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| [[#No11|11]] || Dawn syndrome, what to do? || - || (00:55:54) || [[#No11|Question 11]]
| [[#No11|11]] || Dawn syndrome, what to do? || - || (00:55:54) || [[#No11|Question 11]]
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| [[#No12|12]] || Insulin resistance - how do I know without going to the doctor? What are indicators? || - || (00:39:45) || [[#No12|Question 12]]
| [[#No12|12]] || Insulin resistance - how do I know without going to the doctor? What are indicators? || - || (00:57:32) || [[#No12|Question 12]]
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| [[#No13|13]] || Must I progress to OMAD or one meal a day in order to lose the last 10 or 15 pounds. Been keto for a couple of years. Or is there anything else I can do? Can I just cut? || - || (00:49:45) || [[#No13|Question 13]]
| [[#No13|13]] || Must I progress to OMAD or one meal a day in order to lose the last 10 or 15 pounds. Been keto for a couple of years. Or is there anything else I can do? Can I just cut? || - || (01:01:00) || [[#No13|Question 13]]
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| [[#No14|14]] || Is it possible that some people just can't lose weight on a ketogenic life plan? Following for eight months and old weight loss but feel good. || - || (00:49:50) || [[#No14|Question 14]]
| [[#No14|14]] || Is it possible that some people just can't lose weight on a ketogenic life plan? Following for eight months and old weight loss but feel good. || - || (01:02:35) || [[#No14|Question 14]]
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| [[#No15|15]] || What do I do if I don't absorb fat? Floating poop and diarrhea. || - || (00:51:55) || [[#No15|Question 15]]
| [[#No15|15]] || What do I do if I don't absorb fat? Floating poop and diarrhea. || - || (01:03:26) || [[#No15|Question 15]]
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| [[#No16|16]] || How do we get calcium on Keto? Dairy has too many carbs. Cronometer tells me I get 15% of what I need. || - || (00:53:00) || [[#No16|Question 16]]
| [[#No16|16]] || How do we get calcium on Keto? Dairy has too many carbs. Cronometer tells me I get 15% of what I need. || - || (01:08:36) || [[#No16|Question 16]]
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| [[#No17|17]] || If you fall off the keto wagon briefly go over 20 total carbs, do we jump back on where we left off? When is it best to start at wk 1? || - || (00:53:30) || [[#No17|Question 17]]
| [[#No17|17]] || If you fall off the keto wagon briefly go over 20 total carbs, do we jump back on where we left off? When is it best to start at wk 1? || - || (01:11:10) || [[#No17|Question 17]]
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| [[#No18|18]] || Why does your heart pound after an epsom salts bath? || - || (00:53:40) || [[#No18|Question 18]]
| [[#No18|18]] || Why does your heart pound after an epsom salts bath? || - || (01:12:00) || [[#No18|Question 18]]
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| [[#No19|19]] || Does absorbing abundant magnesium during a bath or float have the same laxative effect? Why or why not || - || (01:01:00) || [[#No19|Question 19]]
| [[#No19|19]] || Does absorbing abundant magnesium during a bath or float have the same laxative effect? Why or why not || - || (01:14:39) || [[#No19|Question 19]]
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| [[#No20|20]] || Can sleep apnea really go away with keto, or will a person always need the c-pap? || - || (01:01:05) || [[#No20|Question 20]]
| [[#No20|20]] || Can sleep apnea really go away with keto, or will a person always need the c-pap? || - || (01:16:00) || [[#No20|Question 20]]
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| [[#No21|21]] || Do you recommend staying under a certain carb level at each meal? I heard that eating over 7 g of carbs at a meal could spike insulin? || - || (01:03:39) || [[#No21|Question 21]]
| [[#No21|21]] || Do you recommend staying under a certain carb level at each meal? I heard that eating over 7 g of carbs at a meal could spike insulin? || - || (01:17:00) || [[#No21|Question 21]]
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| [[#No22|22]] || Please explain why you might stall with weight loss after being keto/lchf for over a year? Is it metabolism? Is it hormonal? || - || (01:03:40) || [[#No22|Question 22]]
| [[#No22|22]] || Please explain why you might stall with weight loss after being keto/lchf for over a year? Is it metabolism? Is it hormonal? || - || (01:18:00) || [[#No22|Question 22]]
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| [[#No23|23]] || Why is the scale not moving? || - || (01:05:26) || [[#No23|Question 23]]
| [[#No23|23]] || Why is the scale not moving? || - || (01:19:00) || [[#No23|Question 23]]
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| [[#No24|24]] || Why is sugar not dropping  || - || (01:08:00) || [[#No24|Question 24]]
| [[#No24|24]] || Why is sugar not dropping  || - || (01:08:00) || [[#No24|Question 24]]
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| [[#No25|25]] || Smoothies || - || (01:08:10) || [[#No25|Question 25]]
| [[#No25|25]] || Smoothies || - || (01:20:31) || [[#No25|Question 25]]
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| [[#No26|26]] || Snacks? When to add? Before or after a meal? || - || (01:09:40) || [[#No26|Question 26]]
| [[#No26|26]] || Snacks? When to add? Before or after a meal? || - || (01:21:00) || [[#No26|Question 26]]
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| [[#No27|27]] || How many snacks while fasting? On and on and on || - || (01:10:00) || [[#No27|Question 27]]
| [[#No27|27]] || How many snacks while fasting? On and on and on || - || (01:21:30) || [[#No27|Question 27]]
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| [[#No28|28]] || I have gained weight on the way to changing my body chemistry. What happened? Maybe all the whipped cream. How do I help myself against stubborn insulin resistant liver? || - || (01:15:29) || [[#No28|Question 28]]
| [[#No28|28]] || I have gained weight on the way to changing my body chemistry. What happened? Maybe all the whipped cream. How do I help myself against stubborn insulin resistant liver? || - || (01:22:28) || [[#No28|Question 28]]
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| [[#No29|29]] || Science based impact of sweeteners, stevia, erythritol, monk fruit on ketones and glucose. There is quite a evidence of literature out there where they put it. I see how that dana green, or erythritol four grams of carbs per teaspoon. And I need at least three for coffee. I don't count those carbs. A friend said that type doesn't count, but I'm using nothing because it's a waste of four carbs to me. || - || (01:15:30)
| [[#No29|29]] || Science based impact of sweeteners, stevia, erythritol, monk fruit on ketones and glucose. There is quite a evidence of literature out there where they put it. I see how that dana green, or erythritol four grams of carbs per teaspoon. And I need at least three for coffee. I don't count those carbs. A friend said that type doesn't count, but I'm using nothing because it's a waste of four carbs to me. || - || (01:28:44)
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| [[#No30|30]] || Is it true if you drink apple cider vinegar with water before bed will help you lower the dawn effect? || - || (01:15:32) || [[#No30|Question 30]]
| [[#No30|30]] || Is it true if you drink apple cider vinegar with water before bed will help you lower the dawn effect? || - || (01:32:42) || [[#No30|Question 30]]
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| [[#No31|31]] || How a  person can have high glucose readings in the morning and also have high ketone levels. || - || (01:16:00) || [[#No31|Question 31]]
| [[#No31|31]] || How a  person can have high glucose readings in the morning and also have high ketone levels. || - || (01:34:18) || [[#No31|Question 31]]
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| [[#No32|32]] || Is it possible to have too much salt? I have a lower limb swelling and I've only previously had the pregnancy. || - || (01:21:39) || [[#No32|Question 32]]
| [[#No32|32]] || Is it possible to have too much salt? I have a lower limb swelling and I've only previously had the pregnancy. || - || (01:36:11) || [[#No32|Question 32]]
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| [[#No33|33]] || After achieving the desirable Dr. Boz ratio, do you keep going? When do you stop? || - || (01:22:13) || [[#No33|Question 33]]
| [[#No33|33]] || After achieving the desirable Dr. Boz ratio, do you keep going? When do you stop? || - || (01:39:41) || [[#No33|Question 33]]
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| [[#No34|34]] || I went to bed with the best numbers. I've had blood glucose to 79, ketones a three, got up eight hours later with the worst numbers I've had a glucose of 117 and ketones a 0.7. What happened? || - || (01:22:50) || [[#No34|Question 34]]
| [[#No34|34]] || I went to bed with the best numbers. I've had blood glucose to 79, ketones a three, got up eight hours later with the worst numbers I've had a glucose of 117 and ketones a 0.7. What happened? || - || (01:41:18) || [[#No34|Question 34]]
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| [[#No35|35]] || When will the hair loss stop? || - || (01:25:00) || [[#No35|Question 35]]
| [[#No35|35]] || When will the hair loss stop? || - || (01:42:56) || [[#No35|Question 35]]
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| [[#No36|36]] || I failed my sleep this week. Most nights five hours, bed by 9:30, totally awake at 3:30 in the morning. It was my norm trying all the guidance and info. How long to get a sleep line? || - || (01:28:12) || [[#No36|Question 36]]
| [[#No36|36]] || I failed my sleep this week. Most nights five hours, bed by 9:30, totally awake at 3:30 in the morning. It was my norm trying all the guidance and info. How long to get a sleep line? || - || (01:43:55) || [[#No36|Question 36]]
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| [[#No37|37]] || When to begin my real exercise happens in the big keto life? Can you have initial weight gain? || - || (01:29:00) || [[#No37|Question 37]]
| [[#No37|37]] || When to begin my real exercise happens in the big keto life? Can you have initial weight gain? || - || (01:44:30) || [[#No37|Question 37]]
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| [[#No38|38]] || I don't feel I have cravings for anything in particular. I just love to eat even when I'm feeling full. Since college I've considered myself a food alcoholic. Yet I have worked to keep my weight low. Is this what you mean by a craving? || - || (01:34:46) || [[#No38|Question 38]]
| [[#No38|38]] || I don't feel I have cravings for anything in particular. I just love to eat even when I'm feeling full. Since college I've considered myself a food alcoholic. Yet I have worked to keep my weight low. Is this what you mean by a craving? || - || (01:48:33) || [[#No38|Question 38]]
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| [[#No39|39]] || Since there's been some time since the study you cited, what are the thoughts of electronics and blue blocking enabled pre bedtime? I read on a Kindle at night, nightshade on. || - || (01:38:40) || [[#No39|Question 39]]
| [[#No39|39]] || Since there's been some time since the study you cited, what are the thoughts of electronics and blue blocking enabled pre bedtime? I read on a Kindle at night, nightshade on. || - || (01:59:38) || [[#No39|Question 39]]
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| [[#No40|40]] || I have butter coffee in the morning. Is that no longer allowed? I eat a snack in mid afternoon and dinner is all keto focused. If we put fat in the morning coffee is that considered a meal? || - || (01:39:50 || [[#No40|Question 40]]
| [[#No40|40]] || I have butter coffee in the morning. Is that no longer allowed? I eat a snack in mid afternoon and dinner is all keto focused. If we put fat in the morning coffee is that considered a meal? || - || (02:01:00) || [[#No40|Question 40]]
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| [[#No41|41]] || I have malabsorption of fat, diarrhea and fasting. Should I use the chia seed and protocol and BHB at the same time? Should I stay under 20 carbs and how much fat should I eat while my body tries to adjust? || - || (01:41:30) || [[#No41|Question 41]]
| [[#No41|41]] || I have malabsorption of fat, diarrhea and fasting. Should I use the chia seed and protocol and BHB at the same time? Should I stay under 20 carbs and how much fat should I eat while my body tries to adjust? || - || (02:03:03) || [[#No41|Question 41]]
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| [[#No42|42]] || Why am I so tired? I'm less than 20 carbs per day, getting plenty of fat. Blood glucose is 90 and ketones are 2.5. || - || (01:42:00) || [[#No42|Question 42]]
| [[#No42|42]] || Why am I so tired? I'm less than 20 carbs per day, getting plenty of fat. Blood glucose is 90 and ketones are 2.5. || - || (02:07:13) || [[#No42|Question 42]]
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| [[#No43|43]] || My day 12 still has an edema, carbs are 20 or under daily. Is this the BHB salts? || - || (01:42:20)|| [[#No43|Question 43]]
| [[#No43|43]] || My day 12 still has an edema, carbs are 20 or under daily. Is this the BHB salts? || - || (02:09:41)|| [[#No43|Question 43]]
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| [[#No44|44]] || When I eat one meal a day I won't gain weight. But if I have two meals the next day I've gained weight. Why is that happening? Even if I work out, did I mess up my metabolism? || - || (01:43:20) || [[#No44|Question 44]]
| [[#No44|44]] || When I eat one meal a day I won't gain weight. But if I have two meals the next day I've gained weight. Why is that happening? Even if I work out, did I mess up my metabolism? || - || (02:14:01) || [[#No44|Question 44]]
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| [[#No45|45]] || I ate the same thing three days in a row and my blood glucose around 85, ketones around 1. Then out of the blue, I wake up a blood glucose of 110 and ketones at 0.6. What happened? || - || (01:48:47) || [[#No45|Question 45]]
| [[#No45|45]] || I ate the same thing three days in a row and my blood glucose around 85, ketones around 1. Then out of the blue, I wake up a blood glucose of 110 and ketones at 0.6. What happened? || - || (02:16:01) || [[#No45|Question 45]]
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| [[#No46|46]] || I am not a newbie. I've been stuck for a long time. The class has helped my dawn effect numbers going lower in the eighties to nineties range. But now with the class my dawn numbers have risen by 30 points. What's happening? || - || (01:49:42) || [[#No46|Question 46]]
| [[#No46|46]] || I am not a newbie. I've been stuck for a long time. The class has helped my dawn effect numbers going lower in the eighties to nineties range. But now with the class my dawn numbers have risen by 30 points. What's happening? || - || (02:18:30) || [[#No46|Question 46]]
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| [[#No47|47]] || Do you have any insight on melatonin in regards to sleep? || - || (01:50:43) || [[#No47|Question 47]]
| [[#No47|47]] || Do you have any insight on melatonin in regards to sleep? || - || (02:19:30) || [[#No47|Question 47]]
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| [[#No48|48]] || Best advice for traveling and not being able to completely control your diet. || - || (01:52:25) || [[#No48|Question 48]]
| [[#No48|48]] || Best advice for traveling and not being able to completely control your diet. || - || (02:20:30) || [[#No48|Question 48]]
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| [[#No49|49]] || I'm five weeks into keto and starting to have joint pain fingers, mostly. Any suggestions? || - || (01:53:20) || [[#No49|Question 49]]
| [[#No49|49]] || I'm five weeks into keto and starting to have joint pain fingers, mostly. Any suggestions? || - || (02:25:22) || [[#No49|Question 49]]
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| [[#No50|50]] || Suggestions from my genetics were to be on a Mediterranean diet that I did not handle, saturated fats well, eating lots of veggies, the issue of histamines. I am concerned about doing too much saturated fat. But on a plant based diet. I wanted eggs so I ate four. When I tried keto last year, it gave me too much mucus. Medical intuitive told me it was an issue with gallbladder. That said, I'm worried about the diet. || - || (01:55:13) || [[#No50|Question 50]]
| [[#No50|50]] || Suggestions from my genetics were to be on a Mediterranean diet that I did not handle, saturated fats well, eating lots of veggies, the issue of histamines. I am concerned about doing too much saturated fat. But on a plant based diet. I wanted eggs so I ate four. When I tried keto last year, it gave me too much mucus. Medical intuitive told me it was an issue with gallbladder. That said, I'm worried about the diet. || - || (02:28:53) || [[#No50|Question 50]]
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<div id="No12">'''Question 12'''</div>
<div id="No12">'''Question 12'''</div>
12. I really need help with meal planning.
12. Insulin resistance - how do I know without going to the doctor? What are indicators?
Very good. So these next two questions are about recipes and sharing recipes and how to do some meal planning and asking for help. Meal planning. I can, I can jump into our foods tab here and show you guys a little bit. How about how to create a recipe and use those recipes to create daily meal plans for yourselves?
Video Time Stamp: (00:57:32):
Video Time Stamp: (00:40:03):


Yeah, it was right. I think that's great because they had said what are some of the suggested foods? And I really liked that option in your app too, that once you kind of have set up a thing saying, well what the heck can I eat? And it's really, it's a really good like idea generator.
Get that little poker for your finger, but for those newbies, you do not need to do this. You can stay measuring urine ketones the whole time as long as you're healthy. I mean when you get to follow your health, okay, if you run into trouble and you want to hack it, that's where we start talking about poking your finger. So please do not be overwhelmed that everybody has to buy a meter and poke their finger. I contend that most of the people watching are ready to put this into high gear. I want to be better. I want to leave my house from Coronavirus. No, I'm not going to have a cytokine storm. All of those things are very real. That's not fake news, but it is not something where you can start the ketogenic diet two weeks ago and today have a beautiful immune system. You have to address this insulin resistance so when people have insulin resistance, one of the ways they know they have it is they're on the ketogenic diet.
Video Time Stamp: (00:40:21):


That's right. And so you can do is so just foods, you can come in here and you can actually grab, let's see when it is, how long it takes load. Yeah. So I can grab any number of things. So this is a full day, so I don't actually have much caloric space left, so I'm not getting any big meal suggestions here. But you can add these to your diary and like I described, I think in the last one you can multi-select multiple items, right click and you can create risks.
They're following Keto and they don't lose weight. They get stuck because your insulin is still outperforming your stress. So I need you to stress to the next level, which is what the ketoCONTINUUM really outlines for you. Insulin resistance is a stubborn or ineffective amount of insulin. It shows that the morning fasting glucose is high and those ketones in the morning are low. Even if you scroll back from my history and Instagram and watch what were my sugars a year ago, what were they two years ago? What were they at the beginning of my fast a month ago? I still have numbers that aren't perfect, that aren't great and they are especially not great if I don't follow the rules. I'm human. We know that when you look at a Dr. Boz ratio, which you're going to learn about in this next week, you can measure your insulin.
Video Time Stamp: (00:40:48):


Oh, right, right, right. They actually, yes. I don't know if he did that on the last one, but that, that I've seen you actually demonstrated that with when we were together in in long beach. Right? So you select those on their right click and then create the recipe from those items. Oh, that's cool. Right.
I mean, I can do that. I do not measure insulin in my patients anymore in the office unless I am at an extreme puzzle because so often insulin is this very volatile, very high moving hormone that if we happen to capture it at the moment that I am expecting, then all is right with the world and peace and harmony. But more often it fluctuates. It goes up and down. And if they have a bowel movement before they go into the doctor to get their blood check, they just wasted their money. I can't make sense of it because of the stress. It wasn't 20 minutes after the bottom of, what was it, 50 minutes like, oh my goodness, that's too many variables. But I can look at the two molecules that insulin controls, which is glucose and ketones. When you look at them in relationship, which is what the ratio does, which is what the book ketone index does, this is the science behind quit looking at the volatile insulin.
Video Time Stamp: (00:41:03):


And we jump over here and now those ingredients are actually added into our recipe. And so then I can save that recipe just up here. And it's now part of, you know, part of what I would do. Now the other thing that'll do is I'll just show you real quick how to do that more manually. So if I go to go to, let's add a new recipe. So all that so what you would do with this is you could set any number of categories. So if it's fat and oil, breakfast cereal, but you shouldn't be eating on this program and instead of serving size, so that might be you know, whatever the amount is you know tablespoons. Sure. And and then the ingredients, it just works. It works. Just like our food search, you know, you can come in here and you can add it in with peanut butter powder. Sure.
Look at what insulin controls, which of these two numbers that slowly change, which is glucose and ketones. And by slow, I mean less slow relative insulin.
Video Time Stamp: (00:42:05):
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<div id="No13">'''Question 13'''</div>
13. Must I progress to OMAD or one meal a day in order to lose the last 10 or 15 pounds. Been keto for a couple of years. Or is there anything else I can do? Can I just cut?
Video Time Stamp: (01:01:00):


Let's see. Yup. Is that the stuff that you like? That's what I found with the star too. Yeah, there you go. Yeah. So we have that in there. There's quite a few. There's, they have a couple of different products there, so. Mmm. So yeah, so we have a few of those. You can add those in. I don't know why I would put that in with bacon, but right. Yeah. And so you get the the whole nutrition information for the recipe and then you can create it just by clicking save changes up here. And that's how you can create a recipe that shows up in your search under the custom tab. And now moving on to the meal planning side of things. What you can do is you'll see, so I'll just show you right here. So I have three recipes that I've created over here.
Here is the best answer, you're going to find out in the next two weeks. OMAD is one option, but I would contend it doesn't fit in everybody's life. And I think some people do Omad and they say they're not really doing the chemistry for OMAD. So you're going to learn about that next week. You're going to totally learn about my pet peeves from people saying, I've been keto for a year and it doesn't work.
Video Time Stamp: (00:42:52):


And they all have their own sets of ingredients in there. Now what I'm going to do is I'm going to create a recipe. I'm going to call it let's say dinner one. And then as the ingredients, what I'm going to do is I'm going to add these three items here. We'll go to the custom tab. Here's my military cous cous. I'm going to add the, Oh call it a fritters and I will add that. So teach in, there we go. So now I have my dinner, I'm going to save that. And now I have dinner and I also did a breakfast and lunch before I joined you guys. So now I have these three meals to create a daily meal plan. And what I can do is I can add another recipe. I can call that meal plan day one and now what I can do, go back down to those ingredients.
I'm saying you're not looking at your chemistry. A keto is not a diet. It is a chemistry set inside you. Look at the chemistry and you'll know where you're going wrong. You do not need any new OMAD in order to do this, but you might have to have, if you're trying to get that extra 10 or 15 pounds down, you might have to have some stresses that I will outline in the next little bit. I have a couple of people who were chronic gum tumors and the chewing of the gum, their insulin, and I don't care if they would have not eaten for four days. They still had so much insulin production. Okay. Maybe four days, but they had so much insulin production that they couldn't lose weight until we addressed that. And that's coming up in the next few weeks here in the next few modules.
Video Time Stamp: (00:43:52):
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<div id="No14">'''Question 14'''</div>
14. Is it possible that some people just can't lose weight on a ketogenic life plan? Following for eight months and old weight loss but feel good.
Video Time Stamp: (01:02:35):


I can search for dinner one, lunch one and breakfast one and now I have my day one meal plan. And you can make that as long or complicated as you want with whatever you're taking. Maybe you're including your supplements or whatever. And so then what you can do is in the diary, I can go to a future day, I can click on whichever group here and then I can say meal plan day one. And I can say add that. Now I have all my nutrition information. I don't know if it's keto foods there, but I have all my nutrition and nutrition information filled out. And what you can do is you can right click on the recipe, you can, there's an option called explode recipe here. It breaks it out to its parts and then you can move those things around into the categories that you have set up and you can break those up as well. And now you can see what you're eating for each portion of the day. And this only takes a couple of minutes. Obviously there's the setup costs, you know, you're going to enter in your recipes, you're going to kind of set that all up ahead of time. But once it's set up, it goes very quick.
Here's the key to this question is she says, I feel good, which means she's fat-adapted. Okay? So if you're fat-adapted, the beauty of being fat-adapted is to use the fat that's stored in your tummy and your thighs and your arms. That fat is sitting there as a fuel source for you. You cannot, you can't get it when you're not fat-adapted without a major price to the human body. When they feel good, they're keto, they're like, gosh, I feel so much better. I never want to go back. Okay, now lean up your body, improve the overall prediction for health. And if you haven't lost weight in eight months, it means you got to a certain level of that ketoCONTINUUM.
Video Time Stamp: (00:45:07):


Great. And this is that same part where I was saying it is worth putting the energy into, just slowing down and, and really figuring this out. Is it the ask Oracle that is the one where you push the button saying, okay, it gives you ideas of what to eat?
And you said, good enough for me. And if that's fine with you, and you do not need to lose weight, you're otherwise healthy. Great state of course. But if you're saying, no, I probably shouldn't be losing another 20, 30, 50, whatever pounds then your ketoCONTINUUM needs to be stressed and you're going to see how to do that in the next week or two.
Video Time Stamp: (00:45:22):
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<div id="No15">'''Question 15'''</div>
Absolutely. Yeah. So what you can do is, so either so you can do suggest foods, which will tell you what based on what was the other one too. Okay. So that will give you personalized things based on your, what you've eaten already that suggest foods. And then the foods have there is ask the Oracle tab. And this allows more of a general search for foods high in a particular nutrients in certain categories. So you can narrow it down to Keto specific foods or categories that we have in yeah. Find, find foods that might fit with what you're trying to achieve.
15. What do I do if I don't absorb fat? Floating poop and diarrhea.
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Right? So once you're set up that you're on the rigorous ketogenic, a 20 carbohydrates total or less, and then you ask Oracle, it can say, well, Hey, you could have deviled eggs or you could have you know, whatever. I mean, it really does allow you saying, well, you can have this and it shows you a very long list longer than I mean, I really find food plans a very easy crutch for, for beginners on day one or two. But because pallets are so stuck in what they've always been eating, I was super impressed with how well Oracle offer things like co heart or you know, beef liver and like, yeah, see these are other foods that might, many of my patients are like, we're even from South Dakota and they don't want to eat those things.
Yes, this is important. I know 52 of you said, what do I do about this? And the key thing is staying the course is really important. I know in the group this past week, there was somebody who struggled with gastric bypass and as a consequence, she really can't absorb that. And if there's ever a patient that I, my heart just breaks for it is the folks who have had the surgery and the surgeon cut out or rerouted their gut to a point where they can hardly have the food, hardly gets exposed in the section of their gut where the hormones are made, where the feedback for how they're going to advance there.
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Yeah. And then down here, Oh, I have this exclusion on right now, but if you've created a bunch of cute friendly recipes to your custom recipe library, you can actually I'll check that and my recipes will show up in the suggested list. So if you have a recipe that will fit with what you need, it'll show it here. Good job. Cool. So I think that's all my questions. I'm going to sit back and just give me a shout out.


No, that's awesome, Spencer. Thank you. Thank you for standing by. I'll I'll wave my hand at you or holler at you if I, if I need a little help. If you can stay for a little longer. If you have to go, that's fine too though.
It's either cut out and gone or it's rerouted that the only food that sees it is the burping food that goes backwards in their gut, which it shouldn't do. Floating poop is malabsorbed fat. And again, this is probably going to be a focused video in the future that I do because there's so many people that need to hear the science behind. Why do I keep saying, if you're fat-adapted, I need you to lick the spoon with that MCT, I need you to take one capsule, one bite on it, and you do that three or four times a day and you just switched the oil mouth and swallow. You don't have to bite it. You can swallow it. But I'm just saying a tiny, tiny dose of MCT, and what you're doing is you are upregulating the receptors in whatever part of your gut.
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Yes.
It's still working, even if they've had this surgery, you can see some of those receptors migrate downward and they somehow absorb the fat eventually. But it is a long haul. One of the key things, if you can't absorb fat, you are going to have dementia. I'm not joking. This is a huge deal. The reason I'm so strict about saying, listen to me, if you have folks floating poop fat in your poop, it is a malabsorption that will rot your brain from the inside because you are low on fat. Fat has essential parts that you can't make. You have to absorb them. You'll know you're getting close to a problem by looking at your vitamin D. Vitamin D is one of those minerals that yes, you need to, the sun helps you turn it into the usable version of that.
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All. Alright. Thank you. All right, so back. So just kind of say good that process of learning, the learning how to log your foods. And what he was answering there is when people write in to say, well, can I have this? Can I have that? The first thing I'm going to do is look it up on the chronometer app and say, well, here's what this says and to remind you why those rules are in place, why the 20 total carbohydrates are in place, I think is to see how quickly people start to say, but if I sneak in this and I, I pour in some of that and suddenly other total carbohydrates is 70. And depending on the, what the health of your gut will depend on whether or not that matters to you. And I don't want you poking your finger and doing a whole bunch of blood tests.
But your ability to absorb fat is one of the major steps in how good is your vitamin D? And if you have an inflamed gut one that's so inflamed, you can't absorb the fat that it goes into your guts and your guts just squirt it out the other end. You're in trouble. You might not feel it yet. You might not have enough storage in your body that you don't feel it. But I would push you to go back and look at your vitamin D in your labs over the last five years. And if it's less than 50, focus, listen to me, it's a really big deal. Your journey to figuring this out is slow and steady. Put that MCT on your tongue. The reason I keep saying MCT is it's the one fat that you don't have to digest. It gets absorbed and then your body can use it. Now, it doesn't have essential facts in it. You still have to put those in your life. But it's the one place where I can methodically put it in a pill and say, please keep putting it in on an empty stomach and just take one pill and watch what happens. Because you're going to have this as your barometer to say how well is your gut healing? And if you take a biopsy of somebody who has fat malabsorption, it is so swollen, it's almost not recognizable as gut as endothelial lining which you're not going to care about because it doesn't look like the normal gut shit. The cell structure is goofy, it's broken and it comes back when the inflammation goes down.
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I want you to just focusing on 20 total carbohydrates a day, especially as beginners, because that alone can be overwhelming. We start adding in too many other factors for them to, to learn. And they fall off. They don't, they don't stay the course. All right, let's go back and finish answering some of these questions and going into here, share my screen. Okay. So yeah, we got through the pink ones. That was all crown winners stuff. Awesome. So question 13, 15 of you assets.
That's why this ketogenic journey is such an important part of saying, don't give up. The gal who said, I just can't handle it. It breaks my heart to say, the problem is you're going to show up in my office and I mean metaphorically in 20 years. And you're saying, well, why didn't somebody try to help me? The truth is fat malabsorption and people after gastric bypass you know, my whole clinic is a collection of brains that don't work. Why am I so passionate about the ketogenic diet? Because it fixes brains in a way that I've never been able to do with prescriptions, but they can't fall off. They have to stay the course. That's why this course is so important.
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<div id="No13">'''Question 13'''</div>
<div id="No16">'''Question 16'''</div>
13. Can someone who experiences gout do well on a keto diet? +15
16. How do we get calcium on Keto? Dairy has too many carbs. Cronometer tells me I get 15% of what I need.
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<div id="No14">'''Question 14'''</div>
14. Is it OK to do intermittent fasting and keto if I've been diagnosed with high uric acid? +5
Can someone who experiences gout do well on the ketogenic diet? The next one is it okay to do intermittent fasting and keto if I've been diagnosed with high uric acid? So your gas is high uric acid and gout go hand in hand and it's actually a uric acid or, or gout or one of those chronic inflammatory illnesses that is like the biggest banner on a patient's chart.
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If they have gout. I know they've had high insulin, high sugars and chronic inflammation for a good 10 years. So you don't get high uric acid in two weeks of eating poorly. You get high uric acid in two decades of eating poorly. To get that uric acid back to normal is a random moment when someone's, when I'm looking at someone's labs and I'm following them on a ketogenic diet. Uric acid is one of these like cheap, easy tests that I'll check in their blood. And what I'm looking for is the trend that it continues to go down. And even though some of the other markers will get quite volatile on the ketogenic diet uric acid is stable. It is slowly going to improve and it will slowly raise based on how well they've done on the long game for their redu reducing of chronic illness.
Okay, good job using a cronometer. I bet my groupies are gonna know exactly what I'm going to tell you. So first of all, calcium is one of those minerals that you don't need as much of as the human, as we've been telling you. You have so much calcium in your body, in the form of bones. Now you say, wait, I don't want to use my bones. I'm like, I know, but if you're worried about calcium being, well, I'm telling you it's not critical. Eating a healthy amount of calcium is a good idea. But it's not the highest focus for what I would have you looking at. Instead, when people talk to me about how do I get this mineral in? How do I get more selenium? What about taking in cocuten? I say, wait a minute.
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I moved those up in the list because I think it's a super important question. So yes, gout is absolutely, you need the ketogenic diet. Unfortunately, when people first start on the ketogenic diet, there is so much shift in the chemistry that if they shift to a ketogenic diet and then they fall off the wagon, this on week two, and then they go back and then they fall off the wagon, they can find that the movement of those gout crystals can be, it can inflame their doubt. So if you have a history of high uric acid and if you have a history of gout, you need to stay the course for three solid weeks, 20 grams of carbohydrates or less. Don't play with that. Or you're going to have a big fat red toe and say, Dr. Boz, look what you did. All right, so stay the course is what I'm saying.
When I look at people taking in a supplement, the supplement is supposed to replace something that's missing within the body. So calcium is a good example of saying you're not missing calcium, you're just leaking it out your body and specifically the gut. So in most people they don't, I mean they have irritable bowels, they have inflammatory bowels, they have ways where their gut is supposed to be this nice tight knit, you know, fit. But as they swell, the cells don't fit. And that's where these little micronutrients slip out. So when people talk about vitamin replacements, and everybody focuses on the supplements and what's going on. I'm saying stop fasting and, and really allowing your gut to heal, which is what other thing for that fat malabsorption that I didn't say is you're going to heal a gut fastest when you slow it down when you stop using it.
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Switch the chemistry and hold tight, especially if you have high uric acid.
If you want to stop, if you want calcium to be higher in your body first of all, I would make a huge bet with you that it's not low, that the cronometer app is showing you. You should have more because it's using the ADA guidelines and stop looking at the guidelines,  the nutritional guidelines. I would contend the chances you're low on calcium is so close to zero. I'm not worried about it, but what it does give me a teachable moment is to focus on stop thinking that you have to replace all these minerals. When I look at my advanced keto patients, they don't take vitamins, they don't take supplements. They don't even have kumon or there's another one that somebody keeps asking about, berberi. They really have restored health to the part where the food that goes in is a high nourishment.
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<div id="No15">'''Question 15'''</div>
15. Is there a chance that keto will help against tinnitus? +10
Is there a chance that ketone will help the tinnitus? So ringing in the ears what tinnitus is and all I know is whatever type that question has not read the book any way you can. Cause I talked specifically about this chap or the section they're saying it is the strangest thing to help people with ringing your that that's a hard problem to fix. Again, there is inflammation inside the inner ear that's causing that nerve to ring, to constantly signal and to live with that sound is awful. But I've never fixed it better in my 20 years of practice until I found the ketogenic diet and I did it totally by accident. I didn't promise it, I didn't over promise it, I didn't even think about it. But as my patients who have suffered with this and they've come to me for years, was trying to get that chronic ringing in their ear to go away and they were keto for like two to three months and they came in and said, you're not going to believe what has gone away.
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And it's the ringing in your ear. Now again, I don't want to over promise, but you switched the chemistry. You start to ring out that inflammation in the body and amazing things like ringing in the ear. It does get better. All right, next is the three questions on chia seeds. So I'm going to read all of them and then try to answer them in pretty succinct question here.
Then the most important part is they don't leak out so much fluid, so much minerals and vitamins because they're not chronically swollen. It's a really good teaching point.  
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<div id="No16">'''Question 16'''</div>
16. Do I have to count the carbs in chia seeds? +50
Do I have to count the carbs and the chia seeds? 50 of you said, I want to know the answer to that. Is the chia seed protocol only for the transition Keto, or we will continue with this to combat constipation. Once fat adapted, if we don't absorb carbs and the chia seeds, do we also access the fat or the micronutrients found in them?
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<div id="No17">'''Question 17'''</div>
<div id="No17">'''Question 17'''</div>
17. Would you review the steps for using Chia seeds for digestive relief?
17. If you fall off the keto wagon briefly go over 20 total carbs, do we jump back on where we left off? When is it best to start at wk 1?
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You go back to 20. Okay, so it says you go back to peak one. Well, again, what you're trying to do is reset where you know their success. Okay? Why do you do that? Because your ketones, especially if you've been fat-adapted, your ketones are going to rise, your glucose is going to go down, you're going to have less inflammation.
 
