Neurological Benefits of Keto/Carnivore Diets with Neurologist Matthew Philips, MD

welcome to the plantree MD podcast with Dr Anthony chaffy where we discuss diet and nutrition and how this affects health and chronic disease and show you how you can use this to optimize your health and happiness both mentally and physically hello everyone thank you for joining me for another episode of the plant-free MD podcast I'm your host Dr Anthony chaffy and today I have a very special guest good friend of mine Dr Matthew Phillips joining us over from New Zealand Matthew thank uh good to see you thanks for coming on you too Anthony thanks for having me absolutely so um Matthew's a a neurologist I don't know if people have may have seen um some of his interviews with Dr Baker and others but he has been using U diet lifestyle interventions to help his neurology patients and um and critically thinking outside the box and looking at data and information in ways that not everybody does in in a sort of spoonfed manner that we get in medical school and residency so I was I've been really excited to uh have this conversation because we've had many conversations on our own but I think everyone would be very interested in hearing your thoughts so um thank you for coming on and if you could just uh tell us a little bit about yourself if people haven't come across you before yeah certainly so I'm Canadian originally as you know but others may not and uh I decided to do some of my training in Canada and then some of my training training in Australia and I ended up doing most of my uh sort of general medicine and neurology training in Adelaide and Melbourne in Australia and then I took three years out where I sort of opened up my mind and I I see those three years as a self-imposed fellowship because I didn't like any of the other options I did do a one-year fellowship before leaving in nerve and muscle studies so that I did do a fellowship but I wanted to do more and so during those three years I went to to basically South America a year Asia one year and then uh Northern Australia working in a place called cans for one year and I did some volunteering a lot traveling and and looking outside the box as you say and and U trying to think about different ways to help people with some of the really tough neurological disorders that I'd seen because I I guess I I just uh it was pretty obvious to me that uh we didn't do a lot for for some people uh people with the bad cancers neurological cancers people with the the bad neurodegenerative disorders especially like Alzheimer's and ALS the motor neuron disease and Huntington and so on so I wanted to do more and I guess I Came Upon metabolic therapies so fasting keto diets uh and similar kinds of strategies as a potential way to do that so I was inspired and then I decided I needed to go to a new country where nobody knew me because you know you need to redefine yourself and it's it's nice to go somewhere where nobody knows you so that you can sort of redefine yourself in a fresh manner so I chose New Zealand because it looked beautiful and I'd been there before and I I I really enjoyed the people and the and the countryside and the land and it's a super place for riding motorcycles which I just love so uh here I am and uh yeah started diving into research as soon as I arrived and and nine years later almost I'm still here yeah great so what is it about um K Jen carbohydrate restriction that is so beneficial to neurological conditions that you found yeah okay well uh I guess you can look at things from a why perspective and a how perspective so why might they be beneficial is is arguably more important and U they're evolutionary so if you look at U the best studies that look at sort of modern hunter gatherers and the hunter gather period of our Evolution was like 99 % of our Evolution as human beings everything before agriculture then uh I can I can link people with the best studies which well the best in my opinion but they quite clearly show that about perhaps two-thirds of all Hunter gather or diets were low carb or ketogenic and maybe another uh sort of 20% were low to moderate carb and then there were just a handful that were sort of higher in carbohydrate content this is all before agriculture before farming and and all the all before culture basically right so there's a lot of cultural diets but they're not uh they've only been around a few thousand years they're not like our hunter gatherer diets and of course a lot of those ketogenic uh and low carb hunter gatherer diets were carnivore based uh I have yet to find a hunter gather population that did not eat meat uh as you know there were human beings that did live many thousands of years ago I think australicus is is an example that we're vegetarian more lesson they died out so um you know especially in the northern latitudes the the Mongols native Mongols native in and Canada where I'm from and Native Scandinavians they were primarily meat-based so um with very few carbohydrates so that's evolutionary why and and I and then you know so we're adapted to that and uh we can get into this if if your viewers might be interested but hunter gatherers lived uh just as long as we do today if you take out chob mortality infu mortal ality and warfare so um they'd live just as long as the world's mean age population is today in across the board so about 72 73 years of age so we can talk about that later if you want but so uh because that's a common misconception so that's the why it's sort of like an ancient thing the fasting ketogenic diets low carb diets that we're used to uh then the how how could it help neuron Health well then you can start talking about all the mechanism Ms that occur inside the body so what happens uh the most obvious thing is you get these production of ketones and so if your fasting the ketones comes from your body fat your liver produces most of them but most of your organs in your body can produce the ketones like your brain and kidneys and so on to some extent and then um if you're eating a high fat keto diet carnivore keto diet whatever then uh the fat you eat can also be converted into ketones and um basically neurons and muscle love fatty acids and ketones as fuel sources so they can use glucose which is the main fuel source most people in the modern era use but as Hunter gathers we would have been using ketones a lot when we were fasting when we were eating our natural diet and uh so the ketones have uh mechanistic advantages for neurons in particular they produce more energy for the amount of oxygen you breathe yet they produce fewer free radicals uh reactive oxygen species which are okay in in sort of small amounts but at large amounts they can be very damaging to cells and and I think contribute to things like uh neurogenerative disorders Alzheimer's Parkinson's and so on so uh there's that and then the ketones is just sort of the tip of the iceberg really there's all these other I call it an orchestra of changes that occur all these other changes that occur within the cells and it all sort of converges on optimizing mitochondria biology uh which is their mitochondria function mitochondria activity the way mitochondria move mitochondria for the very few of your listeners I'm sure who don't know what they are are these organel these little uh almost like organisms there's a few hundred in most cells that move around the cells and they change their shape and they join together and divide they can actually leave the cell and enter the blood they're called cellfree mitochondria and and move around the body on their own so um really I think a where we go wrong with a lot of the lifestyle disorders um and by that I mean uh heart attacks and strokes cancer uh most cancers most neur degener disorders so Alzheimer's parkon ALS Huntington and the metabolic syndrome like type two diabetes and all the things associated with that where we go wrong there I in my perspective is that it's it's fundamentally a problem of damage and uh disruption to mitochondria so the ketogenic diet and fasting protocols and all those things are evolutionary strategies are all aimed at improving mitochondrial Health through so many different mechanisms that that we could talk about but I think what's important for your viewers and I'm coming to the end here is that uh by adopting an evolution based strategy uh stuff that our ancestors around the world no matter what uh ethnicity one is uh did for hundreds of thousands of years is is all about uh improving mitochondria health and uh improving mitochondria resilience and if you're mitochondri you're healthy and resilient then I think your chance of getting a lifestyle disorder all the ones I mentioned which are killing most of the people in the west today is your chance of getting one is much much lower not zero but much much lower and my interest my research and we can Bridge into this is trying to use these strategies to improve people who already have those disorders as opposed to just preventing the emergence of such a disorder so that's my interest I think these strategies and I've concent on fasting keto diets are evolutionarily normal and beneficial the modern diet is not the modern dietary lifestyle is not and the mechanisms there's so many hundreds of mechanisms I mentioned just a few uh are very compelling for neuron Health but particularly the mitochondria that live inside the neurons because I think looking at things from a mitos Centric point of view it's all about health is more about our mitochondria than it is about our cells if our mitochondria health our cells will also be healthy absolutely So yeah thank you for that and and so as a result of this you've started applying this to your patient population is that correct yes so I've decided to so remember all all great ideas start out as heresy so uh you know as you you've probably experienced yourself I know you have uh so there's resistance a lot of resistance to this approach right because in medicine we often try to mask symptoms with medications and things and and it can make people better for a while but it doesn't really get to the core of the disorder why why did this person get this thing so I'm implementing these things in certain populations of people to try and uh heal them try to restore their mitochondria to some extent and I've decided to choose a lot of the toughest ones that I was so frustrated with when I was training in neurology so Alzheimer's and Parkinson we've done two randomized control trials in those disorders uh I've done some case study work in ALS and Huntington's and as you know we've done a a bit of work in G blastoma which is you know a terrible brain cancer and we're we are currently we're over three years into our current trial which is going well so far and uh yeah th those are the main things I've been working on there's a few other things that I haven't mentioned but sort of neurodegenerative disorders and cancer are the two things that I've decided to apply this to and see if we can help these people to have a better quality of life and to also have uh you know a longer life so it's not just about um lifespan uh but it it's about health span and lifespan both hey everyone really happy to announce a new sponsor for the show and for everybody down in Australia Stockman Stakes who are delivering highquality grass-fed and finished pasture raised beef and other meats flash frozen and vacuum sealed to your door something I've been enjoying a lot of myself recently as well they also have a great range of specialty items such as high fat keto mints and carnivore beef and organs mints with liver kidneys and beef heart as well so use code chaffy today for free order of beef mints or another specialty gift along with your order at Stockman steaks.com DOA and I'll see you over there thanks guys yeah absolutely and so that's interesting so in your in your trials with neurod degenerative uh diseases um using ketosis and fasting what what did you find