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your best. Hey everybody,

2:16

Chris Kresser here. Welcome to another episode of

2:19

Revolution Health Radio. I've

2:21

talked a lot over the years about the benefits

2:23

of nutritional ketosis and ketogenic

2:26

diets, a lot of information about how

2:29

to get into ketosis through diet, all

2:31

of the different considerations. And

2:33

we've talked a little bit about exogenous

2:35

ketones, like ketone supplements that you might

2:37

take to help induce ketosis or

2:40

raise your level of blood ketones. But there've

2:42

been a lot of problems with ketone

2:45

salts and ketone esters, which are the main

2:47

two types of ketone

2:49

supplements over time. Ketone

2:52

salts often just don't really move the

2:54

needle very much, they don't raise blood ketone levels,

2:57

and ketone esters have the opposite problem, they can raise them too fast

3:00

and lead to a big spike, and that can cause nausea,

3:03

discomfort, and they taste disgusting.

3:05

I think anyone who's taken ketone esters

3:08

knows what I'm talking about. So

3:10

I'm really excited to welcome Dr. Lat

3:13

Mansour as my guest today. He

3:15

is a global expert in

3:18

ketosis, and particularly exogenous

3:20

ketones. He holds a PhD in physiology,

3:22

anatomy, and genetics from the University of Oxford,

3:25

where his research focused on the metabolism of

3:27

type two diabetic heart and hypoxia. And

3:30

we're gonna talk a lot about ketone

3:33

diols, which are a relatively new form

3:35

of exogenous ketones that are

3:38

much easier to take, have

3:41

a much more optimal form of ketone

3:44

supplementation, because they lead to more

3:46

stable levels of blood ketones, they don't taste

3:49

disgusting, they're more affordable. And

3:52

I'm using these myself, I've recommended

3:54

them to patients and the clinicians

3:56

I train with really good results.

3:59

And so we're gonna do a... dive into exogenous

4:01

ketones, who might want to use them, how

4:03

to use them effectively, different

4:06

considerations, use

4:08

cases, and just how

4:10

you can get the benefits of this

4:13

new form of ketones. So

4:16

I hope you enjoy the show. Let's dive in.

4:19

Dr. Latmans or welcome to the show. It's

4:21

a pleasure to have you on. Thank you

4:23

for having me. So I've had

4:25

over many years, lots of episodes on nutritional

4:31

ketosis, the benefits of it, but

4:33

I always like to revisit this topic because I think

4:35

there's so much new, interesting research coming

4:38

out

4:38

over the last few years. And now, especially

4:41

the

4:42

general public is so much more aware of

4:45

ketones and ketosis and what some

4:48

of the applications might be, both

4:50

for people who are trying to improve their

4:53

performance and recovery as athletes or

4:55

just trying to be able to think more

4:57

clearly throughout the day and stay focused.

5:00

And of course, for the

5:03

application of ketosis in

5:05

a variety of medical conditions

5:08

like diabetes, neurodegenerative

5:10

conditions, traumatic brain injury, et

5:13

cetera. So why don't you

5:15

tell us a little bit about your background,

5:17

how you got interested in ketosis,

5:20

and then we can dive in and just do

5:22

kind of like a brief overview, some basic

5:24

terms for people who are less familiar, and then we'll

5:27

do a deeper dive into the science of

5:29

ketones. Sure. Sounds

5:32

great.

5:32

So I am

5:35

born and bred in Malaysia, grew up

5:37

in Malaysia, and then I left

5:39

the country for the first time and did my

5:43

undergraduate abroad in the UK in

5:45

biotechnology and University

5:47

of Nottingham. And then I moved

5:50

on and did my master's also in biotechnology.

5:52

And this time, it was my first time

5:54

in the US. I did

5:56

my master's in Columbia University

5:58

in New York. And then I thought,

6:01

you know, I'm done with research and science,

6:04

I want to start earning money. So I

6:06

started, you know, got to look

6:08

for jobs and finally landed a job.

6:11

It was a tough time. It was 2010. It

6:13

was a recession time. And, you know, as

6:15

an international student at that point,

6:18

it was very, very tough, because you need

6:20

it like green card and sponsorship and all that stuff. But

6:22

ultimately, I did land a

6:25

clinical trial coordinator job

6:27

with a pharmaceutical company in New Jersey

6:29

called

6:29

the Medicines Company.

6:31

Worked for them for half a year. And then they

6:34

promoted me to full time and

6:36

flew me to Munich,

6:37

Germany and worked in their German

6:40

office for a year before

6:42

I got inspired again by the people within

6:44

the company to apply for my PhD.

6:47

And this time around, I decided

6:50

to apply for a PhD in the UK

6:52

instead of the US because in the US, it takes

6:54

about five, six years. And in

6:56

the UK, it takes three years

6:58

because I already had a master's. So that makes a difference,

7:01

because usually people may

7:03

just move straight in from undergraduate

7:06

straight to PhD in the US that comes

7:08

with all the fundings and then first two years,

7:10

they'll make you take some master's courses

7:13

and stuff.

7:14

Yeah, so I started my PhD

7:17

research was in

7:19

cardiovascular disease and diabetes. I looked

7:22

at metabolism of the

7:24

type two diabetic heart in hypoxia,

7:27

which is low oxygen environment

7:29

as a subset of heart

7:31

attack or ischemia, where

7:33

you have lack of blood going into the heart and

7:36

hypoxia is one of the

7:38

subset of that condition.

7:42

So all in all, I have

7:44

always been really interested in metabolism,

7:47

physiology, just because my

7:50

family, my dad's side has

7:52

high prevalence of heart attack.

7:55

And my dad passed away from stroke.

7:57

He had a heart attack a few years prior.

8:00

My mom's side has really high prevalence of

8:02

obesity and diabetes. So

8:05

together that, you know, you may,

8:07

you may tell me that that's not the best genetic

8:10

combination. So I think that was what

8:12

got me into learning more about

8:15

these diseases and learning more about human

8:17

physiology in general and human metabolism

8:19

in general.

8:20

Because the only then I realized

8:23

there are so many things that I could potentially

8:25

do in my daily

8:27

life, in my daily life to

8:29

improve my health and improve my lifestyle.

8:32

Right. And I imagine in that research at some point,

8:35

because you were focused on metabolic metabolism,

8:38

you encountered

8:41

the ketosis and

8:44

nutritional ketosis and became

8:46

aware of

8:47

how that was being used in these different contexts.

8:50

Exactly. Exactly. And in fact,

8:53

you know, the irony was the first time I heard

8:55

the

8:56

term ketones, even it

8:58

was known as just

9:00

a side product, a byproduct of metabolism,

9:03

a byproduct of respiration, where

9:06

we mainly

9:07

use glucose and fats

9:09

for energy generation or ATP generation.

9:12

Ketone just happens

9:15

to be a side product. So that

9:17

was the first time I heard about

9:19

ketones. And then not until later

9:21

that I looked more into,

9:24

you know, diabetes and chronic diseases

9:26

and metabolic inflexibility that

9:30

ketogenic diet have been used to

9:32

treat epilepsy

9:34

for more than 100 years now.