Just like when people fast for the first, let's say you're on a carb diet. I lock you inside a jail or a hospital, call it what you want and you have nothing to eat for three days. You just get water. If you watch what happens inside their body, they flush out a bunch of fluids. That salt that they flush out is what we want you replacing. But most importantly, they tightened up the inflammation. When you fall off the keto wagon, what we really want is you to feel good as fast as possible. So 20 total carbs or less helps me know that is absolutely insuring you to say you'll feel better. Stay the course for a week, 20 carbs or less. I mean, I live my journey that way now because it's just such a better way of living.
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<div id="No18">'''Question 18'''</div>
<div id="No18">'''Question 18'''</div>
18. Was told not to take anything that swells in gut due to 2 wt- loss surgeries 
18. Why does your heart pound after an epsom salts bath?
Quick question. Would you review the steps for the chia seeds for digestive relief and then finally was not, was told not to take anything that swells in my gut because I've, I had weight loss surgery, three two weight loss surgeries.
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So Metamucil is prohibited. Should I try chia chia seeds? Okay, so let's start by saying yes. Chia seeds go in one and they come out the other, especially when you swallow them dry and you're doing this to expand your, your the, the stretch factor of a bowel. Constipation on the ketogenic diet really wrecks people's momentum. It's for this reason that we deal with this on day four. I'm saying the poop train will knock you right off if you don't have a plan. So that plan can be something as simple as chia seeds, which are cheap, easy, safe, pretty cheap cheesy, safe, and they don't cause a glucose response. Unlike things like Metamucil where sometimes they put in Stevia with it or they make it taste sweet or or even just to look at a fiber that you're not supposed to be able to absorb, but then to watch what it does to their sugars are there insulin is, it doesn't make sense.
There was lots of talk about the Epsom salt baths and I pushed you to say, oh for one of these floats, it really changes how you see it. First of all, you see vacation cause it really is a vacation hour. But looking at the way magnesium goes into your system and really stays there is a powerful change when you look at the heart pounding that happens after an Epsom salt bath. That influx of magnesium does change how your heart conducts. But also if you were in a nice warm bath, you are a vasodilator, which means that your blood vessels are nice and wide open. You go to stand up and your heart can really pound when you stand up. Not bad. This is normal. This happens to every, almost everybody after an epsom salt bath. Just know that this is a shift of chemistry that's happened in your system. It is the real deal. You are adding magnesium to your body when you're in that epsom salt bath. I contend that the best sign that you're not super low on magnesium is you have one of your absence. I'm talking about the float spas. They go in for a float spa and they sleep well, but they don't have the palpitations. They don't have some of the other things that happen when adding magnesium to their system.
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<div id="No19">'''Question 19'''</div>
Something's missing from this. Why does, why do my patients show me that when I use chia seeds to expand their bowel again, goes in one eye and comes out the other, but in the process stretches that bowel so that they don't go from, you know, 80 to you know, 150 carbs a day, which is really full of fiber and stretching that colon to less than 20 a day, at which point their stretch factor is almost absent. And when that happens, the shutdown the bowels and they are saying, this diet is not for me. I can't stand it. I have to poop from the day we wake up in the day we're born to the day we die. You have to manage that. When the stools don't work right, you will, will siphon all of their attention. So the chia seed protocol is meant to help people prevent that fiber or prevent that.
19. Does absorbing abundant magnesium during a bath or float have the same laxative effect? Why or why not
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Constipation. And as your bowels get used to not having such a, such a difficult a waste product to squeeze through fiber, you have to squeeze really hard. It does cause quite a rumble when you, when you, when you have to squeeze it through as you transition to a high fat diet the first of all, the inflammation on the inside of that gut gets less and less and less and less so by at least six weeks. If you took a, you can't really biopsy a slime layer, but if you took a sample of the slime layer that lines the inside of the stool inside of the colon, as the stool passes by, it grows stronger and thicker and more resilient. And that helps to slide those stools along. So that is a healthy gut. A healthy gut has a good slime layer.
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It doesn't eat a lot of fiber to move poop from one end to the other. But we need to get you from here to there. So she has seeds start out with, I need you to explain in your your colon to the point where you have a bowel movement. So that's where to kind of reset. What this protocol is, is you swallow a tablespoon of chia seeds every hour. I think when you're swallowing, you kind of have to chew them a little bit and then drink the water. You'd love to get at least a cup of water for every tablespoon you swallow when that a tablespoon. So let's say you take 10 tablespoons on day four cause you haven't pooped and you go to bed with a little rumbling tummy. I would tell you to take a swig of Malcolm magnesium before you go to bed, to you get up the next morning and you see you have five more tablespoons of chia seeds before you finally have a bowel movement.
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And then so that bowel movement, it took what I say 15 tablespoons of chia seeds to stretch your colon enough to finally give it the, the signal for those nerves to squeeze and move that stool along. So now we have things moving. If you drop back to nose chia seeds right away, you're going back into the same problem. I need you to step down. But instead of chewing on those things and flossing every hour, you can kind of put like half of the chia seeds in the morning and half of the chia seeds at noon to him up swallow them down and then floss your teeth cause they get stuffed between the teeth. But that's the dose that you need for your bowels to stretch and move them along. And you do that for three or four days just to kind of settle down and kind of relieve the anxiety that you're balls are going to be okay.
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And then you start stepping down one tablespoon at a time to decrease the chia seeds. You shouldn't be on chia seeds for the rest of your life. No, your bowel will get used to this. But finding an antidote that is not got a high glycemic index, that's not going to ruin our chemistry set that we're working on on the inside of your body, but that relieves them from that constipation. Because if you look at the number one reason people leave Keto, okay, well actually in my clinic, the number one reason is they couldn't find an antidote for their bowels is why I was so heavily educated in this week. What are the ways you can make those bowels move? As for the gal who had the weight loss surgery your bowel also needs to move along. If you end up on the ketogenic diet, you just, you don't have to automatically use chia seeds. But if you're on the ketogenic diet and you have you have no, you have constipation. Chia seeds are an excellent antidote. Even if you've had that surgery, the reason they told you not to Sue, not to take in things that swell your gut is the anatomy is different.
So it does not have the same laxative effect. It is the lax of effect of magnesium is the salt within the bowel. When you swallow it , it attracts, especially when you swallow a big glob at a time, it pulls in fluid and then the salt is a salt. It flushes the salts. It's a great laxative. But adding magnesium to your circulation is not a laxative. It's just a mineral. Okay, so alternative to baths. I was showing somebody was saying they just don't have access to that. So this is where the float spas really good idea. My 76 year old dad, now he's on dialysis and that would not work for him. But prior to dialysis he would go get in a float spa and do a float a couple of times a month, maybe two times a month.
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You're going to find that a lifelong use of guts, swelling foods is not going to be comfortable for somebody who's had that surgery, but it still can transition you through to get your balls to move along on their own. And the longer you stay high fat, low carb, the less inflammation, the better your, the less effort it will take from your bowel to move the stools along. And that is the real wind that we had this conversation in our group this morning, that when people have poop problems at the beginning, and then they've been keto for awhile, they fall off the wagon, back comes the troubles with their stools, and then they go, they're back on the Keto. They returned to Keto again. They're like, Oh, I forgot how easy it is to poop. You know, when my bowels work well, I have like baby poop that isn't, you know, super pigment and smelly.
Just looking at replacing that magnesium at a level that was predictable, and felt good. He doesn't have a bath that he hates bathrooms. So that was how he did that. Other ways of doing it include like you have whenever I'm doing writing at my desk at home, I have this garbage bin, this plastic garbage bin, and it's filled like four inches from the top with water. I think I have like surge pounds of magnesium in there. And then I grew up on a farm and there was such a thing as a cow tank heater. Now you can buy them in South Dakota. But my friend in Texas says, I've gotten a forecast of Gambell supply and I can't find them anywhere, but it's a heater that you put inside  a cow tank in the wintertime so it doesn't freeze over, but it's an awesome source of heat that keeps the water warm.
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And it also, it is a small volume of waste that ends up at the other end, not this really heavy cramping of of your bowel to get the waste out. I know that's a lot of poop talk, but it's really important to understand that this goes away. And if you read some of the carnivore literature or even just kind of the chats in carnival where they really have taken it down to you know, no fiber and they, they're really super high fat you'll find that one of the coolest parts is there. They poop every couple of days. Again, three poops a day to once every three days is the spectrum of pretty normal. But I've seen people on a, on a high fat diet, they poop once a week. It's not uncomfortable. They don't cramp. They have no malnourishment.
What I will do is I'll put the heater in my water of epsom salt and then I'll heat up the water nice and hot. Then you take the heater out before you put your feet in it, you'll electrocute yourself. Don't do that anyway. You heat the water up and you then have nice warm water for my feet with lots of epsom salt so I can sit there and do that cycle about six times if I'm writing for a day. I love the energy I get from the magnesium, but I also just like it's calming and it's another way to get some salt. The problem with that is the equation for absorbing magnesium is how much area of your skin is touching the water. If your water is only this full, you're going to have to put your feet in there for 60 days or something to get the same as you would in one hour of being in a full spa.
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Their bowels are, are perfectly fine. If you start, if you could tell somebody that on day one, they'll go like, I can't, I can't deal with not to being everyday. All right, so here's another great question.
Just really keep that in mind as you look at the benefit of looking for a float spa, everything in the country seems to be opening up again. That would be an awesome place for you to try, a full spa.
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<div id="No19">'''Question 19'''</div>
19. If we overeat, do we just restart at day 1?
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<div id="No20">'''Question 20'''</div>
<div id="No20">'''Question 20'''</div>
20. When I slip up, like today
20. Can sleep apnea really go away with keto, or will a person always need the c-pap?
If we overeat, do we just restart on day one with poor sleep, bad choices? Another person asked almost the same question when I slip up like today, got tired. Poor decisions. Do I restart a day? One protocol. Again, we want you it depends on how long you've been at it. If you're in the first week or maybe the first two weeks and you really never got to fat adapted, you really never started. But ketogenic rhythm, then I would say yes, go back to 20 carbohydrates a day. Total carbohydrates is what you care about. Stick to that for at least those first five days.
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Really giving your body the reset of the chemistry. If you've been on keto continuum for a while and you've been let's say 23 and one and you fall off the keto wagon down to two meals a day, but it didn't have ketogenic meals, then I would flip back. It depends on, so it just depends on how long you were keto before you fell off. We know that when you're keto adapted, like in my case, I'm S I'm years into this game. If I end up, I dunno, on a cruise ship and all they serve was carbs and I ate carbs for three or four days, I would fall back into my normal life and I would do 20 carbohydrates or less. I would probably supplement with BHB for a day or so to, to rapidly switch my chemistry back to a highly ketogenic state.
Yes. I have so many patients who have given their C-PAP back to the universe. They are truly off of sleep apnea. Number one predictor of sleep apnea is what is the circumference around your neck? 17 inches. Next for the conference is a huge difference between what that cutoff 17 is really important. Have you lost weight? Measuring to see if you have a 17 inch neck. This was actually the case for people who were like NFL bodybuilders, linemen, if their neck size was 17 or more, the chances they have sleep apnea is much higher. Once you lose weight, just like you lose weight in your fingers, you also lose it in your neck. That decreased neck circumference does decrease sleep apnea.
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And because I have the presence of the healthy fat-based hormones it's going to take me a couple of days to switch all the chemistry back. But that's because I've got a couple of years of stable chemistry in my back pocket in my, my body. So the slip-up in general, go back to 20 total carbohydrates a day. Do that for at least five days straight. See how you feel at the end of five days. And most people will see that, Oh, this is a lot harder to do than I thought. Stay the course and then work your way through the steps. It probably won't take you as long to do the steps. And we'd like to think that because your key to adapted, you won't have you won't have the struggles that others have had. When it comes to like magnesium and keto flu and those types of things, your body is much less inflamed.
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At least that's what we hope.
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<div id="No21">'''Question 21'''</div>
<div id="No21">'''Question 21'''</div>
21. Other than morning fasted state, what times of day do you recommend checking BG/K? - 131
21. Do you recommend staying under a certain carb level at each meal? I heard that eating over 7 g of carbs at a meal could spike insulin?
Other than morning fastest state, what's the best times you recommend checking a blood ketone ratio? That's a great question. For somebody who not in week one, we're just to compete on strips. I, we'll get to that question next week.  
 
Yes, you're going to see this ketoCONTINUUM as you work through it right now at the end of module three, you should be trying to reach for two meals per day. The reason is that every time you eat you spark insulin. If you're a hyper insulin maker, if you've already got insulin resistance, every time you have a bite of that food, you make insulin. Even if you only have one bite, the insulin spike has a minimum peak. When people say, I'm all mad, but I have a handful of carbs or a handful of nuts at bedtime and I have cream in my coffee, both of those spike your insulin. If you're trying to repair, I need you to stop doing that and you're gonna learn about that next week.
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<div id="No22">'''Question 22'''</div>
<div id="No22">'''Question 22'''</div>
22. What medications interfere with ketone production? +99
22. Please explain why you might stall with weight loss after being keto/lchf for over a year? Is it metabolism? Is it hormonal?
What medications interfere with ketone production? Good question. Okay. Steroids. Steroids are the number one steroids and insulin both are your enemies when it comes to how do you make ketones. When you produce when you take prednisone or any type of steroid even the inhaled steroids, if you're checking a glucose, you can, you can see the glucose rise. It's supposed to have a very low absorption rate into the system. But I will tell you, patients show me their blood sugars after taking their inhaler and by golly, it's a glucose spike.
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So if you have the ability to watch that, it's a, it's a great teachable moment to say the healthier your body, the less you'll need those steroids. We do have to get that inflammation out of your body to graduate to that. This is why following 20 carbohydrates or less, stay the course high fat, don't look at protein, don't look at calories, don't look at anything except total carbs in that first phase of becoming keto adapted. When it comes to those who are injecting insulin, that's a unique situation that again, you should have a doctor helping you with this, especially if you're a type one diabetic. And the improvements, you'll read more improvements than anybody else on the list. If you're injecting insulin and you're to use the ketogenic diet, you, you, you win. If you can do that, you win. But you really should have your doctor helping me.
You're gonna learn that next week.  I wanted to make sure to address the gastric bypass story and just say that's a really tough case. That's why the course was created. You got to know the basics in order to get you to the higher chapters.
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<div id="No23">'''Question 23'''</div>
<div id="No23">'''Question 23'''</div>
23. Can you have too much protein?- 136
23. Why is the scale not moving?
It should be answered by how, okay, can you have too much protein? How do we calculate the max protein? So what, what I was trying to have a Spencer show you there was when you fill in how many kilograms of lean body mass. So that's your ideal ball body weight in kilograms. So if you have pounds, you divide pounds by 2.2 to get you to the kilograms. So now you have how many kilograms in body weight is your ideal weight? And the answer is D is the number of so hold on, let me just show you something. I want to share a different screen. So I think I have to stop sharing and then share the screen too.
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This one? Yes, sure. Got it. Okay. So here is a BMI chart and I put that on a day seven, a handout to point 10. And so here is the weight in, in pounds here. And here's the weight in kilograms here. So if you just start by looking at your height and I'm a shorty at five, three, if I'm standing real tall Oh, screen 20 23, BMI, 22 BMI. I always calculate my ideal body weight is 125. So that is a body mass or a a, a BMI of 22. So looking at body mass index, all people have a huge like, Oh, it doesn't, doesn't take into the fact that I'm big boned. I'm like, I know every one of my overweight patients tell me they're big bone. But it's a pretty good generalization. When you look at the body mass index of 22 and you say, well, how many kilograms is that?
I think I've talked about that. You've gotta be able to challenge your metabolism. We're going to go through some stresses this week. We're going to have some real stresses in the bonus video.
Video Time Stamp: (01:07:27):
 
56.8. That's how many grams of protein I would recommend in somebody my height at five foot three. So you take 22, because your body mass index, so you find your height here. So if you're five, eight and you go to 22 and you say, okay, what is my ideal body weight? It's 145 pounds, which is 60, almost 66 kilograms. That would be 66 grams of protein is going to be the right amount of protein. Or at least that's going to keep you from overshooting or doing the glucose response. That can be pretty annoying. When people are trying to use a ketogenic diet to lose weight.
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<div id="No24">'''Question 24'''</div>
<div id="No24">'''Question 24'''</div>
24. Can we actually balance hormones with no thyroid, no ovaries, no uterus , no gallbladder
24. Why is sugar not dropping
 
Your insulin resistant to fix insulin resistant? You're going to follow the videos in the next week?
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<div id="No25">'''Question 25'''</div>
<div id="No25">'''Question 25'''</div>
25. I have gastric sleeve and no gallbladder so constipation is not the issue it's the opposite.
25. Smoothies
I have a gastric sleeve. No gallbladder. Okay.
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I have a gastric sleeve and no gallbladder. So constipation is not the issue here. It's the opposite. Again, this group of people is the most important. I put this on here and I wanted to make sure I got to this question before I went over to the other side of your live questions. Tracking poop is or any having loose stools is a huge, huge warning sign that you're not absorbing fat. When you look at fat malabsorption they are the most depleted brains that I've seen. You know, looking at when, when the fat cannot be absorbed and it's all pooped out into the toilet. Some of the other signals that they show are they don't, they can't get the poop to flush down the toilet. Those, it sounds really weird, it's hard to talk about this, but it is a very powerful antidote for nutrition in when you cannot absorb fat.
Video Time Stamp: (01:09:22):


One of the other major markers that shows me they're having fat malabsorption is that their vitamin D, which is a fat-based hormone, they cannot get it to go higher and it's been low for years. Whenever they eat fat, they have explosive diarrhea. Again, they are the ones that need to stay the course more than anybody. And I write about that in my, in my book. Any way you can, that if anybody needs to stay the course, it's the people with chronic diarrhea. So go back to the chapter of the book and we read that. Super important.  
I think don't do that. Don't do smoothies. I don't know. I think of particle size, I think of what are you putting in a smoothie? How do you have a smoothie without carbs? If you have high fat in your smoothie and water? Okay. But that's probably not very tasty. What can you possibly put in a smoothie besides protein powder? Well, why wouldn't you just eat the protein? The satiation or satisfaction from food is about the mastication, which means chewing part. You skip that with a smoothie. Don't do that. I wouldn't do that.
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<div id="No26">'''Question 26'''</div>
<div id="No26">'''Question 26'''</div>
26. Recommendations on magnesium supplement (pill) dosage and brand?
26. Snacks? When to add? Before or after a meal?
 
What are you doing every time you put a snack in? You add insulin. If you're trying to reduce insulin, quit stimulating insulin.
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<div id="No27">'''Question 27'''</div>
<div id="No27">'''Question 27'''</div>
27. Is it possible to overdose on magnesium?
27. How many snacks while fasting? On and on and on
All right, let's quickly cover magnesium because that is the, the focus of this week as well. So I think there are, yeah, I put all the magnesium ones in. A couple of questions here. Recommendations on magnesium, supplements, pill, those brands. Do you offer magnesium and supplements and then is it possible to overdose some magnesium?
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Can a lot of magnesium cause long term damage? I need a bunch. Okay, so this is a really important conversation. So I went through and dedicated a whole day to magnesium because of how many people suffer from the low magnesium can, what it does to sabotage people who are not who are low on magnesium. When you when you look in medicine and there are thousands of answers for a problem, it teaches the physician, it teaches the provider that we don't have a good answer, that when there is a simple tried, tested, true answer in medicine, there are like two or three options when there are thousands, which is what happens to magnesium. The reason there are thousands is none of them are great when it comes to magnesium. The key component is don't leak it out your leaky gut. Okay? You can't that until we take away the inflammation.
No. No, no.
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<div id="No28">Question 28</div>
So when you're keto adapted and you're two to three years into this, you're going to be doing fine. But in the meantime, how do we stop those muscle cramps? People say I need to have, you know, these high doses of magnesium in order to prevent the muscle cramps. And what I keep saying to them is quit focusing on how much you need to put in. I mean you keep doing that cause otherwise you're going to have muscle cramps. Focus why you're leaking out so much magnesium. When we look at magnesium in in the best replacement, if I want, if I am just bent to make sure you replace the magnesium, the most aggressive approach I can take is to put an IV in your vein and drip it into your system. And if you look at a cramping uterus trying to squeeze a baby out when it shouldn't go out, we will shut off that cramping with a magnesium drip.
28. I have gained weight on the way to changing my body chemistry. What happened? Maybe all the whipped cream. How do I help myself against stubborn insulin resistant liver?
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And that little lady will go on bedrest with a magnesium drip in the hospital bed for a couple of days. Everything calms down. We send her home and you'll make it a couple more days, maybe four days before the magnesium. Now is his login. And it's because it leaks right out her gut too. When magnesium is well conserved, it's a not, it's a low inflammation in the body, so to say. Can you overdose on magnesium is re it's, I, I've never heard of that. Magnesium toxicity really hard. Your kidney will get rid of a ton of it and if you've got any kind of inflammation, it leaks right out the gut faster and we can pour it in. And that same response, they say, well, what do you, would you take it orally? If you will look at oral replacement of magnesium, you put in the big slug, it will cause diarrhea.
It's a really powerful teaching point and it definitely belongs right here in module three. When you look at the first two weeks I think back to when my mom had, again, I didn't know nearly what I know now about keto. We just were doing high fat, low carb. That's all we knew. We knew that she had one shot. And we couldn't screw this up.
Video Time Stamp: (01:12:56):


It is a salt, it is a laxative. The reason they'll go, magnesium is at the seven 11 store under the constipation under the laxative aisle is because you put in a bunch of magnesium and it comes out the other end to take milk of magnesium and add a capful to your water so that you're drinking a small amount of it over time. That's a great way to replace magnesium. As much as you add solely water to your coffee, add a tiny amount of milk of magnesia. And what you're doing is really adding magnesium. Now you'll have all kinds of people are you usually have this kind of magnesium. You should have slow man, you should have this mate. And I'm saying, yep, there's lots of arguments out there. And after reading hon, dozens of papers on what's the best way to replace magnesium, the answer is stop leaking it out your gut.
We didn't lose any weight, but oh my goodness, did we feel better? As you are going from a sign of really insulin resistance, meaning the body is holding onto a bunch of water, the body is definitely not in its healthiest version, but you are switching chemistry. I just need you to know with my whole heart, I need you to stay the course. That process of changing chemistry has to happen for you to arrive at the other side and then journey through the improvements that are found in your chemistry. I have a great example of a gal in our keto group who, oh my goodness, if you could find somebody who tries harder, I don't know how you'd do it. She injects insulin. She's been insulin resistant for awhile. She loves herself with carbohydrates or she has for most of her life.
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That's the number one long term answer for magnesium. When I tell patients how are we going to get you through these next couple of weeks, I will tell them to five of those magnesium floats in seven days and watch what happens. It's like getting an IV of magnesium is those five days of magnesium floats. They are, first of all, they're amazing and relaxing. The first one can be a little tough cause it's like the first time you like pray or meditate sloped off too. But you shut off all the noise in the world and you start looking at magnesium supplements or you know, magnesium infusion in that bath water and a lot of things get better. So I'll often say to patients, do five and seven days and you're going to find an improvement that outweighs almost all of I mean even the cost of doing five of those magnesium floats is way cheaper than replacing magnesium for six weeks.
Now she's been coming to the keto group and she's really trying to address this. I think she's stuck at a stable, like we've told her, stop stepping on the scale. Whatever the scale is going to do doesn't matter right now. I need your chemistry to change because it guarantees that you're going to get better. Once the chemistry changes, the weight will come off. It is a chemistry, it is a chemistry effect that is a consequence of arriving over this hurdle. Your stubborn liver took years to get this back. It's going to take us maybe a few weeks in your case. It has everything to do with how could you keep the blinders on. Could you look only at total carbs, stay with total carbs, don't look at anything else. When you do that, the chemistry does change.
Video Time Stamp: (01:14:42):


And then looking at, you didn't hardly make a difference because you put in too much, you pooped up most of it. The magnesium supplement you had couldn't be broken down by your gastric lining because you don't have any, you know, closest to, you didn't have any bio. You know, it's interesting how many things can go wrong with magnesium. And the reason I keep saying go to Milk of magnesium, you can't screw that one up unless you gulp it. So just add a tablespoon to the water. It's cheap, easy, safe and accessible. All right, so let's just I'm going to go to the ones where I really wanted to make sure I answered. If I am reading 1.5 ketones in the morning do I need to take BHB? I so I'm going to guess if this is from a pee tone stick is the way it reason they're saying that.
If the scale is going up, just don't look, do not look at that. I mean I talk about it there. The most I would have somebody check is weighing once a week. Sometimes stepping on a scale is this kind of therapy. So I put it in one of the challenges at the end of, I don't know if it was week two or week three, where I just finally let them step on the bank scale cause they're like, I want to know if I've lost weight. I'm like, I don't care. There's so much more to this than the weight loss, that chemistry becomes the goal. Once you have that, you'll be amazed. You'll be, why didn't somebody tell me it was so stinking easy to lose weight? It's because the threshold you're about to go over. It involves trust. I would contend there are many people in the circle of trust in medicine that we blew it.  
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<div id="No28">Question 28</div>
28. If I am reading .5 - 1.5 ketones in the morning do I take the BHB capsules?
So it means you're peeing ketones don't, don't add ketones if you've already making them save the B BHB capsules for a time where you're having trouble when there are no ketones in your urine and you don't feel well. I mean the supplements are expensive and it's a great trick. It's awesome. But save it for when you need it. Do you have ketones in your urine? It means you don't have a, you don't need to take them. Your liver is making about 500 times as much as is in those capsules. So, okay.
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<div id="No29">'''Question 29'''</div>
<div id="No29">'''Question 29'''</div>
29. I’ve noticed that a lot of us slip off keto after 17 or 18 months. Do you think it is a mental issue over physical issue?
29. Science based impact of sweeteners, stevia, erythritol, monk fruit on ketones and glucose. There is quite a evidence of literature out there where they put it. I see how that dana green, or erythritol four grams of carbs per teaspoon. And I need at least three for coffee. I don't count those carbs. A friend said that type doesn't count, but I'm using nothing because it's a waste of four carbs to me.
Video Time Stamp: (01:28:44):
 
The point I'm making here is there's a lot of ways to manipulate the counting of things in the ketogenic diet. These sugars are a blessing. Before these we really did have to say no sweeteners, stevia, monk fruit and erythritol actually are pretty good at keeping those sugars low. But I'm hedging here because I don't look at any of those. I don't put any of those in my diet anymore because of what happens to the palette. This is another reason why I don't write food plans. I want you getting rid of that sweet taste. I want you having a sweetener in your body once a year, once a year for your birthday. I mean, like really rarely. It should be a treat that is truly a treat, not an everyday treat. Now I didn't start out that way. I started out using erythritol and stevia and I was very used to having sweet land on my tongue. Now it's a rare treat and the difference really is it does provide a lot more pleasure when I do have it.
 
