Keto Diet Raises Cholesterol – Insulin Resistance Matters More

Keto Diet Raises Cholesterol – Insulin Resistance Matters More


so I’m gonna stop streaming um we’re on we’re on every time okay commercials on okay sweet okay we’re doing this is the fourth time don’t give up on us it is through our mistakes that we have finally gotten better at this but we have really strong internet signal and we have the best weather here in Hawaii so let me just try this again I’m dr. Boswell come back it has been three weeks and I am completely on my own without my little helper who’s been with me since I started this he is on a backpacking trip to Hawaii or to Europe and I have been going the other way around the world on a family vacation to see our foreign exchange students family so this is my first time absolutely completely on my own and I’ve been promising myself a new computer but I did not want to take that on while traveling so it’s still my old 2012 computer and I am super happy to say that I think it’s working so I’m back I have a great story to talk to you about today and we’re gonna use it as a teachable moment I’ve seen several comments from you guys asking questions and I’ll tell you it really does spark my favorite thread that God has gifted me which is to be a teacher in medicine and help people improve their health you can’t hopefully you can notice the background here what if we can get the there is a volcano a dead volcano but a volcano that I’m leaving my son with here in Hawaii that’s in the background we are at one of the libraries but maybe my best is I’m gonna get a palm tree in the background but that’s good enough for me so yes we’re in Hawaii and I just thought I’d start by a little recap of where we’ve been if you follow me on Facebook you’ll see some some of the pictures there so if you’re here just to learn about Quito you’re gonna want to skip forward in this if you’re watching this on replay if you’re alive you are stuck with me and you’re gonna hear a little bit about where we’ve been so our family is from South Dakota and we have three sons this year Prescott’s 18 I have a 16 year old and a 13 year old and we’ve had foreign exchange students in our family several times this past year we had a foreign exchange student from China join us and what a great social experiment to add a teenage girl to a house full of teenage boys it was wonderful all the behavior issues that I wanted to happen as a mom suddenly came together when you added the teenage girl so it was wonderful but her family asked us to come visit and we applied for a visa to China and we went to China as we were in China the mechanics of how to get around and how to function are so different here’s a fun fact if you go to China there is an app called WeChat and if you don’t put money on it before you go and you get to China and you get to a stand and you’ve taken your US Dollars and you’ve turned them into yen and you try to buy something from someone they’re gonna look at you very strange and they’re gonna say of course in Chinese and we did use my Google Translate trying to understand what they were saying that they want you to pay with this electronic app and if you haven’t set that up and you’re from South Dakota you’re gonna call your banker and it’s gonna be like 3:00 in the morning and they’re gonna say what do you mean you want me to put all your money onto an app it’s 3:00 in the morning why are you calling how rude yeah but the in the end you you can’t pay for anything unless you use this electronic app and if you don’t set that up before you leave it is a nightmare they don’t take US dollars they don’t take Chinese yen they you can’t go into a bank and say can you just put this on an app they if you don’t have a bank account with them yeah it was not very user friendly so thankfully our host families are our host daughter’s family rescued us with a phone with an app on it and they put our money into the app anyway so long story short we did experience China we got on one of these high-speed trains and in China the government keeps pretty close track of where everyone is so our family goes to get off the train and we leave our some of us leave our tickets on the train like we’ve been to the train that rides over here we go and apparently you can’t get out of a train station until the government has confirmed that you arrived at the location that you said you were coming to so six days in China completely upside-down midnight was noon noon was midnight and we went to Thailand so I was really hoping to show you a video this is a gift a few years ago a patient introduced and gifted my family two tickets to go see the elephants white elephants in Thailand and I was too busy and so my husband and my youngest son went to this elf Thai elephant home which is near this the rulers and what they call him the king of Thailand’s white elephants now since those three years have passed there’s actually been a transition of power and you you’re watching the comments to make sure that okay so as there’s been a transition of power the son is now in charge and it’s not a bad thing but it sure is a transition from this ruler who would travel with the people and be with the people to his son who is not quite as integrated into the community and so he returned to this Thai elephant home because my 13 year old then 10 year old came home and told stories of elephants that were like it was unimaginable you got to ride on the elephants you got to give the elephants a mud bath you’ve got to feed the elephants you did Tora you’re essentially it’s a camp if you would that you are a volunteer at the camp to try and help service the elephants and take care of them and in trade you get this amazing experience like parents if you’re looking for a teenage adventure – the time change it beats the heck out of Disneyland much cheaper but also much more enriching as a family and if you if your Facebook fans of your Facebook people you go to Facebook and type of my name the videos are public but what I really want to encourage is what a great way to detox from electronics from you know the world of being overly stimulated by all of our all of our electronic world so on the way home my son Prescott got his final acceptance letter to the University of Hawaii so instead of flying home my husband and Sons flew home while Prescott one of the oldest son and I stayed here in Hawaii to get him finished registered for school and we’re not quite done it is last minute and he is excited because the University of Hawaii gives reciprocity to South Dakotans so that in-state tuition for home for South Dakotans to go to Hawaii is like a no-brainer I was saying to him I I hope that by the end of the first semester you can focus past all the beautiful weather the incredible opportunities