Long-Term Ketogenic Diet and Cardiomyopathy
This is a followup to another member's AMA question, "Troubling study regarding long term ketosis," inquiring about: https://www.nature.com/articles/s41392-020-00411-4 Rodents are not people, of course. I have confirmed that they didn't make the common mistake of using a very-low-protein diet for the KD (theese are often used for short-term keto studies in rats because rats are recalcitrant to ketosis, but are sometimes ignorantly used in long-term studies and can create artifacts due to kwashiokor ). I'm more concerned about their references (19-20) which document cardiac abnormalities in kids on long-term keto for epilepsy: https://onlinelibrary.wiley.com/doi/full/10.1046/j.1528-1157.2003.26102.x (They suggest it might be Se deficiency, but 8/39 children also had Se deficiency and did not have cardiomyopathy). https://n.neurology.org/content/54/12/2328.short "Twenty patients on the ketogenic diet at one institution were investigated. Prolonged QT interval (QTc) was found in 3 patients (15%). There was a significant correlation between prolonged QTc and both low serum bicarbonate and high beta-hydroxybutyrate. In addition, three patients had evidence of cardiac chamber enlargement. One patient with severe dilated cardiomyopathy and prolonged QTc normalized when the diet was discontinued." https://onlinelibrary.wiley.com/doi/full/10.1111/j.0013-9580.2004.10004.x "Late‐onset complications also included osteopenia, renal stones, cardiomyopathy, secondary hypocarnitinemia, and iron‐deficiency anemia. Most early‐ and late‐onset complications were transient and successfully managed by careful follow‐up and conservative strategies. However, ... four (3.1%) patients died during the KD, two of sepsis, one of cardiomyopathy, and one of lipoid pneumonia."
Test Parameters
You've mentioned in several episodes how your clinic sets different parameters for blood test results/markers compared to the standard ranges (for instance uric acid below 5, ALT below 20, etc.). Can you share those parameters with us? A one page summary of the markers and the preferred levels would be an immense resource, even if not exhaustive!
Cancer diagnosis
My wife was just diagnosed with a rare form of Non Hodgkin's Lymphoma called Mantle Cell Lymphoma. She is 44 with 2 young children. It was caught early during a routine exam and doctors say we have some time before treatment has to start. If your wife was diagnosed with an uncurable cancer but it was caught early, what "alternative" treatments would you recommend she do? Hyperbaric chamber, Ozone therapy, IV Vitamin C, Keto diet, supplements, PEMF are a few of the things we are research.
Inspiratory Muscle Strength Training as a non-pharm intervention for Stage 1 HTN
The two podcasts on Insulin Resistance were outstanding, thank you. This might be a Cats and Dogs question for an AMA podcast … Any comment on the use of Inspiratory Muscle Strength Training as a non-pharm intervention for Stage 1 HTN ? I came across IMST when a patient of mine asked me about using it for his OSA. I never heard about it before excepting having a vague recollection about using such to help to get pts off of a ventilator. As I researched the topic there were some references about it possibly helping to lower BP. With new guidelines for HTN in 2018, I became a Stage 1 hypertensive … my home readings were consistently between 130-135/80-85. Having just made 65 yrs old and not having easy access to a more reliable continuous or overnight home BP monitor, I suspect my BP is slightly higher, and I’d like to avoid having to start meds. Anecdotally after 4 months of 30 breathes BID, I am now consistently below 130/80. I don't know if the links below will work ... Inspiratory Muscle Strength Training Lowers Resting Systolic Blood Pressure and Improves Vascular Endothelial Function in Middle‐Aged and Older Adults - Craighead - 2019 - The FASEB Journal - Wiley Online Library https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fasebj.2019.33.1_supplement.541.4 Effects of Inspiratory Muscle Strength Training on Cardiorespiratory Fitness in Middle‐Aged to Older Adults - Heinbockel - 2019 - The FASEB Journal - Wiley Online Library https://faseb.onlinelibrary.wiley.com/doi/10.1096/fasebj.2019.33.1_supplement.695.4 Inspiratory Muscle Strength Training Improves Vascular Endothelial Function in Older Adults by Altering Circulating Factors that Suppress Superoxide and Enhance Nitric Oxide - Craighead - 2020 - The FASEB Journal - Wiley Online Library https://faseb.onlinelibrary.wiley.com/doi/abs/10.1096/fasebj.2020.34.s1.04717 Daily inspiratory muscle training lowers blood pressure and vascular resistance in healthy men and women - DeLucia - 2018 - Experimental Physiology - Wiley Online Library https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/EP086641 What is Inspiratory Muscle Training? - POWERbreathe https://www.powerbreathe.com/2020/03/22/inspiratory-muscle-training/