9:37

And then, you know, companies popped

9:39

up like Virta Health that use ketogenic

9:41

diet to treat diabetes. And

9:44

then, you know, I started looking into

9:47

ketones and then I got

9:49

hired by HVMN,

9:52

which is the company I'm working for now, as

9:55

the research lead, they

9:57

had a $6 million contract. with

10:00

the Department of Defense of the US looking

10:03

at the effect of exogenous

10:06

ketones on cognitive and physical

10:08

performance in hypoxia. So

10:10

that's where my

10:12

self-expertise and my prior

10:14

knowledge and experience come

10:17

in handy. And

10:19

basically that allowed me to

10:22

look really deep into the

10:25

area of ketosis of ketone

10:27

metabolism of the difference between

10:29

endogenous ketones like what they

10:32

use in ketogenic diet, you know, to

10:34

treat all these different diseases versus

10:36

exogenous ketones which is a supplement

10:39

that you can directly consume to elevate

10:41

your blood ketone levels in order to boost

10:43

performance. And that was also a realisation

10:47

of, you know, these two different

10:49

populations. One is the disease population

10:52

and the other part is the high

10:54

performance population. Essentially they

10:56

are both on the same spectrum. They

10:59

are both on the human

11:01

metabolism spectrum. One just do it

11:03

much better than the others and

11:05

the other group has some form of dysfunction

11:08

whether it's being caused by

11:11

genetic

11:12

factors or environmental

11:15

factors or lifestyle

11:17

factors.

11:19

Yeah and that's

11:21

a great setup and I think it's my

11:23

take on where things are at now just

11:26

as a clinician who's used

11:28

ketogenic diets and also

11:30

exogenous ketones with my patients

11:32

for many years for many different reasons is

11:35

I like that concept of a spectrum. You know there

11:38

are people for example

11:40

kids with recalcitrant and

11:42

drug resistant epilepsy who

11:45

have very very severe some

11:48

life altering, you know, condition

11:50

that

11:51

a very strict ketogenic

11:53

diet that puts them in deep ketosis

11:56

can be a game changer for

11:59

them, you know, can

11:59

can work when nothing else has worked and

12:02

really change their quality of life. But

12:05

they have to be very strict, and

12:07

they often have to be in pretty deep ketosis

12:09

to get that benefit. Whereas on

12:11

the other end of the spectrum, you have, I like

12:14

to say, a weekend warrior athlete

12:17

who's working most of the week, then

12:19

goes out and does a half marathon

12:21

or a 5K or something on the

12:23

weekend. Fundamentally, they're healthy, but they're

12:25

just looking for an additional

12:28

edge in their performance

12:30

and a way of enjoying their

12:33

weekend activities. And then you have maybe

12:35

an executive, entrepreneur,

12:38

someone who relies on cognitive,

12:42

like really sharp cognitive performance

12:44

who's just looking for that additional edge and

12:46

everything in between. And I think now there's

12:49

a greater understanding of how ketones can benefit

12:52

all of those different use cases

12:54

or populations, rather than just people

12:56

with metabolic disease or

12:59

cognitive or neurodegenerative conditions.

13:02

Yeah. So

13:04

let's just like back up a little bit here

13:07

because we have probably some people

13:09

who are less familiar with what

13:11

a ketone even is in the first place.

13:14

And then we can talk a little bit

13:16

about nutritional ketosis

13:19

and well, actually let's just start with

13:21

ketones. And then I've heard

13:24

you say why ketones might

13:26

be looked at as the fourth macronutrients. So

13:29

we have carbohydrates, protein, and fat traditionally

13:32

considered the three macros. And

13:34

I know you've said that ketones may

13:36

be considered the fourth. So let's talk

13:39

about just the basics of ketone

13:41

science and we'll go from there.

13:42

Sure. And I think

13:45

a lot of people don't realize how we are

13:47

evolutionarily able, like

13:50

designed to produce

13:52

ketones as well as metabolize ketones.

13:55

So our own bodies,

13:57

we produce ketones from fats. We break.

13:59

down fat and produce ketones whenever

14:02

we are in a mode of starvation

14:05

or we are in a mode where we

14:07

have little to no access

14:09

to our carbohydrate sources,

14:12

i.e. either blood glucose or

14:14

our glycogen stores.

14:16

And when that happens,

14:19

our brain and our heart

14:21

organs and systems that need to

14:24

keep going

14:26

would run out of source of energy. Because

14:29

most of, for example, our brain,

14:31

it uses primarily sugar

14:34

most of the time. And what happens

14:36

then if we run out of sugar, either

14:39

we're going through fasting

14:41

or we're going through a ketogenic diet

14:43

where we literally just restrict

14:46

the access to carbohydrates.

14:49

That's when our body knows

14:52

that and it needs to break down fat

14:55

to produce ketones to then deliver to the brain.

14:57

But then one might also ask why

14:59

can't the brain directly

15:01

metabolize fats like the rest of the body,

15:04

like muscle cells or

15:07

in the liver where it can use fats

15:10

and other substrates to build glucose

15:13

via gluconeogenesis.

15:15

The answer lies within the

15:18

blood-brain barrier, which is a thin

15:20

layer of epithelial cells that

15:23

stops bigger molecules to enter

15:25

the brain via

15:26

blood and

15:29

glucose

15:29

can answer that because it's a relatively

15:32

smaller molecule compared to a fatty acid.

15:35

Because fatty acid has a long

15:37

carbon chain that

15:40

inhibits it from going through the

15:42

blood-brain barrier. So whenever

15:45

we are in the state of low

15:47

carb, low food

15:50

environment or condition,

15:52

the brain needs to access some form

15:55

of substrates in one way or another.

15:57

And this is where ketones come in.

15:59

And the three main ketone bodies that

16:02

we produce in our bodies are

16:05

acetyl acetate, acetone,

16:08

and beta hydroxybutyrate. And

16:10

the last one, beta hydroxybutyrate, or BHB

16:12

for short,

16:14

is the main ketone body that

16:16

is being used for metabolism and also

16:18

the main ketone body that is being transported

16:21

in

16:22

our blood. And that's when,

16:24

you know, whenever people say, oh, I measured

16:26

my blood ketone levels via

16:28

a finger prick, like either keto mojo

16:31

or Abbott precision extra, or

16:33

sort of a keto meter that you can get

16:35

from Amazon,

16:36

they are essentially measuring the

16:38

blood BHB. So

16:40

that's where

16:42

the idea of, okay, ketones

16:45

being the brain preferred fuel,

16:47

because then with the existence

16:50

of exogenous ketones, meaning

16:52

that ketones, you didn't produce yourself in your body,

16:55

but rather you can

16:57

consume directly to increase your

16:59

blood BHB levels.

17:01

It allowed us to really examine

17:04

these organs.

17:06

When there is presence of

17:09

glucose, would they still take

17:11

up ketones? And the answer is most of

17:13

these organs, like the heart for sure, they

17:16

upregulate the uptake of ketones

17:18

independent of the other

17:20

substrates, meaning that the other substrates

17:22

will still carry on to be

17:25

taken up. But whenever

17:27

ketones are available, it will always take

17:29

up ketones as well.

