Advanced Cellular Metabolism – Ketosis and Metabolic Flexibility (Full Access)

Transcript Below

Rick: Welcome to the Tuesday webinar series, “Chiropractic Economics Webinar for Doctors of Chiropractic.” I’m Rick Vach, editor-in-chief of “Chiropractic Economics.” Today’s webinar, “Advanced Cellular Metabolism” is sponsored by Systemic Formulas, and we’re really excited in our office because we have some big keto fans on this side. And as always, our program is being recorded, and will be archived at “Chiropractic Economics” website, www.chiroeco.com/webinar, for one year. Our expert is on board here today to speak to you and when his presentation is complete, we’ll follow with a Q&A period. You can submit questions throughout the presentation by clicking on the appropriate icon on the right side of the screen.

Our presenter today Dr. Shayne Morris, Dr. Morris will be discussing how metabolic flexibility is opened the doors to opportunities for clinically-based diet and supplemental intervention, how it can be done today in a more personalized matter, and how critical supplements can be targeted to initiating ketosis for this metabolic flexibility, and comprehensive detoxification. Dr. Morris, thanks for taking the time to participate in our webinar. Before we get started, could you please give us a little background on yourself and your work with Systemic Formulas?

Dr. Morris: Yeah, great. Hey, thanks for having me. It’s an exciting time for everybody that follows trends, especially trends that relate to diet, and, of course, my world of supplementation. And my background, so I’ve been doing this a very long time. In the 1980s, I got involved in this industry, as really, you know, one of the founding members of certain companies, you know, it’s companies that we now know that have grown to become very large companies. And early on, while I was manufacturing and in the operational side of things, I was also continuing my higher education. 

So as I graduated my dual major in chemistry and microbiology, I decided there’s a real opportunity in this industry to bring more science because you realize, in the ’80s, the science was quite minimal. It was sparse, to be real, about nutrition and supplements, and how these things affected our cellular metabolism and cells in general. And yet, we knew that drugs came from natural products. So I had a really exciting time through graduate school, received a PhD and MBA and all that boring, fun stuff. Brought me, of course, to where I am now, which is both a researcher as well as a business person, you know, owning my own businesses. And that’s really where I wanted to be because I love this industry, and I love what the practitioners in this industry do for us. And I think it’s the future, I’ve seen more and more people want to gravitate towards natural health, whether it be to help the planet or to help yourself. It’s a much better path that we’re all on. So that’s a little bit of my soapboxing. 

What brought me to this particular subject, though, is, you know, I’m a healthy skeptic of diets, and I think the science behind what we’re doing now with what I call metabolic flexibility, and that’s a term I’ve used to help describe a combination of diets where we look at fasting, we look at intermittent fasting, we look at diet variation, we look at time-constricted fasting, and we also look at ketosis. We look at metabolic changes that show really amazing promise. And those of…most of us now have heard about the word ketosis, and I’m hoping that most of you listeners have also heard of these terms I just used, the fasting terms or the diet variations. Collectively, I call that metabolic flexibility. And it really does drive some important biological processes. And today, what I want to tell you is, I want to describe a little bit about that. So if we look at the next slide, which is my objectives, I want to go through the ketogenic refresh, which is quite simple and quick, most people understand ketosis. Looking at ketone bodies and what that means, we’re going to look at some of the physiology and biochemistry and metabolic flexibility, that’s really where the therapy kicks in. 

That’s where we understand what we can do to our own body, to our patients, to the entire community of people that you’re working with as clinicians. Metabolic flexibility is a powerful tool from anywhere from just looking at simple weight loss all the way to the more complex issues like cancer, for example. I know it’s a scary word, but the metabolic flexibility in certain areas is very powerful tool for many people, including oncologists. We look at diet variation, detoxification, and some solutions. I thrown detoxification in there, because that is one of our tools that we use, that I use, because as you’re going through any these processes there is a natural detoxification that happens. And if you’re not prepared, there are consequences to doing these diet or these metabolic flexible therapies. And if you’re not detoxifying properly, there are consequences, and we’ll talk about that.

