Walt is a 67-year-old patient of mine who suffers from alcoholism. He has struggled to stay sober for the last thirty years. The most powerful improvement Walt has ever felt came when he chose to join my keto support group. Walt’s experiences with sobriety AND keto-adaptation compel me to share his testimony with all of my addiction patients. It makes illustrating the benefits of ketosis easier sometimes to use a real example.
Here is his story:
- Age: 67 Height: 72 in Weight: 270 BMI: 36.07
- Blood Pressure: 4 medications to keep it in the 130s/80-90s
- A1C (Average Blood Sugar): 5.8 Average Glucose= 120
- HsCRP: 4.2 (normal is less than 1.0)
- Reason for seeking the benefits of ketosis: Stop Drinking.
Walt is a 67-year-old medical doctor respected by his colleagues for his extensive service and skills. Walt is wicked smart and has reached the top of his profession. Six feet tall and weighing 270 pounds, his size alone commands attention. Add to this his IQ and authoritative personality and it’s easy to see why many consider him a force of nature.
For 30 years, Walt’s kryptonite was booze. Multiple treatment programs didn’t cure him. His intelligence was hijacked by his drinking habit. He’d once celebrated three years without a drop and called it sobriety.
Unfortunately, a closer look at this ‘dry’ period reveals another addiction. When the alcohol stopped, the sugar started. The sugar helped him stay away from booze, but a total relapse of alcohol addiction consumed him the past three years.
The empire that he had built—the clinic with his name on it—kicked him out. Forty years ago, he founded that clinic and built the army serving the community under his leadership and name. Now, the partners voted and he was gone.
Here he was, in my clinic, 67 years old, kicked out of his career, a wife ready to walk out the door, and his health in the toilet.
Sobering up was something he knew how to do well. He had done it hundreds of times. This time, he chose not to spend another $40,000 on an inpatient alcohol treatment. He had done that many times before without success.
His swollen, booze-soaked brain short-circuited with cravings. These haunted his dreams. The drinking nightmares lingered for weeks while he would white-knuckle the decision not to drink. Then one day, the part of his brain that craved desperately for alcohol would spread the message to cover every wire in his mind.
This time I invited him into our weekly keto support group. He scoffed at the idea that changing his diet would have any impact on his alcoholism. Instead of arguing, I asked him to look in the mirror.
“Walt, look at you. You’re 100 pounds overweight, on four blood pressure meds, you’re a diabetic in denial with rosy cheeks announcing your addiction to everyone. Don’t argue with me, just do what I tell you to do. If you don’t feel better in four weeks with my instruction, you can have your old life back.”
He surrendered. In those four weeks, he gave me 100% of his trust. By the end of his first week of peeing ketones, Walt got off two of his four blood pressure medicines. By the end of week two, his sleeping pattern had settled into the kind of deep, restorative rest that repairs brains.
Each week, his weight and blood pressure decreased further solidifying his belief in the benefits of ketosis. More importantly, he continued to improve mentally at a rate that I have never seen in my medical career.
In four weeks, this amazing, intelligent, driven man who wanted to commit suicide nearly every day of the prior month, had transformed. He walked into the group with a smile. Not the kind of ‘public’ smile that hid his sadness. He authentically felt good.
Each week, his sugar and alcohol cravings lessened. His first week of sobriety was coupled with a 10-pound weight loss. Over the course of the next three weeks, he lost another 20 pounds. Most importantly, he wasn’t craving alcohol.
After six weeks of peeing ketones, Walt shared this, “Doc, I know you’ve told me countless times that my brain will heal if I just stop drinking. It was something I heard, but never really believed. This past month has been the best my mind has worked in over a decade.”
Fourteen months into Walt’s sobriety, he told the group he felt authentically dry. He reported something had changed in a way he did not think possible. Walt lost over 40 pounds and reversed the age of his brain by nearly 40 years.
In this past year, he has slipped into a sugar-craze several times. He shares with the keto-group that it is a relapse that feels just like a hangover. Much like alcohol, when he falls off the keto-wagon he feels a fast reversal to his constant hunger for carbs.
