This transcript is brought to you thanks to the hard work of Alison Gover.

Welcome Renee to the Keto Woman podcast. How are you doing today?

I’m doing well, thank you. Thank you for having me.

Oh, you’re very welcome. It’s nice to see you again. We saw each other at Ketofest.

Yes. Lovely to actually see you back and forth.

I know. It’s nice. It makes it extra special when you’ve met in person and when you see someone, well it’s like seeing them again almost. You have that memory of them being literally in front of you.

Indeed. Yeah. Terrific too get to hug people.

Yes. I’m a big hugger. Did you enjoy Ketofest?

Yes I did I mean it was obviously quite hard.

It was very hot.

We’re accustomed to that in Texas. It was a little unexpected there, but yeah, the festival was fantastic.

Yeah, it was good fun, wasn’t it? But like you say, hot.

Sunday was not quite so hot and that was great, but Saturday, yeah, I think I sweated out all my electrolytes.

That’s true. I ended up flipping burgers actually. Well flipping burger buns. I was walking around the plaza seeing how everyone was doing and Julie from Fox Hill Bagels was desperately trying to get all her buns flipped, and was stressing out because she needed help. So I put my apron on and helped her. But you could imagine in full sun in the heat that we had standing in front of the grill.

I was watching you guys, the sun was coming straight down on you. There wasn’t a cover and you were over that grill. And I thought good grief they’re all going to die!

It was incredible. And I wasn’t doing it for very long and I nearly melted. But the reason I brought that up actually was just to mention Chris Bair from Keto Chow. Luckily not far away, was the Keto Chow stand. And he came over with these beautifully cold bottles of water ready, filled with some electrolytes, which was an absolute mercy. Really, really helped. Because as you say, when you’re sweating and it’s hot like that, you’re just leaching out all your electrolytes and that just ends up making you feel worse, doesn’t it? So enough Keto Fest chatter, tell me a bit about you.

I started my first diet when I was 10 years old and my mother thought, well, if we get this sorted out now, then you’ll be good for the rest of your life. And unfortunately, she had been sort of dieting all of her life as well, and wasn’t very good at it either. So that started the diet yo-yo for us, for me, in particular, and we’d get close to our goal and then something would happen and we’d go off somewhere else. And it just was 40 years of the diet yo-yo for me. But in 2012 I was staring down my 50th birthday and I thought, okay, I’m about to turn 50 things change for women. And if I don’t lose it now, it’s never gonna happen. So I thought, right, we’ve got to get this sorted out now. And you know, I started New Year’s Day and I did pretty well for a couple of weeks and then fell off another couple of weeks and fell off. And by April I actually needed a bigger size. So I was going right the opposite direction.

Well that’s what happens, isn’t it? That’s the problem, it’s just one of the known things about, well, I suppose any kind of diet, actually you could include Keto in that, if you do any kind of diet where you lose weight and then you go back to your old habits, you not only regained the weight you’ve lost, but a little bit more as a nice little bonus.

So I decided to do some research and I recognized that my major issue was because I ate for emotional reasons, if I was stressed or upset, I would just go straight to the refrigerator. So I thought, okay, we have to sort this out. I’ve got to get a handle on that. So I did and I started losing weight and I actually reached my goal weight the week before my 50th birthday. And I’ve been there ever since. So it’s now coming up to seven years of staying right here where I am around somewhere between 115 and 119 pounds. So I’m only five foot three so there’s only so much this little body can carry.

And I know in the notes you sent me talking about it, that you actually, that first chunk of weight you lost when you first hit your goal weight, that was nothing to do with Keto, am I right?

No, it was, it was low fat, low calorie deprivation, starvation kind of diet.

Not much fun then.

It was awful. But I thought, okay, this is what I have to do to get there. This is what I have to do. And unfortunately when I was trying to maintain it, it was a real struggle because I’ve found that you lower your calories, I never went below 1200 but still, I just couldn’t seem to eat too much more and maintain my weight. So two years later I was sort of tired and hungry and really cranky all the time. And I thought, okay, there’s something wrong with this picture, I’ve got to do something different. So I got back on the Internet and was doing some more research and I found a metabolic test and when I got the results of it, it said, you need more fat in your diet. And I thought, fat, fat, we’re not supposed to have fat. So I went through that initial thing. But what I found interesting was that they gave me a diet, it was, it was low carb, it was pretty much Keto throughout the day. But in the evening you got some grain, but not a lot of it, just a small portion. And I was having butter and cheese sauce and thinking I’m going to gain weight, but I lost two pounds that week and I was already at my goal weight. 

So I thought this is not supposed to happen, this is weird, I was sort of skating around things and still having some sugar here and there and all of that. And in the New Year, I guess that was 2015 I started finding stuff on Keto and I thought, okay, this sounds weird, but all right. And I would play with it a bit, but I wasn’t willing to give up my sugar yet, so I wasn’t getting, the whole ketone thing. But I finally decided, okay, I made a rule for myself. I only have sugar on Sundays and after about 10 days, the first week was really hard, but after about 10 days I was like, oh, okay. I see how this feels. I really don’t like the effect of sugar on my tongue when I have it, it’s just this funny feeling. So okay, we’ll just give up sugar, go straight into Keto in April of 2015 and I have tried to find my balance. It took me a while to find what I really needed to do, but I love it. It’s fantastic. I don’t feel hungry all the time. I still have to sometimes think, okay, what are you hungry for? You’re not really hungry. What are you looking for? And sort through that emotional side. But it has worked very well for me.

And so presumably that’s just a much more comfortable way of maintaining that weight loss, a happier way.

It’s much happier way. So I get bacon and butter, what else do I want? If I really need a snack, I’ll go do some bacon and that makes me happy.

That’s a problem, isn’t it? If you’re having to eat in a way that, as you just said before, it was making you cranky and irritable and so it’s a bit of a white knuckle ride the whole time trying to maintain it. That’s a lot of energy. You’re losing doing that.

Yeah, but you’re right. I mean there are times when I get hungry on Keto, but it’s because either it’s been a long time since I ate last or I didn’t get enough fat in my meal at the last one and that I’m beginning to recognize, particularly if I’m like at a conference or something and they serve a meal, I have to make sure I get the fat or I’ll get hungry.

That’s interesting isn’t it? Finding out what for you are the things that really keeps you satisfied and I see a lot of people playing around, particularly with the protein to fat ratio. It seems for some people adding more protein is the trick and the fat makes no difference. You know, obviously I’m not talking about them eating low fat, but that doesn’t make the difference. Whereas other people, if they up the protein too much it actually makes them hungry and then it’s all about just figuring out what that perfect balance is for you.

It’s what works for your body, it’s really important.

And so you’d already approached this whole massive area that affects so many of us, of the emotional side of eating before you even started Keto, so you kind of had a handle on that, well, had more than a kind of a handle on it. You had a handle on it going into Keto, but a lot of people, and I’m one of them, it’s still something that I very much struggle with, going into Keto and they see so many people saying, “Oh, I’m not hungry anymore. I eat till I’m full and then I stop. I don’t have cravings, everything’s fine and rosy and dandy and I’m losing weight and everything’s golden” and it seems to work that way for some people it often seems to be men, and I’ll ask you about that if there is any kind of difference in experience between the genders, shall we say, but I think for a lot of us it’s this bit that’s missing in the picture, I think maybe this is a predominantly female thing as well. We think it’s something that we’re doing wrong that we’re failing because Keto isn’t working as well for us as it is for other people, so it must be something that we’ve done wrong and then we start beating ourselves up and obviously that’s going to just fuel back into the whole problem with emotional eating. Perhaps you could just give us some guidelines, I know this is what you do, so we’ll go into all of that. How did you start doing this? Is this something that you’ve always done? Is this something that you started doing via your own experience? I’ve thrown a lot of questions at you there, so you just start where you want to.

The counsellor and coach in me says, no, you’re not doing something wrong. Lose that thought because that’s not going to help you at all. The problem is that from birth, when a baby cries, Daisy, what do we do? We usually put something in their mouths, whether it’s the bottle or a breast or the pacifier to get them to stop crying we put something in their mouths and it works. So very much it is how we are trained, how we are wired. When we are upset, we put something in our mouths and the problem came when we changed out that dummy that pacifier for a donut. So it’s something that’s hard wired in us, this is how we work and just like, I don’t know how it was in school for you when you were first going to school, but we walked everywhere in a straight line, eyes forward, hands beside our side, whether we were going to the playground or to the cafeteria or to another classroom. But as we got older, we didn’t have to do that anymore. We learned other ways to get where we were going to go. So it was what we were taught as children and as adults we have to learn, okay, I’m upset. I want some soothing. How do I get that soothing in a way that is appropriate for me, for my situation, for my personality, for who I am. So that’s kind of the progression. 

And one of the things that I teach to my clients is it’s not hard to overcome emotional eating. We just have to get the hang of it. And I use hang as an acronym. So the H is am I hungry? And if you’re hungry you probably do need something to eat or you need it soon, right? So if you’re not hungry then go to the A, what is your attraction to food right now? What’s going on? Because there’s always something going on. If we’re crash landing in front of the refrigerator, it’s not just hunger. There’s something within us. So what is that driver and then the N, what do you need other than food? What would soothe you right now? What would help you? What would make you feel a little better? And then the G is go, go get that. Because that will soothe you more than any food ever could. And it’s a process. You’ve been doing it the other way for a long time, so give yourself some grace to work your way into it because once you get the hang of that, then it’s like, oh, okay, what do I need? Um, I need some time with my dog, or I need a hug or I need some help with this project, and then you can get that and it’s much more soothing. Does that make sense?

It absolutely does. I’m just trying to figure out, and presumably it’s a question to a certain extent of simply practice and some kind of discipline in kind of forcing yourself through those steps of exploration in the first place. Because it feels to me, and I know this battle’s gone on in my head, and it can be as you’re walking to the fridge or as you’re walking to whatever contains the item of food you’re going for. I’ve had that conversation in my head as I go there. You’re not hungry. I know I’m not hungry. I know I’m not going to it for that reason, but I guess the problem I have is that that argument is very limited. It’s just, you’re going there for the wrong reason, don’t do it. And the other side is, but I don’t care. I’m going anyway. And it’s this battle battle, battle, battle battle and the “I don’t care, I’m doing it anyway” pretty well always wins. But I’m guessing from what you’re saying that that’s a bit of a negative feedback loop in a way. What you need to do is harness that critical voice and turn it into a different practice.

Yes. Well, and if you can, you obviously recognize, “okay, I’m going to do it anyway”. And sometimes that is a choice. You get to make that choice. You’re an adult, you get to choose that and then you can deal with the consequences later. I often reckon it to paying taxes. We do that because the consequences are great if we don’t. So you have to make a choice there. What will be the consequences for me? Well I won’t get to my goal weight or I will gain, and you know what? That’s okay. If that’s where you are today, that’s where you are today. Tomorrow you may be in a different place and it is the perpetual making different choices that get you turned in the direction that you say you want to go. Well if you don’t want to go there, don’t go there. 

But don’t beat yourself up for it because that’s not what you actually want. And I think learning to choose what you actually want in any situation begins to lessen the hold that has on you. Because it is, it is such a mental process in the end and it’s healing some of those wounds that you may not even realize right now. And that’s, you know, that’s how people end up with me for long periods of time is cause we’re trying to figure out, okay, what exactly is going on and why are you bucking against that? There’s something deeper there because in the end it all comes down to what is the driver of this behavior. And once you figure that out, then you can change the driver. But it is a process and beating yourself up only sends you to needing more soothing, right? And then you get into that perpetual cycle of beat myself up, I need soothing so I eat and then I’d beat myself up for that. And it just keeps going.

And how’s the best way to try and start breaking out of that then?

It is a choice in the end, it is, okay, what do I actually want? And if it’s food, then the consequence is that you will probably gain some weight and that can be okay. But giving yourself the freedom, I know it sounds kind of silly, but somewhere within us likely there is a small child who was not given that freedom and we have to soothe her or him and get that taken care of. This became very clear to me right after my grandmother died because when my mother had passed away a few years earlier, I crawled into the refrigerator and I gained a lot of weight. And when my grandmother passed away, and we were tight, oh my Nan and I were really, really close and I thought, okay, I can do that again and gain more weight or I can start breaking some of the connections that I have with food and her and get better myself. So it very much comes down to a moment that affects you and how you choose to go on from there.

And I do think when you were talking about making that choice to sometimes to eat and there’s going to be that potential consequence of gaining weight or if it’s the wrong, in quotation marks, food it could make you feel ill I do think, well I found myself anyway that Keto gives me some kind of freedom in that that is much more limited.

Yes.

With high carb food, I literally go completely off the rails. You know, the train goes completely off the rails and it goes absolutely crazy. And I can gain weight like you wouldn’t believe in a really short period of time.

I would believe.

But at least with Keto, I’m not saying it’s solved the problem because it hasn’t, but it does limit it and that there’s still some overeating that goes on, but it doesn’t go completely off the rails.

Right, because carbohydrates always want more. You cannot satisfy yourself on all of those carbohydrates. You just can’t, they don’t fill that need in the same way. They’ll fill your stomach in the same way.

Yeah. So it’s that combination, isn’t it, of what you’re still lacking with this needing to fill this emotional need that’s going to exist. If that’s an issue that you have, whatever you’re eating.

Yes.

But if you can remove the physical side of it, it is going to help, isn’t it? It’s going to make it a bit easier to maybe start tackling the emotional side.

Yes. And it does help when you’re not hungry all the time. It is so much easier to overcome emotional eating when you’re not starving because you don’t have that panic of, your base self saying I’m starving, I need something. Well you’re not gonna be starving. If you’re eating Keto, you’re going to be a little more satisfied once you work out what works for your body. But you also, as you say, if you eat something off plan then it kind of makes it worse.

Yeah. And it can really start a binge type cycle. I mean I see so many people. It’s when you talk about the whole, I think this would be an interesting thing to talk about, the whole question about a cheat day or some kind of planned off plan eating and people as much as the plans they make, it’s just going to be for one meal or one day or one holiday. The risk is, and for some people it does work like that. You know, I’m just going to do this while I’m on holiday for example. And when I come back everything goes back to normal. And there is some kind of logic in that and I’ve, I’ve found for certain things that works for me, I actually do that with chips or French fries as Americans call them. I will not make them at home. I never make them at home. I don’t allow them through the door. But if I’m out somewhere, at a restaurant, I don’t go out that often so it’s not actually something that arises very often. If they look like they’re good, I won’t bother if they’re not good chips, then will have them and that for me works. But for other things, interestingly, the crisps or chips, this whole translation with food thing I find fascinating.

It’s amazing. Yes.

But those that doesn’t work. If I have those, even if it’s out of the home, that will lead to a cycle that ends up with me buying them and bringing them into my home and before I know it it’s every day. So it’s interesting, I think that some people can do that, putting it in a certain box and managing it that way. Some people can do it with certain foods, but a lot of times it ends up just starting this cycle that one day, one week’s holiday turns into, before you know it, weeks, months, years even.

I think if you think about that in terms of other places where you are disciplined, then it might give you the tools to apply that same discipline to this unless you choose not to. And that’s fair enough. I went to a wedding in April and there was literally nothing, nothing that did not have some kind of sugary coating to it. And I thought, okay, I can either be really rude to the hosts and not eat at all. Or I can say, all right, it’s one evening, it’ll be fine. So I went with that, so as not to be rude. I didn’t need a lot, but you know, I tried to enjoy every bite of it. And I think that’s one of the things that’s key. If you’re going to have something, try to enjoy it because you’re going to pay for it later. And two days later I snapped at my dear sweet husband and I said, oh gosh, this is the sugar talking, and he was like, okay. 

And I recognize that when I have the sugars or carbohydrates in excess, well, in sugar, anything is excess, right. It does affect me emotionally that blood sugar high and low makes me ratty. Hence the reason I try to stay away from it, but I try to enjoy every bite and I have to say it was all very good, so I enjoyed it and then had to deal with the consequences of my day of not feeling my best because I was just, oh, everything was irritating that day. It is just not worth it to me to do that in another setting, you know? Unless I’m being rude to somebody, then I was like, okay, I don’t want that awful feeling of being that ratty so I won’t do it.

I think a big part of it is being mindful and aware of what’s going on, isn’t it? I often say to people when they’re in that day afterwards and they’re feeling whatever they’re feeling, whether it’s emotionally bad, physically bad, both, I say to them, record this in some way. You know, make a video of yourself, write it down, whatever it is in the moment when you’re feeling it, make a note of it because we’re very good, aren’t we of forgetting.

Deleting those memories, yes. That particular day was very stark to me, so I thought, okay, now you’ve got your memory to hold onto. So do that.

And this work that you do with emotional eating, is this something that you’ve always done or is this something that developed because of your own experience to apply to the counselling work that you do?

Well, I was a counsellor obviously before that, but yes, the focus on emotional eating just came out of my own experience and recognizing that a lot of other people struggle with that as well. And I think sometimes when you’re in the desert and you find water, you want to share it with others because if I can help someone else overcome their emotional eating, that’s wonderful. Because it’s helping them heal their heart a little bit and there are so few opportunities to do that with people that I want to take everyone I get

Tell us a bit more about that. Tell us a bit more about your work and your business. I like reading your notes. I like the whole, the imagery you have with the packing your own bag, that progression.

I think our bags kind of get packed for us as we go through life. Then we’re dragging all this excess baggage with us for decades and sometimes you have to unpack, just like when you come home from a trip, you got to take all this stuff out of the bag and then you can pack what you want for the journey you want to be on rather than the one that you stumbled into. So if the overeating and the emotional eating doesn’t fit who you want to be doesn’t fit the journey you want to be on, then get rid of it and choose what works for you. I tend to work in three main areas for people. We start with your body because if you don’t work out what works for your body, then you’re going to struggle. So find the thing that works for you in Keto. Find your macros, find your comfortable spot. If tracking works for you, track. If it doesn’t work for you, please don’t do it. Right? 

So find what works for your body and then we deal with some of that baggage because that will affect you. And if we can unwind some of the experiences or the things you think about those experiences so that you can get free of them, you can heal your heart a bit, then you’re set and then your best self. So your body, your baggage, your best. Because if you begin to cultivate who you are at your best and live that way more often, then life gets easier. I was born red headed. I have a temper, I am stubborn and dealing with some of those things helps me have a happier, more peaceful life. And I really liked that and I don’t know about you, but when I am living in my best self, I make much better choices about everything. Including food.

Yes, that’s right. And what does your Keto look like?

Right now in August, I’ve been doing carnivore mostly so it’s sort of 90% meat and fat and animal products and I like seasoning. I like cocoa and I like tea. Those are my plants. So I’ve been pretty carnivore. I think we have vegetables on Sundays at the moment and I feel great, but I probably will go back to having at least a serving of vegetables a day because I just like them. I tend to do a fatty tea at breakfast with some Collagen in it and then I’ll have lunch. I’ve also this month been playing with a reduced eating window, so I’ll have my main meal because I wake up hungry. I think my time, my body clock gets stuck on Welsh time from the years that I spent there. So I prefer to have breakfast and lunch, maybe a late lunch and skip the evening meal. And that works for me because I make dinner for my husband and then I have that for lunch the next day. And it doesn’t bother me to not eat. I sit with him but I don’t have to eat at the same time.

It’s interesting how, just like you say, finding what works for you and also appreciating that that changes as well.

Yeah. At some point I will go back to having dinner, you know, at six o’clock with my husband. Just not right now.

Yeah. I’m really interested with how people do on carnivore because I was expecting to find that it suited me really well because I, like you, was finding that I was eating a lot of the time that way anyway. And so thought sort of taking it to the next level would be just like, you know, dialling it up and making it even better. But it went the other way for me. I didn’t do well at all, especially with my mood, but also obviously screwed around with my hormones cause I started getting hot flushes all the time and I just thought, oh well this, you know, it’s just time for that to start them. But when I stopped doing it they stopped as well.

