Transcript for:
Understanding Insulin Resistance and Ketosis

looking across the room now you can diagnose  insulin resistant from across the room in most   people if you fart on the way to the lab you  changed your insulin Dr Anette Bosworth she's   a bestselling author of any way you can and an  expert in fixing the world's most chronic diseases   she will help you get your life back and it starts  with eating more fat I've never known insulin to   be anything but the hormone that puts weight on my  patients that ages their brains that crystallizes   their arteries really makes them crispy and stiff  the opposite of what you want if you want to be   healthy a patient of mine 71 years old her 10  years under my care was with a cancer growing   in her white blood cells and she'd been through  chemotherapy a couple of times and the last time   she went through chemotherapy her brain went  offline and she says what would you do if it   was you and this patient was my mom and I've  been reading about this diet that is great for   brains but there is some research that says if  we put you in an in an advanced ketogenic state   it might be good for your cancer when the reports  came back it showed that her cancer had dropped   by 70% just being on a ketogenic diet insulin is  what caused my mother's cancer you have to be in   a state of ketosis you have to be strict that's  why I put so much energy into saying you're not   on the ketogenic diet if you're not checking  the ketones and finding those little turkeys   in circulation you have to be there in order to  get these benefits this is ketones for life you   recommend for your patients sometimes to have a  butt only day why oh it is the best experiment   first of all this episode with Dr Anette  Bosworth was a topic I've never discussed   on this health podcast insulin resistance now I'm  guessing if you're watching this episode you will   know somebody that is insulin resistant or maybe  you're insulin resistant yourself and by the end   of this episode you'll know the exact signs  to look out for now this information is not   what you'll hear from big food or big farmer  so if you're learning from and enjoying these   episodes please hit the Subscribe button and by  doing so you can help Millions more people hear   this message now let's get into the episode with  Dr Annette Bosworth Dr BOS welcome thank you for   having me I am so excited to be your reader now  you are an internal medicine doctor and you have   thousands of patients that come to you with a  wide variety of problems it could be things like   brain disease diabetes heart problems autoimmune  conditions obesity and all of these chronic health   problems come from one big problem which is hidden  that problem is insulin resistance so today Dr BOS   is going to share her 25 years of experience and  talk about how you can fix insulin resistance the   early visible signs that you need to know and  also why you might need to have a butter only   day so Dr BOS my first question if somebody has  just clicked on this video and they're thinking   I have so many health problems I don't know where  to start why should they first look at insulin   resistance well if you're find if you're looking  for the best first step forward in today's modern   world where you want to stay out of my clinic  I am an internal medicine clinic and I take   people to the Grave with lots of medications and  chronic medical problems if you're looking for the   best avoidance for that the stimulator for every  one of those diseases comes from this Whisper of   insulin that grows and grows into a roar but it  never tells you from the front page it is this   internal message that you can find the answer do  you have this do you not without a lot of fanfare   without a lot of labs and the reversal of it is  absolutely in your court you do not need to see   me to reverse it to keep track of it to measure  yourself to say am I doing better than I was and   and those messages of avoidance for me I wish  I could have told patients 15 years ago uh the   number of funerals and grave site you know tissues  full of tears uh I have a lot of regret for that   I I did not use this message then I I filled  their bodies full of prescriptions their chronic   diseases got worse and uh in honor of them we're  here to keep you from knowing me absolutely so if   we're treating the insulin resistance which is the  root cause of so many chronic health conditions as   Dr BOS is saying you don't have to be on these  medications a lot of doctors they will prescribe   pills first they'll try to look at the diet but  they'll prescribe pills first let's talk about   what is insulin resistance and to understand that  context is first uh very important to understand   what is insulin and the role it plays in the body  so insulin is this wonderful dictator of a hormone   in your body and again you can't live without it  you know when you look at my ability to prescribe   you insulin to try and you know play the endocrine  God within your body we didn't have that option in   1920 it was in in that era in that decade where  insulin came uh uh into our uh world of medicine   that we could give it to people without it and  those diabetics those type 1 diabetics that were   just emaciated they were wasting away from the  inside out because that little dictator that   little hormone is in charge of getting glucose  or carbohydrate based fuel inside your cell and   although that carbohydrate is not required in the  human diet it is uh you do need this hormone to   get some of that fuel in the cells without it  to run solely on fat without without the access   to that insulin gives those cells to use some  carbohydrates uh you're going to you're going   to die you're going to die of very young death and  your body will eat itself from the inside out so   that's what life looks like without it and indeed  it was a horrific death when we when you look at   some of the rescue missions of uh the 1920s and  30s where insulin came to these people who didn't   have it the doctors were the hero they really  did save their life but from that point forward   the use of insulin and the excessive production  of insulin has grown and grown and has exploded   in the last 30 years that our bodies make a  little bit of insulin when you're when when   glucose comes into our systems in fact they make  insulin whatever food comes into our system to   store certain ones for for future use of that fuel  and then to be able to um mobilize fuel in the   right direction using the highest priority when  insulin uh is at the right levels nobody calls it   evil but as in in all of my medical career I'm 25  years into seeing patients I've never known insul   to be anything but the hormone that puts weight  on my patients that ages their brains that that   crystallizes their arteries really makes them  crispy and stiff the opposite of what you want if   you want to be healthy and that insulin is sneaky  uh the first wave of it makes the cells inside the   internal organs in those cells a little bit more  crabby uh as the as the insulin signal gets a   little louder then the cells themselves get crabby  and then the organ systems get crabby and then   only then can you start to see the symptoms of  you know looking across the room now I'm you can   diagnose insulin resistant from across the room  in most people because it's not a subcellular or a   cellular or maybe even a one organ problem it has  it has encompassed their body and the the outward   signals of having too much weight having swelling  in their ankles um having that sluggish mind where   their brain just isn't crisp there isn't you  know responding as as robustly as they should   especially if you get them after they eat a meal  and they do that sluggish thing brains do that   you're like no no no no how do I make it go away  that insulin resistance is um is is is ubiquitous   it's it's everywhere it's in 12 year olds it's  in 95 year olds and the reversal of it is not as   simple as you wanted to be meaning there's a lot  of Temptation and a lot of cultural things that   we have come accustomed to that if you're going  to try to not be on the side of insulin resistant   stay out of my clinic he might need a friend you  might need somebody to help do this with you I   love that you say that support is so important  especially if you want to go into the solutions   what which we're going to get to and also you  mentioned three of those early symptoms which   we're going to talk about 10 of them so there's  more to come um so you mentioned the insulin the   hormone it is a master hormone it is required but  then we have elevated levels of insulin and then   we have a term called insulin resistance I think  many people have heard of insulin resistance but   maybe they don't know exactly what the mechanism  the body is can you explain that yeah so the   beginning part of that insulin was to get the  fuel in the right spots uh and at the beginning   of that message there was one little listening  device one receptor that was saying yep I my   cell that I'm living in needs this fuel but as  the noise for and the signal Rises the amount of   insulin your body is making Rises uh in response  to the excessive amount of processed foods and   carbohydrates that we're consuming that long gone  is the time where teenagers eat a couple of times   a day uh they come from the era where food was  going in every couple of hours and indeed without   that food their bodies got crabby that insulin  that glucose lowered their insulin was a little   lower and that was the right move but in our lack  of you know the Comfort crisis don't let them feel   uncomfortable give them what they want our culture  keeps putting those processed food giving them a   snack and as you added that food as you added all  of those sequential carbohydrates not for one or   two times in life but every day every day for  that age seven 8 nine 10 up into those teenage   years each month after month that you did that  you raised the production of how much insulin   your body was going to make make because you kept  putting a a bunch of carbohydrates in the blood   and your blood can only hold about a a a teaspoon  a heaping teaspoon worth of sugar so every time   you overate and my gosh they're great they're  they're designed to make you eat more so you   would consume more than that tablespoon full or  teaspoon full of sugar and every time you push the   limit your insulin would rise a little bit more  and it it it Whispers it doesn't tell you this is   happening parents think they're doing the right  thing and now they've got a teenager with acne   all over their back cystic acne in armpits because  we've added hormones to you know hormones of their   sex hormones