Ben, Karen and Jenn offer some insight into common health issues and medication that impact the keto diet. If you are ill, there are a few things you may need to know before you start keto, and a few things you may need to do differently.

Please post questions, feedback and comments. Thanks!

  1. hair loss
  2. Kidney  
  3. Hypos 
  4. Overnights
  5. transition from insulin dependant diabetes  
  6. Cramps 
  7. pitting edema
  8. BP meds and electrolytes
  9. blood thinners and vit k
  10. bad breath
  11. keto rash 

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[Music]
00:20
well hello and welcome to another
00:23
edition of the impulsive keto gasps I’m
00:25
your host Ben McDonald today’s episode
00:28
35 common keto health issues we’re gonna
00:31
be diving deep into some of the more
00:34
common health issues that come up as a
00:36
result of the ketogenic diet or as
00:38
concerns for people that are entering
00:40
into the keto diet with me I’ve brought
00:43
along someone who’s got all sorts of
00:46
issues going on some of them are
00:48
health-related all as well know how’s
01:00
your week been it has been a slow and
01:05
steady there’s been a lot of nonsense on
01:08
the board people been asking a lot of
01:10
tough questions yeah I figured we needed
01:12
to dive in and speak to all this stuff
01:16
alright there’s a list of things
01:20
Jenny fair are you with us
01:23
I am hello hello from sunny Georgia my
01:29
all right I did a little Facebook live
01:33
garden tour this morning I think I saw
01:35
all right garden nice down there right
01:39
so we’re just starting to see spring pop
01:42
up you know and I’m like snowing that’s
01:45
why you Kirsten it was there was a snow
01:47
day nice blizzard end of April that’s
01:52
crazy I’m about like two weeks we’re
01:53
having right blueberries down here
01:55
that’s awesome this week I was just I
01:59
was indoors a lot at the the weather was
02:01
beautiful so of course that’s when I had
02:03
all my appointments I’ve signed up with
02:06
a new personal trainer Wow
02:08
congratulations I am super stoked to get
02:11
started we’re starting on Monday
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that’s good I’m looking forward to all
02:15
those form check videos I’m signing her
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up to keep you know fit so you can argue
02:21
with her nice Christmas hit me up I had
02:25
a look at Chris’s but again this morning
02:27
what am I doing wrong
02:29
you like you doesn’t send me those
02:30
pictures I’ll let them know that you
02:32
want to be on the list but I’m happy to
02:37
look All Right see you screwballs you
02:44
already got us off-track common health
02:48
concerns I say okay
02:51
Karen your hair loss we need to speak
02:56
about hair loss this is something you
02:59
experienced yes I did and you
03:01
experienced it outside of nutritional
03:04
events as well I have no hair loss we’ve
03:08
got that as number one because this is
03:10
something that comes up a lot
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our board is 85% women and we don’t
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expect our hair to fall out so I I know
03:21
I know Ben you might not think that this
03:23
is a big deal yeah I have no problems I
03:25
don’t know what you’re talking about
03:26
what’s important but it’s a yeah so
03:31
there’s some assumptions they’re made
03:32
with hair loss that somehow there’s some
03:35
sort of nutritional deficiency going on
03:37
you’re not getting enough calories I see
03:39
a lot on the women’s group oh you need
03:41
to up your protein but I know with
03:44
myself I was getting enough protein I
03:47
was getting enough calories I was doing
03:50
all the right things and yet three
03:52
months after I started
03:53
Kito i start clogging that drain in the
03:55
shower No
03:57
so my husband’s a little upset with me
03:58
cuz you know that’s his job right he’s
04:01
the the unclog or of hairy clogs hmm and
04:05
I I thought over that first summer that
04:08
I was I was keto that I was gonna go
04:12
bald it was not pretty did you know it
04:17
really thin though I can remember seeing
04:19
a photo that my brother taken it was on
04:21
the back of my head and he could see my
04:23
part and it looks pretty it did not look
04:26
good
04:27
I’ve been here to begin with so you know
04:30
it as a woman we kind of like to have
04:33
that that luscious thick mane you know
04:36
and yeah actually exactly the same thing
04:40
happened to me too and I was freaked out
04:41
yeah yeah yeah no but the thing is this
04:45
had happened to me before
04:46
um it had and it had nothing to do with
04:50
diet I was actually you know eating a
04:53
lot when it happened the last time and
04:56
when it happened was three months after
04:58
I gave birth huh so this is what’s
05:02
happening is there’s this huge as Ben
05:04
would say profound hormonal shift that
05:07
happens when you lose weight and it also
05:10
happens to a lot of women after they
05:12
give birth it you have this you know
05:14
this thick hair when you’re pregnant
05:15
often and then three months later even
05:19
though you’re taking the supplements
05:21
you’re eating the right foods you’re
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doing everything usually because you’re
05:26
breastfeeding at that point so you have
05:29
a healthy baby and still the hair will
05:33
fall out and so it’s just this profound
05:37
hormonal shift it’s it happened three
05:40
months before but you start to see it
05:43
three months after so once the hair
05:45
starts falling it’s it’s just going to
05:48
run its course and a few months after
05:50
the hair falls out it starts to grow
05:52
back
05:53
now with us following a nutrient-dense
05:56
version of the keto diet we’re getting
05:58
adequate protein we’re getting healthy
06:00
fats we’re getting all these minerals
06:03
and nutrients so usually the hair that
06:05
grows back is quite healthy there are
06:09
things that you can you can use to
06:11
supplement to ensure healthier growth
06:13
and all this is going to do is make it
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come back a little a little sturdier a
06:19
little shinier it’ll help with your skin
06:21
and your nails too so you can have a
06:23
little a little collagen so that would
06:26
come in the green can is the fourth or
06:28
the popular you could do a bone broth if
06:32
you want to stink up your house you can
06:34
make a bone broth oh man all right
06:41
I’ll take your word for it but and and
06:45
you can also yeah you can use the
06:46
instant pot um another thing you can
06:49
take is biotin I take biotin I have as I
06:52
said I’ve got thin hair and thin nails
06:54
just the the way that my hair grows it’s
06:58
fine no I did notice something
07:00
interesting I do have I showed Ben this
07:02
picture do you remember this picture Ben
07:03
of my regrowth hair I do it was kind of
07:06
it looked like you yeah like the winter
07:09
coat coming in under your normal coat I
07:11
know so I’ve got fine lately wavy hair
07:15
like baby fine hair but the stuff that
07:18
was growing in was like medium and it’s
07:21
in ringlets so I’ve got like this thin
07:24
hair
07:25
he’s a ring that’s coming in that are
07:27
about three inches shorter than the rest
07:29
of my hair now because I did started
07:31
growing back but a year and a half ago
07:32
back thicker and healthier to accept
07:36
earlier yeah it was a young people it
07:42
was like yeah much improved except for
07:45
one thing it and this is actually not
07:48
new it’s it’s been kind of brittle and
07:50
I’ve had like short ends and stuff which
07:52
I learned is linked ISM so they’re not
07:53
fixed by some did happen
07:57
are you hearing or breakup yep Karen did
08:04
you see the article on baking soda and
08:09
it’s provocation of anti-inflammatory
08:13
agents for autoimmune I did I did some
08:16
research on that and what I was gonna
08:19
ask you to do any merit that is damn
08:22
interesting yeah you know I kind of
08:25
gotten away from having my fairy dust
08:26
very often and I think I’m gonna go back
08:29
to it just so the provocation of this
08:33
it’s got a four hour half-life yeah so
08:36
what you would do is you would do
08:40
somewhere between a quarter and a half a
08:42
teaspoon away from meals with a
08:45
four-hour tail okay so it’d be
08:48
interesting on my fasting days that’s
08:49
for sure yep so what I’m gonna have the
08:53
wife do
08:55
is twice a day we’ll do one in the
08:59
morning like an hour to after breakfast
09:03
mm-hmm and then another one like two or
09:06
three o’clock in the afternoon okay I
09:09
don’t know if it’s gonna make a
09:11
difference but it’s very interesting and
09:14
it kind of supports a lot of the
09:16
alkalizing diet stuff that you know
09:20
everybody says he’s uh
09:21
AIE diets work pretty good but they’re
09:24
all alkalizing yeah so there there may
09:29
be some really interesting behavior in
09:32
the gallbladder the problem is the the
09:35
research is very emerging there’s not a
09:37
lot there and you have to you kind of
09:40
have to draw some dotted lines okay well
09:44
no I’ll definitely give it a shot
09:45
because that was something that I was
09:46
having fairly consistently until you
09:49
know like Christmas time and then I got
09:51
Jack just make sure to not squelch your
09:57
stomach acid around meals right yeah
10:01
least 30 minutes before meal or at least
10:04
you know two hours after meal okay yeah
10:08
and it would definitely be interesting
10:09
as I said on the days that I’m not
10:11
eating mm-hmm oh no it would be really
10:16
cool to figure this out just because
10:19
going on especially considering how
10:23
flurry you get with certain foods yeah
10:26
that implies that it’s a provocative
10:29
autoimmune condition this specific
10:34
mechanism the the filtering of these TNF
10:38
alpha x’ is particularly responsive for
10:43
provocative autoimmune reactions so one
10:47
of the things that I’m considering is
10:49
there being almost like a flair protocol
10:52
as it you know so there’d be like a
10:54
maintenance dose but then there would
10:56
also be a flair protocol okay yeah I can
11:00
definitely add that to my autoimmune
11:02
stuff for my peeps
11:04
well and I’ll I’ll tell you that there’s
11:07
no downside
11:08
so it’s like adding fish oil a clue you
11:12
know great sodium source you know it’s
11:14
80% sodium so always looking for more
11:18
sodium right and bicarb is so good for
11:21
you for lots of other reasons yeah no I
11:26
said I was using it topically that was a
11:28
scooters thing that you know I kept on
11:29
breaking out in these weird rashes from
11:32
things that I would eat or you know just
11:35
random stuff and the bike home would
11:38
help a lot okay all right so this will
11:41
be 29 minutes a gen why don’t you come
11:45
back in fresh discussing your
11:48
experiences with biotin and what the
11:52
reaction was to your hair on your
11:54
nutritional changes right okay with my
11:59
hair I had the Kido hair loss thing too
12:03
and then it grew back it was thicker and
12:05
curlier and I was very happy with that
12:07
but one thing that hasn’t changed is
12:09
that my hair is kind of brittle and
12:12
prone to short ends split ends and I’ve
12:15
since learned that that is a symptom of
12:18
hypothyroidism which I apparently suffer
12:21
from so I’ve been working on that and I
12:23
have high hopes good eventually it’ll be
12:26
better that is always a possibility when
12:28
it comes to things like your skin your
12:30
nails your hair if there’s any weirdness
12:32
going on or even with your menstrual
12:33
cycles it could be something that’s
12:36
temporary oh like we were talking about
12:39
with this this hair loss issue or it
12:42
could be something that is some sort of
12:44
deficiency you can get a simple blood
12:46
panel for it or it could be something
12:48
that’s that’s hormonal II related so
12:50
it’s always good to get your blood
12:52
panels done get the proper the proper
12:54
labs and check those things out my hair
12:58
stylist recommended keratin shampoo and
13:01
conditioner too yeah yeah well that
13:03
little that will give it a little
13:04
temporary strength right yeah so let
13:08
maybe throw out a couple of claims I
13:11
claim that if you’re eating more than 50
13:14
grams of protein a day
13:17
this is not the problem right 50 could
13:23
be bad right less than 50 actually
13:26
becomes very problematic now I’m not
13:27
talking about like intermittent fasting
13:29
three times a week you’re you know
13:32
skipping a day or whatever I’m talking
13:33
about you know your macros are fifty
13:37
grams or less we need to talk and that’s
13:40
ultra low protein stuff that nobody
13:43
should be doing if you’re if you’re on
13:45
that in general you you’ve already made
13:47
a pretty big mistake yeah I saw somebody
13:50
who is it was actually a hon Mike
13:53
Berta’s Facebook group talking about her
13:57
macros that were in percentages and it
13:59
had her protein down to what 37 grams or
14:02
something like that yeah that’s
14:03
problematic and we we just don’t
14:05
recommend it because unless you’re you
14:08
know four foot eight that can be really
14:12
a low amount of protein so don’t do that
14:15
yeah if you’re if you’re over fifty
14:19
especially if you’re well over fifty
14:20
that this is not that’s not the thing
14:23
you want to go after yeah let me just
14:26
from a kind of basic 100 level sort of
14:29
point of view if you’re eating protein
14:32
that contains a you know a range of
14:34