However, each time he slips up, the switch back to keto gets easier and easier. He finds the support group one of the keys to sustained success. He also finds great strength in showing people if you fall off the keto wagon, to put it past you and get back on board.
Those are the same words we said to him about alcohol. Walt’s future looks bright. He plans to pee ketones and claim the benefits of ketosis until he dies.
I have walked hundreds of patients through the addiction recovery process—not just alcohol but also heroin, cocaine, nicotine, and, now, carbohydrates.
Chemically, carbohydrate addiction involves the same repeating mess we see with other addictions. You get a burst of dopamine when you eat or drink a bunch of carbohydrates. This chemical surge rewards your behavior.
The resulting dopamine burst feels good. It feels so good, you start craving it. You then ingest more and more sugar chasing that dopamine high. Before long your brain is addicted. You depend upon that ‘hit’ of sugar to just feel normal. Without sugar, you experience a dopamine ‘withdrawal’ state-you feel crabby, irritable and even depressed.
Carbohydrate or sugar addiction is as real as cocaine addiction. My patients coming off of heroin, marijuana, or alcohol experience sadness after they quit. Even if they really want to stop, they can’t help but miss the object of their addiction. Their brains are damaged.
This image below of a 37-year-old chronic alcoholic shows just how much of their brains have “gone offline” due to the repeated swelling found with addiction. Compare that to a healthy brain.
Brain damage also happens when your blood sugars are too high for too long. Compare the previous pictures to a 42-year-old diabetic male. He had only had diabetes for 5 years, but reports being addicted to carbohydrates since a teenager.
Conclusion on Benefits of Ketosis on The Brain
The up and down brain chemistry of addiction happens if you eat carbs to feel better or if you smoke to relax.
You used carbohydrates to increase your dopamine, creating that feel-good release. You must learn a new way to achieve this feeling. Your well-being depends upon a continued production of dopamine.
Food cravings melt away when you switch to a ketone-based fuel. However, this doesn’t address grumpiness left over from the lack of dopamine. This remaining moodiness sabotages many people switching to a keto lifestyle. Prepare for this.
For the same reasons I recommend a peer-based support group to my alcoholics, I recommend that my patients join a support group of ketone producers. Get over the switch and claim a fuller, happier life of freedom. It’s a tough transition, but it is doable. A transition worth the benefits of ketosis.
For more stories like this and other keto information, check out the audiobook ANYWAY YOU CAN.
- Woolf, Eric C., and Adrienne C. Scheck. “The Ketogenic Diet for the Adjuvant Treatment of Malignant Brain Tumors.” Bioactive Nutraceuticals and Dietary Supplements in Neurological and Brain Disease, 2015, pp. 125–135., doi:10.1016/b978-0-12-411462-3.00013-8
- Masino, Susan A., and David N. Ruskin. “Ketogenic Diets and Pain.” Journal of Child Neurology, vol. 28, no. 8, 2013, pp. 993–1001., doi:10.1177/0883073813487595
- Seyfried, Thomas N., et al. “Is the Restricted Ketogenic Diet a Viable Alternative to the Standard of Care for Managing Malignant Brain Cancer?” Epilepsy Research, vol. 100, no. 3, 2012, pp. 310–326., doi:10.1016/j.eplepsyres.2011.06.017
- Cabral GA, Jamerson M.; Marijuana use and brain-immune mechanisms; Int Rev Neurobiol. 2014;118:199-230. doi: 10.1016/B978-0-12-801284-0.00008-7
Ketogenic Diet and Migraines: Assessing and Treating Them.
It’s your choice if you agree with my thoughts about the keto diet or not but there is one thing we can agree on. Migraines suck. Not only do they ruin the day that they happen, but they can also kill brain cells. That is not an exaggeration. When a severe, throbbing pain lasts for several hours, listen. What if I told you the ketogenic diet and migraines were connected in some way?
Stop. Pay attention. Why is this migraine happening? This intense pain is a deep, primal signal from your brain screaming for help.
The advantage of brain scans allows us to look at what happens to the brain during a migraine. We can see the area “under attack” swells the longer the pain continues.