17:31

And there is a pay them up. Sorry for interrupting.

17:33

Does it take them up preferentially or

17:36

does it take them up at similar rates to

17:38

other substrates?

17:40

It is similar rates and

17:42

it's proportional to the availability

17:45

of ketones. And what they have seen

17:47

is that other substrates,

17:49

if you increase the blood

17:52

concentration of the substrates, they

17:55

ultimately reach a plateau

17:56

because of the saturation of transporters.

17:59

So glucose, you'll have glutes, which

18:02

are glucose transporters, and fatty

18:05

acids. You have fatty acid transporters. At

18:07

some point, when you increase the

18:09

substrate concentration in the blood

18:12

to a certain extent, these

18:14

transporters get saturated and they reach a

18:16

plateau in the uptake. But so

18:19

far, I don't know

18:21

whether it's because the ketone that

18:23

they're providing in these studies are

18:25

not

18:26

concentrated enough, are not high enough to

18:29

reach the plateau, but they have seen a

18:32

really directly proportional

18:35

uptake relative to

18:37

the availability of the ketones, meaning that

18:39

they still haven't reached

18:41

that saturation point of plateau yet.

18:43

Which

18:46

is quite interesting. Okay.

18:48

So let's talk a little bit more

18:50

about

18:51

methods of inducing

18:54

ketosis, generating ketones. You've met the

18:56

two primary being endogenous, like we

18:58

produce them ourselves or we get them from

19:01

a supplement of some kind.

19:04

Yeah.

19:05

So one, let's

19:07

talk about, you know, produce our cells. I'm, and

19:09

I talked about this earlier a little bit on

19:12

intermittent fasting and ketogenic diet. So

19:15

the main condition, the main, excuse

19:19

me, the main condition that you need to be

19:21

in is to have low carb

19:24

storage. So you can achieve that

19:26

via just not eating,

19:30

IE fasting, or via

19:32

a diet that severely restricts your

19:34

carbohydrate intake, which is like a ketogenic

19:36

diet.

19:37

So then when that happens over

19:40

time, like one day, two days, three

19:42

days, especially when you go on a longer

19:45

fast, you will see a huge

19:47

increase in your blood ketone levels,

19:50

like two to three days in. If you

19:52

are fasting for that long for

19:54

ketogenic diet, because you still have

19:57

some form of

19:58

intake and some

19:59

of calories. It depends, you

20:02

know, from person to person, obviously, but you

20:05

may see the increase

20:08

in your blood ketone levels not as starkly,

20:10

not as drastic as you would

20:13

if you fast for a long time. So those

20:16

are endogenous ketones, internal ketones

20:18

that you make in your liver.

20:20

Exogenous ketones, however,

20:22

are relatively new, I would

20:24

say in the past 10 years or so. I

20:27

think the first few types of exogenous

20:30

ketones that came out were ketone

20:32

salts and MCT. So MCT

20:34

is medium change triglycerides, mainly

20:37

found in a lot of different healthy

20:39

fats like avocado. I'm not

20:41

sure how to have it but coconut oil for

20:43

sure has MCT. And

20:47

ketone salts are essentially

20:49

BHB, so ketone bound

20:52

with

20:52

a salt molecule, either sodium, potassium

20:55

or magnesium.

20:57

Now, the problem with these

20:59

supplements, these two supplements,

21:02

yes, it does increase your blood BHB to

21:05

a certain extent. So if just for

21:07

reference, if you are not on ketogenic

21:09

diet, and you're not producing your own ketones, your ketone

21:11

levels, your blood ketones levels should

21:13

be around zero to 0.1 millimolar.

21:16

But if you are

21:18

nutritionally in nutritional

21:21

ketosis, the definition is

21:23

anything above 0.5 millimolar.

21:26

So what we have seen in studies is

21:28

that with ketone salts and MCT,

21:31

it increases your blood BHB

21:33

up to about 0.7 to

21:35

maximum a little bit below

21:38

one millimolar. And

21:40

that's when

21:42

people started using ketones,

21:45

exogenous ketones for performance.

21:48

And a lot of studies that use ketone

21:50

salt as performance, they didn't see any

21:52

increase in performance. And then later

21:55

on, they found out it's because of two things.

21:58

One is that it doesn't increase.

21:59

your blood BHB to a high level enough

22:02

because for performance, the

22:04

threshold of around 1.5 to millimolar. And

22:08

two,

22:09

while it is dose responsive,

22:13

like it's just dose dependent, you

22:15

can take more in order to increase

22:17

your blood BHB more, but because

22:20

it is bound to assault, you are significantly

22:23

increasing the amount of salt you're

22:25

consuming, which also increases the risk

22:27

of GI issues. So that's

22:30

where it

22:32

became an obstacle

22:34

for these two

22:36

supplements to be able to raise your blood ketone

22:38

levels up to a higher level. And then in 2017,

22:40

that was when the first ketone, Esther

22:44

entered the market and our company

22:47

HVMN brought that into

22:49

the market for the first time. And that

22:52

does very well in

22:55

increasing your blood BHB level. It can

22:57

spike your blood BHB level within half an hour

23:00

up to three to five millimolar. What

23:02

is ketone? Keto nester is

23:05

essentially BHB bound with

23:07

butanediol.

23:09

It's the bond that binds those two

23:11

molecules. It is called

23:13

a ester bond. That's why it's called

23:15

ketone ester. But nowadays, you get multiple.

23:18

That's just one form of ketone, Esther this ketone,

23:20

Mona, Esther. Nowadays, you can get

23:22

ketone, Dias, you can get

23:25

like to see six bound to butanediol.

23:28

You can get aceto acetate, Dias,

23:30

so different forms of ketone, Esther's these days.

23:32

But the main,

23:34

more prevalent ketone, Esther, that in

23:36

the market right now is ketone, Mona,

23:38

Esther. And then do you

23:41

have any questions, Chris? No, no, go ahead. I'll come.

23:43

I'll circle back. Yeah, sure. Several questions,

23:46

but I want to finish the exogenous

23:48

ketones and then we'll have plenty to chat about. Sounds

23:51

good. Sounds good. And then that

23:53

was 2017. And then a few years down

23:55

the road, and then a lot of cyclists

23:57

started taking ketone, Esther's, you know,

23:59

including those in Tour de France, and it

24:02

was out in the news and everything, and people

24:04

questioning, should this be allowed? Or

24:07

I guess essentially is macronutrient. It is

24:09

not a drug, it's not a stimulant, it doesn't

24:12

directly increase or decrease

24:14

your

24:16

sort of physiology. The

24:19

main process is like anabolic

24:21

steroids would, or performance

24:24

enhancing drugs would. It's just like

24:26

taking in glucose. It's just a source

24:28

of ATP generation. And

24:32

more studies then came out

24:34

that looked at ketone esters, some

24:36

of which shown no improvement

24:39

in performance. And of course there's

24:42

that discrepancy in the protocols

24:44

that they use. How do you use it? Do

24:46

you use it fed? Do you use it fasted? Do

24:48

you use it half an hour before? Do you use it two

24:50

hours before? And then do

24:52

you top it up? Do you wanna make sure, all

24:55

that stuff, all that difference in protocol,

24:57

obviously makes a difference. But then one paper came

25:00

out, McCarthy et al.