But the bigger goal for having the sweeteners is less, less, less, less, less. That's why you see me doing things like I need you to drink something with nothing sweet in it. Get your tongue used to tasting what it looks like. They have no sweeteners in it. And then knowing that yes, there are, and if you saw on the cronometer app, he said you could see those sugar alcohols. That's things like erythritol. I think once there is sugar alcohol keep in mind that I use sugar alcohols in my clinic to help you prepare for a colonoscopy. They go in one end, they suck in a bunch of water to your gut and they flush out the other end. And we let me put a scope up the bottom. It's the cleanest ball we've ever seen. That is what sugar alcohols do.
 
They are a laxative, so they're not good for you. They're not the best thing I would be putting in your body. They are a bridge that can be used in a time of a craving and they are easy to love. If you're using them, that's where I say then get scientific. You want a science-based answer, then use science not for a population, which is what every one of these studies is done on, and so you'll say the erythritol people are going to study what arithmetic does and bodies. Guess who they select to study. They look at healthy, lean people using erythritol. They don't look at insulin resistant people. They don't look at people with a high fatty liver. They look at the perfect people and their study comes out to say, look at how little insulin we simulated. This is a great sugar alcohol and I'm like, party fall.
 
That is not who I'm taking care of here. Wean healthy people don't use a lot of stevia. They don't use a lot of erythritol or if they do good for them, it's not affecting them. The ones I'm trying to rescue from the edge of the cliff are the people just like that woman I was saying, she has been in our keto group trying to change behavior for the better part of a year. As she started out just rescuing from all of the different ways that you can change and eat carbohydrates. She is addicted to these things and she'll put in like six packs in her morning coffee. And I'm like, what? How do you not have diarrhea all day? It's because her body has really grown used to it. I said, all right, here's what you can do.
 
If you want to see what that does in your body, wake up tomorrow morning and check your morning fasting glucose. Okay. And then take one of those packs, dissolve it in a little bit of water and drink one and then set the timer and check your sugar at 30 minutes at 45 minutes and an hour, 30 and 60 minutes is really enough. And what you'll see is if you do, especially ketones and glucose, it's really looking at your insulin. If you only have a glucose monitor, then checking the glucose is another way to say did it give you an insulin search? Did it give you a glucose search? Cause if you're a google search, then your insulin searched. The best way to measure it is to look at the ketone glucose at the same time. It's to say what did it do to your body?
 
Because unlike a population study where you can google and say, I have evidence that shows me what it does. Yeah. Did that population they were studying look like you. I mean on the inside, did it have an inflamed liver? Did it have high insulin? Did it have an addiction to those sugars? And if that's the case, then you can make some conclusions that match you. Most often they did not look like you.
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<div id="No30">'''Question 30'''</div>
<div id="No30">'''Question 30'''</div>
30. Can you burn your own fat when taking BHB? 
30. Is it true if you drink apple cider vinegar with water before bed will help you lower the dawn effect?
Video Time Stamp: (01:32:42):
 
What is Apple cider vinegar? It's a fermented drink now. I showed you the little pH monitor that I use when I do my kombucha because kombucha at the store has a lot of sugar in it. But if you make your own kombucha, you ferment your own tea with sugar in it, that fermentation decreases the sugar content and you'll know by looking at the pH.  The more acidic the pH, the less sugar in it. Apple cider vinegar is one of those fermented sugars that tastes not so bad. But if it tastes pretty good, it's probably cause it's got some sugar in it.  What they're doing is they're shifting your pH. I'm like, okay, that doesn't hurt you. But that's just a trick. It's not really fixing the problem. You shouldn't be having anything.
 
If you've got the dawn effect, the most important time for you to have nothing in your mouth. That includes gum, that includes tea, coffee, all of the above. The only thing you should be putting in your mouth for 12 hours before the sun rises is water. And if you still have the dawn effect, then we'll go 13 hours before the sun rises and then go 14 hours. So if you're saying at bedtime, which I'm guessing is when it's dark out, you're putting in cider vinegar, it's stimulating your insulin. It's stimulating an effect, I wouldn't do that. But lots of people do it, put it during the day if you want, but make sure you check the pH of it.
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<div id="No31">'''Question 31'''</div>
<div id="No31">'''Question 31'''</div>
31. Does taking the BHB capsules cause false ketone readings? Am I really burning fat with these inflated higher readings?
31. How a  person can have high glucose readings in the morning and also have high ketone levels.  
I noticed that a lot of us slip off ketone for 18 months. I saw that too. I'm not going to handle that one right now.  
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Can you burn your own fat when you take BHB? Okay, this was another one I want to make sure again when you look at BHB, it is ketones, right?
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So ketones aren't just a fuel. Okay? You take fat, you break it down when the chemistry is right. And again, that's why it's so important to do not look around this first week, 20 carbohydrates total. That's it. Don't look around. That's the only thing you look at when you get the chemistry right. You'll make more ketones in your liver than you could ever supplement. But if you're having a tough moment and you take BHB, I mean, I've had bad moments. I've had, you know, I, I, I used the example of a glass of wine, which makes me sound like I have a glass of wine a lot. I don't, but when I do, I feel it. I'm swollen. I don't like how it feels. I brain's flows down and I'm like the glass of wine, it wasn't that good. I don't like what it did to my brain.
Yielding a good Dr. Boz  ratio or yielding a high Dr. Boz ratio, example is a glucose of 137 and ketones of 2.9. When you're looking at the insulin effect, and you're going to learn a lot about this in the fasting video. As you had a rise in sugar, it didn't happen yesterday. It happened for the last 10 years, let's just say 10 years. And the first year you had enough insulin that it kept your sugar down and the next year your sugar was still normal, but it was even more insulin to keep it down. And then the third year it was this pile of insulin.
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So if I want to undo that quickly, I just pour in some ketones. And ketones are a signal. They are like hormonal not like they are, they, they signal the different to the body. So once ketones are in circulation, not only is that better for my brain, my brain prefers to use ketones because I've been in ketosis for so long. But it also signals the liver that there's ketones around. So you should be making more ketones like ketones get ketones. That's why when people are in that 200 club, and I send them back to say sip on ketones, sip on ketones it is a beautiful moment where they start to trickle in ketones and and then their body starts to make them the ability to use a ketone is shut off in an insulin resistant patient. And somebody who's got been overweight for a long time just by dripping in the ketones a little bit.
To have a blood sugar in the morning at 137, despite producing ketones, says you've done some amazing things in the last six months. You've got ketones producing, which means your body's chemistry has shifted from yesterday, has shifted from last week. So when you're looking at ketone production, when people say, I have this ketone, that's 0.5, why isn't it higher? I've been doing keto, I'm doing everything right. I'm like, your insulin is stable, your insulin is as it should be. If you want to lose more weight, you have to lower the insulin, which means you gotta stress the metabolism. Stressing the metabolism is how to enhance the keto effect.  What this is saying is stay in the course. You've made such a huge headway. If you stay the course for a year, you're going to be amazing.
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They change the chemistry. And that's why if you're struggling, Oh my goodness, I've learned so much about the people who's truly, truly struggle to get through this first week. And I tell them, stop timeout. Just take a break and get the ketones in a can and sip on them for a week and then try again. Watch what happens. And it is brilliant. It is amazing how much better they do now in that time where they're sipping ketones. If you can give up the white stuff and not have any sugar in your drinks that makes it a lot easier to all right, so does taking ketones give a false reading? Give a false ketone reading. Okay. So, okay, I'm going to take this two, two ways. So false reading. If you pee on a stick after taking BHB any of the ketones in a can or ketones in a capsule, it should turn the, stick, excuse me, positive.
That lowering of the glucose is a sign that you are decreasing the stubbornness of your liver. You're emptying your liver, the insulin effect is growing better when the glucose is still high, it's still coming out of storage that you've been storing for years, waiting for this time where there's no food. And I would contend that if you have that high of ketones, that you could probably benefit from a lot of the fasting cycle that we're going to talk about in two weeks because you have plenty of fuel. You just need to give your body time to burn it. And that isn't easy, but it's possible.
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<div id="No32">'''Question 32'''</div>
32. Is it possible to have too much salt? I have a lower limb swelling and I've only previously had the pregnancy.
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I should turn the stick positive. Though that means ketones were in your circulation. Your mitochondria throughout your body had the opportunity to Mmm. To use those ketones, but either didn't know how to do it quickly enough. Meaning it's not keto adapted. You're really not used to using ketones. And after awhile your kidneys just say, okay, let's get rid of this. We're not gonna use it. But they actually were in circulation. They came into your blood, they circulated for a while, and then you put them in your urine. Now when they were in circulation, they did something, they signaled to your body, Hey, wake up here. And especially those people that are struggling, that is a huge improvement in how long, okay. It takes them to get through this pickup, this difficult time. But when you're talking about blood, ketones, blood ketones you have an art and an S isomer, the blood ketone meter only measures one of those.
You can overdo it. But what I would really contend is in a healthy system your kidneys should flush all that out. Now, I mean, I still get swelling when I have too much salt. So you can overdo it, but it is the rarity. The rarity is to overdo it. Here’s a couple of things that I would do if just to test the salt. Criteria is if you think you're having too much salt, I would Google float spa and go in and soak in, magnesium, salt, float spa. Now, I should say this with the caveat, but heart failure, high blood pressure, diabetes, where you're taking several medications, probably should talk to your doctor before doing any of that.
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Now it is the more active one. It is the one most likely found in the, or if I'm in more abundance, if you would in those ketone salts. So I don't want to say it's false because it's there, it's in your blood, it's measuring it. And your cells don't know the difference between the ketones that your liver made versus the ones that are circulation. So false isn't the right word, but I understand what you're asking. No, that there's more to the chemistry shift. Especially as you ignite or as you rescue out of the ditch, ketones in the supplement form are not forever, but they are absolutely. How do you stay the course for not like white knuckling this? I mean, I've been taking care of addiction for long enough to know that when you give up alcohol in their white knuckling just to try and not, not use alcohol, but they're crabby and they're irritable and they're not at peace with who they are, they're about to relapse or they're going to have no friends or family left by the end of the year.
But if you're just like the normal trying to lose weight and you're saying, I want a lot of salt in, I've had these babies and that gave me some swelling in the ankles. What it's saying is the nourishment is not probably as hard as you think it is. Salt should be delivered to the kidney and the kidney should flush it out and the kidney can handle a lot of salt. So if there's a mismatch, if there's an equation where you're storing that extra fluid I would look carefully at going for a walk that really stimulates the muscles in those legs to pump. I don't promote exercise the first at least six weeks. I really want you focused on changing the food behavior. But if you've got some of that swelling and say, well, how can I undo this? I would push you to go for a little walk or hanging out in one of those float spas. Again, you're going to pull fluid through the skin and watch the dynamic change. I've been impressed to see what happens when they do that float spa. The other part though is if you're having that much salted liquids, you probably should be adding some liquids without salt in it. Cause it shouldn't happen. There's just as much reflection that there is an unhealthy component, meaning a healthy body wouldn't do that. And I know when I've had too much salt that there's still parts of my system from being in some resistance for probably 10 years that says, I'll look at how easy I can put that fluid back in my lower legs. Whenever I take a plane trip, it goes right back in there. So all of those are real.
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If they're saying, but I have that fake beer and I feel better even though there's no beer in it, like that's not the best choice forward. We're going to end up with a problem here. But I've had people use it for a couple of weeks and then they are able to get to the next layer. And again, it's easy to be a purist until you're in the trenches with people struggling. And I have, I contend that behavior changes. The reason I'm so adamant about this course and really giving you these this, this thorough education is because I believe you shouldn't have Keto meetings where where there's ulterior motives. You should have them for the same reason we have AA meetings, which is how do you improve the health of people? You give them the education and then you put them in a group and you say, guess what?
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They're not the only ones struggling. It is about learning from one another that this, that this is, this improves you. And I think that's the greatest gift.
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<div id="No32">'''Question 32'''</div>
32. Please talk about longer term effect on cholesterol levels especially LDL. I am eating lots of fat.
Again, cholesterol, you're getting a lot of fat. Keep eating the fat, you're lowering the cl, you're lowering your inflammation. And that's the most important part of about this. Don't, don't look at your cholesterol for six months for going keto and then I might even push you to go nine months. We'll get to cholesterol in a week is what I'm trying to tell you there. I have no ketones in the morning, but start to see ketones late morning and they build up a lot during the day. Will the Dawn Effect ever go away? This is an important thing. It is really not for our first weekers.
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<div id="No33">'''Question 33'''</div>
<div id="No33">'''Question 33'''</div>
33. I have no Ketones in morning, but start to see Ketones late morning and they build up a lot during the day. Will the Dawn Effect go away
33. After achieving the desirable Dr. Boz ratio, do you keep going? When do you stop?
Dawn Effect is a really great thing to teach.
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The Dr. Boz ratio is helpful for guiding you, saying you're on the right path, the insulin resistant is coming down. But it's expensive to check these little things too many times a day. It does help you have metrics to follow, but it's not without its own consequences of price and poking your finger. That's why you'll see when people first start out, I push them to check every morning and even like around noon if they can for the first week, if they can get me two weeks of data, you're even better.


Ask me that. Next week we're going to talk about gum coming up in the weeks ahead. So she's having a weight loss, but she's in the blood number checks. We're going to save that for future. Okay. If I take the, this is the one, the other one I wanted to make sure I got. This is the last one and I'm going to go to your live questions. Okay.
But after that, I want you checking two or three times a week and then looking, but you don't have to look every day, you're looking for trends. That means you need to check often enough that you can see what's going on. Again, looking at first thing in the morning, it gives you the least amount of variables when talking about these two metrics. When I fast, I want to know that I hit my autophagy ratio. You'll see me check several times a day when I'm fasting and then I'll stop. Part of it's price, part of it's just fingered. If I was in the perfect world, I'd probably have a catheter in my artery and I would check it every few hours. When we're doing this for protocols and we're doing this for like cancer and seizure protocols, we're checking five to six times a day and they have to keep those ratios, the Dr. Boz ratio under 40 the whole time in order to meet those metrics, it is really difficult to do. It can be very off putting people first start cause they're like, I can never eat. I'm like, no, it'll get better, but it is hard. So again, Dr. Boz ratios are just metrics to give you encouragement that you're headed in the right direction. The more strict you are, the faster you'll get better. But sometimes you push them to be too strict and they fall off the wagon cause it was too much change.
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<div id="No34">'''Question 34'''</div>
<div id="No34">'''Question 34'''</div>
34. If I was to take things slower, say 30 total carbs, would the benefits of keto still be the same but just take longer?
34. I went to bed with the best numbers. I've had blood glucose to 79, ketones a three, got up eight hours later with the worst numbers I've had a glucose of 117 and ketones a 0.7. What happened?
If I take it slower, say 30 total carbs a day with the benefit of keto, still be the same, but just take longer. And that's a great question. So first of all is 30 carbs is the best you can do. Then do it now. Make it total, so that's a good start. And then pee on a Peetone stick because then you know, for your chemistry, what I tell people 20 carbs or less is because I get 98% of the people into that carb switch.
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What was going on when your blood sugar was 79, your ketones were three, your insulin was dropped. The whole point of measuring Dr. Boz ratio is their insulin. When you lower insulin in this point keeps things in storage, specifically glycogen, you have glycogen stored in your muscle cells. You have glycogen stored in your liver cells. When that warning popped up that said, hey, it's time to wake up, the sun is rising and that ping from your brain to your liver happens. It landed on a liver that didn't have much insulin around and that hadn't happened to you in a while. Out came a whole bunch of glucose from storage. And of course when glucose goes up, ketones are like, you don't need to be produced anymore. Throughout the night, you probably use some of your ketones to keep your energy.


I get the chemistry switched at 20 carbs. I'm talking to a large audience here, but you're saying, I'm trying to like adjust this for me. Can I have an avocado? I don't know. Test your pee on stick. What is it? If it stayed ketone even if you had 25 carbs or shucks, you made it to 25, but your pee on stick was still positive. You win. That's a win. So as long as you've got that solid switch of the chemistry, then if 30 carbs is as good as you can do, praise God and move on. Good job.
That's when your glucose is 79 and you're using ketones at three and you're like, okay, most of your energy is coming from those ketones now that then as you slept, your ketones got less cause you were using them. That's what your feeling was. When the insulin hits, you will release a bunch of glycogen and you're like, oh, we don't need to produce ketones. Look at all that glucose she's got to use. It is a process of emptying that storage and that's a great example.
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<div id="No35">'''Question 35'''</div>
<div id="No35">'''Question 35'''</div>
35. Short of drinking MCT or eating butter, how do I get my fat without going over all my protein?
35. When will the hair loss stop?
Short of drinking MCT or eating butter, how do I get my fat without going over all my protein? Okay. So again, especially if you're in the first week, I really need you to not look at protein. It's, it's such a minute part of the problem. We absolutely need the key, the inflammation lower.
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We need the insulin lower. And to do that you need high fat and low carbs. So if you just look at, don't look at anything else but total carbohydrates. So let's, let's just foreshadow for if Dave's question really was during a time where he's been keto adapted and then he is saying, but the macros are not matching up and I'm overdoing it. I'm overdoing it on my protein. The question I would look at is how are you doing? Are you losing weight? Are you reaching your goals? Is your doctor Boz ratio healthy? And if that's the case, then who cares? Who cares that the protein doesn't fit into the algorithm as long as your chemistry is set? And we're going to go through that when we do the Dr Boz ratio next week on the live. So if I look at the, the best returns, you're going to just love me for this.
Hair loss is a reflection of nourishment. The reason we want you on the other side of that hormone shift is because we don't want to drop calories in trade for nourishment.
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The best returns for where to eat fat. It is brunch, burger and sardines. And I know if you've been following on YouTube, you've heard me say this again and again. Sardines, win as the answer for the high fat turn on investment for the fatty foods. Just eat the can of sardines. But you look at Bron Schweiger again, fatty liver Pate okay. Yeah, it wins dividends of meetings. I mean, what you're looking for is those are really satiating foods and they are going to be high density nutrients. You're getting a lot of fat. Yes, there's protein in them, but the fat is really high. And instead of looking at you know, butter and MCT stick with the foods that you can eat for a lifetime. I know the supplements are really helpful. But we want you graduating with a, the ability to do this life without constantly looking at the chronometer app.
And you say, well, should I take a bunch of vitamins? No. Quit leaking out your vitamins in your toilet. That means seal up your gut. Well, how do you do that? You stay keto. You stay keto for a month, for two months. That process of sealing your gut, you cannot take in as many vitamins as what most of my leaky gut or my inflamed patients are leaking out their gut in a 24 hour period. You can't keep up. That's why you're malnourished. That's why the hair falls out. No, that hair falls out in phases too. So it's a cycle. The best growth of hair happens when you're not inflamed and when you're well-nourished. So sardines and liver cover a whole bunch of nourishment issues and they're both very keto. Braunschweiger is my favorite way to eat liver.  
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The chronometer app is amazing. It teaches patients in a way that I, I wish I could go back and capture about 40 patients that really struggled because I know it would have been answered. That'd be used. A chronometer would have, they would have not failed. But the journey in life, I don't use the chronometer app much anymore. I know what I eat. I know what my ratios are. I check my numbers. I, and I teach this all day long. Now I got it. But if I did struggle or if I was let's see, I got cancer and I was taking chemotherapy, I would be on that chronometer app. I would be logging my numbers. I would be checking my night micronutrients because that's really where the answers are when, when you look at micronutrients or Mac or macros, like protein and fat.
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<div id="No36">'''Question 36'''</div>
<div id="No36">'''Question 36'''</div>
36. If you're fat adapted, my numbers don't match,
36. I failed my sleep this week. Most nights five hours, bed by 9:30, totally awake at 3:30 in the morning. It was my norm trying all the guidance and info. How long to get a sleep line?
But if you're fat adapted and you're saying, I, my numbers don't match, but don't, don't look at that. Tell me first, how do you feel? Are you losing weight? Are you chronically inflamed? And if you're struggling with one of those, we're going to get to those answers when I do basically my metabolism's coming up in the next couple of modules. Ok
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Sleep habits change slowly. But you have a price you're paying by not sleeping well. So this is definitely something where that's where I really use the sleep protocol for my patients to say, I need you to have three days of vacation and you are not leaving the house. You need to give your keys to your spouse. They need to come into the office to hear what the sleep protocol looks like. And we make you sleep for three days. We reset your sleep. I mean really make you sleep for the first two nights.
 
But it is a really hard reset. And in the process of resetting your sleep doesn't just perfectly magically go back to normal. Watch that sleep video and look at that sleep hygiene. Is there electronics in your bedroom? Do you have a stable place for your electronics outside your bedroom? When you're healthy, people say, I sleep with my phone all the time. I'm fine. Yeah, you have a healthy brain. If you are trying to repair your brain, get that electronic away from your pineal gland. That little gland inside your brain that senses light. And every time you turn that on, it wakes up your brain to a level that surges hormones that fight our ability to get you to lose weight. So bedtime routine having a stable sanctuary for sleep, following that sleep hygiene, those are all the rules you have to take care of.
 
If you say, I'm doing that doc and it sucks, I can't sleep, I'm still not doing well, then I want you to print out that it's a case for sleep and I know it's in one of the handouts. If it wasn't in week three, it's in week four. It's such an important part of sleep or of repairing people that I think I covered it twice. That is, the other part is at 3:30 in the morning, if you say, I'm done sleeping. I pushed my patients to get up. And then you do not get a nap. You can go back to bed at 9:30 that night, but you're up at 3:30 and you really cannot force the brain to fall asleep but you can't force it to keep awake.
 