Originally thought to be from disrupted blood flow, there‘s way more to the story of what happens during a migraine.
Experts summarize the mechanisms causing migraines as “neurobiological changes that occur in the brain.” That fancy talk does little to help my patients and their families understand the cause, the scope, or the cure for the problem.
When explaining what happens at a cellular level, I teach patients that migraines are a chemistry shift causing swelling in that area of the brain.
It contributes to the early onset of death in those brain cells. Yes. You read that correctly. The cells affected by a migraine die sooner and more often.
The death of our brain cells usually takes time and happens with age. Scan an, and you are sure to find imperfections in their brain scan. Scan an 80-year-old who has untreated high blood pressure for years and see many, many more defects.
Want to kill off brain cells the fastest? Put them under high pressure with lots of inflammation. Maybe your brain teeters on the edge of diabetes with “only slightly elevated” blood sugars.
Maybe you deny your brain the proper healing time by chronically living on 6 or 7 hours of sleep. Now add the chemical mystery of a migraine: BAM! The perfect storm for coaxing brain cells to die sooner than they should. The longer that brain cell stays swollen, the more cells die.
IS MY HEADACHE A MIGRAINE?
Ask yourself these questions:
- Has a headache limited your activities for a day or more in the last three months?
- Are you nauseated or sick to your stomach when you have a headache?
- Does light bother you when you have a headache?
If 2 of the three are true, chances are quite high that you damage your brain with every headache. When teaching students or patients how to pick out a migraine from a minor headache I use the word POUND.
Although, brain experts argue over the exact mechanism for why the brain glitches into this searing pain, none say with the scans showing lost white matter. Indeed, the frequency and severity of your migraines unequivocally contribute to just how many brain cells die.
Don’t rush to the MRI machine the next time you get a headache. Instead, focus on stopping the underlying cause of those migraines.
The good news: brain swelling is reversible with treatment.
In past years, this would be when I would chirp at patients to do the following:
- get 8 hours of sleep,
- stop drinking alcohol,
- fix your anxiety,
- reverse your depression,
- stop smoking cigarettes,
- and lose weight.
Also, they should take up meditation practices to lower stress along with turning off all electronics 2 hours before bed.
Those recommendations still stand strong. But that list is impractical. It leaves patients hopeless and overwhelmed.
I have yet to see a patient walk into my clinic and say, “I want to be on the ketosis diet because I heard it helps with migraines.” I hope to hear that someday.
Teaching patients to produce ketones has become the most effective way to get my patients off of migraine medication and on to a healthy, pain-free life. After years of coaxing them to tackle that list written above, my approach now is to PEE A KETONE FOR 6 WEEKS.*
I Find That This ONE Change is The Best First Step.
The root reason is the anti-inflammatory effects of ketosis. The authentic antidote to migraines is to remove the inflammation in that area of the brain. Ibuprofen or acetaminophen certainly help a little bit. But bathe your brain with ketones for several weeks and watch the headaches evaporate from your life.
As patients continue to practice the keto-lifestyle, other improvements get checked off the list. Their sleep is better and more profound. It doesn’t mean they can go with less than 8 hours. However, many of my migraine patients struggling with sleep problems. The magic elixir to sleep lurks in that third week of ketosis. That also seems to be when their mood improves.
Each week into ketosis, more patients report a complete end to their migraines – usually within six months of peeing on that first ketone stick.
Just like other chronic problems, migraines don’t cause brain damage overnight. Similarly, recovering from years of swollen and damaged tissue takes time.
The longer patients stay in ketosis, the more thoroughly they remove the amount of extra brain swelling. At first, the water gets shed from their legs and bloating in the gut.
Over the next few months, patients also experience water removal in your skin, joints, eyes, and brain. Those who stay in ketosis can’t help but observe the following: glowing skin, better joint movements, improved eyesight and overall less pain. These positive improvements show up around the 3-6 month mark, precisely the time most patients’ migraines disappear entirely.