25:01

That showed that because you

25:04

are spiking your blood BHB to such a high

25:06

level, you are essentially

25:09

decreasing the pH of your blood,

25:11

which means it is increasing the acidity

25:13

of your blood. And as a result, you

25:16

are upregulating all your cardiorespiratory

25:19

stress biomarkers. You're increasing your heart

25:21

rate, you're increasing your breathing rate, because

25:23

your body is trying to expel as much carbon

25:26

dioxide as possible in order

25:28

to neutralize your blood pH levels.

25:31

And that, as a result,

25:34

these athletes, these cyclists, did

25:37

not get any performance gain. They

25:40

didn't do worse. It wasn't detrimental,

25:42

but they did have a much higher

25:45

rate of perceived exertion, meaning that

25:47

you're working out as hard or you're feeling that

25:49

subjectively you're working out as hard, but

25:52

you're not getting any benefits. So clearly,

25:54

you don't want that. And two

25:57

years ago, VHVMN,

26:00

decided to come out with ketone

26:02

IQ, which is our latest current

26:04

flagship product that is

26:07

essentially butane dial. Kairi-Ri-Puel

26:10

are 1,3-dupe butane dial. So

26:12

when I said earlier, ketone ester is a BHB

26:15

bound with butane dial. So this, we

26:17

basically took half of it and made it a

26:19

drink.

26:20

And the reason why we evolved

26:24

ketone ester product, our ketone ester product

26:26

into this three reasons.

26:29

One is ketone ester tastes really, really

26:31

bitter. And

26:32

it was really hard to flavor.

26:34

In fact, our $6 million contract with

26:37

the military, one of the tasks is

26:39

to improve the flavor. And we worked

26:41

with Monel Research Center, which is a

26:44

sensory research institution

26:49

who are experts in flavoring

26:52

and masking flavors and all of that.

26:54

They've done everything they could. They put artificial

26:57

sweeteners, natural sweeteners, dairy,

26:59

coat, this coat that

27:01

it didn't do anything. It was really bitter. I

27:04

can attest to that. Personally

27:08

and with patients, I had

27:10

people vomit, people have

27:12

just extreme reactions

27:15

to both the esters and the salts.

27:17

So I think this is a very

27:19

worthwhile innovation and necessary

27:22

to get it to make it accessible

27:24

to the mainstream because most people are just not

27:26

going to tolerate the taste of ketone esters.

27:29

And in fact, some of the studies,

27:32

it has negative results just because

27:36

half of the people were puking their lungs out. So

27:38

I mean, how can you expect these athletes to perform

27:41

well if they're puking their lungs out and

27:43

also having diarrhea from the

27:45

salts or whatsoever? So

27:48

taste at price, it was

27:50

about $40 per 25 grams of ketone ester

27:55

versus $10 per 25 grams of ketone.

27:59

So that's a

28:02

huge difference there. And thirdly,

28:05

obviously the physiological change, the

28:08

pharmacological aspect

28:10

of ketone ester versus ketone IQ as well. Ketone IQ,

28:12

it does raise your blood ketone levels significantly, but

28:16

because

28:17

butane dial goes through your liver and

28:19

gets converted into BHB and gets released slowly into

28:21

your blood, you don't

28:24

spike your blood BHB in the same manner as ketone

28:26

ester. And

28:28

therefore you are avoiding that acidification

28:30

of blood. And therefore

28:32

you're also avoiding all those increase

28:34

in cardiorespiratory stress biomarkers.

28:37

And because

28:39

it is being

28:41

modulated and monitored by

28:43

the liver, the

28:45

liver also gets signal from the rest of

28:47

your body

28:48

to really make sure that

28:50

you, if you are in a

28:53

state of abundance where you have

28:55

enough substrates, then the release

28:57

will be capped. And

28:59

if you don't, then the release will increase

29:02

that sort of way, which is a great sort

29:05

of gatekeeper, gatekeeping mechanism

29:07

that we realize with ketone

29:10

IQ. Now, I give

29:12

you one simple example when I talk

29:14

about this. So three

29:16

of us, Jeff, Michael and myself, Jeff,

29:19

Michael are the co-founders of the company. We were

29:21

on a podcast to introduce

29:24

ketone IQ when we first launched it. And

29:26

all three of us had three different doses

29:29

of ketone IQ.

29:29

One of us took one dose, which

29:32

is 10 grams. The other took two doses, 20

29:34

grams. And the third one took three

29:36

doses. All of us had

29:38

above one millimolar ketone,

29:42

blood ketone levels after, you know, in

29:44

the middle of a podcast. But I

29:46

believe it was Jeff. Jeff was fasting

29:48

that day and he had a much

29:51

higher blood ketone levels as a baseline.

29:54

So here probably start around 0.8.

29:56

And this video is up on

29:58

our YouTube as well.

29:59

Well, I'm sure you guys, you guys can find it

30:02

as an issue of a podcast. Sounds

30:04

entertaining. Yeah. We basically,

30:06

we basically, you know, took a shot on camera, recorded

30:09

our black, you don't have a slide life and

30:12

show, you know, show it to our camera. And

30:15

even at a higher level, when,

30:17

when, when Jeff started at a higher level, it

30:19

capped at 2.3, 2.4, I believe. And

30:23

that's the same as what we've seen in our

30:25

internal pharmacokinetic study. Where,

30:28

when we re increase the

30:31

dose up to one gram

30:33

per kilogram of body weight. So imagine if you're

30:35

an a 70 kilogram person,

30:37

you are having seven shots of

30:39

keto and IQ in one go. Do

30:42

not recommend that because that is not our

30:44

recommended dose, but we had to do that

30:46

for our pharmacokinetic study, right?

30:49

For safety and tolerability. We

30:51

saw a plateauing around 2.5 millimolar,

30:54

which is great because then we know that your

30:56

body can actually limit and

30:58

making sure that your, your like,

31:00

you don't level doesn't go way too high

31:03

because what I tell people about metabolism

31:05

is that it's not about piling

31:07

on something that is good just because something

31:10

is good doesn't mean more is better.

31:13

Metabolism is all about optimal range.

31:15

You have to have the optimal pH range.

31:18

You have to have your optimal temperature range.

31:20

Like you can't be too cold. You can't be too hot. Otherwise,

31:23

you know, your body is going through something wrong. And

31:26

it's the same here with ketone levels,

31:28

like blood ketone levels. You want to be within that

31:30

gold deluxe zone. So what

31:33

with ketone ester, because half of it

31:35

is BHB, it goes directly

31:37

into your blood and that is what spikes your blood pH

31:39

be up. And when it is

31:42

not regulated by

31:43

any organs like the liver, it

31:45

is very dose dependent. So if you have three 25

31:49

grams bottles of those ketone

31:51

ester, you will go up to like six, seven

31:53

millimolar. And we've seen that with our

31:56

military project because we

31:59

are using.

