Two very different patients folks!
Both on the keto diet and both achieving levels of ketosis towards better health. Their paths differ and their results improved their health for different reasons. In this show, I talk about the patients, their stories, and their numbers. Learn through their stories about fasting, autophagy, and the Dr. Boz ratio. We wrap things up with a quick tip about their supplements.
68-year old diabetic for 20 years. His HbA1c dropped from 10 to 9.1 in 9 months while he lost 100 lbs. He stopped taking insulin and dropped his BMI from 38.7 to 28.1. Amazing!!
36-year-old mom, a medical provider, healthy and lean. She felt sluggish despite Cross-Fit training. Adult acne brought her to my clinic because she couldn’t get rid of it. Late-night snacking also increased her blood sugars and likely worsened her acne.
Jerry’s Story of Fasting and Autophagy:
Jerry’s numbers tell a story filled with teachable moments. His blood glucose towers at 279 before fasting. After fasting for 18 hours, it dropped to 238. Add in the calculations of what his ketones did and you find his Dr. Boz Ratio [DBR] went from 111.60 to 91.54. I initially recommended a DBR goal of <100. The DBR reflects insulin production. As he lowers his DBR number, he produces less insulin and the healthier he gets.
A Dr. Boz ratio of 40 or less would dramatically improve Jerry’s situation; a tough challenge indeed. Jerry’s years of bathing in extra insulin created cells used to inflammation. Those cells replicated thousands of times with a high-insulin state. Over time the cells resist the signal from insulin. They grow deaf to the noise of insulins commanding authority. Insulin normally orders glucose into the cells and other storage locations. The longer the insulin stays elevated, the less the cells respond to it and the “older” the cells look.
How do we stop his body from producing insulin?
STOP EATING. Fasting will improve his situation the fastest. Fasting rapidly pushes him into ketosis.
He first ate one meal a day. This improved his chemistry, but his ratios looked like a seesaw: up one moment and then down the next.
Next, he advanced to eating one meal every other day. His ratio went as low as 32.
Look at his spreadsheet. What can we learn?
ANSWER: It takes a lot of time between his meals to deliver a steady chemistry improvement.
Jerry’s years of high insulin resistance led to high triglycerides and being overweight. This means his blood glucose levels cannot be in the 100s unless he eats every other day. Why?
His liver holds a bunch of stored sugars (glycogen). Unless 48 hours have passed, his glucose numbers rise. Years of stored sugars and elevated triglycerides mean he holds an ample supply of energy that awaits the right chemistry to allow his body to burn it.
First fasting depletes his glycogen storage. Glycogen provides replacement sugars to burn. A triglyceride breaks down into three chains of fat with a small amount of glucose. Most of the energy stored as triglycerides exits the body as fat-based fuel called a ketone. Splitting triglycerides apart means ketones enter our circulation and a slight rise in blood sugars.
Can Jerry lose weight and restore his metabolism to normal?
Yes – I think so. He will need to stick to one meal every two days to train his body and do it. It will take months of this improved chemistry state to restore his metabolism.
Metformin, a prescription drug, helps get glucose into the inside of cells and can help Jerry. Without high blood glucose, metformin cannot lower sugars. This makes it quite safe to use to help his progress.
Adding ketones during the fasting period like BHB (beta hydroxybutyrate) will strengthen his mitochondria. The more he uses ketones, and the better he will feel. The more he burns ketones as fuel, the stronger his metabolism will grow.
Recommendations for Jerry:
- OMEOD = One Meal Every Other Day
- Supplement with BHB during times when he feels hungry.
THE DR BOZ RATIO NEEDS BOTH KETONES AND GLUCOSE:
As in any fraction, one number only gives half the story. Remember, looking only at blood sugars means you left half of the math out of the puzzle.
The “dawn effect” happens every morning. The brain directs the release of glucose which gives us the initial energy we need to begin the day.