Oh, you want to avoid that.

Yes, exactly. I do still get a few but just it was like all the time. I said, oh no, this is not fun.

We don’t want to do that. But I tell you, I made a, a bit of a shift earlier this year because I heard someone say that, I think it was Kim Howerton actually, she said we were trained by WeightWatchers that fruit and vegetables are free. So when we come to Keto we know that that fruit must be monitored, but we take all of those vegetables into Keto and wonder why we’re not getting the results that we want. And I thought, oh yes, because I was the queen of the eggs Florentine for breakfast, right, I’d have some vegetables with every meal and it made a difference when I cut those back because they’re carbohydrates too. They may be good carbs, but they’re still carbs and again, dialling in what works for your body.

Yeah, that’s right. I absolutely agree with that. But I found, I think it was Dr Nally who is talking about it on the Two Keto Dudes podcast with Carrie particularly talking about how she tried carnivore as well and didn’t do too well on it and does better with some vegetables. And, and he was saying yes that this, and having a small amount, he wasn’t talking about having massive platefuls of salad, but he was talking about, having some greens, even just a small salad every couple of days could make a big, big difference. But not, having masses. Like you say, having too many can be problematic for people too. So it’s always about finding that balance isn’t it?

Yes, for you. Because your chemistry is different to my chemistry and just because somebody else can can have all the Keto treats and the nut flours and all the rest of it. It’s not a contest of “she gets to have that and I don’t get to have that”. That’s just not the way we need to think about this because what you’re working on is what works best for you.

I think that’s partly what’s enjoyable about Keto and certainly what I see for so many people is that they find it really empowering because they start feeling like they’re getting some control back and starting to make better choices and seeing how their body reacts and finding that they are starting to get some control back over their health, that they felt that they might have lost or was forever gone and they’ve just accepted the fact that they’re on some kind of progressive disorder journey and there’s nothing they can do about it and all of a sudden they start to feel good.

Absolutely. Because I know it made such a huge difference for me because I was no longer hungry all the time. I wasn’t tired all the time and I certainly wasn’t cranky. So it made such a huge difference for me, I can’t imagine ever going back to eating the standard American diet. But what’s interesting to me is my grandmother back in the seventies I guess when we first started, said, Renee, all you have to do is cut your sugars and starches and you’ll be fine. So she knew, she couldn’t do it for herself, but she knew. It’s just been refreshing to come back to that and think, oh yeah, I remember when the low fat thing came out and I was thinking, that doesn’t look good, but we tried it, right. That’s what they told us to do.

Well, and it wasn’t overwhelming. That’s what they told us to do. Backed up with the government health guidelines pretty well around the world. Not absolutely everywhere. But you know, certainly in the States, certainly in Britain and the EU, it’s just this, fat is bad. You need to reduce your fat right down, especially saturated fat because that’s the worst thing of all. You’ve got to eat your five a day, you’ve got to stay away from too much red meat is bad you. But these things have been drilled into us for so long. I think a lot of us, even though we know that fat is fine, even though we know it feels good, we still sometimes feel guilty when we’re eating it. There’s just that automatic response because it’s been drummed in for so long.

There is that, “gee, I hope this doesn’t come back to bite me in about 10 years”, but at the same time I feel so good and the lack of hunger is just wonderful because I was hungry all the time. It worked, I lost weight, but I was not happy on that. And I think food is too big a part of our lives for us not to be happy with what we’re eating.

Yes, and who wants to live in a constant world of deprivation?

Well, one of the things I tell clients when they are like, “okay, I’ve got to have this, this has to be a part of my life”. I say okay, that’s fine, work around it and if you’re going to have something like if you’re going to have your crisps, here’s what you do. You set it aside until you’ve got time and then you put it on a plate and you use the appropriate utensils. You sit down, you lay a place mat, lay your table, make it pretty. Sit down and enjoy every bite of whatever it is you’re eating and if you can do that, have it without any guilt whatsoever. Just enjoy that food. Squeeze every bit of flavour out of every bite because then it will be much more satisfying to you and you don’t have that wraparound guilt thing going on because you’re an adult. You’re allowing yourself to have this particular thing on this particular day. 

The problem is we tend to either eat at the sink or pull up a chair to the refrigerator or watch in front of the television. I had this one client, a fella who had ice cream every night and I said, that’s fine. Just work it into your plan and sit at the table. Well, he said not at all, I want to eat it in front of the TV. I said, are you bored? Are you focusing on the food? Because if you are, if you want this food so badly, then actually enjoy it, focus on it, get all of the sensory experience out of that. If you’re watching TV, you’re not enjoying the food. So just make your choice. What do you want? The TV or the food and if you’re bored watching TV, why are you watching TV?

Yes, I must admit that is my tendency because I live on my own. I tend to, and maybe it’s, you know, it’s a multitasking thing in a way as well, but I don’t really see the point of sitting at the table and just eating because it’s just me, you know? So I’m not talking to anybody or anything. I’m just that, I don’t know, it just doesn’t feel right. So I am always doing something else. Usually watching the TV when I eat, but you’re right, and interestingly enough, when I am eating with somebody else, I’ll eat less, way less. I think that’s partly to do with the speed I eat because I’m talking and eating. So it takes longer to eat what I’m eating, but I would say almost without exception, I eat less when I’m sat down at a table eating with somebody else.

Well, and some of that is just attention. I remember years ago, Oprah had gone to France and she bought two croissants. She said, I knew I would swallow the first one whole and I got the second one so I could enjoy it and I thought, okay, yes, we do that. We get through something and then it’s almost like we haven’t had it because we ate it so fast or because we weren’t paying attention to it. Therefore we need more of it because we want to enjoy it. Well if you just enjoy it the first time, if you allow yourself to have that time when you’re eating, as focusing on the food, you know your eyes on the food that you’re eating. Gratitude for whatever was sacrificed for you. Get the sense of it, the smells of it, listen to your knife and fork cutting. Just get all of that sensory experience. It doesn’t have to take long, but when you’re eating, eat, enjoy the food, and it’s likely that you won’t eat as much because you’re getting all of the sensory experience in that one occasion.

It made me chuckle to myself then, well not chuckle, shiver probably more appropriate word, when you are talking about what Oprah said, because that’s exactly how I feel when I’m eating kinds of foods. It’s actually a sense of panic if there isn’t much of it. If it’s a very small amount, just taking the first, well, just actually the thought of eating it, if there isn’t a large enough stock of what it is, I’m panicked about that because I know that I’m going to run out. And just as you were talking, it made me think, absolutely, you’re throwing away a certain amount of that just sort of trying to fill that need before you even really start tasting it. So you’re having to plan for so much more than you actually need because it’s not actually the need in quotation marks that you’re trying to satisfy, not actually that food that you’re putting in your mouth.

So the question is what is that need?

Yes.

And that’ll be different for everyone. What is it that that says to you?

And I’ve seen the futility of that. I’ve told this story before, Haagen Dazs ice cream was always the thing that I used to really love, I remember it was in the summer. Supermarkets aren’t usually open here on a Sunday, but in the summer they tend to be because the tourists are here. And I raced to the supermarket to get there before it closed at midday, just about got there in time and got a load of Haagen Dazs and I came back and was sitting eating this and I didn’t really want it I knew I didn’t want it. It was at a time I think where I was on, I think probably the low carb part of my journey. It was certainly way before Keto, and it might’ve even been actually way before when I was just in the normal yoyo dieting of things and on an off period, but just eating this working my way through these tubs, and it was multiple tubs of Haagen Dazs ice cream and certainly wasn’t enjoying it. I had tears streaming down my face, I was desperately miserable. I was shoveling this stuff into my mouth, trying this futile attempt, I guess, of trying to soothe whatever the problem was.

Yeah, and if you can find what you were trying to soothe and unwind that, then it’s much more likely that the food will lose its importance to you.

This transcript is brought to you thanks to the hard work of Debbie Mitchum.

Welcome Elena to the Keto woman podcast. How are you doing today?

Hello Daisy. Thanks for having me. I’m actually very excited to finally talk to somebody about migraines. Who knows what migraines are herself, which is really cool. 

Oh yes, absolutely. 

There’s nothing better than introspective when you talk about a disease. You actually know what it is like, right.

For sure. We’ve been trying to record this for ages, funnily enough we were laughing about this before. We’ve both had to cancel due to migraines at some point, which is kind of funny. But we’re, we’re finally here and it’s fantastic to be speaking to you. 

Yeah, it’s certainly also been my fault for having to finish the PhD thesis and lots of things going on. So, my thesis in two weeks, I’m still a little bit stressed, but fairly migraine free, so it’s all good. And I’ve been looking forward to this since you asked me like months ago. Yes. 

Yes. It was quite a long time ago when we started talking about it. But the timing worked out quite well in a way because yes, like you say, it’s good to finish your thesis first.

Yeah. And you even skim read it. I’m well proud of you and honored. 250 pages. Well done.

Well I was, I was very interested in, there were, there were all sorts of things in there that we’ve chatted about a little bit before we start, so we’ll have to remember to bring up all the points in our actual recording.

Okay, great. I guess you have a list. Otherwise I’ll pull out the thesis again and we can go through it.

So, let’s start by hearing about you and how you got into keto, how you got into your migraine research.

Yeah. So, as you can imagine, and as I already mentioned, I’m a migraine patient myself. It’s, I think it started about when I was about 14 maybe half a year after I started the contraceptive pill, which is very interesting because having talked to a lot of patients within the course of my study now there seems to be a connection to starting the contraceptive pill and migraine onset or migraine worsening. But I just went to several doctors, nobody knew what was going on, psychologists and whatever brain scans. And finally, I diagnosed myself using the internet actually with migraine and from them then on is basically continuously gotten worse. So despite trying everything, and you know when you’re 16 you’re trying to go out with your friends or have a drink here and there and the least you want is really have a stable lifestyle of going to bed at the same time and not eating all these triggering foods. And, but I really tried and despite all efforts, alternative and medicine or pharmacological therapies, it just got worse. So after I think it was June, my bachelor’s degree, I was always interested in the brain, but I started reading psychology and my bachelor’s degree and my migraines actually became chronic and that’s something where you have more than 15 days per month of migraines or at least eight of those have to be migraines. The rest can be headache and just really crippling. Your migraines are starting to control life. You cannot go anywhere with that pain. I mean you know that when you have a bad migraine you can’t really control or ignore pain in the brain. Really. It’s a, it was quite tough, and you never knew whether you could take exams or whether you would have a migraine that day and plus social life. It was really bad. People don’t understand and so well by the end of the degree I realized that I couldn’t be doing a normal job with these migraines anyway. So, I decided I’m going to change my career path and not become a psychotherapist but go and read neuroscience instead and maybe within my lifespan, figure out more about what is a migraine and what can we do to actually treat it. So more looking into what might be the root causes, where is it coming from and why? Because I went to so many specialists and nobody actually answered that question, what is a migraine, why are we getting it? And of course, you can’t treat it.

Yeah. Cause if you want to really properly treat something, you’ve got to find that root cause.

Exactly. And not just treat the symptoms, not just treat the pain. And as we discussed earlier before this recording,  with triptans, those acute migraine medication or even with analgesics, you cannot take them more than like 10 to maximum 15 but that’s already pushing it days per months without getting medication overuse headache or this risking to get one of those. Because your brain basically adapts and then it adapts to having these chemicals around. And if you don’t have them around, then you get something like a rebound headache. So, your body is anticipating what these triptans do to your serotonin receptors because their serotonin agonists and if you don’t have those around, there’s not enough serotonin anymore to basically endogenously activate those receptors. So, then you get a migraine when you don’t take those drugs, which is even worse. Right? So, it’s like a vicious circle. So, I was stuck in that situation where half the time I could not take anything against the pain and that basically means you’re out for days in your dark room and you can’t do anything. So very unsatisfying. And  this is why I then went into neuroscience and I was lucky enough to have an open neurologist in Oxford who took me on and I did two of my masters, both master’s projects or thesis in migraine research with chronic migraine patients was one in neuro imaging. 

And the other one was STEM cell IPS, CS induced pluripotent STEM cell research with migraine neurons basically, which was also interesting. But for me it was most fascinating to be close to the patients in that neuro imaging. And there was this one incident and I still remember very clearly where the scanner broke down for one patient and she had to come back and she comes back into the lab the second time and I almost didn’t recognize her. She was walking up straight, she was smiling, she’s lost weight, she was like a completely different person. Back then I already started forming my theory that migraines are at least in part an energy deficit syndrome of the brain. She comes back and I asked her, what did you do? And she told me she’d been fasting for two weeks and that completely shocked me. He says, oh my God, she’s not eating for two weeks. And we know that not eating is one of the most potent migraine triggers. Right.

Typical triggers.

Exactly. And she was having a glass of red wine every night and it was fine. She had not a sandwich and I was like, wow, I couldn’t believe it because this is Oxford medical school or psychology medical school both together and the neuro-science in Oxford. We did not learn that the brain can metabolize anything else than glucose. Right. So, I didn’t even come across ketone bodies during the whole year of my studies there. And I was shocked, and I didn’t understand it. And I went about, and I chose the end of the degree. I was procrastinating in the library again as usual and was flicking through a nature magazine and it had an epilepsy special in there. And one of the articles was actually on the oldest treatment for epilepsy, the ketogenic diet. 

And I read upon the mechanisms and this was like the, I think this was the best aha moment I’ve ever had in my life. I was like, okay, this explains his incident with a patient, and this could also be the solution because reading upon the mechanisms, they were all migraine relevant. And few people know that actually migraines and epilepsy are genetically related. So, some kids would grow out of epilepsy and into migraines. It’s almost very similar pathophysiological mechanisms. The two, so some kind of parts of epilepsy are kind of like more severe versions of a migraine attack in a way you could end a lot of epilepsy patients even have migraine.

That’s interesting. How does that work? Why is the link though?

They see epilepsy as a migraine. It’s a hyper-excitable brain. It’s problems with your ion channels in the brain that make your brain super hyperexcitable and this can be exacerbated by energy deficits and when neurons fire in synchrony and they all fire at the same time, you basically get an epileptic seizure. That’s your seizure, uncontrollable firing, right, and a migraine CSD or Chronicle critical spreading depression, which is the correlate of the aura phase in migraine, which is this phase of visual. It could be visual but could be any other sensory deficiency that precedes the headache for about an hour and can be anything between five minutes and 60 minutes long. Basically patients go black on one side of the visual fields or you some go paralyzed. Some could also be like a aura of the body. Or you lose speech or something like this. But that’s also basically in the back of your head. This is basically a cortical spreading depression means that neurons fire in synchrony go over the cortex in a wave and that’s followed by no activity. And that’s basically when you then lose sight or lose control partly of body or loose speech, wherever that wave is traveling to basically. 

So synchronized uncontrolled firing is basically the underlying physiological correlate of an epileptic attack.  Migraines have that component to at least to some degree also antiepileptic drugs or the preventative drugs that are probably the most effective or among the most effective in migraine. So, if you reduce your excitability in the brain, you can help a migraine attack. And there’s also the link between hyperexcitability and energy metabolism because basically what makes a neuron fire the firing of a neuron is called an action potential. And there’s something called a resting membrane potential between a neuron and the outside of the neuron, which basically determines how likely the cell is to fire. Simply put, it’s almost like a wall between say the ocean and the land, the wave are the action potentials. If you have a high wall, the wave is unlikely to go over the wall onto the land, so you’re unlikely to get an action potential, which means your brain is calm. The lower the wall and the wall would be this resting membrane potential. The lower the wall, the more likely the waves are coming out to come over the wall. And whenever the waves come over the wall, the neuron will fire. Keeping this wall high or keeping the membrane potential high, which in the neuron is done by basically carrying out ions against a concentration gradient to basically keep this potential is an electric difference between inside and outside. In order to do that, you need to spend a lot of energy. So, 50% of the brain’s energy demand actually goes into caring ions across their potential difference in the brain, 50% it’s massive. So, if you have reduced energy in the brain, of course this wall is going to come down. When the wall comes down, your neurons are more likely to fire. What does that do? Well, first of all, you might get a migraine attack. But also, most migraine patients have some kind of sensory sensitivities. 

So hypersensitive to light, to noise, to smells.  Why? Because it needs much less of a trigger for the neurons to fire. If the wall comes down, they fight easily. So, life becomes much brighter and noise becomes much louder.  So, I think that’s how you can explain those other issues that come with a migraine attack before and during an attack as well could also be explained by this energy deficiency and by these neurons that are firing more likely. And the genetic predisposition here is a shared one between epilepsy and migraine would be, and there’s so many different ion channels in the brain that basically carry ions across membranes. That’s a function. Right. And if you have some that are predisposing you for a lower wall already or an increased tendency to fire and you put yourself in an energy deficient environment by only eating carbs. Right. Or you have mitochondria damage, then basically those two come together and you get a migraine or, you get more migraines. And I didn’t want to distract from the personal story, but maybe we could come back to this later. I believe that migraines, one says that chronic pain has lost as one in function. That’s what’d you say? Acute pain. Everybody knows it’s very important for evolution and once it becomes chronic, people say it’s lost the wanting function. We just need to treat the pain. But I doubt that. I think that pain always has a warning function. A migraine is a very potent warning of our brain that it’s in an energy deficit, that it’s, the oxidative stress is too high. It’s a very, very powerful means for the body to force us to stop what we’re doing to rest, to go in a dark room, we’re nauseated. We don’t want to move. That’s one of the most migrant symptoms. Movement makes it worse. Light makes it worse so you basically you shut up all sensory input, you conserve the energy you have until the homeostasis in the brain is restored and then a migraine stops and very interestingly during the migraine attack, early studies about 50 years ago and they’ve completely been forgotten about, showed that during a migraine attack, irrespective of what people are eating, ketone bodies are calling up and like policies is going up so it’s like a counter reactive response of the brain saying Oh we have an energy deficit now we need to ramp up some kind of energy that we can actually use. I now know that my migraines are trying to protect me from something and knowing that also helps you to kind of accept what you have. In a way I guess it’s not your body forcing this migraine onto wanting something bad is actually trying to protect you from something that is super harmful. It might increase your risk for Alzheimer’s in the long run or for some kind of brain damage in the long run because there is migraine stroke in patients that have migraines with aura. Typically for a very long time. I’ve been working in neuro imaging as I mentioned before, for some time you find this micro lesion in the brain. People usually say a migraine doesn’t leave a mark, but it actually does, so the more you get them, you actually do get to see it in the brain. Even with like a very course neuro image of like one square millimeter, which a on a on a much finer level, you’d probably see other things as well. Ions accumulate in the brain and all sorts of things.

Yes, I have read that actually and it makes complete sense.  If something is happening that your body is warning you against, it’s likely to leave a mark of some kind. 