So if you're awake and you're just laying in bed, that's not helping our situation, get up, go do something. And know that as you reset the sleep hygiene with all those rules, this will get better. And when sleep is better, the hormones are better. And I don't mean like estrogen and testosterone. I mean weight loss hormones like insulin and growling are better.
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<div id="No37">'''Question 37'''</div>
<div id="No37">'''Question 37'''</div>
37. How does the ketogenic diet typically affect thyroid hormones?
37. When to begin my real exercise happens in the big keto life? Can you have initial weight gain?  
My question, how does the ketogenic diet typically affect thyroid hormones? Estrogen, progesterone levels? Thank you. Okay, so again hormones are volatile. Let's take on, let's do estrogen, progesterone first and then I'll go and do thyroid in a second. So estrogen and progesterone are fat-based hormones. Just last week in my private keto group that I do at 3:00 AM Hawaii time each week on Friday morning someone was saying, you know what doc?
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I have bioidentical estrogen and progesterone. And I want to know if it's preventing me from doing, you know, from hitting the ketones. And I'm like, no. But if you think the doctor, even though it's bio identical, is going to match the needs of your body, even in a postmenopausal woman as well as your system will match it at you're wrong. We can't, the vault, the fluctuation the volatility of what happens day to date, second to second in these hormones, endocrine systems are not stable. They fluctuate and that fluctuation is normal. That's what your brain is expecting. So when the doctor puts in a prescription of an injection of a testosterone or an injection of growth hormone or you know, birth control pills they will do what? Well, birth control is laying on top of, of all of a fluctuating hormones setting.
Let's just start with when do I get to exercise? This is a broad or an answer for a broad audience where you were before matters. When I start talking about exercise on the ketogenic diet, a lot of other other people feel overwhelmed. Like, I want to keep up with everybody.
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Let's go to menopausal where there are none. And the doctors trying to put in a minimum level, it's going to be stagnant. And that baseline stable replacement is never going to be as as well delivered as a healthy body weight. So you say, well, what's it going to do to my estrogen and progesterone? And I'm saying, expect a period and I've had this happen. Okay. If you don't have a uterus, you're not going to have a period. But if you're menopausal and you're even five years into menopause, I've had them have a period. They're like, what the heck? You brought back my period. Take this away. I'm like, okay. I guess what you, you weren't supposed to go through menopause, but because of that inflammation, your system said, Hey, the supply of these fat-based hormones just isn't stable enough. It isn't reliable enough. We're shutting off.
I'm going to start exercising and I'm saying, if you haven't been exercising, do not add that now. We really need you to stabilize and get your patterns of eating controlled. You do not lose weight in the gym. You gain muscle in the gym, you not lose weight, you lose weight in the kitchen. If you're gaining weight, I really would want to know that you've got a nice solid stable pattern. Like what level of the ketoCONTINUUM are you at and how long have you been there? If you're saying, I'm at ketoONTINUUM number four, and I've been there for two weeks, I would want you to have a weight loss spend keto for a year. And like what number of the ketoCONTINUUM do you think you're on, like, do you have one meal a day? Do you check your morning fasting numbers?
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And the ovary said she aged faster than she should have. She went through menopause earlier than she should have. And for any woman who's done this, do you know that your brain acts differently? Premenopausal versus post-menopausal? Just like a guy whose testosterone gets too low, it isn't the same mental function. And so I'm a brain geek. I want your brain as healthy as possible until the day you die. And that means fat-based hormones are necessary. So when I hear other people advising a client saying, Oh, you're menopausal, your estrogen needs to be replaced. I'm like, don't do that to them. No, you need to have the supply chain of fat in steady, stable flow, which doesn't mean dirty keto doesn't mean carb cycling. It means stable delivery of fat in a way that is not inflamed. So your insulin has down, your glucose has come down and your estrogen supply and progesterone supply is now in a, in a steady stream.
She's been keto for a year. She's one meal a day. She has a Dr Boz ratio that is just over about 103 cause she has a glucose of 103 and they keep you on a 1.0. She started an upright bike and swimming laps seem to be holding the weight and not losing right now.
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And that doesn't mean every weekend you get carbs cycling. It means you are keto for six months and watch what happens to those hormones. When it comes to the thyroid hormone, again, almost all fibroid problems arise because of chronic inflammation. I'm not going to take away that chronic inflammation tomorrow. If, if you've had an ablation of your thyroid, you're not going to find thyroid coming out of ketones. You're, you're going to find a thyroid that functions better, okay? As long as you have an ablated, as long as the radiation didn't take it away, you're going to find a fibroid that functions better when you're not inflamed. Well, thyroids are this weird little organ in your neck. There's yes, there's a blood supply to them, but it's not like your brain or your heart where it's got this really or your lungs, but it's got this really massive blood supply.
Still want to lose about 20 more pounds. She really wants to add exercise. How long has your sugar been that high? My glucose levels have always been higher. My goal for the whole year cause I've got keto adapted or I should say my ketones can range anywhere from 0.5 up to 3 and my glucose levels, fasting never are below a hundred yet. Now if I take my blood glucose levels later in the day, I can get them down to, I think the lowest I've ever gotten so far is 82.
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It's got a trickle of a blood supply and it does just fine, but also so it means it takes a while to get inflamed. But if once you reset the chemistry to a lower inflammatory state, it's going to take awhile for your thyroid to feel the difference. So when I look at thyroid processes, while they're on a ketogenic diet, I see the need for thyroid hormone reduced more and more and more. The less inflamed they are. That uric acid I talked about earlier as the uric acid, which is a stable long marker inside the human body. As it gets closer, you're in closer and closer to normal. That's when the thyroid seems to become closer and closer to normal. Now, I don't have any, I don't have any studies that show that. I just have patients that say as their uric acid got better, that the thyroid needs evaporated.
It's a very good case. You're insulin resistant and you're on a journey where you've lowered the insulin to this level and in order to get healthy, which is where the weight loss comes from you say. When you say weight loss, I'm guessing you don't want to lose anything except fat.
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But you shouldn't take my word on it. You should have that tested. That's a great, easy blood test that's been perfected. That's not overly expensive. And thyroid hormone, unlike some of the other hormones is not as volatile. It still fluctuates, but it's not as volatile. As some of the some of the like progesterone, estrogen, testosterone, they go up and down, up and down. All right, so I hope that answered it. How does it affect it? Your supply of hormones when they're fat-based like progesterone, estrogen, cortisol, cholesterol, cholesterol is a hormone, but people don't think of it that way. Did I say testosterone? I'm forgetting a couple. Anyway. Those fat-based hormones, those are going to improve in their delivery and supply chain. They will be much more predictable. Thyroid hormone is affected by Vitamin D. As the inflammation decreases, the function from that hormone becomes more pure, more crisp.
So you say, yeah, doc helped me lose this fat. In order for you to lose fat, half to empty that stored glycogen that's in your liver and with a blood sugar of 103, you're emptying some stored glycogen every day, but you're filling it back up as well. The process of saying, I've been this way for a year Dr, crazy. It still can't be happening. How can I not change my weight? In the last year? You say, hey, I've got this upright bike. I've been doing some swimming, both very good activities to improve your metabolism, but at the same rate, you're emptying that glycogen inside the muscle using that energy for those muscles in a way that just keeps you barely at that level of. You can't stress it to make some ketones, but you have lots of stored glycogen storage glucose that has not emptied all the way.
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It's not like muted from the inflammation. I hope that answers that. Okay.
This is so you are keto adapted, you are fat-adapted. That's a huge moment. As we move to some of these levels of higher stress for your body, give me just a quick summary of when you say OMAD, tell me a typical day of what you start out with in the morning. What time do you eat?
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<div id="No38">'''Question 38'''</div>
38. Wondering why ketones are strong when I go to bed, but very light not existed when I get up. I have a very low carb dinner meal.  
So wondering why ketones are strong when I go to bed, but very light not existed when I get up. I have a very low carb dinner meal. Okay, so 33 of you said, would you answer this question? And the next one talks about Dawn effects, which are very similar. So again, the Dawn Effect is every morning, and this is even if you're the night nurse who's been working the night shift for the better part of three decades.
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You work the night shift, you sleep during the day, but your brain came from thousands of years of ancestors who said when the sun is cresting the globe, my pineal gland is going to say, Hey everybody, we need to wake up and this message will drip into your liver saying, Hey, release the morning sunshine, which is glucose and glucose is stored in your liver. So to wake up, you're going to have glucose coming out of your liver. The delivery of of hormone from your brain to the liver doesn't change much in life. Maybe tiny little when you're sick or when you're not sick. What does change is how much glucose is stored in your liver. And as we get all the way to the end of this education, which is the fasting cycle, you're going to see why. Why is your sugar high? Why is your sugar high in the morning when you're healthy?
I usually start out with coffee and I don't put cream in my first morning coffee. I'll have two cups. Then I took Topo Chico water for the day or unsweetened tea, and then I don't till dinner time, but I do eat at six so that I can eat with my husband and I probably should try to start eating earlier myself.
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It's not high. So the Dawn Effect happens to everybody because the sun comes up for everybody. And that little message comes from our brains to our liver. In everybody. We call it the Dawn Effect because we've been studying diabetics and we're saying, well, why in the world are their sugars? So stinking high in the morning? And lo and behold, it's from cortisol. It's from that delivery of the brain to the liver. And especially if they're stressed or they're not sleeping well, a rise in the sugar is much more robust when, when they live with chronically elevated inflammation or chronically high cortisol to stop that you have to clean up your system. So week one, 20 grams of carbohydrates or less total total carbs is what we're counting. And as you look at what we're going to learn with the Dr. Boz ratio and some of the much more advanced lessons that are coming which might be released by now in some of your people's worlds, actually I think they're released in another 20 minutes.
There's a few things that say you are a female that has four children. Definitely. I'm in my sixties and have grand lovely grandchildren.
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You're going to see amazing improvements happen in the world of that morning fasting sugar. So the other part that happens when you look at the fuel that you've built up, fuel is released when you call for it. So you through your day and you're using your brain and your muscles and you're doing your day and ketones rise and glucose rises. And that, that does increase your blood levels. When I'm looking at reaching my autophagy ratio of 40 or less each week when I do my fast. Now I will preface that many of, you know, I'm in Hawaii, so as I do my fastest over the last several weeks it looks like it's not a clock at your time, but it's not, I'm five hours difference than Midwest. So when the sun's up, if you've got the ketone numbers, then I let people use them.
When you look at how to take your metabolism to the next level, you have graduated from a six o'clock meal at night that now you can't do it anymore. If you want it to be healthy, it isn't eating at that hour. That was for a younger woman's stage of life. You're no longer there. And if you continue to do it, your body ages faster, your brain ages faster. It is a price that you're paying on top of those 60 pounds that you already lost. You have some undoing. You have some autophagy that needs to be done to guarantee you the health of watching those grandkids live their life out. With that in mind your husband probably shouldn't be eating that hour either, whether or not that's something you can manipulate him into changing.
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A good Doctor Boz ratio. But truly I know that as a female who's had children the closer I use my morning Dr Boz ratio, the less interference happens with understanding what it means. So
I'm going to not touch that, I have a husband too. But it really is a powerful learning curve for both of you to stay the healthiest version of you is least inflamed, lean body weight, the least amount of extra fat, and it doesn't mean none. It just means that your body weight should be closer and closer to that normal. And that means you can't be stimulating insulin at six o'clock at night for a full. For your full meal a day, your meal needs to come closer to noon. With that, you will see all the things you're doing right. The other option that I've had folks say I just can't, my husband won't do it any other time. Is that first of all, you turn all those other drinks into black only. I don't know what Topo chico water is. It's carbonated water. It's just water with gas in it? Yes. Okay. Perfect. Just as long as there's no other substance. That's one of my favorites too. Water with gas is perfect. You say black coffee is what you should be graduating to if you still need cream in that second one. I would say you can have that during your mealtime, but every time you put that in, you're stimulating insulin. So as much as you're disciplining yourself to OMAD, you're still stimulating insulin. When you put those calories and you're fat-adapted, your body will reach for fat. Quit putting it in your coffee and let it pull it out of your fat cells. If you're trying to lose weight and if you say, I just can't get my husband to do this, six o'clock is when we eat. Then you get supper every other night. You eat supper on Mondays, Wednesdays, Fridays, and Saturday night. And the other nights you don't eat, you are fasting for 48 hours in between that, we're going to get to that in two videos, but you'll stay at this because of your 60 pounds that you've carried for those years and that you were, have the blessing of children. Your hormones have a different set of rules than somebody who didn't bear children and that you're at a standstill saying, hey, but I'm working my tail off. Keep working your tail off. That's fine. But if you really want the weight loss, you got to quit making insulin so often.  
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<div id="No39">'''Question 39'''</div>
<div id="No38">'''Question 38'''</div>
39. Can drink lemon water?
38. I don't feel I have cravings for anything in particular. I just love to eat even when I'm feeling full. Since college I've considered myself a food alcoholic. Yet I have worked to keep my weight low. Is this what you mean by a craving?
If they can drink lemon water. Okay. So if you mean lemon water by squeezing a lemon into water, then there's about, I don't know, a teaspoon of lemon juice in the water. And again, there's very few carbs in that. There's hardly a, it's got a little flavor and if that makes water more enjoyable to you, good. I think there's no problem with that. If you mean lemon water by saying lemon plus Stevia and I put a whole bunch of other flavors into it, I think that's a slippery slope in the wrong direction.
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The one exception that I make to having the Stevia in their drink is when there's ketones in it and it's because yep. They're probably really in that phase of trying to give up the sweets. So having a sweet just to kind of get them through while I put ketones in their circulation because of what that chemistry does to their system.
When you are eating because you're comforting yourself, when you're eating out of boredom, you're not eating out of actual hunger. That is in some forms of creating a craving, is an emotional response to food. So they're angry, they're upset, they're happy. They're using food to eat and emotional craving. Then it becomes that's not really hungry, which is the reason we eat. It's very much a time of having food addiction be part of this journey. This past week where I kind of shifted from newbie conversation to this advanced education of people doing a ketogenic diet, that there's a lot of psychology wrapped in this story of when you have ketones and you're trying to get ketone production glucose to be lower, but you have this drive to eat that is not for nourishment.
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<div id="No40">'''Question 40'''</div>
40. When will your product have beat back in stock?
When will your product have beat back in stock? I am so excited. I'm so excited to tell you that last night I sent off the shipping order for the truck to pick up a bunch of it. I am out of Amazon jail. I said the lady, cause I, I've made it to like the one of the executives and Amazon. I've, I'm persistent if nothing else, I said getting reinstated from this nightmare, which was not my fault.
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It's not our product, but nobody told me that. I just did what everybody said was what you're supposed to do. I said he reinstated a fully on Amazon is harder than gestating a baby. That was a lot of work, but I'm so thankful they are on the truck today. They are headed to Amazon. It is, I can say with confidence, we are, and if you go to all of the links, they're all open. And now it doesn't say that this page doesn't exist anymore. It says no, we're out of stock but the shipping truck is headed there right now. I'm just so thankful to tell you that. Anyway. so thanks for asking that question.
It is for emotional reasons. It will sabotage you. It will derail you. It is the reason for the support group that you're eating for reasons that you need to address. And you can call food a therapist, but it is going to lead to a brain and heart and body that deteriorate and welcome to the internal medicine clinic where once that's down. Oh my goodness, it is a long road back to getting you healthy again. If you're saying I just love to eat, okay, then love to eat less often and eat when it is an interval that's healthy for you. The reason we have the support groups is  the craving for sweets after dinner or the food addiction that results in a little bit of a glass of wine and a bite of chocolate turns into what happens every night now.
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<div id="No41">'''Question 41'''</div>
41.  Does autophagy heal a malabsorption of the gut?
Does autophagy heal a malabsorption of the gut? Yes. in fact, one of the fastest things that turns over in the human body is that mucosal lining and that mucosal lining starts just inside your lips, goes all the way through your guts to the anus. And again, your gut lining is that's true. Turnover is very important. All right. Next question.
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<div id="No42">'''Question 42'''</div>
42. Coffee and its effect on adrenals?
Can you address the daily use of coffee and its effect on adrenals?  my God. Drinks coffee. So when I look at coffee tea taking in coffee, there are several people out there who say, yes, if you give up coffee, it is more pure and you're, you're less likely to have some of the stimulus to the adrenal effect.
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But it is such a minor stimulus compared to a cortisol does what high insulin does, what inflammation does that you can have that one. I'm still drinking my coffee and if you give up coffee more to you, we're going to cover that in the fasting one as well.
And boy do they end up in trouble. It's the addiction that just does play forward. So I really look forward to hearing how your first couple of fasts are gonna go. What happens when that thought of food and eating food? What do you do with it?
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<div id="No43">'''Question 43'''</div>
<div id="No39">'''Question 39'''</div>
43. Not eating after sunset.
39. Since there's been some time since the study you cited, what are the thoughts of electronics and blue blocking enabled pre bedtime? I read on a Kindle at night, nightshade on.
You mentioned not eating after sunset. Can you give a reason for that? So yes, that's what the Dawn Effect is being affected by. I'm actually gonna when you look at the Dawn Effect, it is that you stimulated insulin, you stimulated a hormone response by eating. You now have a trickle effect in every human being for about 12 hours after eating eight hours if you're super healthy, but probably 12 hours for most of the people that are trying to lose weight with the ketogenic diet. So when I am saying don't do that it's not something I tell people on week one, I want you eating all the fat and all the hours that you possibly can, as long as you keep that 20 total carbohydrates less per day in that aspect.
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Don't don't sweat when when it doesn't quite fit.
The reason for that night shade Kindle is because of the lower stimulus to the brain. So it sounds like you're doing the right things as far as the type of reading you do in that reflection into your brain. One of the key things I always talk about when advising people on sleep is healthy brains have different rules than non-healthy brains. It doesn't mean that it's kind of like the same rules that we talked about saying who should step on the scale and who shouldn't. Well if you've got a problem with this and just quit doing that to yourself if you've got a sleep problem, I pushed people to say, just turn off the electronics as much as we have evidence to say it does less.
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<div id="No44">'''Question 44'''</div>
44. Struggling with diarrhea
Anonymous attendee says, I am one of the ones struggling with diarrhea. Okay. I am producing ketones, very dark pink on the urine. Sip chia seeds seem to really hurt my insights. Just two tablespoons gave me horrible cramps. You mentioned fasting. How would you start that at this stage? Okay, so this is where when I look at what I've done with my patients the, the easiest trick for where you're at is you have to heal the gut.
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And this is super hard healing the gut while providing solid energy. It's hard. It is also where I use a lot of supplements to get you through this, so I love it. If you get the MCT soft gels in the reason I like the soft gels as opposed to the ones that, the oil that you can pour is I need you to dose it really tiny. Our group calls it WIC, the spoon because you can just put that spoon in a liquid MCT. And lick it. And if you have a fat malabsorption Pam there in the toilet 20 minutes later with just flushing diarrhea, they're like, how can you do that? You didn't even have like, like a dropper full. You're like, it's a baby's dose, but they're really that inflamed. So I tell them to take one MCT capsule and you can just break it open on your tongue and swallow or just swallow it.
Those people they are studying had healthy sleep habits. That's the problem. When I look at somebody who's trying to repair their sleep, I push them towards the paper books. The reflective light off of the book is what they're doing now. Those Kindle really do emulate that. And I have pretty good confidence that we're going to be okay with using that setting, but it's in the targeted answer that I had. If you're struggling with sleep and this is your solution and you're sleeping well, then we're in good spirits. If you're targeting this, how do I repair my sleep and you're reading right up until midnight at night and then you wake up three or four times a night then we have a problem. We have a broken brain and to get it to sleep well that is how you fix these hormones.
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It'll, it'll be fine. But they start with one, and if that doesn't cause diarrhea the next day, they have to in the next day, they have three. And in the meantime, they set BHB because what that's doing is the MCT is oil that does not need to be digested. It can be absorbed. So the absorption of that very special oil gets through that that got stuff, meaning it's, it's absorbed. And so it's going into through your gut lining. It's going into the portal vein and it gets to your liver. Once your liver holds on to that molecule, that specific fat chain of [inaudible] it will turn those into ketones. And now you have ketones in circulation for these five to six hours. That's the point. You're trying to change the chemistry. So if you can change the chemistry inside your body with MCT, and then I have them drink ketones in a, can I just say do it for two days.
They will fix it, but you gotta give it the environment to do that. Sleep is a huge component to weight loss. Don't give up. It's being studied. There's quite a few. The reason Kindle has that setting is because of the study. So I think you're in the right place as long as you're sleeping. If you're not, then I might switch it up. The other thing that I tell people is not to read in bed. So as much as you have the right light, when you put the setting of reading in your sanctuary for sleep, you are, it's almost as damaging as the reflective light. Sleep outside your cape, go read in the chair, in the living room and when you feel tired, go put your head to bed and you're like, but I wake up and I can't fall asleep.
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You're not gonna, you're not gonna make too many ketones, especially you who's leaking all this stuff out your gut. You're not going make too many. So when, when I look at other things I have them do during, when they're really struggling like this I'm trying to think of where if you bought the book anyway you can, you don't have one sitting next to me. The bone broth and I know that it's on my website somewhere to the bone broth recipe where there's chicken feed in it, the really good bone broth. That is something I'll have them do if you don't want to make it. The kettle on fire one is actually really good. Their nutrients concentration runs through the, the nutrients is actually really good. So again, you're looking for the highest density nutrients, smallest volume of food while staying ketone. That's the secret of when I look at people with fat malabsorptions and if there's anybody who needs to fix this, it's you.
Like I know that's the problem. We have to train you to do that. And if you're tricking your brain into sleep, it's really not the setting of sleep that you want to age with.
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<div id="No40">'''Question 40'''</div>
40. I have butter coffee in the morning. Is that no longer allowed? I eat a snack in mid afternoon and dinner is all keto focused. If we put fat in the morning coffee is that considered a meal?


You are the most important people in my whole audience when it comes to, you have the most to gain from figuring out this ketogenic journey, but your, your first week is helped. It's awful. I would contend that the chia seeds aren't probably as much of the cramping as it is. This whole shift in the chemistry. If you don't want to push the chia seeds, then your fasting is really limited to MCT oil sipping on BHB. I would tell you to sip on bone broth. That's what I would do for like two weeks and you will see insane improvements in what happens to your body. Now the problem is, is diarrhea stops you from going to work with coronavirus. I guess that's not anybody else's problem but yours right now. But when you have somebody in an office place that every 15 to 20 minutes, they have to go to the toilet and flush out a bunch of stool.
Let's make sure we address, so the newbies don't get distracted. At two meals a day, I don't even talk about it. You're going to see in the next week, keep doing the fat in your coffee. Keep doing what you're doing. There is a time when you graduate to giving that up. Especially in those first few weeks, I really want people feeling nourished.
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It's just, it's unsettling. It's not socially, it's, you know, there's lots of troubles with that. So that's where if you go into the, any way you can, and you look at the diarrhea section, I say, use these meds. I think I put them in this handout to use these meds. They're over the counter, they're safe. It's just slowing down the bowel so you can function because it'll, it will wear you out. There'll be up all night there. They really do struggle with this. So I really want you to hear me that you are super important to me, that the danger you have ahead, the number of patients that I've buried alive, meaning the brains just don't work anymore and there's nothing I can do to help them. They have this problem for 30 years and nobody told them how to fix it. It's awful.
If you're ketoCONTINUUM number four, which is two meals a day and you still have a high fat coffee in the morning, you're fine. As I'm coaching, some of these people that I’m talking to are for a year, I'm like, then you probably should move along the ketoCONTINUUM. If you want to get better, you've already done the hard part, you're fat-adapted. Now you just need to apply the rules for the science that you've created. So if you're new, if you're just into this and you're feeling satiated, stay the course, you're going to see the next few steps. If you need help. Not everybody needs to advance. If you're healthy, if you're lean and you're feeling good and you're sleeping good and you're healthy, good job, stay where you're at. If you are not, this is where these next few lessons come in.
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<div id="No41">'''Question 41'''</div>
41. I have malabsorption of fat, diarrhea and fasting. Should I use the chia seed and protocol and BHB at the same time? Should I stay under 20 carbs and how much fat should I eat while my body tries to adjust?
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So I hope that answers your question.
Yes. So it is a difficult equation that you're looking at. What the BHB will make you have diarrhea. So be careful. If you're thinking of BHB and the 20 carbs is where I would say if you can get to 20 carbs or less and hold there, then don't worry about the BHB right now. If you're saying I can't do that, it's too restrictive for me right now. I keep falling off the wagon. That's where I say sip on BHB while you get those 20 carbs to the bottom. If you're having the fat malabsorption, you say, I put fat in, I have diarrhea. The chia seed protocol will bulk up that stool and create a slowing of the diarrhea.
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<div id="No45">'''Question 45'''</div>
45. Should we readjust the protein target in chronometer?
Clay asked, should we readjust the protein target in chronometer? So I recommend one-to-one and it's a great place to start where you'll know if this fits for you and we'll go through this a little bit more as people ask questions in the next couple of lives is when you're doing the dr boz ratio and you cannot seem to get your number really good and you're doing a few other things, then I have ranked this approaching ratio down to 0.9 or you saw Spencer put him as 0.7. So we decrease the protein as a way to really just to match that. But I w one to one is where I keep people most of the time, there's a few folks that you can adjust that a little bit one way or the other.
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But the, the majority of people don't struggle with protein once the inflammation is taken care of. Just, I don't focus on this as much as some people do.
Don't be afraid to use the over the counter medications to slow the diarrhea. Just keep your life on track. As you look at fat malabsorption and the replacement of it, that's where as I said earlier, putting that MCT in the capsule form in the system four to five times a day. When you put the capsule in and it no longer causes diarrhea, then take two, then take three. Remember that in the study where we improve brain function using MCT in the dementia and the borderline dementia patients, that was one of the YouTube videos. Those were 30 capsules to 45 capsules per day. There's a lot of fat that it took to get those ketones that high. Your body will make those many ketones when you're keto adapted. So what the MCT is there for is to bridge you when you're struggling or to train your gut to absorb it.
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<div id="No46">'''Question 46'''</div>
46. How do you know if you're insulin resistant?
Okay. Nicole says, how do you know if you're insulin resistant? Are there any tips for reversing it? Yes. Okay. You know, you're insulin resistant if you have first of all, if you took more than four days to Pee a ketone, your influences. When we get to checking blood sugars, if your morning fasting sugar is above 80 in the morning, you're probably insulin resistant. Even if you're thin I've had people say, I can't seem to make ketones every morning. You're probably insulin, resistant. It's so pervasive that it just sounds like everybody's in Florida. And I'm here to say probably there's a lot of insulin resistance out there. The tips for reversing it, 20 carbohydrates per day, total carbs less than 20 for at least two weeks. That's step one. Get that total carbs down and then eating earlier in the day is always a good idea.
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<div id="No1">'''Question 47'''</div>
47.  I've been on Keto for a year. And I still struggle to get fasting blood sugars below a hundred
Okay. I've been on Keto for a year. Good job. And I still struggle to get fasting blood sugars below a hundred. We are going to get there. I can get there later in the day, but I don't get there in the morning. So this is a huge warning that you're headed for danger. I see Mary offering her advice of one meal every other day. That's a huge stressor on the body. Terry then answers one meal every day. Yep. But, but Mary is talking about one meal every other day. So that is something we're gonna cover in the fasting video. So you're going to get there and we're going to get you those answers and you're going to see the evidence behind. Why would I recommend that and why do I do that for my patients?
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So stay the course and just keep participating or really M depending on the season, ketone people, the ones who have studied my YouTube channel, like you have to coach those who are the newbies. So please do, please put your questions into that Facebook group and my seasoned people VV encourager that you would have wanted during that time. But it also helps you practice for when the AiKeto support group is is coming about because you're going to learn what other people would say. And I really do contend that by educating a thousand people on how to do this, we can spread this throughout the country and really save lives. Get everybody back to work again and do it in a way that's sustainable without like all living on all the problems ahead of us. Leave it alone. Okay. So good job on the answering her.
We want you feeling good during this and if to feel good means you've gotta be able to absorb some of that fat or at least turn the ketones on. Sipping on ketones, give you a ketogenic setting and that does make people feel better. So I really am encouraging you to stay the course is the key thing here. All of these options are ways to say being on chia seeds bulks up the stool, doesn't raise the sugar and really kind of slows down a bowel that's used to a lot of fiber that is often the same as the ones who have fat malabsorption. Fat malabsorption gets better when those cells that absorb the fat wake up. And one of the key ones, we want to wake up with the ones that are associated with MCT.
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Mary and Terry, it's a really good question.
And that's what those MCT capsules really do help. Not forever, but until we get your gut awake. That is a great way to say just increase that protocol. Usually by the time the patient's at like 11 to 15 capsules per day, I know their guts doing really well because they wouldn't be that high if it was having diarrhea all the time. So start at one and then the next day, if you didn't have diarrhea, go to two and then the next day go to three and you're, what you're trying to work up to is as soon as you get to a part where there's some diarrhea, then just stay at that dose or go back it down a dose until your gut can handle that. What you're doing is you're waking up those intero sites to absorb the fat malabsorption. The key in that process is to stay as ketogenic as possible because in the midst of fat malabsorption may sound like, okay, I don't have a leaky gut. Yes, you do. You have one of the leakiest guts. So you're trying to seal this up and that is a state of ketosis. So staying the course, you're kind of like threatened four needles at once. I know that's difficult.  
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<div id="No48">'''Question 48'''</div>
<div id="No42">'''Question 42'''</div>
48. My joint pain went away after six weeks.
42. Why am I so tired? I'm less than 20 carbs per day, getting plenty of fat. Blood glucose is 90 and ketones are 2.5.
All right, so Karen says my joint pain went away after six weeks. It came back two months ago. I'm wondering if it could be because I was eating too much protein and I would, I wouldn't blame protein. I wouldn't say that if you're that far into the journey and you have a flare, this is, we're going to go through what this means in the next in these next video is coming out. And what I would recommend this book that I am got one chapter left to right, and it's really close to like just finishing up the images and getting it to the publisher. It talks about a journey of somebody who did great and then doesn't do so great, and then what do you do to get great for a lifetime? And that is what you're learning in this course, but it's also fun to watch somebody else struggle with a problem that's pretty common.
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So I wouldn't worry about Pratt protein. I would go back to strict 20 carbohydrates less than 20 per day as total carbs and you know, keep the fat high. But you're going to be checking some blood numbers that'll tell you where to go to.
I'm going to guess you're a newbie. If you're new and you're saying, I'm on this ketogenic, I did everything she said, my numbers aren't that bad. They've made the switch. And if they're new what happened was they had zero ketones and now they have 2.5 ketones.
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<div id="No49">'''Question 49'''</div>
49. Nausea, headaches creeping in
Can you talk about nausea, headaches creeping in during third week of strict macOS? Is this still keto flu? I'm using salt electrolytes. Salt makes nausea yours and gives me heartburn. Okay. So almost always when there's this symptom in week three, and it's got this kind of a general malaise, so it's nausea, it's headache, they don't feel good. I'm telling you, magnesium until proven otherwise. Magnesium is such a sneaky little Turkey. Some people have the obvious muscle cramps and they feel the muscle cramps. But it's that kind of a story where I'd say five magazines, magnesium floats in seven days, and you cannot believe how much that helps.
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So there's something more that's happening there. Almost always. It is a micronutrient that is not replaced in the chronometer app. If you were sitting in front of me, I would look at a few things in that to say, I wonder how well they're, you know, magnesium is gonna be the first thing. But also I would, I would not worry about chronometer and magnesium. I'd go get five floats in seven days and watch what happens. And then don't judge your symptoms on the first float judge your symptoms after about the third or fourth float and then see how well that works. The other part that I've seen folks do is if you're taking any medications during that time sometimes the medications are pulling down your blood pressure. So if you're on blood pressure medicines, it's the time to not be on them when you're feeling that way.
And what's happening to most of those two point, the high levels of ketones, they're peeing them out. Why? Cause they're there. Their mitochondria is not in shape to use them. How do I do that? You keep making ketones. So the process of becoming keto adapted is impart to make the ketones that you have good ketone numbers. You're doing a good job of lowering the carbs to less than 20 a day. You do not have excessive blood sugars. All really good in the transition of this switch. Many times people feel tired cause their blood pressure's low. That's why one of the things you should be documenting is your blood pressures. So if you have good blood pressures like one twenties to one tens, even like one fives over 60, seventies, eighties, then that's not bad. If you had blood pressure at this level and you dropped it by 20 to 30 points, your brain can say, I just need you to lay down. The symptom is going to tell you to lay down as it's going to feel tired.
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Don't stop it because of me. Stop it because you asked your doctor. Okay, good question
If it's a significant drop in blood pressure, you can see fatigue is an issue that fixes itself. But it's a hydration issue, if it's a salt issue, going from a magnesium float spa is going to fix a lot of issues in the next week. But if it is the use of ketones, stay the course. Your body will learn how to use these. And that's where the energy comes from. If you've ever seen me talk about what happens to that campfire effect when making ketones the first time you throw a log on a campfire, it doesn't burn very well, much like the first time they make a bunch of ketones or like, this is not working. It's not a fire. It's after that body really gets in the system of using a ketogenic energy that they finally have this nice steady metabolic energy.
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<div id="No50">'''Question 50'''</div>
50.  How do you know if you have consumed enough salt?
Greg says, how do you know if you have consumed enough salt? You don't crave it anymore. So salt you should, it's really hard to consume too much salt. I know the world has said forever and ever. You have a low salt diet, have a low salt diet, but the low salt diet still hasn't proven to us that it was going to lower blood pressure sustainably. Unfortunately it changed so many other parts of the human body that had we lowered sugar, have we lowered the carbs? Have you lowered the insulin? The salt would have taken care of itself. And your kidneys are amazing at scaling up to removing salt. So if you've got a salt process that yeah, keep drinking it until you don't want it anymore, watch what happens.
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Yeah, those was a few caveats to that. If they're in severe heart failure. If you've got you know, some, the advanced problems with atrial fibrillation with a DEMA, you're probably gonna want to talk to your doctor about that. Before you do that, or at least be in close observation of it, checking your heart rate, checking your blood pressure. Those are the things that your doctor's going to need to know in order to resolve or really answer it correctly. All right
That doesn't happen in a week if you haven't burned them in years. The good news is is once you've adapted to ketogenic way of energy and you fall off the wagon for a week and then let's say you've been keto for six months and you fall off the wagon for a week, maybe even two weeks, you return back to that ketogenic energy and your mitochondria will, they're in shape now. They will return to that. Now you can't spend two weeks off, one week on, two weeks off, one week on, two weeks off. When we gone and expect that outcome, you'll eventually have the sluggish mitochondria again. You stay the course if you have a hiccup, the good news is it will carry you through that once you're keto adapted.  
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<div id="No51">'''Question 51'''</div>
<div id="No43">'''Question 43'''</div>
51. Magnesium, is there a lotion or oil?
43. My day 12 still has an edema, carbs are 20 or under daily. Is this the BHB salts?
Susie says, when you're discussing magnesium, is there a lotion or oil? So again, the lotion or oil. Mmm, okay. So she says there's no magnesium pool open. Welcome to coronavirus and Epson salt baths are not meeting the cramping. I just want to show you a quick picture of I think if you want to hear, ah, sure.
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And I think this is the magnesium one. So when you're looking at the amount of magnesium that goes in, you need surface area. So you're saying that that doesn't that work. If you have lotion you can put it all over your body, but it's surface area plus the concentration of the magnesium. So if you look at this Epson salt float bath, that's a pretty concentrated amount of water that she's got her feet in there, but it's only covering this small part of her body. So you've got like 0.1 for surface area at 10%.
The swelling in your shins, I'm going to guess that's where your edema is, around your ankles. That did take a while to get there. Even if you didn't notice it until you went keto and you're like, why did I get swelling when I got keto?
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It is a shift. Your blood pressure changes. Your kidneys are trying to catch up. You're putting salt in especially for BHB salts. So there's a lot of shifts in things. You need everything to catch up. If you still have edema at the end of week two, don't be discouraged. It has always been there between those fascia you have added to it in recent weeks or in these last 12 days by all the shifted chemistry. The goal is for it to go away. There are a few things that make it go away a little faster and that is once you're feeling well, walking is a great way to pump those legs and calves to really improve them. A pedicure does, you don't go for the toenail polish. You go for the massaging of the lower leg and feet.


And then you've got good 10 pounds of salt in there. You've got a really dense amount of salt. And so if you left it in there, your feet in there all day long, you've probably absorbed quite a bit of magnesium. So there's that. You can try that. But that's why Epsom salt bath five pounds gets you a number of two 70. But if you put 10 pounds of salt in the bathtub, now you get a number of five 40, and that's for a 60 minute bath and notice that she's covered up to her armpits. So again, 90% a float or 90% for that body covered for the bathtub. But when you get to the spa, you have 1500 pounds of salt, so much salt that you float, and then you stay in there for 60 minutes, you get this unbelievable infusion.
Unbelievable what that does to mobilize fluid. So don't be afraid of that. That's called a lymph lymphatic massage. But you can just go and get a pedicure, that they're going to do the same thing. As long as you say I want an extra massage or whatever, the key isn't so much the salts that are getting in, it’s the body's ability for your heart and your blood vessels and your kidneys to all work in sync to remove the extra fluid and it's going to play catch up. I am five years into keto and I have swelling today. I got my salt rocks from Redmond because I used up all of them. That's what I thought. I had this very diluted solely water and now I have fresh rocks and I keep putting a lot of extra salt in my coffee.
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So when I show you that, not just to say I don't own any abs float spas, I just think they solve so many problems. That it isn't a, intermittent use of this, but it's a regular use of getting magnesium in there. The lotions or oils I've just found kind of like what happens with estrogen and progesterone. Greens patients do a really good job the first little while, but they don't stay the course. And if I look at the biggest impact that you have on magnesium, it's stopped leaking it out your gut. So when I look at magnesium supplements I'm a big proponent of cheap, easy, safe, and accessible. That's Milk of magnesium to get the non-flavored kind put a capful in your water and drink, drink, drink.
And of course now I love the taste of it. So I had a lot of salt in the last few days and know that part of what my legs are doing is a consequence of what I've been putting in. So how did I get that swelling so quickly? Probably five years was insulin resistance with a small layer of swelling there. And what that does is it just creates the space. This should not be a space where you put fluid, but every human being will do it when we put in this chemistry setting. And so I had that space created and I kept it there for five years. And now even though I have lots of times where I have no swelling, I have a really good, my shin, my thumbprint is zero. When I do have swelling, ankles right back to that spot, I can feel it.
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So you're gonna take that away. The cramping is a good sign that it is magnesium. Also. Any way that you can just add magnesium. Keep going. Alright,
When I do as much salt as I've done in the last week, yeah, I gotta dilute that down a little bit. But it is a human response and you will get to a healthy setting, but even years into it, you push the salt equation in short order and you'll swell. So then finding other ways like the magnesium float spa is another way to cool. Put magnesium in, you say, wouldn't that make you more swollen? It is a shift. You are going to move that mineral water. Follow these minerals so you can see the fluid shift during a float spa.
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<div id="No52">'''Question 52'''</div>
<div id="No44">'''Question 44'''</div>
52. Best thing for keto breath?
44. When I eat one meal a day I won't gain weight. But if I have two meals the next day I've gained weight. Why is that happening? Even if I work out, did I mess up my metabolism?
Angie asks, what's the best thing for keto breath? So two things. Ketones in high production will, we'll settle down. Okay. So remember, keto breath is excess ketones just like ketones in the urine. And when you first turn into a ketogenic way of living, you produce more than you can use, but eventually your body will meet wherever you're at and then you're not going to have much of a keto breath. So the other things that a strong breath is when you shift flora in your mouth. So when people go from a high carbohydrate diet to a high fat diet, yes, all these other things shift in their body. But the bacteria that live in your mouth also shift.
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So you can see a really strange difference in the smell of your breath because different bacteria, which is what causes the smell of your breath can be flourishing and other ones can be dying off. So be sure to have a dentist appointment within six months of going Keto, but shift taKeto, stay Keto and then go to the desk. Cause what you're about to do is change the equation. It'll be much easier to remove that plaque when you decrease the, when you change the flora. So if you give it like six weeks of Keto before you go in for a cleaning, you're going to find a pretty, pretty use. Nice. A dental cleaning by then. So the other things for Keto breath are hydration is a really powerful way. You'll just flush it out the kidneys. The, the key component to keto breath as it goes away.
No. What that tells me is you have insulin that is very robust and that's not what we want. Those things in our life. We want robust insulin is not one of them. When you eat, you stimulate insulin. Insulin stores your food. So when you eat twice, you have two spikes of your insulin, which recreates a deposit of calories. Insulin also holds onto that extra fluid. So you have a fluid shift that will happen in that 24 hours when eating twice a day. The other part that I would recommend is one meal a day isn't a bad idea.
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So to stay the course and know that as soon as you reset, you won't have keto breath.
But if you're going to do that, measure something that can be impacted every day instead of weight. Weight will do this and you're gonna find a lot of noise in the weight and people make these decisions because yesterday's weight and today's weight made the shift. And so this is what I'm going to do. And I would say measure this week and next week, meaning take the intervals of weight less frequently and instead measure a Dr. Boz ratio in the morning for two weeks and watch what happens. And when you eat two meals a day, what I would be very curious to know is what happens when you eat? So if you have the two meals, if you eat the earlier meal and you skip the late meal, what happened to your morning sugars? If you skip the early meal and eat the late meal, what happened to your sugars or your Dr. Boz ratio? Those types of metrics are measuring your chemistry within 24 hours. That has better evidence. When you measure weight, there's so much noise in the background that you're measuring the noise and you're making direction out of a noisy metric such as the scale. It's not that weight doesn't matter. It's that weight day to day has too much room for error.
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<div id="No53">'''Question 53'''</div>
<div id="No45">'''Question 45'''</div>
53. When will the mental acuity kick in?
45. I ate the same thing three days in a row and my blood glucose around 85, ketones around 1. Then out of the blue, I wake up a blood glucose of 110 and ketones at 0.6. What happened?
Alright, Mark asks when will the mental acuity kick in? I sure could use some of that. Okay. So I just recorded this Keto of a fasting cycle and I talk all about norepinephrine and how it affects somebody who's insulin resistant and how it affects somebody who's been key to adaptive. So it's coming. Don't, don't run away. You'll find the answer soon, but you're not going to find it the first week. You got to stay the course a little more. Your body makes this hormone and right now you don't have any of the radiance to make normal hormone, at least most of them. 
 
