It's good that you are exploring variations on the keto diet but you are ignoring a huge available option, carnivore. I agree that the super high ketone readings are not the be all and end all of epilepsy treatment. On keto, my seizure disorder improved somewhat but on carnivore, it went away entirely. I think I wasn't getting enough protein on keto plus keto can lack in multiple micronutrients. On carnivore, there is the benefit of the MAD in that you don't have to count and measure everything. I am in ketosis at a lower level but with much better results. It's not ALL about the ketones. It's about the nutrient density as well as getting rid of the pro-inflammatory plant foods.
I started ketovore Jan 23 after 3 months on a low carb that did not stop my 2 monthly seizures which happen around the same time monthly. I stopped all fruit & veg at the end of Jan 23 & eat some cheese, cream, A2 milk, avocado & eggs along with all meats & seafood after listening to various Drs like Dr Palmer, Dr Berry, Dr Chaffee & more. I have also listened to Dr Westman & various other Drs who recommend some vegetables & a small amount of fruit, which sometimes gets very confusing and has you wondering if you are eating the right food. These diets have not stopped the 2 seizures which happen around the end of each month, around when my hormones changed as I am 62yrs. I am presently trying MCT 8 & Coconut oil after listening to Dr Mary Newport and trying to test and monitor the quantity. I have just started taking 4 tbl spns of MCT 8 a day and may be 1 - 2 tble spn of Coconut oil which Dr Newport had her husband on for Alzheimer's.
@@robinbeers6689 I think it was about how long it has been since you stopped fruit & veg & became Carnivore? It was hard for me to listen to Drs like Andrew Chaffee or Dr Westman who both know what they are doing and know which way to go. I stopped fruit & veg end of Jan 23 and a few months later because the 2 monthly seizures were still happening, I thought I would try a few vegetables like Broccoli & sweet potato again. I only lasted about 5 days as I think the inflammation in my knee was returning which has disappeared on ketovore along with the psoriasis on my scalp. I am not having fruit or vege but am still having my 2 monthly seizures. I have just started taking MCT oil, C8 mainly 4 times a day and will see what happens at the end of this month. I came across Dr Mary Newport which I found interesting, she gave me the name of a dietician she works with at The Charlie Foundation but she couldn't fit me in. She has recommended another dietician as I rally need some help. I had a consultation with Dr Bart Kay but I didn't get enough time, he was always too busy to finish the consult. He recommended stopping fruit & veg though. I am also been thinking about Dr Chaffee although he is strict Carnivore, so that has had me doing my research first.
There is still considerable antipathy to this form of treatment for resistant epilepsy in the United Kingdom. A local neurologist refuses to recommend it under any circumstances. And if they can do it in India, why not the UK…!!
I am trying it myself in Australia, stopped all meds in 2012 because of s/effects. I had a bad fall in June 2022 & the Neurologists wanted to put me back on meds but I refused. I have been researching the Keto for over 12 months after stopping alcohol, sugar & carbs from June 22. I only have 2 seizures a month & so far have not been able to stop them. I am presently trying MCT C8.
@@LifeIsWonderful675 Well done. I wish you all success… It takes a while to get into the ‘swing of things’, and measuring fasting Glucose and Ketones every morning is a ‘must’. But it’s not difficult.
@@grahamedwards6824 How long have you been on Keto? Mine is ketovore, I stopped fruit & veg end of Jan this year. Do you take MCT oil? I lived & loved the UK through the 80's, I had a Rubber Clothing /Gallery in West Kensington.
@@LifeIsWonderful675 About three years now. I’m a retired GP, and my wife has Altzheimer’s. We were both pre-diabetic. We have both managed to reduce our fat stores, and the object is to try to achieve fasting ketone levels of 1.5mmol/L, which is described as a therapeutic level. I’m not sure what you should be aiming for, but probably the same, with low glucose levels as well. Once people are ‘fat adapted’, they can cope with low glucose levels that would be thought of as too low by most health care professionals. For trying to reduce many forms of cancer, a Glucose/Ketone index of 1 is extremely likely to disrupt the metabolism of the cancer cells. Similarly I think that if you are to be able to reduce your seizures, you need to be fairly ‘strict’ about it, and being guided by a doctor or nurse who is knowledgeable in this field is encouraged, because it is potentially dangerous…. Dr Annette Bosworth on UA-cam has been extremely helpful for me.
Really great discussion and cool to see MAD doing so well in the pediatric population where they traditionally were thought to need a stricter version of KD. It also seems to me that MAD solves several problems associated with traditional keto diets (measuring food not as strictly required, higher protein for development, and if eating animal protein you are substantially increasing your sources of carnitine which can be a problem in higher fat diets.) seems like a win win win. I have personally found success with something like a MAD + Mct if higher ketones are needed. - Thanks again for the discussion!