Yes, and it hasn’t lost its warning function. It’s just that our environment has become so maladaptive to our migraine warning genes that say that people have it chronically, and of course it’s debilitating, but that also means that they probably have some kind of oxidative stress level in the brain or constant energy deficit. And that’s something you can also measure in migraine with neuro imaging these days, they have about a 20% on average ATP lack in the brain compared to controls, even between attacks. 20% less energy that’s not benign, and that’s episodic patients. That’s not even chronic patients. So, I don’t want to know how much lack of energy in the brain a chronic patient would have, and all the body can do. It cannot talk to you. It can send you pain signals, It turns these ancient mechanisms on, it turns the pain cause Kate on to force you to, to stop whatever you’re doing, to change something and tell you, hey, we’re not doing okay. There’s something wrong here. Right? That’s what pain tells you. And then in chronic patients it’s just that their genetic load is so high, and their mitochondrial functioning might be this bad. And there is other environmental situation with regards to food and energy might be this bad that they are constantly reaching the migraine threshold, the warning migraine threshold basically that the brain is always in such a state that it thinks it needs to warn them. Back to the personal story, just to finish that off, basically I stumbled across ketosis. I was like, this is it. I started self-experimentation. It went very wrong at the beginning because I had no idea what I’m doing and what a cute Jenny died is triggered like the worst migraine ever. I think it was fasting and I wasn’t in ketosis for like 10 days, which is crazy. My body completely had forgotten about how to make ketones or how to get them anywhere. But when I finally got it right, it was pretty amazing. Lots of self-experimentation followed. And then I knew that I wanted to do this in my PhD and nothing else. That turned out to be fairly tricky because everybody was like, Oh, you can come here but you do what we want you to do. I mean, as a pre PhD student, nobody believes you and it was fairly risky project, but then in Basel, and this is why I turned on Oxford in the end, is in Basel they said, if you come here, you can do it as a side project, and then before even starting my supervisor, he has said he has to leave to Germany. He’s, he’s leaving, he’s gone. So, my funding went, but that was basically the possibility then to say, okay, I’m going to make this my major project. I’m going to leave neuro imaging. 

It’s interesting, but it’s too far away from the solution. I want to do this Keto and migraine full time. And in order to get a grant that funds a full phase two clinical trial, which is fairly extensive, we decided to go the exogenous ketone round route, which is basically changing one variable only adding ketone bodies and find out what does the presence of ketone bodies change in a migraine patient with regards to potential mechanisms. And is this enough to show a significant clinical effect in those patients in terms of migraine day reduction and other outcome measures. And that’s been going on for like four years now. I think with the planning and everything and we’re in the last half a year. Last patient cohort is currently, in the study and then hopefully by next year we’ll have the results of that. But that’s basically the journey I’ve been. Now I’m towards the end of my degree and I was able to deep dive into ketone migraine, which is amazing if you can make your disease your passion, it’s kind of cool.

Exactly. So, you not only diagnosed yourself, but you’re going on to find the best treatment for yourself and for others at the same time. Yes, exactly. And we’ll talk a little bit about what your Keto looks like later because I know having had a conversation with you before we started recording, it’s going to play into something to do with what we’re going to talk about. So, I think it’d be better put that in a little bit later, right? Yeah, sure. You have spoken about already a little bit about what migraines are, but perhaps you could just talk a little bit more about that and also the connection you found with all the different triggers associated with migraines.

Yeah. So, migraines typically aren’t. That’s kind of, I maybe one more funny anecdote with regards to what a migraine actually is. Because when I was five or six years, I had a favorite movie called poom tin and Anton, it’s a German movie. And uh, I used to watch it on rainy Sundays with my friends. And in there the protagonist’s mother has migraines and her friend asked the dead, what are migraines? And he says migraines are headaches that don’t exist as in like she’s making this up. So, for the next 10 years following, I actually believe that migraines are a term for a headache that doesn’t exist for a made of headache. And then I had to, once I got there myself, I found out that they’re very real. So, migraines are not headaches that don’t exist. They’re actually even more than a bad headache. Typically, they’re from the headache, from moderate to severe quality pulsating.  They’re typically unilateral meaning they only appear on one side of the head. Typically, it could be some people have it strictly only on the right always and for some people it swaps. But typically, you have a preferred side where it happens, at least at the beginning. Eye pain is very frequent. Then you have kind of a premonitory phase, which precedes the headache attack up to one day or even more. And there you typically have associated symptoms, neurological symptoms like nausea, light sensitivity, noise sensitivity, smell sensitivity. Sometimes moving makes it worse and you have this like feeling of doom. Some people get really agitated. Other people get super tired and super fatigued and those symptoms can last throughout the headache phase. And then they will also typically last for the prodrome phase, which is basically the postdrome phase. Sorry, the phase that follows the headache. There could also be days even while you’re typically very fatigued and sometimes you have gastrointestinal symptoms. Most people have a lot of yawning. Maybe they pee more or increased appetite. It’s like your brain sensing there’s something wrong and now you need to eat as much as possible before the attack comes. A lot of people throw up. It’s much worse than a headache because you can’t ignore it. With a headache it’s like a pressure type of a pain and it’s your whole head typically and moving makes it better in migraine moving any kind of movement makes it worse.   pool sating sometimes stabbing quality is also fairly common. Does that summarize, I mean you could even, you could tell us, would you mind going, it feels like it’s fairly, it’s a fairly individual. This would be like more typical summary. 

 Duration wise, the diagnostic criteria says between 4 hours and 72 hours. So, between 4 hours and 3 days, which is quite correct. Typically, if I have a migraine that’s longer than three days, it swaps sides. So, I know, okay, next attack is starting. It’s not the same. 

You’ve got another one. 

Exactly. So, if that’s how you can tell and some people have an aura phase, you already touched upon this, about a third of migraineurs will have the phase of a visual or whatever, a sensory, defect. It will change. So, it’s only there for about an hour and then it will proceed, it could be a paralysis, it could be typically as visual, so visual disturbances, zag lines, blackout, whatever, these kinds of things. But it could be any sensory quality, losing speech as well. 

That’s fascinating to me because I used to have these incidents when I was younger, and they’ve always been a mystery always. And I may be had about half a dozen in total, but it was my late teens, early twenties. I thought it might be something to do with some type of epilepsy, you know, one of the really sort of low-grade forms of it. I just wasn’t sure. And the reason I didn’t investigate it was because I basically, I didn’t want to have my driving license taken away,  which someone told me if they start investigating thinking you might have epilepsy  that’s going to happen, but it never happened in any way like that. And I always had some kind of warning it was coming, but what happened was that I would kind of black out but stay conscious. Yeah. So, my vision would go completely. That’s a typical aura. My hearing would become muffled and the best thing I could do was just to sort of curl up in a fetal position. Terrifying. It happened once after a very stressful event where it was when I was at university in Liverpool and it happened just, actually on the phone to my mother and I think I terrified her because I said, I’ve got to go, I think I’m going to pass out. And I managed to get myself in the lift. I was on the 11th floor and then it happened. I couldn’t see, I could hear a little bit and luckily my, my roommate was either in the lift or was that, I think I managed to hit the right floor or was there when I got there and I said, you’re going to have to guide me to my room because I can’t see.

Yeah, it’s so scary. It’s so scary.

And it was very, very strange. It was, and I had no idea what that was, and I’ve never associated it with migraines at all.

So, the interesting bit is that all phases of the migraine attack can happen on their own. So, you can have an aura without the headache following. You can have the headache without the aura. You can have premonitory phases without the headache as well. So, people can have isolated auras, which is basically almost like a small epileptic attack. And depending on where this wave is traveling to. So, you have to imagine, right? We said that keeping your resting state with membrane potential upright takes 50% of the brain’s energy. Imagine there’s now a wave of electricity traveling over your cortex at the same time and you then have to rebalance all the minerals in your brain. That takes a lot of energy. I think it increases energy demand by like 200% or whatever and oxygen demand and everything. So it takes some time to basically get those neurons back into a state where they can fire again. If your neuron can’t fire, you can’t see, feel or hear anything. So basically, what probably has happened is that this wave was traveling across your visual cortex in the back because all your vision is basically centered in the back of the head. So that means if something troubles over there and basically enables all these neurons to do anything, that means it’s all vision is gone. That’s very interesting. The studies on the, I think, Second World War, First World War,  British soldier had these very weird helmets that would basically stop at the back of their head. So, you’d have a lot of, or quite a few soldiers coming back that has a wound or a shot into the back of their head and they would lose selective parts of vision depending on where the bullet has hit. So, if something would have hit all of your visual cortex in the back, then you just can’t see because the neurons, they are not working anymore. So, brain function, at least in some regards is localized in the brain.

Oh, how interesting. 

Would you probably have it as an is an aura, a prolonged or maybe even so then you can see it for patients, typically when they have it the first time it’s, it’s terrifying. They think they have a stroke. But the good thing is about an aura phase and that’s, where people shouldn’t be too terrified or worrying too much. That typically function comes back within the hour. So, it is more energy demanding. It does create more oxidative stress, which is probably why often aura phase of migraine headache starts because of all the oxidative stress, all the metabolic strain it puts in your head. Right. I mean, it now has to rebalance all these things after this electrical wave of activity. And that takes a lot of energy. It takes a lot of electrolytes. It takes a lot of oxygen and it takes a lot of things to get back on track, but it usually does. So your vision will come back and you’re feeling in your arm. Will come back and all these things, but it’s a fairly terrifying event. And that will be a prime example for an aura. Quite a bad one.

Yes. How interesting. And it’s, and it’s what I realized that it would pass fairly quickly. It was anything from, you know, 10, 20 minutes. I just knew that, yeah, if I just lay down, I mean, it’s the safest thing to do, isn’t it? Sit down, lie down somewhere.

It’s the best for you brain as well. You rest, you’re not spending energy on walking, for example. That would again, expand energy that your brain would need to restore itself. So, it’s kind of intuitively you do the right thing. How interesting. You’ve solved a mystery. Yeah, yeah. I mean there’s other things I’ve been wondering about and it’s like little puzzles that you can solve along the way. It’s kind of nice if you can explain your symptoms looking back. Because you always end up going to a medical doctor typically doesn’t help because I don’t have explanations as to why things happen. They only have a symptom treatment response. Typically for an aura, there’s some drugs you can take, but it reduces the aura frequency by like 20% or whatever. It’s really not worth it, but it’s good to know that when it happens rest, lie down, don’t do anything. Maybe have some magnesium’s and minerals, maybe if you can get something down.

It kind of makes sense that it happened at that period in my life. Maybe where, you know, a lot of things are changing with your body because it doesn’t seem to have carried on. That was something that happened within a period of a few years.

Yeah. So, your threshold would have been much lower because if you’re stressed, and that’s something that was very interesting to me because there’s psychological stress and there’s physical stress and we always think that these are different things. But actually, they’re fairly similar in terms that all of these stressors or stresses, irrespective whether it’s physical or mental, is basically causing oxidative stress. And oxidative stress is the common denominator of all migraine triggers, irrespective of how unrelated they seem to feel. So, fasting, skipping a meal of course causes hypoglycemia, stressful, oxidative stress, increases stress, mental, physical, aerobic exercise, any kind of exercise. And that’s why migraines typically have an intolerance to exercise, causes a lot of oxidative stress. And if oxidative stress exceeds your antioxidant capacity, so your body’s ability to buffer this oxidative stress, then it will do a lot of harm. So, if your exercise is triggering a migraine, it’s actually doing harm and you shouldn’t be exercising, or you shouldn’t be exercising at this intensity. 

Because what oxidative stress also does is it’s damaging your DNA, it’s damaging your protein, it sets you up for all sorts of potential chronic diseases long term. So, you really don’t want that. Then sleep changes, oxidative stress. Again, you can see that in nurses, in people that change their circadian rhythm, those come with more migraines and metabolic diseases or varying hormone changes. Female hormone changes during this cycle will increase oxidative stress also, and that’s where the pill comes in. I said that was a correlation between pill and a contraceptive pill, which is basically given out like candy to any teenager. I found publications that show that pill onset increases oxidative stress even in athletes by 50% but 50% more oxidative stress. So now if you have a migraine genetics in your underlying system, then taking the pill might be enough to set you off with migraines for life basically.

And talk a little bit about what you were saying about triggers being like a bucket because it really explains, doesn’t it, how some people get them a lot and some people get them rarely.

Yeah, so there’s a few more alcohol, sensory triggers. People have weather changes as a trigger even that makes sense. Because of atmospheric pressure. It decreases or increases the oxygen as in the air and you have alcohol and sensory triggers will also increase oxidative stress, especially blue light for example, is increasing oxidative stress not only in the eyes but also through the skin. So, we can see that all of these migraine triggers that we know are basically working on a similar pathway. Now if something targets a similar pathway, that basically means that you are adding up the stressors and you can think of a migraine threshold maybe as a bucket full of water. Some of us will have the bucket half full already when they’re born because they have migraine prone genetics. Then you’re getting the pill for example, right? So, your migraine bucket is becoming increasingly fuller. 

And then on this bucket you’re now adding, as a female adding this as a cycle in hormones. For example, estrogen is very antioxidant. So, one during the time of your period when it’s high, you’re less likely to have this water bucket overflowing because it’s kind of buffering. It’s a bit like the estrogen is letting out a little bit of the water and increasing your migraine threshold. So, this explains why some triggers like a glass of wine might be fine during some parts of the months. Whereas if you have other stresses at the same time so you haven’t slept well, all of these things you haven’t eaten, you’ve done exercise, you’ve had some alcohol depending on your genetics and your environment and how full your bucket already is. These individual triggers might then set off a migraine, have the bucket overflowing or not. Basically, a full bucket means migraine attack and all these trigger factors together will maybe cause a migraine attack at some point and not at the other point. 

But if you’re born with a bucket that is already full, you’ll have a migraine all the time. Or if you’re born with a, with a bucket that is half full, but then you’re on this worst diet or you have mitochondria dysfunction because of toxins or other things and that sets off that your bucket is full, then you also have a migraine all the time. So, it’s always an interplay between the genetic water load and your environmental water load, and when those two are added together, and environmental could be several different triggers, so many different things coming together. But if both of those come together and make the bucket full, then you have a migraine attack. From evolutionary perspective, it makes sense that some of us have these hyper excitable migraine genes because typically you’re already during attacks. You don’t have this habituation phenomenon, which basically means habituation is a way for the brain to conserve energy, which means that typically one of the rules is that your brain only encodes for change. 

So that means we’re not like a computer, we’re not firing all the time. Basically, a brain is only set up to fire when things change. So, if a normal healthy person looks at a checkerboard, let’s say, or a wide wall and it’s not changing, the brain will just stop firing. But in migraine brain will keep firing. It doesn’t have habituate, so it’s spending more energy, but it’s also basically alerted all the time. And you’ll see that in migraine patient typically is this perfectionist person and always kind of a little bit more sensitive to light noise and on all those things, even between attacks slightly. But if you think about a tribe of people, every seventh person has migraines in the world. There’s like a billion of us. If you think about a tribe being made of, Oh I don’t know, 20 people, you would have three migraine genetic people in there. 

And they would be the first ones to hear when a lion is coming at night because they have light sleep, they pick up very small sensory cues. So those would be the ones that might be saving the tribe from lion because wake up first. There must have been some kind of evolutionary advantage to having these migraine genetics around because if a population is affected, 15% of the population are affected by a certain genetic combination and genotype. There’s no way that didn’t have an evolutionary advantage at some point in time. So that just means that all the environment has changed so much that we’re now at a disadvantage with those genes. But otherwise it would not have stuck around that 15% of the population have this. So migraine really must have had some evolutionary advantage and that was probably maybe on the one hand, and that’s very speculative, but saving the tribe from things that require somebody to be alert all the time, even during sleep, more or less like being hyper-responsive. 

And on the other hand, it’s a preserve mechanism that shows you something’s wrong in your brain where an energy deficit, oxidative stress is too high. We now need to rest. And it’s very interesting how you can, and this is described in this nature and neurology paper that I sent you that was in my thesis. Basically, we cannot even mechanistically explain how we get from attack triggering to the resolution of the attack once. Why adaptive behavioral changes. We are forced to rest and do everything. So that homeostasis is basically conserved. And that is done by via molecule, one of them and neuropeptide that is causing pain called CGRP. And CGRP is basically what now Novartis and Eli Lilly and other pharma companies are blocking with their CGRP monoclonal antibodies, which is these injection-based treatments that have just come out recently. And they call it the migraine with [inaudible]. 

I think it’s an injection you get once per month. This is basically blocking the action of this molecule, but this molecule also seems to be part of mitigating the attack because it’s very antioxidant. Yeah. It’s basically the body sending out a pain signal and the solution in the same time. It’s stopping you from doing things, but at the same time it is kind of treating the initial problem. And another thing that is going on, like the third pillar of the whole migraine attack thing is the metabolic changes that happened during the attack. One of the things that can fairly reliably or was shown like 50 years ago, again to fairly reliably trigger a migraine attack in about 50% of cases is a giving a glucose tolerance test. You get 50 to a hundred grams of pure glucose to migraine patient and 50% of them will develop an attack in the coming hours, like 8 hours. 

It’s always delayed for the eight hours. And if you look at those that develop an attack and those that don’t and their metabolic responses, fatty acids, lipolysis and ketone bodies only go up in the ones that get a migraine attack and they’re eating normally they’re eating the same as the control group basically. If you want to trigger a migraine you give them sugar and then you see that there is a metabolic response. Basically, our body is trying to help us to save us there really because a, it’s changing your metabolism. It’s providing the brain with an alternative energy source because it is increasing glycolysis, increasing ketogenesis. It is sending out this molecule that is antioxidative and other molecules to seizure a piece, just one of them. But at the same time, this molecule also hurts because that’s the only way we would be stopped from running around and doing more damage for the brain. Expanding more energy.

Let it work. Yeah. 

That’s a long explanation. Sorry, I think I’m rambling on too long. 

No, no, it’s fascinating. And I remember what you cited in the migraines used to be referred to as hypoglycemic headaches. So that makes perfect sense. It’s that crash afterwards. 

Yes. About a hundred years ago. And then, you know, modern studies came along, pharma came along and then this was completely forgotten about for 50 years, almost a decade. And people have thought migraines might be a vascular problem and then it was neurogenetic and now it’s hyper excitable. And yeah, those things do play into the picture. But a hundred years ago this neurologist was treating his patients already with a low carb diet very successfully.

And it makes perfect sense then. And that’s the way I’ve always felt with this stacking system. With the bucket being full of the different triggers that by changing your diet you empty a load of water out of that bucket straight away. Yeah, exactly. Lower your threshold right down because there were all sorts of things that used to be reliable triggers for me for migraines. You know, things to do with the weather, surf, it was really hot or if a storm was coming, smell was one of the biggest things for me. If I walked past someone who was wearing some perfume or cigarette smoke. I could guarantee that I was going to get a migraine straight away. They do still happen, but nowhere near as often and so it makes total sense that by changing that big thing, changing my diet has dropped that threshold down.  It makes sense. What you were saying earlier about the problem when you’re  having the migraine is that lowering in ATP function and elsewhere, you talk about with ketone bodies that they’re capable of increasing relatively speaking to glucose that they can, you can produce more ATP. So, it makes sense. Yes. That by treating, if you like migraines with ketones, you’re getting that energy balanced back in place.

Yeah. You have a more effective energy source there. That’s true per oxygen molecule consumed. Basically, you also circumnavigate any problems or a lot of the problems with glucose metabolism and transport. So dude, one transport is might be deficient, which is the officially the transport system that gets glucose into the brain and, and insulin, insulin is also needed for, for glucose metabolism and ketone bodies are completely independent of these two issues. And then there’s more that comes with this dietary change, right? You also have less hypoglycemia. You have a more constant supply because you can use your fat stores now, which you were not able to use before. You might have more micronutrients in your diet as well. When you clean it up, you have less processed foods, less processed foods mean less oxidative stress again. So just getting ketones high is not the answer. 

We saw this very recently with a study on one of the first ones on cancer, brain cancer and ketone bodies. They were put on this very nasty Nestlé shake product, which is like the worst ingredients that you could ever give to anybody like rap seed oil and processed oils in there. But participants were in very high ketosis, like five millimoles and they would still die as quickly as a control group. There was no change at all from being in ketosis, which is why I stress so much. The quality of your ketogenic diet is key. It’s not just about having ketone bodies presence. You also need the antioxidants, the minerals, the vitamins. You need to make sure that you don’t add trans fats or any crappy fats, which would make matters maybe even worse. A high quality, real food ketogenic diets adapted to your micronutrient needs and to your antioxidant need. 