what did you you know how did you apply that and and what were the results yeah okay so first thing we did was Parkinson's and that was a randomized control trial a parallel design so you we had 47 people half went on a lowfat high carb diet and the other half went on a ketogenic diet so this was just looking at a ketogenic diet and comparing it with uh a pretty strong uh sort of uh comparator diet the lowfat diet because our lowfat diet had a lot of carbs but there was no junk ultr processed carbs in there it was all high fiber vegetables fruits so someone who was uh and meat of course but someone who was a low fat proponent would look at it and go that's pretty healthy and uh we compared that against the keto diet which was of course very high fat very low carb it was an omnivore diet so uh meat and vegetables both MH but um and I got to admit my nutrition specialist was a a little irritated because she thought we were the comparator group was too strong she thought the lowfat diet was was uh too good to compare it against uh but anyways keto we just did that for um eight weeks which at the time it was uh you know double what any other study had looked at in Parkinson's the length of time if I was to do it now I'd do it a lot longer but just in 8 weeks the keto group uh the both groups improved but the keto group improved more uh quite a bit more so Parkinson's for listeners that don't know is mainly motor symptoms and non-motor the motor symptoms are like the movement problems uh the Tremors the rigidities the stiffness and the balance difficulties but what usually dominates the quality of life and and makes a person suffer more is the non-motor symptoms so that's uh there's several categories but it's things like Sleep Disorders mood disorders depression anxiety apathy cognitive problems kind of subtle swallowing problems bowel problems like constipation bladder problems there's so many the non-motor symptoms improved by 10% in the low-fat diet right and that was pretty good we got rid of all their ultr processed carbs so good uh and threw in a lot of fiber but the keto group improved by 40% and this was an average so this was an average of all the patients if I took the best three patients they're not motor symptoms got wiped out and then if I took the worst three patients of course they maybe didn't change much at all all but on average it was 40% so pretty powerful for just 8 weeks and it was notable because uh the medications we used for Parkinsons don't help a lot of the non-motor symptoms very much the motor symptoms also improved in both groups by about 20 to 25% uh I do think both diets were better than what the patients were on before uh and also there might have been a bit of a placebo effect involved in that as well but so I got to say though uh in the last four weeks of the trial the keto group was accelerating quite quickly the keto group actually uh their motor symptoms even when their non-motor symptoms didn't uh improve as much in the first four weeks and I think that's normal because there's an adaptation phase where people are suddenly going from a high carb diet to a a very low carb high fat diet and it you know your body your brain your neurons your heart your muscles need time to adjust so that was Parkinson's Alzheimer's we did a randomized control trial randomized crossover trial in that so more powerful design so it's basically uh allows you to get a very strong signal uh as to whether your intervention in this case a keto diet as well has an effect um because we only had 26 people in that but it was very uh well powered so more than enough people to find a strong signal and the reason for that is because you you put half of those 26 on a keto diet and we put the other half on this time a standard uh of care diet so dietician recommend did dietary changes that they implemented into the normal diet and uh we did that for 12 weeks and then we had a 10 week wash out where everyone goes back to the normal diet to try and get rid of any effects good or bad and then 12 weeks where everyone flips and goes on the other diet so everyone gets both diets it's such a powerful design long story short that one showed uh we we looked at three main things so cognition function quality of life and cognition they all improved cognition only improved uh Trend though in a trend manner it didn't get there statistically significantly so you can only say it's encouraging but you know but function daily function which is arguably the most important thing to people with Alzheimer is have proved tremendously and in a statistically meaningful manner but also more importantly a clinically meaningful manner so a clinically meaningful means it matters to the patient it's an obvious change and uh a quality of life too uh special quality of life scale for Alzheimer's improved in a statistic Al and clinically meaningful manner so that was very uh important because Alzheimer's is a super tough one we don't have any treatments any good for that so those are the two main shs and those two that we did yeah well that's fantastic and you know it's it's really encouraging to see more these studies being done because it unfortunately you just hear a lot of clinicians just giving a blanket well we just don't have stud we just don't have data and um my question to them is always uh have you looked because actually there is you know and um we just don't we don't get spoonfed it as I mentioned earlier we don't we don't get taught this in medical school we don't get taught this in residency and we don't have a drug rep coming in or a keto rep coming in every Tuesday to buy us lunch and and tell us about the all the studies on keto but we do have that with with the pharmaceutical companies and so that's where we think wow there's just there's just no data on it we just don't know it's like well but have you looked and so it's great to have have more of these studies coming out because then you can just actually actually no there's some data right here uh which is great so have you have you found that um your colleagues in your neurology department have um sort of come around to this way of thinking seeing the the trials that you've put on yeah so we're at a midsize hospital just over 600 beds it's fourth biggest in New Zealand but it's New Zealand small country yeah and so there's seven of us neurologists and uh and then there's a you know a couple of and some Junior doctors and then and a lot of uh clinical nurse specialists about five or six of them so a couple of the other neurologists are really Keen very supportive highly supportive and then the others are all sort of interested but not quite ready to do it themselves so the other two you know very supportive doing it themselves to some extent and the Juniors uh a couple of the juniors are really super supportive and uh doing it themselves and you know so so it's mixed it's mixed but generally it's there's none nobody against it in my department now when I I just presented at the uh so as you know I presented a number of low carb conferences where I we kep you and I get to catch up but I also present I really try to keep presenting at mainstream neurology conferences so I just presented at uh our national New Zealand one last week which I presented almost every year and uh so I spoke about our recent paper about con how to conceptualize Alzheimer's Parkinson's and these other sords as sort of uh metabolic icebergs with a lot of mitochondrial problems that you don't see and you know the reception was uh mixed again you know number of people came up to me afterwards and said really great talk uh that really was something I just don't understand because the whole conference was basically about genetics right right so the big rage in neurology is about uh genetics and and trying to find therapies which I'm not against but it's only going to help a very small fraction of people so uh but but there were and it's usually the most sort of prestigious uh people at the conference so older older people who you know are more versed they've had more decades in in um in this sort of U traditional model that that throw up the skeptical questions at the end uh so yeah there definitely was more negativity from a just a small number of high status individuals but uh when you you know most of their criticisms are as you say it's because they they don't actually they're not really uh aware of what's out there and they don't really uh a lot of the arguments are aren't very powerfully presented and I'm able to uh quite quite quickly process them and sort of I don't know shoot them down uh occasionally I get a good a good argument and in that case I try to incorporated into my thinking so that I can uh improve uh NE for the next time on whatever that is it's it's important to get that feedback so it's it's a there some more negativity when you go when I present outside of my department to colleagues in other cities and you know internationally as well but uh it's not too bad I think most people are pretty open-minded but at the end of the day everyone almost everyone is still glued and you know uh versed in this uh drug approach to uh trying to help people and uh you know this sort of germ Theory approach where where you're trying to eliminate symptoms and attacking things rather than trying to restore uh People's Health and I guess uh it's just going to take a lot more time I think and we need uh more people to get the word out there like yourself but also we also need better studies to to back it up uh because yeah there are studies supporting this like you know know the two I just mentioned but um there's only a handful of studies in Alzheimer's and Parkinson for these approaches and I I I still I think in terms of randomized Trials you get to a very small number so it'll take more time we need better data but I think it's it's happening yeah and and the good thing is is that it it's starting to put that sort of wedge in the door and start making people start start thinking about this and as more of these studies start coming out that just paves the way for other people to say okay well let's let's really put this to bed let's get 4,000 people and do this for a long-term study and just really Hammer this home is is there something here or not and so you know I think that that's um it all it all builds up to that sort of thing and then you know of course you know there's there's a point where any clinician says you know is this is this a um you know practice modifying you know EV evidence and say okay well maybe I'll try this it's not gonna hurt them you know just taking away carbohydrates you know giving them good nutrition changing that and then what happens as a result of that and and I mean and that's that's why we do studies to see hey what's going to help my patients or what's going to help me and so we take that information and and we apply it and we see wow actually this really helps and so that's all the that's all really study you need as a clinician because if you're getting Improvement marked improvement in these neurodegenerative diseases or or other sorts of ailments well it doesn't matter what studies say I mean you're seeing the evidence in front of you I mean that that goes back to hypocrates where he said hey don't just do things because we've always done them don't just pray to Apollo hoping something happens do things that work observe try test experiment and uh through trial and error you know pick the things that work better and so you know it's great that um that people are starting to uh pick that up which is great yeah I think there's a general awareness uh there and you can see it on social media for example where people are trying stuff themselves and you know a lot of people are getting great results uh with fasting protocols with keto diets with carnivore keto diets and so on and it's um it's really good to see that uh on the other hand I think you know uh it it sort of uh can polarize you know the common