If afflicted by cancer, use the information discussed to identify appropriate clinical trials or pursue therapies under strict medical guidance, as podcast content is not medical advice.
For cancer metabolic therapy, aim to maintain a Glucose Ketone Index (GKI) between 1 and 2, meaning blood glucose (in mmol/L) should be no more than twice the blood ketone level (in mmol/L).
To achieve and maintain a GKI of 1-2, practice supplemented ketogenic intermittent fasting by eating within a restricted window (e.g., 6 hours) and using exogenous ketones during the fasting window if needed.
If struggling to maintain a GKI of 1-2, consume exogenous ketones during fasting periods or even during feeding periods as a non-fermentable calorie source to help lower glucose and elevate ketones.
For GBM, consider hyperbaric oxygen therapy (HBOT) at 2.5 atmospheres for 60 minutes, three times a week, starting at low pressures (e.g., 1.5 ATA) and gradually increasing, while being aware of seizure risk.
To enhance oxidative stress specifically in tumors, consider intravenous (IV) vitamin C (25-100 grams) as a pro-oxidant, especially when combined with hyperbaric oxygen therapy.
Avoid using antioxidant supplements during cancer therapy, as many treatments (like radiation and some chemotherapy) work by enhancing oxidative stress, and antioxidants may counteract their efficacy.
Consider a low dose of metformin (starting at 500 mg/day, gradually increasing up to 2000 mg/day if tolerated) as part of a cancer metabolic therapy to activate AMP kinase, decrease insulin, and potentially increase ketones.
When using powerful glycolytic inhibitors like 2-deoxyglucose, 3-bromopyruvate, and lonitamine, implement a pulse protocol of two weeks on, two weeks off to maximize efficacy and minimize side effects.
In a clinical setting, consider a pulsed low-dose insulin IV to induce temporary hypoglycemia (1-2 mmol/L) to sensitize tumor tissue to other metabolic agents, especially when fermentable fuels are restricted.
If undergoing hyperbaric oxygen therapy, especially with a brain injury, aim for strong nutritional ketosis to reduce the risk of CNS oxygen toxicity and seizures.
For traumatic brain injury (TBI), consider using soft hyperbaric chambers (1.4-1.5 ATA) as a potentially safer alternative to high-pressure chambers.
To increase MCT tolerance and ketone levels, spread MCT consumption throughout the day across multiple meals, incorporating it into foods like salad dressings or coffee.
Be aware that most commercial ketone salts are racemic (contain both D and L forms), and while current research shows therapeutic benefits, the historical context of pharmacology suggests potential unknown risks with non-physiological enantiomers.
When considering ketone supplements, note that racemic ketone salts, which include the L-form, may offer prolonged anti-inflammatory effects due to the L-form’s slower metabolism and longer presence in tissues.
For pure metabolic fuel, D-beta hydroxybutyrate (BHB) may have advantages over racemic forms.
Perform a ‘ketone tolerance test’ by ingesting a known amount of ketones and measuring blood BHB, glucose, insulin, and fatty acids at regular intervals (30, 60, 90, 120 minutes) to understand individual ketone utilization.
Use urine ketone strips as a starting point to determine if you are in ketosis, especially for beginners.
Aim for a urine acetoacetate level of around 80 mg/dL on a urine ketone strip to confirm a state of ketosis.
Incorporate low-intensity exercise, meditation, and yoga into a cancer metabolic therapy plan to support overall well-being and potentially enhance therapeutic effects.
Immerse yourself in what you’re doing and engage in self-experimentation to learn effectively and gain deeper insights.
Visit ketonutrition.org for information on ketogenic nutrition, including podcasts, nutrition consultants, resources like the Charlie Foundation, and blog posts on ketone supplements and self-experimentation.
Attend the Metabolic Health Summit (Jan 30-Feb 3, Long Beach, CA) to learn about basic science, clinical applications, and new technologies in metabolic health and nutritional ketosis from experts and industry leaders.
Follow Dominic D’Agostino on Twitter (@DominicDagosti2) and Facebook (@DominicDagostino1) for updates and information.
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