I think that’s the key. Also checking whether dairy is a problem for a lot of migraineurs. Dairy can be problematic, especially casein. Playing around with a non-dairy, more like paleo ketogenic diet can help.  But there’s a lot of things that this diet can set right. One of them is a mitochondrial functioning. Ketone bodies are antioxidative on their own, so the antioxidants and when you burn them you produce less oxidative stress, which again puts less metabolic strain on already damaged mitochondria. And you have the transport issue, you increase mitochondria biogenesis, so you have more powerhouses in the cell. Ketone bodies are able to reduce brain hyperexcitability via very many different, I think at least four mechanisms are now known. So that’s also another issue that is key for epilepsy and migraine is that you reduce or increase the inhibitory transmitters in the bright and reduces hyperexcitability, which again will empty your buckets of water is one of the ways. 

And, and its anti-inflammatory inflammation plays a role in almost any chronic disease. So again, that’s water out of the buckets. And the nice thing about this ketogenic diet approach or ketosis in general, maybe even in part exogenous ketones, we will have to find out. But is that it targets so many migraines rather than mechanisms, even the gut microbiome. There are about eight migraine mechanisms that we know are targeted or potentially targeted by ketosis. And migraine is a very multigenic disease as any chronic disease. So that means that many different pathways and things are probably involved in an individual migraine patient’s migraine, you cannot treat a chronic disease with a one target drug approach because there’s not one target in a chronic disease. And the beauty about ketosis and ketone bodies is that it targets all of these different mechanisms individually or together and migraine that might be completely different in one person to the migraine mechanisms in another person. 

Both of them might profit because some of their migraine causing mechanisms are effected by ketone buddies and the other person’s as well because they just have such a big variety of metabolic and signaling action signaling being like they change your gene expression or they change hyperexcitability so they’re the signaling and metabolite at the same time alternative energy substrate, but also changing all these other pathways in a favorable fashion. And I think this is why there could be such a potent migraine and even as a neurological disease strategy because they target so many of the known chronic disease or neurological disease pathways that are involved all with one molecule basically. It’s quite fascinating. 

Yes. I was going to ask you about inflammation because I’ve read the migraine is potentially an inflammatory disorder, but it would make sense if you’re causing this damage. 

But that’s again too simple, right? 

Yeah, exactly.

People say it’s a hyper-excitability problem. The, I would say it’s primarily inflammatory. The other people say, Oh, it’s vascular. The other people say, Oh, but it’s purely energetics. It’s too simple. And also, there’s probably migraine subtypes that we just can’t distinguish because the phenotype, so what we see is fairly similar, but this maybe there’s a thousand different migraines. Right. 

And are these also maybe secondary issues? Like what you were saying when we were talking about the triptans, and you just touched on it there, the migraines were thought of as a vascular disorder. Yeah. But your argument is that that’s just a secondary thing that happens because of it. 

See is, you know when you ask a migraine patient, they have this pulsating pain, right? So pulsating pain basically means that some kind of vascular receptors must be involved. Right. So, so when I had migraines 10 years ago, they told me, well, it’s basically that your arteries in your brain are dilating, they’re pressing against the skull and it hurts. 

But that’s the symptom rather than the cause. Yeah. In the dilation. Now they know that the dilation, it doesn’t correlate at all 

the dilation of the arteries and the pain onset is not, the timing doesn’t fit at all. There’s definitely not a vascular disease, definitely not. But the dilation could be the brain trying to get in more blood, more blood meaning more nutrients and more oxygen. Right. So, you have a delayed dilation in the brain. I could just be a secondary effect. As you say, it’s probably not causative, but also the triptans are targeting receptors on arteries. But also, that is a just one thing that we know they do, and they probably do other things as well. They could also inhibit a neuropeptide that is involved in pain for example, or work via completely misunderstood mechanism. We don’t fully understand why triptans are working at all. Really. 

So similarly, to what you were saying earlier, actually part of this pain response that you’re getting but packaged up with that is a potential treatment. So, it symptoms of the cause, but actually what’s happening in your body is helping treat that original cause, treating that migraine and actually by treating those symptoms, potentially you’re dampening the treatment that’s just happening naturally in your body. 

Not with a migraine and not with the triptans necessarily or the analgesic. I would definitely say don’t necessarily suffer through an attack and be like never going to take triptans or ibuprofen or aspirin., I don’t do that because it’s just unnecessary pain and suffering. So I still take those because I know that those don’t target the CGRP, but I think I would personally not do this injection based treatment of CGRP, monoclonal antibodies because I know CGRP, this neuropeptide is also expressed very highly in the gut and it’s not a selective treatment so you basically just block the action of one peptide in the body, which I think is kind of crazy. There’s not a lot of side effects yet, but if you do that for a long time, I’m really not sure what it does because we’re also inhibiting other bodily functions and we don’t really know so I’m going to wait and see, but I know that for some people it really is a life changer in the sense that their pain is gone. 

For others it doesn’t work at all. I think it really depends on what kind of neuropeptide cocktail is responsible for your personal migraine pain, but you need to remember you are blocking the pain and the same goes for triptans. You can see it as a center in the brain and the brainstem that basically lights up. When you get a migraine, you can see that that is still ongoing while you’re taking the triptans, which means the migraine is still there. Triptans do not abort the migraine. It’s just not true. The same as analgesics and this rebound, migraine is not a rebound migraine. When the triptans wear off, the attack is just there and it’s going to be there for that much longer. If you take the triptans and then you go to work and you do your whole stressful day and maybe even do exercise and you’re not resting at all, I will not do that either. You need to be aware that the pain might be gone, but the migraine is still there, so you need to take care of yourself during this attack. If you don’t want it to come back, he would still rest and do things a bit more slowly, in my opinion. So that would be my advice. 

Yes, that’s a good point. So, you’re taking something to get rid of the pain, but you should remember what you would have done where you not to take it, which is exactly that lie down in a dark room. Exactly. 

Don’t endure the pain if you don’t necessarily have to and you can tolerate those drugs quite well.  At least are under 10 days a month I would say. You really shouldn’t be taking them more often day wise let’s say. But yeah, don’t forget that you have the migraine in the first place. That’s a very good tip. Remember what it would be like or what you would be doing if you were still have this attack and it probably wouldn’t be running. You’re going to work, doing the laundry at the same time, picking up the kids and cooking and shopping and everything and like these hours of migraine, probably not. 

Yes. It’s actually still do what you would have done and talking about different ways that you can help. Maybe you could talk about some ofthe preventative treatments you’ve listed in your thesis. There weresome different vitamin supplements, all sorts of different things, including the ketogenic diet. 

Yeah. It’s quite interesting. There are some studies that show that antioxidants basically can help migraines, quite a lot as good as drugs actually. And it’s those could be CoQ10 300 milligrams, that could be riboflavin.  Riboflavin is vitamin B2 400 milligrams, so high dose, but also just a good complex, B vitamin and magnesium can help. Also, it’s responsible for 300 enzyme function and we tend to be too low. So, a good mineral supplement can help and there’s also alpha lipoic acid that has been shown to be my one protective, which is a strong antioxidant. There’s other antioxidants astaxanthin. There has not been a study, but it goes into the similar lines. So that’s something one could think about as well. If one wants to figure out the migraine. A best thing would be actually, I mean these things are just done an edit to the patients. 

I mean CoQ10 you could always do, but there might be other minerals or essential vitamins that are lacking. So I would always try and advise too, if you have the funds, do a blood test, minerals must be checked in full blood and vitamins, you can also check and see whether you might be lacking some of the things or even more. And then you can add a broad spend, high quality multivitamin or selectively take the things that you’re lacking could be zinc as well and that will improve your mitochondrial functioning and mitochondrial functioning is at the key for migraines. And you can add a ketogenic diet if your mitochondria are not working because you are lacking some vitamins or you’re completely toxic, for example. You can add ketones almost as much as you want. It won’t help much because also ketones need to have mitochondria that are producing your ATP. 

It’s like, okay, so in a car, right. It’s a bit like if you are calm and tolerant, if your glucose metabolism isn’t well, it’s like a Petro car and you’re feeding a diesel all the time, it won’t run well. Right. But if you are now giving diesel to a diesel car but the diesel car doesn’t have an engine, it’s still not going to run. So the engine is your mitochondria, you can swap the fuel, but if you don’t have an engine in your car, you can swap the fuel as much as you want. The right fuel won’t do anything. You need an engine that can make energy that can power your car. Right? So, the first step is to get your engine right and then you can change the fuel. So that’s what I was also referring to in this paper that you were talking about is get your mitochondria as best as you can. Antioxidants, whole food diets and supplement either if you have the funds selectively, if you don’t have the funds with a good broad spec multivitamin in a way that has everything that we need. 

And something like magnesium is, is a kind of thing that you can take without doing harm. It’s very obvious when you’ve taken too much, isn’t it? 

Exactly. And CoQ10 is the same. Ubiquinol is the preferred version. There are two versions of CoQ10 which might be worth mentioning. Ubiquinol is the reduced one. You’d ideally want that without maybe a hundred milligrams is enough. If you have Ubiquinol then you probably need to take 400 milligrams because it still has to be converted with the minerals and the or the vitamins more. Always try and take the active version and for example, there’s four different versions of B12 and cyanocobalamin is even toxic. So please also don’t go to the supermarket and take the cheapest multivitamin you find, it’s probably going to do much more harm than it does good because if you have non-active vitamins you liver  needs to detox them again, your liver is already busy with all other toxins and oxidative stress. So yeah, don’t save on that. It’s probably better to take nothing then take a bad supplement. And then there’s other things that you can do. So we talked about vitamins and minerals, we talked about getting antioxidants in your diet, which is basically colorful vegetables if you can. And it could also be in supplement form. 

This brings us quite neatly to a conversation we were having before where I touched upon earlier asking you what your keto diet looks like. We were talking about a few things clicked in in my mind again about what happened when I did my carnivore challenge and one of the things that increased a lot were migraines. I had other issues too with hot flushes and acid reflux and my mood was bad as well. But when I mentioned that to you earlier, your eyes lit up and you said yes it was something that was very common and the people doing a ketogenic diet if they suffer from migraines, need to be aware of and that’s where the importance of these micronutrients might come in. Perhaps you could talk a little bit about that cause you just touched on it there with the fruits and vegetables of different colors. 

Yeah, so basically, I figured out for myself that a very restrictive ketogenic diet that only basically has green and white vegetables wasn’t really cutting it and I mean carnivore would just be unthinkable. I think I did it for a week, it was horrible. There’s something called an ORAC index and that basically measures the antioxidant content in foods, the foods and even coffee has antioxidants. The darker or the more colorful a food is basically the more antioxidants it has. Like blueberries is super high, chocolate, coffee and then other colorful fruits and vegetables and basically if you think about, a migraine patient typically on a regular basis exceeding their antioxidant capacity. So oxidative stress is a good thing in moderation, but whenever oxidative stress exceeds your body’s capacity to fight it, it’s bad. And if you take out all the foods and fats and proteins, they don’t have a lot of antioxidants. 

This ORAC index is very, very low. So basically, that means that likely, even though they have some ketone bodies present and there is somewhat antioxidative, they will still be lacking potentially, or they will still do better with increasing antioxidant via their diet to help the mitochondria fight oxidative stress. I figured I’m doing much better having more food and vegetable colorful because I wasn’t even eating carrots or tomatoes or peppers that really can help getting more of those in it. For me it did. And for some patients also, so then you can either add exogenous ketones or MCT oils or, maybe it’s even enough to just be in ketosis some of the times. Some intermittent fasting might help. A lot of patients also struggled with the fasting because there’s something called glycogen resistance that has been found in migraine. It’s basically the opposite of insulin resistance. 

Glycogen resistance means that you will not turn on ketogenesis and gluconeogenesis as much because you’re resistant to glycogen, which is basically the hormone that tells your body when you’re fasting to produce more energy. And if you’re resistant to that, you get more resistant by fasting. You basically need to do the opposite than an insulin resistant person. You need to eat more to get this fixed. So that’s another interesting aspect in a migraine that is different to other metabolic diseases basically. But yes, so increasing antioxidants can be done with supplements, but also you can use the power foods that come with micronutrients that come with all these polyphenols and flower needs and these things that can be beneficial for migraines. Actually. And for mitochondrial functioning. 

So, you’ve worked your way to, you were saying before we started recording that your ketone levels are lower, but you feel a lot better. You’ve gone through a sort of stricter keto diet to now including, 

and I can still be in ketosis that said though it needed about, and that’s something we find in epilepsy too. It needs about two to five years in an epilepsy kid on a strict ketogenic diet. And then whatever gene expression changes and therapeutic effects they had during the ketogenetic diet is outlasting the duration of ketosis. So basically, if a kid has 80% reduction of seizures, that will be a point in time where they can stop a ketogenic diet completely. And these kids sadly go back to Western diets and it will still have 80% reduction and that might be something that’s happened to me as well. I was in higher ketosis for two and a half years and then was this point where I could go away and still have this reduction in migraine from like I had 20 days on average and I’m now down to maybe three a month. 

I’m not sure if that was the major driver, but even during this stricter ketosis, I would feel better generally. I also like energy-wise in to body ache and like, you know, burning muscles. The more carbs from, not from the grains, I’m not doing any of this or even legumes. I can only beans again and stuff, but I wouldn’t recommend that. But just from more colorful vegetables and having some fruits really helped me. And the only explanation for me is it’s not the carbs, but it’s the things that come with the carbs of fruit and vegetables that you cannot get with the meat. 

Very interesting. And what do you feel about treating when you do have a migraine treating it with exogenous ketones and that, just is a question actually about the trials that you’re doing, are they taking exogenous ketones sort of on a daily preventative basis or are they taking them as a treatment for a migraine? 

It’s prevention. You need to think about, you need to basically on a chronic basis, empty the bucket with the ketone bodies. It’s like it’s my migraine is a cascade of events, right? It could be and I don’t have much evidence and for me it’s hard. It’s work sometimes and sometimes not. If you catch a migraine super, super early and the pain cascade hasn’t started, maybe you can abort it with exogenous ketones. But really what you need to do is increase the threshold or lower the water in the bucket on a regular basis. So, we’re using them as a preventative, increasing the threshold, reducing the frequency. 

Your mimicking what other people are doing with a diet. 

Exactly. If you think about a migraine as a process, like a stone sitting on top of a mountain rolling from a mountain, once the stone gets rolling and it becomes full speed, it’s almost impossible to stop that stone. And it’s a bit like that in a migraine. Once the pain cascade has started, once these newer peptides that caused the pain in your brain have been released, you can take all the exogenous ketones you want. More energy is not going to stop the peptides from being around. Right. It might make the attack less long, less prolonged. It might make it less strong, but it’s probably not going to, it’s not a painkiller. It’s not going to stop the pain because pain basically is these peptides being around and the receptors being activated. So it will be very interesting to see and I would really love to do that trial with patients that are very experienced and can have this like feeling of when the migraine is coming, if they take enough ketones early enough in the whole process, whether it could abort an attack even. 

But we don’t have that data. I only have patients coming to me saying that it’s worked for them and that’s really interesting. Also like on this a ketogenic diet from the conference from Dominic D’Agostino. I had several patients that have seen a video before or read my poster and they’ve done that, and they say it works. But I don’t know if this is a regular occurring thing. I cannot reliably make it work. Sometimes it would, sometimes it wouldn’t, but I’m also now I’m doing so many things. I’m also on the road and I don’t have them with me all the time, so I think I’m taking it too late when it doesn’t work, when the pain is there already, it’s too late. It won’t do anything, 

But it’s kind of something that’s maybe worth a try. It’s just something that I’ve mentioned in my Facebook group. Yeah, and some people have tried and really found it helps. So for me anything like that. Are they taking the racemic or the D, do you know?  Just a racemic type one that you can buy on Amazon, that kind of type exogenous ketones. 

Yeah. Interesting. Interesting. Because the lower blood glucose, the racemic so it’s interesting. 

So yeah. Great. Yes, I mean it seems to me that if you can help with something like that as supplement rather than taking any kind of pain meds, it’s worth a try. Oh, certainly. That’s something that I want to try myself. 

Because yeah, all these pain medications, again, it puts quite a strain on your liver and your liver is already super busy in a migraine patient typically. Any medication has to be detoxed and we typically underestimate how quickly you can kill yourself with ibuprofen because it leads to liver failure. It’s like I don’t know what, you take six of them or eight of them at one go and you can kill yourself. It’s like, it won’t kill you if you take two, obviously, but that doesn’t mean that taking two on a regular basis is not going to somehow negatively impact your liver with time. Right. So if you can find a natural approach to that by all means and a ketones, if even if it’s, if it’s a D BHB, even better because as the endogenous version, the human identical one because then you only have things around that are human identical. So that won’t have any side effects because it’s something that is around anyway. They’re harder to get hold of. Right, they’re harder to get hold of still we’re working on it. I’m working on it because I wanted it for myself. So maybe one day hopefully. But yes, until then, I mean racemic if you don’t take it for like 10 years, there’s also safety data for the racemic is not going to kill you. Certainly not. All right. It’s if it helps by all means.

Perhaps you could round up with what you call the four-step approach to improving mitochondrial functioning and energy metabolism in migraines towards the end of your thesis. I read that the recommendations that you have for everybody who suffers from migraines. 

Oh yeah, certainly. We’ve kind of touched upon the first two, right? The first one we talked about is a individualized supplementation of the micronutrients. And this could also be hormones, so not only vitamins and minerals, but also some people have menstrual migraines which get really bad two days before their period, which is basically the time where your estrogen plummets and you don’t have this oxidative stress protection, your insulin sensitivity changes during that time. So sometimes people with menopause get really bad migraines and maybe they would profit from some human identical. Again, that’s the key. Don’t take synthetic hormones. They’re not the same ones that your body makes. It needs to be bioidentical; hormones can help. So basically, getting the base right, getting your engine working, getting your engines in the body, working, getting the base, giving the body everything, it needs, all the ingredients for good function first. And the second step will then be increasing antioxidant capacity. So that could be with food, with supplements and also would using oxidative stress and that could be toxins. Smoking, too much alcohol. Actually, it’s really interesting if you tolerate alcohol well, it’s basically the best test to see whether your liver is doing fine. If you have alcohol intolerance, that basically means your liver is struggling. It’s kind of nice to check in with yourself sometimes. Can you tolerate alcohol? If yes, your liver is probably doing okay. If not, you might have to increase your antioxidants. The third pillar is stabilizing blood glucose, and this is essential for migraine patients that often get a migraine in the middle of the night because blood sugar plummets. If you have easy carbs like in a glucose tolerance test, typically what comes after is a delayed insulin response that is exaggerated, which then needs to reactive hypoglycemia, which you want to avoid, so basically low GI diet would be essential, so get rid of any. 

Of course, that’s where that one of the biggest triggers is skipping a meal. Exactly. You can just see how eating ketogenically is really going to help so much with that pillar. 

That point doesn’t even have to be ketogenic, that could be low carb. Low carb can stabilize your blood glucose very well. 

Anything you can do just to stabilize it. Stopping several highs and lows. 

The fourth pillar, the final pillar is that if that doesn’t help, then providing your brain with an alternative energy substrate might be key and that’s the ketogenic diet. Potentially if you struggle and your liver isn’t making enough ketones, or you have to put more vegetables into feel better. This is why exogenous ketones could come into the picture and MCT oil if you tolerate it, but if that has not helped yet, then you really need this alternative energy. Then you run better on ketones than you do on carbs due to transport issues or whatever it might be. So that’s when you really should go strictly on a ketogenic diet or get other sources of ketones in if you can. So that would be the four-step approach that I summed up my thesis with. 

