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Weight Loss

The Unspoken Cons of Gastric Bypass.



Gastric bypass is probably one of the greatest crimes committed against Baby Boomers in medical history. I feel it is an atrocious option for weight loss due to the cons of gastric bypass that get swept under the rug. Clinicians who recommend it ignore the body’s weight loss chemistry.

Even worse, once the surgery was over patients were abandoned. The typical surgical package includes a year of follow-up. Once those 365 days are over, the surgical team disappears. Patients are left with their new rerouted anatomy and severe nutrient malabsorption problems. Patients are entirely on their own as they attempt to manage the medical consequences of bypass surgery. On. Their. Own.

These obese patients entered surgery with ‘inflamed brains’ from years of high insulin and no ketones. Insurances will not pay for this surgery until the patient spends years carrying over 100 extra pounds.  It guarantees their inflamed brain combined with malnutrition.

They underwent major surgery. No matter what label the surgery team used, mini-bariatric or sleeve bypass or gastric banding, there’s no denying this type of surgery is major. This procedure added more inflammation and trauma to already burdened and unhealthy patients.

Next, they undergo a year of post-surgery starvation. It injures the patient’s body and brain anew. With starvation-based weight loss in full swing, the year following surgery is often remembered by the patient as a cloudy, dark, and depressed time.

These patient are expected to attend classes to master the advanced science behind their surgically induced, lifelong malabsorption problems. Years after this crime-of-a-surgery, patients suffer from extreme depression, wilted immune systems, tingling or dead nerves and diarrhea with most meals.

They had no idea their gastric bypass was destroying them one day at a time. The majority of them continue to struggle with significant obesity after having spent upwards of $50,000 for this procedure.

Problems Found After These Surgeries

The following nutrients are no longer absorbed correctly after surgery:

  • Thiamin, Pyridoxal Phosphate, Folate
  • Vitamin A, Vitamin K, Vitamin D, Vitamin B12
  • Omega 3 and Omega 6
  • Magnesium, Phosphorus, Potassium
  • Selenium, iodine
  • Zinc, Copper, Iron,  

Copper and zinc levels do not return to normal causing hair loss, poor immunity, anemia and poorly functioning nerves and muscles. Surgery removed the section of their gut that’s responsible for absorbing iron and many of the listed compounds above.

After surgery, these nutrients slowly decrease. Years later, gastric bypass patients live with brain fog, low energy, thinning hair, and slower disease recovery. This malnourishment is PREDICTABLE and PREVENTABLE.

If you’ve had gastric bypass, PLEASE follow up annually with your doctor to measure these nutrients. It is VERY IMPORTANT.

Thanks to the high-density nutrients found in keto-compliant foods, bariatric bypass patients can overcome the nutrient deficiency caused by their surgery. I insist my weight loss patients add two nutrient-dense foods to their menu: liver and sardines. For real!

I show them these charts on the following page. Look carefully at the rows for sardines and liverwurst. These two food items solve a lot of deficits.

Let me expand on the reason I encourage patients to develop a taste for liver. Iron builds healthy brains.  When patients present in a brain fog, I first check to see how much iron circulates within their system. Iron provides one of the primary starting points to make our brain hormones.  To make serotonin, norepinephrine, dopamine, and GABA the patient needs iron to begin.

Iron studies of thousands of patients over the last 20 years have taught me to look at their iron first. Specifically, ferritin level less than 20 guarantees the patient will not get better until I fix that problem.

We Replace Iron in Two Ways. Elemental Iron or Hemoglobin Iron.

Elemental iron refers to iron that comes from the soil. If you are eating vegetables that are toted as a source of high iron, the type of iron those foods deliver to your system is elemental iron. The plants obtained iron through their roots grabbing the iron found in our soil.

Elemental iron, commonly used in vitamins or supplements, follows an absorption rule that catches 1 out of 10 iron particles that pass by the intestinal area that absorbs iron.

When using a tag to observe how much iron is absorbed, elemental iron has one particle out of 10 that is absorbed into our circulation. It is consistent with the side effect that iron causes constipation.  You know this to be true if you’ve ever started taking iron supplements. Start taking 1-2 iron replacement tablets per day. Within 2 to 3 days you will find your stools are much darker. Along with those dark stools, you will see that unfortunate side effect of constipation.

Hemoglobin-Based Iron

Conversely hemoglobin-based iron is iron found with several hemoglobin proteins surrounding the iron element.

Hemoglobin is added to the iron mineral allowing it to enter the creatures circulation.  Who ’s circulation? It doesn’t’ matter if the iron came from a cow, or a pig, or a duck, or a moose, or a fish. All of them added hemoglobin to that element of iron.  When we eat these foods, we have the chance of absorbing iron as part of our nourishment.

The absorption rate for hemoglobin-based iron is far superior when compared to elemental iron. Hemoglobin-based-iron adds 9 out of every ten swallowed. Almost the exact opposite of what happened with elemental iron. Replace someone’s iron with a supplement, and you will cause many weeks of constipated side effects trying to boost their numbers.  Use hemoglobin-based iron, and the task becomes more attainable.