amino acids that’s going to include the
14:37
stuff that is collagen right and your
14:38
hair skin and nails are made up of
14:40
collagen so if you’re not eating enough
14:41
protein you’re not getting enough
14:42
collagen your hair skin and nails are
14:44
going to suffer right it’s just simple
14:46
chain illogic sure no that’s right I
14:50
wasn’t I’m sorry thinking very hard I’m
14:57
trying to put together very complicated
14:59
how do I talk about amino acids without
15:02
going it super nerdy good analogy using
15:09
firemen and amino acids and you know a
15:12
building block right so you ingest them
15:14
they break down and then they come back
15:17
together to do you yes but you know I
15:21
have relatives in Japan and when I visit
15:24
them and they eat a ton of connective
15:26
tissue
15:26
you know tendons and Knuckles and and
15:29
skin and stuff and it
15:30
we’re crazy for not eating that stuff
15:32
yes are you eating it but I mean rape
15:38
here’s my second claim all right by the
15:42
time you notice something has happened
15:44
it’s too late yeah you just gotta ride
15:47
it out there’s nothing you can do
15:49
because by the time you notice it you
15:53
are months too late the insult has
15:57
already occurred and you are deep into
16:00
the peril of telogen effluvium there is
16:05
nothing that you can do to reverse that
16:08
to Lochan cycle you are this where
16:10
you’re at that’s what’s happening next
16:11
that that train is you are on the train
16:15
so do not have a fantasy that if you buy
16:19
some fancy shampoo and conditioner or
16:22
take some fancy vitamin from some you
16:25
know smart selling multi-level marketing
16:28
person okay that you can stop this
16:30
process it is not only started it has
16:34
already finished and you are just seeing
16:37
the repercussions of a of a biological
16:39
process that occurred three months ago
16:41
and it just took this long for the hair
16:44
follicle to actually release I got some
16:47
pictures oh I’ll put them up on the
16:49
Facebook groups if anyone wants to see
16:50
them of my regrowth because you can see
16:53
about one year into it I have hair all
16:58
over my heads it’s a couple inches long
17:00
that actually would be a really good
17:02
idea so we have a frequently asked
17:04
question if you go to the main group you
17:07
know cut it what is a ketogenic diet
17:09
science and support and then go to our
17:11
pin post our pin the post we have a
17:14
frequently asked question on hair loss
17:16
yeah aaron has had those Karen will add
17:21
her shaggy undercoat pictures yeah that
17:24
post so that it’s easy to find in the
17:27
future because I don’t know any other
17:29
way we can do it then to say go to the
17:31
hair loss back yeah it’s good to have a
17:33
second coat keeps you cool in the wind
17:34
in the summer
17:35
alright so those are my two claims and
17:38
our recommended course of action if
17:41
you’re experiencing this is
17:43
do nothing Kito i if you choose you can
17:48
support optimal hair regrowth quality
17:53
with biotin and collagen supplementation
17:56
yeah they’re little you know I used to
18:00
be an esthetician so I’ve got little
18:02
little tips and tricks that you can do
18:05
to make your hair look better while it’s
18:08
growing in or my work from care or
18:11
bye-bye wig again meadow wig calm okay
18:15
what about massage the scalp massage I
18:18
don’t know and neither does I know it
18:22
helps with the regrowth it’s not going
18:23
to help the hair it helps with the
18:28
quality of the regrowth not only does it
18:31
not but there’s been a lot of studies
18:35
done on concentrated plasma because it’s
18:39
bald nobody I’m not bitter
18:44
I’m extremely well informed on I don’t
18:49
care a scalp massage feels good
18:50
bottom line this is a ruse so that
18:53
someone will rub on your head Jennifer
19:01
your hair will stop breaking yes here
19:06
because the court is alright the massage
19:07
relieves the cortisol which helps the
19:10
pyrite which yeah there you go you
19:12
maximizing your t4 to t3 conversion yeah
19:16
clearly it’s just science
19:19
it’s just help I say it dies you can
19:28
take a look at our hair and determine
19:30
this Karen it is not my fault I’m just
19:40
made this way by God he’s just too manly
19:42
per hair associated with male pattern
19:46
baldness that is correctamundo it’s just
19:50
it’s it’s his it’s his musk repelled his
19:53
hair somehow
19:56
this is getting very personal so let us
19:58
move along to the next way Jen now Jen
20:03
has kinda actually has some really
20:05
personal experience with this thinks
20:06
topic which is kidney health why things
20:09
all the time is the keto diet is gonna
20:12
kill your kidneys well and I was going
20:16
through stage one kidney disease and I
20:18
was really scared about this
20:19
I also diabetes all that when I look to
20:22
keto to fix the diabetes and so I was
20:24
concerned that it was going to torch my
20:25
kidneys and you hear this all the time
20:27
but high protein is bad for the kidneys
20:29
so I was really worried that I was gonna
20:32
maybe help the diabetes with keto but
20:34
also make my kidneys worsen I I didn’t
20:37
have serious kidney disease I was Stage
20:40
one kidney disease micro proteinuria
20:43
which is just means protein in your
20:45
urine not a whole lot of protein but you
20:48
shouldn’t have any protein in your urine
20:49
and that’s a sign that your kidneys are
20:52
failing to filter your urine properly
20:55
that you have so much crap in your blood
20:57
because you’ve been eating three pints
20:59
of ice cream a day your blood glucose
21:03
has been damaging your ability to filter
21:05
protein out of your urine so that wasn’t
21:08
good but I read up on it and I read that
21:11
there have been studies showing that the
21:14
ketogenic diet actually can help micro
21:16
proteinuria so I did it I went into it
21:20
and it took a while for my markers and I
21:24
might get far and my various other rates
21:26
to get better it took about a year
21:28
actually even though the diabetes
21:31
cleared up right away but the kidney
21:34
damage thankfully returned to 100%
21:37
normal
21:37
it just took a little long time so
21:40
obviously I dodged a bullet there
21:43
because I’ve read a whole lot about
21:45
people with more serious kidney disease
21:47
either they go on keto and it you know
21:51
they halt the damage but they don’t yeah
21:53
they aren’t able to reverse it and then
21:54
they still end up finding that the rest
21:57
of their lives yeah there are lots of
21:59
sad stories about kidney disease and the
22:02
needing dialysis and transplants even
22:05
though you know you just it’s always
22:07
painful when somebody gets their butt
22:09
that you’re too late you know I must
22:12
have been right on the brink yeah that’s
22:14
really what’s interesting about
22:15
Jennifer’s story is once your GFR start
22:18
moving around though that’s usually a
22:21
irreversible condition so it’s really
22:25
lucky and fortunate that Jennifer
22:28
happened to get in front of her kidney
22:31
disease before progressed to a point
22:33
that it couldn’t grow back because in
22:36
general once the damage is done it is
22:38
done and there’s no going back and it’s
22:42
my understanding that while the myth is
22:45
out there that protein is bad for your
22:46
kidneys then it’s true eating protein
22:49
puts a load on your kidneys but if
22:51
healthy if your kidneys are healthy you
22:53
can handle absurd amounts of protein
22:57
without an issue let’s talk about an
23:01
analogy on this atypical ketogenic diet
23:05
is gonna be 80 to 120 grams of protein
23:08
that’s a it’s a very reasonable amount
23:11
of protein most macro calculators going
23:12
to kick that out for boys and girls and
23:15
what that is going to give you is a
23:18
certain amount of nitrogen load that
23:20
nitrogen has to be disposed of because
23:22
it’s toxic so it’s bound up as ammonia
23:24
and then bound up as urea where it’s
23:27
nice and safe and then turned into urine
23:30
and wastegate it out this is very
23:32
similar to a pool filter and leaves
23:35
going into the pool filter a normal load
23:40
of the occasional leaf is not going to
23:43
clog up a pool filter if you break up
23:46
your yard and dump the bag of leaves
23:48
into your pool it is going to clog up
23:50
the filter and the filter where stopped
23:52
working
23:53
that’s literally what we’re talking
23:55
about normal amounts of protein will not
24:00
negatively impact your kidney function
24:04
okay but if your filter is kind of
24:06
messed up already and maybe you should
24:10
talk to your doctor and keep an eye on
24:12
these things and at a tipping point for
24:14
that is about stage three
24:17
once your GFR and again everybody’s
24:21
different but just to throw some numbers
24:22
out there
24:23
if your GFR is below 40 this is
24:26
something you want to talk to your
24:28
doctor about and you’re probably already
24:30
on a protein restricted diet to limit
24:33
the nitrogen protect them but for most
24:36
people if you’ve progressed to that
24:39
point you’re being very carefully
24:40
managed anyways but that doesn’t mean
24:43
that the keto diet is contraindicated it
24:45
just means that you need to be cautious
24:48
about using a standard protein macro
24:52
yeah you need to keep your ammonia your
24:55
nitrogen load pretty low and there are
24:57
some ways to do that safely and you know
25:00
your doctors probably already partnering
25:02
with you because you’re in that state
25:04
you’re already in that state well you
25:06
just look at I mean there’s dr. Fung
25:08
practicing in my province of Ontario and
25:11
he is a world-renowned nephrologist and
25:14
he preaches a low carb high fat diet
25:18
moderate protein so if he thinks it’s
25:21
okay then for a lot of people except for
25:27
those that are in advanced stages it’s
25:32
generally not much of an issue Jen do
25:35
you think that we should make a claim
25:37
about keto and kidney disease I think
25:42
that there is very solid research and
25:46
experience that for stage 1 kidney
25:49
disease that keto helps reverse that and
25:53
maybe it doesn’t reverse it but it
25:55
certainly stopped the progression of the
25:57
disease I think that is completely valid
26:00
claim to make there’s a lot of research
26:02
showing that and I stand by that
26:06
and I would extend that all the way to
26:09
stage 3 yeah we did have a fellow that
26:12
we worked with it was stage 3 and his
26:14
doctor was fully supportive of him
26:18
pursuing a ketogenic diet and we know
26:20
fund that you know that’s all half of
26:22
funks clinic is stage 3 stage 3 or worse
26:25
so we’re not really you know we can’t
26:30
make a claim for you but we can say in
26:31
general there is no blanket reason if
26:35
you’re in mild D’Amato
26:37
it chronic kidney disease that you
26:40
should be afraid of the ketogenic diet
26:42
just be aware of your protein macro and
26:45
discuss with your doctor yes your unique
26:48
situation and you know there’s gonna be
26:50
different things there’s people who have
26:52
lost a kidney in a car accident have
26:54
compromised GFR and nitrogen clearance
26:56
issues yeah there’s gonna be people who
26:58
have diabetes that damage their kidneys
27:02
is gonna be people with genetic defects
27:05
like we can’t make a blanket statement
27:07
but we’re we’re just saying in general
27:09
your typical you know diabetes kidney
27:13
damage it’s not a problem I would say
27:17
also that if you are aware your kidneys
27:20
are compromised and you’re trying to
27:23
address that with Cato to be just very
27:27
self aware and like if you get the
27:29
hydrated or your kidneys start hurting
27:32
do something about it don’t wait until
27:34
you’re in kidney failure mm-hmm yeah
27:36
definitely and that also brings up a
27:39
good point which is if you’re in an
27:41
advanced stage of CKD you’re probably
27:43
also on a number of diuretics whether
27:47
that’s you know that’s specific diuretic
27:50
or an ACE inhibitors like a lot of the
27:52
blood pressure meds or you know for this
27:55
if you’re on any of those kind of
27:57
medications you know talk to your doctor
27:59
because they’re gonna mess around your
28:01
fluid levels and make electrolytes a
28:02
pain to deal with but yeah it’s not a
28:07
problem I want to get dehydrated
28:08
adjustments right all right let’s move
28:13
on hypoglycemia mm-hmm Jen you want to
28:20
take this one as our resident type-2
28:23
diabetic yeah you’re just talking about
28:25
this today I was reading yeah there is a
28:30
concern that when you’re not eating
28:33
sugar you’re going to or any carbs that
28:37
you’re going to have a hypoglycemia
28:40
especially if you are you know diabetic
28:45
you’re watching those numbers and it’s
28:47
true that if you’re on certain
28:50
medications
28:50
they lower your glucose in a very
28:53
powerful way for instance sulfonylureas
28:56
glimepiride glipizide gliclazide there’s
29:00
a whole whatever I starts with G ends
29:02
and I it it’s probably a sailfin urea
29:04
and there’s other sorts of medications
29:07
that force your insulin out into your
29:10
bloodstream and lower your glucose by
29:12
force
29:13
yeah but Kido normalizes your glucose so
29:17
adding those medications on top can
29:20
cause a hypoglycemic episode it happened
29:22
to me personally when I went keto
29:24
because I didn’t know what the heck I
29:25
was doing so I was on unfortunately I
29:28
was on glipizide and metformin and
29:31
metformin is perfectly safe metformin
29:34
just increases your insulin sensitivity
29:37
and does some other things but it
