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Dr. John Limansky is a board certified physician in Internal Medicine. He has worked as a hospital medicine physician for a decade and saw first hand the destruction caused by a modern western diet and lifestyle. His desire to improved health and longevity for his patients and society led to him creating his own virtual practice based in San Francisco, CA.

Dr. Limansky incorporates biohacking techniques within a ketogenic lifestyle to improve health at a cellular level. He currently is the cohost of The KetoHacking MD podcast with veteran podcaster, Jimmy Moore.

You can find him on social media @johnlimanskymd or via his website www.johnlimanskymd.com

Transcript:

Hey, welcome everyone to another episode of Keto Chat. I am your host Carole Freeman, certified nutritionist, Clinical Hypnotherapist, blah, blah, blah letters and stuff like that. I am so excited today. I do that every time.im always excited. Have I ever had a guest where I’m like, “I’m kind of mediocre excited about this person.” Dr. John Limansky, I met him on Low Carb Cruise a couple weeks ago. We got to hang out and we got to eat dinner together pretty much every night. I’m so excited to have him on today. Well, let me just read his official bio so those of you that don’t know who he is you can know why I’m so excited.

Dr. John Limansky is a board certified physician in internal medicine. He has worked as a hospital medicine physician for a decade and saw first hand the destruction caused by modern western diet and lifestyle. His desire to improve health and longevity for his patients and society led him to creating his own virtual practice based in San Francisco, California. Dr. Limansky incorporates bio-hacking techniques within a ketogenic lifestyle to improve health at a cellular level. He currently is the cohost of the Keto Hacking MD podcast with veteran podcaster Jimmy Moore. You can find him all over social media at John Limansky MD. We’ll link it all below in the show notes too, and his website Dr.JohnLimanskyMD.com. Welcome. Welcome Dr. Limansky.

You’re calling me Dr. Limansky? Come on. What’s going on? We’re like family. You got to call me Dr. John, or hey you.

Hey yo, John. Yeah, no. I picked that up. I started paying attention to the whole yeah, no, yeah, yeah thing. That’s totally an inside joke that’s going over everybody’s head. Well, no it’s really interesting because on the cruise we got to eat dinner every night and hang out with you and Dr. Ken Berry. Then in our little friend group that was hanging out we’d always say, “Dr. Barry.” Then we would call you Limansky. We talked about why was that, that we didn’t call you Dr. John or John.

Yeah, I’m kind of pissed now.

It was just because John is such a common name that people would be like, “John who?” We all called you Limansky because that was like we know who we’re talking about then.

Yeah, there’s not that many Limanskys out there. It’s pretty unique.

Yeah. It’s like how bros call each other by their last name. You were Limansky to us.

Cool. I like it.

Yeah, so anyways, welcome.

Thank you.

Oh my gosh, I’m sure we’re going to have lots of great stuff to talk about. One of the topics I want to pick your brain on is fasting. You inspired one of the people hanging out in our group, Mike Berda, to do his first fast.

Go Mike.

Yeah, he’s doing really great with that. I want to talk about fasting. How do you use that therapeutically, what results and all that kid of stuff. Let’s just start with that. There’s a lot of topics [inaudible 00:03:15].

Okay, sure.

Well, nevermind. I’m just going to be all over the place here. First, we got to get your backstory. We got to start out how did you become you?

I just started fasting. End of story. Done.

You were born fasted and [crosstalk 00:03:31].

This is a very quick podcast. Done.

Are you one of those breatharians?

Yeah, no. Those people scare me. No. Yeah, a little bit of my story, I trained as a regular internal medicine physician. As most physicians I thought I knew what I was talking about. I tell a story where I was pretty athletic all my life. Weight for me was never an issue. I always thought I was healthy. As you get older you figure, being older, I wasn’t that old, but I was getting tired. I figured it’s probably because I’m a medical student and I got to study all the time. We had to do some lab work as part of an experiment. My lab work showed that I was actually pre-diabetic and starting to have insulin resistance, which freaked me out. At the time I thought I was eating really healthy. I was not vegetarian, but I would have a little fish, but no fat whatsoever. I was basically following the guidelines that we were teaching people about.

That really freaked me out because I was exercising a lot. Weight wasn’t an issue. I started really looking into how could this be? Is it a genetic thing? Is it something else that I’m doing that’s wrong? As I started learning more and more about nutrition, because it is true, in medical school we don’t learn about nutrition. We learn about biochemistry. I could recite for you all the pathways that go into the actual process of breaking down into glucose. I could tell you all that. In terms of the macronutrients and micronutrients we don’t really focus on that. I had to start doing it on my own and started learning. Initially, it started for me, I was worried about myself. Then as I started reading more about it I started reading some of the Weston Price information that was out there. You got to remember the internet was very different 12, 13, 14 years ago now where there wasn’t a ton of information like there is now. It was mostly going into the textbooks, going back into books that were available and learning as I went.

What I did realize is that as I start implementing some of the more ketogenic practices I repeated my labs. My labs were getting better. That was a very, very positive reinforcement for me where all of a sudden now things were looking better. Then it’s gradually since then. I’m one of those people that I always want to learn. I feel like in medicine, in life, anything you do in life if you remain stagnant you’re going backwards. You’re not actually learning anything. I’m sure you, like a lot of people in this community, we read, we learn, we watch podcasts, we watch videos. We are constantly learning to try to keep up with the amount of information that we’re learning about. It’s been a very, very long process, but I’ve gotten to a point where I feel like I know a lot about nutrition and about medicine in general. That’s the backstory.

Isn’t it a fun time to be involved in this? It’s pretty much everything we thought we knew is turning out to be a 180.