Most patients with iron deficiency present to the clinic with failing health.  They are tired, weakened immune systems and a brain that seems sluggish. Also, their gut was unable to keep up with the ideal absorption rates.  These ideal absorptions rates of 1 out of 10 elemental iron or 9 out of 10 hemoglobin iron apply to those patients with normal absorption.

Using the ideal absorption numbers, I calculated out how many tablets of iron supplements is found in a tablespoon of a liver.  It took more than 20 tablets of iron supplements to equal 1 tablespoon of iron found in liver.

A tablespoon of liver improves the deficit of iron far greater than a handful of iron supplements. When asking someone with a gastric bypass to absorb iron, it is nearly impossible to meet the demands of their body through supplements. Copper and zinc are also absorbed in the same section as iron. All three of these must be adequately replaced for their body and brain to flourish again.

If you want your system to operate at peak performance, you need to nourish it properly.

Use These Charts To Inspire Your Shopping List:

If you want to learn more about the ketogenic diet, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.


  1. Kratz, Mario, et al. “The Relationship between High-Fat Dairy Consumption and Obesity, Cardiovascular, and Metabolic Disease.” European Journal of Nutrition, vol. 52, no. 1, 2012, pp. 1–24., doi:10.1007/s00394-012-0418-1
  2. Ness, A. “Diet, Nutrition and the Prevention of Chronic Diseases. WHO Technical Report Series 916. Report of a Joint WHO/FSA Expert Consultation.” International Journal of Epidemiology, vol. 33, no. 4, 2004, pp. 914–915., doi:10.1093/ije/dyh209
  3. Nestle, M. “Mediterranean Diets: Historical and Research Overview.” The American Journal of Clinical Nutrition, vol. 61, no. 6, Jan. 1995,  doi:10.1093/ajcn/61.6.1313s
  4. Mechanistic and regulatory aspects of intestinal iron absorption; Sukru Gulec, Gregory J. Anderson, James F. Collins; Am J Physiol Gastrointest Liver Physiol. 2014 Aug 15; 307(4): G397–G409. Published online 2014 Jul 3. doi:10.1152/ajpgi.00348.2013  PMCID: PMC4137115

Weight Loss

Lessons from Dr. Boz: The Science Behind MCT Supplements



mct supplements

If you are new to keto-eating, you may not have heard of these three magical letters: MCT. A seasoned keto veteran still ought to read this post with a high level of focus. MCT stands for Medium Chain Triglycerides. Let’s get to the truth about them. MCT supplements deliver the fats that your body converts into ketones.

MCT supplements supply the perfect sized fats for boosting ketones.Watch out. There is a lot of misinformation out there. Triglycerides are fats floating in your blood. Every time you see the word triglyceride, think of the fat that I could see if I drew some of your blood.

mct supplements

Fats line up in a string or chain.  We sort fats based on the length. The more fat molecules strung together, the larger the molecular chain. Short triglyceride (aka fat) chains have 4-6 links each. Long-chain-fats have 12 or more links. Medium chain triglycerides, MCTs, have 8 to 10 links of fat. Much like Goldilocks, MCTs are not too short, not too long-they are just right. They are ‘medium.’ Just the right size.

Just the right size for what? Just right for slipping through a special nutrient trapdoor hidden in the first part of your small intestines. This trapdoor is your portal vein. It allows direct and almost instant absorption of specific select nutrients.

Your body absorbs food through the gut lining that looks much like a plush carpet. Nutrients then enter into your lymph system by way of this carpet.  The lymph filters food looking for anything dangerous. The lymph functions as a safety net where nutrients get sorted, screened and shuffled before entering your bloodstream. This slower lymph-network protects us against toxins, poisons, or bacteria.

mct supplements

Exceptions to this absorption route exist.  Only valuable foods skip the body’s security check when entering.  

These foods gain direct entry into your blood through the portal vein.  Think of this as a trapdoor or VIP entrance. Valuable foods can bypass the sorting happening in your lymph system.

It is a risky way to allow nutrients into your body. The value of that morsel must be high enough to be worth the risk. If your body messes up and allows a toxin to enter through this back channel, you won’t remain alive for long.

After entering into the portal vein, this vein ports the blood to the liver.  All other veins in the body lead to the heart. This portal vein carries these VIP morsels a few short centimeters away. This special liver-delivery feeds the best foods to the most powerful “furnaces.’

By furnaces, I mean mitochondria.  Mitochondria turn fuel into energy.  Your liver cells harbor the best mitochondria for churning fat into ketones.

Yes. Your liver’s mitochondria produce the lion’s share of ketones within our body.   

MCTs are one category of nutrients allowed through this special entrance. In fact, all fats with ten links or less in their string fit through this trapdoor. These strings line up to fuel the liver within minutes of absorption.