29:39
doesn’t it doesn’t change your your
29:42
glucose by itself it just improves your
29:44
metabolism that’s right oh and does some
29:47
other things too your mitochondria which
29:49
are perhaps not favourable but that
29:53
that’s a different issue
29:54
anyway metformin is fine but if you’re
29:58
on these other medications like I
30:00
experienced with glipizide and you’ve
30:02
gone keto and now your glucose is pretty
30:05
good and then you take a sulfon area I
30:10
went I almost passed out I did kind of
30:13
pass out I was I collapsed and I I’m
30:15
like shaking and cold and I felt like I
30:17
was gonna die and when I was able to
30:20
stagger to my blood glucose meter it was
30:22
26 Meg don’t not good not as low as I’ve
30:27
seen some type 1 diabetics go and they
30:29
live if I can just jump in here any
30:34
medication for diabetes that is not
30:37
metformin or a gliptins like januvia
30:42
Galvis any of those things if it’s not a
30:45
GLIP than a dpp-4 drug or metformin the
30:49
odds are that medication puts you in
30:53
great peril of hypoglycemia because all
30:57
of those other drugs influence your
31:01
blood glucose by unfavourably provo
31:04
King insulin in some manner and one on a
31:09
low-carb diet will put you hypo what
31:12
about the glp-1 agonists like vai että
31:15
for instance those are okay to write
31:18
less so it there there are worse ones II
31:22
like you said that the nasty ones are
31:24
the softener is right right really if
31:28
you’re diabetic your job is to quickly
31:31
transition to a dpp-4 if you need you
31:36
either need straight-up insulin or you
31:39
should be on DPP fours and metformin
31:41
like there should be there’s no real
31:44
spectrum in the middle for the hi-test
31:47
orals does that make sense it totally
31:51
does and I’ve concerns about the DPP
31:54
force – I’ve read a lot about limb
31:56
amputations and going into diabetic
31:58
ketoacidosis well that’s a whole nother
32:02
thing but that’s not specific – that’s
32:06
specific to the drug and people doing
32:08
you know it’s like every other diabetes
32:11
drug if you put your your foot on the
32:14
brake and push it to the floor and put
32:16
your foot on the gas and push it to the
32:18
floor crazy things happen and there’s
32:21
nothing that a diabetic likes to do more
32:24
than eat chocolate cake and double dose
32:27
there so when you read about people
32:35
going into ketoacidosis and stuff like
32:37
that understand that they’re often
32:40
profound consequences for bad behavior
32:44
there’s always a story and it’s never
32:48
good in general and I’ll stand behind
32:52
the fact that all of our low-carb
32:54
doctors will say the same thing which is
32:56
you know if you go to dr. Fung and you
32:58
say I’m on whatever he’s gonna get you
33:01
you know let’s say you’re doing
33:03
full-blown insulin everything else he’s
33:05
gonna try and get you on lantus as
33:07
quickly as possible he’s gonna rant if
33:09
you’re on orals he’s gonna switch over
33:10
to DPP four and then get you down a bit
33:12
Foreman and that’s all gonna happen in a
33:14
matter of weeks and we’re talking
33:16
anywhere from two to seven
33:18
weeks you are gonna be way down on
33:21
medications and certainly off anything
33:22
that is insulin manipulative it seems
33:25
pretty clear to me when I’ve seen you
33:29
know new diabetics besides myself start
33:31
you know using Kido and reporting their
33:34
blood glucose results you can tell that
33:37
some of them are not being strict
33:38
because if they restrict the glucose
33:40
resolves right away and it doesn’t
33:44
there’s maybe some other I mean rare
33:47
cases where maybe somebody is also they
33:49
have double diabetes they have problems
33:50
with insulin production yeah that could
33:53
be an issue but if they don’t if they
33:55
have functioning insulin and they stop
33:57
eating glucose or carbs then it’s going
34:01
to clean up that’s a good point and
34:05
maybe we should just speak to that in
34:08
general which is there’s really two
34:10
kinds of diabetics
34:11
there’s the diabetic who’s on the
34:13
progression you know you start out with
34:16
metformin and then you graduate to group
34:18
bigger and nastier orals then bigger and
34:21
nastier orals and eventually you start
34:23
insulin injection and then there’s the
34:27
people who have been injecting insulin
34:29
for 20 years and have burned out their
34:33
beta cells in their pancreas and they
34:35
actually have compromised insulin
34:36
production those parasitism
34:39
yes variant right those people have
34:42
transitioned away from a healthy organ
34:45
to a diseased state that is not
34:49
repairable with diet and for for
34:52
purposes of our discussion those people
34:55
are no longer a type 2 they are now a
34:56
type 1 insulin-dependent diabetic yeah
35:04
it’s a nasty situation but can be
35:08
greatly improved by going on keto but
35:12
that’s that’s not who we’re talking
35:13
about here we’re talking about your
35:14
standard person who’s injecting less
35:18
than 50 units has not been injecting for
35:20
20 years people that not have
35:22
compromised beta cells yet
35:25
CPAP is a normal insulin reserve that
35:29
let me tell you but I was by the way I
35:32
was I was I was dumb when I got
35:35
diagnosed with diabetes and I’m like oh
35:36
the metformin will take care of it and I
35:38
kind of went around you know eating a
35:40
little better but not great yeah and
35:42
then you know things got worse it took
35:43
more mint form and the doctors like it’s
35:45
not you know doing the job we need to
35:46
keep adding more medication yeah and he
35:49
he actually did prescribe a dpp-4 edge
35:51
Nubia and the cost of these at dpp-4 is
35:56
they’re all brand names none of them are
35:57
off patent yet and it was gonna cost me
35:59
300 bucks a month not I mean that was my
36:02
copay okay Wow yeah and I’m like I can’t
36:09
do that
36:10
doc give me give me something cheaper so
36:13
that’s when he gave me the glipizide
36:15
which was only $3.00 a month mm-hmm and
36:19
you know I didn’t realize that what how
36:22
dangerous health and your ears are for
36:24
your health but now that I know I would
36:26
have paid the $300 but of course keto is
36:28
cheaper than either one of those yeah
36:31
januvia czar going right now for about
36:33
four hundred and thirty dollars a month
36:36
that’s the that’s the cheap discounted
36:39
copay price yeah it’s an expensive
36:44
medication and you know that that’s why
36:47
you just want to get off of a home is
36:49
being how much steak and broccoli you
36:53
could buy for that that’s okay so our
36:55
concern with hypoglycemia is twofold
36:59
number one if you’re on the wrong
37:02
medication you are in great peril of
37:07
overdosing over provoking the amount of
37:10
insulin that you have and that will put
37:13
you into a hypoglycemic state that must
37:15
be treated with an acute dose of sugar
37:18
and don’t worry about whether or not
37:20
that knocks you out of ketosis
37:21
hypoglycemia is a critical issue that
37:24
requires an emergency that’s right and I
37:28
actually cleaned my house out of all
37:30
carbs so I didn’t have any emergency
37:35
wander into the garden and have some
37:37
mirror what are those things pawpaws
37:40
figs actually I actually had an apple
37:43
so that worked but anyway yes grazing
37:46
off of her trees now the second thing
37:49
that we have to be worried about when it
37:52
comes to glycemic states is what goes on
37:56
in the overnight yeah so Karen do you
38:00
want to talk about a yield dawn
38:02
phenomenon and maybe even touch on the
38:05
so miyagi effect if you want to know I’m
38:09
not going to touch on that one so a lot
38:16
of our people they start off with
38:18
intermittent fasting and they’re going
38:21
along swimmingly but they want to have
38:23
that therapeutic fasting so they’ll go
38:26
for an overnight a 36-hour fast right so
38:32
what happens is that in the morning they
38:38
wake up a lot of them they were diabetic
38:40
before so they’re in the habit of waking
38:42
up checking their blood glucose and
38:44
panic sets in because all of a sudden
38:46
you know after being like 120 every
38:48
morning when they wake up they’re 180
38:52
[Music]
38:53
was it what happens is overnight you
38:57
produce glycogen your liver is going to
39:01
squeeze out a little this is how you
39:03
don’t die as dr. Frank was saying and
39:06
his last blog your body does not allow
39:12
you to go into a coma every night you
39:17
are going to produce this blood glucose
39:19
so you can continue to be alive and wake
39:24
up in the morning now with people like
39:28
me that started off really sick and OB
39:31
so it was pre-diabetic I was seeing
39:33
pretty high numbers but not quite as
39:36
high as they were when I was still
39:37
eating cake but they still would be
39:40
elevated while that was fasting so like
39:43
how high are we talked about well with
39:46
me I think I was waking up with with
39:48
180s when before keto and I would still
39:52
wake up some mornings around 1:40 when I
39:54
first started I’m pretty high it
39:58
yeah yeah you know and a lot of doctors
40:00
for pre-diabetes they will prescribe my
40:03
Foreman it is you know something you can
40:06
discuss my doctor was not so keen on it
40:09
I think I I think she just saw the train
40:13
coming you know I think she had seen it
40:15
so many times and she’s never seen it
40:18
reversed before without surgery I was at
40:21
weight-loss surgery so she I think she
40:24
was just thinking you know what I’ll
40:26
tell her you know she’s got some time to
40:28
lose some way but I’ll be there with my
40:30
prescription pad six months from now
40:33
when the a1c is above the the criteria
40:35
for diabetes for full-blown diabetes
40:38
okay so yeah I think with it with that I
40:42
think she was just being really
40:43
pessimistic and thinking what it wanted
40:46
to give me six months without pills that
40:49
was I guess I mean I’m sure like you
40:53
said that she doesn’t see that you know
40:55
success happened in people right off no
40:57
no she said you know that right she’s
41:00
never seen it happen before without
41:02
without weight loss surgery excellent
41:05
well so I have waited the knife yeah for
41:08
you yeah but I’m sure Jennifer you’ve
41:11
seen a lot of panic with people that
41:14
have tried fasting and are type 2
41:16
diabetic and glucose and you know
41:21
they’ve been taught that this is somehow
41:24
it’s because it’s a progressive disease
41:26
right so if you’re waking up 180 today
41:29
then if you keep doing what you’re doing
41:32
then six months from now you’re gonna
41:33
wake up to 20 to 40 right but that’s
41:37
that’s not what happens well and I think
41:39
people see 180 is a you know that’s
41:43
where you know organ damage is occurring
41:45
and you know you’re not gonna be healing
41:46
if you’re at that level well I think Ben
41:51
has some opinions on that I do for
41:56
another show okay it is worth it if
42:01
you’re seeing the you know you’re just
42:03
beginning keto you might want to discuss
42:06
getting a prescription to keep your your
42:10
blood glucose stable
42:12
and let’s talk about specifically what
42:15
is happening for those of us who have a
42:17
CGM like Jennifer is wearing Oh super
42:21
cool here’s the common phenomenon they
42:26
will test their blood sugar at nine
42:28
o’clock before they go to bed
42:30
it’ll be 1:30 and they’ll go well that’s
42:33
pretty normal for a diabetic right yeah
42:35
and then they wake up in the morning and
42:38
test their blood sugar and it’s 220 oh
42:42
crap you know here we go yeah so clearly
42:46
what has happened is throughout the
42:49
night you have generated a whole bunch
42:51
of sugar right so you’re having
42:53
overnight highs that’s the expectation
42:56
of what’s happening the truth is
42:59
actually what I think well that’s right
43:03
if you have a sophisticated monitoring
43:06
system you’ll actually see that what’s
43:09
occurring is in the middle of the night
43:11
you go low you’re going hypoglycemic and
43:15
then your body is releasing glucagon
43:19
epinephrine and you’re getting you know
43:21
these cortisol wakening response so
43:25
you’re probably dipping down below 50
43:27
you know around 2 a.m. 3 a.m. and then
43:31
your body freaks out and dumps all this
43:34
glucagon and cortisol growth hormone all
43:38
this stuff and then this is Ana diabetic
43:41
is gonna shoot your glucose way up so by
43:45
the time you’re measuring at 6 o’clock
43:47
it’s 220 yeah I cannot say how much is
43:53
this libre freestyle libre by Abbott has
43:55
has given me insight into my glucose
43:58
metabolism it’s it’s amazing I was
44:01
trying to be really good with the
44:03
glucose testing before he you know and
44:06
doing the blood test you know what I
44:07
wake up and before I eat and post
44:10
prandial you know one hour two hour test
44:13
but it’s like looking into a black room
44:17
and you just flick the light switch on
44:19
for a second and you try to you know you
44:21
see that first it’s just having the
44:23
light switch on all the time so I
44:25
I see everything now and I can see this
44:28
this bimodal pattern overnight where I
44:30
go to sleep and it kind of raised it a
44:31
little bit and then it dips and then the
44:36
cortisol you know dawn phenomenon wakes
44:39
it wakes me up and it goes down right
44:42
away though you know I’m up I’m walking
44:44
around it returns to a baseline level
44:47
maybe within 30 minutes and it will do
44:50
that in a healthy person I’m a lot of
44:52
times in the diabetic groups you’ll see