Yeah. You see more doctors talking about, historically, what we used to do as physicians. Now when you look back you’re like, “How could you conceptually think that, that was something that we should do?” Well, the same thing is still happening. We’re doing things that we think conceptually are good for people. Then we learn, no. This is probably wrong. The question is do you have it in you to actually look at the data and say, “That’s probably wrong. We should probably do what the data is telling us is right. Then you have stories where people are dramatically improving their lives based on what they’re doing from a nutrition standpoint. Not medications, not surgeries, but just nutrition and lifestyle modifications. I have thousands of people who send me their stories. It’s unbelievable the transformations that people are having. It’s liberating. People are coming off medications that they don’t need. It’s a very exciting time to be a part of all this.

Yeah, yeah. It’s still very fringe, right? You know it works because you’ve seen the transformations, you’ve heard the stories and we’re still taught to be telling people to do this crazy unhealthy thing.

Yeah, it is. It’s still fringe, but I will say that as in everything else that you see with social media and how you can magnify one thing and make it really resonate with everybody, right? It becomes viral. I think the benefit of social media … like you and I wouldn’t have met, is that we learn from each other. We learn from each other’s experiences, and then we can get the information out there. People like Dave Feldman, Ted Naimen, Albert Cummins these guys who are not in the medical profe … I guess Ted is, but the other guys who are not in the medical professions, 20 years ago we wouldn’t have listened to anything they had to say. We would be losing that tremendous amount of information that actually, no. I’m looking to these guys to say, “Tell me what you think about this, because you’re approaching it from a different perspective. You don’t have a vested interest and I want to learn from you.” If we can do that as a society we all benefit from it. That’s part of what I’m really trying to strive for.

Yeah, that’s so great. You got to know you’re a unique doctor that you have that kind of perspective.

Yeah.

Why is it that so many doctors just practice from the place of, “I learned what I learned and that’s all there is to know.” They just dust their hands off of learning anything new.

Yeah, that’s a good question. I think there’s a couple reasons. Unless you’ve been through it, it’s probably akin to going and being a Navy Seal. Unless you’ve been through it where you have spent 15 hours a day learning material that’s so dense, so comprehensive, once you get through that you instinctually think, “I know it all.” It’s just human nature. I think if you get to that point where you think you know it all you will be humbled. The question becomes an average physician is working 80 hours a week, 90 hours a week, 100 hours a week seeing patients working from 8:00 to 8:00 doing charts at home on the weekends, has a family. When is he or she really going to be able to sit down and be like, “Hmm, let me look into this.” Some people make it a priority. For me it’s a priority and I incorporate it into my family. We are always learning about it. I think for a lot of people it’s like, “Hey, I’m a doctor. I know what I’m talking about and this is what I’ve been told.”

The other thing is we have to practice by a standard of care, by guidelines that are made by big institutions. If you step outside of that then you become … you have a liability attached to you. I think a lot of people are risk averse where they don’t actually want to put their heads out there. Then on the flip side you got guys like Dr. Barry who are like, “No. This is the information that needs to get out there. What we’re telling people is wrong and it’s hurting us a society.” I think there’s a lot of individual reasons why people are not stepping up. What I have noticed is that there’s a lot more doctors coming out saying, “This is what we need to do. We need to change the paradigm.” The more that I see coming out I think the more we’re going to be able to change where we’re going as a society.

Excellent. Lots to think about.

I’m an optimist, I guess. I don’t know.

Yeah, no it’s great. I was thinking of more those of us that just love learning, and we can’t understand other people that don’t always love learning as well. You brought up some really great points that are probably all true.

Yeah. If you think about it let’s say just in the keto community, we’re probably hitting 4% of the population. It’s the same thing like anything else in life. We’re no surrounding ourselves with people who think the same way that we do. We assume that everybody else things the same way that we do. The reality is a lot of people either don’t have the information or are being scared and told, “This is actually quite dangerous.” If you’ve been told something for 50 years of your life and all of a sudden people are starting to say, “Well, no. That’s all wrong.

You should do this,” a lot of people are going to be skeptical, because how many fad diets have been put out there? I’m going to be 40. I can tell you at least 10 to 15 fad diets that were the next end all be all diet that everybody should do. It turns out no, that wasn’t right. I can understand why other people are skeptical about low carb or keto. I’m not because I’ve seen the impact that it’s done on people. You, I’m sure, are not, because of your own personal experience and your experience with people. That’s not everybody’s story right now.

Right. Right. Well, Dr. Barry had a fun way that he … remember his story where he said that he any time he gets in an Uber, a taxi or has a waiter or waitress at a restaurant he pulls up some random thing on his phone and he goes, “Have you heard of this keto diet?” That’s his litmus test to know when it’s hit the critical mass. He said once the Uber driver’s and the waitresses know then we’re done. He lives in Tennessee where he’s going to have a different population. Typically things hit east coast first, then west coast, then-

No, west coast. Come on. How do you do that [crosstalk 00:13:34].

[crosstalk 00:13:34] west coast, east coast and then it hits the middle. Interestingly the applications I have right now coming in for most of the people who want to work with me are all from Texas.

Nice.

That’s the [crosstalk 00:13:44] that we’re hitting the middle. Then it spreads out from there. Funny thing that I need to tell Dr. Barry though, is that a few days ago I’m riding in an Uber over to Seattle and whatever the conversation with the guy that I’m with, we’re talking about keto. We’re talking about the conference and the driver goes, “Hey, have you guys heard of keto?” The Uber driver actually says it to me.

Nice.

This was awful, because my backstory is that I was in a car accident because somebody was distracting [crosstalk 00:14:16].

He turned around and started talking to you?