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I'm going to guess you have insulin resistance. She's shifted and does a really good job. She's eating the same thing. She's got this good number, but it takes about three to four days for insulin to really make a pretty good shift. So when they make a change and then they're stable, it's the accumulation of staying stable, of staying that low glucose that just dropped your insulin. I'm like, isn't that good? Yes, but you're insulin resistant. And so less insulin says, oh, we finally get to empty some of this glycogen, especially in the morning because you have that signal that goes from your brain to your liver and it's the same amount of cortisol that comes every day from your brain to your liver.
<div id="No54">'''Question 54'''</div>
54. Pain in the right upper area of my rib
Question by Nan a day. Five, no gallbladder pain in the right upper area of my rib is the pain due to my liver working to adjust to higher fat. Let me grab some thought.
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All right. The right upper quadrant is where your liver is. Ah, so right up under that rib, it's also where when livers change specifically when they swell they stretch the capsule. And that's often when the liver will hurt. A easy abdominal exam will tell you if it is the liver, you lay on your back and you bend your knees, let you tell me muscles are relaxed and the physician will push right there on the liver. And especially, you don't have a gallbladder. It's pretty easy to say that's your liver. I can feel it. When you take a deep breath, you can feel the liver come up under their fingers. And if it's swollen or inflamed, hepatitis is not usually caused by a ketogenic transition. In fact, it is the treatment to reduce the inflammation in the liver. That ketosis will guarantee, but sometimes getting there, that shift goes up and down a little bit in that first week. So if you're on day five, you're having a transition change. I would stay the course. This should get dramatically better by seven days. Seven, eight, nine. Hydration is the other thing. Livers like they like a wet system, they like hydration. So I would say stay the course
What your cortisol lands on will depend on what your sugar is. If your cortisol has been landing on a liver field with storage, but the insulin has been at this higher level for the better part of a year and now you didn't, you went keto, you dropped your intake of carbs. Your insulin is less, but it's impact, meaning you may produce less insulin those first couple of days that it really takes that third or fourth day for the glycogen to release more. And what we look at for a glucose of one 10 ketones, 0.6 is you are in a cycle of emptying. It's powerful to keep, especially with that kind of story. My advice for you would say keep your meal during the daylight hours, the earlier towards lunch and the less you have after four o'clock, the better your system's going to be. Again, another shift is going to change your metrics. So just keep an eye on that. That's why those spreadsheets are so important. I don't know if you took time to watch the tutorial by Patrick V and his explanation of what that spreadsheet does, but that spreadsheet captures what needs to be alive if you would need to be recorded for making decisions on metabolism.
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<div id="No55">Question 55</div>
<div id="No46">'''Question 46'''</div>
55. Patties and hotdogs in restaurants have wheat and sugar
46. I am not a newbie. I've been stuck for a long time. The class has helped my dawn effect numbers going lower in the eighties to nineties range. But now with the class my dawn numbers have risen by 30 points. What's happening?
Done. Okay. patties and hotdogs in restaurants have wheat and sugar. Should we stay away from that? Well sure I wouldn't be that picky. I mean meaning if that's what you have in front of you and that's the only option, it's better than a lot of options. It is one of the reasons there's a can of sardines in my purse, but if I find myself there and I don't want to eat what's on the menu, I remember that human relations or why you usually people eat is for the community, for the relationship. And then I eat the sardines when I'm alone cause nobody likes to smell them. But other patties that are pretty pretty secure in, in their commitment to pork is sausage patties. So if you don't like hamburger patties because they do put a lot of things in those sausage patties are pretty pure.
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Hot dogs aren't the worst things in the world either. And spam. I know we said that last week. All right.
Same thing we were just talking about. She probably, I mean just looking at what happens when you get a tribe, when you get a support group, when you look carefully at the way your body is working, she probably tightened up some things. She took those total carbs down to 20, she just improved things by a notch and at first, not much happened, but as you lower insulin, that whole body has to reset. And the first phase of lowering insulin is if they're checking those morning fasting sugars, they're checking a Dr. Boz ratio.
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<div id="No56">'''Question 56'''</div>
56. Making a blood donation
Next question by Charmaine is I am due to make a blood donation. I've been donating blood for 40 years. My ketone urine stick reads eight every day since May 1st. Well, will that make me more vulnerable to getting dehydrated from donating blood would be better to wait for six weeks. I would wait until you get to the, so you're may, first of all, you're on day eight. I would get to the 15th of the month if you can just to say the transition is the only part where they're really dehydrated and it's really meeting the needs of the salt and those first weeks. And how much of a transition that is for most people. Your body's not going to probably get any more dehydrated from donating a pint of blood now to what it did before.
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Especially if you're a reset, the reset happens in that first 10 days. That's where the keto flu really can wipe people out, push down their energy level and, and knock off a huge amount of their their volume because they don't have those glucose floating around anymore. Once you've transitioned through that though, it's a pretty nice improvement to the stability of your intro vascular volume, which is what you're worried about with a blood donation.
They're going to say, oh no, I totally just saw this rise. What happened? I'm backwards. My body's not working. I'm like, no, don't stop. Your body is emptying. That is a glycogen response of lowering insulin over the course of those last few days. I would totally stay the course. I really hope you have a spreadsheet that you're keeping track of because once again, I want you following, I mean noise is easy to get distracted with. And by noise I mean lots of numbers that don't do exactly what you want them to do. And so in short order, something happens, but we need a trend. We need two weeks of a data point, like a Dr. Boz ratio to say, watch what happens when you lower the insulin, not for a little bit, but you really lower it. And then you see the response your body has.
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<div id="No57">'''Question 57'''</div>
57. Will, taking an aspirin have any effect on this process?
Well, taking an aspirin have any effect on this process? No. Keep your aspirin just like you've been doing.  
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<div id="No58">'''Question 58'''</div>
58. Blood pressure is going up and my glucose is up
After increasing assault, I, blood pressure is going up and my glucose is up in the mornings as well. Okay, so you're in transition data course, especially if you started on day one here, you're somewhere in that first seven days.
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The blood pressure up is better than blood pressure down. Remember that high blood pressure doesn't give you a heart attack because it was up for a day. High blood pressure for six months for a year is what gives people a heart attack. But low blood pressure will land you on the floor with a head injury like that. So prevent the short term problems by increasing the by keeping the salt replace, that is the huge, the biggest problem in the transition.  
Many times when people are stuck at a weight loss stall, it's because the impact of insulin is still the same. You're doing everything right. And I put them on what is one of the strongest instincts to lower insulin. You'll get to that in two weeks and they don't like it. It's hard. But boy, by the third time around, you can ask Angela Earnhardt about this little test where it was not anything she ever wants to do again. But by golly, she broke through that stall and she really did reach her goal. So hang in there, you're not alone. Stay the course and please, use that spreadsheet in case I ever need to help you out or anybody needs to help you. Looking at the spreadsheets, going to you'll be able to easily distract a doctor or an advisor into a flippant answer that makes you feel better. But if you want the answer that's actually going to repair it, you have to have the conglomerate of that data.
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<div id="No59">'''Question 59'''</div>
<div id="No1">'''Question 47'''</div>
59. What about the chronometer and the phone?
47. Do you have any insight on melatonin in regards to sleep?
Chronic chronometer shows everything on the computer. What about the phone? So I think if you join Theresa, if you join that live, that or that training that the chronometer team is hosting this next week, you're going to see that you can find all of the things on the phone.
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It is in a different location and real estate is differently placed on the phone versus the laptop. So I'm sure Spencer will cover that in his training. All right.
Melatonin's not bad. It doesn't hurt you. It does stimulate that first phase of sleep that syncs your brain into sleep. It does not enhance stage four sleep, which is the kind of sleep that repairs a body improves immune system resets insulin resistance. There's prescription strength melatonin that even does a pretty good job. But once again, it's ability to truly reset that human body is not as great as I like it to be. Cleaning up the sleep hygiene, going through that video saying, have your bedroom for sex and sleep. Nothing else should be going on in the bedroom. Looking at those electronics, looking at what your behavior is.
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<div id="No60">'''Question 60'''</div>
60. The high levels of fat I'm eating, makes my stomach hurt
Michelle says, what can I do when the high levels of fat I'm eating, he, my stomach hurt and feel nausea? Well, nausea when eating is a huge, is one of the signs of some type of satiety or feeling full will stop when you get to that feeling of you don't feel you feel full, then stop. If you're saying that when you put fat in your stomach, you get cramping and then you get explosive diarrhea and about 15 minutes, that's a different problem. That's the one we talked about earlier. And that's where starting with slow steady MCT plus a BHB sardines and Braunschweiger and bone broth stable, stable, stable for two weeks is what I would recommend.
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Your gut will get used to this. It is probably not seen this in a couple of decades usually sometimes.  
If you wake up in the middle of the night, get your butt out of bed, quit trying to like linear in the morning, get up. Those behaviors all change how your brain shuts down. Just like with insulin, it's not going to change tomorrow. You have to change. You have to have this pattern for a couple of weeks for that brain to really get the benefits for sinking into stage for sleep, repairing that brain, recovering from chemotherapy. Very important. I would tell people when they're training their brains for sleep, I didn't probably talk about this in the earlier videos but sending them for that five magnesium floats in seven days is a huge, it sounds like a lot, but really just gets their brain slowing down. Even if it takes you 10 days or two weeks to get those five floats in, it is incredible how much better they sleep once they get that magnesium a little higher. It all does play in, but melatonin doesn't hurt you, but it's probably not the best thing long term.
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<div id="No61">'''Question 61'''</div>
<div id="No48">'''Question 48'''</div>
61. I find I have no appetite.
48. Best advice for traveling and not being able to completely control your diet.
Shamala says, good morning, Dr. Boz my diet until last week was primarily carbohydrates. Now, after being in ketosis, I find I have no appetite. I have no appetite but hungry. I only want to consume black, the coffee with butter. Okay. Well if he's been carbon dictated and you're transitioning with black coffee and butter, stay the course. Is that okay? What to expect going forward? So when looking at that first week this is exactly who I want to be talking to as a thank you for posting the question. It is amazing how many people say, I've been eating carbohydrates and meeting that fuel, you know, three, four, five, sometimes six times a day I start eating fat and I'm like, I don't, I want to eat.
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Why don't I want to eat? And this is the message of what happens to Keto or a fat-based fuel. The sign is that you're probably going to transition into ketogenic living pretty easily based on that history. I can't obviously guarantee it, but I would, when I hear this story, it says she can use fat very quickly. Her body's really quick to adapt. So it means that inflammation has not been around for as long as some of the others maybe. And the satiety is very easy for your, this goes away as your body kind of gets in the rhythm of putting food in, absorbing all the nutrients, putting food in, absorbing up the nutrients. The other thing I've done with folks who really have an almost anorexia that first couple of weeks is I would go in with like kettle and fire.
Good luck. It's a hard one. My favorite thing, and I usually have to warn my husband because he knows what I like and he'll do things that comfort me. But the travel advice that I do is I try to fast, especially if I'm changing time zones. It just works better as much as I don't like fasting any more than anybody else. And I really don't like fasting when walking past something that smells good. If I tell my family I'm fasting, my husband brings me a bubble water with gas in it. That changes how I respond.
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If you go to bozmd.com, go to Dr. Boz favorites. You can find this in my Dr Boz  favorites. And you click on that bone broth. I would sit bone broth with a good salt replacement in there. As you're going to get a ton of nutrients enough, I mean, if you've read the book any way you can, we kept my 73 year old mother alive with a fourth of a cup of good bone broth every day for almost 40 days. You'll be fine. The transition will go away, but it can be really comforting to have li
I recruit my support system when I'm going to do this. Other things that if you are traveling just keeping that section of time where you eat very controlled and while you're awake, remember what those people give you on the plane is not healthy. It's just convenient. Please just say nope. The other part about having a successful traveling though is that you do set expectations. If you've ever tried to Google ketogenic food from and then fill in the blank like Qdoba or McDonald's or this used to be a rarity, but it's pretty easy, go into the cronometer app and say, what can I have from McDonald's for this high fat? There's plenty. There are lots of options out there and then just fail upwards.
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<div id="No62">'''Question 62'''</div>
62. My poop comes out in drips and dabs,
This might be a little too much information. Never when we're talking about poop, is it too much information? People are just too shy to ask about it. Gloria, so thank you. My poop comes out in drips and dabs, not in one full movement. Is this normal in the ketogenic journey? Let's see. So can be dehydration says Theresa. It's very true. It can also be keep the salt and water and she sees that salt helps me. So that, that's true. Good job, Theresa. Other things are, when you're, if you're truly in the ketogenic way of living and you're feeling like you've been Keto, then they left and then they come back many times.
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It's amazing how much volume of stool happens when they are eating fiber and the kinds of wastes that your body can't absorb. One of the key things to a ketogenic diet is how much of that nutrients your body will absorb. And especially when once that gut heals and it doesn't leak out magnesium and the fat and all the other things you don't want leaking out that you don't need as much food. You can really absorb the nutrients and keep it on the inside. And then how much the volume of stool is, is much smaller. I think one of the, one of the carnivore books I want to say it's either a title or a subtitle is what happened to my poop? I mean, the volume
The fewer, the better. The other thing I do during, if I fail during a travels section, cause I'll try to fast on the day I travel and then fast on the day I'm first home and it really resets my brain the best. But if I struggle, I sip on BHB, it just adds more ketones because the ketones, especially when you're keto adapted, a little bit of ketones, it suppresses appetite and it just helps you get through that tough moment.
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<div id="No63">'''Question 63'''</div>
<div id="No49">'''Question 49'''</div>
63. Bone pain
49. I'm five weeks into keto and starting to have joint pain fingers, mostly. Any suggestions?
So Rochelle came back and said, my whole arm and upper legs ache from my shoulder to my wrist. So I don't know what does, what's doing this. So there's a lot of questions I have, but aye. I mean the first thing I think of is if you are truly brand new Keto and you have a extremity pain, it's magnesium, it's magnesium until proven otherwise. And you're having micro cramping throughout those major muscle groups in the you say, but why does it hurt my bones? Cause all of your muscles are pulling on the bone. And so the, sometimes the symptoms are bone pain. Within a, within a system, bone pain can mean a lot of not so good things. So I would not take my word for this. I would make sure that your doctor knows about this.
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Cause if you were my patient, I'd be doing a few other things that would help me understand exactly what are you trying to ask. And of course, if I, as your doctor, I'd know a lot more about your history, which would get me some of the other answers. Okay. So good question.
Five weeks is about that time where you had a history of crystals in your joints.
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<div id="No1">Question 64</div>
64. Parkinson's
Can you talk about keto for someone who has Parkinson's? First of all, if my parents had Parkinson's, I would totally put them on keto. Again, the reason I looked into this in the first place was brain data. The brain data is amazing at how much, when the inflammation is less, the brain works better. Parkinson's and it's accumulation of debris within the brain. You, you find he's at autopsy with Parkinson's. People say, Oh, it's genetic. It's genetic. I'm like, yep.
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And there's a lot of people with the genetics for it that never get it. Why don't they get it? Their brain aged better? So first of all, if your, if your Parkinson's is you the faster you can get to an autophagy ratio of 40 or less, the better you're going to be. Don't skip these first couple of weeks of replacing your ketone based hormones. Do not rush through this. The videos in this next week are going to show you what I'm warning you about. Parkinson's is a brain chronic brain illness. Once it's taken over the body it's, it's not a fun way to go. But if you can arrest the development, if you can slow down that progression, it has everything to do with inflammation and you can measure inflammation from the privacy of your home. That's in a meter.
Let's just back up a bit. Removal of inflammation will decrease the inflammation everywhere, in your ear, from your muscles, from your eyes, from your joints. And so a lot of people say, oh, my joints feel so much better. Yes, they do. If you have a crystal process that's been in your joints, it did not come in the last five weeks. It came over the last 30 years. Crystals are, especially if it's a gout crystal, but don't explain that all this gout crystals, people think of toes and ankles. Gout crystals happen in every joint. You only feel crystals when they start to move. Just like a kidney stone, if it never moves, you don't feel anything but if it moves, you feel it. So these crystals, as they start to kind of dissolve and they move, they hurt.
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I hope you come back and ask me some questions in the next couple of weeks after you watch these X videos.
So at five weeks, it makes me worried that it's not a swelling issue. It's a gout thing. So the worst thing you can do if you have gout and you've gone keto and you're in that five week position is, oh my goodness. Of course, don't fall off the wagon right now. If you fall off the wagon and they go a bunch of sugar, the crystal eyes, they really stop dissolving and they can actually form and now they form a new spot in. You shouldn't be getting those crystals out of there. The right thing is they shouldn't have been there in the first place. If you have diffused joint pain in this five, six week time, it is a gout thing until proven otherwise. And I say gout because that's the most common crystal.
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<div id="No65">'''Question 65'''</div>
65. How important is recording your blood pressure?
All right, so let's go to, how important is recording your blood pressure? Is it just there for those who have high blood pressure? So, Robin, that's a good question. What I've learned is many people do not know that their blood pressure goes up and down. The blood pressure changes. So the first week that if you're somebody who dropped their blood pressure and you don't know it, it feels awful. It's like a mystery. And when we check it again, blood pressure is kind of like blood sugar. You don't want one number. You want to, you want to a variety of numbers. If I put a little catheter inside the artery called an art line while you're in the ICU, I can measure the blood pressure for every time your heart beats.
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It changes every beat. So when they give me one blood pressure and they say, that's my blood pressure, that's not how it works. I need a bunch of numbers to say, what is your blood pressure range and are you resting? Is it a time where you're irritable and upset and then your blood pressure's high? That's normal. Now, calm down and see if your blood pressure went back to normal when you weren't, when you were rusting. So when I look at the problems in that first week and the people that fall off the ketogenic diet is because they don't even check. So if you're not able to check it and you're 20 years old with a healthy system, but trying to lose weight, probably going to be just fine. But if you're 50 and you're like, I don't have high blood pressure, I've just been overweight for 20 years, I'm telling you, you probably have a blood pressure problem that you don't know about or it's, it's still controls enough that you can get some normal readings and sneak away from having the diagnosis.
But there are about 20 crystals you can put in joints. The top ones are gout and some other calcium deposits. But what we want to do is reverse that. And the reversal is a chemistry state that promotes the melting of those crystals. That is ketosis.  The key thing for you is to stay the course and know that the more strict you are on those 20 carbs, the better. The other thing I've done for people with gout is I get them sipping on ketones because even if I augment their chemistry by just keeping ketosis available it keeps those crystals from really flaring. I've had people fall off the wagon at this point and they get every joint goes crazy and they never want to go keto again. If I'm just saying don't do that, stay the course.
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But the pressure inside your system is going to drop. When you go keto. And if you can't, if you don't know that you're gonna, it's gonna seem like a mystery and you're gonna say, Oh, this diet's not for me, when in fact you probably need it more than most. Not. You need it as much as the rest of us. But so that's why you check blood pressure. So if you're young, healthy, and you've checked it a few times and it seems to be fine and you don't have any symptoms and you're doing the Keto transition just fine, then state of course. But if I look at the people who fall off, if I look at the mistakes that keto coaches make in those first two weeks, they don't require that people are checking their blood pressure. So nobody has a clue and they drop the blood pressures, people fall off of it and they weren't, weren't replacing enough salts that to prevent that.
You can really hate me if you fall off the wagon and you have a whole eruption of gout. So either sip on BHB or just keep the blinders on. 20 carbs a day. Don't fall off.  
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<div id="No66">'''Question 66'''</div>
<div id="No50">'''Question 50'''</div>
66. What effect can the keto diet have on histoplasmosis that has activated in your eyes?
50. Suggestions from my genetics were to be on a Mediterranean diet that I did not handle, saturated fats well, eating lots of veggies, the issue of histamines. I am concerned about doing too much saturated fat. But on a plant based diet. I wanted eggs so I ate four. When I tried keto last year, it gave me too much mucus. Medical intuitive told me it was an issue with gallbladder. That said, I'm worried about the diet.
Jerry, what effect can the keto diet have on histoplasmosis that has activated in your eyes? Should I be taking any supplements with it? Again, histoplasmosis is a very sneaky, gnarly insidious invasion. I will, I want to say it's the yeast family, but it's a fungal type of process that you don't want to have. You want to get rid of it. And you want your immune system. Again, we have treatments that can affect this, but the best answer is that your white blood cells sharpen up and attack the enemy in exactly the way that it should without exploding with a cytokine storm. But instead really doing a targeted job and then watching for the enemy. So histoplasmosis is a, I don't, I'm sure there's no studies on Keno and histoplasmosis, but in general, if you have a chronic insidious in invasion of something like like that your body should have never let that come in. So it initially says your defense system is weakened just by telling me that you have it. I know that to strengthen it and get rid of it. I don't know if that's possible, but it shows a heck lot more possible if your white blood cells are the healthiest version of themselves. And I contend there's nothing better than a ketogenic living that would do that for you.
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<div id="No67">'''Question 67'''</div>
67. Having a hard time sleeping
I am following first week. Not fasting. Good job. Nobody should be fasting the first week yet have her having a hard time sleeping. Okay. So if you're looking at that first week as you change fuels, this really does affect people. So Cheryl carpenter, I'll just kind of walk through a few things that this next week I give a couple of videos. There's a couple of links that I give you that are outside the course to helping people with their sleep. Sleep is a big deal. So if you're in the first week and you're struggling with how do I fix this don't reach for alcohol, please don't reach for like Ambien, Lunesta, Xanax, Adavan, Klonopin, Valium, all the stuff that really swells the human brain. We don't want you to do that. There are several other things, I mean Benadryls better than any of those.
Video Time Stamp: (02:20:59):
 
And that's got problems for people who are super old and have balance issues. What I'm saying is get through the first week if you're looking for habits that I absolutely am going to remind you of and this week if you didn't, if you wouldn't have asked, this is coming in the next week. There's a video that I recorded when my middle son was just out of the first grade. So I think that's 2012. And it's a great video that I have health teachers throughout the country use in health class. If you look on the show, so you go to YouTube, you type into that Bosworth and you type in sleep and it's the only video from like 2012 in the show notes there's a handout. So you print the handout and you can take notes as a, as you do this sleep lecture, as you unfold these lessons, the next week you're going to see these resources again because it is so important to learn this, that sleep becomes a part of fixing your metabolism.
Video Time Stamp: (02:21:57):


And I'm not, I'm not like over-exaggerating that what happens when you don't sleep becomes part of the problem. So I need you to keep pushing through. Don't use the naughty medicines we want you using the good medicines. If you go to my website, Bozmd. com and you type in a case for sleep, you're going to see one of the folks I coached on the live YouTube show, you'll see several videos from him. And you'll also see a blog that I wrote about one of the patients. That's just one of the protocols I use. I've had people print that protocol out. There are some cited journals and medical articles in that, so you can give them to your doctor to say, here, this is what she does, do this. And there's been a couple of positions where I've really tried to reach out to them because the patient's on reaches out to me saying, can you help my doctor?
First of all, there's a lot of things going on in that question. I'm going to go to genetics first. So genetics are this very fun thing that we have the privilege of looking at in 2020, that we can look and say, here's what your genetics say, but I need to remind you that genetics are flexible. Like what I was born with them like, yep. But what you flex, what ends up on the outside are the epigenetics of your body is related to how you treated it. If you have the genetics that say, I don't handle this, that, or the other, I'm going to bet that you weren't born with that version of your genetics. But this has been an evolution of what is exposed to your system.
Video Time Stamp: (02:22:48):


Can you help my doctor? I used to, one of the first education programs I did was teaching other physicians how to repair sleep and it was through using this protocol. It's brilliant. It's awesome. So a case for sleep gets you there. I have these links coming up in your handouts this next week, so I think you'll be good to go. You'll be able to find them through just being in this course of the job.  
At which point we come back up and say, I can't advise you for all that's going on there. But I do know that the longer I've been taking care of ketogenic people with the most extreme responses, like they have food allergies to everything from eggs to peanuts to shrimp, everything. They have a histamine response. Their body, if you're going to get a cytokine storm, that's the kind of profile that happens, that history. The response to that is to decrease the inflammation in the insight inside your bone marrow. I need this to decrease. You say, well, I made my mucus when I first had this, first went ketogenic. I'm like, yep, you turned something on. That's probably the same process that was making all that histamine, that would give you a cytokine storm.
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<div id="No68">'''Question 68'''</div>
68.  Bubbles in your urine
So Katherine says, what if you notice bubbles in your urine has gone on for a while now with Keto now will ketone make a difference?
Video Time Stamp: (02:23:46):


So first of all, what do you mean when you, when you urinate in the toilet? Is there bubbles and in the process of that, so air in your urine is a mess. You got a problem? I don't think that's what you're talking about. Mmm.
It is the reduction of this response that we're trying to get to in someone like you. So as you say, should I be doing this diet or shouldn't I? If you were my patient or my family member, I would be walking you very carefully to say, look, the way you're playing forward is guaranteed a malnourishment with a life of restriction, meaning everything triggers her. They have allergies, they have histamine responses, the Mediterranean diet, high fat, low carbohydrate diet. Essentially what Mediterranean diet is, gives her all these reactions and you say saturated fats are not the enemy here. The histamine response and your body's cytokine response is the enemy. How do you fix that? You've got to find a way to stay the course. If you're in a 200 club, if you're having more than 200 carbs per day getting you to at least a hundred for a good week or two, and then getting down to 50 for a good week or two.
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<div id="No69">'''Question 69'''</div>
69. Chia seeds and diverticular disease
Let me do Laura's chia seeds and diverticulum and then I'll go back and look up this. let's do any risk with chia seeds and diverticular disease. Okay. So diverticula I want you to remember that my mom, the reason she had no food for a month was for diverticula exploded. Okay? So diverticula which is all poachings in your bowel is because of chronic inflammation in your body. And then the pressure on the inside of that bowel is getting worse and worse and worse as the, as the pressure increases, the diverticular get worse.
Video Time Stamp: (02:24:58):


So by switching the person to achy genic diet, which is low fiber, high fat, low carbs you are decreasing the inflammation. You're decreasing the volume of stool, which is good for diverticula, but it's that transition of going from where you're at right now to where you're headed to be when it comes to chia seeds. The reason we want, you're taking a tablespoon without water and the tablespoon without water is we want them forming this gelatinous substance and you'll know you're right by what comes out the other end. But the, the, the, the, the, the bolus of stool as it moves past those, that diseased bowel, the bowel with the diverticula, we, we want it staying in a bolus. And that's why the consistency of following that protocol is very helpful. I know that every old textbook says no seeds when you have diverticula.
If you've got a few, I would not go to the cronometer app and exclude saturated fats. That's when looking at those that stimulate the highest responses. Saturated fats do not weigh in on this. Trans fats do. That's something that we can talk about. The long term answers for people who have this over responsive system becomes they have a fear of changing it and they actually have the highest consequences when that bit where they're on the edge of chronic inflammation at all times, meaning they have a high histamine response, they'd make an excess of mucus. When you change their diet, these are all signs that your system is fragile. Not fragile, doesn't mean do nothing. It means you're gonna have to do it slower. But I would be peeing on a stick and making ketones every day and then steadily work your way through that ketoCONTINUUM.
Video Time Stamp: (02:25:52):


And I tell grammar roses again and again, and then she'll go back to the doctor and say, but he said, I shouldn't have seeds like poppy seeds. And I'm like, okay, as long as your stool isn't a bolus that it doesn't fall into those little pockets. But that means you gotta do your part. You got to stay the course. You can't have chia seeds once a week and think it's going to not be a problem. I need you to do the protocol, one tablespoon every hour until you have a bowel movement and volume, the two doses in morning and noon, lots of water with it, and you will fix this constipation. But more importantly, you will go from a standard American diet to a anti-inflammatory diet, which is what the whole thing is.  
Somebody responded to you saying, my genetics are telling me to keep saturated fats very well. Again, the genetics that say keep saturated fats low, what they're missing is you go back 2000 years, saturated fats are what we ate. That is the only thing that lasted without cooling storage. If you're taking a 21st century technology in a micro clip of your genetics and making decisions that your ancestors said, no, no, no. That's not how it works. So I am just very cautious to say that I can't have that because of my genetics. Alzheimer's, chronic heart disease, chronic kidney disease, those are all chronic inflammatory diseases associated with high insulin. Get that Dr. Boz ratio down. Keep it down. If you want to do it without saturated fats, that's fine, but it's hard. And I would contend it's probably not the best answer.


