Two years ago I got a call from a woman in Albuquerque who said that Tom, her 60 year-old husband, had started to act “strange.” She told me a little bit about his medical history and then asked if I could evaluate him.

Tom worked at an investment firm and prided himself on being organized, efficient, and able to remember the details about his clients’ investments.

Over the prior months Tom had complained to his wife that he had times when he felt confused and disoriented and couldn’t even remember his clients’ names. The symptoms got progressively worse. Eventually whole chunks of time disappeared irretrievably from his memory.

One day at breakfast, Tom silently stared at his wife while his mouth opened and closed repetitively, with his tongue partially protruded. After ten minutes, when the episode passed, he had no recollection of what had happened.

His wife brought him to the emergency room where the doctor on duty ordered an MRI scan that showed nothing unusual. An EEG of his brainwaves did not reveal any seizure activity.  His blood tests showed elevated blood sugar in the diabetic range, high cholesterol and triglycerides, and unusually high levels of inflammatory markers.

The doctor concluded that Tom’s behavior was due to extreme stress and that he needed to enter into a stress-reduction program. The doctor gave him a referral to a local internist for treatment of his new onset diabetes and his high cholesterol and triglycerides. He urged Tom to take ibuprofen for the inflammation in his body.

During the prior year, Tom’s wife had been immersing herself in webinars and podcasts about natural healing methods for various medical conditions. After the visit to the emergency room, she called me up, asking for an appointment for her husband.

Tom and his wife drove up from Albuquerque for the initial consultation. Tom appeared well dressed and expressed himself clearly, without any evidence of the problems in his brain. He said that he would do whatever it took to get well.

We began our journey to wellness by my referring him to a neurologist who ordered an MRA scan, a special kind of MRI scan that looks specifically at the blood vessels. Among the blood vessels we found the culprit.

The small vessels in Tom’s brain were clogged, probably from years of inflammation, high blood sugar, and high insulin levels. When Tom was dehydrated, the thick blood was not able to flow through the clogged vessels to deliver oxygen and nutrients to specific parts of the brain, resulting in memory loss and episodes of confusion, as well as atypical seizures that did not show up on the EKG.

I explained that his unhealthy standard American diet was probably the main cause of his predicament. The type of foods he ate caused high blood sugar and high insulin that, in turn, caused inflammation throughout his body. The inflammation caused plaque to be deposited in the vessels.

I spoke to Tom and his wife with frankness, saying that he was at high risk for a stroke or heart attack if he took no action. Tom expressed eagerness to begin the program.

I placed him and his wife on a ketogenic diet,and urged them to avoid foods known to cause inflammation in many people, like packaged and processed foods, genetically-modified foods, non organic foods contaminated with herbicides, sugars, synthetic sweeteners, grains, soy, alcohol, and fruit juice. I also urged him to eliminate harmful fats, like refined vegetable oils, fried foods, and trans fats.

The ketogenic diet is high in the healthy fats, with moderate protein, and is extremely low in carbohydrates. The diet includes an abundance of “above ground” vegetables. The starchy “below ground” root vegetables are eaten in limited quantities. The diet includes fresh fruits, but in limited amounts as well.

Tom was skeptical at first about eating a high fat diet. I told him about the misleading, industry-driven information the public had been given ever since the 1960s when we were told that a low fat diet is good for us. I also reassured him that most of the fats that I encouraged him to eat were plant-derived.

Although cheese and yogurt are part of many versions of the ketogenic diet, Tom had to give up dairy products because he showed signs of being allergic to them with the dark rings under his eyes, chronic sinus congestion and frequent upper respiratory infections.

Food allergies and sensitivities cause inflammation. He was relieved to hear that he could still eat butter and ghee because they are pure fat and do not contain the milk protein, called casein. Casein is the most allergenic part of milk products.

Switching to a ketogenic diet entailed a huge lifestyle change for Tom and his wife. I set them up to get coaching in implementing the ketogenic diet so that the transition would be less daunting. I also recommended that they read Dr. Mercola’s book “Fat for Fuel” as well as his “Fat for Fuel Ketogenic Cookbook.”