[crosstalk 00:14:17] pulls up his Facebook and starts scrolling through all the Facebook posts. I’m like, “Stop it.”

No! Don’t do that.

That’s great. Stop it. Then the bartender last night, as well, she had to do a report for her college project on watching The Magic Pill movie, which was a keto movie.

Nice, nice.

Then I’m sitting there. I went there for a comedy thing. She starts talking about this keto thing and how the movie is skewed for all this stuff. I said, “Yeah, I know a little bit about that, or whatever. Then she asked a little more. She goes, “Okay, I think, are you Keto Carole?” When I was doing my research for my project you came up on the first page. I’ve seen you in here-”

You’re famous.

“I think I know you.” I’m like, “Yeah, that’s me.” It’s spreading. It’s college projects, but still this is west coast.

Yeah. Definitely it’s west coast, then east coast. Sorry east coasters. I travel in the middle of the country so I’ve traveled in Louisiana, Mississippi and every time I come back to see people, more people are talking about it. If we can hit populations like that then we’re making a big difference. It’s really going to be not you and me necessarily telling people, “This is what you got to do.” It’s going to be people in middle America who see their neighbor or their cousin or their wife and they’re like, “Wow. Not only are you losing a ton of weight,” because we still use weight as our end all be all marker of success, but you feel good, your joints don’t hurt, you’re dropping your medications. You’re not hungry all the time. Those things, I think, are going to be more powerful. Obviously, us getting the information out there and telling people the science behind it is very important. I think it’s just the visualization of people saying, “Look, my neighbor lost 80 pounds.” I hear that all day long. “We lost 200 pounds.” Dude, that’s amazing. That’s what really sells people on it.

Yeah, yeah. That’s still the thing that motivates people the most to give it a try. Then once they start feeling so great and they discover how delicious the food is then they stick with it.

Yeah, it’s the best of all worlds.

Okay, so we talked about how you got into this. Let’s talk about how you got on the fasting train. That’s one of your go to bio-hacks that you do, I imagine with your patients and with yourself. Talk about that.

Sure, yeah. My think is that the way that we’re set up in our western society is that nutrition obviously plays a huge part of everything that we’re talking about. If you don’t do that you might as well not worry about all the other bio-hacks. Once you’ve dialed that down to what works you got to really start addressing other things. That means sleep, stress reduction, exercise, all the things we take for granted. A lot of people will come to me and say, “I’ve hit a plateau. I’m doing all my macros.” They do not understand that there’s a difference between being in ketosis and losing weight. You can be in ketosis drinking 3,000 calories, 90% fat and still not lose weight. You’re BMR has been damaged from years of cycling through fad diets, so your metabolic rate is low. The idea that calories in equals calories out is not necessarily true.

Calories affect you differently hormonally. You still can’t go out and eat 10,000 calories of fat and expect you’re going to lose weight. You can be in ketosis, but you’re not going to lose weight. A lot of times one simple solution to that, for when you hit a plateau, is to do a fast. Whether it’s a 12 hour fast, 24 hour fast, five day fast. What you’re doing is you’re really starting to activate your own bodies fatty acid, or fat stores and using those preferentially for energy. I think for a lot of people it helps them get to that next level where they break through that plateau. For me, personally, I got into fasting more in terms of intermittent fasting, because of the research, the benefits, but also because I felt a lot better. I felt more energetic.

I realize that for myself and a lot of people I work with I could be in a longer state of intermittent fasting, so I’m in ketosis. Then when I eat I can liberalize a little bit more carbohydrates, so I have a little more balanced meal instead of being like, “I’m going to drink coffee with MCT oil all day and be in ketosis, but not be able to eat real food.” I like the tastes of real food. That’s short term fasting, but I’m getting older and I’m interested in being healthy. I have three little kids. I want to make sure that when they’re older I’m healthy enough as a grandparent that I live a long time and that when I live a long time I feel really good. That’s when the longer term fasting really comes into play.

I want to make sure that I’m recycling through my immune system to create healthier, better immune systems. I want to make sure that my cells, my mitochondria, which are really what drives energy production, are regenerated and made better. All the bio-hacking techniques really focus on that cellular level. That’s why I’m not criticizing people from looking at weight as their goal and their marker of success, but I don’t look at weight as the marker of success. I look at specific labs that look at inflammatory markers and how the cells are actually doing. To me, one you do that the weight comes off. If you have an area where you’re struggling or you’re worried more about longevity, cancer, autoimmune diseases, doing an extended fast can actually benefit you tremendously. The research is really starting to come out showing what a tremendous benefit that is. That’s a short abridged version of how I got into it.

Okay. You have across the board recommendations for fasting or is it just completely individualized?

Yeah. I always start with people who shouldn’t fast. All of sudden people are like, “Oh, I’m going to fast.” If you’re pregnant, not a good idea. If you’re breastfeeding, not a good idea. If you have an eating disorder or have had an eating disorder it might be something you want to not consider. It can trigger, psychologically, the idea that body image. It’s not done for weight loss. It’s done to improve yourself at a cellular level. Kids who are growing, teenagers, they shouldn’t be doing long term fast because they need more energy, the good type, to really build muscle and grow taller. Then I tell people, look, don’t go tomorrow and say, “I’m going to do a seven day fast.” It’s going to be one of the more painful experiences of your life. Start off slow. Start off with intermittent fasting. I think intermittent fasting or alternate day fasting is one of the best things you can do, to not only improve insulin sensitivity, to decrease your glucose load, but also to get you into the mindset of I’m not always thinking about food.