Notice the difference in the Dr. Boz Ratio with high blood glucose in the presence of high versus low ketones. High insulin means low ketones. Excess insulin always makes for an unhealthy state. Always. Elevated ketone production happens when insulin is lower than it used to be. Even in diabetics, we see the increased production of ketones when they “reset” their insulin production to less than it used to be. Less insulin means less inflammation. That’s a win!
Any connection between the Dr. Boz Ratio and Autophagy?
Autophagy means the body cleans and repairs damaged cells. Our body uses these recycled resources to generate healthy, new cells. Lower your Dr oz ratio and watch youthfulness emerge. A high Dr. Boz ratio means high insulin which means no autophagy.
Stacy’s Story of Fasting and Autophagy:
Stacy’s glucose rides well below 100, yet her ketones hover under 1. Her Dr Boz ratio shows that she makes a LOT of insulin to control her glucose. Stacy has 25 years of youth on Jerry, but her DBR is less impressive than Jerry’s.
She’s healthier, younger, and leaner right? Why is her DBR so high? She has had high insulin for a few years. She controls her glucose because her cells still listen to the commanding voice of insulin. But that insulin still costs her a cellular price. In a word, it charges her body with chronic inflammation. That is the root to her acne. Compared that to Jerry. Jerry’s system wore out. His sugars live in the 200-350 range because his enormous amount of insulin falls on cells that don’t listen anymore. Jerry lives years into his insulin resistance; Stacy just recently entered that chemistry.
Stacy also just started on Keto. Jerry’s DBR looks better than Stacy’s because his body has had 9 months to practice using ketones. It will take Stacy time to get her numbers settled into a lower DBR. If she fasted for 3 days, she would be there. I mean only water and salt for 72 hours. Then do keto for the rest of the week and repeat the 72 hour-fast 4-5 more times. This option does not fit Stacy’s life.
14 days into the Ketogenic diet, she did manage to get her ketones up a little.
What’s holding her back?
Stacy’s flirting with early insulin resistance! Teetering on the edge. Being a mom, a hectic schedule, poor sleep, etc. stirs up enough cortisol to perpetuate the wrong chemistry. With stress, her glucose levels rise and her ketones fall. She needs to shift the chemistry and this will reverse. Easier said than done with little kids, and intense job and the frustration of her body-acne.
The solution: LET ME DO THE WORK
Supplement with “ketones-in- a-can.” This will jump-start her metabolism into a ketone burning situation. Ketones in circulation act as a signaling agent. They send messages to the body while providing a steady fuel to burn. The ketones-in-a-can swirl around our body for 2-3 hours after you drink them. During this time, they signal messages to our cells. They tell our brains, “I am not hungry.” “I do not have a craving.”
They decrease swelling and signal the system to not break down muscles for energy. I
Recommendation for Stacy:
- STOP eating at 6PM (no calories or sweeteners after 6PM)
- Drink Ketones-in-a-can all day during work for two weeks.
Sipping on ketones will shift her chemistry away from insulin resistance. Simply adding the ketones will allow her body to burn them instead of glucose. Without the need for glucose, her cravings will disappear. The first day can be rough, but it gets much better quickly. The ketones will circulate for 2-3 hours. Whatever she does not use, she will pee out. But 2-3 days of this plan will awaken many of her cells to burn ketones. She will feel an improved energy and less irritation. Meanwhile, decreased insulin will begin to reverse her acne. This is not fake news. I do not want her on supplements forever, but I do want her body in a healthy chemistry state. This supplement plan works for her life and her early stage of inflammation and insulin resistance.
Stacy’s metabolism will be much easier to fix than Jerry’s. Each time her body shows an elevated DBR, I will encourage her to drink ketones-in-a-can. Over time, the metabolism will improve. Her improved choices will follow her improved metabolism.
Jerry needs this disciplined choices AND the help of extra ketones. Time will show me how much his body rallies.
Thank you, Jerry and Stacy, for your willingness to share your stories.
P.S. Do muscles break down on Keto? Research shows that ketones and the ketogenic diet actually builds muscle. More on that for a different blog.