In addition to switching to a ketogenic diet, Tom undertook an entire lifestyle overhaul. He exercised every day for an hour to help oxygenate his brain, spent time outdoors to get a dose of sun exposure, drank 3-4 quarts of fluid every day based on his weight, and he made sure that he got at least 8 hours of sleep each night. He also took CBD hemp oil before bed to raise his seizure threshold and calm the inflammation in his brain.

Every morning and evening Tom took a handful of supplements chosen for his specific condition, like anti-oxidants, anti-inflammatory remedies, natural blood thinning capsules, vitamin K to pull out the calcium from the deposits in the vessels, herbs to stimulate the mitochondria in his brain, and many more.

To make sure that his brain was not deprived of oxygen while he slept, I sent Tom for an overnight sleep study. The results showed borderline low oxygenation. The specialist told him to retest in a year to see if he would need supplemental oxygen at night.

By the end of two months on the diet, Tom had lost 25 lbs.—without limiting the amount of food he ate. He had also lost all his cravings for unhealthy foods. His fasting blood sugar had dropped from 180 to 100 mg/dl—still too high but no longer in the danger zone. His insulin dropped from 26 to 11 mlU/L. And his triglycerides dropped from 325 to 170 mg/dl. His atypical seizures diminished in frequency. He said that he felt much more alert and energetic and was able to function well at work.

After a year on the program, Tom regained his self-confidence. His blood tests entirely normalized. His weight dropped so rapidly that his wife needed reassurance that the weight would stop dropping once he reached his ideal weight—his weight in high school when he was on the wrestling team.

Although Tom still has a rare seizure now and then when he forgets to drink his quota of water, overall his health has improved dramatically. He is not on any prescription medication.

What is a ketogenic diet? 

The ketogenic diet is a high-fat, moderate protein, and low-carbohydrate diet. The drastic reduction in carbohydrates and increased consumption of healthy fats causes a significant drop in glucose and insulin levels in the blood, along with increased ketones. The diet has a long history of being used to treat multiple medical conditions.

What are ketones? 

The body has two sources of energy production—glucose and ketones.

Ketones, also known as “ketone bodies,” are molecules that are byproducts of fat metabolism.

The body’s main source of fuel is glucose—or sugar. But when the body is deprived of glucose from carbohydrates and the carbohydrates are replaced with healthy fats, the body switches into a metabolic state called ketosis.In ketosis, the liver breaks down the fat and turns it into ketones. The ketones become the principle source of energy for the body and the brain.

Conversion to ketones as fuel occurs during fasting, prolonged exercise, or when eating an extremely low-carbohydrate diet, like the ketogenic diet. When the glycogen (stored sugar in the liver) levels are depleted, the body becomes highly efficient at burning fat for fuel.

Why does our body burn ketones? 

The body is amazingly adaptable to our circumstances. For generations, our ancestors endured prolonged periods of near starvation when the crops failed or game was scarce. When the glycogen stores became depleted, the body had the biochemical mechanisms in place to burn body fat for fuel.

What is the history of the ketogenic diet? 

Fasting and other low-carbohydrate regimens have been used to treat seizure disorders since 500 BC. In the 1920s, physicians introduced the ketogenic diet as an alternative to fasting for treating seizures. The ketogenic diet appeared to be just as effective as fasting.

The differences between a ketogenic diet and other low-carb diets 

The two other well-known low-carbohydrate eating strategies are the Atkins diet and the Paleo diet. Both of these diets, unlike the ketogenic diet, encourage high animal protein. Research suggests that consumption of excessive animal protein can stimulate a pathway called mTOR that can cause inflammation, accelerate aging and increase the risk of cancer. Another difference with the other two low carbohydrate diets is that they place less emphasis on beneficial fats.

What are the benefits of the ketogenic diet? 

Many Americans suffer from chronic illness. One of the main culprits is our diet. The standard American diet is unhealthy and promotes disease.