I don’t know how you are, but for me, one of the biggest benefits was getting out of the idea that I always have to be eating or I’m always thinking about food. When you’re in real ketosis you’re not controlled by food, right? That’s extremely powerful. I think until you get back to that state where you know what it feels like to not always be hungry or thinking about food you can’t understand what it feels like anymore. It’s the same idea that I tell people; When you switch over to a ketogenic way of eating and then you go and you have a cheat day, let’s say, and you feel miserable.

You probably feel a lot worse than you normally did, because you don’t remember what it felt like to feel good. Now that you feel good you get all those symptoms again. Same thing with fasting. You want to take it slow. Start off intermittent fast. Maybe do a 24 hour fast. Maybe do a three day fast. I personally do 24 hour fast five days a week and then on the weekends I’ll usually liberalize a little bit. Then I’ll do an extended fast every three months. Usually five days. That’s just more the longevity to make sure I’m regenerating cells and being as productive as possible.

Nice. One of, probably one of the biggest surprises for me was, I thought before I was a foodie and I was just food obsessed because I was constantly hungry. That’s one of the things my clients say they enjoy the most is just that freedom. They’re no longer obsessed and controlled by food. I naturally fall into intermittent fasting. I probably at least 18 hours a day. I do find the 23 hour daily fast to be pretty empowering as well. I’ve done two three day fasts in my time in ketosis as well. It’s so interesting, because for me the first night is the hardest. That’s when I’m the hungriest. It’s just the most fascinating thing that the longer you go the less hungry you are. We were talking about that before. What are thoughts on that? It seems like back in the day when we were trying to find food if you didn’t go without food it seems like you naturally would just want to be focused on food, but it’s very fascinating that the longer you go the less hungry you are.

Yeah, I think from an evolutionary standpoint it makes sense. Obviously, this is all speculation, but imagine they would go and kill an animal and eat heart content. Well, if they weren’t able to adapt where they could go periods of time without eating it’s not that easy to kill a deer here and there or a bear, or whatever they were killing. They had to, from an evolutionist standpoint, be able to go long periods of time without thinking about food. When your main macronutrients is protein and fat and not refined carbohydrates you’re not getting into the cycle of the insulin glucose kind of cycle that most people are in where you have big glucose spike. That’s followed by big insulin spike and then your glucose crashes and your brain is saying, “Hey, I’m starving. You need to eat whatever you can find.”

Being the way that we are in strict ketosis your brain is getting ketones as energy. Your organs are getting fatty acids, preferentially, as energy, and some ketones. You’re still using some glucose. There is a fallacy that if you’re in ketosis you’re not using glucose. Not at all. You’re using both. It’s not like the body prefers one over the other. It will use whatever is available. I think what’s happened is that the way that we are in a western society, the predominant is all glucose and fructose. Our body doesn’t know how to adapt to that so it’s constantly sending signals that, “I am hungry,” because overall they’re getting calorie consumption, but the hormonal regulation isn’t there. That’s, I think, what people don’t understand. You can eat a whole bunch of food and still be hungry, because hormonally you’re still having signals saying, “I am hungry. You need to feed me. Feed my belly.” It makes sense to me evolutionary wise, I think. Oh, hello kitty.

Well, and we’re talking too, anybody who’s fasted has noticed that heightened mental clarity too, which makes sense that then if the beast was walking by you could focus on killing it instead of going, “Oh, I’m so hungry. I can’t do anything.”

Exactly. Exactly. Interestingly enough there are some studies that are looking at this where just the idea that I’m going to start eating actually does ramp up your glucose level.

Yeah, mm-hmm (affirmative).

And your ketones. It’s almost like to heightened you that, “Okay, now I need to go kill something,” which I think is fascinating. It makes perfect sense. I don’t think we would have survived, because we didn’t have fast food at every corner. Evolutionary wise we had to.

Well, along the same lines of what makes sense, fasting is a controversial topic in the keto world. I’m of the perspective of we’ve got people out there that say you should never go more than 12 hours without eating, because then you start breaking down all your proteins and you’re losing muscle mass. It doesn’t make any sense to me that the body was designed to never be able to go without food. It just doesn’t make any sense to me.

Yeah, yeah. This idea that if you go extended periods of time … Sure, if you’re going to fast for 30 days, yeah, you’re going to lose protein. Are you going to lose the amount that they say you are? No. If you go for a short period of time you are not losing protein. Even if you were in the best keto adapted state you still have glycogen stores. You’re still burning through your glycogen stores. It’s beneficial in a way because what happens? Well, you need to burn through those energy stores in order to actually access your own fat stores. You don’t just go straight to the fat. A lot of people are actually replenishing those glycogen stores because they’re consuming so much in terms of fat, in terms of protein, and so they never actually break it down and so they don’t actually lose weight, which is what they want to have happen. You do lose protein on extended fasts, sure. You’re not going to lose it to the extent that people are concerned about unless you’re doing extreme starvation fasting for an extended period of time, which I don’t recommend anybody does.

I think the benefit that you get really goes down after five days. I don’t see much in terms of your risk to reward ratio. The other thing that people get concerned about is electrolyte imbalances and something called refeeding syndrome. I’ve heard this quite a bit. Basically, with refeeding syndrome this happens mostly in people who are very, very sick in the hospital in ICU status who basically are so malnourished that when us tart feeding them again you get a huge electrolyte shift. You can get potassium shifts, which can cause arrhythmias where you could theoretically die. To extrapolate that to somebody who’s healthy, doing a three day water and electrolyte fast is a big stretch. I think that’s something I see a lot on the internet. “If you do it you’re going to die because you’re going to have an arrhythmia and die from that.” They’re not equating the two and I think that’s important to understand too.

You answered a question that I had.

I’m reading your mind.

Yeah, yeah. Our friend Mike Berta actually asked me that on his fast. He’s doing his first fast, we talked about. He’s on day three, I think-

[crosstalk 00:30:00]

… four. Is it 60 hours? He’s into day four.

