member that stocks the shelves with certain foods that can trigger and cause food noise, then that could really, you know, hamper your compliance to that. But you want to prepare the house before if you're going into a one week or you're going to a

three week, prepare the house and just make sure that you could do. Of course, you could just call it Uber Eats and get anything delivered, but you want to kind of have the house prepared for that and mentally prepared for it. So for you personally, if you had some hereditary gnarliness, right? If you look back at your family tree and you're like, ooh, whether it's a bunch of cancer or a bunch of neurodegenerative stuff, maybe a bit of both, who knows? Would you be more inclined to do the one week per month, just for you personally? Yeah. And I would shoot to get a glucose ketone index of like one to two for at least three days out of that week. So really do a fairly aggressive ketone metabolic therapy intervention, kind of even think about it as like a

prescription intervention, just like Walter Longo's diet, is a prescription medical therapy, right? So I would shoot to achieve a glucose ketone index of one to two for three days. And everything that we've seen in the lab that I've seen sort of on paper, of course, people aren't out there measuring the autophagosome like P62 and other things, but that you are achieving a level of autophagy. And that's also stimulating many of the benefits of ketosis, not just ketones as an energy source, but you're getting many of the robust signaling effects and really adapting your metabolism to fat and ketone sort of oxidation. That has long-term benefits that can go at least three weeks. So I'm convinced that. So you get benefits for three weeks, reset one week,

benefits for three weeks, reset one week, so you're always kind of getting. Whereas if you do three weeks and then take a period of time off, I'm not totally convinced that those benefits are going to stand that amount of time frame. That's my thinking. And you mentioned people can find calculators out there. And actually, a lot of the devices will try to provide this to you. Actually, is that true? I guess they would have to have both data streams. So probably not, but the GKI. So the glucose ketone index, you can find calculators for this, but fact check this, since this is AI overview from Google, I wanted to just take a look at it. Divide your blood glucose level by your ketone level. If your glucose is milligrams per decilator, common in the U.S., you first

divide it by 18, this is an important step, to convert it to millimolars per liter matching the ketone units, then perform the division. So you can figure this out very easily, and that is the GKI that you are mentioning of a one to two. What might that? look like just offhand i'm very uh not known for my quick mental arithmetic on the podcast but what would a gk i of say one or two look like in terms of the readout on the glucometer and the readout on the finger prick for the millimolars for ketones what would be an example if people are like don't want to do the millimolar concentration of glucose if your glucose is 80 and then your ketones are two millimolar you are right into that

that one to two, kind of the glucose ketone index of one to two, you're between that level. If you could bring your glucose down to like, so like 68, 70 and get your ketones up to three, so that would be a GKI of one. So that's pretty hard to achieve, but relatively, definitely doable with exogenous ketones and MCT and things like that. So yeah, I think what's totally feasible is getting your glucose down to like 80, 80 to 80, 50 to 80, five in that range and getting your ketones, you know, at the end of the one week fast, up to two and maintaining that. So that would be kind of achieving that BKI, too.

Yeah. So, look, I think I'm probably saying what I wish to be true, which is that my insulin sensitivity has improved a lot in the last certainly year in particular. and that is to explain in part the, or maybe wholly, the lower readout on the ketone meters. But part of the reason I have confidence in that is that I'm using the same devices that I used to use. And back in the day, I would have much higher billemolar readouts. Of course, I have new strips. I did, at least to the extent that I can, for the continuous monitors.

I've done calibration for the CGM, at least, the glucose monitor. But that presents a problem. Even if that is good news, Tim Ferriss, you're not failing at keto. You've actually just made yourself a lot healthier with intermittent fasting and other things. It still presents a problem for me to figure out if I am in that GKI sweet spot. So how would you suggest I try to figure that out? Is there a way to measure my ketone uptake and therefore modify the equation such that I factor that in somehow? There's a multiplier of the readout on the finger prick or something like that.

How would you handle that? Yeah. Let me look real quick. Domest looking into his Santa's workshop of various metabolic devices. Yeah. So I have a lot of different devices. So one is the keto mojo device here. Yep.

That's the one I have. Yeah, I've got the keto mojo. So that, I mean, you could just calibrate it such that it reads in milly-molar concentration and glucose and ketones, and it actually gives you, this is the GKI version. It'll just spit out the GKI. Oh, you know what? I do have the GKI because you're right. The keto mojo also measures glucose.

I guess what I'm asking for myself is since my readouts are so low, presumably as a placeholder due to improved insulin sensitivity and ketone utilization, I'm going to fail, right? If I'm just using the glucose and the ketone strips for the keto mojo, because the right now, if it's telling me that I'm at 0.4 millimolers, and I can tell you subjectively, I do not feel like I'm at 0.4. I feel like I've got a lot more juice and a lot more gas in the tank. Is there a way to, whether it's on paper or otherwise, account for the increased ketone utilization? I mean, it'd be great for me just to verify that somehow, but then whether I can verify it or not, if I wanted to try to determine,

during that week, like if I'm hitting my target GCI, how would you suggest that someone like me do that if I'm just not getting the numbers necessary to make the regular math work? So one to two is a high bar, I guess, a GKI have one to two, and I think we've had this conversation back and forth with this group that we're working with in the cancer community, the Society for Integrative Metabolic Oncology is a group that we're discussing the GKI. free, it's very adamant about, like, getting to one to two. But I give pushback and say one to four is if you look at the published literature, one to four is absolutely 100% therapeutic across not only cancer, but also like seizures and everything. So I'm going to expand that range to a one to

four. So what does that mean? That would mean that your glucose level can be upwards of 80. So you could have a glucose level of 75 to 80 and then get your ketone levels to one. And that would be a GKI of one, essentially, if you don't have the glucose calibration for that. Or that would be a GKI of four, rather. So it would be really rare, if not impossible for anyone in the general population to even achieve a GKI of like five to 10. That's indicative of like high fat oxidation, between production. and I think that you're getting a lot of therapeutic benefits. Also, a millimolar concentration of one in your blood represents a 10% available energy for your brain. And also, the keto-mojo device is measuring D-Beta-hydroxybutyrate.