44:54
people saying well this means you have
44:56
to eat because when you eat your blood
44:58
glucose will magically go down and so
45:01
they think the fasting is the problem
45:02
but happening is that they still are
45:05
producing insulin right there’s a type 2
45:07
diabetic so they eat they produce min
45:09
Celyn it returns to normal but the
45:12
healing from the fasting isn’t occurring
45:14
if you if you’re doing that that
45:17
phenomenon in a diabetic that’s called
45:19
the so miyagi rebound ago that’s what’s
45:23
unique about someone who’s diabetic and
45:26
why diabetes is unstable overnight is
45:29
actually due to this over this insulin
45:32
resistance that causes an undetected
45:35
hypoglycemic event which then triggers
45:38
this you know cortisol awakening
45:40
response and a bunch of freak out a
45:42
hormone dynamics that causes the raised
45:45
blood sugar in the morning but it’s
45:46
actually due to an overproduction of
45:50
insulin and in a healthy person you you
45:55
have dawn phenomenon which is a
45:56
completely different thing which is
45:58
insulin drifting down and a growth
46:01
hormone surge so it’s a it’s a different
46:05
thing and a lot of times those terms are
46:08
used interchangeable and they most
46:10
certainly are not because they have a
46:11
completely different magnitude and
46:14
etiology my understanding I have a lot
46:17
of type-2 diabetic friends who’ve tried
46:19
fasting and said no it doesn’t work for
46:21
me and they this is not even counting
46:24
the dawn phenomenon this is you know
46:26
they start the day like alright today
46:28
I’m going to try fasting and their
46:31
glucose just starts going up and up and
46:33
they’re like well that’s it I can’t fast
46:35
because it’s locked up at 180 200
46:37
whatever they’re like right
46:38
that’s it I gotta yeah I think what’s
46:41
going on there
46:42
is they find fasting stressful you know
46:46
they’re not used to it so their cortisol
46:48
is kicking in
46:49
they’re releasing glue like agenda in
46:53
response to that I mean cord is always
46:55
higher during the day but that’s that’s
46:56
supposed to happen yeah I mean all those
47:00
stress hormones you know epinephrine
47:01
cortisol even growth all those are gonna
47:05
provoke a major release of sugar from
47:10
the liver yeah I know you see the same
47:14
panic too when they exercise so they’re
47:16
fasting they might do a little a little
47:18
brisk walk then they see that it’s gone
47:21
up so the thought is this is bad mm-hmm
47:24
now I will say that there is a point
47:28
where you do have to treat the high
47:31
glucose is a real thing very much so yes
47:36
but when you see a 160 or 180 that is
47:40
transient yeah it’s gone in a couple of
47:43
hours you you need to be cautious about
47:46
whether or not you’re any healing model
47:49
where you’re trying to prevent the
47:52
insulin resistance or if you’re in a
47:55
protective model where you’re trying to
47:56
avoid the glucose toxicity and am you
48:00
know we’re not here to tell you exactly
48:02
where that line is for you and
48:05
everybody’s kind of got a different deal
48:07
on that but it’s your personal glucose
48:10
disposal profile is very interesting you
48:15
know there’s a very scientific test
48:16
called the craft assay that you can do
48:18
where they give you a hundred gram
48:21
milkshake and they measure your insulin
48:24
and glucose every you know half hour an
48:27
hour for five hours and then you can get
48:29
a sense of what your glucose disposal is
48:31
like and we’re trying to improve that
48:34
profile through this diet and through
48:36
weight loss so there’s a transitional
48:39
period and we want to acknowledge that
48:42
that’s a real thing
48:44
don’t you be talking to me about how a
48:48
waking up in the morning with a 180 is
48:51
is gonna make your toes fall well and
49:00
conversely I’ve seen plenty of studies
49:02
showing that certain drugs the drug
49:06
therapy even though it lowers your a1c
49:08
it doesn’t change mortality so you know
49:14
this stuff is of limited effect unless
49:16
it addresses the underlying cause you
49:19
know I am proudly blocked by RD Dyckman
49:22
from type 1 grit because I’m like a dog
49:27
with a bone on the the nonsensical
49:30
claims of managing glucose I will not
49:33
allow nonsense claims to be made in my
49:36
presence I just won’t stop arguing you
49:41
can’t deny that he’s he’s on the money
49:43
about type 1 diabetics nope I will deny
49:46
that ok he’s wrong about that as he is
49:49
about everything else alright alright
49:52
that’s rather show I ain’t a long form
49:55
on this one baby doll ok evidences which
50:01
is why he blocked me because I just I
50:03
would not stop with the firehose of data
50:05
didn’t finally he’s like well I can’t
50:08
handle it I can’t argue this kind of
50:10
onslaught well I’m definitely curious
50:13
alright but I know about type 2
50:15
diabetics you know that’s my thing and I
50:17
know that for their that really the
50:20
underlying cause is hype you know a
50:23
hyper hyper blaze you know having too
50:25
much glucose in your body not in your
50:30
blood but in you know too much energy
50:34
stored in your body and your body can’t
50:35
handle the energy flows so it’s shunting
50:38
it to you know wherever it can find you
50:40
get this real fat that clogs up your
50:43
your organs and and that’s the
50:45
underlying issue unless you address that
50:47
and sulfon ureas do not address that not
50:50
then that you’re not going to improve
50:53
your health ok so let lets let’s make a
50:56
claim and move on our claim is that if
51:01
you’re diabetic highly insulin resistant
51:04
you should be concerned about deep
51:07
overnight hypoglycemic events and you
51:12
should also be concerned about waking up
51:15
with very high blood sugars there are
51:19
things that you can do to favorably
51:21
influence that apple cider vinegar with
51:25
dinner metformin extended-release and
51:30
generally losing weight reducing your
51:33
glycemic load to stabilize your insulin
51:36
some of this is out of your control
51:39
could I add also depleting your glycogen
51:42
with a little exercise a little exercise
51:45
the next days right you need to you need
51:47
to give the insulin somewhere to go and
51:51
that’s you know we’ve done things like
51:54
people tell people that eat eat some
51:56
slices of ham before they go to bed
51:59
because the protein will slowly digest
52:02
overnight and give them a nice little
52:05
insulin trickle you know there’s just
52:09
there’s a lot of little tips and tricks
52:11
that we have on dealing with it
52:13
depending on your unique response to
52:15
glucose disposal it’s a real phenomenon
52:18
and part of our claim is that you don’t
52:23
need to freak out if you’re waking up
52:25
with morning highs that are a little
52:27
higher than expected but we’re also not
52:30
here to tell you that if you’re going
52:34
over 160 your eyebrows should raise if
52:37
you’re going over 200 you absolutely
52:39
have to treat but there’s somewhere in
52:42
the middle where you might be able to
52:46
get away with it especially if you’re
52:47
doing things like making room and if
52:52
this is a transient thing in response to
52:54
fasting and blah blah blah you know
52:56
there’s a risk reward and you know we’re
52:59
not doctors we don’t know your unique
53:01
profile but in general our claim is that
53:05
the only way to it is through it get it
53:10
get a Libra CDM and you’ll see those are
53:12
super expensive gen that is a ridiculous
53:15
thing
53:16
Hey look my yell at people for buying
53:19
$39 Kido meters I how much did that
53:22
contraption cost you
53:24
it cost me it was $70 for the reader and
53:31
dollars for a month of sensors at all no
53:36
well and what do you have to do with the
53:39
sensor Jen I there’s a little
53:42
spring-loaded device and you slap it
53:43
against the back of your arm
53:44
and bam you’re a cyborg and what do you
53:47
do when you have to take a shower I take
53:50
a shot do you have to wrap it up with
53:52
saran wrap no I did manage to screw up a
53:58
sensor by snorkeling in Hawaii okay all
54:01
right well salt saltwater snorkeling
54:03
we’ll give you a pass on that today
54:07
stuff not a problem
54:10
yeah nothing affects it now Jen those
54:12
numbers are much smaller than I expected
54:14
you say because I’ve looked into this
54:16
and the numbers that I found were much
54:18
much higher so are you giving us copay
54:20
numbers there baby doll I’m afraid so
54:27
hundred dollars for the meter and
54:30
sensors are expensive to like a you you
54:33
could probably do it for about three
54:35
four hundred bucks cash but to what end
54:40
it doesn’t matter because this is
54:42
transient stuff unless you’re super data
54:44
nerds like charge for data
54:46
I reject Jen’s recommendation it’s crazy
54:51
if you can get a hold of one on the
54:53
cheap go for it but ask your doctor to
54:55
get your prescription and see how much
54:57
your insurance will cover because it is
55:00
so much better than a glucose meter or
55:03
do some weight and then Matt I got an
55:11
idea for you put the fork down and see
55:14
what happens diabetes in about a month
55:18
Oh your problem solved involving taking
55:22
the fork and throw nail Widow always the
55:27
solution is the tranquilizer blow dart
55:29
that’s right no I was helping right
55:32
frigerators I was helping to run this
55:34
diabetic type 2 diabetic group I’m a
55:36
Facebook group and you could see people
55:38
that continue the struggle month after
55:40
month and they yeah they weren’t losing
55:44
weight and their numbers were not
55:45
getting better
55:46
well that’s the thing if you if you look
55:48
at clinically supervised highly
55:50
motivated populations a good example of
55:53
that is like beta play i DM pay to play
55:56
heal care clinic with Westman and funds
56:01
you know why does Finney and West men
56:05
and Fung all stand up there and go in
56:07
two months I will have you off all your
56:09
meds and in most cases it’ll be days and
56:12
weeks not months yeah and the reason for
56:15
that is because as soon as they
56:17
effectively have you losing weight and
56:18
reducing your glucose load you’re gonna
56:21
be off the meds so as soon as you tell
56:24
me you’re still on the meds you have a
56:26
damaged pancreas or you’re doing it
56:28
wrong there’s just nothing else to say
56:30
about it and you know if I may say if
56:33
that’s your situation wwm pulse of keto
56:37
com4 slash consult I know this really
56:40
good keto coach get off the path okay
56:49
don’t be complacent diabetes is not a
56:52
pretty way to go and you don’t have to
56:54
do it you you can even if you’re in your
56:56
70s I’ve seen people in this diabetes
56:58
support group who are in their 70s and
57:01
has decided that they are going to make
57:04
the change and they do it and it gives
57:07
them so much improvement in their health
57:09
right away yeah it’s imperative do not
57:12
let this go on no with my my
57:15
mother-in-law’s generation they seem to
57:18
all be accepting that while I’m in my
57:20
70s now so I’m gonna have a little bit
57:22
of diabetes but it doesn’t have to be
57:24
the case yeah it’s absolutely not true
57:25
you show me somebody that still makes a
57:27
little bit of insulin and we we can get
57:29
them off the drugs and if you need a
57:32
little bit insulin than you do and well
57:35
you know that the ability to manage
57:38
stable glucose is very easy
57:42
and it involves some careful selection
57:45
of your shopping cart and that’s about
57:46
it like it it takes I just had a consult
57:50
call with somebody geez prediabetes
57:53
husband type 2 diabetic both mother and
57:56
father diabetic yeah I’m like okay
58:00
here’s what here’s what we’re going to
58:02
do for your whole family yeah and
58:04
there’s just we’re just gonna pull the
58:06
glycemic load of that entire household
58:08
down and then suddenly it’s gonna be a
58:10
lot easier to be diabetic in that family
58:14
it’s super easy to do and we wish more
58:17
people do it I will arrest my family
58:19
would do it please I know right ok so to
58:25
that point I had a note that I want to
58:26
talk about transitioning from insulin
58:29
dependent diabetes but I don’t think I
58:31
want to get into that because there’s so
58:33
many variations and we we had a good
58:35
discussion about the medications already
58:37
bottom line it if you’re on injectable
58:41
insulin your goal is to get on the
58:45
longtail for overnight you know
58:47
something like Lantis for overnight or
58:49
NPH and then you just want to get on
58:52
bolus dose for food and you know work
58:56
your way off that as quickly as possible
58:57
and you’ll if you’re if you’re actually
59:00
injecting insulin you need to be very
59:03
aware of your blood sugar the first two
59:04
weeks of going keto because if you’re
59:07
like let’s say you’re injecting 50 units
59:09
of insulin every day you can go down to
59:12
five in two weeks and if you are
59:16
injecting 50 when you should be going
59:18
down to five you gonna be in a coma
59:21
you’re gonna be they’re gonna the
59:23
firefighters will find you passed out in
59:25
your kitchen floor yeah and if you try
59:28
intermittent fasting the same thing is
59:31
gonna happen
59:31
yeah so be really careful if you’re on
59:35
actual insulin or if you’re on one of
59:37
these nasty drugs because you’ll go hypo
59:40
and there’s a transition we encourage
59:42
you to work with your doctor let them
59:44
know what your plan is before you start
59:45
have a plan have lots of glucose strips