to this insulin hormone which also  dictates how our fat-based hormones work and they   I mean the most common conversation that I have  with moms is how do I get my teenager to do this   because they're so resistant to changing food  and I say tell them one week of keeping their   carbohydrates under 20 and their acne will be  down by 90% and their mothers are like do you   know how valuable that is to my teenager because  it is it is a ubiquitous problem in teenagers the   amount of acne a a a core response of excessive  insulin that inflammatory response of insulin   rising over the last 10 years now when they eat  that gram cracker they make three four some 10   times as much insulin as they would have made in  you know in a season where they were only eating   a couple of times a day maybe you know in a  growing season three times a day but adults I   say you never need to be eating that many times a  day you're just over stimulating the insulin and   to reverse your problems becomes um well you're  going to need me eventually if you don't reverse   the problems I wanted to uh focus on the effect  of insulin and insulin resistance on chronic   health problems because the commonest cause of  death is heart attacks and strokes um if people   understand how insulin resistance actually causes  plug in the arteries if you could explain that uh   that would help them understand the solution so  can you explain how insulin elevated insulin is   going to cause arthrosclerosis arteriosclerosis  which is hardening of the arteries causing heart   attacks and strokes yeah so I will tell you  this process is not as glib as oh go get your   cholesterol checked if your cholesterol is high  you're going to have Harding of the arteries uh   what a disservice we've done to our patients to  say check that bad cholesterol and if it's high   that's how you're making a heart attack uh I would  be you know I tell my patients it has very little   to do with uh what your cholesterol number is  in fact it has almost nothing to do with the   cholesterol you're eating if it's in the setting  of a diet that is low in stimulating insulin so   that insulin resistance was this noise of 10 times  the amount of insulin is being produced when you   eat that same snack that you would have eaten  before you had insulin resistance and now this   hormone the dictator of all hormones is insulin  it's going to tell your testosterone what to do   it's going to tell your estrogen what to do it's  going to tell your growth hormone what to do all   of them are at the uh at the dictatorship of  this insulin and now your insulin is it has   a commanding voice and you consume that food that  has let's let's say it has saturated fat in it and   it's in the setting of um a bunch of carbohydrates  with that high insulin which is what made the the   carbohydrates is the the carbohydrates stimulated  that insulin and that fat the ability to move that   fuel into the place where you store it healthy  you've got easy you can easily do that but as   you look at the carrying units that are going  to circulate that fat throughout your body um   they they also are looking for um their entrance  back into your liver and when when you look at the   recycling of our cholesterol that's really what we  should be focused on if I could have a blood test   that measured how long have you been circulating  that uh that cholesterol in your blood waiting to   get recycled then I could tell you are are you at  risk for a heart attack instead of just measuring   what's your LDL cholesterol so as I look at the  the inner lining of those arteries so if I could   be inside your blood vessels and saying let's see  does Reena have a uh have a risk for heart disease   and sitting inside your blood vessels what you  would look for is who's around you if you have   particles of fat circulating around you that are  they're crusty they're oxidized they've been in   circulation for a couple of days waiting to get  recycled that is a neon sign that your body will   say you know what we give up we're never going  to get recycled back into the liver let's just   help out the liver and store you in this little  pocket Under the Skin in your artery and as that   little fat gets deposited Under the Skin and your  artery yes it might cause a little bump if you get   a few of them in there but as soon as it's in  there it actually looks just like a pimple in   that kid with acne it's inflamed it's it would be  tender if I would touch it uh and what's happening   under the hood underneath that skin is your body  says holy Hannah this does not belong here get   this out of here and your immune response comes  in and says oh my goodness what is this doing   here and your body will attack it will find the  friends to say get it out of here this is not good   what why isn't it in the liver and if there's  only one pimple in your whole body your white   blood cells your immune system will remove it and  you'll never know what happened but that's not how   it works that level of high insulin was 10 years  in the making maybe 20 years in the making and   now that process of recycling fat is so broken  that you have millions of those little pimples   happening throughout your the arteries of your  body from your brain to your toes to your heart   to your organs and your immune response is saying  I am overwhelmed I can't get to all of them and as   a consequence the longer they Peck away trying to  undo this fat is in the wrong spot it should not   be there it leaves behind some calcium that's the  almost like the waste product of your white blood   cells coming in to say I'm the hero I can take  care of this but now it leaves behind uh a remnant   of uh-oh now we've left some crystallization  some some you know mineralization in the spot   where inflammation used to be and over time that  hardening of the arteries doesn't just happen in   your coronary arteries the ones that go to your  heart that that is the rate limiting to life so   everybody cares about that but it's happening  throughout the body it's happening to your to   your um you know your tongue and your fingers and  your toes and and your brain and when we look at   that chronic disease processes and we judge you  by let's put dye in your coronary arteries and   see how narrowed are those I'm like dang they are  some pretty pretty important inches of real estate   when it comes to hoses and your when it comes to  arteries but uh it's not the only ones it is it is   throughout your body that this has been happening  it's a universal process and so I think you know   when when I hear and when I'm trying to educate  patients of where to focus um you know they really   don't like to hear that their LDL cholesterol  is too high that their that one marker that the   American Heart Association has done a great job of  saying hey everybody pay attention to that and I'm   saying I want you to look over there I want you to  wake up in the morning and prick your finger and   tell me what is your blood glucose and if it's in  the two-digit range at less than 100 we're going   to say all right now we're going to check it every  day for 10 days and if every day for 10 days your   blood sugar is less than 100 first thing in the  morning we're doing a pretty good job of saying   probably not terribly insulin resistant um unless  you've got some of those outward signs where   you've got a nice large tummy it looks like you're  pregnant or you've had that female 15 lounds that   you just can't seem to get rid of uh so those  those outward signs will give me a couple other   hints that there that there's a place to focus  let's focus on getting those pounds off instead   of saying doc do I have an LDL um I have an LDL  cholesterol that's you know running in the 130s   and the commercials say it should be less than  100 I tell them stop focusing there focus on the   prevention of that because when you look at the  hardening of arteries if you wait till they are   um bathed in insulin for three decades and then  you asked me to help you get the calcium out of   your arteries uh you got the wrong Focus uh we got  to undo that monster called high insulin before we   can ever make an impact on what your cholesterol  is doing as Dr BOS mentions one way to fix insulin   resistance is to monitor your blood glucose  because if your blood glucose is constantly   elevated it is a sure sign that you have insulin  resistance but I do want to point out this is just   one part of overall health another very important  aspect of a healthy body is brain health and it's   not just what you eat it's your thought patterns  and also dealing with stressful situations in life   and that's why I have better help as a sponsor  of today's video better help will connect you   to a licensed therapist who is trained to listen  to you and give you unbiased advice and through   my life there have been different stages where I  needed extra support and more recently I needed   support dealing with my dad's terminal brain  disease and I found this particularly beneficial   because sometimes you don't want to speak to your  family or your friends maybe out of judgment or   maybe they might not understand and the best  thing about Better Health is that you can do it   all from your phone or computer via video call  phone call or messaging it is the easiest way   to connect yourself to a therapist and they'll  match you to a professional that has years of   experience helping people with struggles just  like yours so if you'd like more support just   head to betterhelp.com 5minute body or choose 5  minute body on the sign up page and get a special   discount on your first month it's not just heart  attacks and strokes and the reason why I want you   um I wanted you to explain that is because people  would come to you or any doctor with a problem   and it's important to understand this is universal  this is not just specifically in the body in   a specific artery it's inflammation caused by  predominantly insulin and insulin resistance it   also affects the endocrine system I also wanted to  focus on this because depending on who's watching   they might think well I don't really have a  heart problem or a brain problem but I do have   a hormonal problem I do have a thyroid problem  how does insulin resistance affect the endocrine   system which is your hormonal system yeah so one  of my favorite ways to teach this is actually to   look at insulin resistant patients and uh uh one  of one of the other tests that I like to say do do   you have a problem let's look at your vitamin  D vitamin D is actually a hormone a fat-based   hormone that you can test without my permission  there's you know there's tests throughout the on   Amazon or that you can prick your finger look at  your