to be outside for hiking and Beach and that’s not to mention the unbelievably gorgeous people you know men and women but unbelievable yeah beach bodies I guess so an 18 year old boy all the way across the world thought his mother probably better than I don’t look anyway welcome to why I’ve been gone just thanks for the forgiveness on doing that we weren’t sure we were gonna get our visas and I just want to say the last time we checked in I was asking for prayers about my dad who despite being on a ketogenic diet and lots of lots of education on the ketogenic diet his kidney function when we started was about 20% of what it should be and he has continued to be a 75 year old man whose kidney function got worse and the day before we left on our trip was his first day of dialysis so I just want to say thank you for everybody he for those of you out there who don’t know much about dialysis my parents have had a crash course his heart is too stiff it’s heart failure so it’s too stiff for the kind of dialysis where they take the blood out of your body clean it and then put it back in instead he uses something called peritoneal dialysis where they are able to put infuse fluid into his abdomen and then the fluid is used as a gradient for for his missing kidney function I think it’s very telling that this though the fluid they put into his abdomen is it’s sugar water so it plays right into some of the teachable things I’m going to go through in the next month but you know we talked about that first few weeks when you become a keto and how your the number of sugar molecules within your bloodstream holds on to so much fluid and as you lower the blood sugar you lose a lot of weight and you’ll see the naysayers microphone a little closer the naysayers see if that works better our quick to tell you yep you’re not losing what water you’re you’re not losing weight you’re losing water weight and what uh what a misconception that can be it is water weight but it is water weight that does not belong there and you can’t you can’t miss how many people say oh you’re just gonna lose that first part of the weight and then you’re gonna be done that’s not true you really do that water does not belong in your system in the book you’ll see me talk very extensively about how important that was to hitting my mom in the right direction was her body was filled with cancer so she had lots of extra fluid in her system and those first 15 pounds were probably 80% water but man she felt better her brain was thinking better and many many parts of her system started to work better even though Dad Falls the ketogenic diet kidney cells are not something you can restore you don’t get to make new ones his kidneys have lasted much longer than anybody expected with only 20% and it’s been I can’t wait to do the post in the next few weeks on the interviews he’s had with the dieticians as they talked to him about three meals a day and so many carbs per day and he’s like I think you should talk to my daughter and I like just hand on the book first it’s just a lot shorter conversation if they start with reading the book so I am I have been reading some of the comments before I started and just want to say thank you for being patient on my little hiccup there of getting all the buttons correctly pushed I want to take time to read a message that I got from some one of you in the last week and I’m gonna use this as our teachable case and then we’ll go to answering some of your questions so it came in an email the first the patient’s first name is Patti and she wrote me a nice email saying that she’s got the book and she’s read the book but she said you know I’ve been keto since February of this year I’ve lost 20 pounds down from 192 168 so I think she should count 22 phones not just 20 and she’s super excited her cholesterol was 250 when she first started but now her cholesterol is is up to 356 so she says I’m worried that my cholesterol is elevated here are my recent numbers with a total cholesterol of 356 so I just do a lot she won’t be 250 to 350 that’s up a hundred points she then goes to tell me that heard LDL or her bad cholesterol is now 253 and which is again really high if you’re a diabetic and you come into my clinic prior to the keto education that I’ve been on I would be very adamant about checking and making sure that that LDL gets below 70 that’s what the goals would recommend but she also says that her healthy cholesterol her good cholesterol 76 and her triglycerides are 74 and that her fasting glucose is are in the 90s so let’s just review a few things here she’s lost 22 pounds she is showing me that that the markers within her body are a panel of cholesterol and although that top cholesterol is higher the ones that matter to me as internal medicine physician are how well does it look when you look at the HDL cholesterol the triglycerides and we start doing things like total cholesterol to HDL ratio hers is 3.4 which is unbelievably good but her when you can get your HDL cholesterol to be higher than your triglycerides I just want to tell you patty that this is a very good marker that your inflammatory markers are low so that’s what today’s lesson is gonna be about is how cholesterol and inflammation yes they go hand-in-hand but what the cholesterol markers that tell me about your inflammation are not necessarily your total cholesterol so I’m gonna start by just three Ewing with you and not using slides but just talking straight to you on how I explain cholesterol to patients when they come in and they’ve been on the cholesterol or they’ve been on the keto diet and their cholesterol is up the first thing I remind them is you know that cholesterol is a really important part of how our body functions but it happens to be something we can measure in the labs but that’s not the only thing that matters when when talking about cholesterol we want you to realize that as a cholesterol level you know total cholesterol is with just one part of it I draw your blood and what how much of the cholesterol is kind of floating around inside your blood and when we look at that it there are several other things that it predicts the reason patty is concerned about it is that the media and the the last 20 50 years have been spent telling patients how important lowering cholesterol is to lowering heart disease and I’m here to tell you that we’ve been misinformed that is not the biggest predictor of heart disease cholesterol is a component but just looking at the panel of what her HDL and triglycerides are I’m gonna hopefully show you that what you really need to be looking at to tell patty and to give patty that confidence that she should keep going on the ketogenic diet is to look at the panel of markers that that improve health number one a slot got her twenty pound weight