59:50
on hand have lots of you know little
59:52
finger prickers on hand be prepared be
59:55
have a plan for hypo have a plan for
59:58
hyper you know have your dextrose tabs
60:02
on hand ready to go keep them in your
60:05
purse keep them in the car like all that
60:08
stuff alright so next common health
60:14
concern is cramps at night especially at
60:17
night now I have a point of view that
60:21
most cramping is a result of electrolyte
60:24
imbalance mostly from magnesium and
60:28
sodium I thought you said it was from
60:30
being an old lady
60:31
well old ladies are absolutely more
60:36
prone to these cramps than every every
60:40
other pot now why that is I’m not
60:44
entirely sure I expect that’s due to
60:48
compromised circulation in the legs you
60:52
said your old lady yes so what we would
61:01
want to do is make sure that if you’re
61:04
someone who’s getting any kind of leg
61:05
cramp
61:05
you can try Jenn’s famous pickle juice
61:08
swig the pickle juice
61:10
emergency cure if it’s happening to you
61:12
at 2:00 a.m. but in the longer term what
61:15
we want you to do is get your magnesium
61:17
up get your salt on point take it you
61:20
know pinch of salt like quarter teaspoon
61:22
right before bed take your magnesium 400
61:26
milligrams every day and it can take up
61:28
the two weeks for that magnesium to kind
61:30
of load up so give that a little time or
61:34
even accelerate the dosing a little bit
61:36
to bring it up to speed if you’re having
61:38
cramps there’s a few different things
61:40
that seem to work pretty good the pickle
61:42
juice works really good heat massage you
61:45
know warm towels wrapped around can
61:47
sometimes release it you know you just
61:50
want to really be cautious not to
61:53
trigger it it’s a seize right and it’s
61:55
an innovation seized so you want to make
61:58
sure that you’re well hydrated so you
62:01
know immediately get some of that salt
62:03
water going as sipping on that while
62:05
you’re working through the cramp with
62:07
this phrase help
62:08
that at all is you know a kind of a spot
62:10
treatment or maybe even I’m in Epsom
62:14
salt baths if you have access to an
62:16
Epsom salt container it would certainly
62:19
be interesting to do an Epsom salt bath
62:22
if you’re really having trouble with a
62:24
cramp that won’t quit yeah and in
62:27
general think about how much Epsom salt
62:30
you need to get a quality load of
62:32
magnesium onto your calf right do you
62:35
think it’s more the heat with the bath
62:37
that helps that’s what I’m saying I I I
62:39
think it’s possible to get it in that
62:42
way and if you have magnesium oil which
62:44
is magnesium chloride lying around you
62:47
certainly try it but really the best
62:51
solution for cramps is preventative
62:53
which is get your electrolytes on and
62:56
minerals on point from day one going
62:58
into it get that magnesium ordered right
63:01
away get going on it and if you’re
63:03
taking magnesium oxide remember that
63:07
magnesium oxide is poorly absorbed and
63:09
although you’re doing the right thing
63:11
you’re doing it with the wrong compound
63:14
and your body’s not able to make use of
63:17
it and unfortunately it’s passing
63:18
through without giving you the
63:20
electrolytes that you need if you’re
63:23
sensitive you can have a laxative effect
63:25
with it right which would just make the
63:27
the issue with the cramping worse
63:28
because you’re losing fluids it can be
63:30
and you know that’s certainly something
63:33
that can be a compounding factor for
63:35
hydration status in general because a
63:38
lot of times when people have radical
63:39
shifts in their diet they’ll get a
63:42
little spot of diarrhea and you’re
63:45
losing you’re breaking up man right so
63:49
it’s my point of view that we want to
63:52
make sure that if you’re having any sort
63:54
of fluid dynamic problems like a light
63:56
touch of diarrhea or anything like that
63:58
that seems to be pretty common when
64:00
people make big diet changes sometimes
64:02
you know that can be a loss of
64:04
electrolytes as well so a factor that
64:06
kind of stuff in if you’re taking any
64:08
sort of magnesium oxide we want to make
64:11
sure that you’re not taking magnesium
64:13
oxide get a different compound pretty
64:15
much any form of an oxide is okay so go
64:20
to the grocery store or the
64:21
drug store whatever look for that you
64:23
know we recommend the magnesium malate
64:25
for a couple different reasons seems to
64:27
work pretty good for most people yeah
64:29
yeah I’ve heard a lot of people say that
64:31
oh this keto diet can’t be healthy
64:33
because if you have to supplement
64:34
electrolytes it can’t be nutritionally
64:36
complete everyone needs to supplement
64:38
magnesium yes everyone being all
64:41
population of North America that’s right
64:45
yeah we do chances are your magnesium
64:48
deficient 60 to 80 percent yeah exactly
64:52
yeah I hear people say oh you know I
64:54
keto I have all these problems you know
64:56
as I wake you what can you have them
64:58
before you know oh you did in line with
65:04
talking about electrolytes another thing
65:06
that seems to happen for a lot of folks
65:07
is if their electrolytes are not on
65:09
point they often get various forms of
65:12
edema swelling fluid stuff you know the
65:16
swollen ankles
65:17
you know bloating things like that
65:21
in particular I worry about pitting
65:23
edema which is you’ll see yeah
65:27
especially in larger folks if you’re
65:29
north of 250 300 pounds if your
65:32
electrolytes are off your fluid will
65:35
start to pool in your extremities
65:36
especially like if you have a desk job
65:39
or you have to ride on an airplane and
65:40
sit there for a long time
65:42
the fluid will actually pool up and your
65:45
feet and ankles and they’ll swell up
65:46
big-time like I’ve talked a lot of
65:48
people whose shoes won’t fit they have
65:50
to take the shoes off yeah you know all
65:53
that kind of stuff if you’re having any
65:54
anything like that
65:55
consider that a problem with your
65:58
electrolytes and specifically magnesium
66:01
and potassium in this case
66:03
you want to have your sodium on point as
66:05
well but it’s actually the potassium and
66:07
the magnesium that seem to have the
66:09
greatest effect at reversing this
66:11
phenomenon now it in addition to getting
66:14
your electrolytes on point if you have
66:16
an acute dose of this edema where you
66:19
have big swelling what you need to do is
66:22
mechanically squeeze the fluid out you
66:26
can Google around on YouTube for lymph
66:29
massage if you have any of those like
66:32
high compression socks or pantyhose put
66:35
those on if you have an ace bandage you
66:38
can wrap that base bandage starting as
66:41
low as you can and wrap towards your
66:43
heart and wrap it as tight as you can
66:45
and then after three minutes unwrap it
66:48
wait three minutes wrap it again and you
66:50
can do that cycle you know four or five
66:52
times and you can do that like once an
66:54
hour to start to flush those fluids out
66:57
you’re literally squeezing the bar rag
66:59
so this is mechanical problem and it’s
67:02
got a mechanical solution for greatest
67:05
resolution if that’s something let me
67:08
ask you a question I heard a
67:09
recommendation to use pillows or one of
67:13
those inclining beds to raise your feet
67:15
above the level of your heart while
67:18
you’re sleeping is that the something
67:20
that’s good idea recommendation in
67:24
context of swelling yeah yeah I’m you
67:29
know okay again it’s a mechanical issue
67:34
it will help a wee bit yeah the the
67:36
problem is most of the lymph system is
67:39
actually not gonna be I mean it’s
67:42
gravity-fed to somewhat but the
67:44
difference between lying flat versus
67:46
having your ankles elevated three inches
67:49
I don’t I would not expect a big payout
67:52
in my couldn’t heart I would say neutral
67:56
the favourable how about it it would
67:58
help me a smidgen like I would get this
68:00
pitting edema if I was traveling because
68:03
you know your food choices are off but
68:04
most of mine was just a mechanical
68:06
problem of walking you know here you’re
68:09
touring around you’re walking everywhere
68:10
so windows are really heavy
68:12
walking everywhere then you know I get
68:14
the the balloon animal legs oh yeah and
68:17
having it elevated at night while I
68:19
slept you know just gave me a few hours
68:21
sure it it certainly wouldn’t hurt to do
68:25
that I would be much more excited if
68:28
this is something that happens to you on
68:29
a regular basis what you want to do is
68:32
go up on Amazon and get you some voodoo
68:35
bands which are basically a high
68:37
strength of rubber bands that are three
68:40
inches wide they’re like an ace bandage
68:42
but more like an inner tube like really
68:46
tough rubber and you can apply
68:49
you know 30 40 psi of squeezing pressure
68:54
versus these socks that are only gonna
68:57
you know apply you know 2 to 10 psi
69:01
yeah the socks you have to wear for a
69:02
minimum of 8 hours a day
69:04
mmm I would disagree with that the socks
69:09
provide again an acute mechanical it’s
69:13
pressure right the way the lymph system
69:14
works as you walk around the motion of
69:16
your legs and muscle you know you’re
69:19
rippling muscles are supposed to drive
69:22
these your lymph system is just a bunch
69:25
of check valves so it squeezes the
69:27
liquid from segment 1 to segment 2 to
69:29
segment 3 of you these check valves it
69:31
never has to go more than a half an inch
69:32
but it’s so if you’re not moving like
69:36
sitting on an airplane are you on your
69:38
feet for a long time and you’re really
69:41
overweight so the fluid load is heavy
69:43
and you’re not squeezing enough any sort
69:48
of external help to squeeze is going to
69:52
be favorable but the best thing you can
69:55
do is put those socks on and then move
69:57
around
69:57
you know lie on your back and do
69:58
bicycles or wiggle your toes or you know
70:01
play air ballerina to try and get the
70:04
lymph system to pump one of my relatives
70:07
has really bad lymphedema in her legs
70:10
and hips unfortunately and she has to
70:12
wear those compression stockings every
70:14
day all day and that doesn’t even fix it
70:17
really she’s got a therapist that comes
70:19
over and puts her in a squeezing machine
70:24
machine yeah yep this is like a it’s a
70:28
pair of air pants with a bunch of what
70:30
is essentially blood pressure cuffs that
70:32
are computerized right so goes just
70:35
squeeze them yeah exactly
70:37
so that’s used in the athlete’s world as
70:40
well to improve recovery but it’s all
70:43
just you know lymph stuff you you can
70:46
learn to do this if you have a partner
70:48
you you can teach your partner how to do
70:50
this with YouTube videos it’s really
70:51
simple you can do it to yourself with
70:53
rubber bands there’s a lot of things and
70:55
there are diseases that involve fluid
71:01
draining problem
71:03
that can be profound and you know
71:05
there’s epidemia there’s like five
71:08
different ones that all are this lipid
71:11
dystrophy and stuff like that there’s
71:14
all these different tissue disorders
71:15
where they hold on to liquid and that’s
71:18
a whole nother thing than what we’re
71:20
talking about we’re just talking about
71:21
your your generic you know eighty pound
71:25
overweight person is gonna get swollen
71:27
ankles if they’re on their feet over or
71:29
sitting in the chair for a bit but
71:31
nothing is there with kiddo has nothing
71:34
to do with keto but it’s exacerbated on
71:36
keto because of the propensity for your
71:39
electrolytes to become imbalanced okay
71:42
it’s it’s not that it’s keto specific
71:45
it’s that if your electrolytes get
71:46
imbalanced you’re prone to edema and if
71:49
your where were weight you’re prone to
71:50
edema so one plus one equals seven and
71:53
now you got big swollen ankles and it’s
71:55
also more noticeable you may just not
71:57
have noticed that you always had this
71:59
pitting edema before because you flushed
72:02
out all this this inflammation when you
72:04
began keto and you lost all that water
72:06
weight and thank you know a few months
72:08
later you’re like me you’re walking
72:09
around to Niagara Falls and you end up
72:12
with a balloon animal legs yeah I love
72:15
those Voodoo bands highly recommend them
72:19
I love those things they are great for
72:22
this sort of stuff definitely look into
72:23
that okay
72:25
next thing so while we’re talking about
72:27
electrolytes there are a couple of
72:29
things that can interact with
72:30
electrolytes we already talked about
72:31
some of the kidney disease medications
72:34
it blood pressure meds in general mess
72:38
around with electrolytes some of them
72:40
are diuretics some of them are specific
72:43
like there’s there’s a class of drugs
72:45
that are potassium sparing if you’re on
72:48
any sort of prescription medication for
72:50
blood pressure you need to talk to your
72:53
doctor about a plan for tapering that
72:56
drug down and or managing your
72:58
electrolytes your blood pressure
73:00
dynamics will be different on the keto
73:03
diet and it will happen very fast and
73:06
you can get yourself into great trouble
73:09
electrolyte wise if you are on some high
73:13
potency diuretics which a lot of people
73:15
are
73:17
look at that you can always you know
73:19
look up your drug on you know Google and
73:22
if you see anything like the word
73:25
diuretic water pill potassium sparing
73:30
sodium sparing if you see any of those