look at your blood uh test put your blood   on a little sponge mail it in and say what's  your vitamin D and it should be above 50 health   brains need it to be about 50 but if you want to  see if insulin is roaring uh that insulin dictates   what happens to fat-based hormones so vitamin D  is one of those fat-based hormones and when I have   patients coming to me saying you know I have a few  problems but really this vitamin D has been low   and I'm trying to get it to be higher I'm taking  all these supplements and I can't seem to to make   it raise and now instantly in my mind I know that  the cause is almost always not not that they're   not swallowing you know repeatable pills it's that  they're insulin the dictator of what happens to   fat in your body is saying put it in storage put  it in storage and as soon as that vitamin D is in   circulation uh it will then be dictated to by your  excessive amounts of insulin and stored in your   fat and when we watch uh we take fat biopsies and  say let's just see how much of the testosterone   estrogen and vitamin D three of the easy to  measure fat-based hormones are found in the   fat cells and it the first time I read the study I  thought I didn't know that no no wonder no wonder   my insulin resistant patients this was probably  about 15 years ago where I'm like oh this is why   they cannot get uh their vitamin D elevated is uh  they were my diabetic patients they were injecting   insulin and I was giving them vitamin D on one  you know one part of the day and I was giving   the dictation that the the the commanding uh  instruction to put that vitamin D in their fat   cells and if it's in your fat cell it is not  circulating to be able to help your brain do   what it's supposed to do your heart do what it's  supposed to do and and I love that teaching point   because vitamin D is something many people um you  know they they know what their numbers are they   hopefully are they care about it it is incredibly  important hormone that uh goes into every cell uh   binds with the nucleus of every cell and depending  on the cell will depend on what protein does that   cell make so your vitamin D does certain things  in your eye cells different things in your heart   cells different things in your brain cells and it  is you you'll think when you read about Vitamin   D it must be snake oil because it affect so many  things but it's because that hormone goes into the   nucleus and helps to trans uh transcribe proteins  based on the cell so once people understand that   they they do want to know their vitamin D and I  am a you know my CL has a hyperfocus on repairing   broken brains uh again you can't do that with high  insulin levels this is how I got into this space   so deep is I can't fix their Parkinson's disease  without uh I can't even impact their Parkinson's   when their insulin was that high I couldn't  reverse that concussion with their insulin   so high and one of the most powerful hormones  that was going to help their brain was I have   to have their vitamin D above 50 and when they  had I insulin I couldn't do it it was after that   study where say oh that biopsy uh was filled with  the fat-based hormones that I'm trying to deliver   to their brain and it is getting you know parked  in the ditch of their fat cells and I think once   patients understand there's another great story I  had with a patient who had just come to one of my   support groups and I said well you're you're new  to this I would love for you to do an experiment   with me uh you know looking at your medical  records it appears you've been insulin resistant   for at least a decade and you know we looked at  the labs but we also the weight had been there for   at least a decade and his profile was gorgeous  he had this nice big round tummy he could have   profiled for Homer Simpson and had the the perfect  shape and I said I know that um looking at these   Labs that your vitamin D is probably in that fat  in your tummy do you take vitamin D and he's like   no no I don't do that I'm like okay I don't want  you to take vitamin D but I will sponsor your the   next eight vitamin D tests every every other week  while you go on a strict ketogenic diet one that   I know lowers that insulin is the antidote it  is the enemy of insulin resistance is to stop   putting in so many carbohydrates and so he was he  was game and he he wanted the tummy to go away and   so I said not only will this help you be really  compliant because I'm going to be doing this   experiment on you but um your vitamin D will rise  and here's here's where it's coming from it will   be in circulation that vitamin D doesn't like rot  or go bad it's it stays there and when your fat   cells open up and they are no longer Shackled by  the commanding voice of insulin that says store   fat store fat store fat and as that insulin gets  better gets lower you you now have a crop of fat   cells that are no longer in that concentration  camp they are now free to open up their resources   and as his uh uh weight loss happened his b  vitamin D Rose as he did not take any vitamin D   I think that's one of my favorite teaching lessons  of here's a demonstration real life medicine   you can do this on yourself if you have insulin  resistance and you have low vitamin D and you go   on a strict ketogenic diet and I I remind people  you are not on a ketogenic diet if you're not   checking to see if you're making ketones ketogenic  diet is not decided by your thoughts that you're   in ketosis you must prove that ketones are in  circulation and as long as that's the case we're   going to be emptying those fat cells we're going  to be improving those fat-based hormones those sex   based hormones and U wow do I get the privilege  of watching people have an Awakening uh for what   happens when their bodies go without that when  they have way too much insulin and then this surge   of improved sex drive better hair better skin  vitamin D is flowing again uh and you know they'll   you know they'll say oh it must have been you  doc I'm like really was just the absence of that   insulin it's amazing when you actually eat more  calories you eat more fat moderate protein and   we're going to talk about ketosis and a ketogenic  diet after uh the signs that you might have   insulin resistance but Dr BOS you wrote an amazing  book any way you can The Beginner's guy to ketones   for life I know why you wrote that book but can  you share what was your inspiration for that book   well that is a great story yeah so I actually  lost a bet to my husband to write that book um   so I have happily married now 30 almost 30 years  and um if you've been married anywhere close to   that long when your husband when your spouse tells  you to do something it's usually the last thing   you want to do uh but this story was happening in  my life where uh a patient of mine 71 years old   had been under my care and I'm not bragging when  I say I really love my patients I take good care   of them and this one was no exception uh but her  10 years under my care was with a cancer a cancer   GR in her white blood cells and she'd been through  chemotherapy a couple of times and the last time   she went through chemotherapy her brain went  offline um to the part where when she got done   with chemotherapy she was a seamstress and she  didn't know what a sewing machine was so here's   my my clinic with a peak brain performance and  This Woman's brain is offline uh now we did get it   back working but it was at least 6 months before  that was even close to measurable that this was a   version of her previous self and she walks through  the door it's been a few months since I've seen   her and you don't need to be a doctor to know that  the Ashen look on her face the dullness in her she   looked like a zombie uh and her to see her cancer  was back so at the oncologist the it was like one   in 500 of her white blood cells was functional  the rest of them were deformed and not able to do   their job 70 out of the last or 50 out of the last  52 weeks had been filled with antibiotics because   her white blood cells were so poorly functioning  and um it is a moment where I had this question   a lot in my practice uh you might have asked  this question to your doctor where they say if   it was you what would you do and I'll be honest um  sometimes I lie if I'm having a bad day if I just   don't have the energy to tell them my personal  truth I will tell them what the guidelines say   now most of my patients know me well enough to  know when that's happening but it's it's it's an   emotional place where we should all be rested  enough and in a resilient enough place that   anytime a patient asks you that question I would  love to tell you that I give the perfect answer   um but I don't always but this patient was asking  me what to do uh she had a six-month survival plan   if she didn't do chemotherapy she did not want  to go through that again she did not want that   offline brain again and and by God she was doing  everything I'd asked her to she was the perfect   patient um and she was refusing chemotherapy  and I'm standing there with her as we look at   the assignment to go get chemotherapy and she says  what would you do if it was you and this patient   was my mom and at 71 years old I knew better  than to to lie uh I said Mom you know I'll be   honest another round of chemotherapy is going to  to put you in a place that you may not come back from and I've been reading about this diet  that is is great for brains which was why I   was reading about it but there is some research  this is in 2015 that says if we put you in an in   a in an advanced ketogenic state it might be good  for your cancer now I didn't tell her any of that   because she would have said what you're speaking  a different language I said Mom do you trust me   and she said with my whole life and we got in the  car together we drove a 100 miles to our family   farm and we avoided the chemotherapy and we went  we cleaned out the cupboards for all carbohydrates   so she didn't have any Temptation and I said  Mom this is going to be difficult giving up   carbohydrates at 71 is like giving up a friend  and I'll do it with you I'll go on a ketogenic   diet with you so we can do it together and it  made all the difference she wasn't alone my kids   got put on a ketogenic diet my husband went on a  ketogenic diet and our journey uh together as a   family was I think we struggled with it more than  she did um I call her you know we this was a 2015   we didn't do FaceTime or any kind of looking so  I'm on the phone with her and I I can just hear   this youthfulness in her voice and I thought wow  maybe I'm maybe I'm wanting it you know maybe it's   me my brain's working better I feel better um and  you know we live