Yeah, yeah. Go mike.

Yeah, so he said he was only going to do 48 hours, two days to start with. He just felt so good he was like, “I’m just going to keep going.” That was his question was, “Where is that point of diminishing in terms of fasting?” You answered that as five days after that it’s-

Yeah, and to be honest with you it would be hard to find studies that say there’s a diminishing return. Just from experience I would say after five days, especially if you’re on the leaner side. Mike is pretty lean at this point. There’s really not that much more benefit. In terms of longevity are you going to lose more fat? Yeah, sure. You can expect on an average day to lose about a half a pound of fat if you’re fasting and your glycogen stores are depleted. That’s a rough estimate. If you continued you would probably lose more fat, but that’s not the point. The point is you really want to regenerate your system. Then also, I think for a lot of people the experience of actually doing a fast is scary.

It’s the unknown. “I don’t know how I’m going to feel.” Once you have done it and have gotten experience from it, it’s a lot easier to do it again. I usually tell people, “Start of slow. Do three days, stop, pat yourself on the back.” If you didn’t make three days it’s not the end of the world. It’s not a competition. Just now you know what to expect.” As you mentioned, for you, you know, because the first day is going to be really rough for me, but after that I’m pretty good. Well, it’s different for everybody.

Yeah. It’s a psychological game. The more times you do it [crosstalk 00:31:38]. It’s not as hard.

[crosstalk 00:31:37] Yeah, absolutely. Let’s not paint a rosey picture either. It’s not like Panacea the whole time, like you’re just hanging out chilling. No, you go through some periods where you’re like, “Okay, I need to eat something but I’m not going to. I know that it’s going to pass.” You get bursts of signals that tell you, “Hey, you probably should eat something.” If you just let it go, calm down for a minute, have some salt, have some water, it tends to go away. You don’t know that unless you’ve experienced it before. That’s also the muscle memory from experience which helps as well.

Yeah, brain muscles.

Yes, big brain muscles.

All right. I think we’ve got as much out of that fasting topic for now as we can. What are some of your other favorite bio-hacks that you do with your patient clients? Do you call them patients since you go and see them? Can you call them patients or you call them [crosstalk 00:32:36]?

Yeah, I just say friends. Clients, yeah. There’s a lot of them. It depends on what the goal is. I can tell you some of the ones that I think are very important. They’re simple and my thing is also I want to make it so it’s accessible to everybody. I think one of the issues in the bio-hacking community is that in order to be the healthiest person imaginable you need to have a $50,000 machine that shoves oxygen up your nose. Hey, if you have $50,000 that does that more power to you. Most people that I interact with don’t. What else can you do to get as much benefit out of it without having to spend that money? Simple things, like sleep. I talk about sleep a lot. I probably put people to sleep when I talk about it. Sleep is so important. Anybody who’s had restless nights, I don’t know if you remember when you had a young baby and you’re not sleeping-

Oh no. My son was perfect. He slept great.

Okay, well your son was perfect, but let me tell you, my kids, they’re perfect except when it comes to sleep. I have three, so inevitably one is up. You have this cortisol rush, which really impacts your ability to control your glucose, and your hunger levels, which really affects people in ways that I think is under estimated. A lot of times people will plateau or have that little pouch around the belly that they just can’t get rid of. We’ll start focusing on let’s look at your sleep patterns. Now, with the benefit of technology we can actually track that. We can look and say, “Oh, this is what’s happening. You’re not getting the quality sleep you want.” The negative side of technology and the head of Apple just came out with this, is that we’re all addicted to our iPhones or Androids or whatever phone you use. We are addicted, as a society to it, and so how many people before you go to bed you’re checking your phone, right? Checking that last Instagram post. How many people liked it? Well, that has a negative affect on melatonin production.

As you get older your melatonin production gets worse. I’m sure, with your history, your melatonin production is not very good. What can we do to improve the melatonin production? You could take melatonin, but then you’re suppressing your own melatonin production. So simple things, keeping the room really dark, not being on your iPhone, iPad, TV a couple hours before you go to bed. Read a book, talk to your spouse. Not eating late at night. If you eat late at night it actually suppresses melatonin production in the pancreas, which is fascinating. Focusing on sleep is huge. I’m a big proponent of exercise, but not like I spend three hours in the gym. I actually prefer that more people workout out doors, functional movement. Not everybody wants to be huge. People who do, more power to you. Really focusing on exercise and muscle is important because it does a lot of things from a hormonal standpoint. You improve insulin sensitivity. You increase the amount of glucose receptors.

When you’re eating something you drive the glucose into the muscles where they actually need them. We go to get away from glucose is the worst thing ever. It is when it’s in excess, but you actually need it for functions. What can you do to improve the absorption and the utilization of glucose? Well, muscle mass will do that. Lifting weights is important even if you’re doing your own body weight that’s important. I think a lot of people that I work with who are females are worried, “Well, I’m going to get huge. I’m going to get giant.” Trust me it’s gong to take a lot of work to get that. Doing lady pushups or real pushups or functional movement is not going to get you huge. Actually, you’re going to lose body fat, so that’s important. I do a lot of cold water stuff.

Oh yeah?

Yeah, a ton of cold water. Myself, I do it five, six times a week. Cold water immersion is tremendous. I’m going to be giving a talk at KetoCon in a couple weeks. I’ll be talking about it. You can really increase your metabolic rate and you can increase the thermodynamically active fat cells in your body, which are called brown fat, or brown adipose tissue, which actually give off heat, because they’re there to actually keep you from getting hypothermia. Like little babies when they come out, they have a lot of brown fat. That’s why they don’t shiver all the time. You would imagine, they’re always naked. Well, they don’t shiver because they have brown fat. That brown fat is burning energy to keep them warm. As adults we thought that we got rid of that brown fat. We actually have it. We just don’t activate it, because we’re never cold. We’re always in 72 degree weather. Maybe not in Seattle, but we’re always in perfectly conditioned-

Today it is.