73:33
words like that you need to talk to your
73:37
doctor before you start keto about a
73:40
plan to manage your electrolytes to make
73:42
sure that you do not go real wonky all
73:45
right so to be clear when you say
73:47
potassium sparing you mean that we
73:50
normally recommend people supplement
73:52
calcium but because they’re on this
73:54
potassium sparing medication they’re not
73:57
going to lose potassium like everybody
73:58
else so if they do supplement potassium
74:01
bad things are going to happen oh yeah
74:07
bad things all right so don’t just start
74:15
supplementing potassium if you’re on
74:17
these drugs is the bottom line yeah
74:18
that’s what that’s why I say you have to
74:20
talk with your doctor because there’s
74:22
gonna be different kinds of drugs you
74:24
know there’s there’s these drugs that
74:26
are like a deaths thrown antagonists
74:29
that are gonna involve massive Rhys read
74:33
it basically turns off the prout the the
74:36
little wastegate that dumps excess
74:38
potassium so you could quickly go into a
74:42
hyperkalemic state and be in bad shape
74:44
in like weird heart stuff very quickly
74:48
if you are on a drug of that class all
74:52
right so I got a question because I have
74:54
relatives that have blood pressure
74:56
issues they’re on blood pressure meds
74:57
sure and maybe they want a coquito but
75:02
they’re worried about you know having
75:04
salt and they’re long low salt diet
75:06
prescribed by their doctor what are they
75:09
gonna do well what do you mean what are
75:15
they you know they’re gonna talk to
75:16
their doctor okay and they’re gonna
75:20
stick with the low sodium diet if their
75:22
doctor says to because that’s what their
75:26
doctor says did that’s right it is not
75:28
my plan
75:30
because there are different drugs you
75:33
know if you’re on a thighs ID that’s
75:34
gonna be different than a potassium
75:35
sparing diuretic like you know a miller
75:38
ID or something like that you know if
75:41
you’re on a Spiro knock was a spy road
75:44
and all acetone man oh what’s the name
75:47
of that absolutely I forget what the
75:49
brand name is for that but you know if
75:51
you’re on some of those kind of drugs
75:53
you have to have a plan for electrolytes
75:57
before you start and that’s gonna
75:59
because it’s not only a diuretic that’s
76:01
gonna make you dump excess sodium but
76:04
it’s gonna capture excess potassium my
76:08
my ability as a you know Internet key
76:12
Toboso coach to tell you what’s gonna
76:14
happen to your electrolytes is not it’s
76:18
not possible it’s that it’s not
76:20
something I could even predict what
76:21
would happen because your unique
76:23
physiology your unique status there’s so
76:26
many things going on it’s not something
76:29
I can help you with your doctor but it’s
76:32
something you need to go into it eyes
76:34
wide open because if you’re on that drug
76:37
and you just start keto your blood
76:40
pressure is gonna get wonky your blood
76:42
volume is will get wonky I promise you
76:46
you will have blood pressure problems
76:48
and quite possibly if you start doing
76:50
supplementation you get stuff in a real
76:52
like hospitalization level trouble okay
76:55
but everybody else who’s not on
76:57
medication and doesn’t have these issues
76:59
you know there’s all this stuff the news
77:01
you know low sodium diet is good for you
77:03
the – diet you know salt is bad right
77:11
they’re just avoiding salt for blood
77:14
pressure concerns not as a medical
77:17
condition but more of a you know I read
77:20
an article in Cosmo that said I should
77:23
try and limit salt because it’s bad for
77:25
your blood pressure
77:26
exactly okay so those people should not
77:30
get their news from Cosmo that is
77:34
incorrect and we have all kinds of data
77:38
that shows that the all cause mortality
77:41
risk is actually
77:43
much greater on the low side than the
77:45
high side and you’re starting to see a
77:48
shift in the way that we manage blood
77:51
pressure with sodium the sodium is not a
77:55
good guy or bad guy
77:56
sodium informs blood volume blood volume
77:59
inflam informs blood pressure and we
78:02
need to have a greater understanding of
78:04
the interaction and the interplay and
78:07
all those things are different for
78:09
somebody on a carbohydrate based diet
78:11
than they are for somebody on a low-carb
78:13
diet that has a low insulin genic load
78:16
because low insulin changes how your
78:19
kidneys work so I don’t need to fear
78:23
salt if I have healthy kidneys correct
78:27
and in fact you should run to it it
78:29
would be much much better for you to be
78:31
50% higher on salt than to be 20% lower
78:37
excellent I love salt yes does that
78:41
answer your questions I mean it is it’s
78:42
kind of complicated to talk about but I
78:47
think it answers my questions Thank You
78:49
Ben okay the next class of drug that can
78:54
be problematic is blood thinners so if
78:58
you’ve had a DVT or any kind of weird
79:00
heart stuff you’re probably on baby
79:02
aspirin and possibly you know some kind
79:05
of blood thinner you know or fahren come
79:08
on or any of these second generation
79:11
drugs my cardiologist took me off the
79:13
baby aspirin took you off of it yeah she
79:16
said they they don’t do that anymore
79:18
really yeah I’m not familiar with
79:25
literature that is saying that that does
79:28
not have shown benefit I’m not that is
79:34
not my area of expertise so yeah I would
79:39
just follow what the doctor said but
79:40
yeah a general practitioner when I was
79:43
diagnosed with my heart condition put me
79:45
on a blood thinner and well you have
79:47
afib though you don’t have a
79:49
constriction issue no the consumer’s was
79:52
with that I would develop a clot so Oh
79:56
she the one doctor put me on and the
79:58
other one took me off yeah I’m gonna I’m
80:01
gonna just pretend you didn’t interject
80:03
because you’re a weird situation they’re
80:06
abnormal oh my situation is marvelous I
80:11
know I’m gonna say it I think that’s
80:13
unique to you and not yeah I know I’m
80:16
just saying with everyone it’s going to
80:18
be a little bit different yes absolutely
80:21
but there there are certainly a lot of
80:24
folks that are out there that are
80:26
dealing with generic blood thinners so
80:30
if you follow the impulsive keto model
80:32
one of the things we recommend is a lot
80:33
of green and leafy vegetables things
80:35
like broccoli and stuff like that that
80:37
are high in vitamin K now the first
80:40
generation blood thinners are
80:42
problematic with that form of diet
80:46
because you are gonna get more vitamin K
80:48
aiding an impulsive keto model than you
80:52
would in a standard American diet
80:53
because we’re telling you to eat all the
80:55
vegetables that have a bunch of vitamin
80:56
K and in fact if you follow our
80:59
supplements lists we then tell you to
81:01
dump a bunch more vitamin K down the
81:03
piehole every day don’t do that if
81:06
you’re on a blood thinner
81:09
don’t don’t follow our direction if
81:12
you’re on a blood thinner because you
81:15
will mess it up especially if you’re on
81:18
the first generation blood thinners
81:20
you’re on the really cheap stuff like
81:22
warfarin especially where you’re having
81:24
to get your labs tested all the time you
81:26
know you getting your INR measured this
81:29
will be problematic my first
81:34
recommendation is get on a more
81:36
sophisticated blood thinner that maybe a
81:38
little bit more expensive but also has
81:39
much better side effects so talk with
81:43
your doctor about if there’s another
81:45
drug that may be better suited or less
81:49
sensitive to vitamin K intake and also
81:52
avoid some of the nonsense that comes
81:54
along with you know long term or far and
81:58
you don’t have to go to the labs often
81:59
get your test which is also a good thing
82:01
too yeah
82:03
just another drug class to watch out for
82:06
I just thought I’d bring that up now
82:08
Karen I’m looking at the clock here do
82:11
you need these are your next two topics
82:14
but you need to step out here don’t you
82:16
I already stepped out that’s the
82:24
feedback has been consistent that take
82:27
too many breaths and give you a chance I
82:31
got him off the bus I brought him in I
82:33
gave him a snack and I and I was here
82:35
before you even knew it all right well
82:41
I’ve got him crafting at the diner
82:42
speaking of your bad breath Karen what
82:45
what do you do to address your bad
82:47
breath yeah I you know what it wasn’t
82:50
much of an issue for me this Kito breath
82:52
but I I guess I’m a bit of a gum chewer
82:55
so I guess I was masking it my husband
82:59
gets this alright
83:00
so it’s the key to breath you couldn’t
83:02
you can smell these these ketones being
83:07
produced and expelled in your breath it
83:09
smells like nail polish it’s acetone so
83:13
it’s sort of a sickly sweet almost like
83:15
a garbagey smell my husband has this
83:17
issue particularly when he is producing
83:20
a high amount of breath ketones through
83:22
intermittent fasting hmm
83:25
so it’s potent and it’s it’s the problem
83:30
is that a lot of things that we would
83:31
normally use to to combat bad breath
83:34
often have sugar all right so that’s
83:38
back in a second because it let’s be
83:41
clear bad breath from keto does not come
83:46
from your mouth no no it’s it’s a
83:49
distinctive smell but a lot of times
83:51
what people will use is something little
83:55
masks it and that’s in the boat right so
83:58
it’s in your breath it’s coming from
84:00
your lungs so all you can do is step on
84:04
it you can’t make it go away
84:07
you’re not brushing it all away
84:09
chanceless yeah you know you can get a
84:14
little you can be your own little spray
84:17
if you want to use a little bit of mint
84:19
oil diluted of course you don’t want to
84:22
be putting those stuff directly in your
84:24
mouth mint is super easy to grow it’s
84:30
it’s terrific we think there’s a long
84:32
cover yeah that parsley works too you
84:36
know maybe I didn’t do the right thing
84:38
by chewing gum but that’s just what
84:41
worked for me um you know I’m writing it
84:44
out it’s gonna come and go so sometimes
84:47
you’re gonna be a little more stinky
84:48
than other times it’s really nothing to
84:50
worry about there are other health
84:54
issues that can contribute to bad breath
84:55
so if you think you might have a stomach
84:58
problem that it’s not really a taquito
85:00
of course it’s worth worth investigating
85:02
with your doctor but if it’s just that
85:05
nail polish smell like it’s a very
85:09
distinctive smell you’ll know it when
85:11
you smell it it’s sickly sweet it almost
85:13
smells a bit like garbage but with an at
85:16
but like an acetone just a hint of nail
85:20
polish it’s actually it can be so stinky
85:24
that you can taste it and it will
85:26
manifest yeah it’s very metallic E
85:31
coppery sort of a taste yeah so
85:35
mouthwash brush teeth chew on some mint
85:40
leaves gonna spray chew gum there there
85:45
are some gums with xylitol in them that
85:47
are favorable to the so little grebes
85:52
that grow in your mouth anyway so you
85:54
could try those out okay just cover it
85:58
up cover that up
86:00
we had a dentist or a dental hygienist I
86:03
forget which one who was concerned that
86:08
because they’re having to hover inches
86:10
in front of their patients nose all day
86:13
oh there that this was gonna be a big
86:15
problem yeah
86:17
what would you tell someone who is in a
86:20
job where
86:22
bad breath could be unfavorable to their
86:24
job performance well I was I was a
86:27
makeup artist an aesthetician so I was
86:30
in people’s faces all day and I would
86:32
just Park something in my mouth I
86:34
wouldn’t chew it but I would Park a
86:37
piece of very strong minty smelling gum
86:40
in there and it would cover it up and I
86:42
was keep hydrated that helps to is I
86:45
ain’t having water in there I can help
86:48
diffuse the smell a little bit these are
86:52
hard at work because of bad breath can
86:56
be mitigated in at the source right yeah
87:03
how would you do that well with the kid
87:08
with the ketone breath I just I just
87:10
ride it out once again you just mask it
87:13
so what do you what do you mean then at
87:16
the source so like you have your
87:18
exhaling breath acetone what do you do
87:21
about that you you make less of it okay
87:25
how do you do that your carbs make less
87:27
ketones
87:28
sure I mean yeah I suppose that’s the
87:30
solution yeah take take take a sweet
87:33
potato cut it into thirds have some for
87:36
breakfast have some for lunch have some
87:38
for dinner
87:39
you’ll be thirty carbs and you’ll you’ll
87:42
be hovering around half a mil mol of
87:45
ketones all day you won’t have any keto
87:48
breath okay well if you’re not if you’re
87:50
diabetic you might that might not be in
87:52
your best interest maybe you should hold
87:53
off on the the fasting until you’re done
87:56
work and maybe not do your intermittent
87:59
fasting in the morning have breakfast
88:00
and then an lunch then skip the dinner
88:03
meal or if you’re gonna do an overnight
88:05
fast saver for the weekend where you’re
88:07
not gonna be breathing on your patients
88:08
your clients so or just work from home
88:12
like I do so that way you don’t even
88:15
have to wear clothes nobody cares if
88:16
you’re stinky you even with the shower
88:17
if you want that yeah yeah let’s let’s
88:21
be clear Liz let’s make a claim here so
88:23
bad breath is a result of high levels of
88:27
