In this episode 41 protocols
▶ 25:12 Urine Ketone Strips Tools “So I was, we were using urine strips. Which are not quite as accurate, but still useful as a general guide from what I understand. Is that right? True. Absolutely.” ▷ 25:27 Measure Ketones Behaviors “So I was strongly recommending that patients achieve urinary ketosis. And the interesting thing is I noticed a pattern that when they were trying the diet and not getting ketones, they often did not get a clinical benefit.” ▷ 26:33 Intermittent Fasting Behaviors “Fasting certainly will limit your carbohydrate intake and get you into ketosis, correct? It will. Did you have any patients fast or do intermittent fasting? I did.” ▷ 26:46 Fat Fast Behaviors “I had some patients, who did what, what Atkins had called a fat fast, where they eat primarily fat. So they either fast and or they eat primarily fats to try to get into a state of ketosis.” ▷ 38:00 Supervised Medication Taper Behaviors “Getting off your meds is very difficult and dangerous. And you need to do it with supervision with a mental health professional or a prescriber.” ▷ 40:33 Frequent Follow-Up During Diet Change Behaviors “I was seeing him once a week. And so I could do a lot of education.” ▷ 40:38 Check Glucose Levels Behaviors “I was weighing him. I was checking his ketones. I was checking his glucose levels.” ▷ 40:43 Blood Ketone Monitor Tools “At that point, I had a blood ketone monitor in my office. So I knew whether he was compliant or not, which is so beneficial in doing clinical work and research on this diet.” ▷ 43:36 Avoid Highly Processed High-Sugar High-Fat Foods Diet “For some patients, simply getting rid of junk food can make a huge difference in a mood disorder, for instance. So a junk food, meaning highly processed food, food that could last on the shelf a very long time.” ▷ 45:04 Reduce Sweets and Added Sugars Diet “So for some patients, I might just want to decrease glucose and insulin levels. And I can do that by getting rid of sweets.” ▷ 45:13 Ketogenic Diet Diet “For other patients, like patients with schizoaffective disorder, or schizophrenia, or bipolar disorder, especially if it's chronic, if I'm using it as a brain treatment, then I do want a ketogenic diet. And I usually want reasonably high levels of blood ketones.” ▷ 51:25 Fasting Behaviors “And this is why fasting has been used as a therapeutic intervention in almost every culture and almost every religion for millennia.” ▷ 1:37:48 Get Adequate Sunlight Behaviors “There is something in our environment. So that is either our food, environmental toxins, stress levels, poor sleep, not getting adequate sunlight, whatever you want to speculate on, all of the above.” ▷ 1:43:10 Avoid Sleep Disruption Behaviors “Sleep disruption impairs mitochondria and mitochondrial function.” ▷ 1:43:17 Reduce High Stress Behaviors “Stress, high levels of stress and trauma impair mitochondrial function.” ▷ 1:43:21 Avoid Tobacco Smoke Behaviors “Drug and alcohol use, alcohol, tobacco definitely in terms of the smoke and marijuana, THC in particular, all impair mitochondrial function.” ▷ 1:43:21 Avoid THC Diet “Drug and alcohol use, alcohol, tobacco definitely in terms of the smoke and marijuana, THC in particular, all impair mitochondrial function. THC directly.” ▷ 1:46:00 Avoid Alcohol Diet “It is clear that, at least to me, based on the data, that regardless of what people have read about red wine, that not drinking any alcohol is going to be healthier than drinking alcohol.” ▷ 1:54:05 Avoid Drinking Your Usual Amount of Alcohol on Keto Behaviors “If you go to a ketogenic diet, please don't drive with the same two drinks because it means your blood alcohol level, if it's any, if it models anything that we found in the rat study, your blood alcohol levels may be five times higher than they would normally be.” ▷ 1:57:55 Exogenous Ketones Supplements “So Stephen Cunane has done studies where he even gives ketone supplements. These are liquid ketone esters... and it has actually found that these brain metabolism deficits can be corrected at least short term by giving a ketone supplement.” ▷ 2:18:41 