                                         www.BozMD.com
                                         www.BozMD.com
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Revision as of 15:55, 25 October 2020

Module 2 Q&A Handout

No Question Votes Time Code Answer
1 How long can it take to become truly fat-adapted? - (00:16:34) Question 1
2 Can you experience autophagy even if you aren't fasting? - (00:21:46) Question 2
3 I wake up three times a night minimum. Does this raise my glucose every time I wake up? Why am I not feeling all this great energy? - (00:24:46) Question 3
4 How can people have a very low Dr. Boz ratio and not be losing weight? - (00:28:34) Question 4
5 Once fat-adapted, do we need to worry about shutting down metabolism with lowered total calories? - (00:30:21) Question 5
6 What effect does exercise have on ketone production? If I'm fat-adapted, could exercise lower the ketones in my blood? - (00:33:21) Question 6
7 How long do I stay less than 20 carbs per day? - (00:35:03) Question 7
8 What do you suggest for sleep medications if you're fat-adapted but you're still not sleeping well. - (00:39:16) Question 8
9 How do I increase low ketones? I'm adding MCT oil and BHB and it increases, but later drops back to under .5 (blood measurement) - (00:43:25) Question 9
10 Will you give us some daily meal plans with <20 g carbs and a good cronometer fat/protein ratio before this is over? - (00:45:16) Question 10
11 Dawn syndrome, what to do? - (00:55:54) Question 11
12 Insulin resistance - how do I know without going to the doctor? What are indicators? - (00:57:32) Question 12
13 Must I progress to OMAD or one meal a day in order to lose the last 10 or 15 pounds. Been keto for a couple of years. Or is there anything else I can do? Can I just cut? - (01:01:00) Question 13
14 Is it possible that some people just can't lose weight on a ketogenic life plan? Following for eight months and old weight loss but feel good. - (01:02:35) Question 14
15 What do I do if I don't absorb fat? Floating poop and diarrhea. - (01:03:26) Question 15
16 How do we get calcium on Keto? Dairy has too many carbs. Cronometer tells me I get 15% of what I need. - (01:08:36) Question 16
17 If you fall off the keto wagon briefly go over 20 total carbs, do we jump back on where we left off? When is it best to start at wk 1? - (01:11:10) Question 17
18 Why does your heart pound after an epsom salts bath? - (01:12:00) Question 18
19 Does absorbing abundant magnesium during a bath or float have the same laxative effect? Why or why not - (01:14:39) Question 19
20 Can sleep apnea really go away with keto, or will a person always need the c-pap? - (01:16:00) Question 20
21 Do you recommend staying under a certain carb level at each meal? I heard that eating over 7 g of carbs at a meal could spike insulin? - (01:17:00) Question 21
22 Please explain why you might stall with weight loss after being keto/lchf for over a year? Is it metabolism? Is it hormonal? - (01:18:00) Question 22
23 Why is the scale not moving? - (01:19:00) Question 23
24 Why is sugar not dropping - (01:08:00) Question 24
25 Smoothies - (01:20:31) Question 25
26 Snacks? When to add? Before or after a meal? - (01:21:00) Question 26
27 How many snacks while fasting? On and on and on - (01:21:30) Question 27
28 I have gained weight on the way to changing my body chemistry. What happened? Maybe all the whipped cream. How do I help myself against stubborn insulin resistant liver? - (01:22:28) Question 28
29 Science based impact of sweeteners, stevia, erythritol, monk fruit on ketones and glucose. There is quite a evidence of literature out there where they put it. I see how that dana green, or erythritol four grams of carbs per teaspoon. And I need at least three for coffee. I don't count those carbs. A friend said that type doesn't count, but I'm using nothing because it's a waste of four carbs to me. - (01:28:44)
30 Is it true if you drink apple cider vinegar with water before bed will help you lower the dawn effect? - (01:32:42) Question 30
31 How a person can have high glucose readings in the morning and also have high ketone levels. - (01:34:18) Question 31
32 Is it possible to have too much salt? I have a lower limb swelling and I've only previously had the pregnancy. - (01:36:11) Question 32
33 After achieving the desirable Dr. Boz ratio, do you keep going? When do you stop? - (01:39:41) Question 33
34 I went to bed with the best numbers. I've had blood glucose to 79, ketones a three, got up eight hours later with the worst numbers I've had a glucose of 117 and ketones a 0.7. What happened? - (01:41:18) Question 34
35 When will the hair loss stop? - (01:42:56) Question 35
36 I failed my sleep this week. Most nights five hours, bed by 9:30, totally awake at 3:30 in the morning. It was my norm trying all the guidance and info. How long to get a sleep line? - (01:43:55) Question 36
37 When to begin my real exercise happens in the big keto life? Can you have initial weight gain? - (01:44:30) Question 37
38 I don't feel I have cravings for anything in particular. I just love to eat even when I'm feeling full. Since college I've considered myself a food alcoholic. Yet I have worked to keep my weight low. Is this what you mean by a craving? - (01:48:33) Question 38
39 Since there's been some time since the study you cited, what are the thoughts of electronics and blue blocking enabled pre bedtime? I read on a Kindle at night, nightshade on. - (01:59:38) Question 39
40 I have butter coffee in the morning. Is that no longer allowed? I eat a snack in mid afternoon and dinner is all keto focused. If we put fat in the morning coffee is that considered a meal? - (02:01:00) Question 40
41 I have malabsorption of fat, diarrhea and fasting. Should I use the chia seed and protocol and BHB at the same time? Should I stay under 20 carbs and how much fat should I eat while my body tries to adjust? - (02:03:03) Question 41
42 Why am I so tired? I'm less than 20 carbs per day, getting plenty of fat. Blood glucose is 90 and ketones are 2.5. - (02:07:13) Question 42
43 My day 12 still has an edema, carbs are 20 or under daily. Is this the BHB salts? - (02:09:41) Question 43
44 When I eat one meal a day I won't gain weight. But if I have two meals the next day I've gained weight. Why is that happening? Even if I work out, did I mess up my metabolism? - (02:14:01) Question 44
45 I ate the same thing three days in a row and my blood glucose around 85, ketones around 1. Then out of the blue, I wake up a blood glucose of 110 and ketones at 0.6. What happened? - (02:16:01) Question 45
46 I am not a newbie. I've been stuck for a long time. The class has helped my dawn effect numbers going lower in the eighties to nineties range. But now with the class my dawn numbers have risen by 30 points. What's happening? - (02:18:30) Question 46
47 Do you have any insight on melatonin in regards to sleep? - (02:19:30) Question 47
48 Best advice for traveling and not being able to completely control your diet. - (02:20:30) Question 48
49 I'm five weeks into keto and starting to have joint pain fingers, mostly. Any suggestions? - (02:25:22) Question 49
50 Suggestions from my genetics were to be on a Mediterranean diet that I did not handle, saturated fats well, eating lots of veggies, the issue of histamines. I am concerned about doing too much saturated fat. But on a plant based diet. I wanted eggs so I ate four. When I tried keto last year, it gave me too much mucus. Medical intuitive told me it was an issue with gallbladder. That said, I'm worried about the diet. - (02:28:53) Question 50



Question 1

1. How long can it take to become truly fat-adapted? Video Time Stamp: (00:16:34): Remember in medicine I told you the reason there's 50 different ways to take magnesium is cause there's no really one good answer. The same reason that how long does it take to become truly fat-adapted? It is variable depending on how insulin resistant your body is. If you have only been insulin resistant for a couple of years and you're 32 years old and you've really done great with keto and lost 20 pounds in the first weeks, yeah, you're going to become fat-adapted a lot quicker than somebody who's been a type one diabetic on an insulin pump for 20 years in your level of insulin resistance is so much higher. That answer of fat adaptation depends on how long excess insulin has been circulating in your body. That's one part. The other part to how long it takes to be truly fat-adapted is how strict are you at the 20 carbohydrates per day? When people want to shift away from that 20 carbohydrates per day?


The part of that question of math is, how much did you stimulate insulin that day? And if you marched through this ketoCONTINUUM, I am trying to guide you into layers of advanced stress to your metabolism in a methodical way. When people show up and say, I want to do keto, I've got a wedding party to be in six months and I need to lose 70 pounds. And if they start right at fasting or eating one meal a day, but in the process, they really didn't increase that fat adaptation. They do one meal a day. They will get fat-adapted over the course of six months, but it's living health. They didn't use the hormones that make Keto feel good. The chances that person is going to stay consistently Keto when they hop over all these other steps is truly why this course is here.


Thousands of people write into the channel saying, why isn't it working for me now? And in part it's because they did not become fat-adapted before they started doing all these advanced stresses of their metabolism. So when they say, how long does it become fat-adapted? Number one, I have to wonder what their insulin levels have been over the last five years. And number two, how strict can they stick to those beginning rules? Those ones I'm truly trying to say, do not distract the newbies with all these other rules. It is really blinders. Seeing 20 carbohydrates per day, total carbs stick there and watch what happens. So the answer is a hedge.


The good news is your body is going to tell you the symptoms of being fat-adapted are so much louder and more consistent than any blood test than any measurement. Your body will tell you. There are some psychological parts in there that can derail people.


There is this guy who will eat three meals a day. He is totally fat-adapted, but his rhythm of eating three meals a day was stuck and he could not advance to the next level. Not because the chemistry wasn't right. He was totally not hungry. He was nauseated by the third meal. But because his rule book said I must eat three meals a day, he totally got stuck. He was fat-adapted, he could move on, but the psychology of this kept him shackled.



Question 2

2. Can you experience autophagy even if you aren't fasting? Video Time Stamp: (00:21:46): Yes, absolutely. So the Dr. Boz ratio gets you a chemistry set that says, we know if you lower the glucose enough and raise the ketones enough. The module four gets you into even more of that Dr. Boz ratio, really gets you into the science of this.

We know that the ratio of low glucose and high ketones will spark autophagy in several, in a crop if you would have cells. So the purpose of autophagy, the word apoptosis is a science word that says, once a cell turns on apoptosis, which means to program it's death. You can't undo it and much like that, apoptosis, it starts in a process and the cell will die so is autophagy. At least that's the theory based on the science today, that autophagy once that still starts to process the recycling of those unused proteins into those cells, they don't go backwards. They really finished doing the cleanup right there and in the proteins that are activated.

Now the question is, if you've got a pile of proteins that all need to be recycled and you clipped autophagy, you pulled off one of them, then yes, you did autophagy, but you say, well, you know, doc, you said your skin is going to look better and your hair is going to have more color and you're gonna not have flabby arms. Why? I did autophagy yesterday? Why is that still there? And it's because you have, it's the pile of proteins that are waiting to be recycled. That impart will show you the outward symptoms of autophagy.

Autophagy is a whisper and it's a cellular whisper of science that's happening. We know that beauty is you can measure it. Now, I don't have everybody out there checking blood numbers, but if you are checking blood numbers and you look for that ratio, the reason I reached for a Dr. Boz ratio of 40 every week is I want a high level of confidence and I just don't think I can do a Dr. Boz ratio of 20 every week. I just don't know. I don't want it to be that strict that this fits with my life, that I can hit that number and then go back to my normal keto journey the rest of the week.

And then week after week I clean out a few more proteins, sometimes sitting at a Dr. Boz ratio 40 without fasting. But the cleaner, if I would, if I was perfect and never had a mistake I bet there would be multiple times in a week I would hit a Dr Boz ratio 40 without fasting. And when you hit that chemistry set, that's what triggers these cells to start recycling.



Question 3

3. I wake up three times a night minimum. Does this raise my glucose every time I wake up? Why am I not feeling all this great energy? Video Time Stamp: (00:24:46):

So let's just review the difference between the dawn effect and awakenings within the night. In the process of a brain sinking down into the deepest sleep that is where your body repairs, that is where your body resets. That is where your healing happens deep in the depths of your sleep. Awakening three times a night is a really tough break in that repair process. You want the best sleep for heaven sakes, don't try to sleep in a hospital cause they're waking you up way too many times. The rest that's needed for repair is long, stable, deep sleep of that six to nine hours, around eight hours of sleep. So when you wake up three times in the night, it's not necessarily, it's the pattern of awakening slows down a healing pattern, but it's not the same reason that you wake up in the morning due to the stimulus of your cortisol that comes from your brain that goes to your liver, which we call the wawn effect.

So this ties into those. The dawn effect is that message with the brain senses the sun is rising. And again, even if you've been working the night shift for 30 years, your brain still senses that the sun is about to come up and that rise in the sun sends a message from the brain to the liver. And what's it doing? It's saying, hey, I'm going to send you some cortisol. I want you to paint me, open a bunch of these leakages and bubbles inside the glycogen. Bubbles are stored glucose and that glucose flows out. Your brain loves using glucose. When it's available, it will use it and that increased energy will wake you up. Now it's all relative. If you've had an average blood sugar of a hundred, and then that cortisol surge happens and now your blood sugar rises to like 120, most people can not feel the difference between a glucose of 120.

And that process is dangerous to say we don't want you to feel that the energy you get from the glucose that is resulting in your liver releasing glycogen is enough to wake you up. But that's probably all. So it's not really this big surge of energy that I often find as people do fasting.



Question 4

4. How can people have a very low Dr. Boz ratio and not be losing weight? Video Time Stamp: (00:28:34): I think I understand what this question is really asking, which is people can look at some of the posts on Facebook or on Instagram and they see these super low numbers. But much like what you don't see me posting throughout the week is what I do, what's my Dr. Boz ratio the rest of the week.

Now I sometimes check it and whenever I check it, I like to post it just so you can kind of see the transparency of what it does, what does a normal ratio look like? But when people hit a Dr. Boz ratio of 20, but then they go back to eating, the ratio doesn't stay that low. It is the process of saying, when we worked through this ketoCONTINUUM you're gonna see me, especially this next week, say each time that we tighten up the metabolism that we stimulate the metabolism, we now would have an average. If I could have a catheter measuring your glucose and your ketones at a constant rate for three days straight, you would see that when they fast and go hours without eating, that ratio really does seem. Again, Dr. Boz ratio reflects insulin so that insulin sinks.

But as you look at the ratio over time it's not nearly as low as what those posts are. So again, people post the shiny pictures of their life. They'll often have really good numbers, but then they go and eat and then the insulin gets stimulated and the ratio doesn't stay there. So if I could put you in a study and watch your Dr. Boz ratio sink and stay there, you lose weight, you would definitely lose weigh



Question 5

5. Once fat-adapted, do we need to worry about shutting down metabolism with lowered total calories? Video Time Stamp: (00:30:21):

What you're looking for fat adaptation is you want the chemistry on your side. So when you know you've got fat adaptation, you feel good, you can find energy even in hours of not eating. And when you eat you have a sense of satiety. That it really can take you for 20 plus hours of no eating. The question that's being asked that I talk about is low calorie metabolism by definition. When that fat-based chemistry is flowing within your body, it is a stimulus of protecting your metabolism. I'd like to just compare it to, go back 500 years where you weren't guaranteed a meal every day. When they have fat adaption, when they have lean bodies, their chemistry was designed to protect the muscle from breaking down, which is what fat adaption does. That dial down metabolism really has a tendency to use the breakdown of muscle products more than a ketogenic state would. That really does summarize the difference between using a ketone based weight loss chemistry versus a calorie based weight loss metabolism.

Can you absolutely protect from shutting down your metabolism? There's no absolute, but it's a really good sense of confidence that if you're eating at an interval of one meal a day or one meal every other day. The total calories isn't what matters. It is that sense that you feel, you will feel good when the metabolism is working in your favor. You will start to have symptoms of not feeling good, crabby. I don't mean like I'm fasting and I got crabby and irritable. This past week we talked about cravings versus hunger. I'm not talking about a craving where you smell cinnamon buns and you really kind of get crabby with everybody around you and start biting heads off. No, I'm not talking about that.

I'm saying it in the sense of really feeling punk like they want to take, they want to sleep, they have low blood pressure, they just feel very low energy that is assigning, you should probably break your fast. That you're pushing it a little too fast, too hard. When the chemistry is matching the weight loss, they feel good. So keep that in mind as you're trying to sort through what's the difference between fat adaption. Do I need to worry about shutting my metabolism down, especially if you stay in the process of following the ketoCONTINUUM? Again, these next couple of weeks are going to really fold closure to a lot of these advanced questions. You should feel good. It's one of the key things when I'm interviewing my team, my folks in the morning, 2:30 in the morning, My weekly keto group when they have questions for me, I keep asking questions until they are able to say, well, if you don't feel well, there is usually something to this.

But most of the time that weight loss is accompanied with a pretty good energy level and a good sleep pattern where I have a lot of confidence that they're doing the right things.



Question 6

6. What effect does exercise have on ketone production? If I'm fat-adapted, could exercise lower the ketones in my blood? Video Time Stamp: (00:33:21):

Absolutely. So ketones are fueled when your body is making ketones and you've got, let's just say 2, 2.1, 2.2 that's a lot of extra ketones. Your body is actually mismatching if you have that many ketones around. So it's wasteful for your system to mismatch your, you will reset to not produce that many ketones. Unless you keep stressing your metabolism and you can stress your metabolism by doing a little exercise or denying food.

When people fast for 18 hours, they get to 36 hours, get to 48 hours and they say, well, my ketones are up to 2.5. I've never seen it so high. It's because you stressed your metabolism and the body produced a bunch of fuel. You can use that fuel by going to do a workout. You will lower the ketone. There's a season last year where I would check my numbers in the morning, I would go for a workout and then I'd get home and before I'd even drink a sip of coffee, I would check my numbers again and you'd always see those ketones lower during exercise. So they are fuel. They will lower your ketone number. It's when people say when should I check my numbers?

I'm like, there's so many variables that go into ketone production and ketone use as well as glucose production and glucose use. If you're going to spend the money and you're going to prick your finger, do it at a time where there's the least amount of variables and that is first thing in the morning, that message from your brain to your liver is very stable. It sends the same cortisol drip every day. How your body responds, how much glucose is stored, how much glycogen is in storage will change as you lose weight. But the delivery of the hormone is very, so morning. Fasting is a great time to check it and yes, you're going to see a higher production of your ketones.



Question 7

7. How long do I stay less than 20 carbs per day? Video Time Stamp: (00:35:03):

It depends on what your goal is. If you look at 20 carbs or less per day tha is a really great way for me to know that you're probably continuing to stress your system and have ketosis adoption. So when people first come on the ketogenic diet, when our newbies come in and they cut their carbs to 20 and they lose all this weight, really put a stress on their metabolism and then you show up a year later and maybe they've kind of drifted up towards 50 carbs per day. But even if they never went to 20 carbs today, they only went to 50 carbs today, but they got all that weight loss and they stayed the course, that is no longer a stress to them, their body's used to that. I know that the human body at 20 carbs or less per day has to be continually stressing to improve their system.

But if you're healthy, if you reach your health goals, then you certainly don't have to stay at 20 carbs per day. There is a variability of, I added this back in my weight loss at my weight, stayed stable, my blood pressure didn't go back up, my glucose didn't go back up. I feel good. This works for me at the season of life that I need. So when people come to me and they say, I'm on to this ketogenic diet, I have cancer like your mom. They do really well for the first couple of weeks, but they don't have a support system. They hopped over all the hormonal improvements and they're still trying to hold it to 20 carbs per day and their brain is like, I don't like this. I stopped.

I say, it's too much for you at this season. I know cancer is scaring you and you really want the metabolism. But the process of improving your health has to fit your life. If you stress to 20 carbs per day or less per day, and then the confinement of Corona virus has ticked off at everybody and is irritable and you're going to sleep in a tent for the next two weeks cause nobody can stand to be around you. Oh, for heaven sakes, make an adaption. But know that the rule of 20 carbs per day, it's just the highest confidence to know that is truly a metabolic stress for the human body. It's 20 carbs or less per day. I really remember I still probably stick to 20 carbs or less per day most of the days. Like it's only when I screw up and cheat that I would have more than 20 carbs per day. My body's used to that. I am constantly in ketosis. I can flex my metabolism to be strong when I needed to be. And I know that if ever I had a reason that my body should attack a virus, that I would need to take chemotherapy, that I have a metabolism that's very strong because I'm constantly stressing it. I'm working it out by not using carbs as my primary fuel. This is a human race. We're trying to help people with not this crash course in misery. So 20 carbs per day, amazing for getting people started and then people adjust to what fits for them. In my little support group, we do talk about when people are having trouble, I want them looking at, reset to 20 carbs per day.

Watch what happens, look at what your sugar does and know that your system is saying, hey, I got plenty of places, I need cleaned up. You can't do that unless you give it the chemistry setting to get that accomplishment.



Question 8

8. What do you suggest for sleep medications if you're fat-adapted but you're still not sleeping well. Video Time Stamp: (00:39:16):

In the handout I shared with you, there is a blog post that says a case for sleep. Jennifer Marie and her husband we're trying to really kind of tighten up their keto adaption. Her husband had a pain syndrome where he'd had an accident, he wasn't sleeping well and he was using some of the not so good medications. It's great for pain and great for short term, but they had really turned into a messed up sleep schedule. Unfortunately when you don't sleep well, the pain gets heavier, the cortisol will eventually get heavier and they don't do very well. So I talk about the ones that are safe in my practice are Tramadols and then what I call the atypical antipsychotics. I know that sounds really bizarre, but they are a very wonderful reset of sleep. Again, sleep is one of my first loves in medicine where the science of getting your brain to sleep really well, like it's one of my favorite things to help somebody with because so many things in their life get better when they sleep better. Now when you tell somebody antipsychotic, in fact, before I would let them fill the prescription, I'm going to say, when you go to Google this medication, you're going to think, I think you're crazy, but you're not crazy.

This medicine just shuts down those processes of sleep. It's like the hard reboot to a computer where I can fix your sleep in a trickle, but that means you gotta be perfect for about a hundred days. Or I can fix your sleep in three days, which means you need to take a vacation from your life and let me control your sleep. And of course I'm not doing this to you, but the reason I'm telling you all about this is when you read that article, a case for sleep, I tell people, print that article out, print that blog post. Out at the bottom there are links to the science based articles that show why these antipsychotics are so powerful at resetting sleep. And that's where you'll find that Trazadonel is also a very good one, but it doesn't screw up sugar.

The ones that are the dangerous ones, they act like boost. And I do a lot of this teaching in my brains of addiction course where I go through what is it doing, why is it doing it and how did we come to treat people with medications that act like boost. And if we want the blue boost for five days, we call it Librium. If we want the boost to last for three days, we call it Valium, if we want the boost for two days, we call it Klonopin, the boost for less than a day we call it Adavan or Xanax and it ages a brain and it does not help your metabolism. That is not the sleep medicines to repair somebody who has diabetes or is overweight. You will not make that problem better. But these are some of the medicines on my list. Obviously you need a doctor to do this.



Question 9

9. How do I increase low ketones? I'm adding MCT oil and BHB and it increases, but later drops back to under .5 (blood measurement) Video Time Stamp: (00:43:25):

So this is really important because there's been a lot of you that I said, if you're struggling, if you're in that 200 club, a sip on BHB, have some MCT, and slowly work through the plan for the next two weeks. Cut those carbs down. If you're above 300, cut it to 200, then cut it to a hundred, then cut it to 50 and then get to the 20. Those steps into becoming keto adapted are super important to not give you such a crash course that you drop your blood pressure and you end up in the hospital while we're trying to help you.

So if you're in that zone saying, hey, I can make my numbers look really good when my blood measurements, when I take these ketones in a can or when I use MCT, yes, these are really good biohacks for me. Making sure that you're a little mitochondria know what to do with the ketone because that first week when we have people keto adapted our newbies, drop their carbs to 20, their body made a bunch of ketones and they peed most of them out because their mitochondria didn't know what to do with them. It also is part of that mental sync for the transition of becoming keto adapted. Their brain doesn't quite know how to lift ketones from the blood across the blood brain barrier cause it's not seen them. So by using MCT and BHB, you can totally surge those ketones and your body knows what to do with them.

So it's not a bad thing. It is something that is a tool that as you learn to say no to some of these other things, the better your ketone production will be when you have ketones of 0.5. First of all, that is ketosis, but it's probably not enough stress to lose weight. So if you're looking or saying, I want autophagy, I want these better numbers. Well that means you need to stress your system. So the first stress that we went through for newbies was cutting to 20 carbs or less. As we move through this ketoCONTINUUM, you're going to see me use different ways to stress your body and, and then leave some of these bad habits, at least compartmentalize to a few hours a day because that is what causes your body to respond. Low ketones are assigned that, yep, you're in ketosis, you can stay in this stable zone forever, but if you're looking to improve the repair, we're going to move you along to ketoCONTINUUM.



Question 10

10. Will you give us some daily meal plans with <20 g carbs and a good cronometer fat/protein ratio before this is over? Video Time Stamp: (00:45:16):

No. When it comes to food plans and food diet meal plans, first of all, there are a ton of people out there that make them and they do a lot of work putting into them. Thank you for those of you that do them, but just like this past week where I asked you to taste sardines and if you need a good belly laugh, go look at the sardine comments over the last week and those striking, just like pinch your nose, I can barely handle this. Then realizing, okay, it isn't that bad of a taste. It really isn't that bad of a taste. But as we take your palettes from a very carby palette, one that's been using carbs a lot, and then I try to to write a a meal plan, it will be specific to what your tastes are and they change so much in the first year of keto that I could have a 20 gram carb meal plan for week four. I could have one for 8, I could have one for week 12. I could have one for week 16. Each time you might get stuck at one of those palette, but if you're maturing your palette, it changes so much in the first year. That's why you see these things fail and I contend you will have the best control by using this little trick that I'm going to start sharing that our friend Spencer is going to share with us.

While we don't offer a specific meal plan in the cronometer, what we do is we have this feature called suggest foods. I'm going to give you guys two different examples. You can access it on the web. Basically what it does is it looks at your current macronutrients and your current micronutrients. If you have, so you can see this, the account on today has a good amount of vitamins but not quite enough minerals and the proteins still need to be dialed in. You can take a look at that. I'll just click that here. It's going to take a minute to load and it's going to suggest foods that fit your macros and fit your remaining requirements for the day, right? And so you can see here we have a couple couple of things and obviously because of the way I have set up my account, that is according to the 20 total 20 grams of total carbs and the protein fat requirements according to Dr. Boz program, you're getting foods that actually fit perfectly within that, and so again, you can see, you can like the foods or not and this program out your further recommendations.

If you just want to cycle through and see a bunch, you can just hit the X button and you're going to see all of the things that are recommended. And now on the side here, if you're a vegetarian or vegan, you can also switch that up here too. This is where you get like the helper of the year award. Cause this is the question that I cannot answer for these patients. I just don't study it enough. I just keep saying go to the cronometer app and find this button.

Yeah, it's a tough thing. That's a vegan ketogenic diet is a pretty masochistic way of life, I think in my own opinion though. So anyway, you can also exclude other things. If you have dairy, nuts or seafood you can exclude those things here. I also have a bunch of funky recipes on here, I've excluded my recipes too, but if you've created a bunch of custom recipes, you're going to be able to see those as recommendations too. Now, the second scenario I wanted to show you guys, now this is in the middle of the day. You may not have the things that we're suggesting in your pantry, but if you want to plan out your meals, actually build your own meal plan. We'll just go to a day in the future here and we're going to click on suggest foods here. Now, I don't have anything logs for the day, so we'll get a sense of what it's going to show me. I'll go to whole foods so you can see you're getting a lot of nuts. On the vegan diet here, if we go to all foods, we'll just take a second here to load up. We see a great protein to fat ratio. And this is basically because we're at the empty day. This is mirroring what the ratio is, purely from that macro a target standpoint that you've set up, following Dr. Boz program. This is where I would recommend if you're looking for some food suggestions, you're not sure what to eat or you're not sure what to shop for in the store. I would go here and check it out so you could get some good suggestions and see how those things fit your macros.

The other thing that we talked about was finding a way that when we ask folks to say, don't look at calories, look at those total carbohydrates. Just go back and show when they were setting up that account where that total carbohydrate a little dropdown is.

Absolutely. There's two things that'll show you here. Go to settings and you'll actually, before I do that, so you'll notice in here, I'll jump back, it would be more clear. I've set this column over here, two grams of carbs, and I can see what the total grams of carbs in each of the things that I've logged on. And to do that, we're going to jump over to settings display. Just in general diary, you can choose what to display in that right hand column. It's by default, it's calories consumed, but you can set it to total carbs here to get a sense of how many carbs each thing you're logging is contributing to your total. So one way I would recommend to kind of filter out the calorie information day to day and also just jumping back to targets to make sure that you have total carbs selected up here and your macronutrient targets area. And you can select total carbs here. We have a couple other more advanced options if you're further down the line in the program. And then at the ketogenic calculator, we recommend the rigorous, I believe the rigorous is the setting that works. That's what I recommend. And if you are doing any adjustments to that you're customizing, I would select custom and again, you can actually edit the values in here so you can either just mirror what's in rigorous or put your own values for your own needs there. And that's it.

There are other carb counters out there that are super easy for patients to learn, but it is at the risk of not really solidifying the level of education that can carry forward for a lifetime. And if your app has all those tools, it does take a learning curve.



Question 11

11. Dawn syndrome, what to do? Video Time Stamp: (00:55:54):

This dawn syndrome, they don't mean down syndrome. They mean dawn's syndrome, which is when the morning comes, their sugars are high. What do I do? This is one of those measurement tools that I think plays into the next question to say, yeah, when your sugars burst up above a hundred in the morning, it really is a reflection. That's your insulin. It has been high for a long time. In the mornings you do not have insulin. Your insulin is never zero, but you have the lowest levels of insulin when you're in those deep hours of sleep. When you awaken in the morning, that signal from your brain to your liver is releasing sugar. If it releases an abundance of sugar, like your morning fasting sugars are above a hundred, you have been insulin resistant for a really long time in at least six months, probably a couple of years. And to get that to go back down, it takes months of staying the course. We know that if you want to do it faster, we're going to move you down that ketoCONTINUUM a lot, to higher numbers or to more advanced levels of ketosis. We're going to go through some of that in the next week. Saying when I get you from right now, end of module three, people are hopefully at least two meals a day. And then I shuffle you through the higher levels of metabolism in this next week. It's those times when they're checking that morning fasting sugar, when they say, wow, my sugars are so high. How do I get this to go away? I'm like, you gotta stay the course. And that's why you're going to see ketoCONTINUUM number six, show up in ketoCONTINUUM number seven. And even if you can't stress all the way up to seven and eight, staying the course at keto continued number five and six for six months, you will steadily see that morning sugar come down. This is a long game.

This is the tortoise versus the hair. And you stay the course to slowly undo what your body did in secret. It didn't tell you it didn't send out an APB saying, hey, this is what's going on. Stop doing that behavior. And now that you have awareness of it and you want to undo it, there's some fast ways to undo it. Once you're fat-adapted and there's some slow ways and really the answer of how quickly you take care of that will be what your life looks like? How is your support system? Which brings you back to making sure you have a support group.