ketones this is very common yeah so this
88:33
is common in the ketone ubi
88:35
who is inefficient in creating and using
88:38
ketones which is why they turn their pee
88:40
strips purple and why they have terrible
88:43
Kido breath this gets better as you have
88:48
consistent levels of nutrition intake
88:50
because your ketone levels stabilized at
88:53
a relatively low level and this will
88:56
just kind of fade away yeah if you are
89:01
someone who needs to mitigate the bad
89:04
breath right away there are two things
89:07
that you need to do number one do not
89:11
let your ketone levels get very high and
89:13
the way you do that is by stepping on it
89:16
with carbohydrate number two you want to
89:20
avoid now see I disagree with boobs
89:23
I really do I don’t get paid by the
89:28
number of ketones in your blood I could
89:30
not care less whether or not you’re even
89:32
in ketosis
89:33
well my issue is that that level is
89:37
going to get high when you are fasting
89:38
there’s so many benefits to the fasting
89:41
that it’s like just write it open and
89:43
see that’s where that that’s the that’s
89:46
the next part of this which is you can
89:49
step on it by keeping the ketones low
89:51
with a very minor amount of carbohydrate
89:54
intake you have a big meeting with the
89:56
boss and you don’t want to have you know
89:58
stinky breath you could pop up you know
90:01
a little dextrose tab a couple hours
90:04
before and your ketone levels will come
90:06
down somewhat you’ll be fine if you are
90:10
doing any sort of fasting especially
90:14
overnight fasting your ketones are gonna
90:16
shoot up dramatically and even in
90:18
someone who is a salty keto veteran like
90:21
Karen she’s gonna get stink breath are
90:24
you telling me I’m stinky right now you
90:26
might be even someone like Karen will
90:35
start to get really stinky breath and
90:37
tea on a long fast it is true so you
90:42
need to avoid those things if for some
90:45
reason having mildly stinky bad breath
90:48
is a problem
90:49
yeah they’re two posts taking my mind
90:52
number one was the dentist who was like
90:54
look I gotta be breathing up people’s
90:56
nose all day this isn’t gonna work
90:57
all right you solve that right the other
91:02
one was more interesting it was a 22
91:05
year old college girl who had just met a
91:08
boy and they were dating and she did not
91:14
want to have stinky breath on their
91:16
dates so we would knock her out of
91:20
ketosis for the dates so like two
91:24
o’clock
91:25
she’d have half sweepstake bring her
91:28
ketone levels down give it you know two
91:30
three hours to burn off and then she
91:33
would not have keto breath for the day
91:37
why not what do you care
91:41
Jennifer and I are coming from a
91:43
background with us being personally very
91:46
sick so just what didn’t factor into our
91:52
equation even in a hopeless diabetic
91:55
who’s deep on insulin dependency what
91:57
kind of coach are you forwarded grams of
92:01
low GI sweet potato or green lentils
92:06
does not generate an insulin load well
92:12
it’s a specific it has a specifically
92:14
favorable glycemic load all right I’m
92:19
just saying one of us knows how to make
92:22
bad breath go away
92:23
the other mother has minty bad breath I
92:26
have my clients fruity breath your
92:31
clients minty bad breath um my clients
92:34
have a wonderful breath let it be me
92:36
let it be known that there is a
92:38
difference in approach I’m saying that
92:41
there is a cost to the having all the
92:44
wonderful metabolic advantage of fasting
92:48
and healing your disease State and the
92:52
cost is going to be a little bit of
92:55
chewing gum to get rid of the bad breath
92:58
fair enough spare me
93:01
only some kind of hippie that would rub
93:04
apple cider vinegar on their Quito rash
93:06
would be telling people to chew on to
93:10
solve their bad with the key to rush
93:14
things there is a really good article on
93:17
the diet doctor you can look up if you
93:20
think you might be experiencing the kita
93:22
rash so what we see in some people is
93:24
they get an itchy rash is typically on
93:26
the trunk you’re not going to see it on
93:29
the extremities usually it’s usually a
93:31
trunk issue it’s usually where you sweat
93:33
the most so you’ve got some of these key
93:36
tones coming out in your perspiration
93:38
and you know rash is a real thing you
93:41
you you values yeah definitely they’re
93:45
not imagining it I have seen the
93:47
pictures particularly people that are in
93:50
deep ketosis we’re doing fasting and
93:52
they are sweating so they’re out there
93:54
they’re in the gym just pounding it I
93:56
see it a lot of men that are
93:58
particularly more sweaty than women
94:00
today it’s like they’re it’s like an
94:04
allergic to their own sweat
94:06
yeah they’re havin they’re havin
94:09
irritation so that a stone that makes
94:12
your breath stink
94:14
well so wastegate via sweat that’s right
94:17
so you’re you’re putting nail polish
94:20
remover on your skin that’s right right
94:22
so what causes the rash is it an allergy
94:24
a sensitivity histamine reaction
94:27
it’s an irritation it’s it’s just simply
94:30
irritation a chemical irritant yeah yeah
94:34
so you know you the same way they you
94:36
know you wouldn’t be rubbing nail polish
94:39
remover in your cleavage or on your
94:41
armpits where you get the kita rash is
94:43
you have that irritation so they’re
94:46
young how come long time killers don’t
94:51
get Cato rash because we’re not
94:53
expelling all those ketones were using
94:54
them but you said people who are doing
94:58
extended fast even long time key doors
95:01
get the breath acetone so why wouldn’t
95:03
they also get it in this wet well it
95:06
seems to take priority through the
95:07
breath is it not then I mean if you’re
95:09
if you’ve been doing this a long time
95:11
you seem to lose these ketones through
95:13
the
95:13
breath more than you’ll see them in the
95:15
blood or in perspiration so a a stone it
95:21
so when you make it I’m trying to think
95:23
give me some tongue-tied on the camel
95:27
always thought that it was
95:29
preferentially yeah so this is very
95:33
complicated I’m gonna oversimplify all
95:35
right your liver is going to primarily
95:37
make ketones in the form of BHB now
95:41
there’s another form of ketones code
95:43
acetoacetate and that is an unstable
95:46
molecule now BHB when it gets to the
95:50
cell and has actually burned is actually
95:52
decomposed into AC AC and that AC AC
95:56
will eventually become a stone which is
95:58
the the waste product so if you’re using
96:03
your ketones
96:05
the waste by-product will be asked them
96:08
and that is going to come out in your
96:12
breath and your sweat if you are not
96:15
sweating it will not come out of your
96:18
pores to the as great but I don’t know
96:21
about you guys but if I’m if I’m fasting
96:24
like if I’m on a two day fast yeah I
96:26
smell my forearm which is not sweating
96:29
it’s there it is there in a big way yeah
96:35
if Kino rashes from is strictly from any
96:38
of this mechanical response to acetone
96:41
knowing that you should know that not
96:43
everyone gets it I’m liking that
96:46
not everyone gets it I had a slight
96:49
amount of what I think might have been
96:51
keto rush once again as these things are
96:53
really hard to diagnose I mean even your
96:54
general practitioner tends not to
96:56
diagnose benign rashes just they’ll just
96:59
say oh you know you takin Aveeno baths
97:01
yeah I had come to problems with rashes
97:04
as we’ve discussed before but I never
97:06
had Keo rash no I don’t paint it yeah I
97:09
think this is a hit-and-miss
97:11
sensitivity thing just like why do some
97:15
people have sensitivities to some
97:17
chemicals and not others exactly and it
97:20
does seem to be very specific to places
97:24
where there’s really thin sensitive skin
97:26
like the Klee
97:27
edweena yeah between those you know it
97:33
on that breastplate on your armpit any
97:36
of those really thin thin skin where
97:40
your another anyplace that you would get
97:43
acne is really subject to getting ya
97:47
body acne I’ve seen it on on some of my
97:49
you know younger male gym rats right and
97:52
then they’ll even get on their back
97:53
mm-hmm yeah see that on the on the
97:56
fellas you’ll see it across the shoulder
97:59
blades yeah exactly
98:00
yeah and with women I see it more more
98:03
face and cleavage you sometimes you see
98:06
it because I tend to perspire a little
98:08
bit on the face when they work out many
98:10
a dermatologist has chased their tail
98:13
for months trying in this go away and
98:16
there’s even like a website that’s like
98:18
keto rash comm some one of the I think
98:22
it’s caveman keto or BJJ keto a camera
98:25
like okay he had a he was getting this
98:30
he’s a you know a pretty fit guy but
98:32
sweating a lot getting this weird rash
98:34
couldn’t couldn’t make it go away
98:35
without reducing the ketones so he
98:39
starts going to the dermatologist and he
98:40
realizes there’s thousands people out
98:42
there getting these rashes so he create
98:44
a website where he’s collecting all
98:46
these people what did you do to make it
98:48
go yeah what worked and what didn’t and
98:50
you know what different for everybody
98:53
that website is a absolute waste of time
98:56
because there are a hundred and fifty
98:59
solutions that work for a hundred and
99:02
forty five people it is bizarre how
99:06
broad the approaches there is no common
99:09
ground there are some people who claim
99:12
the antifungals work there are some
99:14
people who claim antibiotics work there
99:16
people who claim the hydrocortisone work
99:18
some I’m gonna claim that all these
99:20
people have rashes but they’re not
99:22
necessarily from Quito that’s yeah I
99:25
will absolutely guarantee yeah we
99:28
guarantee that you know if it is kita
99:31
rash but sometimes it’s just it could be
99:32
a viral rash it could be a yeast based
99:36
rash it could be an
99:38
infection because you know they too many
99:40
carbs in their their skin swelled up and
99:43
got irritated yeah I don’t want it I
99:48
don’t want to unvalidated Akito rash
99:51
thing because percent of the time it is
99:55
provoked by this ketogenic rash like
99:59
this this a stone waist is absolutely
100:04
provocative to a number of people and if
100:07
you go up on this website I’ve read
100:09
literally hundreds of first-hand reports
100:12
of people’s journeys trying to resolve
100:15
this rash because you know I figured a
100:17
someone like me who’s seen a lot of
100:20
stuff if I read like I have a pattern
100:23
matching brain if I just read 300
100:26
people’s personal accounts I would see a
100:28
pattern there’s a pattern in skin and
100:35
ketosis and I can’t make sense of it
100:37
either as soon as you raise those ketone
100:41
levels or raised a carbohydrate level to
100:44
diminish the ketone wasting that’s
100:47
really rash goes away yeah that may be
100:50
the case but this this sweat business I
100:52
mean if it was just that simple you’d
100:54
think that using an antiperspirant would
100:57
would fix it well I wish them I had a
101:01
monkey that I could play with and try
101:03
that because I bet it would work
101:06
with some people it does some people
101:07
they find less of this rash with
101:10
frequent showering showering and with
101:13
the use of deodorants antiperspirant
101:16
doesn’t always work no it doesn’t and
101:19
there’s no aluminum plugs that
101:21
antiperspirants provide in that get here
101:24
and take the skin even more that’s right
101:26
if it’s already irritated because you’re
101:28
actually having a follicular irritation
101:31
it’s like you know the little bumpy
101:33
rashes that’ll make that so there’s like
101:35
four different kinds of keto rash –
101:37
right that’s right you know there’s some
101:39
that that people think are caused by
101:41
mites a mite infection there’s some that
101:43
are just a generalized that’s the thing
101:46
it’s it’s so different it’s impossible
101:49
to talk about it really and truly is it
101:52
here if you’re experiencing Quito rash
101:54
my first recommendation is to play
101:57
around with your ketone levels and take
102:00
frequent showers I usually if it’s
102:06
particularly if it’s a woman she’s
102:08
getting her face if she’s not really
102:13
sick with you know diabetes that some
102:16
kind of neurological condition that
102:17
she’s using ketosis to treat then my
102:20
suggestion is to break ketosis for three
102:24
days up to up to two weeks and just you
102:28
know increase the carbs up to a
102:30
reasonable amount usually it’s between
102:32
fifty and a hundred and just let the
102:37
skin recover and then slowly scale back
102:40
and find that comfort zone where you’re
102:42
still in ketosis but you’re not
102:45
excreting this acetone that’s that’s
102:49
irritating the skin and I would say that
102:51
about 50% of people it appears that they
102:54
go into keto they get the rash so they
102:58
come out of keto and then they kind of
102:59
do you know paleo or something and then
103:02
you know again and the rashes not there
103:04
yeah I wonder if that’s because they fat
103:07
adapted by staying on a low-carb but non
103:11
ketogenic diet so they become more
103:13
efficient at using ketones yeah which
103:15
means they make a lot less of them and
103:18
it’s more of the adaptation than
103:21
anything else and that if they were to
103:22
start doing extended fasting they would
103:25
immediately get the rash again you know
103:27
it now that we’ve had this discussion I