loss that alone should just be something that she gets praised for and said congratulations this is the right direction please keep going continue to check your cholesterol but I’m gonna give you some other things that I think you’re gonna be more powerful they’re actually cheaper and they do a better job of telling you what your cholesterol is right now or excuse me what’s your risk of heart disease is right now if you look at why why doctors look at cholesterol they’re trying to predict do you have heart disease are you gonna be that 30 40 50 year-old who has a heart attack unfortunately as our baby boomers have gotten older the risk of heart disease has been something that’s on their minds on our minds and as we focus on predicting their risk of death heart disease becomes this number one focus it is you know the the risk of heart disease predicting predicted by total cholesterol still is not well done in fact if we look at cholesterol and I had all the money and resources in the world I would take Patty’s blood and I would do a couple of things I would look at say me what size of particles does she have floating around in her system you know no cholesterol comes in different sizes as you put cholesterol into the Machine it measures is that a big cholesterol is it a smaller cholesterol or is it a you know is it you know the healthy cholesterol is made up of different lipids your bad cholesterol is made up of different types of fats and really what we’re trying to say is if we have a lot of the LDL cholesterol that are tiny and small I like to think of them this isn’t exactly but it’s I like to think of the tall tiny small particles can slip into the skin lining of your blood vessels and that’s where a thorough school sclerosis has been connected to your heart disease so when Patty’s blood comes into the machine she’s just looking at total cholesterol it’s gone up from 250 to 350 oh my goodness I’m gonna have a heart attack however several other indicators show us mm that’s probably not the best way to predict her heart disease I would say that if we could have a point-of-care test done to look at heart disease we should be looking at insulin so I’m gonna hop over here and push play on this part of the presentation and so Prescott’s gonna make sure that this looks right on the machine but all of you can help me with comments to see that you can see what I’m seeing again my poor computers from 2012 so here’s what I here’s the message that I want you to take home from this and that is it insulin causes heart disease yes insulin and if you’ve read the book anyway you can it is the way this channel is funded so please look at the link below buy it for a friend buy it for your doctor and send me the email as to what happens I’ve used several of these to prepare a couple of videos that are coming up I really love those stories because I’m all about educating not just my patients but my colleagues if it wasn’t for the teachers that taught me I would probably still be skeptical or at least highly questioning that I want my patients to eat 80% fat all right so here is the data that we’re gonna show you insulin causes heart disease so here is a risk you say what is the the major risk of heart disease and I can see this is not lining up correctly on my computer but we are looking for death or non-fatal Mis as the way that we predict heart disease and we have really good data from 1998 that says if you look at heart disease and you watch these people for 25 years as they aged we can see that yes we can predict the way they have a heart attack but it doesn’t have anything to do with cholesterol it has everything to do with how much insulin they had so at the beginning we’re at zero years because nobody has died we’ve all entered they entered the they entered the the study and then we divided them into quartiles of quintiles five different sets of what were their insulin levels over time and especially at 25 years how many of them had a coronary heart of heart disease event which meant either they suddenly died of a heart attack or they had a near heart attack they had a stroke so these are coronary heart disease events and if you look the lowest insulin was the lowest risk for heart disease the highest insulin was the highest risk for heart disease and again this data isn’t new the data is from 1998 so when patients come to me and say hey my cholesterol is high doc I’m gonna have a heart attack the first thing I remind them of is heart attacks isn’t what lips does not ought to do heart attacks isn’t what we use we don’t use insulin to predict heart attacks excuse me we don’t use cholesterol to predict heart attacks we you should be using insulin and as I look at the insulin ratios or the insulin test for patients that come in it’s not the easiest thing to test in a patient insulin is a blood level and yes you can get a fasting blood test if I look at my my star patients and I say okay we’re gonna check your insulin this is really important for the ketogenic diet be sure you don’t have any stress before the test you don’t eat anything 12 hours before the test that means no coffee no nothing we want you truly fast and you can have a sip of water if you need it do not take your medicines I don’t want you to have a bowel movement before you have your your insulin tested I want you to be super mindful and in a peaceful place when they draw your blood because stress increases your insulin level and so they go into the lab they are perfectly Zen and they get these beautiful insel numbers of four or three or something but then the patients that come in and that’s eight or ten or fifteen and you say well tell me about that you know doc I forgot your holes and I got up at midnight I had a little you know bit of you know whatever teehee or so I had something to drink or you know what I wasn’t feeling well that morning because I was kind of nervous about the test and I I did I went to the bathroom and oh shoot I had a bowel movement you know something silly in the in the end the ability to get a perfect insulin test is because so many things variate and when you look at the insulin if you have constant monitoring at insulin it’s just a very volatile moving test so there are tests out there where we can check your insulin before you eat and then you eat and then we watch your insulin and your sugar you know five times over the course of several hours and the cost of that is nearly $2,500 in some places so it’s ridiculous there is a point-of-care test that you can do yourself but I’ll be honest my patients that are motivated enough to do that test often are not as they’re not the ones that need the suit they don’t need convincing they already know that this is the right test for them and they have plenty of other ways that they’ve educated