- Achanta, Lavanya B., and Caroline D. Rae. “Î²-Hydroxybutyrate in the Brain: One Molecule, Multiple Mechanisms.” Neurochemical Research, vol. 42, no. 1, Aug. 2016, pp. 35–49., doi:10.1007/s11064-016-2099-2
- Bergin, Ann M. “Ketogenic Diet in Established Epilepsy Indications.” Oxford Medicine Online, 2016, doi:10.1093/med/9780190497996.003.0006
- Craig, Courtney. “Mitoprotective Dietary Approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric Restriction, Fasting, and Ketogenic Diets.” Medical Hypotheses, vol. 85, no. 5, 2015, pp. 690–693., doi:10.1016/j.mehy.2015.08.013
- Lorenzo, C. Di, et al. “Migraine Improvement during Short Lasting Ketogenesis: a Proof-of-Concept Study.” European Journal of Neurology, vol. 22, no. 1, 2014, pp. 170–177., doi:10.1111/ene.12550.
Keto Diet and Brain Health: What Ketosis Does to Depression Symptoms.
Mental Effects on Brain Function from the Keto Diet
I’ll be honest. This is what kept me keto. It wasn’t the weight loss. It was the benefits of the keto diet and brain health. Certainly, I started ketosis because of my mother’s cancer, but its anti-cancer benefits aren’t the reasons I kept going.
It’s hard to believe switching to a keto diet is going to improve your mental processes-especially during the initial transition from carbs to fat. As your brain adapts to using ketones for fuel instead of glucose, you get a woozy feeling. Often, this comes with a noticeable slump in your thinking. Your mood dips while your irritability goes up.
This can be rough. I have lost several patients to this slump when I failed to properly warn them that this gets better. As those first days lead you into your second week of ketone production, things change dramatically. The brain is one of the last organs in the body to adapt to using ketones. The cells in the brain tend to hang on to the quick and easy carbohydrate fuel.
When I first became a doctor, it was very hard for me to guess how medications I prescribed would affect patients. For example, when I would write out a prescription for an antidepressant, patients would ask how long before they feel better.
The Right Answer Was, “I Don’t Know.”
Different people respond to medication differently. Also, the depths of one person’s depression looks quite similar on the outside but is indeed very different on the inside as compared to another.
Some get better in two months while others take much longer. At first, I over promised the way patients would feel. I told them they would notice improvement without properly understanding how poorly their brain was working and how little the medication would do. Years of experience have taught me to carefully answer that question based on many factors unique to each patient.
When I first transitioned into producing ketones, I did not really expect it would improve my mental functions or emotional well-being. I didn’t suffer from depression or anxiety. Slept well. I, essentially, felt normal. Indeed, any claim I had heard regarding ketosis and mental improvement reminded me of those over promised expectations I spouted to patients two decades ago.
By the end of the second week, I wrestled with giving credit for my improved energy, focus, and mood to the ketones coursing through my veins. Since then, I have continued to see nothing but improvement in my brain function. I feel like I am 25 years old again. I can concentrate on complex tasks for hours straight.
Keto Diet and Brain Health on Reversing Depression Symptoms
Patients report their dreams became more vivid after successful keto-adaptation. Personally, I think many of these patients had a form of depression. Even if they resisted that depression ‘label’-and I don’t blame them for pushing back against the term-the improvement in their cognitive state mirrors that of recovering depression patients.
Watching a patient come out of the depths of depression teaches the observer how far the brain can sink and yet quickly recover and self-repair. If I could bottle the secret formula for that awakening, I would use it hundreds of times a month in the patients I see.
My severely, chronically depressed patients waddle in the sludge of darkness and brain fog for months-even years. They struggle to make decisions. When I insist they switch their diet, even their dog groans with disbelief. A successful behavior change appears too heavy of a burden. When they fall that far into the depths of brain-fog, they want a quick fix. A pill. A jolt of “fix-me-doc.”
For these patients, I look to their caregiver. Their spouse, or parent, or even their child must lead the way to this new way of eating. Just like when I lead the way for my mom at 71 years old and suffering from a decade of cancer, the diet was just as helpful for me as it was for my mom.
Whatever reason they started eating 80% fat, I don’t care. I am awestruck at how fast their brains become re-energized.