Something that just dawned on me  just going back to the beginning when you started talking about those different steps, if somebody has a regular, like with time of the month when they always get migraines, they can reliably know that they’re going to get migraines. Like you were saying that the couple of days before their period say, and that happens every month despite all the other things that they’ve done. Would that be a good example of when you were talking about taking exogenous ketones more as a preventative way or right at the top of that pain cascade getting in there before the pain starts, would it may be good for somebody like that to say take exogenous ketones for those few days when they get migraines every month certainly as a preventative measure.

 For example, before your period, for some people,  period is stressful, estrogen plummets if you have menstrual migraine, it might well be worth experimenting, adding exogenous ketones in two days before the period starts because they know they will get a migraine and seeing if that helps things. That’s exactly what you can do for like a targeted approach where you know, or when you’re extremely stressed, and you know you didn’t sleep well, and you know you’re bound to get a migraine. Maybe not wait for the first symptoms. Just take high dose exogenous ketones and see how you’re doing. 

 Because if you’re saying that for it to be effective, you need to get in there before the pain starts. Exactly. That just suddenly dawned on me. That might be a good way to do it. I would definitely recommend that. It’s been wonderful talking to you, and I could go on all day. Likewise, but I know you have to go. Perhaps you could round us up with a top tip. 

If there’s a numberone tip that I would recommend, and that’s something that I had to learn quite painfully because I was one of those perfectionist migraineurs who’s always listened to everybody else and I took all these, general advice on board, like, sport is good for everyone. Do sports, don’t do that. Don’t do that. Whatever the number one thing you can do and really learn is listen to your body. Your body will tell you what it means. Once you get rid of your addictions or whatever, the best thing you can do is listen to your body. Does this feel good? Does exercise feel good? Does it trigger a migraine? Does cheese feel good to me? Does whatever? Does a very strict ketogenic diet few good or does something else feel good to me? Don’t think because it works for somebody else it’s going to work for you. 

It was so individual, nothing even the color red is going to look different to every one of us. There’s nothing that is basically assured to be the same with you then to somebody else. So, the only person who knows you have to become your own doctor. You have to take care of yourself and your health yourself and listen to your body. It’s going to send the right cues if you listen to it. And the migraine is one of those cues. So, the migraine is telling you something and you need to change things in your environment until you figure out what is good for you. And this could even be getting rid of toxic relationships that chronically stress you and put water in your bucket. So, you really have to sort out through not only your diet, but also your supplements, your relationships, all of these things that stress you and that you might have not been aware of. All these things will make your bucket full in order to get water out of the migraine bucket. If there’s one advice is listen to your body while doing it.

 Perfect. 

Thank you so much. Yeah. 

 It’s been a great pleasure. 

Thank you, Daisy. Have a good day. 

And you 

Bye.

This transcript is brought to you thanks to the hard work of Liz Myers.

Welcome Maggie, to the Keto Woman podcast. How are you doing today?

Fine, thank you.

Now, we’ve known each other for a long time, and I have to say that when I started this podcast, I had you in mind to interview — because I think people will find your story and what you do really interesting. So, going away a little bit from the kind of people I usually interview in that you’re not keto, but you’re certainly extraordinary. It’s nice to be here, and be here with you, actually face to face in my living room, today, here in sunny France. So perhaps you could just tell the listeners a bit about you?

Oh, where to begin really? The job I’ve had for the last 18, 19 years was a total change of direction for me, because before that I’d been a teacher in a secondary modern school in North Yorkshire for 20 some years I suppose. Something like that. And I decided, although I loved the job – and I really did love the job teaching, it was great, lots of challenges – but I decided it was time to go. One year I was cycling through Europe on a summer holiday, and I just decided I wasn’t going to go back to teaching that September, and I’d already got my notice written out and I submitted it from Slovenia – actually Ljubljana – that was taken in by the office staff and I never went back, which was probably not such a nice way to leave. But that was just the way it was.  So I decided that’s what I’d do.
For a couple of years I was doing some supply teaching, and I was doing a few other bits and pieces, traveling, doing a lot of cycling, a lot of traveling across Europe, and had been to South America before that. 

And the Kosovo war happened, 1999 roughly. It broke out, I think it was 1999, and out of the blue I got a phone call from an organization based in Canterbury to ask — I don’t know how they got my name. I have no idea, I never ever found out.  But they asked me if I’d be prepared to drive a convoy vehicle to Kosovo with aid, because the war was, as everybody knows, it was a long time ago — It was very vicious in Kosovo. The Serbs and the Albanian Muslims were being attacked. The Serbs were actually doing a lot of the attacking, both sides were entrenched in warfare, and the people were suffering very badly.

Villages were being burned, and some terrible things as happened also in the Bosnian war before that, although I wasn’t involved with aid work in that particular confrontation. So I decided, okay, I would, I didn’t know quite what to expect. I didn’t know whether it would be or not dangerous. I just thought, why not? And I drove a vehicle out with a convoy to Kosovo. It was a very difficult time. The war was still just going on, although they were desperately trying to get some peace agreements going. Then of course the UK government decided to bomb Belgrade, which more or less ended the war. But where I was positioned up in the north in Mitrovica, there was still a lot of shelling going on. It was an interesting time, not having been in an area where they were shelling ever before, and rifles firing at night over the river into our areas.

We delivered the convoy, we delivered the stuff to the people who needed it, and people who lost everything, and then drove back to the UK. But I met somebody there who said, “Look, can you come back out? Because we have an organization working here in Mitrovica, which desperately needs volunteer help”. That was in the November of ’99, and in the January/ February of 2000, I went out again with a van that somebody had lent me, full of stuff, and drove up north to Mitrovica by myself, which was a bit tricky. I stayed in Mitrovica, and I met this organization up there who were reconstructing Albanian villages from the shelling and the burning, and was trying to give people back some shelter. Big job, very big job funded by the EU, and I joined them and then I was there for three months, and that was the start of my aid working life really — as a volunteer.  I’ve always been a volunteer.

Was it interesting? I can’t — knowing you, I can see why somebody would contact you in the first place, but how fascinating that — wow. I wonder where your name came from.

I don’t know where it came from. I think I’d been writing some…I can’t remember what it was. Definitely through some contact I had that I’d met doing something in that two-year period. Somebody had contacted this organization in Canterbury because they were involved with it and said, look, I bet I know somebody who will come out and you know, your shorter drives – I bet I know somebody will do it called Maggie. And I guess that’s how it happened. But that’s all I can imagine happened. So that was it – three months in the north of Kosovo as the war sort of died down and reconstructing and trying to help people and build houses and deliver shelter in the high mountain villages. So, that was the start of it. 

I carried on working there over the next couple of years. And then in 2003 the organization called Edinburgh Direct Aid, which is the one I now work for, they asked me whether I’d be prepared to front a project working in the West Bank. The situation in the West Bank was getting ever more difficult. The occupation by Israel — villages were being cut off from other villages. They started to build the new Israeli wall, and we were taking medical supplies to clinics that couldn’t access the main towns. So, I went out to liaise with the Israeli army, which was another very challenging job and prepare for that. And then the rest of the team came out. Again, another very challenging, very sad, very distressing, very anger inducing job. Because I went out thinking, well the Israelis, you know, they suffered a lot of suicide bombs.

This is during the period when the Palestinians and Hamas and everybody was, you know, there were suicide bombers going, quite frequently bombs going off in buses in Israel. And of course, that was appalling. But on the other hand, the West Bank Palestinians were being denied access to Jerusalem, to Bethlehem, to lots of places. And so I felt sorry for both sides – but for my first 24 hours in the West Bank trying to get in into the West Bank through the main checkpoint at Ramallah, and I saw how people were treated and I’m afraid, I realized where my loyalties began to lie from there because what I saw go on was very distressing for people.

It’s very difficult isn’t it? Because it’s the everyday normal people who are affected by it.

Yes, exactly.

Not the same people or people who are in power controlling it. Different groups of people isn’t it? That’s where it gets very difficult I think, working out sort of where your sympathies lie because it’s very emotive, isn’t it when you are dealing with ordinary people?

So, I mean you have ordinary Israelis being killed, of course, on buses. And I mean at that time, if we were driving, if I was driving in Jerusalem, I was always told to not drive behind a bus because the risk was very high at that time. Sometimes you couldn’t avoid it, but…

And how terrifying for people to live that that?

Yeah, absolutely. Very terrifying. But then you began to see what was going on, and why the Palestinians were reacting like that – it was out of just desperation. Then I got involved in… well, I pretended to be a journalist, but I was attending a lot of the peaceful rallies to try and stop the olive groves being destroyed for the wall. To stop the wall, preventing access to the farmer’s fields. You know, farmers, Palestinian farmers who’d been working their fields and their olive groves for hundreds and hundreds of years, and old farmers who would sit — I saw them sit down in the field and cry as bulldozers moved in.

Just sliced through them.

Army bulldozers just moving in and it’s very difficult to stay impartial when you see the suffering of people. I didn’t see any bus bombing, so I didn’t see the aftermath of a bus bombing, which of course would be horrendous.

And of course, that’s not the impact of the ordinary people in Palestine, is it?

No, it’s not.

And that’s not the farmer sitting down in his olive field doing that?

No, because if they been able to access their land as they’d always been able to and carry on with their – not to have these new settlements, which of course were settling into the West Bank, which was meant to be the land for the Palestinians. It’s a very complicated situation. But settlements were growing up everywhere. Israeli settlements, they were a group of very right-wing Israelis that would go up to some hill top on the West Bank and they’d start to build simple wooden shelters and they say “This is Israeli land now”. And the army would protect it. So, then they’d have a big fence around it and a big wall and that would cut off another road.

The Palestinians couldn’t drive on road certain roads to get to places. Gradually you saw all their freedom being eroded. Not only that, the checkpoints, the checkpoints became something like out of, oh I don’t know, out of the Second World War – big wire fences, loads of barbed wire – big watch towers and turnstile gates that you had to queue for hours to get through. I mean, I’ve seen elderly people faint at those checkpoints because they just were having to wait so long to just to get home, having been to try and visit somebody in hospital and so – so many freedoms going. So that was the project we were doing, and we were trying to provide medical stuff to these small outlying clinics that were cut off from even towns like Ramallah and Bethlehem and Jerusalem. So that was quite an interesting time but, upsetting. Very upsetting, I found that.

Yeah, it must take its toll on you personally.

Yes, it does. I mean the women were incredible. The women would go peacefully to the army lines, because the army would have their Land Rovers lined up ready to move in with the bulldozers behind them. And the women would go… because the trouble with the men going, you’ve got these young men who pick up and throw stones, and you can understand why they want to throw stones at the army Land Rover. A, it was pointless, and B of course, the army would just fire rubber bullets and lots of tear gas. I mean the number of times I got caught up in tear gas was, oh…and once you’ve had a bad tear gas attack, you never ever forget it. Horrible.

But the women would go, and the army were much more restrained. The women would go, and they would talk to the men, talk to the army. There were some members of the Israeli army who were very reasonable, they looked a bit sad that they were having to do what they were doing. They were following orders, and the women, sometimes women would turn them back. They were more successful in turning the bulldozers back. And I would join those protests with the women. But of course, as a Westerner, I still had to pretend I was a journalist. Otherwise, I would have been not allowed back into Israel. You can’t just, you know – that’s what’s happened to so many western protesters out there. They’ve not been allowed back in, and then you can’t do anything.

So, there was that. Yes, that long distressing period of work there and then lots, and lots, and lots of work over the next 10 years. Pakistan earthquake, tsunami in Sri Lanka.

You go wherever you are needed?

Yeah. Where we are asked to go. I mean we’re only so small, so we get very little funding so we can’t do a great deal except that when there’s a major disaster. The Pakistan earthquake in 2005 was the case in point. There is a huge Pakistan community in Edinburgh and in Glasgow where we are based, and when that earthquake struck – I mean killing 75,000 at a stroke, really more or less – our office was inundated with requests from wealthy Pakistani families saying, “Please can you go? We don’t know what’s happened to the family here. We don’t know what’s happening here. Please can you go, here’s money. We can put in as much money as you need.” And we got thousands and thousands of pounds in. So, I was sent out to see where the greatest need was and what we could best do with this money. I worked there from 2005 and of course it was terrible, the earthquake. I remember going into a mountain town called Balakot, and the stench of dead bodies – I’d never smelled anything like that. And the destruction, it would look like a nuclear bomb hit the place. And there were many towns like that. Living conditions were terrible. I was in a tent most of the time, and we were working up in the mountain villages where whole schools and whole villages had been wiped out. They had no shelter, they were sleeping out under winter, Pakistan winter.

It was very urgent. I went out and was transported from village to village by UN helicopter. I was dropped in with my tent and my gear and maybe another colleague and we would stay there for maybe a month working, and then the UN would supply us with what was needed, like stoves, winter stoves or whatever, and that went on. The projects developed. We put clinics in, we put so many things into the villages that had lost everything. They’d lost all their medical clinics.

That’s why I like having heard your stories over the years, you get called into that emergency relief situation.

It is emergency relief. Yeah.

But then you also work on some projects that are going to have a more long term, sustainable impact.

Yeah. What we never do at Edinburgh Direct Aid, we never just go in, try to deal with an emergency when we can’t deal with it – when we’re not big enough to deal with an emergency.

But we do emergency aid in the places where big agencies don’t get to. And they don’t get often to the sort of, the really little difficult places high up or wherever and that’s where we go. But then we tend to stay there and we tend to develop projects from that, like “Where most needs a medical clinic?” Because all the villages need…they’re very highly populated and they all need medical care. We would start thinking what we used to do though, one of the best things we did, we’d send in a big container of aid, a 40 foot, 10 ton, 12 ton container. We’d empty it, distribute the stuff, and then most people just send the containers back to the pool. But I suggested that maybe we could buy the container and we could convert it into a clinic because it’s a big space inside a container.

But the problem was getting that as a converted clinic, we could convert it – which we did, I did it with a fireman, a local fireman who came from Edinburgh and the two of us were out there two months converting this container – then we had to get it flown in to a mountain village at 10,000 feet. I went to the UN said, “Look, do you fancy this challenge? Because we’ve got it here and we can put it somewhere lower, but I know that this particular village, Koncan really needs it. I’ve been up there for several months in the tent and it’s desperate”. So they talked about it. The pilots of the helicopters, great big helicopters they were using, they said, ”Okay, yeah, we’ll do it” – the UN said we’ll do it, why not? 

We converted it on the field up in the northern part of Pakistan, unbeknownst to us, only about 300 meters from where Osama bin Laden was living and was later killed by the Americans.  But we didn’t know he was there, he was in a house next to the airfield. We converted it and then the day came when the UN were going to airlift it. It was a fine day, I was up in the mountains ready to receive it. Somebody else was down and waiting for the helicopter to attach the strops and carry it up over the mountains. Well, it’s a story in itself really. I don’t know whether you want me to tell you very briefly the story? They got it on the strops. They flew it on a pretty windy day up into the mountain at 10,000 feet. All the villagers were waiting to see it, about a thousand villagers, which we’d kept back up the hill. I was down with a special handpicked team of local villagers. We’d prepared the base, in came the helicopter. This thing was swaying and spinning in the air and the helicopter you could see was struggling bit to control anything.

And we were waiting for it and our job was to grab the strops as they came down to try and stabilize it. So we did, we ran onto this narrow terrace and grabbed the strops, brought it down – but the helicopter was spinning and you couldn’t control it. We had to drop it, and we had to release the strops to release the helicopter before it crashed, climbing up onto the top of the thing and crawling on our stomachs to release those strops off the top of the roof of the container. Unfortunately it dropped it with the door jammed against the side of the mountain. After the two months of converting it, we couldn’t even get in it and it was absolutely – well, I was at my lowest ebb at that point and sat down and had my head in my hands.

I just thought all that work, all that money – not that it costs so much. Suddenly I looked up the hillside and a thousand villagers were rushing down the hillside, like Zulu, and said, “Don’t worry Maggie, you relax, you stay there, we’ll move it”. And of course, over the next five hours they got levers, they got planks of wood and millimeter by millimeter they moved it back onto its base until we could open all the doors and everything was absolutely fine. That was a tremendous memory I have of just how badly the villagers wanted their clinic, and how much they were prepared to do and how hard they were prepared to work. And when I was at the point of giving up, really.

I think it’s also a good illustration of the relationships you develop, because as you mentioned before, you go into these places.

Yeah.

But then you stay a while and you develop these relationships and it has become, you know, a challenge that you want to achieve because you’ve made these relationships.

Exactly. You, it goes beyond that. You invest in the village, and you invest in the people, and they get to know you and you know them. You know what they need and what they want and yeah, like absolutely, you’re right. You build up a very close relationship with people – there are people I’m still in contact with in that village, because the clinic is functioning. It’s a vaccination center now, delivering babies. Later that year I delivered a baby myself up there when I was up there very late at night, I was needed – the midwife couldn’t cope on her own. She needed somebody there to help. There was no light. The light had failed – times like that you realize just how important that clinic was and still is. Yeah, it was good. And we did other things, water systems, new pipe systems for the villages.

And the conditions you’re often living in when you’re there, you’ve told stories of bedbugs and fleas.

The fleas. The fleas… one of my real worst things, I did everything to avoid the fleas, but it was impossible. They just were everywhere. And you know, you’d go into some of the houses to have some of their milky tea on a cold winter’s day and you’d sit on the – they were in their blankets. I mean, they’re immune to them. But of course, they loved me and I, every now and again I’d have to go down to Islamabad to deflea and wash my clothes, and try and get some ointment for the bites. Oh, terrible, terrible time.

It’s the kind of thing that could tip you over the edge, isn’t it?

Oh, easily.

Dealing with those levels of stress. It’s just the kind of thing that…

No, scratching yourself to death up there in a tent at night…oh, horrible. And you know, there was nothing to be done. I had flea powder everywhere, which is pretty toxic, actually. Stuff that you shouldn’t really have, but I didn’t care at the time. I’d have basked in it, I’d have swallowed it, I’d have done anything to get rid of them.
There were many, many interesting years in Pakistan, and other projects. And then flooding – we had flooding emergencies and I was up, I was back out for the flooding, and then I was back out to put another clinic in. One we built this time ourselves.

And landslides, caught in landslides, so many landslides and some very dotty times. Really, when I look back on it, it makes my spine shiver now. When I think what I got away with, really. I think I was very lucky. I mean, I have absolutely no religious, not a religious cell in my body. I think I was extremely lucky to get away with what I got away with. And other people didn’t, some of our villagers lost their lives going over the track, you know, up to the village where the clinic was. Their vehicle got swept over by landslides. But I was never in a vehicle that happened to. We always managed to just stop suddenly before the landslide hit and reverse…. things like that.

Well, I know you’ve been in places where you’ve been ducking down low to avoid the crossfire.

Yeah, well that happened in Kosovo, one time we had to dive in between a load of big lorries because they were shooting across and trying to sniper the at the soldiers.

Where was the place you ended up, I remember you telling me this story where you were ill on the plane, and you ended up on this great long trek sort of semi-conscious.

I was hijacked by some Kosovo Albanians who were smuggling – I think smuggling arms into Kosovo. I think they were part of the Kosovo Liberation Army. I was on the plane, and we’d landed. I’m very, very sick. If the plane is turbulent coming down and I was so ill, I couldn’t, I was virtually unconscious, and I got to the queue. They carried me. These four men carried me to the queue for the passports. Took my passport out my bag and I was carrying a lot of money – stuffed down my bra, stuffed down my knickers, everywhere I was carrying money. They took the passport, and they got me through immigration, and somebody was supposed to be meeting me outside, but I didn’t know who it was. Somebody from the organization, but these four chaps just threw me in a car. Well, they didn’t throw me in a car, they put me in a car. I was so ill…I was so ill, had all my bags and my money and everything and they took me through the UN border and because I am a westerner, I think I was probably very useful to them, because they kept saying this woman’s ill, we’ve got to get her.