a 100 miles apart so we don't get   to see each other that often she comes back six  weeks later and you know she's been great we've   been on a we didn't lose any weight but we felt  amazing uh and as she walks through the door for   the oncology person I was like out of a movie  like back lit by a sunlight her face was just   glowing and the only other clue I knew that we  were headed in the right direction is I was that   doctor writing the prescription for antibiotics 50  out of the last 52 weeks and she had not asked for   antibiotics in the last six weeks we were hoping  that her chemotherapy would have blunted that uh   that uh cancer down dropped it by by 30% um you  know cut it in half would have been a miracle   uh but we had no place in our brain that when  the reports came back it showed that her cancer   had dropped by 70% just being on a ketogenic diet  and of course the doctor's like what are you doing   and before he walked in he's my friend and I said  I mean I knew she was I knew she looked better I   said you know mom um if he asks what we're doing  just shut up I don't know what to tell him I'm   really nervous about manipulating your health like  this and putting your life at risk and um just   shut up so we get through this moment where her  her ketogenic um intervention had really helped   her cancer uh I think that's gets you to like  the fourth chapter of the book uh what really   happened was this resurrection of a woman at 71  years old who acted 90 and that's not her spirit   uh my um my image of my mother is Mary Poppins she  had abundant energy and life was magical growing   up with her love and that woman was long gone my  kids hadn't seen her in at least a half a decade   and um I am so happy to report that she stayed on  a strict ketogenic diet that I learned more about   the ketogenic diet and became now what I would  call an expert on the ketogenic diet because of   her first my first patient which was my mom and  um the book I wrote it tells her story but also   is a basic set of lessons of here's how you screw  it up here's what most people screw up here's why   you should care uh and it's more than just weight  loss it is how can we get our bodies to live in   this removal of inflammation and I know that  word inflammation is used so much today that   people kind of tune it out but it is that message  it is that process that insulin is what caused my   mother's cancer the insulin resistance where it  was at least 10 to 15 times higher than it should   have been for for 15 years at least and when  we put her on that ketogenic diet her her her   insulin went down her ketones went up and the body  started sweeping out the inflammation that was   causing her to be the Zombie that was robbing her  of Being Mary Poppins and you know that book uh I   self-published it and thought no one would read  it and it's sold over a million copies so I just   think how much grandma Rose's uh story has helped  other people it's important to say because I'm I'm   glad that you mentioned that insulin resistance  is linked to cancer I think people again they   think cancer is something that I'm just going to  die from it I can't do anything about it but with   a ketogenic diet which we'll talk about ketosis  and also spotting the insulin resistance in the   first place you can prevent all these chronic  Health um conditions let's talk about signs and   symptoms early signs that you can visibly see  in your body this is kind of fun I have 10 well   I have nine here but you mentioned some earlier  but let's spell them out one by one the first one   is increased body mass index right yeah so that  that hormone is telling your body store fat store   fuel store fat uh and when we look at folks being  overweight if you go back 200 years ago this was   not that common of a problem you had to be a very  elite person of our society to get enough of that   processed sugar uh to to be able to have enough of  the fat on your body to be insulin resistant that   you know I people beat this uh metric up like oh  I'm big boned and or oh that metric doesn't work   because I have an excessive amount of muscle mass  I'm like you're one in a thousand I mean that's   not the norm and I'm glad you have excessive  muscle mass but there is still uh a very good   metric behind most people using body mass index  body mass index which takes your height and your   weight and says when you get out of the green zone  when you get above 25 you're insulin resistant   you're storing too much fat and the ability to  remove it because you live in 20 24 is uh yeah   you have too much insulin too much processed foods  that have allowed you to put that squishy layer on   your body so body mass index is number one and uh  you can make the argument where you put the fat   gives me a little more understanding but I try not  to parse those words just being overweight today   says you got too much insulin you got to lower the  insulin here's the rules okay next one is skin why   does why is skin an early sign early warning sign  of insulin resistance so that there's a there's a   couple of classic uh med student questions that  I think are great for people to uh uh to notice   there is a process that the uh the skin responds  to when it's been exposed to high insulin uh the   so again the in insulin does a lot of things one  of the things that I I haven't mentioned on this   podcast is that it's a growth hormone it makes  things grow and one of the things that grows is   skin so the first uh easiest thing that you can  see across the room is anybody with a skin tag if   they've got their hair up and they've got a skin  tag on the back of their neck they say oh it's   from my collar I'm like no it's your collar plus  insulin that's been around for a long time they're   like oh it's from my my seams under my armpits  I'm like no it's from the insulin and then maybe   your seam is stimulating it meaning the friction  that happens in the places where you grow skin   tags well that happens to everybody you you must  add the secret ingredients of excessive amounts   of insulin to grow those skin tags and it is a  very phenomenal process when people say I didn't   you know I didn't think that I could reverse uh  my skin tags because they don't care about those   by the time they're coming to see me they've got  heart disease they got a brain that's not working   they got a heart that's failing they got a liver  that's full of fat uh skin tags does not even make   the list for the first seven or eight visits but  when they accidentally fall off it is the top of   their list like I've had those things forever  and I'm saying that was your warning that was   one warning that your body was making excessive  insulin uh there's another another process that   is a a Latin word for a velvety looking skin and  it's I point to the back of my neck because it's   often this uh place that's on the back uh of uh  of the neck and it's more prominent it's easier   to see in people with dark melanin higher melanin  In Their Skin So you'll you'll often see um you   know mothers and sons saying no I you know it's  it's not clean and it's as clean as anybody else's   skin but it's skin grown in a bath of insulin and  these are teenagers that have excessive amounts   of they have the skin tags they have the um the  velvety skin under their armpits and and on the   back of their neck uh and they'll get it in the  folds of their of their their thighs as well when   when you look at uh the number of years spent with  high insulin uh just looking across the room at   the folds of in their elbows uh the back of their  NE if you if you happen to see their armpits they   have a brown Hue that is uh related to that high  level of insulin and it is a tellall as you said   all those things I was checking myself so when  I was listening to all these signs I was looking   at okay I don't have anything here fantastic the  next one is hilarious um thumb print test on the   shin yes well so again insulin is the in excess  does it shifts the chemistry of your body uh what   thing you can think about is that when the insulin  resistance is happening you're holding glucose in   circulation too long and as a result that glucose  holds on to water so you are circulating more   water uh than you need to be when you're insulin  resistant and your body will leak you can't hold   that much liquid in your veins it will seep out  so what we're looking for with this test is the   tissue the the the fluid that's found between the  cells in your tissue tissue and I'm not talking   about when you cut and those out comes blood I'm  I'm actually saying if you've ever seen if you've   ever had a pimple and the pimple pops and then out  ooes this kind of seramy uh see-through stuff part   of that is interstitial space and there's this  pressurized system throughout your body that's   really kind of hard to measure except on your shin  so if you go to the Bony part of your of your leg   below your knee uh and you look that's where the  bone should be and you take your thumb and you   push on the bone and when I do this to patients  they often say ow so you're pushing hard enough to   actually take the capillary to whiten the tip of  your thumb you're going to hold that Thumb in your   shin for 30 seconds and then you're going to take  your thumb out now if an indent is left remaining   in that spot you have fluid in the interstitial  space which is a huge sign of you've got insulin   resistance dude or dudette uh that uh that that  area of your body first of all doesn't have fat   in it you are not pushing on fat even if you say  well I have fatty ankles I'm like no no no no I'm   not talking about that I'm talking about this F  this this fascia this kind of like Saran wrap that   usually goes around muscle layers and compartments  of your body that's not fat over the bone that is   fluid and that fluid does not belong there the  longer it's there the more it's there gives meat   a signal of here's a history lesson in a in a  hurry how long has this patient been insulin   resistant and you push on that Shin print you hold  for 30 seconds and then you pull that thumb up   and if there's a dimple that stays there that is  insulin resistance the next one is swollen ankles   yeah almost along those same lines when patients  get done with the day and they say boy you know my   my ankles collect water throughout the day yeah  gravity will do that uh but not if there's not   excessive insulin around that excessive insulin  caused your body to have a decreased amount of   the the lmph uh lymph um circulation as well as  the same problem that caused that Shin print and   that was excessive fluid is there and by golly  it goes away in fact one of my favorite things   when I do check-ins for