uh a lot of people out there with the the modern medical system and it might make some of the some of my colleagues dig their heels in more about you know like in cancer for example is a good example where we're doing this gloma trial a lot of the oncologists some are open-minded uh in my Hospital they're very open-minded in general but you know uh they've had to put up with me for a few years talking about it but uh other places you know I get emails from people around the world as you do too I'm sure that where they're having a lot of difficulty with their oncologist and wherever they are and the oncologist just flatly doesn't says eat what you want it doesn't matter and uh so this is uh a case where I guess uh you stick with what you know and you dig your heels in and the more people come up to you talking interested in a keto diet for their cancer you know uh or something the more the oncologists might some people will just dig their heels in more and just say that's stupid and then you know uh it gets difficult because things get polarized but yeah it's good to see that most people are sort of thinking outside the box uh I think most and if you're a patient you have one of these disorders you absolutely have to because let's face it the standard of care for the many of the conditions that we're talking about here is is not so good yeah absolutely and so I mean yeah you keep doing the same thing you're going to keep getting the same results and um that's not what we want we want uh different results better results that's right um so you know we touched on the the gleo blastoma work but um you know that's something that's that's obviously very very interesting to me as well can you tell us a bit about that you know that's been going for three years now and there there are a handful of these studies but this is um this is one that's been going on probably longer than than most of them at this point and be really interesting to to hear how that's going and what the results have been yeah sure yeah yeah can tell you what I I can tell you as much as I can yeah I can't tell everything because of the hasn't been published yet but uh so we're doing uh what is the most intensive metabolic Therapy Program ever applied to to any group of people that I know of and uh we're applying it to Glo blastoma it's based on the theory a lot of it comes from Dr Thomas aed's um work who I'm I'm sure you've interviewed and uh you know the idea is that cancer is essentially a mitochondrial metabolic disorder uh rather than a genetic disorder per se it's it's a bit of both obviously but the genetic stuff a lot of it probably comes as a consequence of the mitochondrial defect that's the theory and so what we're trying to do uh and and when these cells become cancerous they undergo this warberg effect where they start to use glucose as a fuel source in a in a rampant manner uh they become ravenous as Sam Apple's book uh you know a great book if you haven't read it uh about the history of warberg and cancer mentions and at the same time they can also use other things like glutamine which is an amino acid so they they they sort of change their metabolism and become a bit um abnormal and uh so they become sugar-loving uh cells essentially and the metabolic therapy when you implement fasting and keto diet therapy the idea is that it it really makes life difficult for them and and there is a reason to believe it can also enhance the standard the effect of the standard treatments the chemo radiation while protecting normal cells from those treatments because they are pretty toxic to cells across the board and we you know it's it's very tough for these people to go through chemo and radiation I I I could tell you and and as you know because you're a you know with your neurosurgery background so that's the idea and uh you know deep down I'm hoping that maybe we can restore their mitochondrial health I believe in some patients we may be doing that so the protocol is uh basically a 5-day fast every month roughly with a ketogenic diet in all other days and it's a ketogenic diet with intermittent fasting so one meal omad or Tad one meal a day or two meal a day and I tell them when to eat one and when to eat two it's quite a quite a rigid protocol and it's timed in a very particular manner with the chemo and radiation to try and maximize the damage of those treatments on the cancer cells while protecting normal cells and we do that for about 10 months because that's how long the standard treatment protocol lasts and then after the 10 months I sit every it down with everyone say what do you want to do now do you want to go back to your normal diet not one person has done that yeah not one and then I but then I say well we can modify things now you've done this uh program that I have it's it's a it's largely an omnivore based keto diet which you can divert into carnivore or vegetarian keto options and I sit down with people and say what do you want to do and then people uh often they want to do a version of of what we've been doing so they want to add in some extra recipes uh that they're more familiar with usually based on ethnicity so uh you know we have a Mari couple that decide to do a Mari style ketogenic diet and we have a South African couple who are veering off to a South African style ketogenic di we have a couple people who want to do carnivore no problem so we we put them on you know get a carnivore D and it's it's usually the younger guys who you know just want to eat the meat and eggs and butter and and make it real easy MH and that's really great because you could just you know no carbs coming in uh so that's very effective and simple uh and then you Mediteranean keto is a pretty popular one uh as well so there's different ways to do this after they they finish the formal protocol and then we just carry it out and see what happens I I see them every two months measure their quality of life and their KY tones and their glucose Ketone index for people who don't know that's a ratio of the glucose and Ketone level in the blood you want the glucose down and the Ketone high and uh of course I you know I'm am looking at their survival time because that's what matters to people they want to live longer and better with these terrible tumors so that study is ongoing the first patient we enrolled is is at 38 months now so just over the three year mark and uh you know it's it's been uh very difficult to apply at times because of the a lot of it's the friction with with the standard of care um approach I've got to be honest uh just when things get bumpy the uh a lot of uh my colleagues tend to blame the metabolic therapy when it's not the metabolic therapy it's something else uh but then it takes a while to sort of um sort of help them through that process and all the meantime you're trying to help the patients through the process too so but I can say that um the study is basically looking at feasibility can they do it safety is it safe and uh check check so they've had a very low gki for a very long time and you know it's nobody's uh you know they they embrace the dietary change in general uh the 5-day fast is variable some people like them totally fine some people are less keen on them understandable and then uh you know we're looking at safety so there's been no serious adverse effects from the metabolic therapy at all nothing serious it's all been put there have been occasional serious effects requiring hospital admission but they have all been ascribed to the standard treatments uh in general and then uh we are looking at uh the quality life measures those uh and the and the how long they live and all I can say is things look encouraging on both counts but I can't give numbers because um that would probably be a little irresponsible because you know GL still you know you know as good as things are going things could change in two months with GBM you know it can it can uh change quite quickly it's quite a capricious thing so I don't want to get you know too uh get ahead of the data that's a a a mistake but look at this point um I honestly can't see it getting published before 2026 okay and that's a good thing so the longer people are living uh the longer it's going to take and we're just going to keep going and and I I think it has the potential to really uh it it's already a success in terms of you know the feasibility safety data which has never been done in this extrema protocol you know it's it's it's extreme to a modern dietary lifestyle perspective but you know it's it's a protocol in all honesty I basically have done for a long time myself and it's not extreme once you once you live it like you know eating one meal day keto as you know yourself uh it's normal but uh what what I think it I hope the study if it keeps going as it is will show something very powerful on all those measures and make people think a little bit more about what the best way to manage GL blast is yeah definitely and um so is is this um as I understand this is just this cohort are you comparing this to historical averages or do you have a another group so it was difficult to start a randomized trial in this one for many reasons um one though was ethically it would be hard to have a patient diagnosed with the globa I I just felt it would be very difficult and I enrolled them in the trial and randomized them to a normal diet versus the keto the the protocol and then tell them sorry you get the normal you're these are people's lives yeah and I know the whole point of the trials to see if it helps them live longer so of course we you know but still um I think it would have been difficult so we went with a single group and two things we have sort of a control group who's all the people that were eligible fully for the trial but we're not offered it for one reason or another um so we've got that data and then there was uh there's the thing that like I guess if they live a few extra months like two three four extra months uh the people on the metabolic program I I wouldn't be too excited about that but if it's uh there's thing called the parachute effect where you don't need to do a randomized control trial to know that if you jump out a plane with a parachute it's probably going to help you live longer right yeah so I'm relying on the parachute effect the difference I would only be excited if the difference was so uh so profound that it would make even a Harden SC skeptic go take a second look at it and go what what happened there yeah so uh those are the things so we sort of have a control group but it's not a proper control group it's a non-randomized control group uh receive standard of care and everything but I'm relying on I guess I'm uh My Hope Is that we find a difference and we just have to wait and see how it goes you know uh we we find a parachute effect in the results and you know even if we don't it's still going to make people think but if we do it'll make them think uh a lot more yeah yeah yeah and and I suppose too I mean there's going to be some people I I mean assume everybody's obviously offered standard of care most of them would have accepted that but then some everyone yeah yeah perfect and so um but then do you have anyone who has had a tumor in a location like a brain stem or somewhere else we're really able to get a biopsy and really weren't able to get like a full 95% plus resection um and and see how they're doing yeah we've had uh tumors in difficult places the thalamus the brain so on but one of the we have few inclusion criteria for the trial but one of them we have to have biopsy proven globl and we're only looking at the idh wild type which is about 90% of them so we're not looking at the idh mutants which are now called used to be called gasta but now they're called uh grade four asroy so um you know that's some uh like Pablo Kelly who many of you viewers might know he had a grade for asoma did extremely well uh with his approach but uh we would have he he couldn't have entered the