Adrenal Fatigue & Exogenous Ketones

Health benefits #1
It’s no secret that I believe the ketogenic lifestyle saved my mother. My 71-year-old mother hosted a body filled with cancer. She had more cancerous white blood cells than normal ones. A grave had her name on it, had we not intervened the way we did. Our goal centered on the resurrection of her healthy cells while sabotaging her cancerous ones. For many people, weight loss is Goal #1 regarding the keto diet. The health benefits surface as a pleasant side effect.

The earliest phases of the ketogenic lifestyle may not equate to a smaller waistline. Instead, visceral fat—the dangerous fat that laces itself around the body’s major organs and is nearly impossible to lose—is the first to melt away on a ketogenic diet. I’ve seen this proven time and again on DEXA scans.

Visceral fat is the main cause of heart attacks and organ failure. It cripples the organs like a venom, silently coating the cell until it dies.

The Cliff Notes to these pleasant health benefits of a keto diet: Maintain a Dr. Boz Ratio (blood glucose ÷ ketones) of less than 80. When you achieve this chemistry, the fat around major organs begins to melt away. Patients start to feel better because they are better. Better from the INSIDE OUT.

Every patient I see could benefit from this lifestyle.

Answers for the adrenal system

This episode, we tackle how ketosis affects patients’ hormones. The specific hormones in this discussion are from the adrenal glands. Jennifer Marie faced the struggles of “hormone imbalance” in the years and months prior to her keto journey. She knows first hand what symptoms link to this mysterious term called adrenal fatigue.

As an internal medicine physician and a keto advocate, I get a lot of questions about adrenal fatigue. Most patients who report having “adrenal fatigue” have been tired and suffering for years. Most find this term in the centerfold of a women’s magazine, or infomercials about chronic fatigue syndrome. The label “adrenal fatigue” turns into a garbage basket where patient stories of fatigue, foggy mind, poor sleep, depression, and low sex drive land.

Adrenal fatigue is not a diagnosis. And, as much as it is not a diagnosis, it does not have to be a life sentence.

So, what is adrenal fatigue?

Located above the kidneys, our adrenal glands cover the hormones that control our kidneys, liver, and reproduction. Simply put, the adrenals handle hormones of salt, sugar, and sex.

SALT: Aldosterone is the hormone on the outermost part of the adrenal glands. This hormone helps balance the “salt” levels of our body. Aldosterone commands the actions of the salt-channels in your kidney.

SUGAR: Have you seen those commercials where the salesman offers to lower your stress with a pill? Don’t fall for that. He is selling some sort of manipulator of CORTISOL. High stress drives up cortisol. Cortisol increases glucose — also known as blood sugar.

SEX: Sex hormones come from the innermost layers of our adrenal glands.

Salt. Sugar. Sex. The functions of the adrenal glands get sweeter the deeper you go.

Patients burdened with the symptoms of adrenal fatigue have “chemistry issues” with salt, sugar and sex hormones.

Their salt hormones are low, their sugar hormones are high, and their sex hormones are all but missing. Five years ago, my approach to patients with “adrenal fatigue” would have started with a battery of tests, followed by several prescribed medications to help curb symptoms. Usually, those expensive workups fail to find an underlying cause. The treatment plan usually centered around improving their sleep, addressing symptoms of depression or anxiety and helping them start a gentle exercise program. Improvement would take at least six months and rarely resolved their symptoms.

Today, I have an answer that can take effect in just two to three weeks.

Sleep and fat to the rescue … again!

Overcoming the symptoms of adrenal fatigue takes time. Keto-living has shortened that timeframe. Patients struggling with adrenal fatigue feel improvements in as little as in two tweeks. How? Sleep and fat.

The body’s panic mode in these patient has become hyper-sensitive. Years of over-taxing schedules, chronically elevated stress, highly processed food and little sleep destroyed them. They fight depression, anxiety, worries and memory issues. Many don’t recognize their sluggish brain function. It took years of slowly wilting their mental function. They often recall that these symptoms “just started.” But a careful history unveils the slow, insidious loss of their energy.

The sleep protocol that I prescribed to John several weeks ago resets that panic button. Mental health is fragile. After the sleep protocol, lots of things improve.