a support group is people  who say I have ankle bones again that's one of   the benefits of doing a ketogenic diet and being  in ketosis and eating more fat okay let's get to   uh number five is hairy toes a sign that you have  insulin resistance or that you don't yeah so hairy   you want hairy toes you want hair on your toes  I know ladies will do things to make them look   lovely but uh it's it's actually a signal about  microcirculation in one of the most distal parts   of your body from the heart so as your heart's  doing its job it's going to sacrifice uh parts   of the body when you don't uh when when you  you're not healthy and years of not being of   having that excessive insulin if you go back to  those pimples on the inside of the blood vessels   as that's happening to the bigger blood vessels  it's also narrowing those tiny blood vessels   and it will it will pinch off that peripheral  delivery of of blood when you do that and the   the the tissue the real estate on the other side  of that that part that got pinched off was the   hair follicles on your toe the hair stops growing  now I'll have patients who the the hair on the toe   is actually one of the last parts to stop growing  you'll often see that the distal part of the leg   right above the ankle is also a place that stops  growing hair and you cannot guess what the number   one answer is when I point this out to patients  guess what they think it is what they think it's   their socks um you wore socks for 60 years that  didn't take the hair off the bottom of your legs   why do you think it's taking the hair off of the  bottom of your legs now it's not your socks it's   that the vessels that go to that part of your body  are clogged and not working and the hair follicles   were the first to be sacrificed they're not going  to grow let's go to the next one which is change   in spage especially after eating cobs yeah so  I'm a brain person right so watching how brains   function and what they do in different states  of uh of energy is is it's like second nature   to me when somebody's eating and they're insulin  resistant so they've got pretty good glucose   fuel happening at the uh beginning of the meal and  then about maybe even 15 20 minutes after the meal   the insulin is going to be the highest which is  pushing all that glucose it out of the circulation   hurry up get it out of the circulation and it's a  relative drop in glucose and during that time you   can see their spee is slower now I'm exaggerating  it here for effect but it's remarkable you watch   somebody's Cadence of delivering those words and  when that the swelling is what's really happening   in the brain the insulin causes the glucose to  shift the water will follow it uh that's what   that's swelling of the brain like a concussion  and it also changes the Cadence at which they   can articulate they just can't push the words  out as fast and it is recognizable when they   when they stop uh changing that blood uh sugar  so much when they go on a ketogenic diet it's   you can just hear it in their voice much like  that phone call I had with my mom you know six   or eight days into this ketogenic you're like oh  my gosh she just sounds youthful she's she's back   to normal and you can see that in patients where  they've they've left normal this is clearly not   normal okay similar to feeling tied after eating  carbs if you have fatigue yeah that's exactly the   same thing similar process that it it really is  is it's a brain thing I mean that that shift in   fuel uh also results in a shift in what the  brain if you could do a functional Mr after a   high carb Spike and an insulin response to it  in an insulin resistant patient you're going   to see parts of the brain just they shut off  and it's not um you it's not you saying oh I'm   carb drunk you really are concussed you've got a  brain contusion from excessive amounts of sugar   I think most people feel tired after eating carbs  especially fruit I'm going to ask you about fruit   later okay these are sexual function erectile  dysfunction yeah so yeah I think that's one of   my most popular YouTube video and I will credit  my husband to this like if you're trying to get   the attention of men you should just tell them the  same thing you told me if you keep gaining weight   like this your penis isn't going to work like huh  that does get the attention of boys they come in   they don't care about the the you know 20 Ines  of hoses that run through their heart but they do   care about what goes into the however many  inches of genitals those arteries are the   same they are the same pimples they are the same  calcification they are the same processes that   that uh that decrease how a an erection can um be  firm enough for penetration as the blood supply   is now compromised to that heart muscle uh those  are the same pathology it's just different parts   of the real estate you know I I also uh you know  when when one of the other benefits um when people   are in this very high insulin State yes the  hardening of the arteries is one thing um but   they'll come into me and say hey my testosterone's  low and the first thing my brain is is well it's   probably all in your fat cells if you would just  change your Chemistry we could empty it and you   would be getting testosterone injections from your  own fat over the next six months um but they'll   ask say oh I I need testosterone injections and  I'm like here's what's going to happen with that   there's this dictator called insulin and when I  put it in when I put testosterone this fat-based   chemical in your body it's under the dictatorship  of that hormone and your hormone is so high that   I don't care how much testosterone I give you  you're going to still put about a third of it   into your fat cells the other two3 you're going  to get to use but as as you watch what happens   to that testosterone process uh the effect of  their sex drive will initially be improved but   then it flatlines and and now we have a problem  now you're dependent on my testosterone in order   to have any sex drive and uh you you didn't  do much to reverse that insulin resistance in   the last six months the last one I want to ask  you about is the Dr BOS ratio because that is   how you can detect if you have insulin resistance  um you don't need a lab but you do need a little   device but can you explain what that is and how  somebody can test right so I I I arrived at this   uh DR Boss ratio kind of by accident and I'll go  back to my mom so again she's a 100 miles away   from a hospital uh and she's not unlike many of my  patients in South Dakota where they live distant   from we've been social distancing for 200 years uh  and that ability to have them go check in insulin   well it came after a 40 minute car ride and then  they waited in the lab and it's never first thing   in the morning uh that insulin is very sensitive  it's a volatile hormone that changes dramatically   I mean I would tell patients if if you fart on the  way to the lab you changed your insulin you know   it it is super responsive to what's going on  in your body and I'm going to make a bunch of   decisions based on where that's at so God  forbid you happen to suck on a cough drop   or you do something on the way to the lab now  you just screwed up my insulin test and it's   kind of expensive so we're going to use that to  judge you for the next year no that's not going   to work instead let's look at the two molecules  that insulin is most the commander of that are   very volatile and accessible and that is how much  is your glucose and how much how many ketones are   in your blood so first thing in the morning I  have patients prick their finger and say Here's   my glucose and here's my ketones and I'll be  honest I got this information from the glucose   Ketone index which is where cancer researchers  across the globe use to predict are we impacting   the growth of cancer are we are they in autophagy  and I'm trying to teach my mom how to take glucose   convert it to Mill moles and do a bunch of math  and she's like uh-uh and I said okay Mom we're   just going to do dirty math uh we're going to have  the glucose in one metric we're going to have the   kones and the other I want you to take the big  number the glucose and divide it by the little   number the ketones and I'll get you the I'll  convert it for you so if you take the big number   the glucose and you divide by the ketones and your  your doc we call this the DR Boss ratio it's dirty   math for glucose Ketone index but if the DR Boss  ratio is less than 100 many people lose weight if   it's less than 80 a whole bunch I mean it's hard  not to lose weight first thing in the morning that   that uh glucose or that Dr B's ratio is 80 when  I'm trying to reverse things like um autoimmune   problems or um I'm really helping them with  reversing some some heart disease I want that Dr B   ratio to be 40 or less and then finally if you're  one of my seizure patients we're trying to prevent   seizures with a ketogenic diet or you're like my  mom and they are in the midst of fighting cancer   I want that Dr BOS ratio to be 20 or less so what  is this number really predicting it is predicting   how much insulin are you making today and as you  watch people reverse insulin resistance this is   the hardest part if I'm only measuring the metric  of insulin it's really difficult to assess well   how well does that affect your glucose in your  body and that's the goofy part about insulin   resistance when as you're on your when they're  on the way up of making ins insulin resistance   that insulin Rises and they do get a little um  you know a little worse a little worse a little   worse but they don't get you know no APB goes  out that this just happened inside your cells   and a very secretive process happens on the way  down as you're lowering the glucose and your your   pancreas is learning to produce less insulin  when you eat uh it's a slow process how you're   doing today actually might not be the same as how  you're doing in a month but we'll know by how much   glucose is your circulation and how many ketones  are in circulation when insulin is high it push   you you don't make ketones when insulin is high  your glucose is usually stimulating it to be high   as you lower glucose insulin lowers and as that  insulin stays low your ability to make ketones   which is the mobilization of fat and turning that  fat into fuel uh activates and you can see it you   can judge this you can see it on your own you do  not need me to do this but you do need a meter yes   so you don't need a doctor Dr buz I'd love to see  you anytime but um we just have a simple device   okay let's talk about ketosis because that is the  way to have to fix insulin resistance whether that   