Longer fats, like those containing 12 links or more, use the standard absorption process.  These fats trickle through your lymph system getting sorted and screened. This process takes 2-3 hours before entering your circulation.

VIP fats that fit through the trap door turn into ketone energy that your body can use immediately.

As a baby, you stored fat all over your body.  

The fat swaddling a healthy baby holds high amounts of fat with 8-10 links of fat. Fats called C8 to contain eight links of fat in their chain. Those with ten lengths we call C10. Infants fill their cells with this high energy fat.

How come? Speed. C8 and C10 convert into abundant ketone fuel in rapid order. Between milk feedings, a baby taps this fat storage system for quick energy. It is an evolutionary advantage. When food is scarce, babies survive by fueling from their stored fat. A fast-growing baby requires fast access to abundant energy: C8, C10.

Why should you care about any of this? Some of you won’t care. You will transition to a high fat, ketogenic diet and eventually your system will purr along on a ketone fueled motor by following the rules. I wish I could say that from here on out you will live happily ever after.

Some of you, unfortunately, won’t enjoy such a perfect journey. Your first attempt at keto will be new and exciting. Weeks later, your carb intake sneaks back up, and your ketones fall. Ketosis’ benefits fade and you bounce out of the keto wagon completely. Your newfound keto lifestyle did not become a lifelong habit.

Your initial ketosis success fades further and further into memory. You felt better when you did keto, and you’d like to try again.

You join many others that hate the keto transition.  Suffering through the transition the first time stinks.  But the second time, you know what is coming. People struggle with the mood and energy slumps between giving up carbs and arriving at the other side: nutritional ketosis.  

People are switching to a keto lifestyle use one of 2 tricks.

TRICK #1: Use “ketones-in-a-can.” These are ketones made in the laboratory and consumed in supplements. Exogenous ketones come from outside of the body.  They come from a chemist in a lab. That topic is for another day. Another blog.

TRICK #2: Use MCT supplements.

MCTs cut the transition short. MCTs slip into the liver and line up in front of the cell-furnaces. MCTs, skip the 2 hours ‘holding cell’ used by the lymph system. These fats process through the mitochondria and provide ketones within minutes. Unlike “ketones-in-a-can” MCTs arrive naturally in circulation.

mct supplements

MCTs produce ketones in a flash.  This trick allows you to avoid the side effects found in the slump when your body goes from glucose to ketones. Package labels for MCT supplements promise rapid ketones and thus lower side effects.

The only fats that produce rapid delivery of ketones are ten links or shorter. They must fit through your trapdoor to deliver on that promise.

C8 fits. C8 is the chemistry shorthand for the string of fats with eight links.  We named that fat chain with eight links caprylic fatty acid.

C6 bears the name caproic. C6 fits through the trapdoor too, but it is short enough to qualify as a short chain fat. C10, capric, also fits. C12, chains with twelve links don’t fit.  C12 is too long.

Longer fatty chains trickle through your lymph system using the slow, safe entrance.  Fats found in butter and heavy whipping cream stroll through your security check. These longer chain fats may convert into ketones somewhere in the future. They don’t fit through the VIP entrance and take much more time to process.

Pricey MCT supplements sell you on the speed of their ketone formulation.  The money buys you speedy ketones and fewer side effects when transitioning.  Quick ketones in the blood push away hunger. The faster you circulate ketones, the swifter your mitochondria start processing them. Weeks without seeing a ketone and mitochondria put the ketones-burning-parts back into storage. Waking up those tools begins with exposing them to ketones.  

MCTs are worth the money.  They work well. Unlike “ketones-in-a-can” I recommend MCT supplements to all my patients.

PAY ATTENTION:  It is easy to get fooled into paying for fats that are too long. Fats longer than ten links do NOT gain you any advantage. These do NOT metabolize into ketones quickly.

Let’s use the biggest scam I see: coconuts. Hold on; coconuts have lovely fats in them.  That is not the scam.

Advertising teams linked the letters MCT to coconuts. A coconut abounds with fats too big to squeeze into your portal vein.  Yep.

Coconuts have 85% of their fats with chains too long to pass the test. Most coconut fat joins butter-fat in the leisurely stroll through the lymph system.   

Slick marketers focused on the 15% of coconut oil that does fit. Suppliers of supplements convert coconut oil into powder form and market it as MCT. They keep the long-chain fats in their product and don’t pay to remove them.

Look at this size chart below comparing the different fats.

NOTICE: The three smallest fats found in coconuts bear similar names: caproic, caprylic and capric. With 6, 8 and 10 chain-links, they all fit into your portal vein and zip into ketones.

mct supplements

These three fats come from the same root word: caprine. Caprine originates from the Latin word for goats. Goat products deliver many products with C6, C8, and C10.  

Had the goat industry hired a better marketing team, we would associate goats with MCT instead of coconuts. It would make more scientific sense.

