<p class="p1">In part 2 of this special AMA episode, ketosis expert Dom D'Agostino once again joins Bob Kaplan, Peter's Head of Research, to discuss the impact of ketosis on various chronic diseases as well as the latest research on the metabolic management of cancer. Dom also discusses the numerous applications of hyperbaric oxygen therapy, provides insights into the application of ketosis on female health and performance, and much more. If you're not a subscriber and listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your <a href="https://peterattiamd.com/members/private-podcast-feed/"><span class="s1">private RSS feed</span></a> or on the website <a href="https://peterattiamd.com/domdagostinoama02/"><span class="s1">show notes page</span></a>.</p> <p class="p2"> </p> <p class="p1">We discuss:</p> <ul class="ul1"> <li class="li1">Update on Dom's Press-pulse therapeutic strategy for the metabolic management of cancer [2:05];</li> <li class="li1">Potential role for vitamin C in cancer treatment [12:45];</li> <li class="li1">Glutamine targeting in cancer therapy—evidence that the mitochondria in cancer are damaged? [17:45];</li> <li class="li1">Can a ketogenic diet lessen the toxicity of cancer therapies? [24:45];</li> <li class="li1">3BP—a promising agent in cancer therapy [26:45];</li> <li class="li1">The relationship between cancer and ketogenic diets [29:30];</li> <li class="li1">Hyperbaric oxygen therapy (HBOT)—primer, protocols, and therapeutic uses [33:30];</li> <li class="li1">Is there a potential role for HBOT in treating COVID-19 patients? [44:15];</li> <li class="li1">Non-cancer applications of HBOT [47:30];</li> <li class="li1">The inverse relationship between glucose and ketones [50:30];</li> <li class="li1">Is a ketogenic diet appropriate for type 1 diabetics? [54:00];</li> <li class="li1">How ketosis may reduce the risk for Alzheimer's disease and Parkinson's disease [1:00:30];</li> <li class="li1">Ketosis for females—considerations, fertility, performance, and the latest research [1:11:00];</li> <li class="li1">Low-carb diets during pregnancy and postpartum [1:17:00];</li> <li class="li1">A high-protein diet to counteract common hormonal issues associated with the ketogenic diet [1:21:15];</li> <li class="li1">Nutritional tips for remaining metabolically flexible [1:22:45];</li> <li class="li1">What is one belief Dom has changed his mind about? [1:26:45];</li> <li class="li1">In utero experiments, and other interesting questions Dom wants to explore [1:29:45];</li> <li class="li1">The anti-catabolic effect of ketones, cancer cachexia, and nutritional interventions for cancer patients [1:38:30];</li> <li class="li1">What is the one interesting experiment Dom would do if money and time were not a barrier? [1:46:25]; and</li> <li class="li1">More.</li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode: <a href="https://peterattiamd.com/domdagostinoama02/">https://peterattiamd.com/domdagostinoama02/</a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.</p>
Actionable Insights
1. Maintain Ketosis During Interventions
Maintain a state of ketosis while undergoing radiation or hyperbaric oxygen interventions, as there is an absolute benefit to doing so.
2. Target Low Glucose Ketone Index
Aim to achieve a Glucose Ketone Index (GKI) of one to two, or ideally below one (glucose level over ketone level in millimolar concentrations), as this slows tumor growth and proliferation, making tumors more vulnerable to therapies like hyperbaric oxygen.
3. Utilize Therapeutic Ketosis for Cancer
Implement therapeutic ketosis to suppress insulin signaling, lower glucose availability to tumors, and elevate ketone bodies, which cancer cells struggle to use as fuel, thereby impairing their antioxidant defenses.
4. Combine Ketosis and Hyperbaric Oxygen
Suppress glycolysis by reducing glucose and inhibiting insulin, then apply hyperbaric oxygen therapy to create an oxidative challenge that can potentially kill cancer cells.
5. Ketogenic Diet & HBOT Protocol
For metastatic cancer, consider a modified ketogenic diet combined with hyperbaric oxygen therapy delivered at 2.5 atmospheres of oxygen for 60 minutes, three times a week, as this showed decreased tumor burden and extended lifespan in an animal model.
6. Potent Pro-Oxidant Cancer Therapy
Consider combining hyperbaric oxygen therapy, radiation, and intravenous vitamin C, or just hyperbaric oxygen and IV vitamin C, as a potent pro-oxidant therapy to target cancer cells.
7. IV Vitamin C as Glucose Antagonist
Administer intravenous vitamin C to achieve millimolar concentrations in the blood, as it acts as a glucose antagonist by using glucose transporters and dramatically increases reactive oxygen species in cancer cells due to their high free iron content.
8. Combine Fasting with IV Vitamin C
For aggressive KRAS-mutated tumors, consider a combination of fasting with intravenous vitamin C, as a mouse study showed remarkable effects with this non-toxic approach.
9. Fasting, Ketogenic Diet, Immune Therapy
For difficult-to-treat cancers like metastatic thymoma, consider a protocol involving water fasting, ketogenic diet, periodic water fasting, and immune-based therapies, which has shown significant tumor burden reduction in a case study.
10. Oxygenate Tumors Before Radiation
To increase the efficacy of radiation therapy, oxygenate the tumor prior to radiation, as the damage is directly proportional to oxygenation due to increased reactive oxygen species generation.
11. HBOT During Targeted Radiation
Dramatically sensitize tumors to targeted radiation therapy by undergoing hyperbaric oxygen therapy concurrently with the radiation.
12. HBOT Before/After Radiation
Undergo hyperbaric oxygen therapy before or after radiation therapy, as this can lead to a residual elevation of reactive oxygen species in the tumor for hours, potentially enhancing treatment.
13. Target Glutamine in Cancer
Consider targeting glutamine with inhibitors like DON as a cancer strategy, but be mindful of its toxicity and the need for developing less toxic molecules that reduce glutamine levels or act as antagonists.
14. Ketogenic Diet Reduces DON Toxicity
When considering glutamine inhibitors like DON for cancer therapy, combining them with a ketogenic diet may help reduce toxicity, as observed in mouse studies.
Investigate metabolic drugs such as 2-deoxyglucose, 3-bromopyruvate, DCA, metformin, high-dose vitamin C, and SGLT2 inhibitors, as these can inhibit glycolysis and other pathways relevant to cancer.
16. Consult Healthcare Professionals
Do not use this podcast as medical advice; always seek assistance from healthcare professionals for any medical conditions.
17. Utilize VMM3 Cancer Model
Cancer researchers are encouraged to utilize the VMM3 model for studying metastatic cancer and cancer cachexia, as it is considered a highly effective and deadly animal model.
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