The list of benefits from eating a ketogenic diet is very long. Some of the conditions that respond well to the ketogenic diet are obesity, type II diabetes, dementia, seizures, cancer, hypertension, depression, low energy, high cholesterol, blood sugar swings, sugar cravings, and inflammation.

What are the different ways to follow a ketogenic diet?

The standard ketogenic diet contains about 70% fat, 20% protein, and only 10% carbohydrates—which means between 20-50 grams of carbohydrates per day. When you get coaching in how to implement the diet, you will learn about keto calculators that help you determine the amount of the fat and carbohydrates your body needs to go into ketosis.

The cyclical ketogenic diet involves 5 days of eating a strict ketogenic diet, followed by 2 days of re-feeding oneself with extra amounts of complex carbohydrates.

What would a typical meal look like? 

Sample Breakfasts:  

1) My favorite morning drink with organic coffee, cacao powder, chai spices, MCT coconut oil, butter, and homemade nut milk.

https://www.musingsmemoirandmedicine.com/2015/08/my-favorite-morning-drink/

2) An omelet made from eggs produced by pastured chickens, with spinach, a finely chopped red onion, red bell pepper, parsley and cilantro, cooked on low heat with ghee

Sample Lunches: 

1) An almond flour tortilla wrap with a strip of Alaska salmon, strips of green onions, slices of avocados, and broccoli sprouts

2) Chicken salad made from pasture-raised chickens, with celery, carrots, finely chopped raw kale, olives, freshly squeezed lime juice and extra virgin olive oil

Sample Dinners: 

1) Roasted Brussel sprouts with olive oil, olives, freshly-squeezed lemon juice, pecans and avocados

https://www.musingsmemoirandmedicine.com/2015/11/roasted-brussels-sprouts-recipe/

2) Quinoa salad (grain-free) with cashews and lots of finely chopped vegetables

https://www.musingsmemoirandmedicine.com/2017/10/quinoa-salad-delicious-and-nutritious-and-grain-free/

Sample Desserts 

1) Coconut-Avocado Mint ice cream

https://www.musingsmemoirandmedicine.com/2017/08/coconut-avocado-mint-ice-cream-sugar-free/

2) Chocolate Tort made with cacao powder, almond butter, coconut butter and avocados, sweetened with chicory root and Monk’s Fruit.

To find the recipe, go to www.musingsmemoirandmedicine.com and click under the heading “Recipes for Healthy Living.”

Are there side effects from this diet? 

Several of my patients have experienced transient side effects in the first few weeks of starting the ketogenic diet. The most common symptoms are related to withdrawal from sugar and simple carbohydrates.

If a person on the ketogenic diet has a heavy overgrowth of yeast and other fungi, the organisms will die from lack of the sugar that they need to thrive. When the fungi die, they release endotoxins that can make their host have flu-like symptoms. These symptoms will eventually disappear. Other temporary effects of beginning on the diet include:

• Fatigue
• Irritability
• Brain fog
• Headaches
• Digestive discomfort

Once the yeast die back and the withdrawal from sugar is over, the body will readily adapt to being in ketosis. If that’s not the case and the symptoms persist, introduce the ketogenic diet more slowly by eating less fat and adding back some starchy food into the diet for a few weeks.

The ketogenic diet is not suitable for people with gallbladder disease. The increased amounts of fats require adequate bile production.

I had one patient who had a paradoxical reaction on the ketogenic diet and actually gained weight. It appears that she never went fully into ketosis, the state that burns fat for fuel instead of glucose.

It’s important to drink plenty of water and take extra minerals while on the ketogenic diet, especially Himalayan salt, potassium and magnesium.

What conditions benefit from the ketogenic diet? 

The conditions that benefit from the keto diet are numerous. Below are some of the conditions that are dramatically impacted by this diet.

Obesity

If you are trying to lose weight, then the ketogenic diet is one of the best ways to achieve your goals. In spite of eating large portions of food, weight drops off without a huge effort. Because the diet requires fat with every meal, the sugar cravings disappear and the blood sugar remains stable, without major peaks and troughs.