Instead, coconuts hold the marketing title as an excellent source of MCT.  Goats better deliver over coconuts for true MCTs.

How can you tell the difference?  

1)Read labels.  Quality providers that deliver true MCTs in their supplements tell you.  They boast of NO LAURIC ACID (C12) in their MCT. My chemistry professor would scold them for not being able to count if he saw them labeling Lauric Acid a medium chain fat. It is a long chain fat.

2) Check your numbers.  If you’re keto enough to spend the money on supplements, spend the effort to check blood ketones.  Test out your supplements. Check your ketones before you take in your expensive MCT oil. Then set your timer to check your blood ketone numbers every 15 minutes for an hour.  

If the fats in the supplement fit through the portal vein, you will see it. Some patients see their ketones rise at the 15-minute mark. Others struggle with inflammation in their gut and don’t see the spike until 30 minutes.  If you see very little change in your blood ketones after 60 minutes, something is wrong. Maybe your blood meter isn’t accurate. Or perhaps you were sold LONG chain fatty acids instead of the medium ones. The numbers will tell you what your body did with that supplement.  

The CLINCHER: MCT OILs and POWDERS created unequally. Use MCT C8: C10 powder to boost your ketone production. This healthy way to promote your ketone production also reduces inflammation.  

Don’t waste your money on fats that are too long.

Read the ingredients label. If the MCT’s root word is not caprine, it is the wrong size to be a rapid converter. Longer fats take hours to process through your slower, safer lymph system. If you want C12, it’s cheaper to use a scoop of coconut oil.

For fast ketone production, use MCT C8: C10.


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Quick and Easy Rules of the Keto Diet



rules of keto diet

Rules are important when it comes to tricking your body into altering it’s chemistry. The rules of the keto diet are not complicated but I can assure as weird as some of these guidelines sound they will help you.

Step 1: No sugar. No starch. High fat.

The best summary of this diet is “no sugar, no starch, high fat.” Say those words out loud. Again. No sugar. No starch. High fat.

Step 2: Remember the Number 2

It is critical as I will explain later. For now, commit this number to memory:

Step 3: Buy Urine Ketone Strips

rules of keto dietI hate even to have to say this, but I recommend you buy something. Yes, as a physician who has been subjected to more multi-level marketing pitches than I care to admit, typing this recommendation makes me uncomfortable. But it is necessary.

To succeed at switching your fuel source from sugar to fat, you need to know if you are producing ketones. Spend some money. Ketone strips typically cost about $15.

Buy the smallest quantity you can. I buy bottles of 50 strips. I have put them in every single bathroom at my clinic and my house. I have even been known to leave a bottle at a friend’s house because she always complained that she could not lose weight.  

It is super important because the keto diet is measurable! Here is my favorite part.

I have coached patients for decades that come in and say “Doctor, doctor, my diet is just not working for me.” And they’re right. The scale didn’t move.

These changes seem strange to most everyone I advise. Keto strips allow me to measure patients’ compliance. More importantly, the strips allow patients themselves to monitor their progress.

In the first two weeks, I want you peeing ketones as quickly as possible. Burning fat for fuel is the basis of this diet. Getting to the other side has proven to be unique to each patient. You will need the feedback that what you’re doing in YOUR SPECIFIC situation is the right thing for you.  

Some patients, usually men, stumble into ketosis. They pee ketones within 24 hours of changing habits. They may not always stay there, but they can pee a ketone mighty quickly.  Other patients may take several weeks to burn through their stored sugar and struggle with their body chemistry due to insulin resistance.  

Sometimes this is because they don’t know what they’re doing. But more often than not, the bodies were merely locked into using only sugar for fuel for years-if, not decades.

Some have been living with chronically high insulin levels for years. It can take weeks to burn up all the extra stored glucose in the body and finally see their insulin fall back to normal range. Remember, you can’t produce ketones until both your blood sugar and your insulin comes down.

How resistant is your body to insulin?  

There is a blood test you can take to get the answer. I offer this to my patients when I see them in the clinic, but I don’t routinely recommend it. The test is expensive and coupled with the cost of a doctor’s visit. It won’t tell you anything you don’t already know you are addicted to sugar and have been for a long time. You have gained weight and can’t seem to lose it because of your body’s insulin cycle.

You will have a rotten time giving up carbs initially. Most people don’t need a blood test to tell them that. Spend your efforts and money measuring something that does matter: The time it took for you to start producing ketones. Start using those urine sticks! If they turn pink, this means you made ketones. Pat yourself on the back, jot down how long it took you to pee that first ketone-and keep going!

Step 3.5:  Buy MCT C8: C10

We will get into how to use this powdered fat supplement later. For now, click on BUY and get it shipped to your home. Local stores are not likely to have this on hand, so I recommend searching the internet for direct delivery. Search these words: MCT C8: C10

Step 4: Empty Your Cupboards  

It is a challenging step. Empty out your cupboards.