trial because we're only looking at the gastas the pure ones and those are the worst they have the worst prognosis much worse than well worse than the grade four astras so without a biopsy it would be difficult I we've had a couple of patients in the last three years who who might have who who were not eligible for iy and unfortunately you know I'm not able to offer it because we have to be sure that it's GBM and not something else yeah are there are there ones that you were able to get a biopsy but not a full resection that yeah four or five of those yeah great absolutely because those those ones will I mean you you'll start seeing that disparity earlier presumably because I mean these these averages change they get re-updated but you without surgery um and just chemo radiation I you're think looking like 9 10 months as exactly exactly it's uh it's really tough and we've had people who are you know they have multiple tumors a diagnosis which is not common for GBM but it can happen there's two or three of those multiple tumors so you know those are those are tough too yeah so you know it's uh it's been a a really a big learning experience for me because I you know you the neurosurgeons you guys see a lot more of these brain cancers than neurologists do Tech typically I'm probably the only neurologist I'm pretty sure I am in in this country that has any significant input to patients with GBM now because of this trial and I've learned a lot so yeah but anyways we're accepting anyone uh who has proper GBM MH who basically uh accepts the standard of care which is almost everyone but not not quite everyone and uh yeah then then we're we're good and they have to live with you know they have to be at our at our Center I've had a few people contact me from different cities and so on but unfortunately I couldn't enroll them because uh we have to we want all the standard treatments to be done by the same people to keep the consistency okay right yeah helps answer the question yeah yeah and is that um is that possible for people to sort of move in you know and get treatment at at your facility or would they have to relocate or is that not really in the public system it's pretty tough it is physically possible like the logistics is there there's a cancer center near the hospital where people can live for a few weeks while they they do this but uh it's it's just that um in New Zealand the medical system is quite oh it's it's uh it's got fewer resources than uh the Australian system or you know other systems in general actually many other systems and so uh there would be a it would it would be really hard to get someone um to be treated here CU we're already at maximum overload with our oncology uh ability to just administer the standard treatments I could enroll Lots but uh it's it's there are um pressures on the system that unfortunately preclude that okay yeah yeah we're gonna see if we if we wanted to do a call out people in New Zealand had a GBM wild type sort of thing um if they still accepting sort of patients but that might that might um not be POS possible yeah well we're fully recruited now so uh can't enter this yeah we're fully recruited so I'm just following people now yeah right yeah um actually when we caught up in Switzerland there in June I can't remember was it June we had yeah we were fully recruited uh by um you know August or so like very quickly after that so since then I've just been following people yeah it's been good um because recruitment was pretty challenging too yeah but yeah for future studies uh it would be great to try and figure out those kinds of things because there's so many I know there were so many people that wanted to enter the trial that just didn't live in our wado Bay of Plenty and Lakes Region that were just not eligible because they oncologists at their city were were not you know they they were not part of the trial so I couldn't yeah yeah that's unfortunate well I I guess the good thing is is that you know this is something that if it's it's not like they need a prescription or you know they need guidance but if it's something that if they wanted to do that on their own outside of the trial you know there something that they can do which is nice as well yeah and there have been uh a few of those it's just difficult because like like I said for you and myself it's pretty normal like if to do a one meal a day keto strategy but for for many people and the people getting the GBM many are are in the older generation that the grow up in the low fat era where fat is bad saturated Fat's really bad and you know you don't want too much salt and of course you need salt and saturated fat and all this stuff when you do these things it's they're your allies making that mind flip that that psychological flip is very difficult for some people and I find the guidance is really crucial to get them through uh not just the the keto diet but also the 5-day fasts in particular like so I the first five-day fast I'm I'm emailing them daily and I give them a couple of phone calls and see them if necessary just make sure everything's going okay uh and you know and it and it goes by fine as long as you're on top of things but things things can get out of control quickly if people just don't realize how much salt they need to have on a fast or something very simple to fix so I I guess I uh people who trying it trying it on their own uh outside of the protocol it's uh I think it would be quite a bit harder it's not that the protocols that hard it's that not having a guide to show you where to go and what to do uh makes it hard because very few people really understand what it's all about so I think you know that's um that's the thing that a crucial role and I I've seen that with with my own patients here like the guidance is super critical certainly in the first few weeks and months after 6 months or so there most people are pretty good they don't really need me anymore and I I can almost delete myself I've made myself um what is it sort of almost obsolete not quite but almost and I think that is actually a very good thing that is that really is the goal isn't it to try and get people to he People's Health to a point where they know what to do and they don't need you anymore mhm whereas I guess the current system is doesn't always work that way yeah well it's um it's about it's about the return customer isn't it you know it's um yeah was it saying um a patient cured is a customer lost so yeah can't have that but yeah yeah I I I told my patients that in my metabolic Health practice say like look I'm I'm trying to get you into a position that you have the life skills and and resources that you don't need me and you don't need to come back and you don't need establishment unless there's actually some sort of emergency and um and and so that's my my business model my business model is to to not be in business you know but the thing is is like it's it's never going to not happen there's just there's so many sick people out there yeah um you know I think that hopefully long term when we get all this information out there and this becomes more mainstream and accepted and people start implying this in their own lives and raising their children like this we're going to see a lot less of this chronic disease like we did historically and at that point then we're going to go back to doing real medicine where you have these accidents emergencies these Critical Care sort of issues these acute care sort of issues the the things that we were were dealing with as as doctors 100 years ago 150 years ago um that that you your body isn't going to be able to fight off necessarily and Y and so that's that's also something I like to look into that's why I started getting interested in in in the trauma side of neurosurgery and you know the accidents and emergencies you know people are always going to be falling off ladders they're always going to accidents and have emergencies that you know break their their back and their spine or have some sort of you know peripheral nerve injury that you have to you have to fix so you know that sort of thing it would it would be nice that if in my the the lifespan of my career I could then go to basically doing that full-time I that's might be a pipe dream but it is my dream and hope that one day that that's just all I'll be doing I think it's it's a it's a good dream and you know like if you look at the the two main cause of death of Hunter gather times were infections and warfare yeah so uh War for you know trauma so uh infections we could that's one thing modern medicine is really good at acute infections we're really good at treating that with our antibiotics and so on uh and a lot of the trauma Warfare related stuff uh we have laws that prevent a lot of it but also we're really good at putting B knitting bones together and fixing joints and things so yeah yeah I think that's it and those guys those hun gathers really didn't die from lifestyle disorders very rare yeah so if we can get back to a point where we can just keep those lifestyle disorders right down what a wonderful uh vision for the future I mean it's just that you know people uh not just healthspan but lifespan would be increase you know well beyond what it is now I think the human potential is is more than is realized and um yeah then you could return to be in a trauma do sure yeah yeah well that was that was what I was taught in um genetics in my undergraduate class 24 years ago at University of Washington was it genetically based on the L of our tiir we're already designed to live 120 years on average you know and so I was told then it was um right now the first person that live past 120 years has probably been born right now and we'll and we'll see uh when they show up but obviously with all our modern advancements you know we should be fine it was always the you know the traumas and the issues before and just just this lack of modern medicine was the only thing there but you know genetically we should make it um but like you say that that's not what people were dying from uh or dying from now in the 100 gather population I I saw a paper written by an anthropologist um at Arizona State University that had did years and probably Decades of work with an Amazonian tribe and and studied them long term and and he said that exact same thing that if you if you discount um infant mortality rates these people were living into their 70s and 80s y you know as an average right and the modal age of death the most common age of death was 72 and these people yeah exactly the current population current world average age of death is 73 yeah there you go and and and like you said you know this is this is a wellestablished you know of you know fact in anthropology that these 100 gather populations are alive right now and historically and prehistorically they did not die from the chronic diseases they F died from you know infections and and traumas basically and that but then when they transition into a post-agricultural society then that changes then the main issues that they get are all these non-communicable chronic diseases the diabetes heart disease cancers autoimmunities Etc neur degenerative diseases um and and it changes and that becomes the most common issue which is interesting because the life expectancy doesn't change yeah living law longer or something yeah so if you take like the three Achilles heels of the hunter gathers were infant mortality death during childhood and then uh infections and homicide Warfare and modern medicine is really good at treating all three we can get we've got INF mortality very low we can treat the acute infections very well and uh trauma Warfare we have laws and things that keep that down so it that's it's awesome we could have really um you know take the Hunter gather a lifestyle and then amplify it with modern what we can offer for modern medicine get rid of the lifestyle Diss and I I don't know it's the sky it's almost the sky the limit with