31:59

weight match dosing. So some

32:02

of these guys are huge, right? So they'll have like,

32:04

I don't know, 50, 60 grams of

32:07

ketone esters

32:08

and they'll feel ill afterwards.

32:11

They just generally feel unwell

32:14

when you have that high of a black ketone

32:16

levels. It's the same thing. And you can do that

32:18

with any other substrates. If you overdose

32:20

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32:23

right? If you have too much sugar, you will literally

32:25

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Yeah,

36:06

so I want to just review a

36:08

little bit here because I think as

36:10

we talk, I want to just focus mostly

36:12

on exogenous ketones because I've done

36:15

a lot of podcasts on ketogenic diets

36:17

and the benefits and how to optimize

36:19

and different ranges of

36:22

ketosis, et cetera. But we haven't

36:24

really done a deeper dive into

36:26

the different types of exogenous ketones,

36:29

how to use them, what the considerations are. So

36:31

just to summarize, with ketone

36:35

salts, you have a pretty low

36:37

peak. So they just don't

36:39

move the needle very much, in other words.

36:42

And so that was one of the main problems there.

36:45

With ketone esters is the opposite

36:47

problem. You had this huge spike. If you're

36:49

imagining a graph, you've got

36:51

like just a straight up

36:53

line on the left as it goes

36:56

up and then it just falls off really quickly.

36:59

So you can have side effects on

37:02

both parts of that journey, going

37:04

up and going down, right? Exactly.

37:08

And so if those are the sort of two bookends

37:10

of the curves on the chart, then you have

37:13

ketone dials, which kind of

37:15

strike a middle ground there, where you have a slower

37:18

rise in ketone levels. Then

37:20

you have a peak, like you just said,

37:22

of around 2.5. So

37:25

you don't skyrocket into

37:28

a range that could make you feel uncomfortable,

37:30

but you also have a more extended

37:33

persistent curve, meaning you're

37:36

staying in that optimal level

37:38

of ketones for longer because

37:40

you have a slower build and then a slower

37:42

decline in blood ketone levels.

37:45

Is that accurate? That is absolutely

37:47

accurate. And in the

37:49

internal study that we did as well,

37:52

we all had to fast overnight

37:54

and we took it and we had to prick ourselves every hour

37:57

for six hours.

37:58

So we got seven pricks

38:01

because you get, you know, T equals zero

38:03

as well as one prick. So we ran

38:05

our fingers almost, um, to prick ourselves.

38:08

And, um, we saw that,

38:11

you know, at, even at six hours, if you're

38:13

at rest,

38:14

you are getting your blood ketone levels

38:17

above one millimolar, um, still

38:19

after six hours, which is something that we have not

38:21

seen with ketone esters as the,

38:24

the, the drop is quite,

38:25

um, significant because you,

38:28

you've sort of spiked it up and then your body uses

38:30

it really quickly and then it goes back down. Yeah.

38:33

Yeah. That's really interesting. And, you

38:36

know, I'll share some, my, my personal experience with

38:38

ketone IQ toward the end. And, but I,

38:41

I can say that I've, I definitely can feel this difference

38:43

because I've tried all the different methods

38:45

of exogenous ketones. And I've also tried

38:48

and still cycle through ketogenic

38:50

diets. So I, I'm familiar with how endogenous

38:53

ketosis feels and, um, but

38:56

I want to, I want to talk a little bit more

38:58

about the various factors

39:00

that affect blood

39:02

levels of ketones with exogenous

39:05

ketones. You mentioned one of them, which is whether

39:08

you're in a fed or fasted state. So,

39:10

and you're going back to your experiment with the co-founders,

39:14

if you're in a fasted state and you take 10

39:17

grams of exogenous ketones,

39:19

you might end up, you're going to end up with a different

39:21

blood level than if you're in a, if you

39:23

take it right after a meal. So what

39:26

are some of, what are some of the other factors that

39:28

might impact that

39:31

curve? You know, how, how ketones

39:33

affect your blood level?

39:35

You know, this is a very interesting question

39:37

as well. So what we have received

39:40

in terms of people reporting

39:42

that when, or actually in

39:44

some studies as well, whenever they have

39:47

a fed

39:48

demographic, so, so they asked these participants

39:51

or athletes were fed before they

39:53

were given ketone esters, their

39:55

blood ketone levels seem to

39:57

be a little bit lower they're

40:00

fasted. What we have seen in

40:02

our ketone IQ study that we just

40:05

completed with the University of

40:07

North Georgia, it is under

40:09

review right now with the Forentius

40:11

of Physiology journal,

40:13

we did not see any difference

40:16

if you're fasted or if you're fed

40:18

when it comes to black ketone levels. I

40:20

don't know if that has something to do with,

40:23

you

40:24

know, butyl nal going through a liver versus

40:27

half of ketone ester is BHB

40:29

that goes directly into the blood.

40:31

I don't quite know what the mechanism is. I

40:33

don't think we do, you know, as the

40:36

scientific community,

40:38

but we have seen really

40:40

interesting results with UNG1 now that I'm

40:42

talking about it. It's the first anaerobic

40:45

exercise

40:47

trial that has

40:49

ever been done because whenever we talk

40:51

about ketones, exogenous ketones,

40:53

people think of endurance exercise.

40:56

People think of cyclists. People think of triathletes.

40:59

But for the first time, we decided to do a

41:02

true anaerobic test, which uses

41:05

the Wingate anaerobic test. We

41:08

asked these participants to go on five

41:10

bouts of sprints on a stationary

41:12

bike at 7.5% of body

41:14

weight as resistance. And

41:17

they have to go as hard as they can. And we

41:19

measure the peak power, the

41:22

average power, the velocity, as well

41:24

as their fatigue levels.

41:26

All of those parameters

41:29

improved. They improved their peak power.

41:31

They improved their average power. They improved their

41:33

velocity and they decreased

41:36

their fatigue as they go

41:38

towards, you know, the last bout of their

41:40

anaerobic test, which is super interesting

41:43

because we didn't really expect that

41:45

to be that significant because

41:47

we know that in anaerobic exercise,

41:50

glycolysis and glucose or

41:52

dependency on glucose is still very

41:54

much, you

41:55

know, dominant and

41:58

really the preferred pathway

42:01

of metabolism when it comes to

42:03

that sort of exercise. Yeah, that's really, really interesting

42:06

and kind of flies in the face of conventional

42:08

wisdom when it comes to anaerobic

42:10

training. What was their speculation

42:12

on what the mechanism was there?

42:15

Yeah, I think we sort

42:17

of concluded that the speculation,

42:20

it could be something to do with

42:22

signaling in the brain. Essentially,

42:26

some form of analgesic effect

42:29

similar to that of

42:30

caffeine, where you just feel

42:32

less pain when you're pushing

42:35

through because anaerobic exercise essentially is

42:37

the goal

42:38

is to go as hard as

42:40

you could, but as a result, it's almost

42:43

inevitable to have

42:45

high buildup of lactic acid and

42:47

the burn and that

42:50

muscle fatigue

42:52

while you are in a hypoxic state.