One of the hardest changes you will have to make when adjusting to a high fat, low-carb diet is dealing with temptations. You need to put a lot of distance between yourself and the high carb foods you previously loved to eat. Do yourself a big favor and rid your home entirely of these distractions and temptations. Cleanse the places you control.

rules of keto diet

When walking addicts through a recovery plan, we start with asking a friend to help them cleanse their environments. It means throwing away all the signals that tempt you to go back to your old habits.

For an alcoholic, this means booze bottles stashed in the silliest places. For a drug addict, it involves needles, spoons, and lighters. For a carb addict, your enemy is processed food. The more food has been prepared, the quicker it ends up in your mouth. Moments later, your system is crammed with glucose molecules ruining your ketosis.

Even when you have cleansed the areas you control, be prepared for temptation. The devil has placed carbohydrates everywhere-from gas stations to coffee shops to your workplace. Protect the sanctuary of your home. Keep carbs out.  

How do you know which food items to throw away when rifling through your cupboard?

Look at each item’s label. Any item with a high level of carbohydrates or sugars needs to go. When trying to decide to keep or throw something, another rule-of-thumb centers around processing.

If the food is highly processed, lose it. In our family, we took a box and everything that was made with flour, rice, corn or had sugar in it, we simply put in the box and took to the community food pantry.

This was therapeutic for my household. My kids helped with this. If they considered keeping it, I had them count how many ingredients were in the product. If it had more than 8 ingredients, we tossed it. Keto can be very stressful. Do this with a friend and make sure you don’t quit until it’s done.

Here are just a few things that ended up in the box that we took to the food pantry:

  • Hamburger Helper
  • Bags of pasta
  • Bags of rice
  • Flour
  • Sugar
  • Refried beans
  • Cans of corn
  • Cans of pears and other fruits (remember, fruit is evil)
  • Ketchup   

Step 5: PAUSE

After the cupboards are bare, STOP.  PAUSE. Do not rush the next steps. Grocery shopping will still be there tomorrow. Just pause long enough to understand these following few steps.

Step 6: Remember That Number?

What was that number you were supposed to remember?  Yep: Twenty.  20. To start on your path to ketosis, you are allowed 20 grams of carbohydrates per day. The only thing I want you counting in a day is carbohydrates. Not calories. Not grams of fiber or fat or protein. Not pounds or inches. I only wish you focused on carbohydrate grams.

Forget about net carbs. Forget about dietary fiber. Don’t distract yourself with ‘sugars.’ Just remember 20 and start counting carbohydrates! Restrict yourself to only 20 carbohydrate grams per day.

Transitioning people’s behaviors starts with clear instructions and something measurable.

The clear instructions?

  • 20 grams of carbohydrates per day.  

The measurable factor?  

  • Peeing ketones.

Here’s an objection I usually get when I discuss this step with my patients:

“Doc, calories matter. Why aren’t you telling us to count calories?”

For the last four decades, the medical establishment in the US has been preaching that calories matter. The truth? They don’t matter when insulin is ruling your body. We can talk about calorie balance after you’re keto-adapted. But the first thing you need to focus on is reducing your bloodstream insulin level, and that means HIGH FATS, LOW CARBS. Your mission right now is to get rid of those carbohydrates!

Step 7: Eat Enough Fat to Feel Full

It is what sets this diet apart-there is no starvation! There is no want for food. I’m not exaggerating. With this approach, there’s enough fat feeding your body that you don’t feel hunger. Your brain receives a powerful chemical message of fullness from your system. This process begins when you eat fat after cutting out sugar or carbs.

rules of keto diet

Don’t believe me? You have my permission to begin your day tomorrow by eating a stick of butter. Yep. You read that correctly. After not eating anything for several hours (because you were asleep) you can have a stick of butter for breakfast. Add salt for added taste if you like. Pair it with water or black coffee. Still, the only ‘food’ you should eat is butter. Don’t imagine this story. Do it. Listen carefully to what your body is saying. Notice the sensation your brain sends to your body? Your brain detects the signal that you are full when fat fills your stomach.

No wonder, so many of my patients boast about how sustainable and satisfying the ketogenic diet is.

Step 8: Eat Only When You Are Hungry

Do not sabotage your system’s chemical transition from sugar to fat by snacking unnecessarily.

Your habits may seem so automatic that you hardly become aware that you’re snacking until the bag is empty. Recognize these habits. Bring the habit out of your subconscious by keeping a food log.   

My downfall was morning breakfast. For so long I told myself that breakfast was the most important meal of the day, that I did not stop to ask myself if I was starving or just eating breakfast out of habit. After two months of keto eating, I challenged myself: No calories until I felt hungry. When hunger hit, I would take in my favorite foods first: coffee with heavy whipping cream. Before long I stopped eating breakfast, sipped on my favorite coffee with cream until well into the afternoon.

If you’re suffering from anxiety or stress, make sure you only eat when you’re hungry instead of eating for comfort. If you do choose to snack, reach for fat instead of carbs!