And if you're doing supplementation with racemic d and L, then you're not picking up the L. So that could be a factor, too, if you're using racemic ketone salts. and there's a number of publications that have already happened and some in the pipeline basically showing that L-bate hydroxybutyrate takes about four to five times longer to metabolize, so that's in circulation more. And also, like, if you're on a ketogenic diet for reasons we don't fully understand and we are to rip out the heart, about 34 to 40 percent of the ketone in the heart is L-Beta-hydroxybuterate. And we don't know why it converts the D to the L, but it serves,

a function that the groups that have done the research are convinced it's not an energetic, but it's actually impacting cardiac output and reducing peripheral vascular resistance, maybe at the glyco calyx. So I don't want to go down that rabbit hole. But basically it's like if your heart is pumping against pressure and think of it as like a garden hose and you kind of take the kink out of the garden hose, the L beta hydroxybutyrate is kind of taking the kink out of the garden hose of your vascular. vascular endothelium. And then that's also in your brain. So you have better blood flow to your

brain. And I am convinced, I mean, there's tons of data out there showing an increase in brain blood flow with beta hydroxybutyrate and the L trends better to increasing that blood flow. We do a Doppler blood flow measurement on various wound healing things that we've done in the lab. So I think that's blood flow. I mean, a lot of people have vascular dementia, right? So there's different types of dementia, and it might be not like completely one or the other. And the metabolic phenotype of dementia could be vascular. You're just getting, you got a restriction of oxygen and energy to the brain. So I think my point is that one millimolar of beta hydroxybutyrate in circulation has an energetic effect, and it also has a pronounced effect on the vascular endothelium to increase

blood flow and circulation. So you are getting a benefit. I've never had this experience in ketosis before where these levels have been this low. It's so bizarre. And yet, let's say back in the day before the intermittent fasting, and it's pretty much the lever that I pulled that I think changed things. Prior to that, I could tell you probably within 60 minutes of hitting 0.7 millimolers on the precision extra. Like I knew when my brain clicked past that point. And I did years of the years and years of this stuff. So I think as much as I like to measure things, I should just assume, right, if I'm having a bowl of mackerel dog food with MCT oil and apple cider vinegar and salt and pepper, then having a meal later that effectively has close to zero carbohydrates,

If I'm doing that for almost three weeks, there's just, there doesn't seem to be a physiological option C for failure, right? It's like, what's my body going to do? Like, it has to be doing something. I'm not getting the dietary carbohydrate and I'm not just mainlining weight protein isolate all day. So I think I'll probably just have to kind of trust in the process because if I do have the increased ketone utilization,

and just somewhere between 0.2 and 0.4 millimolars for the most part, I just don't think that the math might be really hard, even to hit the GKI of 4. But it's like, if you're following the process, I guess you're following the process, right? I say trust the process and also think about, I'm talking about blood biomarkers, but let's talk about like physical metrics that could be considered biomarkers, right? So if you're training, So for me, it's all about the numbers. Like my lab books and stuff like that have numbers like in the lab, but also training. It's like, I know exactly what I'm going to do going into the next workout.

And it's all about, you know, X amount of weight for X amount of reps. So you can also do that with various brain training apps. You can do reaction time. So for our NASA Nemo experiments where we're in extreme environment and we're working with astronauts, like, you know, we're assessing reaction time, decision making, risk taking. where like this balloon blows up and you don't know when it's going to blow up, but you have to stop. It's like a weird risk game. So we have this whole metric of testing cognitive function,

reaction time and things like that. So there are things that you could do, you know, even with an app-based thing to assess that. And I think that would be a good thing. And we know that brain training, we have a massive NIH grant University of South Florida on brain training games, you know, and assessing performance on that. If Alzheimer's was in my family, I would basically be doing everything possible, physical training, dietary, metabolic training with nutrition, supplementation, and also brain training.

And with brain training, games, and we use Joggle, the NIH toolbox. I mean, we have like about six or eight different types of tests that we do to get a very objective measure of cognitive function. And I think it would be good to establish that now. And then get your baseline, just like we're doing a DECSA for body competent. position and then test that every six months and then do it in the absence and presence of being in ketosis. So I would suggest, you know, something like that. I'm actually, I have time blocked out my calendar this Friday to do a whole battery of cognitive testing. And I've also, I will say, and again, this is not super precise, but having tracked myself for so long and developed a

water feel for certain types of performance. Zone 2 feels a lot easier right now, a lot easier than usual. And coming back to your prior comments. And then I would say I'm using software right now, at some point I'll be able to talk more about this, but to basically train my visual processing to compensate for presbyopia, it is crazy some of the effects that this stuff has. But it also is very much indirectly a measure of reaction speed. And they see some really cool carryover effects. And my speed in terms of time to completion for four bouts, like modules of tasks, has just gone up and up and up since I've sort of been in extended ketosis. And that's very easy for me to see. So folks who are listening, I'll have more to share on that later,

but it's pretty mind-blowing stuff. So dumb, you know, a few things, have come up that I would love to chat about because I get these questions all the time which relate to exogenous ketones. And people have heard this term exogenous endogenous. It's very fancy talk in a tuxedo for outside the body in the body, right? So I'm simplifying here, but the easy way to remember exogenous is exoskeleton, right? It's like a skeleton on the outside of your body, exogenous ketones, ketones that you're taking from outside and putting inside. People always ask, and I know you kind of have a dog in the fight here, so I want to recognize that too. But how should people think about supplemental ketones? And are there any

warnings or disclaimers that you want to add to that? Because this is a topic de jour. I think there's probably no biological free lunch if people are going to be mainlining fruity pebbles and eating tons of carbohydrates, maybe not a great idea to eat tons of exogenous ketones. I don't know. I'd be curious to get your take on that. But what's the good, the bad, and the ugly of exogenous ketones? Where should people go?