be you have diabetes dementia cancer heart disease  depression Auto well autoimmune conditions maybe   fixing that would fix the autoimmune condition  I'll tell you the first time I I saw that in   a patient I thought I was actually just on an  interview the other day with Dr fun and I told   him the story uh so Dr fun was one of the first  brave souls to step out into the universe and   talk about a ketogenic diet and how fasting  is probably the best answer once you're keto   adapted and he was talking about thyroid disease  um I had bought the the lecture series from a a   conference in um South Africa Cape Town South  Africa and it's like 2015 2014 2015 super long   time ago and I remember seeing Jason fun on this  lecture and he said something that I was seeing in   my patients that I didn't know how to explain and  that is you have an autoimmune disease that means   your body was attacking the thyroid your immune  system screwed up and labeled your thyroid as   the enemy and it's pecking away at it and you're  you're just screwed you're going to need thyroid   medicine forever you're going to need to see  me forever this is not undoable and yet people   on a ketogenic diet when they were persistently  in ketosis they would I was overtreating their   thyroid so I'd lower their thyroid Mets they'd  come in you know six weeks later I was still   overt treating their thyroid so we lower their  thyroid meds and I'm like dang let's just stop   your thyroid Med we lowered it three times maybe  it's not a problem anymore and in my H my mind I'm   like that's just not true I've never seen that  before I've been doing this for a decade that   can't be true and I'm like and when I saw Jason  fun say that lecture he's like I didn't know what   to do with this at first but I'm telling you I see  this and I'm not crazy I have labs to prove this   and I'm like I have the same I see the same thing  and and then then my heart broke I mean one of   the worst autoimmune disorders that I um that I've  seen witness is Crohn's disease um where that gut   uh is being attacked by the immune system all sort  of colitis and Crohn's disease different parts of   the gut that the immune system attacks and they  were young they were 21 years old and they were   typical South dakotans working hard wanting to go  party do their life at 21 years old and their gut   was under a Warfare it was just a bloody mess and  I can remember I was a medical student at the time   and you know the doctor before we walked in to  see the patient he's like you know this kid just   won't take our advice we want to cut the colon  out if we cut the colon out this would all be   better yes he would need a colostomy bag but you  know he's just going to he's just going to have to   have to take our advice and of course I'm pretty  naive like well why wouldn't the knucklehead and   take your advice I mean of course that's the only  option there is and and he um I can just remember   beautiful young man and he's like I'm not letting  you cut this out I not going to be that guy with   a bag of poop hanging out on my tummy and and he  I mean I can remember he got super sick his colon   shut you know swelled shut so now you know we're  going to see him in the hospital and he's like see   I told that kid if he didn't do it he was going to  have to you know all glib and they didn't mean it   but nobody likes to see your patient die and that  autoimmune problem in the years of seeing um what   a state of ketosis can do uh that immune system  is being revved up by a growth hormone the growth   hormone is excessive amounts of insulin not for a  week or two but over and over and over again it's   screaming at your white blood cells to overproduce  and the error actually produces easier when that   when it's inflamed when all that swelling that I  was talking about is chronically at the cellular   level and when you reverse that when you take  away the swelling by being in a persistent   state of ketosis oh my goodness I have seen people  reverse their Crohn's disease reverse their ulcer   D citis stuff I didn't think was possible I mean  it was actually an emotional this is selfish to   say but it was an emotional thing for me to say  oh my God that kid was right there was another   answer we were wrong and to know that the immune  problems that I mean autoimmune problems they are   happening younger they're happening more often  they're happening I mean and if you come to my   prescription pad and say how am I going to treat  that well I'm just going to sh down your immune   system we're going to give you an immune modulator  which is a lovely word to say we're just going to   weaken your immune system and then say now don't  get a virus and don't get exposed to this and d   and if you have herpes it's going to flare and  all this stuff that is like yep that's our plan   for Life For Life instead of saying or you could  remove the excessive insulin and you could bathe   those cells in ketones and that process allows  the reversal now it's not right away me one of   the best parts of that Jason fun woman he's like  it started happening about 8 months after patient   said I just don't want to get out of ketosis I  feel so good and it was those patients that said   that he said and then the thyroid kind of gave me  a right hook like nobody told me you could reverse   a thyroid problem of autoimmune origin nobody told  me you could reverse autoimmune origin causing all   sort of citis Crohn's Disease rheumatoid arthri  these other problems and indeed you have to be in   a state of ketosis you have to be strict that's  why I put so much energy into saying you're not   on the ketogenic diet if you're not checking  the ketones and finding those little turkeys   in circulation you have to be there in order to  get these benefits but for those patients it is a   Lifeline let's talk about how to get into ketosis  because I think people like I think people some   know and some don't know can you walk us through  how you can get into ketosis to get those good   Ketone numbers yeah so there's a there's uh a  hurry up and do it kind of way and then there's   the way that you you do it and you're there for  life so I like to talk about the Dr BOS brand as   not the first time they've tried keto but we like  to think it's the last time that they'll want to   you know Adventure into the ketogenic diet because  you'll stay there uh and I do think this is uh not   everybody has to stay there to to have the best  health uh I'm going to stay there because I I get   the unfortunate uh point of view that well that's  what life looks like when it doesn't have ketosis   uh so a persistent life with ketosis is not only  a good example for my patients but it's a better   life and when we see people I call them my my ass  over apricot people they come in and say I'm going   to do everything you tell me to Doc I'm going to  do it perfectly and they drop their carbohydrates   to 20 they don't know a thing about what's about  to happen they flush out a bunch of extra fluid   their Shin thumb print on their leg goes down they  lower their blood pressure sometimes they pass out   by day two because they lower it so quickly  so fast and then by day four they can't poop   and say this diet is terrible so that's what ass  over apricot looks like uh what I do and when I   teach in my books and when I teach to people who  come to see me is you must do a couple of mental   shifts uh number one why are you doing this and if  your reason is for a skinnier waistline probably   not going to be a good enough reason to stay the  course I'm going to have you look a little deeper   uh you know one of the you know predecessors of  my life you knowe pre-seasons of my life was to   work with patients with addiction and when people  would show up and say I'm here to take care of my   addiction because the court service officer and  judge have mandated me to do it I was just like   you need to find a different doctor unless you  want to find a deeper reason for being here we're   not your team I think the same thing goes for  a ketogenic Journey if you're here to lose 10   pounds and then you're done we're not your team  we're way too complicated for that but if you're   saying I want to show the Next Generation how life  can be done how you can age without these problems   or your team and so we start with mindset like you  really need to know what you're saying goodbye to   and what you are dreaming for um so we we set that  framework the second thing we do is you must clean   out the cupboards the day before you start and you  have to share that picture with a friend and you   do this even if you have a husband and even if  you have kids cuz this process of saying you're   going to eat over here like uh in a ketogenic  way and then no one else in your sphere of   influence is going to be with you on that Journey  we just we think that's ridiculous we think that   there is um there you know families do things for  a reason because somebody needs help if you're not   vulnerable enough to say husband I am struggling  I need the last 30 l pounds off I can't sleep   my sex drive is terrible I want to do this that  relationship and addressing some of those issues   we we Foster that on this team because it matters  if you're doing this and you're the outsider in   the family it will only alienate the process  and by gosh if you're the mother if you're the   matriarch of the home which across the globe women  that's our job is to set the tone for what is what   the nutrition is in a family that your children I  mean I'm all about Peak brain performance my kids   had keto they were and not like I was crazy keto  I was like no if you're eating and I'm paying for   it this is what we have in our home we don't have  cereal we don't have bread we don't have processed   food sure do we have Easter you know um treat on  Easter uh do we have a Christmas treat oh yeah   on Christmas but not on a random Saturday because  that's what great moms do no it's not uh this life   that I'm teaching you to to eat this palette that  I'm introducing you to will set the tone for what   you want for life and as your mom this is my job  so we have that conversation and if people don't   want to do that find somebody else there's lots of  people that teach a halfway ketogenic diet this is   ketones for life and when we do that we say all  right we're going to start this uh the timer on   the you're going to start it but it came after  you shared the photo that your pantry was empty   the carbs are out of your sphere of influence  you've got your a few partners that are going   to either try to do this with you and even if you  fail and many do a f the first few times they do   not realize how addictive how much dopamine you  get