Prozac or no Prozac, I switch all of my depression patients to a keto diet. The results have been nothing short of impressive.
We know that remission of clinical depression is associated with normalization of inflammatory markers. Although this does not link a cause and effect, the link matches what I see clinically.
Relationship Between Depression and Inflammation
Many disorders with root causes of inflammation include emphysema (COPD), heart attacks and strokes, multiple sclerosis, Parkinson’s disorder, as well as autoimmune disorders such as Rheumatoid Arthritis, Crohn’s disease, or some thyroid disorders. These inflamed situations all are linked to increased populations with depression.
Another example of inflammation and depression is the recent advances in Hepatitis C treatment. The miraculous interferon drug used to kill this nasty virus is infused into patients and sparks quite a spike in inflammatory markers. One-quarter of those people develop major depression.
Just like other chronic problems, these problems don’t cause damage overnight. Similarly, recovering from years of swollen and damaged tissue takes time.
When you become fully keto-adapted, about 4-6 weeks into the production of ketones the evidence of improved brain function is clearly present. The journey over those several weeks has shown that this awakening occurs at different times for people. As you continue to practice the keto lifestyle, the list of symptoms related to chronic inflammation slowly fade away. Sometimes reversal is so slow they don’t identify the fact that the symptoms have gone down until I question the specific symptoms.
Within 6 months of peeing on that first ketone stick, I have seen many of my chronic depression patients get off all of their medications. I did not think this was possible. This all started with a ketone.
The longer you stay in ketosis, the more completely you remove the amount of extra fluid lurking between those brain cells. Some swelling is found WITHIN the brain cells. That takes even longer.
At First Sign of Ketone Production
At the first production of a ketone, the easy water gets shed. This is the water weight often found in your legs or feet. The next time you take off your socks, take notice if there is a ring left by your socks. That is not caused by extra fat. That is caused by water hanging out where it shouldn’t. That the swelling that disappears first when you start peeing ketones. Next, I notice the reversal of the bloat in the gut. By the second week of ketones, they look at their tummy and clearly it is not as extended. Stop peeing ketones and BOOM, it comes back.
Over the next few months, you’ll experience water removal from places that are harder to reach: your skin, joints, eyes, and even your brain.
What do I see in my three months follow up patients that tell me they have peed ketones for the better part of those 100 days? Glowing skin, better joint movements, reduced neck pain, improved eyesight, and a brain that seems much more resilient than it was then.
These positive improvements show up around the 3-6 month mark, precisely the time most patients’ migraines disappear.
The first transition into ketosis does have reports of depression, lethargy, and tiredness. Especially if they are going from a heavy carb diet to a low carb diet. Some patients struggle with a rise in anger and anxiety when they transition.
Switching Fuel Sources
Switching fuel sources from carbs to fat affects all areas of the body especially the brain. That striking change is FOR THE BETTER. The transition is tough. I’m not going to lie. The good news? There are tools to help you get through the switch as quickly and successfully as possible.
- Lowe, Aileen, et al. “Neurogenesis and Precursor Cell Differences in the Dorsal and Ventral Adult Canine Hippocampus.” Neuroscience Letters, vol. 593, 2015, pp. 107–113., doi:10.1016/j.neulet.2015.03.017
- Maalouf, M, et al. “The Neuroprotective Properties of Calorie Restriction, the Ketogenic Diet, and Ketone Bodies.” Brain Research Reviews., U.S. National Library of Medicine, Mar. 2009, www.ncbi.nlm.nih.gov/pubmed/18845187
- Masino, Susan A., et al. “A Ketogenic Diet Suppresses Seizures in Mice through Adenosine A1 Receptors.” Journal of Clinical Investigation, vol. 121, no. 7, Jan. 2011, pp. 2679–2683., doi:10.1172/jci57813
- Seyfried, Thomas N., et al. “Metabolic Therapy: A New Paradigm for Managing Malignant Brain Cancer.” Cancer Letters, vol. 356, no. 2, 2015, pp. 289–300., doi:10.1016/j.canlet.2014.07.015
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