How should they think about it? The things to consider would be when you're thinking about a ketone supplement to think about palatability. If it doesn't taste okay, you're not going to consume it. I would, but most people won't. Pallitability, tolerability. it gives you disaster pants or it makes you nauseous or something. So palatibility, tolerability, and then the next one, the third one would be the pharmacokinetics. So you want something that when

you consume it, that it has an ideal pharmacokinetics, meaning it's not going to spike up in 30 minutes and be out of your system in like an hour or two. Yeah, pharmacokinetics is like the stock chart for something you put in your body, right? In this case, right? And that's kind of important because if you have a very rapid rate of rise of ketones, that can trigger an insulin response. And what I've observed, if I'm cruising in ketosis and I take like a large dose of a ketone ester, it shoots my ketones up real high and it's back down within like two hours, but it also kicks out insulin and that shuts off my own ketone production. Then I'm hypoketotic and hypoglycemic from the insulin.

And that can create an energy deficit in the brain. How long does that last for you? And it lasts in the context of consuming, for example, a ketone ester by itself. But if you consume the ketone ester with MCT, if you could tolerate that, you could buffer that response to some extent, or you'd take it with food or something, or you could avert that by different ketone formulations. And we could talk about that. But I just want to move down.

So you got palitability, tolerability, pharmacokinetic properties, and you also have toxicity. So that would be the four things that you need to consider when sort of selecting an exogenous ketone, and those things differ depending upon if you're using it acutely, like in a medical situation, or it's like a daily thing that you want to take every day for prevention, right? Yeah, let's talk about toxicity first. Toxicity is probably the most important, too. Let's, for the time being, not talk about the acute medical delivery.

Let's talk about recreational slash better said layperson use. This is as a dietary supplement. Could you speak to the toxicity piece? I can say now with, well, what we observed like about 10 years ago was that formulations that contained 1-3 butane dial, that includes an ester, I have a lot of patents on, and I have actually ongoing experiments with 1-3-butane dial by itself is a ketogenic agent, and that can have toxicity when used chronically. 1-3-butan dial is an alcohol dimer, and it gets metabolized through alcohol dehydrogenase

an aldehydeididrogenase. Althagide diadrogenase kicks out a beta-hydroxibbutary aldehyde that can be toxic. How is it toxic? What are its toxic effects? Alcohol deidrogenase uses NAD, consumes NAD as its function, right? So it can basically deplete the liver of NAD, and aldehyde dehydrogenase also consumes up NAD. And it rapidly depletes, for example, the liver, the epatocytes of ATP. So we've know that there's a paper coming out that'll show that in our lab, we've is seen therapeutic effects in certain contexts when delivered acutely, but when consumed chronically, when we go beyond our experimental window and give these things chronically as like a lifestyle exogenous ketone, and then we sacrifice the animals and then we do blood work

and we look at the liver, we see signs that are kind of scary. This could be inflammation, the liver, TNF alpha, sinusoidal dilation, sort of like gaps in the liver, fatty liver, a number of different things start to surface. And that's pretty much just due to metabolizing something that's considered a toxin to the body, 1-3-butan-dial. It's a very versatile drug. 1-3-butan-dial by itself is more toxic than 1-3-butan-dial-based ketone esters. So you have the ketone mono-ester, which is technically the millimolar concentration.

you have 51% of a ketone monoester is 1-3-butan dial. So it hydrolyzed in the liver gets into circulation. Still, over 50% of that is 1-3-butan dial. That kind of needs to be detoxified, but 1-3-butyndial does get broken down to beta-hydroxybutyrate. The diester is about 35% 1-3-butan dial. So I see these as potentially problematic. The diester is what percentage?

The ketone diester, which would be 1-3-butan dial with 2. ketones on it, we use acetoacetate. That's 35% of that molecule is 1-3-butan dial in circulation. I got it. The beta-hydroxybutyrate monoester is 51% 1-3-butan dial in circulation. This can become problematic when it's used as like a supplement and a lifestyle thing, like day in and day out. How would you translate, can you translate from the animal models to humans,

Do you think, because we all know humans are not just big, furry mice, right? Do you think it translates? I mean, and this might be just like a precautionary measure. It's like, well, pending additional studies, let's hit pause in a sense. But if it were to translate, do you have any idea what type of dosing per day or per week with which we might see this toxicity in humans? So there is a deficiency of data on the use of these agents, 1-3 butane dial, that are long-term studies. The only study that I'm aware of is a case report with Dr. Mary

Newport's husband, Steve. And then there's a 28-day study that used 25 grams. 25 grams per day. Yeah. And that produces like 0.1 to 1 millimolar. But what I have done is I took the R13 butane dial and then the racemic 1-3 butane dial at different time points. And I basically dosed it for two weeks to keep my ketone levels at 2-millimeter, which would be like a therapeutic. And when you do that, what you will see, and I, well, I was going to say I, you know, tell people that go ahead and do it, but maybe don't do this. But when you take something like 1-3 butane dial at a dose, which for me requires 30 milliliters three times per day to keep at two millimolar throughout the course of the day, if you do that for two weeks and then you test

your transaminases, so that would be AST, ALT, and GGT, they will go up. So that's a clear indication. So we've done this in animals and fed it at a pretty high level, and we did not see transaminases going up. So transaminases are what people could think of as liver enzymes on their blood panels, right? AST, ALT. Is GGT typically tested? GGT is like the wild car, but what's good about GGT is like it's the canary and the coal mine. It will go up before ALT and AST. So if you expect someone has a problem with alcohol and say they're not drinking and you want to figure out if they're drinking or not, say, hey, when you get your, can I see your blood work and make sure the doctor adds GGT? And that's elevated and your ASE and are not. The only things that will really shoot up GDT is like alcohol. It's a very sensitive. And also the size of the red blood cell too can be if they're like larger. That's an indication like someone's drinking too much alcohol. And they could be like completely. It could be just like two or three glasses. a day, but that will elevate GGT. So we observed that transaminase is actually didn't go up in our animals fed the ketone esters or 1-3 butanidyl chronically, but when we pulled the livers out