out of that surge of glucose that is that is   showered with excessive insulin and then making  that insulin resistance perpetuate and so as we   look at how once all that is once I have the Right  audience and these are the people that I really do   want to say let me show you how to do this for  good uh we walk them through and say 20 total   grams of carbs per day not net carbs 20 total and  uh I usually feed them a couple of ideas for the   first few days because people are a little wigged  out you're going to get up in the morning you're   going to have eggs with the actual yolk and you're  going to cook it in some butter and you can have   some sausage or bacon with it no toast no almond  anything just bacon and eggs and eat them and then   you can put some you know some uh salami or some  hard hard salami in your uh snack for for lunch   and you could have some cheese and again uh that's  a little bit of the the food that you can have for   lunch other things we show them how to do and then  for supper that night we want you to go to like   a a Buffalo Wild Wings and have hot wings with  blue cheese no beer and no breading and that and   that kind of shows them there's some really great  satisfying foods that are in your world you don't   need to you know reinvent your life but they're  out there they're high fat they're low protein or   excuse me high fat low carb and medium protein  and at the beginning all we care about is that   they don't have carbs in them we we push them to  to Really embrace the fat because there is quite   a fear that this is way too fatty and you'll  often find that some people have been lowfat   for so long that they have a sausage eggs that  you know buffalo wings with blue cheese and then   they get a bunch of fatty diarrhea because their  gut's ability to absorb the fat is so out of shape   but they just pooped it right out we're like just  hang in there it'll go away you're going to wake   up your gut here in the next two or three days  just keep eating and really what we find is to   not limit their Foods at all we want them finding  out what things on their palette taste good and   because they've come from this low fat World  they kind of forgot how great some of this food   tastes and then they start to realize how much  they really did like the processed carbs uh and   that I think is the Journey of the long game um so  step one is to mind be mindful and set that mind   frame up for what it looks like to do this and  then as they step through those first three days   um I know I have a workbook that I used to give  to patients and now I say you don't need to see   a doctor to do a ketogenic diet but it really  prepares them day one this is going to happen   day two this is going to happen day three on day  four we talk about poop because if you're going to   have the um the shift in your bowels where you  didn't hear me talk about a lot of vegetables   on those first few days um most of the time they  overeat the vegetables so much on those first few   just because they're craving the carbohydrates  that I really pushed them for this high fat   um mostly carnivore plus eggs whatever that is  in carnivore these days uh and and really ask   them to just find what tastes good and if they  are coming into the ketogenic diet like most   people that the way your bowels have been moving  for the better part of a decade is to stretch   the colon and there are stretch receptors in your  colon that cause the peristalsis the contraction   of that colon to move the stool along but if we  don't have fiber your body has to use a different   mechanism and it's built in you've got it there  but it might be a little sleepy and that's where   constipation shows up on that third day and fourth  day and we say we have a fix here's what you do so   I can walk you through that if you care but we  can talk about that I want to talk about fat uh   because you recommend for your patients sometimes  to have a butter only day I'm fascinated why oh it   is the best experiment first of all so let's just  place this the scene let's say you're a month and   a half in you've done this ketogenic kept those  lot carbs to less than 20 or less and now we have   you you know we're done peeing on a peton strip  we actually have you pricking your finger with   with glucose and ketones and if we're fighting  insulin resistance what's happened in that six   weeks is you used to make five cups of insulin  well now you're making four and the first you   know couple weeks of making four cups of insulin  uh your cells were a little confused the ketones   came to rescue them they delivered the energy you  got through that and now your body is reset so now   the sergeant of arms does not need to scream  as loudly to get the job done there's still   an excessive amount of insulin there to reverse  that we got about a year and a half of timeline   before that's gone but they get to this place  where doc my my ketones used to be like 2.5 3   you know three or four and now they're like 6.5  I can't get my ketones to rise and indeed it is   a place where we said all right this is the real  Crux about what happens with insulin resistance is   I'm doing your ketogenic diet and I don't feel  nearly as good as I did that first couple of   weeks it's not working for me anymore and I'm  like let's just do an experiment for the next   day I want you to check your ketones and glucose  three times a day for the next 3 days that's not   normal we don't usually make them prick that much  but I want you to eat only butter today and then   for breakfast tomorrow morning so 24 hours I want  you to eat butter and by gosh when they eat just   fat they eat just fat what's what happens is of  course there's no carbs in that and the stimulus   to produce insulin is now really so now they've  got gone from four cups of insulin and now they   produce three and the next thing that happens  is this way their body is already in shape to   make ketones so we don't have to wait 3 days like  we did when they first start the ketogenic diet   before their body is making ketones within 24  hours boy they have a ketone number of you know   2.4 and you know they're back in that level where  the brain is flooded with a bunch of ketones their   energy is good again and they're like oh so the  answer is to eat butter the rest of my life I'm   like not quite but this is a great teaching moment  to say You're still making excessive insulin what   the butter did was lower the insulin from wherever  you were to this new low and you could do that by   first of all you were satiated you you felt good  people think it's easy to eat butter and I'll tell   you by the end of the first stick it's a little  you're like oh God I don't another bite of butter   ever again but what's happening is this excessive  amount of fat that's going in keeps them from   snitching or craving and it's it doesn't stimulate  insulin and now you've got a lower insulin another   wave of Ketone uh improvements and ketones in  circulation be get more ketones so when you do   that surge like that um now you've got you've got  a grace period of at least a week where they're   going to have production of ketones better so they  can tighten up there there's there's all kinds of   little things we can do after the butter to keep  them in the good Zone but that's why we do that I   wanted to ask about ketosis and fasting because I  think people they hear many different things they   think what should I do what's more important  ketosis or fasting oh that's a nice question   um so I I I'm going to start with the answer to  someone who's never been on the ketogenic diet   if they've never been on a ketogenic diet and they  ask what's better fasting or being in ketosis I'm   going to say ketosis every time uh the production  of ketones really is this Fountain of Youth your   body is repairing when those ketones are on the  Rise um when you look at somebody who's coming   into a fasted state or they're going to try to  fast and they are not in ketosis they have this   High insulin uh they're like pretty much 90% of  the planet uh insulin resistant and they are not   a standard American diet whatever you want to call  it the amount of time they have to fast to get to   ketosis is like 72 hours and to ask somebody to  fast that long first of all they're going to hate   it I mean the the amount of chemistry shifts that  people go through when uh when they stop eating   and they are in a high insulin State uh it's a  heck of a roller coaster IDE it's not fun uh so if   they have never been in a state of ketosis I would  say go for it I you should be in ketosis but when   I look at people who are on a ketogenic diet and  they're trying to reverse their insulin resistance   I remind them it took you a couple decades ades  to get here and you kept inching that insulin up   because of the persistent Behavior now as you are  trying to inch it down it's going to Plateau the   way you inch it down to the next level is to go  long enough that you shift a chemistry you shift   the chemistry like personally I fast every week  you know when my mom and I started that story in   2014 um i' had three babies and I worked way  too hard and I was pudgy and I had all the   problems I was trying to prevent from happening  in my patients so I'd been insulin resistant for   at least a decade that's thanks be to God for  children that's what you need to have in order   you got to be insulin resistant to carry babies so  I'm happy that it happened but I didn't want it to   be happening anymore and I really realized after  I was in a state of ketosis how easy it was to   Plateau when you're just being a normal person um  so it was only by adding fasting on a regular St   regular time that I was able to take that insulin  resistance down probably took me 60 years to   reverse the insulin resistance and I at first was  fasting intermittently like I would go 48 Hours   here 48 hours there and I think it was 2017 when I  just started doing it every week I would start uh   fasting on my show I'd fast for 72 hours and I got  that by looking at what the data was that I really   wanted to burst my growth hormone and I wanted  to you know increase the carrine in my brain   and you know do all the things that are very well  documented with a state of fasting but only if the   insulins down so you do not get those benefits of  a surge of neopine phrine a surge of without that   pred that that that premise that your chemistry  set can produce the ketones that you can get   past that cortisol level and and then burst the  the growth hormone the neurop nephrine you can't   do that in a high insulin state so in those  with insulin resistant if they're in a state   of ketosis and then they add fasting and I would  contend that