I was vaguely aware of that, and in the middle of the night we drove through the night. I don’t know where we were going, and I ended up in some remote farmhouse somewhere in the middle of Kosovo. I don’t know where it was, and I was so ill, I didn’t care. I was put into bed with three children who were all asleep by this time. I don’t know what time of the morning it was, and I went to sleep. I just slept. And then I woke up in the morning and I, well, I woke up some time in that day and I felt a lot better. I thought, oh my God, where am I? Where’s all the money? Where’s my passport? Where’s my bag? Where is my luggage? Where’s everything? It must’ve gone. I sat up and I got out the bed, and at the bottom of the bed was every single possession I came in with.

They put there, all the money, my passport, everything. And then within the hour, they’d given me some breakfast and taken me up to Mitrovica where I was working. So, there you go. You see, it could’ve been so much worse. How did I know? And I didn’t care. I really didn’t care. I just wanted to die. So – one has to have faith in mankind, I guess.

Maybe that helped in a way, that you were so out of it.

Maybe. Well yes, otherwise I’d have wondered what the hell was going on, I think. I’d have thought, well, you know, they would have taken money. Because I do remember vaguely that night they were unloading stuff from the boot and we were stopped at an army checkpoint, and they were looking in with a torch. The army, this is UN troops peacekeeping. I know these chaps were taken out and were frisked and I don’t know how they got away with it. I wasn’t really conscious enough to know. Yes, that was another interesting experience — I’d forgotten about that.

You were in Greece for a time weren’t you? With the…

When the Syrian refugees were coming across in the rafts in there, hundreds a day, well, thousands in a day. Yes. I spent two weeks there. That was very distressing too.

I bet.

Very distressing. The height of the Syrian war, little kids, little babies. The rafts would break, the engine would break down, and you’d have to run into the waters. They were coming in and they couldn’t get in and you had to pull them in, and then you had to get them from some remote beach to some help center. And I hadn’t gone out to do that particular job. I’d gone out with some money to offer it to a Greek organization that we were working with. But I ended up, I had this little tiny hire car and I was driving this little hire car over beaches, and tracks, and mountain roads, stuffed full of wet, drowning, Syrian refugees. And I don’t know how many I managed to cram in my car each time. They were wet, they needed help. I was passing babies in through the window. Then I had about three in the front with me, this tiny car and I would drive them to a shelter and then I just go straight back down again for the next rafts coming in. Yeah, that was very distressing, actually.

So often we’re so disconnected from the reality, the real human reality of what’s going on. And it’s just the immigrants – this group of immigrants, refugees. And they just become…

This amorphous group with long clothes, half drowned.

Exactly. And this is something we don’t know and are labelled by certain journalists as cockroaches.

Yes, that’s right. “Why are they coming here?”

But for you, you must, and anyone who watches the news can’t fail to be hit emotionally by those pictures of little children. Eh. You know? But for you, it must have been so overwhelming to be there, in the thick of it.

Yes. I mean, the thing about that job, and I suppose the thing about my job is that you are so busy and you’re so focused, and you have to think of the next thing you’re going to do, that you don’t allow yourself time to think, “God, this is terrible. I can’t do this, this, oh, I have to get away from here. I can’t bear to see another half drowned baby coming ashore crying for its mother”. And there’s no mother because the mother’s in some other boat or we don’t know what’s happened to the mother. You can’t stop to think, you just have to act all the time. And I suppose that’s what I’ve always done, and I certainly did in that situation. And you’re right about the refugees because so many people who don’t experience them close at hand fleeing from some terrible – the shelling in Syria was, was just ongoing all the time.

And they are teachers, they’re doctors, they’re nurses, they’re it IT consultants, they’re engineers. The ones I was bringing ashore, they were skilled people. They were, not all of course, not all highly skilled people, but so many were skilled people. Of course what gave it also a bad reputation was there’s also a lot of Africans coming in from Afghanistan, Africans, Afro from Afghanistan actually I met, but they were Africans too. So they were mixed in with the Syrians. They know this became a bit of a problem because people were saying, well – when the Afghanistan – why are they coming in? They were fleeing the terrible, terrible war going on still in Afghanistan. I mean the Taliban were blowing people up, attacking everybody and you know, they were caught in the middle of it and they have no hope.

These people, these young people, Europe was their big dream. Well, I mean I don’t think it turned out to be so good for so many of them, but…

They’re often this tiny minority. I mean maybe there are few people who are doing it for some kind of choice or economical reasons, but I can’t think how…

Economic migrants, yeah. I mean there were a lot of those, but most of them were fleeing conflict.

Yeah. But you know, the tiny minority in it, but they were all made to be, this is the majority. They’re just coming. It’s their choice or you know, they’re terrorists or whatever.

Yeah, absolutely.

Actually the majority are just very normal people, desperate.

Desperate to try and get some sort of better life for their families. You know, it was, they’re the children that were the driving force for these parents and, and they, they couldn’t foresee any future for them and they could only foresee death or hopelessness.

Yeah. Cause you’re not going to put your kids through that.

You’re not going to take on that journey and pay all that money. The ones that really need — the smugglers were obviously scurrilous. I saw them when I was in Turkey, and they would do anything to get money out of the refugees. The Syrians, they had quite a lot of money. In Syria, the life had been quite good, at a certain level, and they had money and they were bringing their money, and of course nearly all of that went to these smuggling groups, as it still does. We see it now happening from Libya of course. But that was another very — I keep using the word distressing. There isn’t really another word to use because when you see people in those situations, whether they’re Palestinians in the West Bank having their olive groves torn down, or they’re Syrian refugees trying to get into Europe through the Greek route to Lesbos, or Pakistani people in Kashmir after the earthquake, sleeping out under the open with aftershocks all the time and screaming.

It’s all distressing, of course. Always distressing.

They’re just people.

They’re just people, absolutely. They’re just people like everybody else here.

And how do you acclimatize going from that, to coming back home?

Well, that’s always difficult. The coming home is always difficult. Very difficult, I find. I get used to it after a while, but I don’t find the first couple of weeks very easy. I always find I don’t relate to people, because people will come up and say – friends who come up and say, “Oh, you had a difficult time there. What was it like?” They are happy to talk for 15 minutes maybe and then say, “Well, he hasn’t got a job yet, this son of mine.” Or he hasn’t got this or I don’t know what to do about this – and you think…

Everything must pale in significance.

But it’s a bit unfair on everybody because what’s going on in their lives – it’s very important. So you have to try and understand that. I do try hard, sometimes it’s a bit difficult. I suppose I’ve got used to it now. 

Lebanon has been particularly difficult. The Lebanon-Syrian border where I’d been working since 2014 – that’s been our main focus. That’s difficult because it’s been very dangerous through 2015-16. Again, I think I was very lucky to get away with that. I was tagged a few times by the militants because I was a prime target for kidnapping. But never, gung-ho. People say, “Oh, it’s a bit gung-ho to be there when all the other organizations had dropped out of the border towns”. Because of the risk of the Islamic state were there and Al-Nuzra, they’d taken over the town. We did stay in and work, but I could only stay there for maximum, a week. I stayed 12 days once, and I think I was probably very lucky to get away with that. Several times I had to come out after two days. I was so protected by the Syrian team around me, they kept me safe. Without them, I don’t know what would’ve happened – but we got a lot of work done. Was it worth the risk? Well, yeah, I would say worth the risk – but other people would say, “You’re stupid. That would’ve been stupid if they got hold of you as a bargaining chip, that would have been bad”. And it would, of course.

We balanced the risk very carefully beforehand – very carefully. And so, it wasn’t gung-ho. It was a very considered managed risk. That risk is now more or less gone, it’s much safer there now, but now we have other pressures. This year has been with climate… well, who knows if it’s climate change, but the weather this winter has been horrendous. The worst ever weather they’ve had, so I’ve been out there three times for emergency weather related work, and then I’ve just come back from political pressure on the Syrians to be to be sent back to Syria, which would be a disaster for them. They’ve been destroying the shelters, the army have moved into destroy their homes – their shelter homes – and so we’ve had to try and help with that work.

I saw a post recently that you put up on Facebook, something about they had to reduce the height to be allowed.

That’s right, for new rules. Crazy. Crazy.

Is that basically just an excuse to get rid of them?

Yes, it is, It’s pressure on them to go. It’s only in our town they’ve done that, where at the moment there’s about 60,000 refugees. Over the last three years, the refugees have tried to weatherproof their shelters. So they built cheap cement walls around, or put cheap cement roof on because they’ve needed to. That doesn’t mean they want to stay in Lebanon – the last thing they want to do is stay in Lebanon – but the government decided that anything with cement was a permanent structure, and they do not want them there as a permanent presence. So, they made a stupid rule how everything had to come down to one meter in height. The army said “If you don’t do it, then we’re going to move in with bulldozers and you’ll lose everything”. How could the disabled, which there are many, how could the elderly start to demolish their cement homes?

You need lump hammers and you need pneumatic drills and, they have reinforced with steel rods. We got a team of Syrians together that we had trained already in construction. We do a lot of training in construction, ready for their return, and they’ve got all the skills. We put a team of 15 together with our manager, Nabeel, and they went to the worst camps. The UN asked us to go to the camps for the disabled and the children’s camps and the widow’s camps and do managed demolition – which is knocking it down without destroying their water systems and their sewage and their possessions. So that’s what we were doing, then rebuilding with cheap, nasty UN supplied plastic sheeting and wood. So, come this next winter when the snow comes heavy, those shelters will collapse.

That would be very frustrating.

Very frustrating, yeah. We knew we were building shelters that would not withstand the next winter, or the next storm, really. The weather is changing there, the climate is changing. So, they won’t be very warm, whereas the cement shelters were much warmer. So we don’t know what will happen there, but at least we, you know, and that was fair. That was so distressing – elderly people would come to me and say, “We’d rather die. We’d rather die than have this happen to us, have our home destroyed. We might as well die. We can’t go back to Syria, they don’t want us here.” And it’s true – what do they do? And the disabled who didn’t understand, a lot of the mentally disabled, did not understand what was happening, they suddenly saw their home had gone. That’s still ongoing, the team is still working on that, still reconstructing. So yes, it’s, it’s been a very busy year this year.

Tell us a little bit and just briefly, about how Edinburgh Direct Aid works. I know you’ve explained to me before, it’s a very different structure from a lot of the bigger charities.

It’s entirely voluntary. We have a warehouse team in Edinburgh that works very hard filling the 40 foot containers, we send out two or three containers a year with clothing, with sewing machines, with looms, with material, with wool, with many things for women’s workshops and for clothing, for the children’s sports, clothing, toys, many things, basic medical supplies, although we’re not allowed to take in much medical. They’re all volunteers – the whole team is volunteers. We have a Treasurer, and we have two Fundraisers, and we have the Chairman who is 91 years old and still running 10 kilometers to raise funding for us – and it’s just run as a big family. I’m their main field person that goes out. Sometimes other people do go out, but I’m obviously the chief sort of Field Officer. So that’s how it’s run – just purely on a volunteer basis.

But what that means on a practical level, is that people who donate – all that money gets used. 

It does, yeah.

Rather than with one of the bigger charities…

Yeah, that’s right.

…where a big chunk of that presumably…

Yeah

I’ve no idea what kind of percentage, goes on wages and all sorts of things.

No, there’s a few stories about that, but I won’t go into that. I don’t know what our percentage that goes straight to the beneficiaries is. It’s very high, because also we try – I can’t always fund my own expenses for travel because I’m out there so often, I can’t. But I do when I can, because I don’t have much of an income really. Others that go out, – we have a retired doctor, and Dennis himself, who’s a retired mathematician, and some others who do occasionally go out, everything is funded by them. Nothing comes out of the funding – it’s all personal expenses that they pay themselves. That is very different to how most organizations would work. And of course, there’s no salaries or anything. We don’t get paid anything, it costs me some money during the year to go out, but I do get some of that back because I can’t simply afford to keep doing it. Some four, five times I’ve been out this year. So you’ve got flights to Beruit, and yeah, that’s how it works.

So it’s a small charity, but actively speaking has a big impact.

Big punch – I’d say we have a fairly big punch for such a small charity, and somehow the money just keeps coming in. It’s endless fundraising events that are very hard work. I don’t do the fundraising – I do talks, but I’m not big on the fundraising side, and I think that’s just as hard a job as what I have to do when I go out to the Syrian border. Fundraising is a nightmare, and we just rely on regular donors – some businesses, sometimes the Scottish government gives us some money. We have a very good reputation, I think that’s how we keep the money coming in. So – long may that continue!

Well, thank you for sharing some of your stories. Like I say, I’ve wanted to share them for a long time. When I heard you were here, I grabbed the opportunity.

It’s always a good opportunity for having my little relaxing holiday here now. Yeah, absolutely. It’s nice to tell the story of what we do.

And so what might be a top tip that you could share with our listeners? It can be anything you like.

Well, I suppose in the end, it would be what I’ve always said – even when I wasn’t aid working, when I was on my year long trip around South America and getting into all sorts of scrapes and difficulties, and Tiananmen Square and the massacre and I got caught in so many things…. It would be that no matter how bad things are, somebody somewhere will come along and help you out. Always, somebody will be there to help you out. You’ve just got to have faith that that will happen. Just when you think there is nothing that’s gonna get any better, and you don’t know what to do, and you’re really stuck, somebody comes along. There’s always a solution from another person or people. I would say that that’s probably my top tip – always think something will come along. And it does.

And you did mention earlier that you have this underlying faith in humanity that probably, may be what helps you get through some of those sticky situations.

Yeah, I think so. Absolutely. Even talking to a member of the Islamic state once by chance, I didn’t know he was – he was a very fluent English speaker, protecting his family, was going back to Syria to die. We had a really interesting, nice conversation. Not that I’m supporting in any way the Islamic state did, because they are really terrible. Maybe he was just a slightly different version of that, you see? So yeah, faith in humanity always – I think we have to have that. Definitely.

Well, thank you very much Maggie, it’s been a great pleasure.

Thank you.

This transcript is brought to you thanks to the hard work of Christine Specht.

Welcome to the Keto Woman podcast live from KetoFest! 

[Cheers and applause]

You can hear that in the background, the lovely audience who have made the trek up the hill in this incredible heat and humidity. So, thank you so much for making the effort, and welcome Karen Ogilvie to the Keto Woman podcast. I have been trying to get you on the podcast for ages.

Yes. Delighted to be here.

So, thank you, thank you for joining me here today. 

Thank you for having me. Yes, it’s been a long time coming. I think we’ve been trying to do this for two years now. 

Absolutely. So, tell us a bit about you. 

I’m a mum and a registered holistic nutritionist, working out of Ottawa, Canada. I’ve been working as, specifically, a low, very low carb registered holistic nutritionist for a year. Before that, I was working as a volunteer coaching people online, on how to reverse their diabetes and claim better health through a low carb lifestyle. At home, I have one little son, he’s 11 years old. And through him, I became interested in nutrition and that’s what brought me to keto. When he was three years old, he was diagnosed with autism and I was keen on helping him reduce some of his symptoms by following the recommended diet, which was gluten and casein free. Through that, I became more interested in exactly how nutrition affects our mental health and our general wellbeing. That’s what eventually brought me to keto, after my own diabetes and a-fib diagnosis. 

So how’s it been working for him? What kind of changes have you seen and over what kind of time period?

With him, I didn’t find too much of a difference following specifically the diet that was recommended by his doctor, the gluten and casein free. What I did find was that when I eliminated sugar and grains, he had good results, and when I increased his fats, specifically his fats through animal fats such as high DHA omega three fatty acids, he had more impulse control and he had better focus.

Tell us a bit about how that works. I know it can really, with autism you need to try and keep things as stable and in routine as much as possible, is that right? I can imagine that swing in blood sugars being the exact opposite of what you need. 

Everyone that has these ADHD behaviors will find a benefit from stabilizing their blood glucose, so that they don’t have the rise and the crash. With Freddie, I wasn’t specifically trying to help him with autism. He is proudly autistic, but some of his issues were stemming from the ADHD symptoms that he would have, so lack of focus and impulsivity. So by keeping his blood sugar stable, by removing refined sugar, and then helping him foster a better mood and better concentration by incorporating fish, fish oil, he found great improvement for those particular symptoms. 

What kind of issues do you find that he faces, you face, as a family? I’ve seen some of your posts online and you just have to deal with different stereotypes and all sorts of things flying around about autism. Tell us a little bit more about that cause it sounds like it can be difficult sometimes. I see you getting heated. 

It can be difficult sometimes. As I said, he’s proudly autistic and I catch him online sometimes. People don’t know that he’s 11 years old. I catch him trolling anti-vaccine people on YouTube. 

He likes to educate them, doesn’t he? 

He likes to educate them. He takes great offense to the idea that he somehow is disabled or injured because he’s proudly unique. He’s keen on that. He’s also very proud of his interests. He’s a math savant; he’s very interested in science. As I went back to school to learn about nutrition, he became very interested in learning, particularly about sugar. He’s a big fan of Gary Taubes. He likes to talk to people about the sugar in kids’ foods, fruit juices and fruit snacks and that sort of thing. He did a little demonstration for the kids at his school where he had all the different drinks that they would have in their lunch, like Gatorade or fruit juices, and then he would have the bags of the equivalent amount of teaspoons of sugar next to it.

That’s a good visual, isn’t it? You can see straight away just how much sugar you’re piling into your system. 

Exactly. From something that would seem as innocuous as a fruit juice. 

It’s supposed to be healthy. 

Is it supposed to be healthy? 

So, you got into keto as a byproduct of doing it for him. Just supporting him as a family, presumably. 

Yes, doing it for him, I became interested in nutrition. So when I was called into my doctor’s office and was told that I was this far off of the full blown diabetes diagnosis, I had an A1C of 6.2 and a heart condition called atrial fibrillation. I wanted an alternative to what she was suggesting, which was just restrict calories and get a gastric bypass. So I wanted to explore doing a restricted carbohydrate diet. I had done that in the past, and I had good success but kind of strayed, because I’d be told that’s not healthy longterm, it’s not sustainable. So, I decided to give it one last effort before agreeing to having a very invasive surgical procedure. I’m still down 80 pounds and the doctor is very happy with the results, particularly for my A1C. Now I’m nowhere near being diabetic with an A1C of 5.0.

Good for you. Along the way, you discovered passion for this. You want to help other people, made it formal. Tell us a bit more about that.

When I decided that I wanted to try being low carb again, when I was considering surgery, between the time when I had done Atkins in the 90s and now, all these Facebook groups popped up. So, I decided I was going to find Atkins groups. But, I was surprised when I went searching on Facebook, that there were very few Atkins groups, but I kept on seeing all these groups that were called keto or ketogenic. Doing Atkins in the 90s, I knew what ketosis was, so I’m like Oh, I’ll just join one of these. So, I joined a small group of people that seemed to be really keen on learning the science behind the nutrition of low carb. Before I knew it, I had agreed to help run the group. It grew; I think there was 3000 when I took it over and now there is over 110,000 in the one group and I think about 115,000 in the other.

Just a few, then. 

So just a few. 

What are they called?

We have two main groups, one is Keto Science Alliance, that we have general discussion and nutritional science. Then, we have another one that’s specific for food and recipe discussion, that we call Nondenominational Keto, so all forms of very low carb are welcome there. We have people that eat very clean, more of a paleo style, very low carb. And then we have the people that are “if it fits in your macros” and carnivores, and vegetarians, even have a couple of vegans but they’re all pursuing better health through a ketogenic diet. 

Keeping that focus in mind, not getting too judgmental about exactly how people do it, as long as they’re achieving the results they’re looking for.

That’s right. I know I have my own particular way of being keto. I prefer the paleo style where I restrict dairy and stick to whole foods, meat and vegetables mainly. 

So tell us a bit about your keto. What does your everyday keto look like?