and then looked at the livers, then we saw things that kind of concerned us. And we published this recently. And it's good to know, like when someone has non-alcoholic fatty liver disease, they can have normal transaminases but have a necrotic liver. Yuck, I did not know that. That's terrifying. Yeah, yeah. So if, I mean, you look very closely at ALT longitudinally and that creeps up. But basically, you basically have to do like a CT scan or a high resolution ultrasound

of the liver. And basically, you could just take a subset of the American population that trends to be overweight and you do some liver scans. and you find that they can have overt fatty liver disease and have completely normal transaminase as they're just trending up. So my liver enzymes tend to trend a little bit higher just because I eat a lot of protein. So with 1-3-butan dial and 1-3-butan-dial-based ketone esters, you have a problem with tolerability, palatability, potentially feasible pharmacokinetics, and also toxicity. So it almost like checks all the boxes in a negative way.

The field is trending towards non-13 butan-dial-based exogenous ketones, and that could be free acids. It could be a triester with glycerol and also the ketone electrolyte salts. But you could also avert part of this just by formulation. The issue is that companies have one molecule, and then they test that one molecule. But I think formulation is the way to go. And companies don't kind of want to. hear that because they have all their IP in like one molecule. But we've always been a formulation

kind of based lab. And always saw that these things always have drawbacks when you used as a monotherapy, but when you start combining them together, that's when you get better therapeutic effects. Got the hounds. Yeah. Yeah. Out there. Hopefully not next to the gators. We won't spend any time on this, but I just wanted to tell people that before we started recording, you're telling me that you caught a 10-foot alligator that was trying to eat your dogs. And then you, like, pinned it down, taped its mouth, and then measured its glucose and ketones. Turns that alligator had a pretty good GKI. But, you know, that's a story for another time. So only in the things that only Tom would do category, that's a standout. So, but we're talking about a lot of terms that are likely

unfamiliar to folks. I don't want to throw anybody under the bus here. But people should do their homework. One three butane dial is very, very, very common. It's very inexpensive or relatively inexpensive to produce. So just keep an eye out for one three butene dial. If this is of interest to you, I have no investment in any ketone supplement company or anything. I do not have a stake in this. But what I would love to ask, I would like to ask a couple of things. So I have experimented, as you know, with ketone monoester, diester, ketone salts. I've kind of played with everything. And I found the diester to cause quite a bit of intestinal discomfort, to put it mildly, at least the first one or two times. I will say for folks, if at first you don't succeed,

meaning you have to run to the toilet, you may acclimate to it, which I did in that case. But I felt subjectively less and less effect. I seem to develop tolerance very quickly. I don't know why that would be the case, but I seem to experience it. The ketone monoester, which is the 1-3 butane dial bound to B.HB, if I understand it correctly, right? I do like that. I like the subjective feeling of it, but if that's only at about 11 milliliters, if I take 25 plus speaking to your pharmacokinetics, right, like the stock pops and then it drops, and then I feel very tired and often feel more anxiety. It seems to prompt me more anxiety. So I guess my question is, and then we got to talk about this, not that it invalidates what

you're saying in any way, but your wife runs a company that sells ketone salts, which I also have been using most consistently. Keto start, people can check it out. But on the keto and monoester, what I'm wondering is if I'm only taking, let's say, 11 milliliters once or twice a day, I'm taking it alongside MCT oil. Where would you put the kind of risk analysis on something like that? would say the risk is very minimal for a healthy person. I have a super healthy liver. I even take, you know, anesthetal cysteine, alpha lipoic acid, all these things. So I was surprised to see liver climbing. What we see in our older animals is that they are selectively vulnerable to 1-3 butane dial toxicity from acutely and also chronically. So for a normal healthy person,

especially someone that's sort of, you know, really good metabolic health and liver function and, you know, they don't drink or drugs that compromise the liver, I would say upwards of 1-3-butan dial 20 to 20 milliliters a day is probably where you want to cap it and maybe not do it every day. A 3-butan-dial-based ketone ester would do that, but you can also probably achieve and maintain the same level ketosis with a ketone salt, beta-draxiboutate salt, and I do like the idea of a D and the L, the two anantamers, which is a conversation. that you may or may not want to have.

So the L is basically like it's packaged beta-hydroxybutary in the time release form, and it has some signaling effects. And then you have free acids, too, that are kind of coming up on the market. And various liposomal formulations. I'm not sure if they're commercially available yet. But these are some things in the pipeline. Yeah, 1-3-B-10-based mono-ester. I think there's good data behind it.

I think the science that's published is kind of biased in the direction because that was the molecule that a lot of companies associate with, and then they test that molecule in and of itself as a monotherapy. And I am of the opinion that things are definitely optimized. You could avert a lot of the problems just by formulation. How does the MCT oil help? I guess basically it makes the ramp up more gradual. Is that the effect that the sort of co-consumption of the MCT oil has? Yeah, it delays gastric absorption for one thing. But it's also stimulating the production, your endogenous production. So the MCT is, you know, goes to the liver. Right. Right. Right. It goes right to the liver and stimulates your body's ketone production.