themselves to be confident that that cholesterol going up by a hundred points isn’t the best predictor so let’s back up to this patient who wants to understand do I have a risk of heart disease my cholesterol went up by a hundred so I was telling you about if I could take Patti’s cholesterol and I could look at it in the machine what I would be what I would want to see is that as she’s been on the ketogenic diet her size of cholesterol has gone from a smaller dense cholesterol which is really common on the low-fat diet when cholesterol sources are low the use of your cholesterol is important it repairs ourselves it improves our brain function you know it is it is the carrier for nutrients throughout the body and you need that nutrients too have any type of healing to restore a brain from depressed to healthy it needs high fat in order to do that several of the fat based vitamins including vitamin D vitamin K those are really important for repairing up nerves and repairing a brain but even my patients with like numb feet from diabetic neuropathy as I put them on the ketogenic diet and I say you know you get about a millimeter a month if we have to keep you in ketosis we can repair this if the nerves are well nourished the guy who’s nourishing that is your cholesterol so when Patti first went in before she was on the ketogenic diet and her total cholesterol is only 250 I would guess that her size of her particles was small and dense but as you as you improve the supply of fat by having an 80% fat diet so now you’re on the ketogenic diet and you have started putting fat into your system you’re doing it in the setting of less than 20 carbs which is really important not only do we decrease the inflammation and decrease the water in the body that doesn’t belong there so our joints feel better our swelling is less our repair systems are better we get to the part of the of the system that now is efficiently enhancing your skin waking up your collagen cells replacing the damage and that’s all through cholesterol in the setting of low inflammation you say hey I want that that’s how you know if you’ve seen my videos on auto AG and how do you reverse age well you have to have the supplies the nutrients that is needed for the repair of the body and that is found in high fat if you have high fat with high carbs you have inflammation and so it is really important that you are checking yourself like let’s just make some guidelines on why I would be so adamant about checking the the numbers if you would on a ketogenic diet so we’re gonna go to and we’re gonna go to – to do we’re gonna go to this one so I am going to happen you testing oh okay so I totally had you on the screen that doesn’t have sound on it so I’m gonna try that again I’m super sorry okay so let me push play and do that again all one so sorry okay well that was a really good story we’re gonna try that again we’re talking about the doctor basri she oh and I’m gonna push play here okay so so you’re gonna say thanks to Prescott for pointing out the Sounders off because on my old computer I can’t see that when I give you slides so thank you Prescott okay even under college tuition even if it is in-state division yes I’ll do that okay dr. Basra she oh why do I have pati doing this so first of all Patty’s giving me some information about her cholesterol that it went from 250 to 350 right that’s a good idea Cajon to save run oh my goodness her cholesterol is up this must be terrible I’m saying wait a minute I want to learn a couple more things I want to know does Patty’s doctor Basri she Oh has it improved enough that I can be confident that her insulin is lower so the dr. Parrs ratio is something that I use to predict patients that are struggling with are they confident in the health of their body on the ketogenic diet so if you’re new to the data the ketogenic diet what I really want you to hear is do not panic do not panic the first few months of being on the ketogenic diet just like patty is somebody where I want them to not not focus on their blood numbers but I want them to focus on the diet and keeping those carbohydrates low I want them to focus on not eating at night but instead shutting off the food you know 7 o’clock maybe even 6 o’clock if they can instead of and then keeping those carbohydrates under 20 I don’t want them poking their fingers and getting all this analytic data I want them feeling better well Patty’s done that she’s two and a half months into this diet and she really does feel better she’s lost 20 pounds so that gives me a hint of how her blood glucose and and ketones are doing but there’s nothing like numbers to give me even more confidence because I’ve never met Patti but when I look at her cholesterol numbers as a point of education I will tell you what I would worry about as a physician is I want to know does is her morning sugars as good as she said her morning sugars are 91 so that gives me a little bit but is she making ketones with that we’ve just talked a lot about supplying the body with fat and at first when they’re on the ketogenic diet it is such a shift of how they’re bought how they eat that we don’t talk about you know those different kinds of fat we just say no we want high fat just whatever fat it is that tastes good to you while keeping the carbohydrates low we want bacon we want processed and you know like cold meat cuts which we want sausage and if you’re really health-conscious you’re gonna say but dr. Bosworth that’s not good fats I’m saying I don’t scare people with that begin the diet with what tastes good to you and then stay on that Patti has now come to and a half months into her diabetic or into her keto diet and she wants to know my total cholesterol went from 250 to 350 should I be scared that’s when I want to increase her courage hopefully a little bit to be able to poke her finger and check not just her morning blood sugars but her ketones what’s happening with this is we are estimating her insulin so instead of her insulin going into my lab and getting a very volatile number when you take the glucose and the ketones together you’re estimating the average insulin which is actually a better way to look at her insulin than measuring the actual insulin so let’s look at that so here’s Pattie or here’s some examples this glucose was a hundred and forty again Patties from America so that’s the units that we use her ketones for 0.7 if if you divide those out that would give her a dr. Baz ratio of 200 I would say that that insulin is quite high the dr. Baz ratio is of above 100 is high that would be an insulin that’s high so if you say well what if she got her Sugar’s down to 120 and she increased those ketones just a minor amount 20.8 it brings her dr. Baz ratio down to 150 now that’s better that’s lower insulin but it is not