what humans could do in terms of longevity and health I I don't I I wouldn't even Hazard a guess how long we could live on average but it's it's certainly not 73 yeah and it's not even you know in the 80s which is a lot of the Western countries so it's it's beyond that too and so I you know yeah anyways yeah well yeah I mean if you think about it if if you're dying of of you know complications of diabetes that means that you've been sick for like 40 years and finally your body's just given up okay well what if you just remove that and and your body's just allowed to to continue on it's not just degrading as the as the the years and decades go on like of course you're going to live longer you're going to live a lot longer and a lot healthier and you know it's going to be like like we see animals in the zoo where they just they're just this healthy active adult not that active because they're in a box you know sort of live there so it's not like they're getting exercise even and um and then they're sort of doing their things going around entertaining people being bored eating food and then one day they just sort of start slowing down other day they're slowing down a little more and they sort of go into a corner and they just sort of sleeping all day and then they don't wake up that's pretty much it you know they're they're very healthy could be active adults if they weren't in a box and and then one day it's just like that's just sort of come to the end of the tether and and just that's it and they just sort of peacefully drift off that's that's I I read descriptions you like Dr JH Salsbury came with the Salsberry stake and was was doing this in the 1800s he he described a very similar pattern in the Native Americans I don't know if it was the cheyen but anyway people in the Great Plains that that predominantly subsisted on uh the American buffalo Bon and he was saying there was a couple there was 115 and 110 years old and and the man who was just just spry and active he's running around he's getting very panicked because his his wife of you know nearly a century was starting to sort of slowly drift away and he was panick like oh my God she's you know she's going to die but she wasn't sick she wasn't having a problem it was just she was just just slowing down and slowing down and slowing down and so he's running around trying to do all these sorts of things and Salsbury described him as as a very very spry and Physically Active 115 year old you know and um interesting yeah and then and then then the wife sort of slipped away and and passed away peacefully like we see in in animals in captivity and so you we see that I mean there's um you you have to take it with a grain of salt we don't know we don't have a a birth certificate on these people yeah half the birth certificates from from random countries I don't know if you can trust them I mean there's that whole Scandal even in um the blue zones well the blue zones definitely yeah yeah and if you and if you take the blue zones that face value then why aren't you taking you know the Native Americans at face exactly yeah yeah it's good to be skeptical and uh even you know especially your own work so uh it can be it's harsh but yeah maintaining a critical skeptical eyes is really important and um finding the balance is important too like you don't want to be overly skeptical you want to be openminded but you don't want to embrace every new idea that comes along without some kind of self-reflection and criticism uh constructive criticism of the idea or what's presented to you yeah yeah interesting yeah definitely well I I I found other stuff other things as well and there was there was a guy named chief John Smith whitewolf and you'll look at blogs and people oh this couldn't possibly be as old as he said he was but these are people's opinions these are blogs you know you know we don't have hard evidence one way or the other um but we have his his account and his children's account and their records and he died in the 1920s he said that he was 137 his family said he was 137 he was a chief of this this people and he and so people like well that's that's an insane amount of time it's like you know like Bible story Methuselah or something like that but you know again if we're if we're working on 120 130 year average genetically it's not all that farfetched it's very long lived even for that but you know at least you're in you're in the ballpark but then you know he has he has accounts multiple accounts of describing his experience fighting as an adult in the War of 1812 right so he dies in 1920s and he at least says he was in the War of 1812 maybe he was telling his uncle's stories and just said they were his these are these are the sort of the claims that people make but you know it's interesting anyway and it sort of raises that question mark and then you go back further uh to Herodotus and I don't know if i' I've mentioned this to you before but there's a historical account from Herodotus you know the father of historians um looking at the interaction between the Persian Empire and Ethiopian Kingdom Persia had just taken over Egypt and they were sort of eyeballing their their new neighbors and potential ad adversaries in Ethiopia and the Diplomat from Persia uh was speaking with the King and so Herodotus chronic that interaction and the king of Ethiopia asked the Persians said hey you know what does your Emperor eat you know how long do your people normally live and you know 2 200 years ago or so and the Persians said you know described growing wheat and making bread and said our people would normally live about 70 years and the Ethiopian King said well no wonder you live such short lives of all you eat is dirt um our people only e boiled meat and only drink the milk of our cattle besides water and and we would live 100 20 years sometimes much longer you know and there and there's that that number again 120 and yeah so you have the you know Salsbury talking about people living be 110 115 as active healthy adults and Herodotus and other accounts in the native Australian aboriginals the nette uh the Inuit they commonly you know seeing these people there like they're out there you know nette you know hurting uh caribou and they're like yeah I'm 99 they're like couldn't possibly be you know but it it's just dismissed out of hand um even though we're seeing again and again in different continents and different cultures and that have no internet they're not talking to each other but they're consistently saying the same thing that they're living to a much older age with much more Health as a result of that and I think that that requires at least some sort of U introspection on this this whole idea 100% I mean good to be skeptical and you know I'm I'm I would be wanting to verif ify it somehow a bit more the these ages but you know 120 seems like a pretty reasonable mean age for humans who are metabolically healthy truly metabolically healthy which is a very rare thing as you know MH and yet uh you know if they have trauma or anything like that they they can get that fixed H with modern medicine I I'd be open to that uh possibility I mean I remember uh type two diab type two diabetes is a great example like when I came out of training even in 200 uh end of 2012 and I'd always been taught as you have probably been taught the type two diabet a chronic disease it's and it just slowly worsens and you keep trying to manage it usually by increasing insulin slowly which is the exact opposite of what you should do right but this is what I was taught and then um when I first came across I think it might have been Jason Fun's work where you know he he claimed that he was able to reverse think we may have some connection issues see if that comes back we'll just give it a moment okay had a bit of technical issues but we are back yeah so I was just saying type two diabetes is a great example so like when I finished training uh you know about 10 years ago now that I learned that type two diabetes was a chronic Relentless disorder and you know you had to keep increasing insulin every year and treat it with drugs and you know that's probably uh in some ways the opposite of what you should do to improve this disorder and it was I think Jason Fun's work that made me uh think about the possibility of actually putting it into remission and reversing it and he seemed to be able to do that with most cases at least he claimed to in his book the Obesity code so I was skeptical but I I guess I was interested enough to actually go and spend a week at Jason's clinic in Toronto and verify this so I was able to speak to dozens of patients and see their lab work and of course speak to Jason himself and Megan Ramos who was working with them at the time and I it was a it was it was verifiable and I I saw that you know these people were truly putting their diabetes into remission and coming off the medications and I thought to myself that was a just mind-blowing to me it's so obvious to me now like diabetes is quite straightforward to reverse in most cases but at the time it was mindblind and so if I had just been overly skeptical I guess I would have never gotten that plane and and gone to see him and I probably would maybe I'd still be thinking it's a chronic disease that you never get get off your meds but uh I guess embracing it without digging a little further is is important too and I think that's how you find the truth you you you be critical and but but keep looking mhm yeah well and and that that's it you know you keep asking questions you keep probing and you keep you know trying new things and and you see like okay well this this makes sense it's safe it's not going to hurt anybody first Do no harm and um and then and then you see you see for yourself well and it's just the same as if you had you know a major study that said hey we should use this drug okay that makes sense okay well what happens when I try it everyone's getting worse guess what not using that drug anymore just because some studies said so um if I'm seeing you know direct harm as a result of that and worse outcomes uh because obviously there there might be something wrong with the study or maybe it just doesn't apply to my patients for one reason or another or that patient for one reason or another so you have to be critical about that and um but but the the reverse is true you know if you if you see something that is uh out of the scope of the mainstream but you're seeing direct evidence that this is makes sense from a mechanistic point of view biological point of view evolutionary point of view it does not cause harm and there are and there is evidence that this works why the hell not give it a try and then see what happens and if that's getting a better result than your than your standard practice that you're doing right now what I don't see the problem with that and um you know I guess some people are just maybe a bit worried about branching out they want to sort of protect themselves if they sort of hide within the guidelines then at least they're uh protected but um yeah there's always a s sorry to interrupt no you're fine no you okay there's always a risk when you you depart the mainstream it's like if you're in the mainstream and you're doing what everyone else does even if things go south and they go badly you you're okay from everyone else's perspective because you did the standard of care even though it didn't work out yeah but you didn't help the patient yeah so whereas if you go off the beat and check and you try something new I have found that if it doesn't work out you you you can get uh probably get even more heat on you mhm and if it does work out it it can be brushed off as lucky or maybe it was something else that caused it rather than the intervention or whatever it was you did so it's always a risk to to go off the Beaten Track and try these things but for the patients um it's really a no brain to to have a certain path that goes to is associated with