Health and Wellness Coach Tools “And that support could be a health and wellness coach. It could be a dietician.” ▷ 2:18:49 Prepared Ketogenic Meals Diet “It might even be providing them with dietary, like meals, that maybe for six months, we actually provide them with ketogenic meals once a week. Put them in your freezer. You know, microwave them when needed to make this diet as easy and doable as possible.” ▷ 2:28:16 Use Noncaloric Natural Sweeteners on Keto Diet “You can have added natural sweeteners like stevia or monk fruit.” ▷ 2:28:20 Avoid Artificial Sweeteners If Possible Diet “You might use artificial sweeteners. I'd probably, years after doing this, I'd probably recommend steer away from them if you can, because I think they tend to stimulate cravings for high carb foods.” ▷ 2:30:26 Use Keto-Compatible Protein Sources Diet “But they can eat meat if they like meat, or they could eat eggs, or if they don't like meat and eggs, they could eat sardines or things of that sort.” ▷ 2:31:04 Increase Dietary Fat on Keto When Needed Diet “The thin person is going to need to eat a lot of fat because they don't have a lot of fat stores on their body. And if I want them in ketosis, clinical ketosis, I'm going to have to feed them fat.” ▷ 2:32:53 Low-Carbohydrate Diet Diet “I'm probably actually going to recommend the protocol you described, which is let's see if we can just carb restrict for a while and see if that produces clinical benefit.” ▷ 2:35:09 Dietitian Support Tools “We have that. We have a hundred-year evidence base. We've got dietitians who know this like the back of their hand. They can monitor your level of ketosis.” ▷ 2:36:22 Water Fast Behaviors “Sometimes I will ask him to do either intermittent fasting or even a three or four day water fast. And it is shocking. When he does a three or four day water fast, you know, the first day or two, he feels like crap.” ▷ 2:36:50 Plain Black Coffee or Tea During Water Fast Diet “I usually tell him he can have plain black coffee or tea.” ▷ 2:43:27 Prioritize Sleep to Prevent or Break Hypomania Behaviors “You need at least six hours of sleep a night, period. End of story. That's non-negotiable.” ▷ 2:44:21 Magnesium Supplements “And then I might use supplements, melatonin, others that you mentioned. Magnesium is a big one.” ▷ 2:44:21 Melatonin Supplements “And then I might use supplements, melatonin, others that you mentioned.” ▷ 2:44:28 Eat Carbohydrates in the Evening for Sleep Support Diet “And for some, I will recommend exactly what you're doing. Eat some carbohydrates in the evening before you're going to bed.” ▷ 2:45:05 Use Prescription Sleeping Medicine Only as a Temporary Stopgap if Needed Behaviors “If they still can't do it, if they can't sleep even with supplements, over-the-counter supplements, then I'm probably going to go with prescription sleeping medicines as a temporary stopgap to try to get them three to seven days of decent sleep.” ▷ 2:45:43 Avoid Trazodone in Keto-Related Hypomania Supplements “I would not use trazodone. I would actually specifically avoid trazodone because it's an antidepressant and they're already hypomanic and I certainly don't want to push that further.” ▷ 2:45:58 Zolpidem (Ambien) Supplements “I'm going to use a benzodiazepine or either commonly called the Z medicines for sleep, Zolpidem or Ambien or something like that.” ▷ 2:46:14 Klonopin Supplements “I usually start with something like Ativan or Klonopin or something like that.” ▷ 2:46:14 Ativan Supplements “I usually start with something like Ativan or Klonopin or something like that. Probably Ativan because it's shorter-acting.” ▷ 2:58:12 Good Sleep Behaviors “I would much rather see people with type 2 diabetes control their diabetes through diet and lifestyle and that might be a ketogenic diet or a low-carb diet or exercise or good sleep or all of the other things, all of it.” ▷ 2:58:12 Exercise Behaviors “I would much rather see people with type 2 diabetes control their diabetes through diet and lifestyle and that might be a ketogenic diet or a low-carb diet or exercise or good sleep or all of the other things, all of it.”