a low insulin State that would put her 350 cholesterol into a higher risk category than a 350 cholesterol or her dr. Baz ratio is less than 100 so now let’s take a blood sugar of 80 that’s a really good blood sugar her ketones of 1 again that’s not an uncommon finding and that puts her dr. Baz ratio less than 100 once you get down under 100 you really can be confident that the inflammation is improving that the insulin is lower in your system so by looking at the glucose and the ketones together now she can say okay I’m there I’m gonna keep going on this ketogenic diet and I’m gonna keep looking at my cholesterol the last one is a number that I would find some somebody who’s probably doing intermittent fasting which is a glucose of 68 and the ketones of 1.7 that puts the doctor basra show of 40 and if you can get down to less than 40 that’s one of my goals that I have every week mind you I did not do it while on vacation but too fast long enough to get my Sugar’s low enough and my ketones high enough that my doctor Baz ratio hits 40 why do I do that because I was like many of my patients for many years had inflammation and a few extra pounds on there where I do need to induce some otology to repair the system to improve my health from the probably decade of not following such a processed chemistry and what I mean by that is the auto fudgie that I’m trying to ignite is much more likely if I can get that dr. balls ratio less than 40 so again the final number on this is a 20 and if you’ve read the book anyway you can you’ll know that that’s what I was trying to get grandma rose to we used the ketogenic diet and grandma rose to help her fight cancer she just turned 75 this past three weeks and she is off of chemo she has normal blood counts as she looks and feels amazing and praise God because now she’s got to take care of dad but having said that she is in the most vibrant health she’s been in in 40 years I can’t tell you what an awakening it’s done to my 71 now 75 year old mother and if you want to read more about that you can’t leave the book without being inspired it is the lessons I wrote from my mom that thanks to my husband he kept telling me to push publish despite my fear of not being a good writer he definitely is gets credit as the helicopter goes over I’m gonna go to one more slide and just point out that the insulin levels on the slide as the doctor Basra she o goes down it is the insulin we’re trying to predict and that is how you can predict heart disease is high insulin predicts the highest heart disease my diabetics when I put them on insulin I know I am assigning them a younger death it is dangerous to have high sugars it’s still dangerous to have high insulin so as you look at how to do that the ketones and glucose numbers can be best done I like the four I care and you can see that in the notes below it is a meter that you have one meter but you have two different sticks that you put into the meter I find it’s incredibly accurate when I compare it to my blood tests but I also know that the strips don’t aren’t as fickle they can get a little hotter or colder and I’m from South Dakota where there’s a hundred and ten degree heat it’s nicer in Hawaii than it is in my hometown of South Dakota this week so when the strip’s get cold in the wintertime or hot in the summertime with patients would be really upset because they would have to pay for a whole new set but I really found that for our care has us much more stable strip and the strip’s can get expensive so if you put in dr. Boswell you’re checking out you can get a little discount apparently I’ve been quite a promoter for their their their meter but I like that meter there are other ones out there that work just well but that’s the one my patients of life and I liked just to review if you get that dr. Baz ratio under 80 you might get into Auto AG I know you’ll get weight loss if you’re in a weight loss stall and saying what do I do now what do I do now I can’t seem to get this under 80 or I can’t seem to get my weight-loss push that dr. Baz ratio to under 80 if they’re under 40 that’s what I reach for every week which is a solid chance of auto fangy and it does repair immune systems it also is my if I’m looking to help a diabetic with neuropathy I really like it when they get there dr. Basra’s oh under 40 we know that we’re repairing that nerve faster with the intense nutrition that goes with a ketogenic diet and a dr. Baz ratio of under 40 finally the hardest to reach are those who are either my seizure patients on a prescription ketogenic diet and those who are doing this for cancer augmentation like I did with my mom keep in mind this did not take the place of her regular chemo or her regular care it just made it so much easier for her body to fight the cancer that she is now off of medications at 75 from something she was and I have told her she’s never going to get off of so I just can’t say enough good things about how when you follow that process and protocol you really do have an improvement in your immune system so there’s a couple things I want to make sure I don’t know if I said them out loud on the I said them a lot on the first time but I don’t know if I said them as much on the second time when the psalm is off and that is when you’re looking at predicting the nourishment that comes with a ketogenic diet keeping those carbs less than 20 while increasing the fat boy really important those first two months of being on the ketogenic diet as you return to as you return to the ketogenic diet as we return to a more stable chemistry in all those first few months your body is making a ton of changes and we know that those changes are good for your system but then they kind of level out so some people say hey I’ve fallen into a weight loss stall or much like Patty’s situation her cholesterol is what made her right into this and I’m saying yes cholesterol is something you’re gonna hear us talk about it’s not nearly as important as insulin and if you want to predict your risk of heart disease to get to that next for the number one thing that I would ask Patti to do she’s already checking her blood glucose by telling me her morning fasting glucoses actually that might have been from her lab so I would encourage her to get the you know get the courage to poke your finger do it in the mornings is the most valuable data so putting that information into a spreadsheet or keeping notes on it I’ve had lots of folks write in to me and say can you take a look at this and I kind of share a Google spreadsheet that I got from another patient to say look if you fill in these things I can process and help you say here’s what I would do again I use your information to help teach other people please do not let the substitute for your own relationships with your physicians