42:55

So we know the effect

42:57

of ketones in hypoxia, like

42:59

that has been shown again and again to be

43:02

very beneficial, but most of the time

43:04

it's not that acute of a setting,

43:06

it's more of a

43:08

hypoxic adaptation or

43:10

mitigation of cognitive decline

43:12

in hypoxia versus like

43:15

this anaerobic sort of setting. So I think

43:18

it's more to do with

43:21

the brain and

43:23

perception and being in the zone versus

43:26

purely energetics play here.

43:29

What

43:29

about exercise? If

43:31

someone has recently exercised,

43:34

will that affect the metabolism

43:36

of exogenous ketones? So like someone

43:39

who takes ketone IQ prior

43:41

to a workout versus someone who

43:44

takes it during a workout or after a workout.

43:46

Is there any significant difference there?

43:48

Um, I would say if you

43:50

are at rest, your black

43:53

ketone levels would obviously stay up longer

43:55

compared to when you work out as

43:57

to whether you take it before.

43:59

during or after. I think

44:02

if you take it before or during, you

44:04

will probably see your blood ketone levels

44:07

drop up a little bit quicker. Whereas

44:09

if you use it after, I personally,

44:11

I haven't seen any

44:14

sort of measurement

44:15

of blood ketone levels when people take it after

44:18

exercise. A lot of these studies, one

44:20

of the study that got really popular

44:23

by Haspel's group in Belgium, they

44:25

looked at recovery. They looked

44:27

at exogenous ketones and recovery when

44:30

cyclists were given proteins, carbs,

44:32

and ketones after exercise.

44:35

So 30 minutes after exercise and 30 minutes before

44:37

bed. Unfortunately, I don't think they

44:39

measured blood ketone levels after because they're

44:41

like, what's the point? But what they

44:43

did measure is

44:45

the

44:47

effect of the recovery or the

44:49

outcomes of the compounding effect. Because

44:52

three weeks after utilizing

44:54

that nutritional protocol, they

44:57

have seen an improvement of 15% increase

45:01

in power output

45:02

in the group with

45:04

carbs, proteins, and ketones.

45:07

Yeah, that's amazing. And I mean,

45:10

I've certainly,

45:12

it's probably the most significant

45:14

benefit I've noticed is in both

45:16

performance and recovery in long

45:19

mountain bike rides or when I'm backcountry

45:22

skiing or even lifting

45:24

weights, more anaerobic exercise

45:29

in addition to cognitive benefits. But I

45:31

want to explore a few different

45:34

use cases and get some ideas

45:36

from you on how

45:38

best practices for these different use cases,

45:40

both in terms of frequency

45:43

of dosing and

45:46

overall dosing. And,

45:48

you know, not asking you to give medical advice,

45:51

but more just sort of scenarios

45:54

here. So consider, since

45:58

we're on the topic of athletes and employees, improving

46:00

performance and recovery, take

46:02

somebody who's either a competitive athlete or someone

46:04

who's exercising fairly hard, whatever,

46:09

whether it be running or mountain biking, weightlifting,

46:11

et cetera, is there sort of an optimal

46:15

use that you would suggest or

46:18

that has emerged in studies or in the

46:20

work with the military, like pre-workout

46:23

and post-workout? How

46:25

do you use it during recovery days? That

46:28

sort of thing.

46:29

So from the study, so whatever

46:31

I, obviously, like you said, I'm

46:33

not giving medical advice, but I can certainly share

46:36

what all these studies are pointing

46:39

towards, right? So we have our

46:41

FAQ on hvmn.com as well, wherever

46:44

you, if you want to search, what's

46:46

the best use case for athletic

46:48

performance? What's the best use case for recovery?

46:51

It's also all there. So it's all based on all these

46:53

existing studies. So whenever, when

46:55

you talk about pre-workout and

46:58

using it for

46:59

performance, we recommend taking

47:02

half an hour before.

47:03

And then if your workout is longer than two hours,

47:05

top out every 90 minutes

47:07

into the workout, right? So

47:10

in that sense, in terms of dosing,

47:12

we generally recommend one

47:15

dose, you know, whenever you take it, which is 10

47:17

grams. But most of our athletes,

47:20

because all these studies are weight

47:22

matched and they use between 0.3 to 0.5 grams

47:24

per kilogram of

47:28

body weight, which comes up roughly around 20, 30 grams. So

47:30

about two to three doses every time

47:32

they take it. So our athletes,

47:35

if you're using for performance, you might want to

47:37

start with

47:38

having two shots of 20 grams

47:40

from the big, or 70 mils

47:42

from the big bottle. If you're taking the shots, then

47:45

it's like two shots, a half an hour

47:47

before you start exercise, and then 90 minutes

47:49

into the exercise, top up another two,

47:52

and then top up every 90 minutes thereafter.

47:55

In terms of

47:56

recovery, like I

47:58

said, the study...

47:59

that I mentioned earlier,

48:01

you can take it half an hour after together

48:03

with whatever post-workout recovery

48:06

drink that you're taking, your protein

48:08

shake and all that. Don't recommend mixing

48:10

into your protein drink. I don't know, some people might like

48:13

it. I don't. I like to take my shot and then wash

48:16

it down with my frozen shake.

48:17

Some people like to take it right before bed

48:20

as well. I've got

48:21

quite mixed message around

48:24

that. I personally like to take it right before

48:26

bed, but some people find that they

48:29

get too energetic or their

48:31

brain is still too much awake if

48:34

they take ketones before bed. I think that really

48:36

varies between people to people.

48:39

Yeah. That's true

48:42

in almost every case in my experience

48:45

with supplements in general,

48:48

ketones definitely. Even

48:50

endogenous ketosis, of course, there's

48:52

huge variation of how likely

48:56

people are to produce ketones in response

48:59

to the same. You could have two

49:01

people following an identical diet,

49:03

you'll see different ketone production in each of

49:06

them based on a whole bunch of different factors

49:08

that we don't need to go into. It

49:10

could even vary from day to day based on what's

49:13

going on, how all of those factors

49:15

are varying. I know

49:17

from my own experience with this product

49:21

and people who I've recommended it to in patients

49:24

and stuff,

49:25

you mentioned you like to just take the shot. Some people

49:27

like to sip on it throughout the day.

49:31

Given that even if you take the

49:33

shot, the curve is fairly spread

49:35

out. What would be the half-life? If you were

49:38

to take a 10 gram

49:41

shot, how long would you expect

49:43

that to your blood

49:45

ketone levels to stay elevated?

49:48

10 grams is quite low. Some people,

49:51

maybe if you're at rest, it'll probably stay

49:53

around like three, four hours. Some

49:55

people start to peak around at two

49:57

and then they start dropping at three, four hours.