And I think that's important. It's almost like training your liver to ramp up fat oxidation. And it's almost like exercising your liver to stimulate it. What we've also observed and we published on that like a large dose of MCT, when you take the liver out and look at it, there's globules of fat all in the liver. Oh, that sounds bad. We see a fatty liver, but we did not see evidence of necrosis, but we did see some inflammatory markers. Necrosis is dead tissue, dead cells. We did not see that, but we saw sinusoidal dilation, and TNF alpha was elevated and some other things to suggest that large doses of MCT. And if you do the human, the human equivalence, it would be like me taking upwards of like 80 to 100 milliliters per day. so that that's a lie yeah although it's not that much though right i mean because 30 mil liters is like

two tablespoons is that roughly right so it's like six tablespoons if you're just squirting it into your coffee like it's not hard yeah to necessarily get above a hundred it's actually pretty easy so where would you recommend capping mccc consumption i'll get rid of my camel back with the mcc oil in it but where would you recommend capping the mccc consumption the studies that were done showing benefits is like 20 milliliters per day but they only did like a single dose which is kind of weird but that was the old axona studies

and like 80% of people tolerated that 20% didn't but I'm of the opinion that 20 milliliters twice per day would be perfectly fine for essentially most people that can tolerate that and you're going to have probably about 30% or more but MCT is much more tolerable

when you take it with a meal so if you take MCT on empty stomach prepare to be close to a bathroom Yeah. You know, of all the disgusting things that I have consumed in my life, and I've had a lot, right? I mean, I've tried early prototypes of some of the esters and like all sorts of stuff. I'm not going to say it was a pinia colada, but I was fine with it. MCT oil to this day, I just find so absolutely revolting. I don't know if it's the neutrality and the mouth feel, but mixed with the mackerel and that apple cider vinegar, it sounds so disgusting. my friend almost puked in his mouth yesterday when I was describing it. It's actually really good. I'm just a sucker for mackerel. I'll take mackerel over sardines all day long. But let's see here. So I think we've covered a lot of the exogenous ketones. I'll just pull this from our text thread because I think it might be a question on some people's minds. As I was trying to troubleshoot my apparent failure

mode with ketosis because of my low numbers, I asked you, is there any argument to be made that I should have a ketogenic breakfast instead of intermittent fasting. Could it be that I'm causing problems with exogenous ketones? Am I delaying potentially the onset of my own ketosis? Is it like TRT? Right. If you're taking exogenous, remember that word. If you're injecting or rubbing on or swallowing testosterone, it's like your Lydig cells are pretty smart. That's the reason your balls turn into raisinets is because it's like, cool, we don't have to make that anymore. So I thought, am I shooting myself in the foot by taking anisogynous ketones? And it sounds like a little bit goes a long way, but like most things, in excess, it kind of

becomes its opposite, right? It becomes a hindrance and makes it problematic. Is that fair to say? We've only seen the anti-endogenous ketosis effect with 1-3-butan dial or 1-3-butan dial-based ketone esters, due in part to their potency and also, the rapid elevation of ketones seem to have an insulin effect that can double or triple insulin. And we don't, even if we elevate ketones to the same level with the salt, we don't see that spike up in insulin. So that could be coming into play with your low ketones if you are

consuming the monoester. Not much. Every once in a while, like before exercise, because I might not mind the spike. I'm not consuming a ton. But the breakfast, I'm of the opinion that protein loading in the morning. Actually, when you first wake up, and I think Donald Lehman and maybe Stu Phillips would also agree with this, maybe Lane Norton to sort of, you know, the protein guys in the camp is that protein in the morning kind of amps up your metabolism throughout the rest of the day. And I think if you abstain from eating during the day, you tend to get the munchies later in the day and you tend to overeat, whereas if you have a protein heavy meal in the morning with high fat, that can sort of rev up your metabolism for a good part of the day. And then again, some

people, me included, like, my mind is not as sharp. That's the thing, right? I would say that, I mean, for 15 years, right, the sort of 30 grams within 30 minutes of waking up has been this sort of easy to remember sureistic that I've recommended for folks. And that if I am not intermittent fasting, that's also what I do. But I've become so addicted to the mental sharpness that it's just like, man, I know that if, for instance, if I want to do three hours of writing, I do not want to have food immediately prior to that. But I would say if I'm also at a point, I think, where thrown up really heavy weight and for me and getting as big and strong as possible is just not, it's less of a priority, right, than it once was after shoulder surgeries and

elbow surgeries and various things. Not that I want to be the skinniest guy in the room, but okay, it sounds like the pharmacokinetics are maybe to blame with the associated spike in insulin for some of the issues you might run into if you're taking the 13 butane dial-based products. It can be, and I suspect it is, and I've kind of, you know, proven kind of with myself, that's the case, but it also can be mitigated in part by mixing, you know, taking it with a or taking it with MCT. But then you get the, you know, it is metabolized, like 30 million years of 1-3-butan dial is kind of like 30-millimeterers of ethanol.

And then 1-3-butan dial is also can create dependence, and it also can create you get withdrawal. So it's established in the literature. There's several publications just showing that with 1-3-butan dial will produce dependency. And when you abruptly stop 1-3-butan dial after, consuming it for a period of time, there's essentially alcohol withdrawal from that. What are the symptoms of that? I mean, imagining you don't get like DT, right? You're not getting like shakes or anything, are you? But I mean, like, what happens? I mean, it's like classical

kind of ethanol withdrawal, maybe not quite as dramatic, but the glycols or diealkals do have a gavergic effect. So you're, you know, doing that. I mean, it's well established. one three is it has narcotic like properties and that kind of stymied its use as a synthetic food for spaceflight well i think the palatibility also factored into that but also in the literature it notes you know a narcotic effect of this and then the animal studies and yeah really showed dependency on withdrawal just to give a reiteration of that you know the one three butane dial-based stuff is also sold as an alcohol replacement you know so of course being the idiot that I am. Not idiot. Just like, I'm eager to experiment here and there if it's not going to