Question 12

12. Insulin resistance - how do I know without going to the doctor? What are indicators? Video Time Stamp: (00:57:32):

Get that little poker for your finger, but for those newbies, you do not need to do this. You can stay measuring urine ketones the whole time as long as you're healthy. I mean when you get to follow your health, okay, if you run into trouble and you want to hack it, that's where we start talking about poking your finger. So please do not be overwhelmed that everybody has to buy a meter and poke their finger. I contend that most of the people watching are ready to put this into high gear. I want to be better. I want to leave my house from Coronavirus. No, I'm not going to have a cytokine storm. All of those things are very real. That's not fake news, but it is not something where you can start the ketogenic diet two weeks ago and today have a beautiful immune system. You have to address this insulin resistance so when people have insulin resistance, one of the ways they know they have it is they're on the ketogenic diet.

They're following Keto and they don't lose weight. They get stuck because your insulin is still outperforming your stress. So I need you to stress to the next level, which is what the ketoCONTINUUM really outlines for you. Insulin resistance is a stubborn or ineffective amount of insulin. It shows that the morning fasting glucose is high and those ketones in the morning are low. Even if you scroll back from my history and Instagram and watch what were my sugars a year ago, what were they two years ago? What were they at the beginning of my fast a month ago? I still have numbers that aren't perfect, that aren't great and they are especially not great if I don't follow the rules. I'm human. We know that when you look at a Dr. Boz ratio, which you're going to learn about in this next week, you can measure your insulin.

I mean, I can do that. I do not measure insulin in my patients anymore in the office unless I am at an extreme puzzle because so often insulin is this very volatile, very high moving hormone that if we happen to capture it at the moment that I am expecting, then all is right with the world and peace and harmony. But more often it fluctuates. It goes up and down. And if they have a bowel movement before they go into the doctor to get their blood check, they just wasted their money. I can't make sense of it because of the stress. It wasn't 20 minutes after the bottom of, what was it, 50 minutes like, oh my goodness, that's too many variables. But I can look at the two molecules that insulin controls, which is glucose and ketones. When you look at them in relationship, which is what the ratio does, which is what the book ketone index does, this is the science behind quit looking at the volatile insulin.

Look at what insulin controls, which of these two numbers that slowly change, which is glucose and ketones. And by slow, I mean less slow relative insulin.



Question 13

13. Must I progress to OMAD or one meal a day in order to lose the last 10 or 15 pounds. Been keto for a couple of years. Or is there anything else I can do? Can I just cut? Video Time Stamp: (01:01:00):

Here is the best answer, you're going to find out in the next two weeks. OMAD is one option, but I would contend it doesn't fit in everybody's life. And I think some people do Omad and they say they're not really doing the chemistry for OMAD. So you're going to learn about that next week. You're going to totally learn about my pet peeves from people saying, I've been keto for a year and it doesn't work.

I'm saying you're not looking at your chemistry. A keto is not a diet. It is a chemistry set inside you. Look at the chemistry and you'll know where you're going wrong. You do not need any new OMAD in order to do this, but you might have to have, if you're trying to get that extra 10 or 15 pounds down, you might have to have some stresses that I will outline in the next little bit. I have a couple of people who were chronic gum tumors and the chewing of the gum, their insulin, and I don't care if they would have not eaten for four days. They still had so much insulin production. Okay. Maybe four days, but they had so much insulin production that they couldn't lose weight until we addressed that. And that's coming up in the next few weeks here in the next few modules.



Question 14

14. Is it possible that some people just can't lose weight on a ketogenic life plan? Following for eight months and old weight loss but feel good. Video Time Stamp: (01:02:35):

Here's the key to this question is she says, I feel good, which means she's fat-adapted. Okay? So if you're fat-adapted, the beauty of being fat-adapted is to use the fat that's stored in your tummy and your thighs and your arms. That fat is sitting there as a fuel source for you. You cannot, you can't get it when you're not fat-adapted without a major price to the human body. When they feel good, they're keto, they're like, gosh, I feel so much better. I never want to go back. Okay, now lean up your body, improve the overall prediction for health. And if you haven't lost weight in eight months, it means you got to a certain level of that ketoCONTINUUM.

And you said, good enough for me. And if that's fine with you, and you do not need to lose weight, you're otherwise healthy. Great state of course. But if you're saying, no, I probably shouldn't be losing another 20, 30, 50, whatever pounds then your ketoCONTINUUM needs to be stressed and you're going to see how to do that in the next week or two.



Question 15

15. What do I do if I don't absorb fat? Floating poop and diarrhea. Video Time Stamp: (01:03:26):

Yes, this is important. I know 52 of you said, what do I do about this? And the key thing is staying the course is really important. I know in the group this past week, there was somebody who struggled with gastric bypass and as a consequence, she really can't absorb that. And if there's ever a patient that I, my heart just breaks for it is the folks who have had the surgery and the surgeon cut out or rerouted their gut to a point where they can hardly have the food, hardly gets exposed in the section of their gut where the hormones are made, where the feedback for how they're going to advance there.

It's either cut out and gone or it's rerouted that the only food that sees it is the burping food that goes backwards in their gut, which it shouldn't do. Floating poop is malabsorbed fat. And again, this is probably going to be a focused video in the future that I do because there's so many people that need to hear the science behind. Why do I keep saying, if you're fat-adapted, I need you to lick the spoon with that MCT, I need you to take one capsule, one bite on it, and you do that three or four times a day and you just switched the oil mouth and swallow. You don't have to bite it. You can swallow it. But I'm just saying a tiny, tiny dose of MCT, and what you're doing is you are upregulating the receptors in whatever part of your gut.

It's still working, even if they've had this surgery, you can see some of those receptors migrate downward and they somehow absorb the fat eventually. But it is a long haul. One of the key things, if you can't absorb fat, you are going to have dementia. I'm not joking. This is a huge deal. The reason I'm so strict about saying, listen to me, if you have folks floating poop fat in your poop, it is a malabsorption that will rot your brain from the inside because you are low on fat. Fat has essential parts that you can't make. You have to absorb them. You'll know you're getting close to a problem by looking at your vitamin D. Vitamin D is one of those minerals that yes, you need to, the sun helps you turn it into the usable version of that.

But your ability to absorb fat is one of the major steps in how good is your vitamin D? And if you have an inflamed gut one that's so inflamed, you can't absorb the fat that it goes into your guts and your guts just squirt it out the other end. You're in trouble. You might not feel it yet. You might not have enough storage in your body that you don't feel it. But I would push you to go back and look at your vitamin D in your labs over the last five years. And if it's less than 50, focus, listen to me, it's a really big deal. Your journey to figuring this out is slow and steady. Put that MCT on your tongue. The reason I keep saying MCT is it's the one fat that you don't have to digest. It gets absorbed and then your body can use it. Now, it doesn't have essential facts in it. You still have to put those in your life. But it's the one place where I can methodically put it in a pill and say, please keep putting it in on an empty stomach and just take one pill and watch what happens. Because you're going to have this as your barometer to say how well is your gut healing? And if you take a biopsy of somebody who has fat malabsorption, it is so swollen, it's almost not recognizable as gut as endothelial lining which you're not going to care about because it doesn't look like the normal gut shit. The cell structure is goofy, it's broken and it comes back when the inflammation goes down.

That's why this ketogenic journey is such an important part of saying, don't give up. The gal who said, I just can't handle it. It breaks my heart to say, the problem is you're going to show up in my office and I mean metaphorically in 20 years. And you're saying, well, why didn't somebody try to help me? The truth is fat malabsorption and people after gastric bypass you know, my whole clinic is a collection of brains that don't work. Why am I so passionate about the ketogenic diet? Because it fixes brains in a way that I've never been able to do with prescriptions, but they can't fall off. They have to stay the course. That's why this course is so important.



Question 16

16. How do we get calcium on Keto? Dairy has too many carbs. Cronometer tells me I get 15% of what I need. Video Time Stamp: (01:08:36):

Okay, good job using a cronometer. I bet my groupies are gonna know exactly what I'm going to tell you. So first of all, calcium is one of those minerals that you don't need as much of as the human, as we've been telling you. You have so much calcium in your body, in the form of bones. Now you say, wait, I don't want to use my bones. I'm like, I know, but if you're worried about calcium being, well, I'm telling you it's not critical. Eating a healthy amount of calcium is a good idea. But it's not the highest focus for what I would have you looking at. Instead, when people talk to me about how do I get this mineral in? How do I get more selenium? What about taking in cocuten? I say, wait a minute.

When I look at people taking in a supplement, the supplement is supposed to replace something that's missing within the body. So calcium is a good example of saying you're not missing calcium, you're just leaking it out your body and specifically the gut. So in most people they don't, I mean they have irritable bowels, they have inflammatory bowels, they have ways where their gut is supposed to be this nice tight knit, you know, fit. But as they swell, the cells don't fit. And that's where these little micronutrients slip out. So when people talk about vitamin replacements, and everybody focuses on the supplements and what's going on. I'm saying stop fasting and, and really allowing your gut to heal, which is what other thing for that fat malabsorption that I didn't say is you're going to heal a gut fastest when you slow it down when you stop using it.

If you want to stop, if you want calcium to be higher in your body first of all, I would make a huge bet with you that it's not low, that the cronometer app is showing you. You should have more because it's using the ADA guidelines and stop looking at the guidelines, the nutritional guidelines. I would contend the chances you're low on calcium is so close to zero. I'm not worried about it, but what it does give me a teachable moment is to focus on stop thinking that you have to replace all these minerals. When I look at my advanced keto patients, they don't take vitamins, they don't take supplements. They don't even have kumon or there's another one that somebody keeps asking about, berberi. They really have restored health to the part where the food that goes in is a high nourishment.

Then the most important part is they don't leak out so much fluid, so much minerals and vitamins because they're not chronically swollen. It's a really good teaching point.



Question 17

17. If you fall off the keto wagon briefly go over 20 total carbs, do we jump back on where we left off? When is it best to start at wk 1? Video Time Stamp: (01:11:10):

You go back to 20. Okay, so it says you go back to peak one. Well, again, what you're trying to do is reset where you know their success. Okay? Why do you do that? Because your ketones, especially if you've been fat-adapted, your ketones are going to rise, your glucose is going to go down, you're going to have less inflammation.

Just like when people fast for the first, let's say you're on a carb diet. I lock you inside a jail or a hospital, call it what you want and you have nothing to eat for three days. You just get water. If you watch what happens inside their body, they flush out a bunch of fluids. That salt that they flush out is what we want you replacing. But most importantly, they tightened up the inflammation. When you fall off the keto wagon, what we really want is you to feel good as fast as possible. So 20 total carbs or less helps me know that is absolutely insuring you to say you'll feel better. Stay the course for a week, 20 carbs or less. I mean, I live my journey that way now because it's just such a better way of living.



Question 18

18. Why does your heart pound after an epsom salts bath?

There was lots of talk about the Epsom salt baths and I pushed you to say, oh for one of these floats, it really changes how you see it. First of all, you see vacation cause it really is a vacation hour. But looking at the way magnesium goes into your system and really stays there is a powerful change when you look at the heart pounding that happens after an Epsom salt bath. That influx of magnesium does change how your heart conducts. But also if you were in a nice warm bath, you are a vasodilator, which means that your blood vessels are nice and wide open. You go to stand up and your heart can really pound when you stand up. Not bad. This is normal. This happens to every, almost everybody after an epsom salt bath. Just know that this is a shift of chemistry that's happened in your system. It is the real deal. You are adding magnesium to your body when you're in that epsom salt bath. I contend that the best sign that you're not super low on magnesium is you have one of your absence. I'm talking about the float spas. They go in for a float spa and they sleep well, but they don't have the palpitations. They don't have some of the other things that happen when adding magnesium to their system.



Question 19

19. Does absorbing abundant magnesium during a bath or float have the same laxative effect? Why or why not Video Time Stamp: (01:14:39):

So it does not have the same laxative effect. It is the lax of effect of magnesium is the salt within the bowel. When you swallow it , it attracts, especially when you swallow a big glob at a time, it pulls in fluid and then the salt is a salt. It flushes the salts. It's a great laxative. But adding magnesium to your circulation is not a laxative. It's just a mineral. Okay, so alternative to baths. I was showing somebody was saying they just don't have access to that. So this is where the float spas really good idea. My 76 year old dad, now he's on dialysis and that would not work for him. But prior to dialysis he would go get in a float spa and do a float a couple of times a month, maybe two times a month.

Just looking at replacing that magnesium at a level that was predictable, and felt good. He doesn't have a bath that he hates bathrooms. So that was how he did that. Other ways of doing it include like you have whenever I'm doing writing at my desk at home, I have this garbage bin, this plastic garbage bin, and it's filled like four inches from the top with water. I think I have like surge pounds of magnesium in there. And then I grew up on a farm and there was such a thing as a cow tank heater. Now you can buy them in South Dakota. But my friend in Texas says, I've gotten a forecast of Gambell supply and I can't find them anywhere, but it's a heater that you put inside a cow tank in the wintertime so it doesn't freeze over, but it's an awesome source of heat that keeps the water warm.

What I will do is I'll put the heater in my water of epsom salt and then I'll heat up the water nice and hot. Then you take the heater out before you put your feet in it, you'll electrocute yourself. Don't do that anyway. You heat the water up and you then have nice warm water for my feet with lots of epsom salt so I can sit there and do that cycle about six times if I'm writing for a day. I love the energy I get from the magnesium, but I also just like it's calming and it's another way to get some salt. The problem with that is the equation for absorbing magnesium is how much area of your skin is touching the water. If your water is only this full, you're going to have to put your feet in there for 60 days or something to get the same as you would in one hour of being in a full spa.

Just really keep that in mind as you look at the benefit of looking for a float spa, everything in the country seems to be opening up again. That would be an awesome place for you to try, a full spa.



Question 20

20. Can sleep apnea really go away with keto, or will a person always need the c-pap?

Yes. I have so many patients who have given their C-PAP back to the universe. They are truly off of sleep apnea. Number one predictor of sleep apnea is what is the circumference around your neck? 17 inches. Next for the conference is a huge difference between what that cutoff 17 is really important. Have you lost weight? Measuring to see if you have a 17 inch neck. This was actually the case for people who were like NFL bodybuilders, linemen, if their neck size was 17 or more, the chances they have sleep apnea is much higher. Once you lose weight, just like you lose weight in your fingers, you also lose it in your neck. That decreased neck circumference does decrease sleep apnea.



Question 21

21. Do you recommend staying under a certain carb level at each meal? I heard that eating over 7 g of carbs at a meal could spike insulin?

Yes, you're going to see this ketoCONTINUUM as you work through it right now at the end of module three, you should be trying to reach for two meals per day. The reason is that every time you eat you spark insulin. If you're a hyper insulin maker, if you've already got insulin resistance, every time you have a bite of that food, you make insulin. Even if you only have one bite, the insulin spike has a minimum peak. When people say, I'm all mad, but I have a handful of carbs or a handful of nuts at bedtime and I have cream in my coffee, both of those spike your insulin. If you're trying to repair, I need you to stop doing that and you're gonna learn about that next week.



Question 22

22. Please explain why you might stall with weight loss after being keto/lchf for over a year? Is it metabolism? Is it hormonal?

You're gonna learn that next week. I wanted to make sure to address the gastric bypass story and just say that's a really tough case. That's why the course was created. You got to know the basics in order to get you to the higher chapters.



Question 23

23. Why is the scale not moving?

I think I've talked about that. You've gotta be able to challenge your metabolism. We're going to go through some stresses this week. We're going to have some real stresses in the bonus video.



Question 24

24. Why is sugar not dropping

Your insulin resistant to fix insulin resistant? You're going to follow the videos in the next week?



Question 25

25. Smoothies Video Time Stamp: (01:20:31):

I think don't do that. Don't do smoothies. I don't know. I think of particle size, I think of what are you putting in a smoothie? How do you have a smoothie without carbs? If you have high fat in your smoothie and water? Okay. But that's probably not very tasty. What can you possibly put in a smoothie besides protein powder? Well, why wouldn't you just eat the protein? The satiation or satisfaction from food is about the mastication, which means chewing part. You skip that with a smoothie. Don't do that. I wouldn't do that.



Question 26

26. Snacks? When to add? Before or after a meal?

What are you doing every time you put a snack in? You add insulin. If you're trying to reduce insulin, quit stimulating insulin.



Question 27

27. How many snacks while fasting? On and on and on

No. No, no.



Question 28

28. I have gained weight on the way to changing my body chemistry. What happened? Maybe all the whipped cream. How do I help myself against stubborn insulin resistant liver? Video Time Stamp: (01:22:28):

It's a really powerful teaching point and it definitely belongs right here in module three. When you look at the first two weeks I think back to when my mom had, again, I didn't know nearly what I know now about keto. We just were doing high fat, low carb. That's all we knew. We knew that she had one shot. And we couldn't screw this up.

We didn't lose any weight, but oh my goodness, did we feel better? As you are going from a sign of really insulin resistance, meaning the body is holding onto a bunch of water, the body is definitely not in its healthiest version, but you are switching chemistry. I just need you to know with my whole heart, I need you to stay the course. That process of changing chemistry has to happen for you to arrive at the other side and then journey through the improvements that are found in your chemistry. I have a great example of a gal in our keto group who, oh my goodness, if you could find somebody who tries harder, I don't know how you'd do it. She injects insulin. She's been insulin resistant for awhile. She loves herself with carbohydrates or she has for most of her life.

Now she's been coming to the keto group and she's really trying to address this. I think she's stuck at a stable, like we've told her, stop stepping on the scale. Whatever the scale is going to do doesn't matter right now. I need your chemistry to change because it guarantees that you're going to get better. Once the chemistry changes, the weight will come off. It is a chemistry, it is a chemistry effect that is a consequence of arriving over this hurdle. Your stubborn liver took years to get this back. It's going to take us maybe a few weeks in your case. It has everything to do with how could you keep the blinders on. Could you look only at total carbs, stay with total carbs, don't look at anything else. When you do that, the chemistry does change.

If the scale is going up, just don't look, do not look at that. I mean I talk about it there. The most I would have somebody check is weighing once a week. Sometimes stepping on a scale is this kind of therapy. So I put it in one of the challenges at the end of, I don't know if it was week two or week three, where I just finally let them step on the bank scale cause they're like, I want to know if I've lost weight. I'm like, I don't care. There's so much more to this than the weight loss, that chemistry becomes the goal. Once you have that, you'll be amazed. You'll be, why didn't somebody tell me it was so stinking easy to lose weight? It's because the threshold you're about to go over. It involves trust. I would contend there are many people in the circle of trust in medicine that we blew it.



Question 29

29. Science based impact of sweeteners, stevia, erythritol, monk fruit on ketones and glucose. There is quite a evidence of literature out there where they put it. I see how that dana green, or erythritol four grams of carbs per teaspoon. And I need at least three for coffee. I don't count those carbs. A friend said that type doesn't count, but I'm using nothing because it's a waste of four carbs to me. Video Time Stamp: (01:28:44):

The point I'm making here is there's a lot of ways to manipulate the counting of things in the ketogenic diet. These sugars are a blessing. Before these we really did have to say no sweeteners, stevia, monk fruit and erythritol actually are pretty good at keeping those sugars low. But I'm hedging here because I don't look at any of those. I don't put any of those in my diet anymore because of what happens to the palette. This is another reason why I don't write food plans. I want you getting rid of that sweet taste. I want you having a sweetener in your body once a year, once a year for your birthday. I mean, like really rarely. It should be a treat that is truly a treat, not an everyday treat. Now I didn't start out that way. I started out using erythritol and stevia and I was very used to having sweet land on my tongue. Now it's a rare treat and the difference really is it does provide a lot more pleasure when I do have it.

But the bigger goal for having the sweeteners is less, less, less, less, less. That's why you see me doing things like I need you to drink something with nothing sweet in it. Get your tongue used to tasting what it looks like. They have no sweeteners in it. And then knowing that yes, there are, and if you saw on the cronometer app, he said you could see those sugar alcohols. That's things like erythritol. I think once there is sugar alcohol keep in mind that I use sugar alcohols in my clinic to help you prepare for a colonoscopy. They go in one end, they suck in a bunch of water to your gut and they flush out the other end. And we let me put a scope up the bottom. It's the cleanest ball we've ever seen. That is what sugar alcohols do.

They are a laxative, so they're not good for you. They're not the best thing I would be putting in your body. They are a bridge that can be used in a time of a craving and they are easy to love. If you're using them, that's where I say then get scientific. You want a science-based answer, then use science not for a population, which is what every one of these studies is done on, and so you'll say the erythritol people are going to study what arithmetic does and bodies. Guess who they select to study. They look at healthy, lean people using erythritol. They don't look at insulin resistant people. They don't look at people with a high fatty liver. They look at the perfect people and their study comes out to say, look at how little insulin we simulated. This is a great sugar alcohol and I'm like, party fall.

That is not who I'm taking care of here. Wean healthy people don't use a lot of stevia. They don't use a lot of erythritol or if they do good for them, it's not affecting them. The ones I'm trying to rescue from the edge of the cliff are the people just like that woman I was saying, she has been in our keto group trying to change behavior for the better part of a year. As she started out just rescuing from all of the different ways that you can change and eat carbohydrates. She is addicted to these things and she'll put in like six packs in her morning coffee. And I'm like, what? How do you not have diarrhea all day? It's because her body has really grown used to it. I said, all right, here's what you can do.

If you want to see what that does in your body, wake up tomorrow morning and check your morning fasting glucose. Okay. And then take one of those packs, dissolve it in a little bit of water and drink one and then set the timer and check your sugar at 30 minutes at 45 minutes and an hour, 30 and 60 minutes is really enough. And what you'll see is if you do, especially ketones and glucose, it's really looking at your insulin. If you only have a glucose monitor, then checking the glucose is another way to say did it give you an insulin search? Did it give you a glucose search? Cause if you're a google search, then your insulin searched. The best way to measure it is to look at the ketone glucose at the same time. It's to say what did it do to your body?

Because unlike a population study where you can google and say, I have evidence that shows me what it does. Yeah. Did that population they were studying look like you. I mean on the inside, did it have an inflamed liver? Did it have high insulin? Did it have an addiction to those sugars? And if that's the case, then you can make some conclusions that match you. Most often they did not look like you.



Question 30

30. Is it true if you drink apple cider vinegar with water before bed will help you lower the dawn effect? Video Time Stamp: (01:32:42):

What is Apple cider vinegar? It's a fermented drink now. I showed you the little pH monitor that I use when I do my kombucha because kombucha at the store has a lot of sugar in it. But if you make your own kombucha, you ferment your own tea with sugar in it, that fermentation decreases the sugar content and you'll know by looking at the pH. The more acidic the pH, the less sugar in it. Apple cider vinegar is one of those fermented sugars that tastes not so bad. But if it tastes pretty good, it's probably cause it's got some sugar in it. What they're doing is they're shifting your pH. I'm like, okay, that doesn't hurt you. But that's just a trick. It's not really fixing the problem. You shouldn't be having anything.

If you've got the dawn effect, the most important time for you to have nothing in your mouth. That includes gum, that includes tea, coffee, all of the above. The only thing you should be putting in your mouth for 12 hours before the sun rises is water. And if you still have the dawn effect, then we'll go 13 hours before the sun rises and then go 14 hours. So if you're saying at bedtime, which I'm guessing is when it's dark out, you're putting in cider vinegar, it's stimulating your insulin. It's stimulating an effect, I wouldn't do that. But lots of people do it, put it during the day if you want, but make sure you check the pH of it.



Question 31

31. How a person can have high glucose readings in the morning and also have high ketone levels. Video Time Stamp: (01:34:18):

Yielding a good Dr. Boz ratio or yielding a high Dr. Boz ratio, example is a glucose of 137 and ketones of 2.9. When you're looking at the insulin effect, and you're going to learn a lot about this in the fasting video. As you had a rise in sugar, it didn't happen yesterday. It happened for the last 10 years, let's just say 10 years. And the first year you had enough insulin that it kept your sugar down and the next year your sugar was still normal, but it was even more insulin to keep it down. And then the third year it was this pile of insulin.

To have a blood sugar in the morning at 137, despite producing ketones, says you've done some amazing things in the last six months. You've got ketones producing, which means your body's chemistry has shifted from yesterday, has shifted from last week. So when you're looking at ketone production, when people say, I have this ketone, that's 0.5, why isn't it higher? I've been doing keto, I'm doing everything right. I'm like, your insulin is stable, your insulin is as it should be. If you want to lose more weight, you have to lower the insulin, which means you gotta stress the metabolism. Stressing the metabolism is how to enhance the keto effect. What this is saying is stay in the course. You've made such a huge headway. If you stay the course for a year, you're going to be amazing.

That lowering of the glucose is a sign that you are decreasing the stubbornness of your liver. You're emptying your liver, the insulin effect is growing better when the glucose is still high, it's still coming out of storage that you've been storing for years, waiting for this time where there's no food. And I would contend that if you have that high of ketones, that you could probably benefit from a lot of the fasting cycle that we're going to talk about in two weeks because you have plenty of fuel. You just need to give your body time to burn it. And that isn't easy, but it's possible.



Question 32

32. Is it possible to have too much salt? I have a lower limb swelling and I've only previously had the pregnancy. Video Time Stamp: (01:36:11):

You can overdo it. But what I would really contend is in a healthy system your kidneys should flush all that out. Now, I mean, I still get swelling when I have too much salt. So you can overdo it, but it is the rarity. The rarity is to overdo it. Here’s a couple of things that I would do if just to test the salt. Criteria is if you think you're having too much salt, I would Google float spa and go in and soak in, magnesium, salt, float spa. Now, I should say this with the caveat, but heart failure, high blood pressure, diabetes, where you're taking several medications, probably should talk to your doctor before doing any of that.

But if you're just like the normal trying to lose weight and you're saying, I want a lot of salt in, I've had these babies and that gave me some swelling in the ankles. What it's saying is the nourishment is not probably as hard as you think it is. Salt should be delivered to the kidney and the kidney should flush it out and the kidney can handle a lot of salt. So if there's a mismatch, if there's an equation where you're storing that extra fluid I would look carefully at going for a walk that really stimulates the muscles in those legs to pump. I don't promote exercise the first at least six weeks. I really want you focused on changing the food behavior. But if you've got some of that swelling and say, well, how can I undo this? I would push you to go for a little walk or hanging out in one of those float spas. Again, you're going to pull fluid through the skin and watch the dynamic change. I've been impressed to see what happens when they do that float spa. The other part though is if you're having that much salted liquids, you probably should be adding some liquids without salt in it. Cause it shouldn't happen. There's just as much reflection that there is an unhealthy component, meaning a healthy body wouldn't do that. And I know when I've had too much salt that there's still parts of my system from being in some resistance for probably 10 years that says, I'll look at how easy I can put that fluid back in my lower legs. Whenever I take a plane trip, it goes right back in there. So all of those are real.



Question 33

33. After achieving the desirable Dr. Boz ratio, do you keep going? When do you stop? Video Time Stamp: (01:39:41):

The Dr. Boz ratio is helpful for guiding you, saying you're on the right path, the insulin resistant is coming down. But it's expensive to check these little things too many times a day. It does help you have metrics to follow, but it's not without its own consequences of price and poking your finger. That's why you'll see when people first start out, I push them to check every morning and even like around noon if they can for the first week, if they can get me two weeks of data, you're even better.

But after that, I want you checking two or three times a week and then looking, but you don't have to look every day, you're looking for trends. That means you need to check often enough that you can see what's going on. Again, looking at first thing in the morning, it gives you the least amount of variables when talking about these two metrics. When I fast, I want to know that I hit my autophagy ratio. You'll see me check several times a day when I'm fasting and then I'll stop. Part of it's price, part of it's just fingered. If I was in the perfect world, I'd probably have a catheter in my artery and I would check it every few hours. When we're doing this for protocols and we're doing this for like cancer and seizure protocols, we're checking five to six times a day and they have to keep those ratios, the Dr. Boz ratio under 40 the whole time in order to meet those metrics, it is really difficult to do. It can be very off putting people first start cause they're like, I can never eat. I'm like, no, it'll get better, but it is hard. So again, Dr. Boz ratios are just metrics to give you encouragement that you're headed in the right direction. The more strict you are, the faster you'll get better. But sometimes you push them to be too strict and they fall off the wagon cause it was too much change.



Question 34

34. I went to bed with the best numbers. I've had blood glucose to 79, ketones a three, got up eight hours later with the worst numbers I've had a glucose of 117 and ketones a 0.7. What happened? Video Time Stamp: (01:41:18):

What was going on when your blood sugar was 79, your ketones were three, your insulin was dropped. The whole point of measuring Dr. Boz ratio is their insulin. When you lower insulin in this point keeps things in storage, specifically glycogen, you have glycogen stored in your muscle cells. You have glycogen stored in your liver cells. When that warning popped up that said, hey, it's time to wake up, the sun is rising and that ping from your brain to your liver happens. It landed on a liver that didn't have much insulin around and that hadn't happened to you in a while. Out came a whole bunch of glucose from storage. And of course when glucose goes up, ketones are like, you don't need to be produced anymore. Throughout the night, you probably use some of your ketones to keep your energy.

That's when your glucose is 79 and you're using ketones at three and you're like, okay, most of your energy is coming from those ketones now that then as you slept, your ketones got less cause you were using them. That's what your feeling was. When the insulin hits, you will release a bunch of glycogen and you're like, oh, we don't need to produce ketones. Look at all that glucose she's got to use. It is a process of emptying that storage and that's a great example.



Question 35

35. When will the hair loss stop? Video Time Stamp: (01:42:56):

Hair loss is a reflection of nourishment. The reason we want you on the other side of that hormone shift is because we don't want to drop calories in trade for nourishment.

And you say, well, should I take a bunch of vitamins? No. Quit leaking out your vitamins in your toilet. That means seal up your gut. Well, how do you do that? You stay keto. You stay keto for a month, for two months. That process of sealing your gut, you cannot take in as many vitamins as what most of my leaky gut or my inflamed patients are leaking out their gut in a 24 hour period. You can't keep up. That's why you're malnourished. That's why the hair falls out. No, that hair falls out in phases too. So it's a cycle. The best growth of hair happens when you're not inflamed and when you're well-nourished. So sardines and liver cover a whole bunch of nourishment issues and they're both very keto. Braunschweiger is my favorite way to eat liver.



Question 36

36. I failed my sleep this week. Most nights five hours, bed by 9:30, totally awake at 3:30 in the morning. It was my norm trying all the guidance and info. How long to get a sleep line? Video Time Stamp: (01:43:55):

Sleep habits change slowly. But you have a price you're paying by not sleeping well. So this is definitely something where that's where I really use the sleep protocol for my patients to say, I need you to have three days of vacation and you are not leaving the house. You need to give your keys to your spouse. They need to come into the office to hear what the sleep protocol looks like. And we make you sleep for three days. We reset your sleep. I mean really make you sleep for the first two nights.