as I work towards meeting the demands of so many people writing in and educating them I’m trying to find a process that would satisfy people at a cost effective rate and I’m not there yet but YouTube is free please buy my book so I can keep doing this in order to help more people so when I look at the last thing I want to tell patty so first thing I tell her is you’re losing weight there are other things that you’re being that predict whether or not you’re going to have a heart attack cholesterol is not the only thing in fact I would contend it’s not the most important thing your insulin is the most important thing don’t run off and get an insulin blood test they are expensive and volatile and you really do need to have a coach to tell you exactly what to do when they’re measuring an insulin level so if you don’t have that coach just get a just get a four a care monitor and monitor your numbers those numbers really do help me help you or you help you you can watch these videos and see what I do with my numbers follow me on Instagram it really is an audience I’m trying to grow that’s kind of been something I didn’t know is this so important when I first started but I can’t get a couple of the key things for teaching until I get ten thousand followers on Instagram and I’m somewhere like at 8,000 or 9,000 so please please be my friend or whatever that’s called on Instagram even if you don’t have an Instagram account just set it up and that way if I get a few more fun I can turn on a couple of tools that really do allow the teaching to reach out to other folks just like patty I would want to say hey put your numbers into Instagram if you put in you know hashtag doctor Basri she oh I I look at that and I follow those now I might not have been so good the last three weeks because I didn’t have internet while I was in China but I I look for people who put in the doctor baz ratio to say good job here’s what I would do here’s my here’s the video that I talked about this on so you can use this as a teachable moment so let’s get to the last thing that I would recommend and I don’t have good slides on this it is something I’m writing in my next book to be it’s just the data it comes out almost as fast as I write it I got one chapter done and then another study came out that said it would be it would be not honorable to put out a book with the without this new data in it so and it has to do with calcium tax scores or CAC scores coronary artery calcium scores so I’m going to give you about three or four minutes of a history on coronary artery calcium scores and I’m gonna use my dad as a teachable moment because of my dad’s an old man he’s an old man from South Dakota who had meat and potatoes his whole life was not significantly overweight but he wasn’t nearly as lean as he should have been and he had high blood pressure the high blood pressure was a manly thing that he thought he could just like not take his medicines for until he got to the point where I scolded him enough saying just take them unfortunately he lost a lot of kidney function from not taking those medicines and we were in the hospital over a year ago when we were again coming to some serious conversations about his his heart disease and his kidney disease and on an x-ray you could actually see the calcification of his coronary arteries of the arteries that supply blood to the muscle of the heart the coronary arteries they were calcified on the x-ray that’s a lot of calcium now you don’t need to wait for that kind of calcium to know if you’ve got a coronary artery calcium score that’s elevated there is actually a cat scan out there that’s very limited radiation like less than mammogram and mammograms are actually really tiny these days for the amount of radiation the coronary artery calcium scan is a quick flash of imaging that looks at the calcium that’s already in the arteries of your heart so what that does for me and for our science-based predictions is we can say right now what is your risk of a heart attack and if patty wanted to if patty wanted to measure what her risk of a heart attack is today she could go get a coronary artery calcium scan in most of your communities you do not need a doctor’s prescription it is almost like I’ll say this in the nicest way it’s almost like a sales funnel that the coronary screening teams they are looking for people with really high coronary artery calcium scores and be careful if you get a really high one just taking a friend with you if you go to to get one of these done but type Google in local coronary artery calcium score and I will bet you that your cardiologists in your area are paying for advertisement SEO advertisement online to say anybody looking for one of these pick us because if they if you have a heart problem and you end up in their system that it they can help you and I don’t want you to be afraid of their help but what I encourage you to be mindful of is if you step into a coronary artery calcium screening there’s more going on than there’s a reason it only costs you $50 and don’t be skeptical just be mindful so if patty said hey I’m gonna check out my coronary artery calcium score and if she was lucky enough to be able to get a zero on her coronary artery calcium score that would mean that they did this cat scan they took a high-resolution image of her arteries in her feeding her heart and bam there was nothing nothing in her arteries for calcification that would be amazing that would be awesome so that gives her a really high risk a really high chance that she is not gonna have a heart attack for ten years so even though her cholesterol went up in the last two months while she’s been on keto I would say stay the course girl it’s going to settle down right now you are replenishing your system it’s been low on fat nourishment and the pipeline to feed your body’s nourishment through high fat nutrients which is why the ketogenic diet improves our brain function our decreases seizures decreases inflammation improves your immune system and oh by the way lowers your insulin so it allows us to lose weight that the reason it does that is from the highly dense nourished food that isn’t high fat if you hadn’t been on that before which most of us hadn’t the first few months you’re gonna see a surge in that total cholesterol because cholesterol is the little boat that goes around delivering this high fat nutrients and I would say you have low HDL cholesterol and you have low [Music] triglyceride high HDL cholesterol and you have low triglycerides two of the most other important predictors of whether or not your body’s inflamed but if you added for $50 which is what it costs most people cash walk in you don’t even need to give them your insurance card just pay cash and say then you don’t have access to all my other