they don't add fasting randomly they   find a rhythm to it and you fast to a certain  chemistry set you fast to an increased to a DR   Boss ratio you know get reaching that level of of  bursted metabolism gives you the first it gives   you the ownership this is you know your body  has rules they're not like your wives they're   not like your kids you have a different Journey so  know what your journey is and don't reach for the   the clock to measure how you're doing look at your  metrics and it really does take out the confusion   last question for you people love supplements you  mentioned vitamin D I'll ask you about vitamin D   but I'll first ask you about magnesium why is that  important for the brain oh my goodness magnesium   is important for every single cell but it's mostly  that when you look at the the mineral that people   have a consequence quence of when when we ring out  that inflammation we flush it out with a bunch of   fluid so especially in a state of ketosis you  don't have that excessive fluid around and what   got washed away is the one that was right at the  edge of normal anyway which was magnesium uh as   magnesium um percolates back through the body not  only is it helping an incredible number of enzymes   do their job it's also helping muscles to contract  brains to relax that that depth of sleep that um   you know being a physician that studies brain  repair I need them to get into the depth of sleep   where the dishwasher is washing off the brain and  if you have low magnesium you will not get there   you can't get there so having not only magnesium  that's present in your circulation enough that   you don't tip into the deficiency St State uh  when you when you fast for 12 hours uh but also   that you guarantee the depth of sleep every night  which is where you're immune system reboosts it's   where your brain repairs it's where your heart  disease is prevented it's where the erectile   dysfunction is prevented um uh and magnesium not  only helps with all those enzymatic things on the   periphery of the brain but as you watch for depth  of sleep magnesium levels are a huge predictor for   whether they'll get to that dishwasher effect  so vitamin D do you think that every person   should take a vitamin D supplement if they are  under 50 yes that's so again the 50 is really   where um I I'm in I'm in the world of repairing  brains and not not just that I want my brain to   be at Peak Performance so the literature is very  clear that if you want your brain to have this   Peak Performance to have this ability to to comp  you know today's commodity is how well can you   deal with you know stress change life differences  you know setbacks and and even successes uh and   that brain performance is related to how well  you can make the proteins in inside your brain   that are needed to function and that vitamin D  is critical at at producing that so to me was   you know the sneaky setbacks that you see patients  suffer with after 25 years in medicine yes insulin   resistant is one of those gnarly sneaky things  that the patient did not get the memo on that it   was happening but the other one is mental health  issues that they have the strong identity of who   they are and what seeps into their their ecosphere  is a brain that can not function like it used to   because it isn't nurtured it isn't hasn't been  sleeping well and it doesn't have the nutrients   to actually build the the the neurotransmitters  that we're asking them to use and vitamin D is   a critical part of that so you know for many  years I've said 50 is the number I don't want   to be below 50 now I'm below 50 all the time  I'm terrible at taking supplements but I keep   reaching for it and um I have all kinds of new  little tricks I keep trying to keep my vitamin D   okay is there anything that is pertinent to your  work that we didn't cover in this episode that   you would like to discuss I think there there's  one thing that I I think um I would say and I'll   let you decide if it's pertinent to your audience  but when I when I entered into medicine you know   I chose to be an internist because it was the kind  of Doctor Who was really advanced in how they were   answering questions and when my parents would  ask me questions I didn't like the feeling of   answering a little bit I loved going all the way  to the bottom of the understanding here's what   what the answer is and as you look at that job  of Physicians to educate patients to to Really   Bridge the understanding of what is wrong with  you why is this happening and you shouldn't get   the patient addicted to you in the process like  oh you need my prescription medication in order   to feel better that's a bunch of Hoy that's not  how the human body is supposed to work if we're   really doing our job and as I transitioned into  this you know Strange World of educating through   a YouTube channel um my popularity of my clinic  became overwhelming in fact it there were times   where I was like I I can't I can't tell people  I actually see patience cuz all that happens is   the phone goes off the hook staff can't get their  job done you know people call the Better Business   because we didn't answer the phone I'm like no I  can't de I can't handle all of it and when I um   so I recently moved to Florida uh I moved during  the pandemic life happened and uh I moved from   South Dakota where I'd been for 50 years and now  I said I'm going to do my life here in Florida and   when I did that there were some hiccups in how the  federal government registers a medical clinic when   the provider was moving and the paperwork looked  like we were either doing something fraudulent or   something went wrong and of course Washington DC  is shut down so the people to undo the paperwork   we kind of absentee or that's what it felt like to  us so the paperwork to start my clinic was super   delayed here in Florida and I did something  that I I know it was God helping me I I don't   know that I would have had the courage to do this  had I not been boxed in a corner what am I going   to do I still have payroll to pay right is I've  had this idea for a long time that patients when   they would come to see me for addiction didn't  get better because of the prescription I wrote   they didn't even get better because that the  super great therapist walk them through their   lifehood trauma no they got better based on how  well they attended the support group and I have   often said you know these chronic diseases they  come to see me their Medicare will pay for them   to see the doctor for chronic diseases once every  12 weeks for that chronic problem now you get 20   minutes of my time four times a year and you  think that's enough interface for me to help   you get over this it it doesn't work I mean it's  just not a formula for improving you and I said I   think if we had a class where I showed them what I  do with patients who have the most severe problems   the seizure patient who needs a strict ketogenic  diet the cancer patient like what my mom needed   you need to stay the course Mom this is what you  need and you can't do it alone I'll do it with   you I said we're going to have a class that's live  that where it's three weeks and we may never do it   again we are going to do what I do in the clinic  uh over what would take probably two to three   years to get done on a one toone basis but in a  group setting we get done in 21 days and Arena   I think it is the best medicine I've done in 25  years when patients join that class they show up   with broken metabolisms and a minor understanding  of what the ketogenic diet can do or does and 21   days later they have a support group that's been  trained by us you all know the rules now there's   no arguing over the rules you got them answered  completely by the time that course was over you   own the group that's your problem and your J so  that transfer of responsibility I think is very   important in the health of people you need to take  ownership of this not your medical team and when   when we watch we're about to start our third year  of this which will be our uh fifth class of this   uh and the number of people that have been healed  by um being in that support group and they do it   all on their own after class I mean I'm trying to  get to the to the right side of Heaven someday and   I swear to go the work we do in that class is the  best work we've done that's wonderful I'm going to   leave all the links for Dr BOS the support group  the books because you have two books um any way   that you can begin's guide to ketones for life  and you also have uh how to stay consistent on a   keto diet because that's also the other problem  that you have to stay consistent on a ketogenic   lifestyle um so all the links are going to be in  the show notes of the description of this video   but Dr BOS thank you for this master class on  insulin resistance ketosis and how to live an   awesome life um if people want to find you apart  from your support group where can they find you   YouTube's the best place to land from there you'll  you'll hear all the goodies that we do but thank   you for uh highlighting the insulin resistance  and I really just want to praise the work you   do I've uh been watching your show and it's  just it's getting all the accolades it deserves   because it is a great collection of speakers I'm  honored to be part of this thank you for joining   me on this episode with Dr Annette Bosworth  if you're learning from and enjoying these   episodes please hit the Subscribe button that is  an excellent zeroc cost way to support this free   health podcast if you have a question for me or  a recommendation of a guest speaker please leave   that in the YouTube comments as I check every  single one you can also find me on other social   media accounts I'm on Instagram and on X formally  known as Twitter under the name of five minute   body I generally share different information to  what you'll see here on YouTube I share health   tips and advice that I hear from the best experts  and finally if you love this episode you'll also   enjoy another episode I did with Dr Georgia Eid  Dr Eid is a 25-year Harvard psychiatrist and she's   specifically interested in nutritional therapy  pertaining to brain health Dr Eid asserts that you   can reverse brain diseases like Alzheimer's and  Dementia but also mood disorders like anxiety and   depression with diet and it comes down to eating  saturated fat and increasing your cholesterol Dr   ID will also talk about the Ro of different  medications including statins and how they   affect the brain as well as the role of spices  particularly a certain spice and how that affects   your brain finally thank you for your interest  in root cause healing and I'll see you next week