Thank you for your comments. I like your mention of using MCT if you want to drive your ketones higher. I think having easily available and accurate ketone monitors really helps with the flexibility of MAD and still tailoring it for clinical benefit.
How much MCT oil do you use and what type? I have started on MCT 8 and only heard after listening to this Drs talk about using may be 4 tbl spns a day which I have just started. I recently came across Dr Mary Newport who was using Coconut oil on her husband to help Alzheimer's. I am also doing some tests daily to check the Ketone levels, I did not know what they should be either until a few days ago, again after listening to Metabolic Mind which has been so helpful. Thank you to the family & Dr who have put Metabolic Minds together.
I have been using the urine tests to check Ketones but will have to look for another monitor that is more accurate. I don't really want the blood monitor but may have no choice. It all takes time trying to work out how much MCT 8 & how much Coconut oil to take daily.
I personally test with the acetrack breath acetone device, and then spot check a few times here and there with the blood tests (biosense is another highly regarded breath acetone monitor). Breath is great because all you do is blow into it for 10 seconds or so, super easy. As far as mct I use Costco's mct which is a c8 c10 blend but mostly c8. In terms of how much, I usually use it around higher carb meals or take 1 tablespoon at a time to make sure my breath ketones are in the range I like.@@LifeIsWonderful675
I'm really missing the carnivore diet. It is well known that meat contains several "neuroprotective" substances like some B-Vitamins, DHA, Taurine, Carnosine, etc. etc. Also, I would like to really know how much seed oils and refined carbohydrates, especially fructose/sucrose each type of a KD included in the study contains. That might be a much bigger factor than just some macros-ratio...
18:57 great insight! more ketones for most is probably unnecessary.....I wonder if there are adverse effects (aside from ketoacidosis) when ketones are "high" over extended periods
Curious to hear your thoughts on LGIT, as it's much less restrictive and my understanding is that beta-oxidation (which doesn't require ketosis) drives most of the adaptation to fat-based metabolism anyways.
Thanks for your comment. I think it depends on your goals and your response to therapy. As this paper showed, LGIT worked well for seizure reduction, although maybe not as well as a "stricter" keto diet. Could we see that same thing in psychiatry? I would assume so, but we need more data to demonstrate that. The keys are finding a diet that is sustainable and gives each individual the results they are looking for. Beta-oxidation is important, but we wonder if ketone levels are also important. Time will tell, and in the meantime, that's why we recommend everyone work with an experienced clinician to help individualize this aspect of treatment. Thanks!
@@michellecronje6476 low glycemic index treatment, u can find info ab it if u search that up. it's a non-ketogenic low-carb diet that focuses on lower glycemic index foods
Thanks Dr. Sher for all this research and presenting it so well. I have a question, maybe hard to answer: if one is on a keto or low-carb diet, might an occasional binge shoot the person's glucose responses up to a much higher spike, being not used to a sudden proportionately big sugar load? With a greater chance of a seizure than those not on a keto diet, whose system is used to assimilating a moderate level of sugar For a special birthday celebration, etc, it is hard to ban particularly a child from not joining in. Would on the other hand a consistently low carb diet/keto make it easier to assimilate a sugar spike once in a blue moon, because one hasn't been hammering one's system daily (i.e. consistently being close to overload) ?
Adding to my above comments, it may be that a suddenly higher carb meal when on low carb makes sugar spikes much higher, this is important for me because I think my son's epileptic seizures are highly carb-affected, and I may be exposing him to greater risk by his being on low carb all times except a night out with friends. Somewhat confirmed, looking at Dr. David Unwin's site : "...Because your body is fat adapted and no longer using sugar as its main fuel, you may have an exaggerated blood sugar response to the glucose drink." I really need to know if I am exposing my son to more epileptic seizures than he'd otherwise have!
@@MildAutismPete People that have been on a ketogenic state for a long time may have a very small amount of insulin available in their pancreas to deal with high loads of sugar, so your son has to be careful not to binge on carbs. Something you can do is to give slightly higher amounts of carbs once a week to encourage the production of small amounts of insulin. But I would suggest no more than 100g of carbs, and start with 50g so that the body is not shocked. Another option for you is to have a vial of slow acting insulin available to use in days that you know your kid is going to have a higher consumption of carbs.
Higher dosage of b vitamins helps to reduce and regulate the insulin spikes. Carbs reduce and can cause b vitamin deficiency and malnourishment overall. A b complex vitamin with magnesium (not oxide) taken with vitamin c (camu camu or acerola- ascorbic acid is not vitamin c) and berberine all help with insulin regulation. Look up EOnutrition channel for more help on this.