stuff I guess and just get the $50 worth of check your coronary artery calcium score here’s where it gets puffy is if it gets to be above a hundred people are gonna get a little nervous if it’s above 200 they get a little more nervous I had a patient come in and we’re gonna talk about him on the channel the next couple weeks excuse me whose was 3,600 yes 3,600 yeah that was really high but I would guess that my dad who’s got coronary artery calcifications on his x-ray and oh by the way whose kidneys failed because his daughter didn’t know this one I should have but here’s to forgiving yourself and everybody else maybe if I helped more people up through this channel I can ask for forgiveness for not getting it and my dad who has calcified coronary arteries he has calcified kidneys he has calcified renal arteries which are the arteries that feed blood to the kidneys and I don’t say that out of pity I say that out of look what happens when physicians who have a really good intention as as I do as most of my colleagues do when I don’t have the right information when I’ve been fed that I should put my dad on the statin because his risk his cholesterol is high it wasn’t terribly high but was a little high and I did it over the age of 70 which really isn’t gonna save one patient life in 10 years and I did that and what it did was enhance his calcium production into his coronary arteries instead of remove it one thing my dad was low on was vitamin D and vitamin k2 these are two fat based molecules that if I look at anybody who has missed the boat they are late into their diseases of health and you say what are some of the things that I universally recommend to patients I mean not only getting on the ketogenic diet while checking your doctor boz ratio super important for my folks that are up there in years to to check themselves not only is that for you but it’s for your doctor the second thing I tell them to do is get on k2 and vitamin D these fat soluble vitamins super under-delivered in my American patients anyway and we’re gonna go into that into another into a different video so I’ve been watching lots of your comments in the last little bit just to give you some some feedback Patti thank you for writing into your your question I hope this answered some of your questions I hope that you were watching I didn’t see your name as I was clicking along but maybe in the replay as we will see it Patti wrote in because she was worried about her cholesterol but everything else in her life and body had been doing super well and I would say that without a doubt Patti’s overall health has improved in the three months she’s been on a ketogenic diet but she’s at that tipping point where two months in they feel pretty good and they get a negative signal whether that’s from their doctor sometimes doesn’t understand a ketogenic diet or they’re not checking blood Sugar’s and then they check it for the first time and it’s higher than they expected and maybe it’s lower than it would have been but nobody’s been looking so this is where I say Patti get yourself a monitor and check your doctor Baz ratio if you have the funds and resources to get a coronary artery calcium score I would totally recommend it something that you can measure over time to see if calcium is growing but if you’re lucky enough to have a zero on your zero on your coronary calcium score you’ve got a ten years where you can be pretty confident I would probably still check it in three to five years just to see how you’re doing and go from there so let me click over here and I see a couple people I mean I go through some of the comments because there’s one little panel here where I can use to read them and it’s a little bigger for me somebody says get a patreon account for financial support so I actually have set that up but I hadn’t turned it on yet I was kind of waiting for a major decision from the Medical Board of South Dakota which came last month I’ll tell you the reason I needed a vacation was there are so many things that happen in my last four months of life I buried my mother-in-law we’ve graduated my son from high school and we I had a decision from the Medical Board that has been just looming over my life for seven years now that finally came to a decision about four weeks ago and I just didn’t want to do anything that would upset them or be controversial I’m actually looking for applications for medical licensure outside the state of South Dakota just because I don’t want to do that again so I do appreciate the encouragement to go forward with a patreon account I haven’t ever thought about that I really like it when you just buy a few books and what it does for me is I just know that we’re educating people this is super easy to understand if you look at the power behind the ketogenic diet and I think if I could have had somebody teach me about this 15 years ago my dad wouldn’t be on dialysis today so my new book is going to be a workbook and very very heavy on the science so the storytelling for my a mother is nice in that I do have actually dr. Baz k2 vitamin D coming out this was I put I put my name and resources behind supplements that I would prescribe to my family my parents are both on k2 d3 it was not easy to find the one that I liked so I finally just had to make one just took a while to get out the other supplements that I have out there people are asking is I do have ketones in a can which has a sugar substitute in it it tastes like raspberries and my children drink it they use it for debate tournaments they also used it to treat acne if you google the acne video it might be my favorite one of my 16 15 16 year-old son who I bet his inflammation on his face would go down if he just had ketones circulating I have several of my demented patients who really can’t follow a ketogenic diet that we’ve put the supplement in and we’ve put it in their nursing home schedules if they just drink on it all day amazing what kind of awakenings they’ve had but they really did need to stick to it for two months before we really could pull the supplement away and then some of them their memory wasn’t good enough to stay on a ketogenic diet they would still get offered carbs and eat them because I just couldn’t remember why they were supposed to say no to that so the supplement has really worked for them I don’t like sugar substitute and my husband is allergic to stevia so I put the ketones in a capsule that’s just ketones in a can if you open up the capsule when you put that on your tongue it tastes terrible so don’t do that that’s why everything supplement has a sugar substitute in it so my husband now can take ketones in a capsule he and I got married 21 years ago and his he had several vices but one of them was always drinking a coke which I’ve said yuck to for years but now