a prognosis that's not that great versus a more unknown path but a potentially much greater outcome I think you're going to take this second path most of the time unfortunately people are also susceptible to pressure from the doctors from family members and so on and and there's a lot of people that don't understand the you know the fasting ketogenic diet carnivore diet protocols and what they're about and and a lot of people even think uh that they're unhealthy that that pressure can can unfortunately Veer a lot of people into just sticking with what is the known path so yeah it's it's difficult when you for both the the the person trying to help the patient and also the patient themselves to come off the beaten path I guess even though uh they should at certain times when they should yeah definitely um and or they could just you know dis is it oh it's just anecdotal just anecdotal like well I've got 500 patients that yeah 500 anecdotes you know it's like I'm gonna work on this study that has a cohort study of 13 patients you know that we follow for five days and that that's that's real evidence you know um but yeah it's it I understand the the impulse to sort of you know protect yourself but you know at the end of the day it is cya medicine you know just cover your ass medicine and you know it's not necessarily the best thing you can do for your patients and I I have heard people say I mean you know there's the idea of evidencebased medicine like well look this is what the evidence shows and i' I've actually legitimately heard doctors say well I don't practice evidence-based medicine I cover I practice guideline based medicine and if it's not in the guidelines I'm not going to I'm not going to Veer from the guidelines it's like well the guidelines are 10 15 years behind the evidence typically and the evidence is typically two to three years behind The Cutting Edge because those are the papers that are being published by people like yourself who's had an insight and say hey why don't I apply this to GBM patients and uh and see what happens we already have enough evidence to show that this is safe and and at least effective in animal models and smaller studies and case Series so why don't we try this in in a real study That's The Cutting Edge that's trying something new to tr try try to find um a better treatment and that doesn't get published for several years so evidence-based medicine is years behind what people are actually doing to try to push the Forefront of our understanding and then guideline based medicines are freaking light year behind that you know so if you're practicing guideline based medicine you know it's it's it's a bit it's a bit concerning to me if you're a new doctor and you're just starting out and you don't know as as much as you could in your specific field sure stay in the guidelines that's your safe path those are your training wheels but you know do you you know you don't want to be working with training wheels you know eventually you want to get the training wheels off and you want to be doing back flips on a on a BMX you know I mean that's that's what we're trying to do here so you know the guidelines are are safe and help you get going but then they need to come off and you know it is it is a bit concerning you know you you you do risk things and you know if things go wrong then you know you pay the price for it or if things go perfectly right but you piss off enough people you know you're also going to be in trouble um I had uh my dad actually got one of the first arthoscopic uh um knee operations in America there that his surgeon was the first guy that brought this um surgical practice to America he studied with this Japanese group who um who uh innovated it before that they had the arthroscope but what what surgeons would do is they stick the Scopes in they'd look around they talk about the anatomy they take a bunch of notes and then they just open the whole thing up and and compare what they saw with the scope with which they saw when it was open not really helping and you know we're paying for them to sort of tulle around in our knee um the Japanese actually started using using the Scopes as as a surgical interventions he went and studied with them for 6 months brought it back to the US but it was not covered I mean he was and he said to my dad you know this is getting much better outcomes for people and so he's like I have to do it but I'm flying without a parachute I no insurance no malpractice um insurance will cover me for these sorts of surgeries at all so you know all there has to be is just one little old lady to say oh I've got my my knee is sore and I'm done you know my livelihood is gone but you know he was able to pay that way and that and that's that is the practice I mean no one doesn't open meniscus repair anymore like it's just like where you know it's just not that's not what happens but so you have to sort of um for the sake of your patience and also for you know posterity you you sort of have to take um I guess you know risk is probably the wrong word but it is a risk you know but but put yourself out there and be vulnerable to do the right thing to do something that you de is the best thing for your patient and and to get demonstrable results that you can then share with your colleagues to hopefully change practice but during that initial that requires bit that requires something that's very rare nowadays it's called courage yeah is that yeah it's it's uh it's much easier to just follow the guidelines obviously but you're absolutely right Anthony I mean you for junior doctors and people who are who don't know a topic well that's what the guidelines are for but for people who are who have been doing this for a long time the so-called experts or someone who's you know deals with this certain condition all the time the moral imperative really is to push past the guidelines and try to improve things especially if the outcomes aren't great with what your guidelines give you the moral imperative really is to try and make things better uh and if you're not doing that if you're just sticking to the guidelines you're not only not being courageous you know you're you're not helping the patient which is uh morally questionable and so yeah you're right you should be taking those risks don't go don't need to go crazy but you know there's a lot of data backing up the safety as you say the safety feasibility of these kinds of approaches and so you know you you you want to push you definitely want to push things and not just stick to the guidelines yeah definitely well you know to that end um you o mentioned that you had some uh some case reports on things like ALS and Huntington which is here to four like there is no treatment that will never um get better Huntington that that is considered uh one of these things that is that is 100% genetic you just you get this Gene and you will have this disease it will present it sometime in your life and and it is invariably fatal and will go in One Direction in One Direction only um what what have you what has your experience been with the sorts of very serious illnesses hey guys just want to take a second to thank our sponsor at carnivore bar I don't promote many products because honestly all you need to be healthy is to just eat meat for those times that you're out hiking road tripping or stuck at work and you want nutritious snack that is just meat fat and salt if you want it the carnivore bar is a great option so I like this product not because it's just pure meat but also because I want the carnivore Market to thrive as well and the more we support meat only products the more meat only products there will be available in the main Stream So if this sounds like something you'd like to get behind check it out using my discount code Anthony to get 10% off which also applies to subscriptions giving you 25% off total all right thanks guys so there have only been one there's only been one person with ALS WR published who went on a fasting ketogenic diet protocol we published that early this year and only one person with Huntington who's done this who's been published we published that a couple years ago there is some good animal data in animal models of both conditions uh but you know at the end of the day you have to look at Interventional studies involing humans so with the ALS um fellow basically this guy was declining over 18 months it can take a long time to diagnose ALS it's not the easiest thing but you get a lot of and uh basically he had sort of the worst form of it which is the or onset form so it starts with his swallowing speaking and breathing and he was declining he had about I just I can't remember seven or 8 kilog of weight loss it's in the paper during that 18 months and he was declining so they were sort of desperate and by the time he got diagnosed uh and then you know a few more months later they were wanting to try something else because the only treatment we have for ALS really is a drug called real isol which doesn't do a heck of a lot so you know they wanted wanted to they knew about our work and they wanted to uh try a metabolic Therapy Program ketogenic metabolic therapy so I said okay for ALS um let's try a two meal a day ketogenic diet so that's Tad two meal a day so it's a sort of a moderate form of daily fasting uh no snacks between the two meals it's nice because it's flexible you can choose the timing of meals and it was a keto diet and we did that for 18 months and we measured him every six months Baseline in every six months I had a you know neuropsychologists and neurologists not myself I was not involved in the assessments just arranging everyone to get together assess him and they didn't know what he was doing you know as well so they were blinded uh and then blood tests and so on and we had uh respiratory function measures uh from our respiratory text and so on and basically long story short over 18 months his his function which is the main thing with ALS it really hammers your function there's this scale called the ALS uh F FRS uh rating scale which is sort of the gold standard way to monitor ALS it usually declines every month um by a certain amount and he actually slightly improved by the end of the 18 months so he was supposed to decline by a tremendous amount by the end of the 18 months and he improved not much but he did and that was actually a pretty major change of trajectory yeah and his breathing parameters notably his Force vital capacities every six months kept getting better yeah it was those are supposed to decline that's a reasonably robust measure of lung function and you know the way people with ALS usually die is because they die from poor lung function and they get a pneumonia and they can't clear it so they pass away but he his got better every six months and it was a trend his weight uh he only lost like sort of two to 3 kilograms of weight so his weight loss despite the fact that he's on a fasting protocol mhm was mitigated now if you subscribe to the calories in calorie out Theory which has some validity to it but it's not the whole story at all uh then that doesn't make any logical sense but of course um it's not just about calories in calories out there's more to it than that and I believe that he basically made his metabolism more efficient because in ALS the metabolism is not efficient you lose a lot of the calorie energy through heat processes and other things and um I speculate that he tighten all that up so he was despite taking in fewer calories more nutrient-dense meals he he but still fewer calories overall he was actually uh making his metabolism may have reset so he was losing less energy and hence less weight loss anyways uh I mean it's it's an N of one you have to be skeptical as we were just saying but the results uh that the paper out out there you can read it for yourself the results were very encouraging to say the least and you know I just spoke to his wife a couple weeks ago and he's still doing