Type II diabetes

For people with diabetes, their daily intake of carbohydrates is limited to 20 grams per day.  Diabetics on this diet will need to monitor their blood sugar closely to see how much to lower their medication. When type II diabetics stick to the diet, they likely will be able to eventually stop their medication.

Dementia

Underlying dementia is inflammation of the brain that leads to degeneration. There are many causes of inflammation of the brain, but a significant cause is the inflammatory foods that we eat. When we eat a high fat, low carb diet, the brain switches from burning glucose to burning ketones for fuel. Ketones are a cleaner source of energy than glucose because they produce fewer free radicals and cause less oxidative damage, allowing the brain to achieve optimal function. Many of my patients report that their cognitive function improves on the keto diet.

Seizures

The keto diet was designed originally to control seizures in children who did not respond to anti-seizure medication. It’s not totally clear why the keto diet is so successful in controlling seizures, but it might be related to the brain functioning most efficiently when burning ketones.

Fungal overgrowth

Yeast is a common complaint in my medical practice, probably related to our high carb diets, the overuse of antibiotics, and food contaminated with herbicides, like glyphosate, which kill the beneficial bacteria that help maintain balance in the gut. The ketogenic diet virtually starves out the yeast colonies that depend on the sugar to survive.

Cancer

Similar to yeast, cancer cells are gluttons for sugar and need the sugar in order to grow. By depriving them of their primary source of fuel and by restricting animal protein, cancer cells will literally starve to death.

Inflammation

The ketogenic diet is anti-inflammatory for all the reasons mentioned above. Much of the inflammation we experience in our bodies is food-related. Once the inflammatory foods are identified, they can be removed from the diet, including the foods one is allergic to, processed foods, sugars, simple carbs, grains, herbicide-contaminated foods, and excess animal protein.

Eating out on a keto diet 

When you are new to the ketogenic diet, I suggest that you avoid eating out while you are adjusting to the diet. Finding a restaurant that cooks with healthy fats and organic foods can be challenging. In Santa Fe, we have a few restaurants that go out of their way to purchase organic produce at the farmer’s market and cook exclusively with butter, ghee or olive oil. Many restaurants use corn or canola oil for cooking. I don’t recommend using vegetable oils for cooking. They are highly refined, often genetically-modified, and easily damaged by heat.

How to get started 

Easing slowly into a keto diet is best for people who eat the standard American diet. Begin the journey by first eliminating processed and packaged food from your refrigerator and your pantry and introducing more fresh foods into your diet.

The second step is switching to an all-organic diet, if that is feasible for you.

The third step—when you’re ready—is to get rid of sugars and simple carbohydrates.  Simple carbohydrates include sugars and milled grains, such as pasta, bread, chips, tortillas, and crackers.

The fourth step, difficult for most people, involves getting rid of all grains. While you’re taking these steps, introduce as many vegetables as you can into your diet. If you eat meat, make sure that it is 100% grass fed and not finished off with grains at the end of the animal’s life. If you eat fish, I suggest you limit yourself to Alaska fish, sardines, and herring, due to concerns about toxicity in the fish from our contaminated oceans and fish farms. All Alaska fish are wild caught.

Now you are ready to take the leap into the keto diet. I strongly urge you to get guidance from a health coach trained in nutrition and knowledgeable about the keto diet.  I also recommend that you read Dr. Mercola’s book, “Fat for Fuel.”

After the initial adjustment phase, if you still don’t feel well on this diet, then I suggest you switch to a more moderate diet with less fat and with more complex carbohydrates.

Here’s to your good health!

Stay tuned to learn about the benefits of intermittent fasting.

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Dear Readers,

I have received numerous emails from readers worried about me, wondering why I haven’t posted any blogs for the past two months.

I have been immersed in preparing for publication my manuscript about my time among the Navajo people—first as a schoolteacher, then a sheepherder, and finally, years later, as a medical doctor. I’m hoping the book will be out by the spring.

I am publishing through Balboa Press, a subsidiary of Hay House. Hay House has funded my costs of using Balboa Press and said that if the book does well when it first comes out, they will take it over and publish it under their name and help me market it.

Please let me know if you have any brainstorms about a title for the book.