kill me. And so I thought, you know what? I don't want to drink tonight. This was in. I remember where I was. I was in upstate New York, about to go to a restaurant with a friend. I knew he would want to drink. And then I wanted to be able to say, hey, I already had this ahead of time. Don't worry. Like, we're on the same level. And I chugged a small can. It wasn't in terms of liquid volume a lot, right? I don't know, six ounces, eight ounces. And I felt like I could barely walk to the bathroom. Like, I was smashed. It was, like, almost knocked the glass off the table. I was like, holy shit, I did not do this sort of risk assessment properly. Like, thank God, I'm not about to get into a car because it took a little while to wear off. So that

narcotic effect is really, it's not always subtle. I made jello shots. I made 1-3 butane dial gelo shots and before we made the ketone esters in 2009, Patrick Arnold and I like kind of formulated Patrick Arnold. So people who don't recognize Patrick, listen to my conversation with him from years ago. But if you know Balco or remember what Barry Bonds grew a few head sizes or any of that stuff, anyway, Patrick's got some stories. But so the jello shots, so what happened with the jello shots? Yeah, well, that was the way to get it down because one through butane dial so nasty, right? So you could basically just warm up pure 1-3 butane dial in a pot and then add cherry-flavored sugar-free jello and then stir it up and then pour it into like a cookie pan and then cut it into cues, which you get 20 milliliters per jello shot and make it pretty strong. So it's like firm jello and I would just hit like two or three of them and just be buzzing.

And, you know, I talk about it. Like, 1-3 butane dial can be fun, and it's a lesser of two evils when we're talking about ethanol. So I actually tried to file a patent for the use of 1-3-butan dial for alcohol withdrawal and things like that. But actually, there was some prior art on that. And this is many years ago. But I actually do think it could be part used by people if they could transition off

of ethanol, potentially use that. But there are other ways to get off alcohol. I'm not advocating for that. But my concern is why I'm talking about it. now, too, is that I know there's older people out there with dementia, perhaps Alzheimer's disease, that if they're consuming 1-3 butan dial as a ketogenic supplement, it's going to make you dizzy. It's going to decrease your stability. Like, it's going to make you potentially fall, break your hip. And then, you know, when you're older, your ability to detoxify alcohol

and 80-year-old only has like 20 or 30 percent of the capacity to do that. So the same amount of 1 3butan dial for a 20-year-old is going to be like, you know, three to five times harder on your liver, like as we age, right? And people note that. Like, as you age, you just can't tolerate the same amount of alcohol. So I think these things, the 1-3Betan-dial-based supplements, the straight-up 1-3-Betan-dial and 1-3-butan-dial-based ketone esters are problematic for the age population that I think some of these products or companies are targeting. And I say that not only as a science, but because of the volume of emails that I get on that if people were like, you know, I got super buzzed. I didn't know what happened. And some people are very sensitive to it. Like I gave my wife

just she can't tolerate alcohol at all. And she took a shot glass of the stuff and she like could not believe that it was like a legal supplement to sell. And now this will probably interest a lot of people so they'll probably go out and buy it. But I'm just saying like if you're sensitive to alcohol, you're going to get overly buzzed. And my concern is that, hey, if you want to use it for recreational, like, that's your thing, and maybe it's better than alcohol. But for older people, you know, a large dose of 1-3 butane dial is problematic from a narcotic, from a, you know, just the potential for just getting drunk, just straight up drunk. And Dr. Veach told me that a long time ago, I was like, because I was trying to get the ester from him. And I was like, what if I just

use 1-3-butane dial? It's like, you'll get drunk. So it's like he instilled that that do not do that. That's what he said. And Veach was the co-inventor, is that fair to say, of the bonded mono-ester that was funded in part by, was it to the DoD or DARPA? Darpa and then patented at Oxford, is that right? Am I getting my facts straight or am I getting things mixed up? Yeah. Well, Oxford sort of acquired the IP and made a company out of it, but we have to credit Dr. Richard Veach, who passed away a few years ago for the conception of a ketone ester for just, you know, Dr. Beach was the student of Hans Kreb. Kreb of Kreb cycle?

Kreb cycle, yes. That's wild. Wow. Yeah. I went to Dr. Beech's lab at the NIH. I saw the whole ketone process. I tested different things. We were in communication.

He was a very colorful character and he had an amazing mind. We disagreed. We agreed to disagree on some things. but I consider him a mentor of mine, and I think we all owe a lot. I don't think exogenous ketones may even not exist. Well, Henri Bruningraber and some other people, Sammy Hasham developed the triester. So there was other people in this space,

but he really advanced the science and ultimately the application of exogenous ketones, and I think has written extensively about it. I mean, these things were around for a long time, and I think as science advances, we have more information, and then we can, I have pivoted away, from these things, although we still use them in some experiments. I published some really nice data on 1-3 butane dial, actually even in cancer studies, too.

But at the same time, I realize that the negative effects, and I can pivot away from that. We have other molecules like in development now. So I know, as I'm watching, things get dark on the East Coast for you that we'll wrap up in just a few minutes. But in brief, you mentioned fat, salt, fiber as things that can be helpful for slowing, I guess, gastric emptying of these meals that I'm having. And I'm curious for you on a ketogenic diet, what are your favorite sources of fiber, supplemental or in whole food form? Whole food form, I like broccoli. I buy broccoli florets, and then I cut the tip of the florette off. And I have like a bowl of that and I give like the stalk and stuff to my dogs and I chop it up for for their fiber. So that's something that I do. I don't know. Just to get a higher dose of broccoli. But broccoli and then wild blueberries that has about half of the sugar and more fiber. They're about a quarter of the size of like the huge blueberries you buy like Walmart. So wild blueberries. I like apples because they have a certain fiber called pectin in it. Some people that have a problem with fiber can't identify.