Step 9: Restrict Protein

Nearly every person I have coached at some point overate protein. They are confusing boosting fats by loading up on protein. Perfectly understandable. The notion of a high protein diet as a healthy option has been around for a long time. Bodybuilders and health food promoters all have a protein supplement to help you remain healthy. In our minds, it all seems natural that protein is healthy. Those same people think high-fat diets are unnatural. According to this ‘conventional wisdom,’ it is safe to eat lots of protein, and it is unhealthy to load up on fat.   

rules of keto diet

What’s going on here? Lipophobia: the fear of fat. The media won this game. They successfully frightened us from enjoying fat.

I correct this thinking by educating patients that we are solving a human biochemistry puzzle. Our body’s chemistry controls weight loss. The most crucial piece of the puzzle is insulin. Keep insulin down, and weight loss happens.  

In the absence of carbohydrates, fat does not spike your insulin. Fat also sends a robust hormonal message to your brain to stop eating. This chemical shift is what makes the keto diet so powerful and effective. Fat does not spike insulin. Carbs spike insulin. Excess protein spikes insulin, too. For me, the most challenging pantry item to throw away was the protein powder.

On a ketogenic diet, how much protein does it take to spike your insulin?

Here’s the formula I teach my patients: write down your ideal body weight-the weight you want to be. I’m 5’3” and would love to be 125 lbs again. Divide 125 (your ideal body weight in pounds) by 2.2. This is the number of protein grams per day that you should eat. In my case that is about 56 grams of protein per day. If I stay under that goal for the day, my insulin does not surge. The first month when I failed and failed and failed to produce my first ketone, I was adding a scoop of protein powder to heavy whipping cream. That one scoop had 50 grams of protein and blocked my insulin from falling. No ketosis.  

The number 20 was the only number you need to insist remember-I you stick to that for now. This protein number only surfaces when patients are having trouble. If you are in week 2 and you still haven’t peed ketones, you have a problem. The culprit? You’re probably eating a high protein diet instead of a high-fat one. This is the most common mistake I see.  

Eat too many proteins, and your body will start to squirt out insulin. Insulin is the enemy of ketones. For more information on the benefits of a ketogenic diet, check out the book ANYWAY YOU CAN written and recorded by Dr. Bosworth.

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Growth Hormone

How to Increase Human Growth Hormone Naturally: Mother Nature’s Way.



BABY BOOMERS: I am sorry. Your generation paid the highest price. At the age of 30, you were told to eat low-fat food or you’ll have a heart attack.

You listened to this mantra throughout your life. Now you’re in your 60s or 70s. Your fear of fat is solidly wired into your brain. ‘Do not eat fat or you will die.’ Oh, SNAP! I am sorry. This was the wrong advice.

I’d personally like to apologize on behalf of the medical establishment for how poorly we have advised you. You’ve had more surgeries than any previous generation. The medical industry talked you into over-medicating thanks to the ‘packaged truths’ about those drugs. We’ve opened your hearts, got you on statin meds, and stented your arteries instead of teaching you how to fix your troubles the correct way.  

Instead, we should have taught you to manage your body chemistry-not re-route your blood flow. In your remaining decades, I offer you a secret that course corrects your body:

Growth Hormone!

Increase Human Growth Hormone Naturally

One hormone can reverse every conventional crime medicine has done to you: Growth Hormone.

Human Growth Hormones’ (HGH), mass media popularity, started when bodybuilders injected it with the promise of strong and lean muscles. This touchy little chemical does not work optimally when swallowed. Human Growth Hormone, or HGH, must be injected. That scares off most of my patients, but not bodybuilders. They used this hormone with great success to grow muscles. That audience consumed this drug, and soon they shared trade secrets with Hollywood and the like. Take a look at the latest movie starring a big, buff, cut actor or a sleek, lean actress. Chances are they got their physique courtesy of HGH. Attend a Broadway or Las Vegas theater show. Look carefully at the lean, strong dancers or flying acrobats. That’s HGH in action.


For twenty years I’ve heard the desperation of patients trying to lose weight. The answer is growth hormone.


Wait. Before you rush out and shoot up with growth hormone, finish reading. This chemical compound provides a good answer for much of your middle-aged problems, but it is tricky to dose correctly. Let me teach you how to get your body to produce more growth hormone. That’s right, trigger your body to squirt out more growth hormone.

Endocrinologists, physicians who specialize in hormones, are thrilled about HGH. It fixes everything wrong with a middle-aged, overweight, slightly depressed, low-energy person. Growth hormone reverses your age. It’s THE anti-aging cure.  


My medical school textbooks taught me that growth hormone decreases as you age. After age 50, your body’s HGH production slows to a trickle never to rise again.


I am here to tell you: that’s not true. You absolutely can stimulate your body to make more growth hormone at any age.


Before we go into that, let’s review what growth hormone does.