There isn't a lot in the literature about it, but here is a paper that may be of interest. www.ncbi.nlm.nih.gov/pmc/articles/PMC8146910/ People and clinicians are gaining experience with it, and hopefully, more studies will follow.
For me, carnivore was what cured my decades long seizure disorder. I did a very strict keto for five years before going carnivore and it did help some but carnivore is so much better. While keto made my seizures less frequent, carnivore has made them go away completely. I would really like to see more attention paid to this option.
@@robinbeers6689 To my understanding, keto diet is what human ate for millions of years after several hundreds hours of keto videos and like maybe a hundred of different doctors and dietitians making videos. The conclusion I have is actually human is carnivore, with tiny level of adaptation of plant foods seasonally, and most of the time no plants. So congratulations, I guess you got to the optimal diet for yourself and for human as a species.
@@LittleRadicalThinker Yep. I'm not super strict. The only people who need to cut out absolutely all plant matter are those unfortunate people who suffer from major auto-immune disorders. I use spices and drink tea and have an avocado or some berries now and then. Otherwise all animal foods. Works for me.
I am presently ketovore but haven't quite got it right as yet. I have been researching since June 2022 and tried a low card diet for 3 months at the end of 22 which did not stop my 2 monthly seizures. I went ketovore the end of Jan 23 & stopped all fruit & veg. It has helped the arthritis in one of my fingers & stopped the psoriasis on my scalp, although I have had a hard time with hair loss the last 6 months, could be a lot to do with stress & hormones. I have just started on MCT C8 & will see what happens at the end of this month.
So happy to see this non profit and that you ( Dr. Bret) are the messenger. Making a difference for sure - THANKS SO MUCH
Thank you!
Excellent presentation.
It's good that you are exploring variations on the keto diet but you are ignoring a huge available option, carnivore.
I agree that the super high ketone readings are not the be all and end all of epilepsy treatment. On keto, my seizure disorder improved somewhat but on carnivore, it went away entirely. I think I wasn't getting enough protein on keto plus keto can lack in multiple micronutrients. On carnivore, there is the benefit of the MAD in that you don't have to count and measure everything. I am in ketosis at a lower level but with much better results. It's not ALL about the ketones. It's about the nutrient density as well as getting rid of the pro-inflammatory plant foods.
I started ketovore Jan 23 after 3 months on a low carb that did not stop my 2 monthly seizures which happen around the same time monthly. I stopped all fruit & veg at the end of Jan 23 & eat some cheese, cream, A2 milk, avocado & eggs along with all meats & seafood after listening to various Drs like Dr Palmer, Dr Berry, Dr Chaffee & more. I have also listened to Dr Westman & various other Drs who recommend some vegetables & a small amount of fruit, which sometimes gets very confusing and has you wondering if you are eating the right food. These diets have not stopped the 2 seizures which happen around the end of each month, around when my hormones changed as I am 62yrs. I am presently trying MCT 8 & Coconut oil after listening to Dr Mary Newport and trying to test and monitor the quantity. I have just started taking 4 tbl spns of MCT 8 a day and may be 1 - 2 tble spn of Coconut oil which Dr Newport had her husband on for Alzheimer's.
Hi Robin I tried to contact you a few months ago but received no reply, not sure if you received it or not.
@@LifeIsWonderful675 No, I didn't receive anything. Can I help you with something?
@@robinbeers6689 I think it was about how long it has been since you stopped fruit & veg & became Carnivore? It was hard for me to listen to Drs like Andrew Chaffee or Dr Westman who both know what they are doing and know which way to go. I stopped fruit & veg end of Jan 23 and a few months later because the 2 monthly seizures were still happening, I thought I would try a few vegetables like Broccoli & sweet potato again. I only lasted about 5 days as I think the inflammation in my knee was returning which has disappeared on ketovore along with the psoriasis on my scalp.
I am not having fruit or vege but am still having my 2 monthly seizures. I have just started taking MCT oil, C8 mainly 4 times a day and will see what happens at the end of this month. I came across Dr Mary Newport which I found interesting, she gave me the name of a dietician she works with at The Charlie Foundation but she couldn't fit me in. She has recommended another dietician as I rally need some help.
I had a consultation with Dr Bart Kay but I didn't get enough time, he was always too busy to finish the consult. He recommended stopping fruit & veg though. I am also been thinking about Dr Chaffee although he is strict Carnivore, so that has had me doing my research first.
@@LifeIsWonderful675 I went from keto to carnivore ten years ago.