103:29
actually there was a period two years
103:31
ago where I was reacting to my own sweat
103:34
and I’d kind of forgotten about it but
103:37
it’s true and I would start getting
103:38
hives and itchy
103:40
whenever I sweat so I wonder if that’s
103:44
related it’s possible and you know
103:46
people get sweat rash I I’m actually
103:48
really susceptible to just general sweat
103:51
rashing and in general like if I if I’m
103:55
on the rowing machine in the morning if
103:57
I don’t take a shower like if I have to
103:58
hurry up and get to work and take the
104:00
shower at night I will instantly get
104:02
rash like I’ll get a rash that day
104:05
so yeah my even my Viking skin is very
104:07
sensitive to whatever is in my sweat
104:10
whether that’s a a stoneware that’s you
104:13
know some other weird chemical I don’t
104:15
know manly musk whatever it is my well
104:22
since married I’ve been very careful to
104:25
shower and you know clean up after after
104:28
getting sweaty so you know I think that
104:30
that is just a good I Jean tip people
104:33
yeah it could be preventive definitely
104:36
well if you live in the South a what do
104:39
you do take three showers a day if
104:41
you’re outside shower three times a day
104:44
that’s your problem it is my problem
104:46
that’s my point correct that’s my
104:49
problem
104:50
and actually my tolerance for getting
104:53
sweaty has greatly increased and I don’t
104:55
have any problem with getting a rash
104:56
anymore so it’s good awesome alright so
105:01
the idea here today was to discuss some
105:05
of the common concerns and phenomenon we
105:08
see around health problems Jennifer is
105:11
not a doctor I assure you Karen is not a
105:16
doctor she’s not even board-certified
105:18
yet not yet
105:20
I know nothing I am so unqualified that
105:26
I’m resorted to having to have a podcast
105:29
in order to get my crazy ideas out there
105:32
we are not intending to provide you with
105:36
medical advice
105:37
we were discussing prescription strength
105:39
medication for profound health disorders
105:43
today nothing we said should be taken to
105:46
the bank it should be taking your doctor
105:48
that’s right we do not want you to have
105:52
a problem in the pursuit of health
105:55
because you got bad advice from a bunch
105:57
of internet bozos with a podcast in our
105:59
basement don’t be don’t don’t do not try
106:03
and solve your own problems I cannot
106:06
tell you how many pose I took myself off
106:09
my BP meds because you said it was gonna
106:12
be bad like we see that that is crazy
106:16
what people will take it upon them
106:18
else to do because they believe that
106:21
they’ve received Internet advice that is
106:24
applicable to their unique situation and
106:26
then gone forth and and just decided to
106:29
do whatever without consulting their
106:31
doctor and having a plan that said we
106:35
don’t don’t just take your doctor’s
106:38
advice he isn’t God he or she isn’t God
106:41
they may not be giving you the the best
106:44
direction either so you need to be your
106:46
own best advocate and take your health
106:48
into your own hands and be responsible
106:51
for what’s going on with you don’t let
106:53
somebody tell you what to do it could be
106:55
wrong even if they are a doctor yeah you
106:58
can always get a second or third or
106:59
fourth opinion from another doctor it I
107:02
I’m gonna come at it a little bit
107:04
differently than Jennifer did which is
107:06
to say your doctor is a paid trusted
107:10
adviser trait you should be working with
107:14
your doctor to support your lifestyle
107:17
choices if you go to your doctor and you
107:21
say I’m on all this blood pressure
107:23
medication and blood thinner and I
107:26
intend to pursue this low-carb ketogenic
107:30
diet and I’m worried about my
107:32
electrolytes because the guy and the
107:34
internet told me that was gonna be a
107:35
problem can we come up with a plan you
107:38
know what do I need to do I need to
107:39
change doses do I need to take sodium
107:41
pills what I need to do what if her
107:43
doctor just says no you can’t do that
107:45
it’s a picture right so when that
107:50
happens you have to evaluate your
107:53
employee this doctor who is your paid
107:56
trusted adviser employee and you need to
108:00
remind them of the relationship you are
108:03
my paid trusted adviser here are my
108:06
intentions if you would like to talk me
108:08
out of a low carb diet I’m interested in
108:11
your advice however what I’m here for is
108:17
to get your medical support and if you
108:21
can’t provide that prefer me to someone
108:24
who will anybody many of doctors is so
108:28
different you you could have just gotten
108:31
this doctor because he was in the
108:32
they’re your providers directory and he
108:35
had a you know open appointment if he
108:37
isn’t good get a better doctor and and
108:41
doctors have areas of interest just like
108:43
all of us do you know I have certain
108:46
areas of interest in nutrition I
108:47
couldn’t care less about cooking asked
108:50
me about which sweetener works best on a
108:52
high temperature fat head cobbler dough
108:55
and I’m just gonna look at you like
108:57
you’re dumb because I couldn’t care less
109:01
right that’s right that’s not my area of
109:04
interest so if you asked me about it I’m
109:06
gonna give you a pretty blow-off answer
109:08
if you ask your doctor that doesn’t
109:10
believe in nutrition as medicine they
109:13
may give you a blow-off answer or just
109:15
be completely unwilling to participate
109:16
in that conversation that’s all you need
109:20
to know and all you have to say is I
109:23
would like to be referred to someone who
109:25
does want to help support their patients
109:29
with this kind of intervention if you’re
109:31
if that’s not you is there someone in
109:34
this practice who is and if not can you
109:37
refer me to someone outside of the
109:38
practice who is and in almost every case
109:42
if you make that a non-confrontational
109:45
discussion doctors are very willing to
109:48
go I don’t care about that and I don’t
109:50
like working with patients on keto
109:52
because I don’t think it’s the best
109:53
thing you know alright fair deal do you
109:57
got you know anybody who does and you go
109:58
okay you find the expert you know don’t
110:01
don’t hire your landscaper to dig pool
110:04
because they although they both of those
110:07
people work with a dirt they they’re
110:09
different skill sets they’re different
110:11
areas of interests and it’s important
110:14
for you to not forget the relationship
110:17
your doctor is not your boss your doctor
110:20
is your paid employee you are the boss
110:23
you are writing a paycheck to this
110:26
person to do a service for you and as
110:29
service is highly trained and the person
110:32
is wearing a lab coat but do not forget
110:34
about the fact that they you’re paid a
110:37
trusted adviser because it takes many
110:40
many years of schooling to be smart
110:42
enough to make wise choices about some
110:44
of the
110:45
stuff and your you’ve hired them to
110:48
provide that expertise in your general
110:50
direction to support your unique
110:52
situation including your unique
110:54
nutritional choices here it’s not a
110:59
confrontational situation so many people
111:01
are scared of their doctors or scared or
111:03
whatever it your doctors a person it
111:07
gets in his Honda and drives home at the
111:09
end of the day settle down just have a
111:11
conversation with them you know what
111:13
they call the person who graduated last
111:15
in their class at medical school now
111:17
would you stop bashing doctors you know
111:20
your medical treatment into a thimble
111:23
how dare you I know but I almost got
111:27
killed by my previous ex doctor and I
111:30
know how important it is to be your own
111:33
advocate we all agree that your personal
111:39
advocacy do not be a passive participant
111:42
in your health care try and learn as
111:44
much as you can but let’s be honest
111:46
let’s people ain’t got time for that it
111:54
is your job to find a trusted adviser
111:58
who is trustworthy that’s your job if
112:03
you want to go further and become an
112:05
informed advocate and debate with your
112:07
doctor and drive directional care you
112:11
might even be lucky enough to find a
112:12
doctor who will let you do that I did
112:15
many of us in this podcast I’ve done
112:18
that a great investment in education and
112:26
that most people do not have the time to
112:28
skill up to be able to debate with
112:32
doctors at their level and you you
112:36
should need to that’s why they went to
112:38
school for 20 years you didn’t know but
112:40
you have their expertise and that’s my
112:43
point Jennifer and that’s that’s why I
112:45
don’t like bagging on doctors because
112:48
there are doctors who are dumb let’s be
112:50
clear but most of them are just
112:54
genuinely interested in helping people
112:57
and
112:58
have either points of view or holes in
113:00
their training and that can sometimes be
113:03
in conflict with your best interests
113:07
we’ve talked about this before and so I
113:10
agree but you can’t just be complacent I
113:17
think most people are gonna be
113:19
complacent there Jennifer do you
113:21
honestly think that many people wouldn’t
113:23
be well yeah I understand the way that
113:28
our society is structured the the title
113:31
MD confers authority and you should be
113:34
able to trust that authority to guide
113:36
you wisely right and if it all worked
113:40
out for me I still would be living in
113:42
that happy bubble and not even have
113:45
thought about any of this stuff our role
113:48
is to be the third party to whisper in
113:53
your ear and say hey you’re on a cell
113:56
phone oriya maybe you should have a
113:59
discussion with your doctor about that
114:00
since you’re on make antigenic diet
114:03
that’s always what your medications are
114:05
we can’t can’t we can tell you itself
114:08
and your ears are you know not good but
114:12
we can’t say stop taking them because it
114:14
could be that you’re in a situation
114:15
where hyperglycemia is a dangerous
114:19
concern and you can’t just change your
114:23
medication without consulting with your
114:24
doctor that’s right that we don’t have
114:27
your medical history and we have no
114:29
training we’re not to be trusted we are
114:32
not a trusted adviser
114:33
we are untrustworthy advisors our job is
114:37
to provoke an effective conversation
114:40
with your doctor nothing more but we
114:43
also demand that you have an effective
114:45
conversation with your doctor especially
114:47
for some of these very serious issues
114:49
that can escalate quickly or if your
114:52
doctors a bozo get a new one
114:54
there you go I couldn’t have said it
114:57
better I’m not saying anything
115:01
like do you understand that once my
115:03
board certification comes through that
115:05
most of my clients will be coming from
115:07
doctors
115:12
all I can say is that’s very interesting
115:15
and ask your doctor and I am here to
115:19
educate you okay all right we do try to
115:27
help point people to the right resources
115:29
if you have weird situations a lot of
115:33
times we can’t provide any medical
115:34
advice especially not specific to you
115:37
but you have something weird going on
115:40
and you want to find out if that’s
115:42
something that is known to be wonky with
115:44
keto poopy shy about coming on to the
115:47
old board and asking about it either
115:49
we try to cover a lot of common health
115:51
concerns but like especially on the
115:53
neuro board and people have strange
115:56
diseases I mean stuff that I’m like I
115:58
had to google that just to understand
116:00
what part of the body that’s affecting
116:01
mm-hmm so sometimes we can help a lot of
116:05
times we can’t if it’s a really weird
116:07
thing but don’t be shy about asking for
116:09
help and trying to find a community of
116:11
folks who may be in a similar boat that
116:14
one of the fascinating things about
116:17
having 250,000 people in the group is
116:20
that’s a big pond with a lot of fish and
116:23
you’d be surprised
116:24
there’s like twelve people in the group
116:27
that live within walking distance of me
116:29
it is bizarre
116:30
how many people are in my city that are
116:34
right in the group the guys around it I
116:36
know you might have some weird disease
116:38
and there’s four other people in a group
116:40
because a population so big that just
116:42
statistically that there’s probably a
116:45
hundred people in the group that have
116:46
your same birthday I mean that’s the
116:49
kind of stuff we’re talking about when
116:50
you start getting that many people in
116:51
one place so take advantage of the scale
116:54
of numbers all right
116:58
bla bla bla bla bla that’s it I’m
117:02
putting a pin in it I’m done okay I
117:06
think I think we beat that one to death
117:09
that’s right and fire your doctor says
117:12
Jen ah oh yeah
117:17
no one in this podcast is a provider of
117:19
health care and our discussion is based
117:20
on things we’d be done the Internet it’s
117:22
not an intensive Leonard medical
117:23
community institution and the you and
117:25
their doctor practices
117:27
a treatment diagnosis and specialty
117:29
impact
117:30
always check with the prescribing doctor
117:31
on ability their medication before
117:34
change nutritional furs or fatty little
117:36
mini vacations are known incompatible
117:38
upon their past
117:39
be safe and open
117:43
you
117:47
[Music]