Is it?

Yeah.

Yeah, there you go. See.

One day.

Yeah, but if you get outside in the cold, jump in a lake or a do an ice bath or just do a cold shower you’re going to start maybe activating some of that and benefit yourself from a hormonal perspective, but also from a fat loss perspective. Same thing with sauna work. Jumping in a UV sauna or just a regular sauna, tremendous benefits. Improves norepinephrine production. It really does a number of things from a hormonal perspective that I think really augments the ability to lose real fat, which is what most people want, but also improve longevity. From my perspective as a physician I look at this more as how am I going to improve people’s lives, their longevity, get rid of health issues that they have. Yeah, weight loss will come off, but to me that’s a side effect of everything that we’re focusing on. I think if more people started thinking of it that way will make a lot more progress.

Just as simple as a cold finish on your shower, right? You’re not talking about going and buying a tub and keeping it cold?

Well, so again it’s one of those things where if you look at the research you have to hit a threshold in terms of cold water. The cold water shower at the end of a shower is really to get you used to the idea of being cold. If you do 30 seconds with cold water at the end of it, cold water shower at the end of your shower, you’re now really going to activate the brown fat. You need to be in cold water less than 60 degrees alternatively you can do cryotherapy, which has gained popularity, where it’s very, very cold, 120 degrees negative, but you do it for three minutes, so it’s more tolerable. Not everybody wants to or can spend 60 bucks a pop or whatever it is. That’s why I do the poor man’s version, which is just ice bath.

I got a better idea. I’ve got an even easier version.

Tell me.

Go to one of the warehouse type stores and stand in their cooler for a while.

I’m just looking for some ice.

Just sit down on of the heavy cream pallets and just chill out for a while.

We’re going to be arrested. People are going to say, “Yeah, I heard this doctor said, ‘Just go in the ice cooler, and I froze to death.'” No, don’t do that.

Well, it’s really interesting to me, because after my … for people listening the [inaudible 00:40:16] on my history of traumatic brain injury after car accident; What I’ve noticed sine then is that my tolerance for being in that cold environment, and that’s why it popped it in my mind, because specifically going to a warehouse store where I have to walk into the cooler or whatever, it makes me feel really light headed and uneasy. There’s something about my activation of whatever part of my brain that’s sensing that cold that it still freaks it out. I don’t have a very tolerance for a total immersion of cold like that. It’s really interesting to me. Before that I didn’t have anything like that. I was actually enjoying cold.

Yeah, one of the things that I find really fascinating about traumatic brain injuries or strokes or anything where the brain has been affected it’s pretty common that extremes of anything are difficult to manage, so really, really hot, really, really cold. I think your brain, because of the trauma that it’s had, doesn’t have the ability to auto control itself as well as somebody who does it. We see that a lot with blood pressure management for people who have had strokes or internal bleeding in the brain or traumatic brain injuries. It’s very, very difficult to control, because the brain is just not where it normally was. I’m not surprised that you would have that reaction. Most people, I recommend they start slow, so very simple. Dunk your face in ice in a sink. Get used to the feeling of I want to be cold. Don’t go and jump in the lake that’s 20 degrees day one and say, “Hey, he told me to do it.” No, that’s stupid. Just build up to it like anything else. Build up to it. Again, the only thing that I would say is you could do all these bio-hacks and then go out and go to fast food and eat crap food. It’s not going to do much for you. You got to focus on the nutrition first. Then build these things in to really augment what you’re doing. That’s what I tell people.

It makes me think of you’ve got a lot of people out there, they’re trying to out supplement a bad diet. There’s all this long list of supplements and then because they’re actually following a diet that’s actually the most healthful. The same thing, you can’t bio-hack your way out of a bad lifestyle.

Right, right. No. I think that’s hilarious. I see that a lot where it’s like, “I’m taking 10 supplements, but my food doesn’t have any nutrients in it.” I’m a big proponent of supplements to augment what I’m doing with food. That’s the way I put it.

Yeah, and I found for most people just getting on a ketogenic or low carb diet that 90% of the other supplements that they were taking are totally unnecessary.

Yeah. A lot of those things are not regulated so they could have whatever they want in it. A lot of them have sugar, Maltodextrin, fillers that actually could be pro-inflammatory. You might actually be doing yourself a disservice by taking them. Now, having said that there’s some very good ones out there that I do recommend people to take, in addition to changing their diet to more of a low carb and ketogenic. The other thing on that message is that I don’t think everybody needs to be hardcore ketogenic all the time. I don’t. I think if you’re doing it for a therapeutic reason, you’ve had a brain injury, you have epilepsy, you have cancer, you are metabolically damaged, meaning you have insulin resistance, type two diabetes, then I think it’s important to do very, very strict ketogenic diet. You can reverse a lot of those maladies. For people who are just young and healthy I don’t think you have to be in strict ketosis all the time. I think it’s a good idea to cycle through. I think you also have to take it with that big picture as well.

Yes. Excellent. Yeah. All right, any other bio-hacks you like to use? What about-

How much time do we have? I have tons left.

Food lockers and [crosstalk 00:44:31].

Yeah, yeah.

It’s called the Himalayan ice [crosstalk 00:44:34].

Oh, you have one?

Yeah.