when he drinks a coke he says that’s okay I’ll take some ketone capsules afterwards he’s totally pushing my buttons there but what I’m telling you is if you if you fall off the wagon of the ketogenic diet which I went to China now I did really good actually but there was a few times where I just there was nothing I could have fasted but it was sleep deprived and anyway so what did I did after I had carbs was I would take three to four of those capsules and set a timer and have to take three or four of those capsules again in about three hours so it would give me six hours of good ketones in my circulation man the cravings for carbs would drop and I was back on the back on the straight and narrow the next day I don’t like taking capsules so when somebody asked me the other day which would I prefer would I prefer the ketones in a capsule or drinking them I think I would prefer drinking them like I think the sugar substitute I put heavy cream and ice in with mine and I like that it’s a high fat a little high fat heavy cream in there as well as the the substitute it seems to taste pretty good for me if you type in dr. Bob’s on Amazon you’ll find the supplements the k2 d3 comes out in the next week so you won’t find that just yet let’s see other things what do I recommend krill oil for people with high cholesterol yeah I do actually I think you can find that in a ketogenic diet too Tom actually talked about that my dad have them take k2 mk7 that’s what the supplement is that I have him on yep let’s see if I’ve got any other ones the one person keto life says cola is why I developed insulin resistance and have the fatty liver I swear my husband does a really good job of fasting he but point his his downside is definitely he loves his coke the exaction is ketones are something to help people at the beginning or help people that just can’t stick on the diet or that fall off of it so somebody asked why do you use them at first I didn’t use them and I recommended people not to be on them I just said you should be able to get these from your own fat cells but much like you know you look at the journey I take care of folks in medicine where they’re just too sick to follow all the rules to get back to health and we use medications to help them get to the certain level and then we hopefully have them get off the medications not always do we accomplish that but that’s our goal and I would recommend that the the best beginning is the circulation of a ketone and what that does not only to the blood-brain barrier you start to upregulate the ability to pull those ketones from the circulation and put them in the brain so that they don’t go through a huge brain fog or I’ve had folks complain of depression when they first start on the ketogenic diet and it’s during the swamp that the glucose goes down but the ketones haven’t quite ketones haven’t quite risen and that’s happening at the blood-brain barrier when you fix that when you put ketones in the circulation and now your blood-brain barrier is ready you can lower the glucose and your ketones continue to function and really give you a steady supply of energy and their brain doesn’t go slump it’s also why my memory patients have had such positive results from the supplements so let’s see I have this the happy cook of the Happy Hooker my CA C was 2600 would like to figure out how to lower it so let me just say one more thing about calcium or coronary scores is that once the calcium is in there we have some studies coming out to say over time we think we can lower it but that is really early in the data and I wouldn’t be overly stressed about lowering it I would just be about maintaining it do not let it go higher and really the best thing that you can do for that is you need to have a dr. Baz ratio of under 100 every day you’ll see me chirping about getting it under 40 and getting it under 80 and getting it under 20 but you want low inflammation you want it under 100 every day and whether you have to take supplements to get it under 100 or you have to start intermittent fasting to get it under 100 you really want to keep that lower your body will decrease and it’s amazing how fast I’ve seen them feel better and over time they do get stabilization of those coronary arteries or so that’s that’s nice to see but you only check those every couple of years I mean you can at six months but I would just be careful about checking on that closely I mean you’re looking at deposition into the coronary artery calcium so you’ve got to give it stable time you can check every day is those morning fasting sugars and boy we had our hyped in from Hawaii for our weekly Kido meeting this week and it’s just amazing when you check in with a team of people with all trying to improve your process of health you know we don’t charge for that we do that for free in my community to say we want people being healthier and you can do that by uniting as a community so I think I am gonna sign off it’s been almost an hour and I appreciate those of you being patient why I started and say thanks to Prescott who is about to start his senior year excuse me freshman year of college and I’m I still have to buy the ticket to fly home yet I haven’t done that yet I’m totally struggling I don’t I also want to say thank you to a New Hope Church this morning Prescott googled and found us a church to go to and you know when you’re making transitions and like I’ve said there’s been a lot in our life in the last two months that has really come down as I’ve been in the wrong time zone for almost three weeks now between sleep deprivation and making some saying a big goodbye to my son is that I leave him in Hawaii it was so comforting to be welcomed by a church they’re the ones who actually gave me this beautiful lei that smells amazing and you know just said we’ll pray for him and we’ll check on him you know even if he doesn’t check on them but to be a part of a community where you know we have lots of political things going on in our country today and I will say that the most important messages come out of our homes and our local churches to say be active in your community take the gifts that God’s given you and use them for one another and that’s why I do this channel that’s why I really encourage you to buy the book it really does support this channel and I hope that you’ve learned something I do read your comments even if I’ve not gotten to the internet much in the last three weeks it’s a huge part of how I’m trying to plan the next chapter of my life so thank you for the support thank you for being present and say a big prayer for my dad and my son as they take on chapters of their life signing off is dr. Baz we are here improving your one ketone at a time until next time everybody

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