So let’s kick this thing off in the interest of time. So what is ketosis? Ketosis is where we take our body, our diets, and we shift our diet from carbs. And you see on top of this slide, where it’s mostly a traditional diet, where you have a higher propensity to eat carbohydrates, even complex carbs, and of course, those then stimulate through our energetic profile. Now remember, whenever we eat food, macronutrients, I should clarify, macronutrients are things like proteins, carbs, and fat. Whereas micronutrients are the vitamins and minerals, the other unique chemicals that we can get, or metabolites we can get from a lot of different sources. But the macronutrients is what provide our body energy or ATP. We can get it through our traditional diets, which are generally carbs, you can get some from a little bit of protein and fat as well, but it’s carb driven. So when you think of the citric acid cycle, and hopefully, as I talk later, you guys will remember what the mitochondria is, I’ll mention it again, that drives you through the glucose pathway. So you eventually end up making glucose and from glucose, you make ATP. When you look at keto diet, you’re restricting carb and you’re pushing everything through what’s called a fat-driven metabolic process. 

So your fat will break down into what we call ketones, and there’s a couple of ketones, we’ll talk about. Ketones then drive energy production through a process that will look at in more detail. In fact, we’ll get into the science, for those of you science people that love science. So that’s the different positions we take. And the keto diet has been used historically, in a number of unique cases, like epilepsy, but it hasn’t really taken off until now. And because I’m not a strictly diet guy, I don’t believe in strict diets, I’m a little more…I’m a moderate, so to speak, that’s why the flexibility of these different approaches like the fasting, including, you know, sometimes increasing your fat intake into ketosis, and then getting out of ketosis when you need to, and women in particular need to. So in the end, hopefully you guys will remember that and ask me that question. 

So what are we talking about? To achieve a state of physiological ketosis, and later on, we’ll talk about exsanguinous ketones. But to get into a physiological state of ketosis where all of the ketones circulate in your body are made by you by your own metabolism, there’s ways to get in there, you can fast for long periods of time. In fact, you start seeing raised ketones in your blood after up to 16 hours of fasting. Now, if you eat a lot of carbs, that’s going to quickly reverse. There is starvation. This is different from fasting where, in fasting, you can take different approaches that we’ll talk about in a little while. 

But briefly, fasting can be where you restrict you eating over 12, 24 hours up to let’s say, 72 or more, whereas starvation is prolonged fasting. That’s not something I recommend, but there it is a way of achieving ketosis. Neonatal, not that you can do that, but as a neonate, you’re in ketosis. Post exercise, oftentimes, after you’ve done some exercise, whether it be it’s mostly aerobic, you’ve depleted all of your glycogen stores, all your glucose stores, and you find yourself in a state of ketosis. Low carbohydrate diets, so not necessarily high in fat, but low carb, or high protein and high fat, you can achieve a state of ketosis.

The last two are just notes that I want to refer back to. Fatty acids cannot pass the blood-brain barrier. So you guys remember that. So those in the audience, please remember that. And then, no gluconeogenesis comes from fatty acids. So ketones come to the rescue when you’ve depleted all of your sugar stores, or your glycogen stores. That’s important for later. We want to look at the benefits of ketone bodies, right? Or excuse me, ketone bodies. We have acetoacetate, which is one, and then we have beta-hydroxybutyrate. The butyrates are what you’re going to see commercially available. It’s also the main ketone your body produces. 

Acetoacetate is involved in the process, but the big one is that beta-hydroxybutyrate. For those of you that want to educate your patients on this process, remember the beta-hydroxybutyrate, because that is the key ketone that we can either supplement and/or we drive to produce. It’s a simple metabolite, and it’s important because it can fuel the brain during starvation. And it’s also a ketone body that’s not dangerous. And it can also be used as we figured out, the pleiotropic effects of ketone bodies like beta-hydroxybutyrate, it can feed other tissues, it didn’t used to be thought of as a systemic nutrient, or a systemic ATP source. Now it is, we know that it can be used by most of your tissues, most of your cells, as well as other organisms, not that it matters, but other organisms on the planet, use these ketones as fuel all the time. 