just pectin or they get gassy so it's on the fob map list or whatever but wild blueberries just green vegetables in general but i like broccoli and apples are pretty much something i have every day no the wild blueberries just want to really underline wild for people because that is not what you're necessarily going to get at your local grocery store that's been optimized to be as sweet as but they're in public so i can get them in public here and i think actually i think they're in walmart too i think you can go to walmart and i think you might have to like sneak around for them but there's like a brand they have wild raspberries and blueberries and blackberries together i forget the name of the brand but they come in like big two pound two or three pound bags too

so how much can you eat of apples or berries before undoing all the good metabolic work that you're doing in ketosis right because Because even, for instance, we've talked about how easy it is, and it really is easy, as long as you're pretty simple to please dietarily to say travel for keto, right? So you just pack a bunch of canned sardines, mackerel, maybe some oysters and macadamia nuts, and like, you're kind of good to go. Like, these things are pretty calorically dense. But the macadamia nuts, right, I was looking at the bag the other day because it's one

of the few kind of crunchy things that I feel like I can eat aside from some of these vegetables. And I was like, wow, like you can, if you go a whole hog on the macadamia nuts, like you can rack up the carbs after a while. What about apples and berries? Like how much, where's your cutoff point for yourself? Macadamia nuts actually had that three to one, the four to one ratio of fat too. So they are pretty high in fat, but like cashews and then almonds and other other nuts. I like walnuts too. I forgot to mention. So I have walnuts, small organic apples. buy wild blueberries and broccoli pretty much every day. And all that together ends up being about 60 to 70 grams of carbs, but one third of the carbs is fiber. So it's essentially

non-glycemic. And then I tend to, like haven't had any of that today, but I tend to have that at dinner and then my snack at nighttime. So everything that I just mentioned, the carbs. But I don't think about it as undoing like, you know, ketosis. And I do think my glucose tank is always like maybe 10 or 20% full, so I'm always running kind of low on glucose and on, you know, some days I'm more active. What's your height and weight, Dom, at the moment? Six foot 220. And I've been give or take five pounds for years now. Yeah. So just always bruise it like 220. Yeah. A hundred kilograms. Yeah, good body composition. That is a lot of muscle for people that are not watching the video. I'm just trying to set the maybe context for

what your tolerance might be for grams of carbohydrates. I have pretty good tolerance for carbs now, but I think I have good tolerance more now because I've titrated some carbs back in because I did go probably at least five years on like very low, like clinical ketogenic. And I did end up losing like almost like 18 pounds of like lean body mass. And then I took a year off in 2018 when we bought our farm. I was very busy on the farm. Then I bought weights and just have it on the farm, and then I've been doing Dexa. My last Dexa, it was 2.18, but under, I was like 9.8% body fat, like still under 10%. But I gained muscle when I got back into lifting and just did the heavy compound movements

again, but I don't go super crazy on the wage. I do train hard. But you found the addition of the carbohydrates to be beneficial, that slightly higher quantity of carbohydrates. I've added more carbs back in over the years, and that has helped me maintain my body weight. And I just, I like eating those foods. I enjoy those foods. I think they have beneficial fiber, phytonutrients, other micronutrients that I think are beneficial. And I can maintain a level of ketosis about, you know, 0.5 to 1.5 day in and day out, eating those foods every day.

And I do titrate in like the MCTs and I get like, you know, one or two packets of keto start a day, maybe up to three if I'm traveling. But that's my normal protocol and that's has optimized all my biomarkers. I actually got full blood work today, kind of waiting for that to come back to see. It should be interesting. I was inadvertently took something that I thought was laced with something, some gummies I told you about. People are going to assume when people hear of gummies, they assume it's THC, but this was what, thionine and magnesium? It should have been really innocuous, right? Is that right? Thianine and magnesium, my wife bought it at Marshalls. We both took two. We woke up in the morning and she says, I'm dizzy. I was like, she's asking me, what did you give me last night?

I was like, I didn't give you anything. Because sometimes they give her stuff. I tried to get up, fell like flat on the floor. Both of us could not walk. We were both like completely incapacitated. I called the poison control center. Yeah, so basically I've been running around to different labs and now I'm doing forensics. So do it was something. I'm still buzzed. So if I don't seem like myself. Wow. Really? I'm still buzzed 48 hours later. So we took something. We had the spinneys, and even this morning I woke up, I had the spinies, like, walk in, you know, to, so whatever it was, it was pretty powerful. And I have a little bit of a back injury from about a week ago, and I don't have any pain from that. So I think whatever it is, I'm thinking potentially a fentanyl derivative or something, but my wife does not drink, she doesn't use any drugs.

So she was pretty much, you know, really floored by this. and wow did you go back and buy some more of them to like send off to get well i have less yeah so i collected my urine my wife collector urine and then i'm doing the necessary blood work and i've contacted a forensic lab and we have like you know doctors involved in all this now wow dose the wrong guy yeah we're the right guy because you imagine like what if that had been a you know 80 year old woman sleeping on the second floor i mean absolutely dangerous yeah absolutely like i just took two and i'm a pretty big guy and everything but if a little kid took two or four or five so obviously i don't know the company and the company you can find it on

amazon mixed it up and it's like it's laced with something or they just put high concentration t hc and i kind of know what teach but this is we're talking 48 hours later and i'm still yeah i'm feeling it so i'm super curious with my blood work so i'm waiting for that to come in so be careful people out there be careful be careful with those gummies folks yeah don't is there anything else you would like to mention or anywhere you'd like to point people before we wind this to a close i don't think so i mean we talked a lot about like sardine fasting and everything i think before in the prior conversation yeah i'd like to credit to dr annette bosworth dr boz because, like, I mean, I've kind of, like, came up with this idea, but it got traction, and I think

she has a lot of people that email me about sardine fasting, heard it from Dr. Baas, and she's amplified the message with millions of YouTube followers, but she kind of, like, took an idea and actually put it into practice and amplified it through a lot of people, and then those people emailed me about it. So that amplified sort of and secured, like, my knowledge, yes, okay, these benefits it's R. And now she's been on, like, Diary of a CEO podcast, I think, and some other podcasts. So I'd also like to mention, I'm testing today even, there's a company coming out, I don't know if I can mention it, but I will, Meta Foods. And I, for years, I was kind of, there's no whole food based ketogenic diet prescription foods. So I have no association with the company. I'm just