49:59

But if you're taking two doses, then

50:02

it's probably gonna be a little bit higher. And

50:05

I think

50:06

one good thing, one thing that

50:08

you pointed out, you know, a good point

50:10

is that because the curve is quite

50:13

smooth and slow anyway,

50:15

it's very slow and steady, even at

50:18

a higher dose. So whenever we run

50:20

studies or I'm talking to researchers

50:23

in order, because, you know, if you drink a

50:26

lot at the same time, obviously,

50:28

you know, with any products, like it's

50:30

gonna have some side, some form of side effects. So

50:33

if

50:34

they are taking more than four

50:36

doses because of their weight,

50:39

body weight, and they have to match it, I

50:41

usually recommend them divide

50:44

that into two boluses. So take 20 grams,

50:48

half an hour before workout, 20 grams right

50:50

immediately before you work out and then

50:52

just hop up to two grams every 90 minutes.

50:56

Well if you're, if you're doing an extended workout.

50:59

Yeah, if you're doing extended workout. Yeah.

51:02

And then let's talk about someone who let's say,

51:04

you

51:05

know, they're not like working out really intensely,

51:07

they exercise, but maybe

51:10

they're looking more for a cognitive benefit

51:12

or just maintaining focus. What

51:15

would you suggest there in terms

51:17

of how to use it? Some people like to take

51:19

one shot just 10 grams in the morning before

51:22

they start work or you know, and in

51:25

some people do it instead of coffee, some people

51:27

do it stacking with coffee, there is

51:29

no right or wrong here. There

51:31

is no counter contraindication

51:34

when you stack it

51:35

with coffee. What I tell people is

51:37

that, you know, coffee or caffeine

51:40

is a stimulant. It

51:42

increase your blood pressure, your heart rate, and

51:45

it blocks your adenosine like

51:47

receptors that actually

51:49

make you not feel tired of fatigue, but it doesn't.

51:52

And it may even increase your energy

51:55

consumption, right? Your brain energy demand.

51:58

Ketones on the other hand. And it's

52:01

the

52:02

brain fuel is the fuel that

52:05

meets the demand. So in a way it's

52:07

quite synergistic, but at the same time, some

52:09

people like myself, I can't

52:11

drink too much coffee because I get like

52:13

jittery and anxious.

52:16

So instead I just use ketone

52:18

IQ and that works perfectly fine for

52:20

me because I still get the alertness.

52:23

I get the focus without the

52:25

jittery feeling. Yeah.

52:27

One of my, one of my favorite, I

52:30

do okay with coffee in the morning. If

52:33

I drink it past like 11, I'm, I don't

52:35

sleep, but I

52:37

will often use some ketones.

52:40

I'll take like a shot in

52:42

the early afternoon after lunch. Cause

52:45

that tends to be my, my, the

52:47

lowest energy point for me or

52:49

at least mental focus. And

52:51

I find that if I do that, it's easy for me

52:53

to just like jump back in and

52:56

keep and stay focused, which is amazing.

52:59

Cause the only other things

53:01

that seem to have, you know, that

53:04

impact were things that, you

53:06

know, like

53:08

that do have some level of caffeine. It might be,

53:10

it might've been less caffeine than coffee, but

53:12

still I'm just so sensitive to caffeine

53:15

that small amounts in the

53:17

afternoon would interfere with my sleep. So

53:19

it's been pretty amazing to have a different

53:21

way of achieving

53:24

a fairly similar effect. I mean, it's slightly

53:26

different, but in some ways better because

53:28

it doesn't come with those jitters and it's,

53:30

it's a more

53:31

relaxed focus, I guess is the way

53:34

I would describe it. Yeah. No,

53:36

that's exactly how we say it. Like it's relaxed,

53:38

it's supple, subtle. And a lot of people

53:40

got confused, right? Because we have been

53:43

so conditioned with coffee. It's

53:45

like whenever we talk about energy and alertness,

53:47

we think of coffee. So they're like, how can you

53:49

say use the word relaxed and

53:52

energy at the same time? They're

53:54

like, you know, they get really confused and that's

53:56

exactly how I describe it. You know, it's a subtle,

53:59

relaxed.

53:59

So you don't need to, you know, jump off the

54:02

wall kind of energy.

54:07

It doesn't come with the anxiety that coffee

54:10

can produce or any kind of caffeine. And

54:14

in terms of sleep quality as well, I think that's a great point

54:16

because a lot of people would want

54:18

to avoid coffee closer

54:20

to sort of bedtime or even past

54:24

afternoon and ketones don't have

54:26

the same effect as coffee. So

54:28

that's why people like to use ketone

54:31

as the pick me up sort of after lunch. Yeah.

54:35

Uh, is there anything, I think you, you already

54:37

addressed this, I believe, but I just

54:39

want to clarify, cause I know, you know, people will wonder about

54:41

this. Are there any, um,

54:44

either contraindications, so things

54:46

that would preclude somebody

54:49

from

54:50

taking

54:51

ketone dials and

54:54

are there anything, is there any dietary

54:56

things that should be avoided

54:58

concurrently, like, so, um,

55:01

anything that could counteract the effect

55:03

essentially or interfere with the absorption? So

55:06

I'll answer the lot, the, the, the

55:08

last question first. Um, no, there isn't

55:11

anything that's the beauty of it because

55:13

it's a direct

55:15

ketone that you consume. So, you

55:17

know, even with food with

55:20

ketone dial, unlike ketone ester,

55:22

we have seen there is no diminishing

55:25

effect, uh, on, on your black

55:27

ketone levels as far as. Let

55:30

me ask a follow-up question on that too. How

55:32

about like nutrients or supplements, like

55:34

any minerals, vitamins, anything

55:36

else that anyone should be aware of taking

55:39

it concurrently? Like if someone wanted to combine

55:41

it with electrolytes, for example, could they do that?

55:44

That's absolutely fine. I mean, it's,

55:47

it's much better. I would rather you take ketone

55:49

IQ and then combine it with electrolyte, then

55:51

just take ketone salt because a lot of people are like, Oh, well,

55:53

why don't I just take ketone salt because

55:56

it's ketones and electrolyte,

55:58

but then. they're bound

56:01

so you can't have

56:03

high enough ketone levels without

56:06

overdosing itself with the salt. So

56:09

that's a great suggestion. And I don't

56:12

know of any supplements

56:15

or any form of products or food

56:17

products that have

56:20

diminishing effect or detrimental effect or

56:23

contraindication effect to

56:25

ketone IQ because

56:27

ultimately it is not

56:30

a drug, it is not a phycological

56:32

invention. It's like sugar.

56:35

It's like fats, right? We

56:38

don't have, we can pretty much take sugar

56:40

and fats with anything. That's how

56:42

I would see it. It's just a substrate.

56:45

And the

56:47

first question was,

56:50

what are the precaution, are there people

56:53

who shouldn't be taking ketone IQ and all of that?