And of course, they’re water soluble, and they have an anti-catabolic effect. And we’ll talk about the true benefits clinically a little bit later. But it’s interesting to know that as we studied these just in the last five years, we keep finding amazing whether it be for our own muscular performance, or anti-inflammatory performance, or even anti-aging, there’s a bunch of applications now that are hugely beneficial to the body, as long as we moderate it in a flexible way. And we’ll get to that as well. So one of the benefits, weight loss, anti-oxidation, ketones raise glutathione, that’s what GSH stands for, can produce inflammatory markers, clearly, we see that. 

We’ve seen that in a number of cases where patients that are struggling with neurological disorders, that it lowers inflammatory markers, it gets rid of things like seizures that’s been known for many…half a decade. It protects the inner mitochondrial membrane. Glucose metabolism is much more oxidative than ketone metabolism, that’s why you can get more ATP from fat, of course, as we know, as biochemists, you get a lot more ATP from fat than you do sugar, so it’s more efficient. It also, when you have higher ketones in the blood at least a few times a week, or multiple times a month, we find that insulin stays much more sensitive to those people. 

When you’re living on strictly sugar, insulin becomes very desensitized and you enter into sort of metabolic issues, you know, we have metabolic X syndrome, etc. When you find yourself…when you put yourself in ketosis throughout a month, you find that your insulin remains much more sensitive, and you have fewer problems with glucose when you do eat sugar, for that matter. And then we know that it’s an epigenetic. It has an epigenetic effect. That’s not something I’m going to get into today. It’s way more complicated. But those of you that are interested, you can look into that, and it’s fascinating on how it controls your genes. 

So look at the metabolism. And I know I’m going very fast. But as I said, this is going to be recorded. And furthermore, I want to get to some of the clinical work that you guys need to go over. And I’ll do that a little more slowly. This is more of the biochemistry of why we get to the clinical piece. So taking that moment out, let’s look at the metabolism, ketogenesis. So we have fat metabolism, up on top of this slide, it is called beta oxidation. That’s where we convert fats into smaller chain fats, and then we run those into our citric acid cycle, through citrate, and so on. 

We can also create new sugars from things like fat. And you’ll notice in the slide, there’s something called oxaloacetate in the middle, top middle, and you’ll find it again in the mitochondria in the middle left side, that oxaloacetate, excuse me, oxaloacetate is a fat metabolite that you can either convert back into glucose, or you can convert it into other things. In this case, normal fat metabolism can push things into the glucose cycle. However, when we decrease the gluconeogenesis, and we start increasing ketogenesis, that all happens in the liver. All ketogenesis happens in the liver, meaning that when you metabolize fat, all the ketones you’re making are coming from the liver, and they’re going to be distributed to the rest of the body. 

And that’s a key thought for those of you that are involved in this industry. And like myself, we want patients to get well for a number of conditions that come to see you. And when we want to put them into ketosis, the first thing I want to warn everybody is that we are putting a strain on the liver, the liver is doing the bulk of that work. Now, and that becomes important for a number of reasons, as you probably now in your mind thinking, “Wow, if my liver is central to ketosis, I had better take care of my liver, because it’s going to also be central to some of my healing protocols.” And that’s actually one of my take home messages from this talk. 

The liver is key. So as we look at the process, we look at making ketones. On your left, you see the little icon for the liver. And we start with fatty acid oxidation, we make acetyl-CoA, and I know this is heavy biochemistry, but it’s a really easy slide to follow. And it’s good for those of you that want to move this to the next level in the science world for yourself. So if we make acetyl-CoA, we get down into the mitochondria, central left of your slide. The mitochondria is the one of the key organelles inside of each and every liver cell. And remember, mitochondria is the powerhouse of the body. Without it, we would die instantly. It’s where all of the energy in our bodies are made. So then, you’ll notice now, even in ketogenesis, the mitochondria is central. 