Yeah, I do a lot of things. I always look at things more from the perspective of is this safe? Am I going to tell people to do something that’s really dangerous? If it’s dangerous then I’m not going to tell people to do it. I might try it myself, but I won’t tell people. Then, is there any benefit from it? The Himalayan salt, I think it’s great. At night instead of having halogen lights, that are mostly blue light dominant, having a halogen like that, number one, gives you that incandescent light bulb, which doesn’t have a lot of blue light. Number two, it actually gives you off ions that could help with melatonin production and sleep. I turn off all the major lights in my house starting at 7:00. We have different lights that are only basically amber or the Himalayan salt lamp. I do essential oil, lavender, to try to help calm me down at night. What else do I do? I do too many things I forgot about them.

Meditation, I’m working on. I think it’s really hard for me. I think everybody has their own one that’s really, really hard and they’re like, “Oh, I can’t do it,” so they don’t focus on it. I’ve tried to start focusing on the things that are really hard for me to do. That one is really hard. I do a lot of photobiomodulation. We’ve been telling people for a long time that you shouldn’t have sun exposure. We’ve done that to the detriment of people. Especially in the northern parts of the country where you are, you’ll go months without really, really good sun exposure. Well, there’s a lot of negative side effects from that, right? Seasonal effective disorder is very big in those parts of the country. A lot of that is because you’re not getting sun exposure. You could do that with an artificial sun. You can get some photobiomodulation machines. There’s a couple out there. There’s more coming, which I’m excite about, because it’s dropping the price. A lot more people can afford it. I do that every morning.

I get a good amount of sun or UVA, UVB exposure. My vitamin D level is through the roof because of it. I don’t need to supplement. I do a lot of things on circadian rhythm where our body, each organ has its own circadian rhythm. We got to stay within that normal pattern, right? Well, with the way that we live most people can’t do that. We wake up, it’s dark, we go to work, we’re in doors all day. Our body has no idea if it’s daytime, night time. You know when you travel and you get that jet lag, and you’re up and it’s 2:00 in the morning and you have no idea where you are? Well, a lot of people’s body’s are always like that. What do we do? Well, we supplement.

We say, “Okay, let’s have some caffeine in the morning to get going. Then we take some wine or alcohol at night to pass out, or we take sleeping pills to pass out. That’s because our body doesn’t know where we’re at. You can reset that by doing simple things, right? Either get some sun exposure in the morning, go outside, have your lunch middle of the day, so at noon your body knows it’s supposed to be outside. Then at night turn off those devices, turn off those lights so that your body knows it’s time to go to bed.

Yeah, it’s interesting. I never really even thought about my own bio-hacking that I’ve done, but a lot of what you were just talking about is all that I incorporate in my life. Yeah, [crosstalk 00:48:14].

[crosstalk 00:48:14] bio-hacker. There you go.

Yeah. Pseudo affective disorder is no joke up here in the Seattle area. I got to say sadly almost every year around February another person or somebody else related to somebody else I know commits suicide because of the depression up here. It’s terribly sad. I know Robb Wolf, he’s of the mindset that nobody should live up here. This should just be turned back into rain forest. Nobody should live up here.

Well, we’re all going to be concentrated in one little spot that has sun [crosstalk 00:48:46].

Right. We’re all going to move to Reno with him, right?

All right Robb, we’re coming.

Yeah, we’re coming [crosstalk 00:48:51].

Can I crash at your place?

Yeah. What I found, and my family has a really strong history of seasonal depression or just depression in general, keto took away most of that. What I’ve added onto that is that I’ve got the bright light box over here that I put on daylight hours. I’ve got f.lux on my computer so that the blue and red light come with the natural rhythms. I live in a house with a lot of light and skylight [crosstalk 00:49:24].

I see that.

That’s really helped. Also, [crosstalk 00:49:28].

And you have plants.

Plants, yeah, yeah. My office that I spend most of my day in I created it like a tropical oasis, was the theme that I have in here.

I love it.

It reminds me of bright sunny places. I travel-

As you can tell I did the same.

Yeah. It’s yellow like Cuba right there, right?

Well, I’m traveling right now. This is a hotel ambiance. It’s really not [inaudible 00:49:53].

Then the other thing I’ve added this last year is actually a tanning bed, which is really controversial. I travel frequently as I can to sunny places, but it’s not enough to go a couple weeks to sunny places. I’ve added the tanning bed and it’s been probably three days a week I’ll go and get the bad ones with the UVB, because that’s what creates the …

The cancerous cells, yeah.

Well, I was going to say vitamin D, but yeah. It’s made a huge difference. I feel really great. I too as well in the evening turn off all lights. When the sun goes down I turn off all artificial lights and have a special orange light in my room. The only devices I’m looking at have the f.lux on it as well. [crosstalk 00:50:45] get that too. Those are all the things I’ve done personally for bio-hacking. I never even thought about them that way.

You’re not going to be Keto Carole anymore. You’re going to be Bio-hacker Carole.

Yeah. Well, I did last year as well, for further healing for my brain stuff is I did some hyperbaric oxygen therapy and IV nutrient therapy as well.

Nice.

I was having, last year, one of the residual other things going on with the brain injury where it was central sleep apnea, which is very different than obstructive apnea. Everybody I reached out to they were like, “Oh yeah. That’s a tough one.” Nobody had any ideas. The hyperbaric oxygen worked really well for that. That resolved that. I’ve got some [crosstalk 00:51:29]. I’m inspired now to perhaps get back on adding some fasting in and things like that [inaudible 00:51:36]. You’re the fasting inspiration-er.

Apparently, yeah. I’m going to start a trend. The Seattle Fasting Club. There you go.

Oh okay, there we go. Yeah. I’m still [crosstalk 00:51:47].