Supplements for the adrenally fatigued

When patients don’t have time for a three-day sleep timeout, I recommend exogenous ketones. The standard American diet feeds their mitochondria glucose. As the SOLO fuel, their cells grow inflamed and age at a faster rate. It’s amazing what happens when ketones circulate in their blood. At first, their cells don’t know how to use the ketones. Two to three days into the added supplement and several mitochondria adopt this new fuel as the source of energy. Within a week, without changing anything else in their diet, they find improved thinking, stronger energy and fewer cravings for sugar.

Waking up their cells’ mitochondria fires up an engine they forgot they had. Energy, focus, metabolism and sex hormones improve! From depression to dementia, I’ve seen exogenous ketones awaken brains to a better way of living.

Take a SIP!

Ease into exogenous ketones. DON’T CHUG. If you swallow your first dose of ketones-in-a-can in one gulp, you will quickly learn why I warn against this. Ketones are chemically a salt. Add a whopping dose of salt to any person’s gut and listen for the rumbles. Within the hour, you will find a date with the toilet as you flush out the colon. Each bottle of powder runs from $45-60. Sip those exogenous ketones for the best return on your investment.

Unlike some supplements, you can measure the effect of this one. Grab that FORA 6 monitor and poke your finger. You can see ketones circulating within minutes. The highest I have found in my patients is 8.5 ketones about 12 minutes after they took the supplements. Don’t panic. That is not ketoacidosis. Nope. It is just circulating ketones. If your cells are not used to this option, many will end up in the toilet at first. Your kidneys will remove some from your blood. Your bowel will fail to absorb some at first. Exogenous ketones only last for two to three hours. Use this knowledge to your advantage. Drink them slowly. Get the best, longest-lasting effect. Several days of adding ketones to your circulation and your cells will use this fuel to kick your energy into a renewed status.

Exogenous ketones are bitter. Nearly every supplement adds artificial sweeteners to cut the taste. These sweeteners help with the taste … but I don’t recommend taking those sweeteners in as a lifetime option. I mix mine with a fat, such as heavy whipping cream. This helps your gut absorb these salts with less of a rumble inside. The added fat also makes them more palatable.

I recommend exogenous ketones for the first few weeks as a way to help boost your mitochondria into gear. FAT GEAR. Ketones come from fat. Your liver will make bundles of these when you are keto-adapted. Before that happens, this shift can be a barrier for folks to get started. I help transition the patient into ketosis using ketones-in-a-can. Personally, I use them after I make some mistakes. Too many carbs — I’m rescued with exogenous ketones. A glass of wine left me feeling swollen the next day. Exogenous ketones to the rescue! The better I got at following the rules, the less I needed them.

For patients like Jennifer Marie and myself, who have been at this lifestyle a while, exogenous ketones are rarely needed. Jennifer Marie carries exogenous ketones when she travels. I add them when I my focus slumps.

But ketones keep me up at night!

Timing is key for exogenous ketones. Taking exogenous ketones late in the day will add power to your metabolism. If you add ketones, don’t be surprised if you struggle to get any sleep—let alone good, deep sleep.

Remember, ketones are fuel. Sip them throughout the day. Add them too late in the day and you will find your brain over fueled for sleep.

Salt?! But I have high blood pressure, Doc!

One viewer asked about their elevated blood pressure following exogenous ketone use.

For my whole career, I have told patients to avoid salt and fat. Keto breaks all the rules. In the early days on a ketogenic diet, patients’ blood pressure levels may rise or fall.

Keto FLU is associated with low blood pressure. Adding ketones-in-a-can works to buffer that mental slump. Beware! Adding these salts while still eating carbs can RAISE your blood pressure. When large amounts of salt are added via these ketone drinks, the pressure can spike temporarily. Take it easy. Go slow. CHECK YOUR BLOOD PRESSURE. You can’t guess on this. You must check. The key word here is temporary! Salt is hard on a SAD body. But for the keto-adapted, extra salt actually helps during times of “keto flu.” Monitor blood pressure during the transition to ketosis. But remember people don’t have stroke from blood pressure that’s high for a day. They die of high blood pressure for six months. In this transition, seeing spikes can be motivation to get to the other side of that plan. Once you reach ketosis, we use salt to maintain that state. The salts minimally affect blood pressure once keto adapted.