Growth hormone. Say it out loud: growth hormone. You got it. It makes things GROW. This hormone is produced inside your brain-in your pituitary gland to be exact. Like many of the other hormones in your body, the chemical structure of growth hormone begins as a fat.

As you were developing through childhood and adolescence, this hormone told your muscles and bones to grow. Growth hormone was critical in transforming your body from a child to an adult. Naturally, the body cranked out its most substantial amount of growth hormone during puberty. HGH seeps out of your brain cells during sleep. Your grandma’s excellent advice to you when you were a teenager about getting lots of rest was spot on accurate. Well-rested teenagers produce the most robust growth hormone of all – and they produce it best while asleep. During your adolescent years, if you want the best-developed body, get deep, predictable, sound sleep.

From puberty onward, your body produces less growth hormone.

Measuring growth hormone in the human body is quite difficult. HGH only lasts for a few minutes in the bloodstream. Competitive athletes take advantage of this. They inject HGH into their systems knowing the sports doping police won’t be able to measure it. Naturally, your brain squirts a burst of HGH into your body every night right after you enter a state of deep sleep. Typically, this is six hours into the sleep cycle or around 4 o’clock in the morning.

Once in your bloodstream, HGH begins a cascade of other reactions. First, your liver releases a substantial sugar dose into your bloodstream causing you to wake up. Subsequently, HGH gets to the business of what it does best, stimulating growth. It grows in the following cells: immune system, skin, hair, liver, bone, nerves, muscles and many more.

To supply fuel for all this growth, HGH triggers fat cells to open up and empty their stored energy. In comparison, this is the opposite of what insulin does to those same fat cells. In the presence of growth hormone, your storage cells release fat into your bloodstream. HGH improves your overall energy levels by freeing up stored fuel. It revs up your metabolism, brightens your mood, and suppresses your appetite. It also boosts your sex drive! What a great drug, right?!


Conversely, low HGH causes fatigue, decreased stamina, depressed mood, reduced muscle mass and strength, thin and dry skin, increased fatty growth, slow thinking, and reduced bone density.

Can you see why this hormone is perfect for every middle-aged person looking to reverse the effects of aging?

At this point, you’re probably asking, why don’t people shoot up HGH?

HOLD ON. Don’t do that.  

Hijacking the squirt gun for HGH has some SERIOUS consequences. Those experts I mentioned earlier called Endocrinologist – they know what they are doing. These super smart, specialized doctors have tried many ways to get the HGH formula precisely right. When they overshoot and inject too much hormone, bad things happen.

Overshoot and you will soon become a moody, pimply diabetic with high blood pressure and an enlarged heart. Not to mention, men start growing boobies. That is not a joke. That’s real. Their breasts go from boy’s breasts to milk-producing girl’s breasts due to the excess HGH converting to estrogen. That extra estrogen also shrinks their testicles.


Increase Human Growth Hormone Naturally

When HGH dosing is not calculated correctly and timed, the effects can be gnarly. Although teenagers depend upon growth hormone to lengthen their bones, the adult bones are fused and can’t grow any longer. However, too much HGH in an adult morphs their face bones into a Neanderthal-like look. Overshoot that HGH and their forehead thickens and their jawbones overgrow. Additionally, a poorly timed injection of HGH into adults will cause mood swings and pimples that flash you back to your teenage years. Too much HGH at the wrong time and you can take a perfectly decent Dr. Jekyll and awaken the evil Mr. Hyde.  

Also, injecting HGH for unapproved purposes is illegal and expensive.  

Mother Nature Does A Brilliant Job

It turns out nature does a way better job squirting the perfect dose at the right time to give you all of the awesome benefits without breaking the law, draining your wallet and accidentally morphing you into a raging monster.  

How do we get more of this excellent hormone that melts your fat away, increases the strength of your muscles, concentrates the density of your bones, boosts your energy, erases your wrinkles, focuses your brain, improves your memory and sparks your libido the 100% safe and natural way?

Answer: FASTING.

Take a deep breath. It’s not the end of the world. Fasting isn’t your enemy.

Granted, I don’t bring this up to patients until they have been in nutritional ketosis every day for at least SEVERAL weeks. Sometimes, we wait for months. If a patient tells me how little they feel hungry, I might ask that patient to fast sooner. This advanced education about growth hormone and fasting promises many benefits. If I broach this subject too early in patients’ education, they do not believe me.   

“I know you told me this, doc, but I didn’t believe you. I don’t have the hunger I used to.”

Remember, your blood glucose fluctuations cause hunger. You will feel less hungry when your glucose level remains stable thanks to ketosis. Entering the second or third week of ketone production, patients find they unintentionally skipped a meal for the first time in their life.

Telling patients about this before they experience it has not been rewarding. They thought that was impossible.

When in your third week of ketone production, I encourage you to try to eat one meal a day for two days. Have a lovely, high-fat-low-carb supper. Eat until you are full. No snacking after supper. Go to bed if you feel like eating. When you get up the next morning, have black coffee without food. Pick a busy day to do this. Allow your mind to be distracted from eating. It is one of the keys to success. If anyone offers you food, say these words, “No thank you. I am fasting today. Please, don’t tempt me.”  Seriously. Practice saying those words out loud. They work like a charm.