56:55

And I think the wonders of ketone

56:57

is that

56:58

because we are

57:00

evolved and designed

57:03

to create and

57:05

metabolize ketones and this, even

57:07

though it's in the form of butane dial,

57:10

your body will create

57:12

BHB from it and BHB

57:14

is BHB is BHB is the same molecule. And

57:16

that's what your body recognizes. And

57:18

that's what your body will use it as. So

57:21

there will be, it will be the same BHB that

57:23

you produce yourself as you would

57:25

consume. The only thing

57:28

that I want people to know is that

57:30

when you drink ketone IQ about an hour

57:32

after you will see a slight drop

57:34

in blood glucose. So if you are someone

57:37

with

57:38

a tendency to be in hypoglycemia,

57:41

you might want to be a little

57:43

bit careful and just making

57:45

sure, you know, you check your blood glucose levels, either

57:48

you have a continuous glucose monitor

57:50

or whatnot, just to make sure you don't

57:52

get into that hypoglycemic state where

57:55

you will get like chills and like not

57:57

feeling well. And if you do

57:59

feel that.

57:59

you know that it is because

58:02

of the hypoglycemia effect.

58:04

And then lastly, I know

58:07

this is a huge topic so we're only going to

58:09

be able to scratch the surface, but

58:12

how much research is there so far

58:15

on ketone dials in disease

58:18

states? Whether that's metabolic

58:20

disease like type 2 diabetes or traumatic brain

58:22

injury or anything like that?

58:24

That's a great question. So as far

58:26

as diabetes go, there is

58:29

already a study, even though we've only

58:31

been out for a year and a half,

58:33

there is already a published study using

58:36

ketone IQ to lower blood glucose published

58:38

by Dr. Jonathan Little from

58:40

University of British Columbia in Canada. And

58:44

this goes back to what I was talking about,

58:46

the glucose lowering effect. And

58:48

a lot of people, even though they see

58:51

their blood glucose level drop like 50 points

58:53

up to 50 points, they don't

58:55

feel hypoglycemia. They feel quite energetic

58:58

on the contrary because the ketone is

59:01

essentially being their main source of energy

59:03

for the brain. And for

59:06

TBI, we are actually in the middle

59:08

of applying for additional

59:10

grants with the military because the military

59:12

population has very high

59:15

risk of traumatic brain injury. So

59:18

we are actually compiling

59:20

a bunch of literature around

59:23

exogenous and endogenous ketones related

59:27

to brain injury in

59:29

both animals and human

59:32

work. So it's looking

59:34

very, very promising. In fact,

59:37

last year we published a review

59:40

paper, myself, Jeff, and

59:42

our scientific writer Naomi, we

59:45

published it in Frontiers in Physiology.

59:48

We looked at potential use of lactate

59:50

and ketones in treating

59:52

traumatic brain injury and as an extension,

59:55

neurodegenerative diseases because they

59:57

both share a lot of hormones.

59:59

marks of metabolic dysfunction as

1:00:02

far as glucose

1:00:04

metabolism goes as far as

1:00:07

deficit in energy goes because

1:00:09

in traumatic brain injury, you get a

1:00:12

deficit in energy and you get a hyper

1:00:14

metabolism of glucose in the beginning, you

1:00:17

know, 48 hours after you have an injury, you up

1:00:19

the brain upregulates glucose metabolism.

1:00:22

Some may say it's being upregulated

1:00:24

because we need the energy to deal with the

1:00:27

damage and some say

1:00:29

that the glucose is being

1:00:32

shoved into pentose phosphate pathway to

1:00:34

create NADPH which will then help

1:00:37

with the mitigation and recovery

1:00:39

of the injury.

1:00:41

But then afterwards they get hyper

1:00:43

metabolism. So they get a deficit in energy

1:00:46

and this is where ketone could potentially come in

1:00:48

and really sits

1:00:51

right in between that, the lack

1:00:53

of energy and glucose metabolism

1:00:55

to normal function. Yeah,

1:00:58

fascinating. That might be a future episode,

1:01:00

looking at more in depth about how to use

1:01:03

it in disease states. But yeah,

1:01:05

thank you, Lat, for joining me

1:01:08

and sharing all this. It's really

1:01:10

fascinating. I'm a big

1:01:13

advocate of nutritional interventions

1:01:15

that are safe and effective and

1:01:18

easy to implement. And so I'm

1:01:21

always on the lookout myself for things

1:01:23

like that. And not just any intervention, not

1:01:25

just nutritional things, things that have

1:01:28

a pleiotropic effect, right? That

1:01:30

can make, you know, put in

1:01:32

late, late person's terms, the rising tides

1:01:34

that lift all boats, things that

1:01:36

you can do almost regardless

1:01:38

of what the problem is, they

1:01:42

will help and they can help in multiple different

1:01:44

ways. And of course that's true of exercise. It's

1:01:46

true of a good diet. It's true of maximizing

1:01:48

your nutrient intake. And I

1:01:50

found it to be true of ketones

1:01:53

as well. And the challenge

1:01:56

has always been, as we've discussed,

1:01:58

that there, you know,

1:01:59

If you're

1:02:01

not following a strict ketogenic diet

1:02:03

because that's either you

1:02:05

don't want to, or it's contraindicated,

1:02:07

or you don't want to have that, you know,

1:02:10

you want more carbohydrates in your diet for

1:02:12

any number of reasons, there has not

1:02:14

been an easy way to benefit

1:02:16

from ketones because of the problems

1:02:19

with ketone salts, just not really raising

1:02:22

ketone levels enough or ketone esters,

1:02:24

which are arguably even worse because they

1:02:26

raise them too fast and all the side effects

1:02:28

associated with that. So ketone

1:02:30

dials have really been a game changer for

1:02:32

me and for my patients. I

1:02:35

use ketone IQ every day, sometimes

1:02:38

less, sometimes more, depending

1:02:41

on what I'm doing. And it's one of the

1:02:43

few things that has just become

1:02:45

a staple, you know, something

1:02:47

that I do every day

1:02:49

along with electrolytes. I mentioned electrolytes,

1:02:52

those are big for me too, living

1:02:55

in probably one of the driest places

1:02:58

in the US and at altitude,

1:03:01

both ketones and electrolytes

1:03:04

have been game changers for me and my daily

1:03:06

routine. So for all the listeners,

1:03:09

if you want to give

1:03:11

ketone IQ a try yourself,

1:03:14

you can go to HVMN, that's

1:03:18

Harry, Victor, Mary, Nancy, HVMN.com

1:03:23

slash Chris Kresser. And they're

1:03:26

very generously offering 20% off for

1:03:29

all of the Revolution Health Radio listeners.

1:03:32

And then there's two options

1:03:34

there. One is the shots. And so

1:03:37

these are 10 grams, just chug it back,

1:03:39

like Latt said he likes to do. And

1:03:42

there you go. And then the other is

1:03:45

the ketone IQ bottle.

1:03:48

And those are 10 servings

1:03:50

of 10 grams each. So it's

1:03:53

a hundred grams in the bottle. And

1:03:56

that's just a different way of getting

1:03:58

the benefit if you're going to be out. about or

1:04:00

you know you're doing a really hard,

1:04:03

long workout that day, that might be a better

1:04:05

option than carrying 10 different shot bottles

1:04:08

with you, for example. So

1:04:11

it just depends on what your

1:04:13

preferred use case is and I would

1:04:16

encourage people to experiment and see what

1:04:18

they like to do best because there's

1:04:21

no one size fits

1:04:22

all approach.