There is still considerable antipathy to this form of treatment for resistant epilepsy in the United Kingdom.
A local neurologist refuses to recommend it under any circumstances.
And if they can do it in India, why not the UK…!!
I am trying it myself in Australia, stopped all meds in 2012 because of s/effects. I had a bad fall in June 2022 & the Neurologists wanted to put me back on meds but I refused. I have been researching the Keto for over 12 months after stopping alcohol, sugar & carbs from June 22. I only have 2 seizures a month & so far have not been able to stop them. I am presently trying MCT C8.
@@LifeIsWonderful675 Well done. I wish you all success…
It takes a while to get into the ‘swing of things’, and measuring fasting Glucose and Ketones every morning is a ‘must’. But it’s not difficult.
@@grahamedwards6824 How long have you been on Keto? Mine is ketovore, I stopped fruit & veg end of Jan this year. Do you take MCT oil? I lived & loved the UK through the 80's, I had a Rubber Clothing /Gallery in West Kensington.
@@LifeIsWonderful675 About three years now. I’m a retired GP, and my wife has Altzheimer’s.
We were both pre-diabetic.
We have both managed to reduce our fat stores, and the object is to try to achieve fasting ketone levels of 1.5mmol/L, which is described as a therapeutic level.
I’m not sure what you should be aiming for, but probably the same, with low glucose levels as well.
Once people are ‘fat adapted’, they can cope with low glucose levels that would be thought of as too low by most health care professionals.
For trying to reduce many forms of cancer, a Glucose/Ketone index of 1 is extremely likely to disrupt the metabolism of the cancer cells.
Similarly I think that if you are to be able to reduce your seizures, you need to be fairly ‘strict’ about it, and being guided by a doctor or nurse who is knowledgeable in this field is encouraged, because it is potentially dangerous….
Dr Annette Bosworth on UA-cam has been extremely helpful for me.
Really great discussion and cool to see MAD doing so well in the pediatric population where they traditionally were thought to need a stricter version of KD. It also seems to me that MAD solves several problems associated with traditional keto diets (measuring food not as strictly required, higher protein for development, and if eating animal protein you are substantially increasing your sources of carnitine which can be a problem in higher fat diets.) seems like a win win win. I have personally found success with something like a MAD + Mct if higher ketones are needed. - Thanks again for the discussion!
Thank you for your comments. I like your mention of using MCT if you want to drive your ketones higher. I think having easily available and accurate ketone monitors really helps with the flexibility of MAD and still tailoring it for clinical benefit.
How much MCT oil do you use and what type? I have started on MCT 8 and only heard after listening to this Drs talk about using may be 4 tbl spns a day which I have just started. I recently came across Dr Mary Newport who was using Coconut oil on her husband to help Alzheimer's. I am also doing some tests daily to check the Ketone levels, I did not know what they should be either until a few days ago, again after listening to Metabolic Mind which has been so helpful. Thank you to the family & Dr who have put Metabolic Minds together.
I have been using the urine tests to check Ketones but will have to look for another monitor that is more accurate. I don't really want the blood monitor but may have no choice. It all takes time trying to work out how much MCT 8 & how much Coconut oil to take daily.
Hej 33
I personally test with the acetrack breath acetone device, and then spot check a few times here and there with the blood tests (biosense is another highly regarded breath acetone monitor). Breath is great because all you do is blow into it for 10 seconds or so, super easy. As far as mct I use Costco's mct which is a c8 c10 blend but mostly c8. In terms of how much, I usually use it around higher carb meals or take 1 tablespoon at a time to make sure my breath ketones are in the range I like.@@LifeIsWonderful675
Thank you for all the wonderful information!
Thank you 🙏🏻
great info
I'm really missing the carnivore diet.
It is well known that meat contains several "neuroprotective" substances like some B-Vitamins, DHA, Taurine, Carnosine, etc. etc.
Also, I would like to really know how much seed oils and refined carbohydrates, especially fructose/sucrose each type of a KD included in the study contains.
That might be a much bigger factor than just some macros-ratio...
@@REL602 I'm talking about all these studies, not what I eat personally...
I would love to see some studies done specifically on keto for adult onset seizures. And also carnivore specifically for seizures.
Like and share
18:57 great insight! more ketones for most is probably unnecessary.....I wonder if there are adverse effects (aside from ketoacidosis) when ketones are "high" over extended periods
4:1 , 3:1 sound very difficult
❤❤
Do you have a doctor you’d recommend for keto for mental illness who’s taking patients and who does appointments over the phone?