Drink water or coffee. Put a few Pink Himalayan salt crystals in your pocket for easy access. If you experience a wave of hunger, put one of those salt crystal on the tip of your tongue.  

Then pause.  

Listen. Listen for the shift in what that salt crystal does to your system during a fast. Take that moment to assess what happens honestly. I have learned so much about my coping skills in this tiny, reflective, mindful moment.

Most often you can get past waves of hunger and get to supper without eating any calories.  

It sounds crazy when you have not experienced it before. For years, this was an impossible task. So impossible, I could not imagine it. A body fueled by glucose does NOT miss a meal. You get shaky, you can’t think or stay focused, and food becomes an obsession.  

When your body is fueled by fat, hunger pangs and cravings disappear. As long as you stay hydrated, you can smoothly go 24 hours between meals. If the body needs fuel, you are minutes away from producing ketones from your stored fat. Your insulin stays low enough to allow your body to release and convert energy as it needs.

If you need to lose weight, you have lots of stored energy you can tap. The previous weeks of producing ketones set up your body chemistry to create and access fat-based fuel.

Let’s get back to the typical Baby Boomer. You find yourself in your mid-50s, 60s, or 70s. You’ve got that extra flab.

How can you empty those fat cells? GROWTH HORMONE

Not the illegal, expensive injectable kind of HGH. Your body will not forgive you when you overshoot that hormone. This compound is just too easy to mishandle. There’s a better, safer, cheaper, smarter and more accessible way. No needles required. Start with three weeks of peeing ketones. No cheating. You must begin with three weeks of ketosis. Then migrate to the goal of eating one meal a day. Unleash the power of the anti-aging effect of HGH. Each surge of hormone at 4 AM will build upon yesterday’s results.

One more drop from key cells in your brain each morning will transform your body. No, you won’t turn into a neanderthal. Instead, HGH will reverse your body’s clock. Best of all, your body determines what the proper dose is. There’s no chance of overshooting this sensitive biochemical.

The net effect? In one year, you can achieve the following: fewer wrinkles, clearer thinking, more extended focus, improved libido, thicker skin, denser bones, and higher energy. You get all these benefits on top of HGH emptying your fat cells and growing muscle mass. Remember it is a GROWTH hormone. Boomers, this is your hormone! Start making it now.

Intermittent fasting with only one meal per day for one whole year increases your HGH production. If that I’ too extreme for you, fast intermittently for 4 of the seven days of each week. That’s one meal a day for four of seven days.

Increase Human Growth Hormone Naturally

There are many social and psychological shifts patients must do before they can fast successfully. When you have conquered the fear of only eating once a day, you will unleash options you didn’t know were available.

Before you dismiss this as downright loony, take a look at this study from 1982. Look at the HGH chart of the participants. They start off with a minuscule amount of HGH at 0.73ng/ml.

Now, look at their numbers as they fasted day after day. By the end of the 36 days of fasting, they have increased their HGH by six times. WOW! Without all the side effects and cost of injections.

This study showed the increase of HGH as patients fasted for over a month. Hormones of keto adapted patients show benefits with fasts as short as 24 hours.

Please don’t let this example of extended fasting intimidate you. It is meant to show you the potential hidden within your body. Start with consuming only 20 grams of carbohydrates or less.

Many of my patients feel so much better with ketosis that we never need to advance the conversation to fasting. Like any of life’s changes, start with a step and stay at that step until you master it.

Then take the next step.

If you want to learn more about the ketogenic diet, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.


  1. Franklin, Carl, and Richard Morris. “Ketogenic Forums.” Ketogenic Forums, – Love their podcast.  Thanks for keeping it real!
  2. Fung, Jason. “Blog.” Intensive Dietary Management (IDM), Great blog!
  3. Effects of Human Growth Hormone in Men over 60 Years Old, Daniel Rudman, M.D., Axel G. Feller, M.D., Hoskote S. Nagraj, M.D., Gregory A. Gergans, M.D., Pardee Y. Lalitha, M.D., Allen F. Goldberg, D.D.S., Robert A. Schlenker, Ph.D., Lester Cohn, M.D., Inge W. Rudman, B.S., and Dale E. Mattson, Ph.D. DOI:10.1056/NEJM199007053230101
  4. Felig, Philip, et al. “Metabolic Response to Human Growth Hormone during Prolonged Starvation.” Journal of Clinical Investigation, vol. 50, no. 2, Jan. 1971, pp. 411–421., doi:10.1172/jci106508
  5. Kerndt, Peter R., et al. “Fasting: The History, Pathophysiology and Complications.” THE WESTERN JOURNAL OF MEDICINE, vol. 137, no. 5, Nov. 1982, pp. 379–399

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