But it is a really hard reset. And in the process of resetting your sleep doesn't just perfectly magically go back to normal. Watch that sleep video and look at that sleep hygiene. Is there electronics in your bedroom? Do you have a stable place for your electronics outside your bedroom? When you're healthy, people say, I sleep with my phone all the time. I'm fine. Yeah, you have a healthy brain. If you are trying to repair your brain, get that electronic away from your pineal gland. That little gland inside your brain that senses light. And every time you turn that on, it wakes up your brain to a level that surges hormones that fight our ability to get you to lose weight. So bedtime routine having a stable sanctuary for sleep, following that sleep hygiene, those are all the rules you have to take care of.

If you say, I'm doing that doc and it sucks, I can't sleep, I'm still not doing well, then I want you to print out that it's a case for sleep and I know it's in one of the handouts. If it wasn't in week three, it's in week four. It's such an important part of sleep or of repairing people that I think I covered it twice. That is, the other part is at 3:30 in the morning, if you say, I'm done sleeping. I pushed my patients to get up. And then you do not get a nap. You can go back to bed at 9:30 that night, but you're up at 3:30 and you really cannot force the brain to fall asleep but you can't force it to keep awake.

So if you're awake and you're just laying in bed, that's not helping our situation, get up, go do something. And know that as you reset the sleep hygiene with all those rules, this will get better. And when sleep is better, the hormones are better. And I don't mean like estrogen and testosterone. I mean weight loss hormones like insulin and growling are better.



Question 37

37. When to begin my real exercise happens in the big keto life? Can you have initial weight gain?

Let's just start with when do I get to exercise? This is a broad or an answer for a broad audience where you were before matters. When I start talking about exercise on the ketogenic diet, a lot of other other people feel overwhelmed. Like, I want to keep up with everybody.

I'm going to start exercising and I'm saying, if you haven't been exercising, do not add that now. We really need you to stabilize and get your patterns of eating controlled. You do not lose weight in the gym. You gain muscle in the gym, you not lose weight, you lose weight in the kitchen. If you're gaining weight, I really would want to know that you've got a nice solid stable pattern. Like what level of the ketoCONTINUUM are you at and how long have you been there? If you're saying, I'm at ketoONTINUUM number four, and I've been there for two weeks, I would want you to have a weight loss spend keto for a year. And like what number of the ketoCONTINUUM do you think you're on, like, do you have one meal a day? Do you check your morning fasting numbers?

She's been keto for a year. She's one meal a day. She has a Dr Boz ratio that is just over about 103 cause she has a glucose of 103 and they keep you on a 1.0. She started an upright bike and swimming laps seem to be holding the weight and not losing right now.

Still want to lose about 20 more pounds. She really wants to add exercise. How long has your sugar been that high? My glucose levels have always been higher. My goal for the whole year cause I've got keto adapted or I should say my ketones can range anywhere from 0.5 up to 3 and my glucose levels, fasting never are below a hundred yet. Now if I take my blood glucose levels later in the day, I can get them down to, I think the lowest I've ever gotten so far is 82.

It's a very good case. You're insulin resistant and you're on a journey where you've lowered the insulin to this level and in order to get healthy, which is where the weight loss comes from you say. When you say weight loss, I'm guessing you don't want to lose anything except fat.

So you say, yeah, doc helped me lose this fat. In order for you to lose fat, half to empty that stored glycogen that's in your liver and with a blood sugar of 103, you're emptying some stored glycogen every day, but you're filling it back up as well. The process of saying, I've been this way for a year Dr, crazy. It still can't be happening. How can I not change my weight? In the last year? You say, hey, I've got this upright bike. I've been doing some swimming, both very good activities to improve your metabolism, but at the same rate, you're emptying that glycogen inside the muscle using that energy for those muscles in a way that just keeps you barely at that level of. You can't stress it to make some ketones, but you have lots of stored glycogen storage glucose that has not emptied all the way.

This is so you are keto adapted, you are fat-adapted. That's a huge moment. As we move to some of these levels of higher stress for your body, give me just a quick summary of when you say OMAD, tell me a typical day of what you start out with in the morning. What time do you eat?

I usually start out with coffee and I don't put cream in my first morning coffee. I'll have two cups. Then I took Topo Chico water for the day or unsweetened tea, and then I don't till dinner time, but I do eat at six so that I can eat with my husband and I probably should try to start eating earlier myself.

There's a few things that say you are a female that has four children. Definitely. I'm in my sixties and have grand lovely grandchildren.

When you look at how to take your metabolism to the next level, you have graduated from a six o'clock meal at night that now you can't do it anymore. If you want it to be healthy, it isn't eating at that hour. That was for a younger woman's stage of life. You're no longer there. And if you continue to do it, your body ages faster, your brain ages faster. It is a price that you're paying on top of those 60 pounds that you already lost. You have some undoing. You have some autophagy that needs to be done to guarantee you the health of watching those grandkids live their life out. With that in mind your husband probably shouldn't be eating that hour either, whether or not that's something you can manipulate him into changing.

I'm going to not touch that, I have a husband too. But it really is a powerful learning curve for both of you to stay the healthiest version of you is least inflamed, lean body weight, the least amount of extra fat, and it doesn't mean none. It just means that your body weight should be closer and closer to that normal. And that means you can't be stimulating insulin at six o'clock at night for a full. For your full meal a day, your meal needs to come closer to noon. With that, you will see all the things you're doing right. The other option that I've had folks say I just can't, my husband won't do it any other time. Is that first of all, you turn all those other drinks into black only. I don't know what Topo chico water is. It's carbonated water. It's just water with gas in it? Yes. Okay. Perfect. Just as long as there's no other substance. That's one of my favorites too. Water with gas is perfect. You say black coffee is what you should be graduating to if you still need cream in that second one. I would say you can have that during your mealtime, but every time you put that in, you're stimulating insulin. So as much as you're disciplining yourself to OMAD, you're still stimulating insulin. When you put those calories and you're fat-adapted, your body will reach for fat. Quit putting it in your coffee and let it pull it out of your fat cells. If you're trying to lose weight and if you say, I just can't get my husband to do this, six o'clock is when we eat. Then you get supper every other night. You eat supper on Mondays, Wednesdays, Fridays, and Saturday night. And the other nights you don't eat, you are fasting for 48 hours in between that, we're going to get to that in two videos, but you'll stay at this because of your 60 pounds that you've carried for those years and that you were, have the blessing of children. Your hormones have a different set of rules than somebody who didn't bear children and that you're at a standstill saying, hey, but I'm working my tail off. Keep working your tail off. That's fine. But if you really want the weight loss, you got to quit making insulin so often.



Question 38

38. I don't feel I have cravings for anything in particular. I just love to eat even when I'm feeling full. Since college I've considered myself a food alcoholic. Yet I have worked to keep my weight low. Is this what you mean by a craving? Video Time Stamp: (01:48:33):

When you are eating because you're comforting yourself, when you're eating out of boredom, you're not eating out of actual hunger. That is in some forms of creating a craving, is an emotional response to food. So they're angry, they're upset, they're happy. They're using food to eat and emotional craving. Then it becomes that's not really hungry, which is the reason we eat. It's very much a time of having food addiction be part of this journey. This past week where I kind of shifted from newbie conversation to this advanced education of people doing a ketogenic diet, that there's a lot of psychology wrapped in this story of when you have ketones and you're trying to get ketone production glucose to be lower, but you have this drive to eat that is not for nourishment.

It is for emotional reasons. It will sabotage you. It will derail you. It is the reason for the support group that you're eating for reasons that you need to address. And you can call food a therapist, but it is going to lead to a brain and heart and body that deteriorate and welcome to the internal medicine clinic where once that's down. Oh my goodness, it is a long road back to getting you healthy again. If you're saying I just love to eat, okay, then love to eat less often and eat when it is an interval that's healthy for you. The reason we have the support groups is the craving for sweets after dinner or the food addiction that results in a little bit of a glass of wine and a bite of chocolate turns into what happens every night now.

And boy do they end up in trouble. It's the addiction that just does play forward. So I really look forward to hearing how your first couple of fasts are gonna go. What happens when that thought of food and eating food? What do you do with it?



Question 39

39. Since there's been some time since the study you cited, what are the thoughts of electronics and blue blocking enabled pre bedtime? I read on a Kindle at night, nightshade on. Video Time Stamp: (01:59:38):

The reason for that night shade Kindle is because of the lower stimulus to the brain. So it sounds like you're doing the right things as far as the type of reading you do in that reflection into your brain. One of the key things I always talk about when advising people on sleep is healthy brains have different rules than non-healthy brains. It doesn't mean that it's kind of like the same rules that we talked about saying who should step on the scale and who shouldn't. Well if you've got a problem with this and just quit doing that to yourself if you've got a sleep problem, I pushed people to say, just turn off the electronics as much as we have evidence to say it does less.

Those people they are studying had healthy sleep habits. That's the problem. When I look at somebody who's trying to repair their sleep, I push them towards the paper books. The reflective light off of the book is what they're doing now. Those Kindle really do emulate that. And I have pretty good confidence that we're going to be okay with using that setting, but it's in the targeted answer that I had. If you're struggling with sleep and this is your solution and you're sleeping well, then we're in good spirits. If you're targeting this, how do I repair my sleep and you're reading right up until midnight at night and then you wake up three or four times a night then we have a problem. We have a broken brain and to get it to sleep well that is how you fix these hormones.

They will fix it, but you gotta give it the environment to do that. Sleep is a huge component to weight loss. Don't give up. It's being studied. There's quite a few. The reason Kindle has that setting is because of the study. So I think you're in the right place as long as you're sleeping. If you're not, then I might switch it up. The other thing that I tell people is not to read in bed. So as much as you have the right light, when you put the setting of reading in your sanctuary for sleep, you are, it's almost as damaging as the reflective light. Sleep outside your cape, go read in the chair, in the living room and when you feel tired, go put your head to bed and you're like, but I wake up and I can't fall asleep.

Like I know that's the problem. We have to train you to do that. And if you're tricking your brain into sleep, it's really not the setting of sleep that you want to age with.



Question 40

40. I have butter coffee in the morning. Is that no longer allowed? I eat a snack in mid afternoon and dinner is all keto focused. If we put fat in the morning coffee is that considered a meal?

Let's make sure we address, so the newbies don't get distracted. At two meals a day, I don't even talk about it. You're going to see in the next week, keep doing the fat in your coffee. Keep doing what you're doing. There is a time when you graduate to giving that up. Especially in those first few weeks, I really want people feeling nourished.

If you're ketoCONTINUUM number four, which is two meals a day and you still have a high fat coffee in the morning, you're fine. As I'm coaching, some of these people that I’m talking to are for a year, I'm like, then you probably should move along the ketoCONTINUUM. If you want to get better, you've already done the hard part, you're fat-adapted. Now you just need to apply the rules for the science that you've created. So if you're new, if you're just into this and you're feeling satiated, stay the course, you're going to see the next few steps. If you need help. Not everybody needs to advance. If you're healthy, if you're lean and you're feeling good and you're sleeping good and you're healthy, good job, stay where you're at. If you are not, this is where these next few lessons come in.



Question 41

41. I have malabsorption of fat, diarrhea and fasting. Should I use the chia seed and protocol and BHB at the same time? Should I stay under 20 carbs and how much fat should I eat while my body tries to adjust? Video Time Stamp: (02:03:03):

Yes. So it is a difficult equation that you're looking at. What the BHB will make you have diarrhea. So be careful. If you're thinking of BHB and the 20 carbs is where I would say if you can get to 20 carbs or less and hold there, then don't worry about the BHB right now. If you're saying I can't do that, it's too restrictive for me right now. I keep falling off the wagon. That's where I say sip on BHB while you get those 20 carbs to the bottom. If you're having the fat malabsorption, you say, I put fat in, I have diarrhea. The chia seed protocol will bulk up that stool and create a slowing of the diarrhea.

Don't be afraid to use the over the counter medications to slow the diarrhea. Just keep your life on track. As you look at fat malabsorption and the replacement of it, that's where as I said earlier, putting that MCT in the capsule form in the system four to five times a day. When you put the capsule in and it no longer causes diarrhea, then take two, then take three. Remember that in the study where we improve brain function using MCT in the dementia and the borderline dementia patients, that was one of the YouTube videos. Those were 30 capsules to 45 capsules per day. There's a lot of fat that it took to get those ketones that high. Your body will make those many ketones when you're keto adapted. So what the MCT is there for is to bridge you when you're struggling or to train your gut to absorb it.

We want you feeling good during this and if to feel good means you've gotta be able to absorb some of that fat or at least turn the ketones on. Sipping on ketones, give you a ketogenic setting and that does make people feel better. So I really am encouraging you to stay the course is the key thing here. All of these options are ways to say being on chia seeds bulks up the stool, doesn't raise the sugar and really kind of slows down a bowel that's used to a lot of fiber that is often the same as the ones who have fat malabsorption. Fat malabsorption gets better when those cells that absorb the fat wake up. And one of the key ones, we want to wake up with the ones that are associated with MCT.

And that's what those MCT capsules really do help. Not forever, but until we get your gut awake. That is a great way to say just increase that protocol. Usually by the time the patient's at like 11 to 15 capsules per day, I know their guts doing really well because they wouldn't be that high if it was having diarrhea all the time. So start at one and then the next day, if you didn't have diarrhea, go to two and then the next day go to three and you're, what you're trying to work up to is as soon as you get to a part where there's some diarrhea, then just stay at that dose or go back it down a dose until your gut can handle that. What you're doing is you're waking up those intero sites to absorb the fat malabsorption. The key in that process is to stay as ketogenic as possible because in the midst of fat malabsorption may sound like, okay, I don't have a leaky gut. Yes, you do. You have one of the leakiest guts. So you're trying to seal this up and that is a state of ketosis. So staying the course, you're kind of like threatened four needles at once. I know that's difficult.



Question 42

42. Why am I so tired? I'm less than 20 carbs per day, getting plenty of fat. Blood glucose is 90 and ketones are 2.5. Video Time Stamp: (02:07:13):

I'm going to guess you're a newbie. If you're new and you're saying, I'm on this ketogenic, I did everything she said, my numbers aren't that bad. They've made the switch. And if they're new what happened was they had zero ketones and now they have 2.5 ketones.

And what's happening to most of those two point, the high levels of ketones, they're peeing them out. Why? Cause they're there. Their mitochondria is not in shape to use them. How do I do that? You keep making ketones. So the process of becoming keto adapted is impart to make the ketones that you have good ketone numbers. You're doing a good job of lowering the carbs to less than 20 a day. You do not have excessive blood sugars. All really good in the transition of this switch. Many times people feel tired cause their blood pressure's low. That's why one of the things you should be documenting is your blood pressures. So if you have good blood pressures like one twenties to one tens, even like one fives over 60, seventies, eighties, then that's not bad. If you had blood pressure at this level and you dropped it by 20 to 30 points, your brain can say, I just need you to lay down. The symptom is going to tell you to lay down as it's going to feel tired.

If it's a significant drop in blood pressure, you can see fatigue is an issue that fixes itself. But it's a hydration issue, if it's a salt issue, going from a magnesium float spa is going to fix a lot of issues in the next week. But if it is the use of ketones, stay the course. Your body will learn how to use these. And that's where the energy comes from. If you've ever seen me talk about what happens to that campfire effect when making ketones the first time you throw a log on a campfire, it doesn't burn very well, much like the first time they make a bunch of ketones or like, this is not working. It's not a fire. It's after that body really gets in the system of using a ketogenic energy that they finally have this nice steady metabolic energy.

That doesn't happen in a week if you haven't burned them in years. The good news is is once you've adapted to ketogenic way of energy and you fall off the wagon for a week and then let's say you've been keto for six months and you fall off the wagon for a week, maybe even two weeks, you return back to that ketogenic energy and your mitochondria will, they're in shape now. They will return to that. Now you can't spend two weeks off, one week on, two weeks off, one week on, two weeks off. When we gone and expect that outcome, you'll eventually have the sluggish mitochondria again. You stay the course if you have a hiccup, the good news is it will carry you through that once you're keto adapted.



Question 43

43. My day 12 still has an edema, carbs are 20 or under daily. Is this the BHB salts? Video Time Stamp: (02:09:41):

The swelling in your shins, I'm going to guess that's where your edema is, around your ankles. That did take a while to get there. Even if you didn't notice it until you went keto and you're like, why did I get swelling when I got keto? It is a shift. Your blood pressure changes. Your kidneys are trying to catch up. You're putting salt in especially for BHB salts. So there's a lot of shifts in things. You need everything to catch up. If you still have edema at the end of week two, don't be discouraged. It has always been there between those fascia you have added to it in recent weeks or in these last 12 days by all the shifted chemistry. The goal is for it to go away. There are a few things that make it go away a little faster and that is once you're feeling well, walking is a great way to pump those legs and calves to really improve them. A pedicure does, you don't go for the toenail polish. You go for the massaging of the lower leg and feet.

Unbelievable what that does to mobilize fluid. So don't be afraid of that. That's called a lymph lymphatic massage. But you can just go and get a pedicure, that they're going to do the same thing. As long as you say I want an extra massage or whatever, the key isn't so much the salts that are getting in, it’s the body's ability for your heart and your blood vessels and your kidneys to all work in sync to remove the extra fluid and it's going to play catch up. I am five years into keto and I have swelling today. I got my salt rocks from Redmond because I used up all of them. That's what I thought. I had this very diluted solely water and now I have fresh rocks and I keep putting a lot of extra salt in my coffee.

And of course now I love the taste of it. So I had a lot of salt in the last few days and know that part of what my legs are doing is a consequence of what I've been putting in. So how did I get that swelling so quickly? Probably five years was insulin resistance with a small layer of swelling there. And what that does is it just creates the space. This should not be a space where you put fluid, but every human being will do it when we put in this chemistry setting. And so I had that space created and I kept it there for five years. And now even though I have lots of times where I have no swelling, I have a really good, my shin, my thumbprint is zero. When I do have swelling, ankles right back to that spot, I can feel it.

When I do as much salt as I've done in the last week, yeah, I gotta dilute that down a little bit. But it is a human response and you will get to a healthy setting, but even years into it, you push the salt equation in short order and you'll swell. So then finding other ways like the magnesium float spa is another way to cool. Put magnesium in, you say, wouldn't that make you more swollen? It is a shift. You are going to move that mineral water. Follow these minerals so you can see the fluid shift during a float spa.



Question 44

44. When I eat one meal a day I won't gain weight. But if I have two meals the next day I've gained weight. Why is that happening? Even if I work out, did I mess up my metabolism? Video Time Stamp: (02:14:01):

No. What that tells me is you have insulin that is very robust and that's not what we want. Those things in our life. We want robust insulin is not one of them. When you eat, you stimulate insulin. Insulin stores your food. So when you eat twice, you have two spikes of your insulin, which recreates a deposit of calories. Insulin also holds onto that extra fluid. So you have a fluid shift that will happen in that 24 hours when eating twice a day. The other part that I would recommend is one meal a day isn't a bad idea.

But if you're going to do that, measure something that can be impacted every day instead of weight. Weight will do this and you're gonna find a lot of noise in the weight and people make these decisions because yesterday's weight and today's weight made the shift. And so this is what I'm going to do. And I would say measure this week and next week, meaning take the intervals of weight less frequently and instead measure a Dr. Boz ratio in the morning for two weeks and watch what happens. And when you eat two meals a day, what I would be very curious to know is what happens when you eat? So if you have the two meals, if you eat the earlier meal and you skip the late meal, what happened to your morning sugars? If you skip the early meal and eat the late meal, what happened to your sugars or your Dr. Boz ratio? Those types of metrics are measuring your chemistry within 24 hours. That has better evidence. When you measure weight, there's so much noise in the background that you're measuring the noise and you're making direction out of a noisy metric such as the scale. It's not that weight doesn't matter. It's that weight day to day has too much room for error.



Question 45

45. I ate the same thing three days in a row and my blood glucose around 85, ketones around 1. Then out of the blue, I wake up a blood glucose of 110 and ketones at 0.6. What happened?

I'm going to guess you have insulin resistance. She's shifted and does a really good job. She's eating the same thing. She's got this good number, but it takes about three to four days for insulin to really make a pretty good shift. So when they make a change and then they're stable, it's the accumulation of staying stable, of staying that low glucose that just dropped your insulin. I'm like, isn't that good? Yes, but you're insulin resistant. And so less insulin says, oh, we finally get to empty some of this glycogen, especially in the morning because you have that signal that goes from your brain to your liver and it's the same amount of cortisol that comes every day from your brain to your liver.

What your cortisol lands on will depend on what your sugar is. If your cortisol has been landing on a liver field with storage, but the insulin has been at this higher level for the better part of a year and now you didn't, you went keto, you dropped your intake of carbs. Your insulin is less, but it's impact, meaning you may produce less insulin those first couple of days that it really takes that third or fourth day for the glycogen to release more. And what we look at for a glucose of one 10 ketones, 0.6 is you are in a cycle of emptying. It's powerful to keep, especially with that kind of story. My advice for you would say keep your meal during the daylight hours, the earlier towards lunch and the less you have after four o'clock, the better your system's going to be. Again, another shift is going to change your metrics. So just keep an eye on that. That's why those spreadsheets are so important. I don't know if you took time to watch the tutorial by Patrick V and his explanation of what that spreadsheet does, but that spreadsheet captures what needs to be alive if you would need to be recorded for making decisions on metabolism.



Question 46

46. I am not a newbie. I've been stuck for a long time. The class has helped my dawn effect numbers going lower in the eighties to nineties range. But now with the class my dawn numbers have risen by 30 points. What's happening? Video Time Stamp: (02:18:30):

Same thing we were just talking about. She probably, I mean just looking at what happens when you get a tribe, when you get a support group, when you look carefully at the way your body is working, she probably tightened up some things. She took those total carbs down to 20, she just improved things by a notch and at first, not much happened, but as you lower insulin, that whole body has to reset. And the first phase of lowering insulin is if they're checking those morning fasting sugars, they're checking a Dr. Boz ratio.

They're going to say, oh no, I totally just saw this rise. What happened? I'm backwards. My body's not working. I'm like, no, don't stop. Your body is emptying. That is a glycogen response of lowering insulin over the course of those last few days. I would totally stay the course. I really hope you have a spreadsheet that you're keeping track of because once again, I want you following, I mean noise is easy to get distracted with. And by noise I mean lots of numbers that don't do exactly what you want them to do. And so in short order, something happens, but we need a trend. We need two weeks of a data point, like a Dr. Boz ratio to say, watch what happens when you lower the insulin, not for a little bit, but you really lower it. And then you see the response your body has.

Many times when people are stuck at a weight loss stall, it's because the impact of insulin is still the same. You're doing everything right. And I put them on what is one of the strongest instincts to lower insulin. You'll get to that in two weeks and they don't like it. It's hard. But boy, by the third time around, you can ask Angela Earnhardt about this little test where it was not anything she ever wants to do again. But by golly, she broke through that stall and she really did reach her goal. So hang in there, you're not alone. Stay the course and please, use that spreadsheet in case I ever need to help you out or anybody needs to help you. Looking at the spreadsheets, going to you'll be able to easily distract a doctor or an advisor into a flippant answer that makes you feel better. But if you want the answer that's actually going to repair it, you have to have the conglomerate of that data.



Question 47

47. Do you have any insight on melatonin in regards to sleep?

Melatonin's not bad. It doesn't hurt you. It does stimulate that first phase of sleep that syncs your brain into sleep. It does not enhance stage four sleep, which is the kind of sleep that repairs a body improves immune system resets insulin resistance. There's prescription strength melatonin that even does a pretty good job. But once again, it's ability to truly reset that human body is not as great as I like it to be. Cleaning up the sleep hygiene, going through that video saying, have your bedroom for sex and sleep. Nothing else should be going on in the bedroom. Looking at those electronics, looking at what your behavior is.

If you wake up in the middle of the night, get your butt out of bed, quit trying to like linear in the morning, get up. Those behaviors all change how your brain shuts down. Just like with insulin, it's not going to change tomorrow. You have to change. You have to have this pattern for a couple of weeks for that brain to really get the benefits for sinking into stage for sleep, repairing that brain, recovering from chemotherapy. Very important. I would tell people when they're training their brains for sleep, I didn't probably talk about this in the earlier videos but sending them for that five magnesium floats in seven days is a huge, it sounds like a lot, but really just gets their brain slowing down. Even if it takes you 10 days or two weeks to get those five floats in, it is incredible how much better they sleep once they get that magnesium a little higher. It all does play in, but melatonin doesn't hurt you, but it's probably not the best thing long term.



Question 48

48. Best advice for traveling and not being able to completely control your diet.

Good luck. It's a hard one. My favorite thing, and I usually have to warn my husband because he knows what I like and he'll do things that comfort me. But the travel advice that I do is I try to fast, especially if I'm changing time zones. It just works better as much as I don't like fasting any more than anybody else. And I really don't like fasting when walking past something that smells good. If I tell my family I'm fasting, my husband brings me a bubble water with gas in it. That changes how I respond.

I recruit my support system when I'm going to do this. Other things that if you are traveling just keeping that section of time where you eat very controlled and while you're awake, remember what those people give you on the plane is not healthy. It's just convenient. Please just say nope. The other part about having a successful traveling though is that you do set expectations. If you've ever tried to Google ketogenic food from and then fill in the blank like Qdoba or McDonald's or this used to be a rarity, but it's pretty easy, go into the cronometer app and say, what can I have from McDonald's for this high fat? There's plenty. There are lots of options out there and then just fail upwards.

The fewer, the better. The other thing I do during, if I fail during a travels section, cause I'll try to fast on the day I travel and then fast on the day I'm first home and it really resets my brain the best. But if I struggle, I sip on BHB, it just adds more ketones because the ketones, especially when you're keto adapted, a little bit of ketones, it suppresses appetite and it just helps you get through that tough moment.



Question 49

49. I'm five weeks into keto and starting to have joint pain fingers, mostly. Any suggestions? Video Time Stamp: (02:25:22):

Five weeks is about that time where you had a history of crystals in your joints.

Let's just back up a bit. Removal of inflammation will decrease the inflammation everywhere, in your ear, from your muscles, from your eyes, from your joints. And so a lot of people say, oh, my joints feel so much better. Yes, they do. If you have a crystal process that's been in your joints, it did not come in the last five weeks. It came over the last 30 years. Crystals are, especially if it's a gout crystal, but don't explain that all this gout crystals, people think of toes and ankles. Gout crystals happen in every joint. You only feel crystals when they start to move. Just like a kidney stone, if it never moves, you don't feel anything but if it moves, you feel it. So these crystals, as they start to kind of dissolve and they move, they hurt.

So at five weeks, it makes me worried that it's not a swelling issue. It's a gout thing. So the worst thing you can do if you have gout and you've gone keto and you're in that five week position is, oh my goodness. Of course, don't fall off the wagon right now. If you fall off the wagon and they go a bunch of sugar, the crystal eyes, they really stop dissolving and they can actually form and now they form a new spot in. You shouldn't be getting those crystals out of there. The right thing is they shouldn't have been there in the first place. If you have diffused joint pain in this five, six week time, it is a gout thing until proven otherwise. And I say gout because that's the most common crystal.

But there are about 20 crystals you can put in joints. The top ones are gout and some other calcium deposits. But what we want to do is reverse that. And the reversal is a chemistry state that promotes the melting of those crystals. That is ketosis. The key thing for you is to stay the course and know that the more strict you are on those 20 carbs, the better. The other thing I've done for people with gout is I get them sipping on ketones because even if I augment their chemistry by just keeping ketosis available it keeps those crystals from really flaring. I've had people fall off the wagon at this point and they get every joint goes crazy and they never want to go keto again. If I'm just saying don't do that, stay the course.

You can really hate me if you fall off the wagon and you have a whole eruption of gout. So either sip on BHB or just keep the blinders on. 20 carbs a day. Don't fall off.



Question 50

50. Suggestions from my genetics were to be on a Mediterranean diet that I did not handle, saturated fats well, eating lots of veggies, the issue of histamines. I am concerned about doing too much saturated fat. But on a plant based diet. I wanted eggs so I ate four. When I tried keto last year, it gave me too much mucus. Medical intuitive told me it was an issue with gallbladder. That said, I'm worried about the diet. Video Time Stamp: (02:28:53):

First of all, there's a lot of things going on in that question. I'm going to go to genetics first. So genetics are this very fun thing that we have the privilege of looking at in 2020, that we can look and say, here's what your genetics say, but I need to remind you that genetics are flexible. Like what I was born with them like, yep. But what you flex, what ends up on the outside are the epigenetics of your body is related to how you treated it. If you have the genetics that say, I don't handle this, that, or the other, I'm going to bet that you weren't born with that version of your genetics. But this has been an evolution of what is exposed to your system.

At which point we come back up and say, I can't advise you for all that's going on there. But I do know that the longer I've been taking care of ketogenic people with the most extreme responses, like they have food allergies to everything from eggs to peanuts to shrimp, everything. They have a histamine response. Their body, if you're going to get a cytokine storm, that's the kind of profile that happens, that history. The response to that is to decrease the inflammation in the insight inside your bone marrow. I need this to decrease. You say, well, I made my mucus when I first had this, first went ketogenic. I'm like, yep, you turned something on. That's probably the same process that was making all that histamine, that would give you a cytokine storm.

It is the reduction of this response that we're trying to get to in someone like you. So as you say, should I be doing this diet or shouldn't I? If you were my patient or my family member, I would be walking you very carefully to say, look, the way you're playing forward is guaranteed a malnourishment with a life of restriction, meaning everything triggers her. They have allergies, they have histamine responses, the Mediterranean diet, high fat, low carbohydrate diet. Essentially what Mediterranean diet is, gives her all these reactions and you say saturated fats are not the enemy here. The histamine response and your body's cytokine response is the enemy. How do you fix that? You've got to find a way to stay the course. If you're in a 200 club, if you're having more than 200 carbs per day getting you to at least a hundred for a good week or two, and then getting down to 50 for a good week or two.

If you've got a few, I would not go to the cronometer app and exclude saturated fats. That's when looking at those that stimulate the highest responses. Saturated fats do not weigh in on this. Trans fats do. That's something that we can talk about. The long term answers for people who have this over responsive system becomes they have a fear of changing it and they actually have the highest consequences when that bit where they're on the edge of chronic inflammation at all times, meaning they have a high histamine response, they'd make an excess of mucus. When you change their diet, these are all signs that your system is fragile. Not fragile, doesn't mean do nothing. It means you're gonna have to do it slower. But I would be peeing on a stick and making ketones every day and then steadily work your way through that ketoCONTINUUM.

Somebody responded to you saying, my genetics are telling me to keep saturated fats very well. Again, the genetics that say keep saturated fats low, what they're missing is you go back 2000 years, saturated fats are what we ate. That is the only thing that lasted without cooling storage. If you're taking a 21st century technology in a micro clip of your genetics and making decisions that your ancestors said, no, no, no. That's not how it works. So I am just very cautious to say that I can't have that because of my genetics. Alzheimer's, chronic heart disease, chronic kidney disease, those are all chronic inflammatory diseases associated with high insulin. Get that Dr. Boz ratio down. Keep it down. If you want to do it without saturated fats, that's fine, but it's hard. And I would contend it's probably not the best answer.

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