My everyday keto, I have sort of the Monday to Friday keto. I believe in the 80/20. So 80% of keto for me is lots of olive oil and avocado oil, healthy fats and saturated fats from meat and leafy green vegetables. On the weekends, I put on my mom hat and do baking for my son to have his crackers and cookies and muffins and that sort of thing. So we’ll have little keto-fied treats. That’s been a lot of fun learning how to do some baking, with all these new products that weren’t around when I was doing Atkins. 

You aren’t a natural born baker, are you?

Not really, no. I’m just a cook at home or for my, for my son. But, the Keto baking’s been… 

Does he enjoy it? Does he help you out? 

He’s my food critic; he’s not really my assistant chef. So he’ll be brutally honest if a recipe is good or not good. He’s very particular because he’s sensitive. He’s very particular to certain sweeteners. So, he’ll tell me what he thinks. 

And you are now a qualified nutritionist, is that your label? What’s your preferred label? I know there are different labels that go around. 

I’m called a registered holistic nutritionist. So after running these Facebook groups for a couple of years, I decided that this is what I would like to do professionally. I went back to school, just as a general nutritionist course. I had the choice, I looked into going into university to becoming a dietician, but the problem with that is that I would become part of the college of dietitians in Ontario. They are still very much beholden to the food guide, which is very similar to the US food pyramid, healthy plates that you have in other countries. I couldn’t in good conscience do that because my preferred clientele would be somebody that is trying to control their diabetes through diet.

If you go down that route, you’re stuck, aren’t you? You have to recommend their guidelines. 

You’re very stuck. You’re generally working in a hospital or under a doctor. I did have some dieticians in the course with me; they expressed a great deal of frustration that all they were doing with their degree was handing out Xerox copies of the same old diet of heart healthy grains and fruits and that wasn’t ideal for most of their patients. So, I decided to take the hippy-dippy course that’s a registered holistic nutritionist. We deal with nutrition mainly, but mind, body and spirit as well. So there’s lifestyle coaching with that. 

You can color outside the lines. It doesn’t surprise me that you took that route; much more fitting for your character, I think. 

Yeah, I think so. I think so. Yeah, and I did enjoy it. It was really interesting taking this course because it was general nutrition and being a holistic nutritionist, they believe very strongly in biochemical individuality so that what works for me isn’t necessarily going to work for you and you address your client as a whole person. I’m not addressing just a symptom like you would in a hospital setting as a dietitian. 

I love that approach, and presumably you’re looking at everything else that might be affecting whatever issue it is they have, sleep, stress.

Oh, everything. Their relationships, their sleep, their career. Yeah. All those things to try to help them live their best life and have their best health. 

People tend to underestimate that. They often just, especially I guess if they’re looking at weight issues, always this blinkered vision really with just thinking about food. It’s got to be the food that’s the issue, without necessarily thinking so much about all the other things that have such impact.

It’s true! We hear it all the time. You know when you go to the doctors that if anyone who has a weight issue, they talk about it’s gluttony and sloth, right? Clearly you’re eating too much and moving too little, and I’ve found working with thousands of people over the last few years that it rarely has anything to do with either of those things. 

They’re far from that. Yeah. We just get a bit sick of being told the way out.

Sometimes, yeah. 

I would love to open this up to you lot out there. Maybe you’ve got some questions for Karen. Come up to the mic and ask away, please.

They’re shy, it’s early. 

Don’t make us put on our pretend voices. We did have this as a plan; it was an option. We figured first one of the day, searing heat, there might not be anybody there at all and we might have to put on pretend voices. Here we go. So, just tell us who you are and fire away. 

I’m Jackie and I would like to know how you handle plateaus in weight loss, for a woman.

Well, it depends on how long the plateau is. In our group, we think plateaus are normal and healthy. People reach a certain level of homeostasis, and that is something that they can either choose to break through and if they choose that, they’re no longer happy at that particular weight. Then we start looking at things like their food journals, particularly with meal timing. I find that a lot of people that are having a plateau, it’s not so much what they’re eating, it’s how they’re eating and when they’re eating. So we try to switch up fasting schedules. For me, I find with women in particular, especially mothers, sleep is usually what’s missing. So what’s happening is that they are very fatigued and they’re trying to get their me time after the kids go to bed and they should be going to bed too. So, this is when night eating is happening. So I find that if we can get good sleep hygiene with these women that a lot of the issues that are coming with night eating, snacking, eating out of the window and also hormonal balance resolves itself.

Right

Yeah. 

Thank you. Here comes my favorite.

Hi, I’m Becky.

You’re Becky! 

This was a perfect question; I had similar question with stalls. I’ve lost quite a bit of weight and certainly have a way to go, but there’s times that I’m pretty happy just having really good bloodwork, but you hear people talking about when we get this obese that our fat cells are dysfunctional or unhealthy. Is that unhealthy for us to continue to carry that weight or is there any research behind that?

There is research coming out of a lot of Nordic countries right now that actually as you age, maintaining the slightly overweight BMI and slightly overweight body fat percentage is actually healthier for longevity, that it is protective against disease. My only concern, if somebody is going to be maintaining a great deal of weight as we age is injury. It’s not a matter of that those health cells being damaging, they’re not disease causing, but it is good to maintain balance and flexibility. So ,with somebody like that, I would definitely be looking into, I’m finding some sort of physical activity to keep that person moving, to keep the joints healthy. But no, I really don’t see somebody maintaining a certain amount of body fat and as he gets older that being a bad thing.

Thanks Becky.

Hi, I’m Marie. I have a question about hormonal changes. So as we, we age and we go through the menopause, is there things that we can be incorporating into our diet that can help us without artificial supplementation, if you will?

For just some people that they have black Cohosh, they’ll take certain herbal supplements. I don’t really specialize in, in the herbals thats an extra area of nutrition that I haven’t really gotten into yet. But, there are some nutritionists who, who do that, that specialize in natural alternatives to maintain hormonal balance. I also work with a nurse practitioner, and she specializes in bioidentical hormonal replacement therapy. And I know, Jennifer Kleiman, who is my podcast partner, has worked with her and has had fantastic results supplementing for her hormonal health.

Thanks. Are there any just general foods that are preferred for it?

General foods? Well, I’m usually, I’ll try to get them to limit the, the phytoestrogen, things like flax and soy if you’re going through that particular change because some people find those aggravating when they’re, when they’re going through these hormonal fluctuations. Honestly, just having a very low carb diet and staying away from foods that can have soy and soybean oil added really does help keep energy levels stable and make those changes seem more bearable. 

Thank you

Hi, my name is Madge. As people see your success in what you’re eating, they always want to know what you’re eating and I try to tell them, well, this is what I eat.

But, it might not be the best for you. So I wondered, as a holistic nutritionist, how do you decide how to start them off? Do you just go with the basic, keep it low carb or do you listen to them and say, well, maybe you want to try this or…?

If they’re just learning, then one thing that I really like is Dr. Westman’s “Page Four”. It’s very simple. I don’t know if you’ve ever seen that, but you can, you can download it online. Dr. Eric Westman’s page four. So it keeps it very simple. It’s just meat, fat, vegetables. As a holistic nutritionist, because I’m treating the person as an individual, I go through a whole interview process where I, first of all, I had to figure out what they don’t like, you know, and a menu is not going to be very useful to something if I’ve got it full of tomatoes or something and they can’t eat it. And so, you know, we go through this whole interview process. I figure out what their primary health concerns are, their likes, their dislikes, their habits and we work from there and I give them a sample menu of, of things that I think that they would enjoy. After a couple of weeks, they’ll come back to me and we’ll discuss. It’s an ongoing conversation, discuss with them, what they did, like what they would like to try and how it was making them feel. 

That’s great because so, so many of them are like, well, can I have that and I can’t have that. And I was like, no, I can’t have that.

Yes. Yeah. Well, every, everyone’s different. I mean, my husband is very much, just a low carb if it fits in your macros person. But if I eat some of his grain based, low carb wraps, I feel terrible. 

Right.

So there’s no point in eating something that you don’t love, that you don’t enjoy, because the ketogenic diet is delicious. And there’s no point in eating something that’s going to make you feel sick. So, yeah. 

Great. Thanks.

Anyone else? Come on. 

Hello, I’m Lynne. Are there any patients that come your way that they have an like, alternate medical condition that you’re like, alright, I can’t touch you. Right. Or like if they have like severe heart history or whatever that might be, what are some key things that you go, okay, you need to really go to a higher level.

If I have somebody that’s coming to me with, with a health concern and sometimes they don’t even know that they have a particular problem, but that is part of my job is to get them the proper referral to somebody who specializes in their particular health concern. So, oftentimes I’ll refer them to a doctor or a nurse practitioner or a counselor. Oftentimes, they’re coming to me and they, it becomes apparent that they may have some kind of disordered eating, or some kind of serious psychological issue like depression, or suicidal thoughts. So then it’s my responsibility to get them to the proper services that are out of my scope. So, I do prefer to work with somebody who has a doctor that’s willing to explore in my area of expertise, which is the low carb diets, and I work within the parameters that that doctor or nurse has set up. 

Thank you.

Thanks Lynn. 

Has that ever caused issues? Have you locked heads, as it were, with a client who’s come to you and they’re like, oh, I talked to my doctor and they said I couldn’t do what you’d been recommending. Have you had struggles like that? 

Yeah, I mean, there are, there are some doctors that are still very much locked in. You know, the, the diet that we’ve been following since the 70s, 80s and 90s. Or, doctors that want their patients to go low-fat vegan. And I simply tell the person, well, you can get a second opinion from a different medical professional. I’ll never say that a doctor is wrong. Or, if somebody is very keen on following nutritional advice that is completely out of my area of expertise, like if they wanted to become a vegan, I would refer them out to a different nutritionist. It’s not my area of interest and it wouldn’t be worth their time or mine because this is the area that I’ve done all my research in.

That’s the kind of thing you need a specialist for, don’t you, because you really have to work hard to get everything you need. It’s possible, but it’s a challenge. 

Yeah, it’s true that some people that I’ve worked with that you have to tailor their, their diet because they have serious health concerns. Like, they’ve had gastric bypass and what I would do for somebody that wanted to control their diabetes through diet would be to have them fast and then feast. But, I can’t do that with somebody that has a stomach the size of a hard boiled egg. So, I adjust things and work with the medical professional that they’ve been seeing, if possible. 

Hi, I am Jeff Halverson, I’m with the Greater Boston Keto. So I guess my question, is how you decided where you wanted to get your credentials because I’m thinking of doing something similar, thanks.

With the school that I picked, I had choices, as I said. I looked into the university program to get a degree as a dietician, and it just, it wouldn’t have worked for what I wanted to do. I already been volunteering for a couple of years, coaching people in a very low carb diet. I had some options; it’s important to do your research. There are a lot of online courses right now that I see people getting credentials for, they call them credentials. There was one that I saw that a friend, a friend took and Amy paid good money into this, but the certification, when I looked into it myself, was pretty much meaningless. So, you really want to look into your state, your province, what sort of credentials you would need to have an alumni association, that’s important, and to be insured. So, there were a couple of schools in my city, in Ottawa, and I wanted to actually be physically in a classroom, that was important for the way that I learn. And I picked one because, actually the lady that owned that particular branch of the school, I had gone to high school with, so I did. I had the choice of one or two, and I went with the one that I knew and that had been established. So, I picked the Canadian School of Natural Nutrition. They’ve been well established. They have a really good alumni association. So, why that’s important is that if I have a client who has a complaint about me, she could go to my alumni association. There’s a reporting body; we’re self-regulated in Ontario. So it’s important to have that reporting body for your client’s safety. And, it’s also important to have insurance. If you’re not part of one of these alumni associations, it’s very hard to protect yourself, with liability insurance. 

Hi, I’m Scott, thank you so much. With these Facebook groups of over a hundred thousand members, first of all, that’s incredible. Congratulations. One thing I observe, is they exist for all different types of diets: the snake diet, high carb diet, the baby food diet, whatever, you name it. There’s always hundreds or a few thousand of members who are posting a lot, posting before and afters, clearly having success. Then there’s probably a ton of lurkers, you know, 60,000 people call it, who are just observing and learning. And then there’s the invisible graveyard of people who are not successful, who maybe have tried it and failed and stay in the group. So I’m curious how you kind of think about adherence, managing adherence with such a large group of people, making it easier to adhere. Or, if you just think about that as kind of not your responsibility, more sharing information and helping people who want to adhere.

We talk a lot in our admin group about protecting the novice experience. Once again, we keep it nondenominational keto; nobody is wrong, we’ll explain why, perhaps, something wouldn’t be a good idea for them. I’ve discussed it with my team quite a bit that when somebody starts a new diet, particularly when that’s as much of a drastic change from going from the SAD, Standard American Diet, to keto, you’ve got them for about three months on average, that that is the statistic. People will try a new diet, and within 12 weeks, they are gone. So, our idea is to protect that novice experience, that they have very positive results and also we make it so that they realize that this is an easier way to eat and that it is a healthful way to eat. So, when they do quit within 12 weeks, they will come back. So we do have a lot, I do see in our particular Facebook groups, a lot of people that they fall off the wagon for whatever reason, but because they had such a positive experience as a novice, they return. We do have very good participation rate in our group; in comparison to other ones, it’s about 70%. We’re very happy with that. That is one thing that I think we’ve done well. 

Great. Well I believe we have a bit of a funny. A KetoFest funny story to share. I think it stems back from last year…

Yeah. Last year, last year. Yeah, I was telling Daisy, when we were talking in the kitchen that I was hoping this year would be less traumatic at Keto Fest. What happened last year, Daisy was, there was a prank that was played on me and I think it was meant for Daisy. 

Yeah, I missed out, I didn’t, I didn’t know about this. It was all to do with the, the beach admin house. Yeah. The admin house was supposed to be a beach house.

Last year. 

So we get there and I’m thinking as we’re driving there, this doesn’t look like it’s close to the beach, but you know, maybe it’s somehow at the end of the garden or something? Didn’t look right. Get there. Cause I’m excited. You know, I love the beach and, all right, where’s the beach? Where’s the beach? That was the first thing as soon as I got there, it wasn’t there. So they, they changed the house, but my plan had been for all the admins to go for a midnight swim. I love that. I love, it’s a bit weird. I have a lake nearby, and I’ve been for midnights swims before and it’s great fun. I love it. So I had this plan that we were going to go for this midnight swim, but of course it all fell away because we weren’t by the beach. But unbeknownst to me…

No, see I was, I was not in the admin house. I was at the Holiday Inn and so was Richard Morris, and he had known about this admin house, there was supposed to be a beach and they were going for this midnight swim that didn’t happen. So we’d been working all day in RD86 in the kitchen and it was hot and we were tired. I got back to my hotel room and I had a shower and all of a sudden my phone goes, ding. And I look, and it’s Richard Morris, and I says, Hey, do you fancy a swim or you don’t want to come down to the pool with me? I’m like, Oh, yeah, sure, give me, give me a few minutes, I’ll meet you down there. He goes, no, no, no, no, I’m going to meet you in your room, which should have been, a tip for me. I’m thinking, he’s nice, he’s going to escort me down to the lobby. No. I’m like, well, give me, give me a few minutes. I’ll get into my suit. I get the knock on the door and I open it up and he’s standing there and he’s got his hands behind his back looking all proud, chest puffed out. And the first thing I think is, dear God, this man has walked down the hallway in wearing nothing but a black tee shirt. 

[muffled giggles and “oh wow”]

And then I suddenly realized that no, he’s not naked from the waist down. Instead, he’s wearing the world’s smallest black Speedo with his black tee shirt. 

[laughter]

And he goes, okay, well, let’s, let’s go downstairs. I said, you can’t walk down through the lobby towards the pool in that. He’s like, why not? This is my suit. And just then he laughs and he’s got his hands on his back and he pulls out and he’s got decent swim trunks.

[laughter]

And, he says, no, I brought this for the beach swim that didn’t happen. And he turns around on his heels to go into my bathroom to get changed. And just then I see it as he’s walking away, on the back of his tiny Speedo, Australia written right across his bum. But I’m pretty sure that was meant for you on the beach. 

I missed out. And of course, and of course in Australia, those are known as budgie smugglers, right? 

I didn’t get a very close look. I went hysterically blind for a brief moment. 

What I want to know is, is where they are this year? I mean, I’m staying in the Holiday Inn, perhaps we can do a replay. So as is customary, can we round up, please Karen, with a top tip. 

Sleep. I think I touched on this earlier before. Sleep is so important for your hormonal balance. And I find that a lot of people that are struggling with night eating, myself included, I have a busy life. I’m a mother, a volunteer. I work, I’m on the Facebook groups all the time. And, a lot of times we try to claim some of that time for ourselves after, our children go to bed, and it’s quiet, but often when you think you’re hungry, you’re actually tired. So, try to get that, that eight hours every night. I’m better at preaching than practicing myself as we all are. Especially when it comes to sleep.

It does make a difference, doesn’t it? I seem to fall into my natural sleep pattern when I come to the States. I’m absolutely dreadful about staying up too late, and end up still online probably because yes, I was nodding over there. Probably one of the people who say Daisy, are you still doing online? Go to bed because it’s four o’clock in the morning or something my time. But of course when I shift back in time here, I’m waking up at six o’clock in the morning all bright and sparkly and getting to sleep at a good time at night and getting a good chunk of sleep. So, I do well when I’m here. 

Well maybe I need to come to France to get better sleep.

Maybe we can do a swap. 

Yeah, there we go. 

Rangan Chatterjee talks as a podcast that I really enjoy listening to and he talks about the pillars of health and he maintains that sleep is the pillar that actually supports everything else. 

It’s true. 

And if you can get that solid foundation, the others will all stand up better. 

It’s definitely, it’s easier to exercise if you’ve had a good night’s sleep, it’s easier to keep your, your blood sugar stable. I know, if any of you test your, your blood glucose in the morning, if you haven’t had a good night’s sleep, a fitful sleep, not enough sleep, you’ll find that your, your fasting blood glucose is much higher. 

I’ve ordered, getting in on all these people with their self experimenting, I’ve ordered a CGM, so I’m going to see just how much my 4:00 AM late nights impacts my blood sugar and maybe that will be what I need along with people like Sandy telling me off to go to bed, might be what I need to, to get some sleep. 

And even with somebody who’s had a nightmare, you can see it in the CGM. It’s really interesting. 

Really interesting. Well thank you so much for sharing this Keto Fest live experience with me. 

Thanks for having me on. No, I’ve been waiting to do this for a long time. I’m glad we could do it. 

Nice. It’s so nice to spend time with you again, in general. Enjoy Keto Fest and thank you, my wonderful Keto Fest Lovelies out there for, for coming up here in this heat and sharing it with us. Thank you so much.

This transcript is brought to you thanks to the hard work of Jeanne Wagner.

Do you think people with weight to lose need to consider calories if they are experiencing a long plateau when eating a ketogenic diet? It’s that dreaded word, isn’t it? Calories.

Calories. You know what? The answer is, maybe, maybe they do. There’s a whole long list of things that we can consider when somebody is experiencing a weight plateau and yeah, calories is one of them. So for example, if you are just taking in too much energy from fat or from protein or even from carbohydrate or alcohol, if you’re just taking in too much energy and pushing through those hunger and satiety signals, because you’re eating for all the raisins or whatever it may be, then definitely reducing calories and trying to tune back into those hunger and satiety signals might be a strategy. So that’s often why people will use something like intermittent fasting. You know, they’ll spend that period, whether it be three months or six months or whatever it is, or shorter to get themselves fat adapted. And then they start to notice that the appetite goes down, and so they’re like, okay, well now I’m ready to do something else. 