Tricking the mind can sometimes be tricky for the body

I recommend avoiding artificial sweetener most time. They are good for tricking the mind into thinking you’ve satisfied your sweet tooth. Unfortunately, they also trick the body into producing insulin. Remember, we want LESS insulation — less insulin. We’ve all heard lab rat fed Diet Coke gain as much weight as those that drink the real stuff. This is largely due to insulin production in response to that fake sweet taste. The fake sweeteners cut the bitter taste exogenous ketones, but that can still cause problems in the long run. Use the sweeteners to keep you from binging on sugar. Keep your eye on the long-game with fewer and fewer of these sweeteners over time.

MCT oil

Medium chain triglyceride (MCT) oil also can quicken your transition. C8:C10 MCT isn’t digested. It’s absorbed into the liver. Fresh ketones pump out of your liver’s mitochondria within 30 minutes of taking in MCT C8:C10.

If you are new to these super-powered, special fats, start by licking the spoon. Yes, lick the oil off spoon! That is the safest starting dose. If your gut has not seen these fats in a while (maybe in forever), you must slowly introduce them to your gut. If you take a swig of these fats, you’ll start a friendship with the toilet. Jennifer Marie experienced gastrointestinal distress with a teaspoon a day. I use a tiny bit of MCT C8:C10 mixed with heavy whipping cream and ice for a solid t ketone boost. Nothing bumps me back onto the keto wagon better than a little MCT C8:C10 and a bit of BHB.

Vitamin D

Low VItamin D and adrenal fatigue often go hand in hand. The mental sluggishness can be improved with the rise in a low Vitamin D. The faster they feel better, the better when it comes to low Vitamin D. When a lab value shows a Vitamin D level greater than 50, I can be rather confident we are in a good place. However, when I see a Vit D level less than 30, I know their brain is suffering with decreased performance.

Adrenal fatigue usually involves Vitamin D deficiency. Keto can help replenish this fat-soluble vitamin. But it takes months to rebuild. I often recommend supplementation–that can be in the form of sunlight or a pill. I prefer 10 minutes of sunlight between the hours of 10 and 2. Short-shadow sunlight.

Always take supplements with a grain of salt

“Doc, can I take this supplement?” I get this question often.

My struggle centers around the limited regulation of over-the-counter supplements. Most supplement companies hire evaluators to test and confirm their analysis of ingredients. It doesn’t take a chemistry degree to realize the conflict of interest!

A good example came a few years ago from one of the nation’s most recognized producers of magnesium supplements. Their advertising on the bottle of magnesium boasted of “no tummy rumbling.” Magnesium causes the bowels to move. Period. To claim that their product caused no “rumbling” was remarkable. The supplements were studied by independent evaluators There was ZERO magnesium in the leading magnesium supplement! Mind-blowing.

On the flipside, let’s take a look at cannabidiol—also known as CBD oil. Recommendations for use of these products have been on the rise in recent years. If you google CBD oil, it fixes anything from joint aches to migraines to seizures. Most companies claim theirs contains no THC. Recently, the military sent samples of 24 CBD oils to the FDA for independent evaluation of their contents. All 24 contained THC!

Taking supplements can be dangerous when you do not know what you are taking. And, in the case of CBD oil, could cost you your livelihood!

Always, always, always seek your physician’s advice before trying new supplements.

Have you read my book yet?

Anyway You Can is an amazing resource to guide you on your ketogenic journey.

Keto Reference Guide
Glucose & Ketone Testing Kit
Exogenous Ketones BHB

When first embarking on my KETO adventure, I said NO to exogenous ketones. I bought into the mantra, “These are not natural. Don’t do that.” I was wrong. Research continues to strengthen our understanding of the mental performance on this supplement and the powerful benefit for cancer patients. I recommend exogenous ketones for my patients struggling with severe or longterm weight problems, those struggling with chronic allergies, and newbies trying to get used to burning ketones for fuel. All keto supplements should have magnesium in them. This one does. I own Dr. Boz® trademark, brand, and the Dr. Boz® supplements.

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