[crosstalk 00:51:48]

.. the higher protein bio-hack that I’ve been enjoying for … it’s been doing well at taking off some extra subcutaneous fat for me. I really need to check my insulin again to see how that’s effecting that as well. I’m riding that train right now. Then after that train comes to a nice landing I’ll jump on the fasting as well.

The fasting. Yeah, you’ll go from protein, you’re going to build muscle, and then you’re going to fast and you’re going to lose it all.

All of it. I’ll just be a pile of bones on the floor.

All of it. You’re just going to melt into a puddle of skin. Make sure you bulk up on the protein. What I like is that in the community is that people are open to trying things. I’m open minded enough to say, “Okay, let’s see what this big protein thing is about.” A lot of people are coming to me and saying, “Hey, I want to do this amount of protein. Well, let’s look at it. Let’s try it. Let’s see what it does.” I can tell you my experience. I can tell you when I look at the research what it says. I’m also open minded enough to say, “You know what, maybe we need to increase your protein a little bit.” I’ll give it to you; Ted is very, very convincing. He’s got some good studies. He’s jack so more power to him.

He’s [inaudible 00:53:08].

[inaudible 00:53:09] jack. Right. He came out that way and he stayed that way his whole life. I think if we can get, as a community, where we’re not going after each other, and instead we’re actually building each other up and saying, “Okay, let’s talk about, let’s have a discussion,” I don’t think there’s anything wrong with that. When I get so entrenched where it’s my way or the highway then I think we’re doing a disservice to the whole community in general and we don’t need to do that.

Yeah, that’s one of the things I love the most about going to these different conferences in this community. Together, face to face, everybody is very collaborative. We can get stuck in our own little world in social media and argue about who’s right and wrong, but when we come together we’re having really great discussions and people are open to learning from everyone and everyone’s inspired from everyone else.

Yeah, absolutely. I think it’s great. Social media is good in the sense that it connects you with people, but there’s the downside where it’s like anonymous people who are just trying to bring you down. I like the in person. I’m old school. I like in person connection. I really enjoyed meeting you and a whole bunch of people on the cruise.

Yeah, me too. I appreciate it so much. I felt very lucky and grateful that I got sit at the table that I did the [crosstalk 00:54:26]. Well, just wrapping this up, was there anything else that you wanted to talk about here at the end or anything else that you were hoping to cover? I’m sure we could have you get back on 10 more times and not run out of things to talk about.

Well, I think we could always go into more specifics about bio-hacks and how to implement them. I gave you the overall quick abridged version, like the Cliff Note version, but if you’re ever interested in more science behind it and the how to implement … I think my take away from most people would be start with your nutrition. Use macros initially to give yourself an idea of where you’re at. Count the calories you’re consuming and the rations initially. Don’t be obsessed about it. Don’t try to hit your macros by adding liquid oils. Don’t do that. That’s not the purpose. Start with real food. Whether it’s paleo, keto, low carb, high fat, whatever it is start with real food and good quality food if you can afford it.

Then from there you can start tinkering with it. A lot of people will say, “Well, I tried keto. It didn’t work for me.” Well, yeah because you probably didn’t do something right. You probably thought you were doing it in the correct version and you weren’t. Don’t give up. Figure out what wasn’t working and starting tinkering with it. Get more knowledge, from people like yourself, so that you can implement for a lifelong kind of regeneration. This is lifelong. This is not a diet. This is not a fad. Do something that’s going to work for you to keep you healthy the rest of your life so you don’t have to see people like me, you don’t have to see doctors. [crosstalk 00:56:04]

Your goal is to work yourself out of a job, right?

We will always have jobs. I’m not concerned about that. What I’m concerned about is how do we, as a society, change the direction that we’re going? You and I know this, and people around us know this, but I look around and I see a population that has no idea what’s coming, especially with the children. The obesity rates in children are going astronomical and we’re not doing anything to change that. If anything it’s getting worse or being stagnant. If that continues I don’t know what we’re going to do as a society, because they’re going to be very unhealthy for the rest of their lives. That’s my biggest concern.

Yeah. Well, I really appreciate you coming on an hour has flown by.

Yeah, thank you.

You know, if you watch my episode, you know my closing question.

Bring it.

Your last day on earth is today. The meteor is coming. It’s going to wipe us all out. What’s your final meal?

That’s kind of a depressing question. Mine would be surrounded by friends and family.

Oh, I love that. Nobody’s said that part of it.

I would want to be around everybody that I love and it would be a potluck of every favorite thing that I’ve ever eaten. I would want people to bring their favorite dish. It wouldn’t be one thing that I would eat. It would be more the community and being surrounded by people that I love. If I had to say one meal it would be some big Alaskan sockeye salmon cooked well with a big salad, avocados, olives, olive oil. Probably some really good cheese, since I don’t each cheese that much anymore. Yeah, pretty simple.

I love your answer so much. It’s so appropriate for a bio-hacking physician to think about the whole environment of the food and not just the food. I love that. It’s so unique and very different than anybody else has said before. I love it. [crosstalk 00:58:36]

I’m a rare butterfly.

You have the best answer.

All right, good to know. Good to know.

You win for now. If somebody else [crosstalk 00:58:44] try harder.

Oh yeah, they better try hard. That was a good one. All right. Well, thanks Carole. I really had a good time. I look forward to doing more in the future and seeing you at some of these crazy conferences.

Yeah, yeah for sure. If you guys enjoyed this give us a thumbs up. Share this with people you think will benefit from this information. Subscribe if you want to see more. I’ve got lots of great more … lots of great more. Lots of more great awesome interviews with bonus cat popups in them as well. Thank you all for watching. We’ll see you next time. Bye.

Bye guys. Thank you.