And maybe the weight has plateaued. So then something like intermittent fasting where calories are being either spontaneously or purposely reduced by reducing meal frequency or reducing the eating window, can certainly be effective. But I guess as well, there’s so many other things to consider. It’s very easy just to default to the whole calories in, calories out thing. But you know, a lot of people, again, they try the calories in, calories out thing and it doesn’t work. So if it’s not working, well what else can we consider? And there’s a few little things that I look at in particular when it comes to weight loss resistance or weight plateaus. And one of them is iron levels. So if somebody is low in iron and it’s usually iron stores. So on the blood test, it’s called Ferritin, that’s your iron stores.

So if we’re low in iron, well that means we’re basically low in energy. So we need iron to transport oxygen around our body. And that’s how we produce energy. So if you’re trying to lose weight, you’re basically trying to get your body to expend energy to burn its stored energy. So it’s like a double whammy trying to get rid of energy from the body, but you don’t have enough iron to carry oxygen around the blood sufficiently. So the body is going to be like, well, hang on a second. We’re not getting rid of this precious energy that we have and we’re not gonna waste any energy burning fat because we don’t have enough iron. And it’s not like the body is consciously making that decision. It just can’t do it. And there’s the other theory as well where if the body is low in something like iron or one of those essential vitamins or minerals, it releases a bit of a low level stress response, which increases insulin resistance, which helps the body hold onto stored fat because any type of stress, it’s kind of like the body thinks it’s in a famine or in some sort of danger mode. So it’s not going to comfortably release any stored energy. 

So iron is a big one, massive one. And that’s something I think people should check specially, women of childbearing age or people with gut problems. So if you’ve got any sort of gut issues like inflammatory bowel disease or IBS or something where your ability to absorb nutrients is hindered iron is usually one of those things that’s not absorbed very well in those sorts of people. And then other things too, so it could be magnesium, a inadequate intake of magnesium is very strongly linked to insulin resistance. So you could have the perfect diet in terms of your carbohydrate macros, carbohydrate, fat, protein macros, sorry. And you may even be eating low calorie or you may even be in a calorie deficit and you’re still not losing weight. And so magnesium is a huge one because if you’re deficient in magnesium, essentially what that means is that the insulin signaling becomes less efficient.

So you become insulin resistant and then being insulin resistant actually makes you more deficient in magnesium because you use up more magnesium to make more insulin that you need. And so it’s actually like a vicious cycle, whereas your body is making you more and more deficient in magnesium when you’ve really need magnesium to get out of there and maybe restart weight loss or something like that. And magnesium deficiency is common. I know, I mean, when I was going through my dietetics practice, I remember learning about magnesium and they just said to us, Oh, you don’t have to worry about this one because no one’s deficient in magnesium. And I was like…

I thought it was more a case of everyone pretty much.

I was like, whoa, whoa, whoa. So we just don’t worry about it? Like no one’s deficient? Have you surveyed me? You don’t know what I ate. You don’t know if I’m deficient. Like how do you know? And I was just like, that’s not right. And so I actually delved into it a bit deeper and what they were trying to say, in their defense, was that so many foods contain magnesium. It’s abundant in our food supply that it’s not likely someone’s going to under eat it. So like, you know, it’s not like as obvious. Whereas if you stop eating meat, you’re probably going to be deficient. And I, and there’s, you know, cause a lot of food groups have it. But I thought that was, you know, that’s still not enough to then be like, okay, well everybody’s going to be safe from a deficiency because what we know about magnesium is that we all have a different magnesium bucket that we’ve got to fill up. 

And if you’re under a lot of stress, for example, which most of us are in this modern world, or you’re going through a very stressful period of work, or you’re doing a lot of fasting, which is a stress or whatever it may be, your magnesium bucket actually gets bigger. So now you’ve got to fill up a larger magnesium bucket so that you don’t have a deficiency. So trying to fill up a huge magnesium bucket -let’s say you’re really stressed at work, you’re also doing this fasting thing. Or maybe you’re doing a low calorie diet, they’re all stresses on the body and maybe you’re not sleeping well. Maybe you’re taking lots of medications- you’ve got this massive magnesium bucket and you just can’t, you can’t fill it. You can’t fill it up. So you become deficient. And that’s maybe where supplementation could be useful.

Because isn’t part of the argument, you mentioned that their argument was, that it’s really easy to get magnesium from foods. But I thought that that was one of the arguments actually that foods have less than less magnesium in them, so it is more difficult actually to get enough magnesium from the foods. Even if you’re eating a diet that is allegedly rich in magnesium.

Agreed. So the soils are becoming more and more deplete in magnesium. So we don’t even really know how much magnesium is in the food were eating, you know, from the vegetables and the seeds and all of that. You know, if a food is fortified with magnesium, which a lot of those packaged bread and cereal products are fortified with magnesium, well that’s kind of a supplement really. If it’s being fortified, it’s not in the food naturally. If you’re doing that, then yeah, you might be able to argue that you’re getting in enough magnesium. 

But, you know, a lot of people particularly in this space aren’t eating those fortified breads and cereals and that’s when I think short term periods of supplementation can be warranted. So for this particular person who is trying to figure out why they are in this weight plateau, you’d go through those different types of things as well. So a lot of it is micro nutrient based, trying to figure out if somebody’s got a deficiency in one of these major micronutrients and if they do well, can we use short term supplementation, to help boost up the levels. And then once they are able to get things going again and we’ve seen adequacy in those micronutrients, then we can try and keep that there with food. So yeah, there’s, Oh my God, there’s so many others. Like I’m just thinking of more that I come into my head a well.

It can be difficult to test magnesium can’t it though. I seem to remember reading that the blood test to see if your levels of magnesium isn’t particularly accurate. Is it sometimes a case of sort of guessing what the problem might be in? I mean something like taking magnesium supplements is unlikely to do you any harm, is it? You just end up, you can tell if you’ve had too much because things tend to move through your system a little bit too quickly to put it a bit lightly.

Yeah, no, you’re right. So, a lot of the blood tests for vitamins and minerals are just completely inaccurate. Sodium magnesium is one of them. The blood tests for serum B12 is highly inaccurate and the reason the blood tests and the magnesium is inaccurate is because magnesium is stored in our bones. So it’s not really frolicking around our blood stream anyway. So it’s more used in the acute care setting where they’re trying to work out, um, people’s electrolyte balance and whether or not they need to give them supplementation to keep them alive and things like that. So that’s why the magnesium always appears on your blood test, but it’s actually not useful in determining whether or not you’ve got a deficiency. 

The way I do it is by one trying to predict how large someone’s magnesium bucket is. So do they have higher requirements and if they have insulin resistance, if they’re taking multiple medications, if they’re under a lot of stress, if they’ve got anxiety, things like that, then I just make the assumption that they’ve got higher requirements for magnesium and then you can supplement based on that assumption alone and then just sort of track symptoms and see if things improve. But also the other thing is as well is that you can calculate people’s magnesium so you can sit down and you can go, well, what are they eating? How much of my magnesium are they eating and match it with your prediction for increased requirements. 

But then the other factor that comes in, which is how this conversation all started, is that people are usually trying to lose weight as well. So if you’re trying to lose weight on top of an increased requirements for vitamins and minerals, sometimes you actually can’t eat enough food. Even if you’re eating all these magnesium rich foods, you can never get to that point where you’re going to meet your requirements because you’re also trying to lose weight and you’re trying to keep your food intake low. You don’t want to overeat. So that’s the other thing. 

You know, sometimes when you sit down and you put together, well this is what you’d have to eat in the day to meet your magnesium requirements. Someone’s magnesium requirements are really high. They’re just like, I can’t eat all that. Like if I eat all they have, I’m gonna gain weight and they might be right. So that’s another thing that needs to be factored in. But there are some blood tests which are good. So you know, vitamin D is usually a pretty good correlator of your vitamin D levels and your vitamin D status, and also some other good ones. Iron is good.

The iron tests are reliable aren’t they?

Yeah. But like for the minerals, they’re all pretty basic. They’re not really going to tell you much about your actual diet. Another good one that I’ll share is that I think a really good blood test to request from your doctor is something called homocysteine. Have you heard of it?

I have. I couldn’t talk about it. I’ve definitely heard of it. So I’m fascinated. I know the word.

Yeah. Well, I mean, I didn’t learn about this at uni or anything either, and I don’t think a lot of people know about it, what it is or what it does, but I learned about it through my own sort of health journey as well, and then I dived into the research. So basically it’s a protein and it will build up in your blood if you have a deficiency in either folate, which is vitamin B nine or vitamin B12. So if you just got a blood test for vitamin B9 and they looked at serum B9, a lot of the times your blood has a lot of this serum B9 floating around a lot of B12 floating around and your doctor goes, oh, that’s good, you’ve got no deficiency. But those two vitamins need to be activated to actually be used by yourself. 

So they can be floating around the blood and high amounts. But the question of whether or not your body is actually using those B vitamins can be answered by testing homocysteine. So if you test your homocysteine and your levels are elevated, you can assume that you’ve got a deficiency in either vitamin B9 or vitamin B12 or both. And you just sort of play around with that until you get the homocysteine levels down. So I think that’s a really good one because that definitely happened to me. 

I you know, when I went through my kind of stage where I was doing a lot of restrictive eating, I ended up with nerve damage in my hands and my feet and they, all, the doctors tested me for vitamin B 12 because vitamin B 12 is linked with peripheral neuropathy, which is nerve damage in the hand of feet. And My B12, my serum B12 always came back high, you know, it was, it was always, Yup, you’re fine. It’s got to be something else. They called it idiopathic peripheral neuropathy. And you know, seven years passed before I finally found out that the B12 blood tests really just does not correlate to your B12 stores. And my body had a problem in activating B12. So even though it was in the blood, my body couldn’t get it into the cell. 

And so I had to supplement with an activated form of B12 to help my body get that sort of B12 into the cell. And boy, I wish I knew about that seven years ago because maybe the nerve damage is permanent, and maybe that’s something I’m going to have to live with. And if I can prevent other people from having any permanent damage from a B12 deficiency or a folate deficiency, I’m going to spread that message. So homocysteine, get it tested.

That sounds like it’s potentially wrapped up with the problems that some people have with the MTHFR gene. Yeah, it sounds like it could be linked.

There’s a lot of different genes which are gonna affect your ability to activate B vitamins and other vitamins and minerals and so on. But yeah, so essentially when I say activation, that actually means methylation and the MTHFR gene mutation that you’re talking about, there’s a few different types, but one of the more well researched ones means that if you’ve got the mutation, then you have a reduced ability to methylate things in the body. So turning things on or turning things off like for example, being able to activate a B vitamin to get it into the cell, your body can’t do that very well. And you know there’s a lot of people walking around with these genetic mutations who have absolutely no problems.

And just because you have a genetic mutation doesn’t necessarily mean that you’re going to develop these medical problems from it. Everybody’s different. It’s kind of how it gets expressed in your body. I know with that particular mutation, a lot of people end up with miscarriages and problems with fertility because we know that folate, vitamin B9 is essential to grow in your human and to be fertile. And so if you’re not activating vitamin B9 and you’re not able to actually get that into your cells and tissues, then yeah, there could be problems with fertility and there could be problems with having a healthy baby, which is awful to think about and awful to think that there’s a lot of people that may have this mutation and may have those issues but don’t know it and don’t know how to actually test whether or not they are deficient in B12. I mean B9 or B12. So you can get tested for the mutation pretty easily and you just ask your doctor to throw on a test for MTHFR and they can just do it with your regular blood test and if you want to know about it, you can know about it.

I mean really the way you sort of manage that mutation is, is by checking on homocysteine anyway. So you know, it’s more linked to those deficiencies in B12 and B9 so if you’re looking at your homocysteine and keeping that am in a good range, then it doesn’t really matter whether you have the mutation or not kind of thing, but a lot of people like to delve into their health more. I would put a, a big beware sticker on that though because it is a little bit scary if you type in or if you Google the MTHFR genetic mutation… I don’t know, have you googled it?

Yeah, a whole slew.

Oh yeah. It’s like all the worst things, you know, just pop up like cancer, depression, stroke, miscarriage, nerve damage, Alzheimer’s. It’s like everything that you want to not get in life is what you’re now learning you’re at greater risk of. And so, you know, it was really scary finding out that I had that and I’m a health professional who’s able to look through the literature and kind of just cycle through it and figure out what I need to do. But there’s a lot of people that that would just completely overwhelm them and be far too much and maybe they don’t even need to worry about it. That’s the thing. It’s going to be a different outcome for different people depending on your lifestyle, you may have absolutely no problem whatsoever with the mutation or it could be something that’s crucial in your health journey to find out about.

Yeah, that’s the thing. I think it can totally be overwhelming, but it can also be that missing link for something like for example, when I interviewed Carrie Brown and when she discovered that there was this problem, it was suddenly, you know, light bulbs going on everywhere and gave her a way to treat and reverse, you know, her bipolar disorder along with eating Keto. It just, it suddenly, it’s a relief to somebody like that because they find out one of these root causes and the problems and it gives them a path for treatment. But yes, I can totally see the other way. If you’re not looking for something, if you’re not looking to try and fix a problem and you suddenly find out that potentially you’re vulnerable to a whole myriad of things, that could be very scary. So I suppose it depends what angle you’re coming at.

Yeah, that’s a good way of looking at it. And I’ll just quickly finish up by saying what you just said there about knowing she had the mutation and that knowledge and that management strategy in combination with the ketogenic diet is important actually because she may, let’s say as an example, never knew she had the mutation but when and changed her diet and she could still ended up improving her health with the same outcomes. It’s obviously going to depend, this is completely, I actually didn’t listen to the interview I don’t know her, but you don’t have to know you’ve got it. You can still just make the best decisions for your health and keep going on how you usually, you know, doing your, health goals and then working towards them, fixing your diet, whatever it is and you can still be fine. You don’t always have to know you have it. And so the ketogenic diet, the way it can help with the MTHFR mutation is by reducing or eliminating your intake of folic acid. Did she discuss this?

Not so much. It was more, she, well she found a big improvement just with the Ketogenic Diet and that really helped with her bipolar. But then it didn’t take her quite far enough. And by discovering that she had this gene mutation, that’s when she started supplementing with methylated B vitamins and noticed a huge improvement after doing it.

Yeah, that’s awesome. And so where that first benefit could have come in, obviously there’s all those mechanisms with the ketones that would be good for brain signaling and all of that. But as well if you go on a Ketogenic Diet you’re essentially getting rid of a lot of products containing wheat, and wheat is fortified, at least in Australia. Most countries is fortified with folic acid, which is the synthetic form of folate, which is actually really not good for somebody with an MTHFR mutation because you can’t process it. So you can’t activate that folic acid and turn it into the folate you actually need. It’s a synthetic form, which they say is very bioavailable. They say all folic acid, you can absorb it really well all as well, but you can ‘t actually then go and activate that if you’ve got this genetic mutation.

So having folic acid or a lot of folic acid can sometimes make your symptoms worse. So step one could be getting rid of the excess folic acid and then as Carrie has shared step two might then have to be going supplementing with those vitamins that you’ve been missing out on. And certainly that was the same with me. So I cut out my folic acid and had some benefit, not very noticeable with my nerve health. And then learning about this mutation and what it does with the activation of the vitamins just opened this whole new door for me cause I was at the point of my investigation of my nerve damage where I was kind of ready to give up. I was saying this is the last person I’m going to see about this and then I’m just never going to talk about it again. I’m just going to deal with the pain. But now it’s like I’ve got this, this hope again. So it is, yeah, it’s, it’s cool. But it is overwhelming.

Yeah.

So people out there, you know, if you’re going to test for genetics, take your genetic tests to somebody who knows how to deal with it and talk to you about it in a way that is applicable to you.

Yes. Real and practical solutions rather than being overwhelming. I think it’s fascinating how we start. I always wince when someone talks about calorie counting and and should I lower my calories? I get this reflex and I think straight away to start with, you started talking about energy intake and I think I prefer to to think of calories as energy intake. And yes, it might be necessary to literally reduce how much you’re eating, but I think it just goes to show and you’ve highlighted with potentially things that you need to supplement. I mean, and there are a whole load of other things that you could be looking at like stress and sleep and all kinds of things. But I think what’s so interesting is that we tend to jump straight to that conclusion because it’s been rammed into our brains that you’ve got to keep your calories down if you want to lose weight, but actually there’s a whole load of other things that you should be looking at first, and they all revolve around improving your health and well-being and actually it could be those that you need to look at probably are those that you need to look at rather than jumping straight on with cutting calories.

Exactly right. You said it. It was a really great question because it’s funny how we started with calories and then ended up with genetics. Sorry, just goes to show you know, there’s so many different things and I think it’s not a pretty answer when you can’t give a yes or no answer to that, you know, it’s not pretty, but it’s the truth.

Yeah. Just like you were saying in the interview, people generally, we all like a yes or no answer, but it’s just more complicated than that, isn’t it? That sort of, you know, it depends. Well maybe, but the other thing is what’s a plateau? You can get people saying they’re on a plateau they haven’t lost weight and you find out it’s just been a week. Well that’s certainly not what I think of as plateau. I mean I would go for months at a time without losing weight. Again, it’s just a natural part of the process, isn’t it? Just leveling out every now and then?

Yes. Super good point. I think that was my top tip on your last podcast. On our first interview. It was my top tip. I remember saying, you know, weight plateaus are a good thing or can be a good thing because yeah, we don’t just lose a kilo a week until we reach our goal. That’s not how our body works. We’re not machines. So having that period where you’ve lost some weight and then stabilizing so your whole energy homeostasis can reset and actually, you know, get that new set point and not work against you the whole time. Then can allow you to safely lose some more weight or more effectively lose weight, and keep it off.

Yeah, exactly, yeah.

Yeah. Instead of your body always wanting to revert back to the start weight, it will revert back to where it’s last got that homeostasis. If you do ever sort of revert, that’s because people are so afraid of putting all the weight back on and well, yeah, maybe if you lose it all at once by drastic measures, maybe you will put it back on. But if you do it slowly and gradually with those, you know, stepwise reductions and stabilizations in between, then you’re probably not going to put it back on.

Yes. I always think of it as your body just taking a bit of a breather. This whole losing weight business, it’s, you know, it takes quite a lot of work. It takes quite a lot out of the body. I just want to rest and sit where I am for the time being, but I love what you were saying about it’s a good way of just slowly bringing your set point down over time rather than your body wanting to go back up. But we do panic. I think if we’re someone who’s been overweight for a long period of time and we’re used to either gaining or losing weight, that’s what it’s always been. It’s been the cycle of one or the other and we lump maintaining a loss in with gaining because it’s not a loss. We shouldn’t, it’s a perfect place to be in just holding your weight.

MMM. You could argue the same for like HBA1C for example. If your HBA1C is 6.4 and then you get it tested, three years later and it’s still 6.4 I would be patting you on the back saying great, you’re doing something right. You know, cause it’s not progressively going up. Okay. But if we want to get it down, what can we do? And yeah, people are too quick to just find the negative in things and we need to look at outcomes not as like just good or bad. You know? We need to think of them more of sort of just like a continuum, like a scale.

Absolutely.

So, oh my gosh, we’ve almost recorded another podcast here.

Yeah I know! I was just going to say thank you so much. This is all first bonus content package and what a bonus content it is. Thank you so much Jessica, for taking that extra time.

That’s all right. I think I was about to say something else and then I was like, you know what? I think my brains fried now. It’s my bed time, so…

I’ve been draining, I’ve been sucking the life out of your brain, and this is you. You recorded another podcast earlier as well, so you must be completely frazzled.

No, it’s fine. I loved it and I think this is fantastic to everyone who’s a patron of a Keto Woman. I think that’s great. So I, I’m happy to give this long interview at 11:30 at night.

Oh my goodness. Well, thank you so much. We’re going to switch off now and I’m going to let you get some sleep.

All right. Good night. Thank you so much for having me.