pretty good oh wow he's he's gone he's gone off the protocol to you know by about 50% so he's slowly declining again but very slowly and he's sort of at five years or something post diagnosis now which is pretty good yeah uh the Huntington's fellow so Huntington's is uh so okay so ALS Alzheimer's Parkinson's ALS are 90% sporadic 10% genetic so in 10% of cases there is a gene problem that's directly related to the onset of the condition but and these people usually get it uh the disorder at a younger age but 90% of these conditions are sporadic we don't have any such genetic marker and in those cases probably a combination of liestyle factors that are somehow causing the disorder now Huntington in every case pretty much every case there's a known Gene defect it's called The Hunting tin Gene and it makes this Huntington protein now everyone has a Huntington Gene and a Huntington protein it's actually a crucial Gene with a crucial Protein that's involved in many aspects of metabolism and particularly mitochondrial metabolism throughout the body so everyone's got it the problem with Huntington's people is they get this sort of CAG repeat uh a whole bunch of sort of U mutations in the Huntington Gene which causes sort of defective protein and if you get sort of four 40 or more of these repeats you're going to get Huntington the more repeats you get the sooner you're going to get it it times pretty well so that's why people say if you've got the Huntington Gene you're going to get Huntington that is true from our current level of knowledge but there are studies out there twin studies for example that show twins with the same number of CAG repeats the same exact Gene and you know a pretty similar environment but maybe a little different can get hunting years apart the onset of it and it takes a different form so if it's purely a genetic disease that does not make sense right so it's it makes you wonder what else is going on we also know that exercise and dietary lifestyle probably these are correlation studies but they are suggestive that exercise and diet May alter the timing of when hunting ttin comes on so for example with uh diet high Dairy and higher calorie take seems to be a negative thing may lead to earlier onset and SED being sedentary so low exercise uh you know for example may be assoc is associated and may lead to Huntington coming earlier so uh this has made me question maybe there's more to it than just the genetics per se and if you look at what the Huntington Gene does it it it affects so many mitochondrial functions if you can offer for therapy that circumvents the genetic defect and improves the mitochondria a different way maybe you can slow down the onset and slow down the progression of Huntington right uh so that's the idea so we applied this to this guy and again similar story to our ALS guy we had a 41y old fellow who he had pretty Mo moderately bad Huntington already he Huntington is three things it's a movement disorder a cognitive disorder and a behavioral disorder they get a lot of difficult behavior problems and he already had um evidence of all three to a moderate degree but again they were desperate because there's really again no good treatment for Huntington we give them we give them drugs to try and improve the movements which don't work very well in all all honesty and antis psychotics and things like that to try and calm them down but it's all very symptom based so again you know he was a thin guy and I was he' already had 5 six kilograms of weight loss or something like that in the proceeding 12 months and I was like do I start a fasting protocol sure let's do it what's he got to lose so Tad Poquito diet same thing we gave the ALS guy measured him at 0612 months and yeah his movements by again the movements improved by about 25% by six months they improved by 50% at 12 months wow that's pretty massive yeah again blinded neurologist reviewing this guy and uh we had a blinded neuropsychologist reviewing him for his cognitive and behavioral stuff the cognitive stuff stayed stable didn't improve but didn't Decline and the uh behavioral stuff was really the most interesting because the behavioral symptoms he had he had suffering from uh anger irritability apathy uh you know terrible things a lot of it they there were lowered to the you know by at least 50% or in some cases 100% 50 to 100% and again it was a trend 6 months better at 12 months even better so you it's nice to see that Trend when you see things cuz then you know that one day maybe he just had a really great day or a really bad day but if you see a trend over months that's that's nice to see in a in a n of one case report MH so again be skeptical n of one but it's encouraging so and again his weight loss he he lost much less weight on this protocol again similar thing Huntington's uh probably a lot of metabolic inefficiency going on in different parts of the brain and body um but maybe we improve that so so all these uh yeah all these neurodegenerative disorders by The Bu they're not really just brain disorders they're whole body disorders Alzheimer's Parkinson's alos hun they all affect uh the different parts of the brain and nervous system but all of them affect the heart you get degenerative changes in the heart all of them affect scal muscles so it's not just about the brain stuff and and you know you look at Alzheimer's and Parkinson they affect lots of the internal organs so you know uh there's many reasons and this makes sense if you view these things as mitochondrial disorders rather than as you know single disorders of a certain brain structure which they're not so that's the two case studies and they were very encouraging and I was quite nervous of applying a a fasting protocol especially in both these disorders which are associated with you know weight loss and Decline and they're they're even harder to deal with than Parkinson's and Alzheimer's probably arguably so uh but but yeah that that data was is out there it's quite encouraging so what we need now is uh bigger trials yeah yeah well that would be great um thankfully those things are those issues are are very rare but um yeah hopefully yeah we can get um some bigger trials going that would be that would be amazing I don't know how I I don't that probably be something that we' want to do in the US might just just as far as getting enough patience is concerned population side I've got some ideas it's just matter of time my time is my limiting factor but they are rare but they're all increasing so Alzheimer's and Parkinson are doubling every 20 to 30 years Jesus ALS and Huntington even Huntington and again this is makes you wonder about the purely genetic nature of it which I don't believe is true um they're they're increasing by sort of 50 60% every 20 years wow so an ALS is actually not it's uncommon but it's not rare it's just the people with ALS don't live very long so you know it's the uh prevalence is low but the incidence that the rate of people developing it is is not that low yeah yeah well then let let's do that you need any help I'm I'm happy to to help with that time is a factor and I'm sure we can people as well um yeah I mean that I mean that that'd be huge you know I mean those sorts of things that people people get those diagnoses and they just they lose all hope because they're they're not giv any and so you know getting something be huge yeah that's another thing in medicine like you know if you if you if you stick to what you know in quotations and sell someone with global sto you know your average survival time is X and you don't give them any hope you offer them a treatment protocol the standard treatment protocol but then you say even with this you're average survival time is X MH it's it's it's tough for people you know you need to give some hope even but be real be realistic and so with metabolic therapy you can honestly say look this may work this may not work but at least the door is a jar and you know we just honest I honestly that's why I say people I honestly don't know if it's going to work but the theory is good um I I have enough experience now to say you know maybe it's it's a little better than good but yeah you you've got to give people some hope because that will drive them to improve themselves and do do things themselves that you know they they may not have thought they could do like a lot of people think at the age of 70 that they can't do a five-day fast it's inconceivable but they can so you know um you need to have a some hope and balance it with uh some realism but you must always have some hope for a person with these terrible disorders no matter what yeah definitely um I wanted to to touch something quickly if if we had time um I do good um you know you mentioned you mentioned the sort of germ Theory as opposed to you know trying to make sure that people are healthy that's something that's that's starting to regain popularity this discussion on germ Theory versus terrain Theory i' I've heard you have some very interesting talks on the subject obvious you don't have to give the whole dissertation but can you um you know maybe just elucidate for for our listeners you haven't come across this this discussion and this argument a bit about U germ Theory versus Trin Theory I'd be happy to and this is this is so crucial uh so it might be the most important thing uh that I say so there was this sort of debate in about 200 years ago in France between Lou pasture and antoan bamp most people have heard of Lou pastour he was this champion of this thing called germ theory he was a a scientist and pasture thought that the origin of disease a lot of infectious disease at the time was bacteria viruses and so on and that you had to Target these things and eliminate them with drugs vaccines whatever okay so there was that and then but he had this uh colleague bash who sort of had a in a way the entirely opposite theory he said okay I believe in this thing called host or terrain Theory which is that um okay there bacteria and viruses exist but most of the time they're just scavengers they're not causing a disease if the terrain I.E the health of the host is good and that made a lot more sense to me when I thought about this because a lot of people um don't get sick when the flu comes around or don't get covid H you know I I I guess I'm one of them and I suspect you are probably are too like they don't get sick and uh well why is that if the germs always cause the disease pasture style germ Theory then everyone who gets the germ should get the disease and that's false MH so but but you know at the time uh for various reasons Pastor was sounds like he was a better speaker and he had momentum on his sidec and most of the bad disorders of the day were infectious rather than lifestyle based his theories won over and antoan bash's sort of terrain Theory faded Into Obscurity and then for the last 200 years what we've had is uh germ Theory uh Gone on hyperdrive mhm so now we apply germ Theory not just to infections we don't just Target bacteria and viruses anymore we're trying to Target almost everything so example would be uh you know diabetes we're trying to Target the blood glucose level and how do you get the glucose down you give more insulin that's a great way to do it but doesn't help people with diabetes in the long term aerosis so hardening of the arteries leads to most of the heart attacks and a lot of The Strokes what are we doing there we're trying to Target the LD cholesterol we're trying to get that down or we're just targeting the clots that form in you know along the vessels when the plaques rupture we're trying to trying to just eliminate and remove stuff and it's having limited success cancer we're trying to Target the tumors of course with our chemo and radiation and we're trying to now even Target the genetic defects with gene therapy um cancer is more common now than it was even 20 years ago the n degener disorders the the big rage is to Target the um abnormal