testing your product, but they're called Medi Foods. How do you spell that? M-E-T-I-I-F-O-O-M-D-D. I got a meddy foods with a z and i got to tell you these are like gourmet foods and then they hit the macros of like a modified ketogenic diet and we talked about if someone says the ketogenic diet is not palatable they have to see these foods their prescription whole food there's other companies that tried to do this and they even got like the packaging is compostable like it looks like plastic but i could throw it in my garden and it breaks down i'm very impressed with this. I just mentioned that because, you know, I just got these foods yesterday and I was like really impressed, but other companies have not been so impressive. So many foods is

pretty impressive. And Quest Nutrition tried to do this a while back and I think their foods were good, but they got a new CEO and just phased it out. I like the idea of a prescription, whole food, ketogenic diet that like potentially a doctor could write a prescription. And these a week of foods could be sent to the patients. I've been questioning. why this someone has not done this but I know the margins are very small like in the food world so it's hard to you know kind of get that up and running well I mean look I mean they could take the approach that a lot of companies take a lot of tech startups take like Uber Tesla etc you sell in the beginning for much higher price to people who are willing to pay that you use

that to subsidize the R&D or the scale necessary to then offer right instead of Uber black you have Uber-X. And similarly for a lot of companies, I would pay for this, right? And I'm, yeah, I wouldn't say totally price and sensitive, but I'm willing to pay for convenience because there does come a point where I've had enough canned mackerel and salads with ribby that I would love to have something else. In any case, so I will check out many foods. Let's see, Dom, are you active on social anywhere? Should people find you anywhere online? Yeah, I'm not too active, but I try to jump on about, you know, once or twice a week and maybe I cap my social to maybe an hour a week.

But I try to respond back to things. Yeah, kind of delete the apps from my phone or some of them. I repost things and try to acknowledge like some questions and stuff people have on this. And then I collect questions. And then we have our own podcast, the Metabolic Link podcast. And we have a metabolic initiative platform, which has ACCME accreditation. So it's like, you know, you can get CME credits from it. So that has been a project that we're working on and trying to advance everything we're talking about into human application through that.

Yeah, beautiful. Well, trying to think of any other links. Are there any other links that you want to mention? And we'll stick these all in the show notes as well for people. Ketonutrition.org. No products. I don't sell anything. So ketonutrition.org information website, the metabolic link podcast and the metabolic,

like health initiative education platform are like the three biggies, I think. Beautiful. We will link to all of those things for people listening as well as, God save, the people who help me do the show notes, they're going to have a lot to dig through. But we will link to everything that we can find a link for at tim.blog slash podcast, just search Dominic. And this will be the most recent episode. I mean, we may have some in the future, so you'll find it. And Dom, thank you so much for taking the time, man. Always great to see you. My pleasure. Thank you, Tim, for having me. Appreciate it. Good seeing you. Yeah, and everybody, as per always, thanks for tuning in. And until next time, be just a bit

kinder to others and also to yourself, especially if you might be self-flagellating yourself or not heading your GKIs like yours truly. All right, take care, everybody. Hey guys, this is Tim again. Just one more thing before you take off. And that is Five Bullet Friday. Would you enjoy getting a short email from me every Friday that provides a little fun before the weekend? Between one and a half and two million people subscribe to my free newsletter, my super short newsletter, called Five Bullet Friday. Easy to sign up.

Easy to cancel. It is basically a half page that I send out every Friday to share the coolest things I've found or discovered or have started exploring over the that week. It's kind of like my diary of cool things. It often includes articles I'm reading, books I'm reading, albums perhaps, gadgets, gizmos, all sorts of tech tricks and so on that get sent to me by my friends, including a lot of podcast guests. And these strange esoteric things end up in my field and then I test them and then I share them with you. So if that sounds fun, again, it's very short, a little tiny bite of goodness before you head off for the weekend, something to think about. If you'd like to try it out, just go to tim.blog slash Friday. Type that into

your browser, tim.com.com slash Friday, drop in your email, and you'll get the very next one. Thanks for listening. I asked millions of you about Gusto on social media, and I've never seen such overwhelmingly positive responses. It was kind of bonkers, honestly, because I've done this dozens of times. And it makes sense. More than 400,000 small businesses already trust Gusto, and it's been named the number one payroll software by G2 for fall 2025. If you're a small business owner looking to simplify payroll and HR tasks, because why would you want to spend more time on those things? Gusto could be the game changer that you need.

Gusto is the all-in-one payroll benefits and HR platform designed specifically for small businesses. They automatically file federal, state, and local payroll taxes, handle W-2s and 1099s, what a pain in the ass, all those can be, and offer straightforward health benefits and 401k options for nearly any budget. Now is the perfect time to choose Gusto to take care of your team and stay compliant. So go to gusto.com slash Tim to see why 9 out of 10 Gusto customers recommend gusto. Listeners get three months free once they run their first payroll. Again, that's g-U-S-T-O.com slash Tim.

Terms and conditions apply. I have been fascinated by the microbiome and probiotics as well as prebiotics for decades, but products never quite live up to the hype. Now things are starting to change, and that includes this episode's sponsor, Seeds DSO1 daily symbiotic. I've always been very skeptical of most probiotics, but after incorporating two capsules of Seeds DSO1 into my morning routine, I have noticed improved digestion and improved overall health. So why is Seed's DSO-1 so effective? For one, it is a two-and-one probiotic and

prebiotic formulated with 24 clinically studied strains. But if the probiotic strains don't make it to the right place, they're not as effective. So Seed developed a proprietary capsule and capsule delivery system that survives digestion and delivers a precision release of the live and viable probiotics to the colon. And now you can get 20% off your first month with code 20 tim at seed.com slash tim using code 20 tim all put together one more time seed dot com slash tim code 20 tim