You can try the clinician directory on Dr. Georgia Ede's website www.diagnosisdiet.com/directory
@@metabolicmind thank you
Curious to hear your thoughts on LGIT, as it's much less restrictive and my understanding is that beta-oxidation (which doesn't require ketosis) drives most of the adaptation to fat-based metabolism anyways.
Thanks for your comment. I think it depends on your goals and your response to therapy. As this paper showed, LGIT worked well for seizure reduction, although maybe not as well as a "stricter" keto diet. Could we see that same thing in psychiatry? I would assume so, but we need more data to demonstrate that. The keys are finding a diet that is sustainable and gives each individual the results they are looking for. Beta-oxidation is important, but we wonder if ketone levels are also important. Time will tell, and in the meantime, that's why we recommend everyone work with an experienced clinician to help individualize this aspect of treatment. Thanks!
Please elaborate. What is LGIT diet
@@michellecronje6476 low glycemic index treatment, u can find info ab it if u search that up. it's a non-ketogenic low-carb diet that focuses on lower glycemic index foods
@@metabolicmind It is hard to know who to use as they all have different ideas.
Thanks Dr. Sher for all this research and presenting it so well.
I have a question, maybe hard to answer: if one is on a keto or low-carb diet, might an occasional binge shoot the person's glucose responses up to a much higher spike, being not used to a sudden proportionately big sugar load?
With a greater chance of a seizure than those not on a keto diet, whose system is used to assimilating a moderate level of sugar
For a special birthday celebration, etc, it is hard to ban particularly a child from not joining in.
Would on the other hand a consistently low carb diet/keto make it easier to assimilate a sugar spike once in a blue moon,
because one hasn't been hammering one's system daily (i.e. consistently being close to overload) ?
Adding to my above comments,
it may be that a suddenly higher carb meal when on low carb makes sugar spikes much higher,
this is important for me because I think my son's epileptic seizures are highly carb-affected,
and I may be exposing him to greater risk by his being on low carb all times except a night out with friends.
Somewhat confirmed, looking at Dr. David Unwin's site :
"...Because your body is fat adapted and no longer using sugar as its main fuel,
you may have an exaggerated blood sugar response to the glucose drink."
I really need to know if I am exposing my son to more epileptic seizures than he'd otherwise have!
@@MildAutismPete People that have been on a ketogenic state for a long time may have a very small amount of insulin available in their pancreas to deal with high loads of sugar, so your son has to be careful not to binge on carbs. Something you can do is to give slightly higher amounts of carbs once a week to encourage the production of small amounts of insulin. But I would suggest no more than 100g of carbs, and start with 50g so that the body is not shocked. Another option for you is to have a vial of slow acting insulin available to use in days that you know your kid is going to have a higher consumption of carbs.
Higher dosage of b vitamins helps to reduce and regulate the insulin spikes. Carbs reduce and can cause b vitamin deficiency and malnourishment overall. A b complex vitamin with magnesium (not oxide) taken with vitamin c (camu camu or acerola- ascorbic acid is not vitamin c) and berberine all help with insulin regulation. Look up EOnutrition channel for more help on this.
@@nataliajimenez1870
Has it been used/tried to treat Autism?
There isn't a lot in the literature about it, but here is a paper that may be of interest. www.ncbi.nlm.nih.gov/pmc/articles/PMC8146910/ People and clinicians are gaining experience with it, and hopefully, more studies will follow.
Where is the carnivore diet?
For me, carnivore was what cured my decades long seizure disorder. I did a very strict keto for five years before going carnivore and it did help some but carnivore is so much better. While keto made my seizures less frequent, carnivore has made them go away completely.
I would really like to see more attention paid to this option.
@@robinbeers6689 To my understanding, keto diet is what human ate for millions of years after several hundreds hours of keto videos and like maybe a hundred of different doctors and dietitians making videos. The conclusion I have is actually human is carnivore, with tiny level of adaptation of plant foods seasonally, and most of the time no plants. So congratulations, I guess you got to the optimal diet for yourself and for human as a species.
@@LittleRadicalThinker Yep. I'm not super strict. The only people who need to cut out absolutely all plant matter are those unfortunate people who suffer from major auto-immune disorders. I use spices and drink tea and have an avocado or some berries now and then. Otherwise all animal foods. Works for me.
I am presently ketovore but haven't quite got it right as yet. I have been researching since June 2022 and tried a low card diet for 3 months at the end of 22 which did not stop my 2 monthly seizures. I went ketovore the end of Jan 23 & stopped all fruit & veg. It has helped the arthritis in one of my fingers & stopped the psoriasis on my scalp, although I have had a hard time with hair loss the last 6 months, could be a lot to do with stress & hormones. I have just started on MCT C8 & will see what happens at the end of this month.