proteins different protein for each Disorder so like amalo and Tow and Alzheimer's Alpha clean and Parkinson's and so on and that's having limited success as well arguably not much at all so what I think has happened in the last 200 years is that germ theory has spilled over into all the non-infectious disorders and we're still stuck in this germ Theory what we need to balance it out is to balance it out with some terrain Theory now the problem with bash is he didn't have pasture had targets he had these bacteria and stuff that he could Target and bamp had nothing he didn't he it was he had a lot of silly ideas bamp I have to say but it was difficult to define the terrain uh mitochondria were discovered later and so if we have the now we have this chance for terrain Theory to revitalize itself knowing that mitochondria do so much within our cells and I see the mitochondria as coordinating cell metabolism and sort of as the the uh the main thing that we need to restore and it's a target of of restoration and you don't Target it directly the mitochondri Dy directly you target them by applying a blanket therapy like a fast or keto diet or whatever to improve them in a general sense so if we want to do a lot of good for people with the lifestyle sores which are now the problem infections have gone way down lifesty sers are killing most people in the west today I think we need to get a lot of terrain Theory going and that doesn't mean we need to commit the same mistake that we did 200 years ago and get rid of germ Theory no we can use both but germ theory is taken to the nth degree at the moment in medicine terrain theory is like nobody's heard of it we need to balance these things out and really terrain Theory should be the aame and the main bullwark for preventing all these disorders and then we can use germ Theory approaches drugs and other symptom based treatments to help people improve in different ways in terms of making them feel better and stuff but if you want to actually mitigate the core process by improving People's Health terrain Theory makes a lot more sense and that's all about restoring health whereas germ theory is about attacking disease yeah and and that's the thing you know that's um the point that I make is that the natural state of humanity the natural state of all life is that of Health you know we were descended from the winners we're descended from the healthy and the successful and the ones that were the survival of the fittest the ones that were the fittest were the strongest were the healthiest so when did we come when did we become an entire species of sick dis dysfunctional uh creatures that just Decay and rot away unlike any other animal and unlike ourselves 100 years ago or unlike ourselves eating you know in a in a pre-agricultural uh setting um I yeah I think that we've for many reasons more recently being um economic reasons and and um Financial interests we've started just focusing just on symptoms and we just don't we're not looking for root cause anymore it's just like oh well here's this problem here's this pill we need to find pills because all these problem like you said you have these targets and they're looking for genetic targets they're looking well we found this little Gene okay that's a problem what does it do it makes this protein this defunct okay well what if you do something that attacks that okay fine you know that that's that's that's pretty clever you know trying to figure out those sorts of things but you you're talking about one process in uh you know in you know one cellular process in a system that has multi-trillion cells and millions of chemical interactions every single second in every single cell so yes maybe that one target is everything but more likely you're talking about this in in in the complex of this entire system and you have to look at that in that in that way and right now we're just looking at symptoms and I mean it's even been said by you know Goldman Sachs is is curing people of disease a viable business model and of course no it's not you know because if you you cure some a disease when you can't keep selling them medications to treat the disease Chris Rock even said this the comedian and I I I rewatched an old clip of his back in the 90s uh from a stand-up routine and he said you know they're never going to cure AIDS they're never going to cure never going to cure AIDS because you know it's like you know you know never say never it's like I'm saying never they're never going to do it because there's no money in the Cure you know it's all it's all about you know drug dealers are all about the comeback you have to come back for more you got to come back for more and so if you just cure the disease it goes what they're going to do is they're going to get you medicine that you can take every day that allows you to live with the disease that would never cure the disease so that they have you for the rest of your life he called it he called it in the 90s he he saw right through that and um and I I think he's exactly right and then now we have evidence you know the Goldman Sachs U meeting that got the slide that got leaked out someone took a picture of it it straight up said you know is is curing people of disease a viable business model so that was their words you know they're they're looking at this so we know they're not going to try to treat the Cure the disease they're looking at this from a germ Theory point of view here's a Target we can treat this with that with this drug Target and we can have people on these drugs for the rest of their life which will recoup our cost and pay for the R&D on the next on the next set of drugs fine that's their business model but we need to look at it from another point of view how do we get people better how do we get people to their natural state support them so that their body can be healthy and just get rid of this stuff because I think that n well 90% of of the deaths in Western world are from these non-communicable chronic diseases which I think are if not entirely then close to entirely preventable and if you can prevent it by doing something well that means you can actually crawl back some territory even reverse a lot of these issues as well using the same techniques if you're addressing the root cause and so you know by by doing that by just allowing your body to to heal and repair you should be able to get rid of about 80 90% of these issues should people actually you know take this on um so it's just a matter of of letting your body heal itself and so what does that mean that means that we're getting things out of the way that are damaging our bodies that are messing up our our cellular metabolism that are messing up our mitochondrial function you know elevated insulin suppresses mitophagy and autophagy so you very simply keep that down and now you can recycle and replace and and regenerate your mitochondria and other cellular structures um so this is why I think that you know 90% or so of the treat of the issues that we treat are really not diseases they're not a pathogen with a with a with a drug Target they're just environmental exposures toxins and toxicities that disrupt our physiology our cellular mechanism and and make our body start to just fall apart and they just you know the wheels start falling off the car if you don't take care of it and I fully agree yeah yeah I think the body initially compensates for a lot of these things um you could say insulin resistance is a compensatory thing yeah designed elicited as a defense mechanism to prevent the cell in mitochondria from getting exposed to Too Much glucose so you know but as these compensatory things fail because you keep doing the you keep exposing the body to the wrong things like a bad diet and lack of fasting the compensatory mechanisms fail and then you get into these sort of more severe things metabolic syndrome and then that if you keep that up you you start to get into the you know become at risk of aerosis and a lot of cancers and degenerative disorders and so on so yeah you're right I I believe if you're right it's we shouldn't look at these things as diseases they these uh disorders or conditions should be seen as consequences of of um abnormal exposure to a lot of bad things in the environment yeah definitely yeah and that and that plays right in with you know the train Theory we're we're damaging the playing field and yeah what do you know players are tripping like there you go it's makes sense you know and and then you know to to further illustrate your point um you we we know that we're colonized with bacteria all the time and we know that you know MRSA is you know very serious infection that that people can get it's very resistant as the name suggests it's resistant to a lot of these antibiotics um but you know Hospital workers can you know up to 25% are colonized with MRSA in their in their nasal passages commonly and we're not all dying of you know um MRSA infections and abscesses in our heads so you know obviously there's something else going on yeah yeah I agree yeah great well Matthew it's been an absolute pleasure I it's it's always great talking you it's always great to see you likewise and um and uh really appreciate you taking the time um I know that you're doing a lot of great work just because i' I've spoken to you and seen you but I I mean as I can see just right behind you you have a lot of looks like thank you cards and letters from from patients and things like that so you can you can see very clearly that you're having a huge impact on people so I really appreciate the work that you're doing and continue to do so thank you very much for that thanks for having me Anthony it's always a pleasure to catch up and I'll see you at the next conference whenever that may be absolutely is is there any way that um people can support you follow your work are there any websites or social media pages that um people can follow you at yeah I try to limit my exposure to social media but I do have an account on X and I always forget the handle I think it's DRM Phillips or Dr Matthew CL Phillips try try one of those too and I do have a website metabolic neurologist dcom that's probably more useful because I put all of our major studies up there uh podcast videos like like this one will go up there and um you know there's other tidbits of information for people people with with uh certain disorders and yeah people can subscribe to a I send out a information on our work once in a blue moon that they can subscribe to that if they want so that that's it just those two sources unfortunately no well that's well you you you're better off staying away from social media I absolutely hate it it's it's a complete time suck and and um but it does help you know sort of get get these sorts of things out there but you got to you got to do it for what you're doing so yeah kudos to you for doing it yeah well thank you well thanks man it's um I'll put all those links in the description so if people want to uh follow you there please do and please go support Matthew's work he's doing great stuff thank you very much it was great to see you and uh you too yeah and for everybody watching thank you very much for joining hopefully you found that as interesting as I did please do send this to someone that you think would uh be improved by this at least one person and please do like uh leave a comment and subscribe if you haven't already if you like this and want to see more of it thank you very much we'll see you next time hey guys thank you very much for taking the time out to listen to what I had to say if you like it then please like And subscribe to my YouTube channel and podcast and if you're on YouTube then please hit that little bell and subscribe and that'll let you know anytime I have a new video out which should be every week if not more and if you could share this with your friends that would help me get the word out and let me know that you like what I'm doing thanks again guys