So when you look at this little enzyme called HMG-CoA synthase, you don’t have to memorize that. That’s an enzyme in the mitochondria that is critical to the making of ketones. If you damage or otherwise restrict that enzyme, you cannot make ketones. So it’s a central player in this whole process. And it’s in the mitochondria within the liver cells. After you start making ketones on the right-hand side of the cell, you can see the slide, as we continue from acetyl-CoA, and we travel down the path, we end up with an acetoacetate, which is then converted into beta-hydroxybutyrate. And you can also get off gassing of acetone. It’s also a ketone. And that’s when you know you’re in really strong ketosis is you can actually start smelling acetone on people’s breath. 

That’s one way of knowing if you don’t have the tools to test it, you’ll start smelling acetone. As we make beta-hydroxybutyrate, we now have the circulating hydroxide, or excuse me, the circulating ketone, beta-hydroxybutyrate, is now sent out of the liver to circulate into all the other tissues. It now is becoming the food source because of all the fatty acid burning that is now our food source for our brain, for our muscles, for other tissues, uniquely not the liver, though, but it is the energy source for every other tissue. That’s, that’s critical, because when you’re in ketosis, and you want to use ketones as your major energy source, that’s how you get there. 

But what happens when you now have circulating ketones? You have something called and this is found in all the other body tissues. And I want to mention another little note for you to take, this also happens in the mitochondria of other tissues, other cells. Remember, it’s still happening at the cellular level, which is really amazing for me, it’s exciting for me, I love it. So if you look at this ketolysis, this is where we take ketones, and we burn them as energy. So we start with beta-hydroxybutyrate at the top of the slide, and then we go all the way down to the bottom of slide where we make acetyl-CoA, and acetyl-CoA becomes the major contributor to the energy of making ATP inside of the mitochondria. 

This pathway, although again, it’s complicated with enzymes, you don’t need to memorize it. You also get spontaneous acetone exhaled, so again, you’re smelling acetone. And the final product is now ATP from burning ketones. This is another critical piece because ketones can pass the blood-brain barrier, whereas fats cannot. When you want to feed the brain, you’ve got glucose, and you’ve got ketones. Fats won’t make it across the blood-brain barrier. So it’s brilliant, it’s absolutely brilliant that our liver can make ketones from fat, and that can then sustain all of the brain’s activity, because when you think about how much ATP between the heart and the brain, you need about a kilo, a kilo is 2.2 pounds of ATP, an energy molecule. You need to build that or manufacture that inside of your body every single day. You’re manufacturing that much ATP to keep you alive and running. And more when you’re active, when you’re thinking, when you’re, you know, exercising, etc. You make even more than that, more than a kilo. That’s an amazing amount of chemical you’re producing to maintain health. And it’s all happening through this process when you’re in ketosis. 

So I want to differentiate briefly, now you guys understand the biochemistry of getting into ketosis and what ketones do for you in terms of the biochemistry, getting to your brain, and they help you stay alive through providing energy. It’s an energy source. There’s a difference between endogenous source, what we just described. We had described the entire endogenous process, meaning that’s how your body makes it for you. We can also use exogenous ketones, these are ketones you would supplement into your diet. The most common being beta-hydroxybutyrate, and salts of those beta-hydroxybutyrates. So exogenous ketones, they’re advantageous because you don’t have to make them, meaning that you don’t have to go through that whole first process, which does burn energy, by the way, to make these ketones. And yet you can supplement them into you and raise blood levels of ketones. They can be used by skeletal muscle. 

So they are used metabolically by tissues, fat muscles, skeletal muscles, excuse me, fat tissue, skeletal tissue, heart, etc. And they also can help provide that insulin sensitivity. So having ketones circulating improves the glycolysis effect or the burning of sugars. For those people that are trying to get themselves into ketosis, having exogenous ketones around once a day can help drive a more efficient process in both the liver and in the skeletal muscle. So it helps you burn fat. It’s somehow, and we don’t understand the science yet, but it somehow triggers the body to say, “Hey, we’re burning fat because we have ketones in our circulatory system. Let’s burn more fats, let’s tell the body to continue to burn fat, because we see that this is happening and let’s do more of it.” I know there’s going to be more to that story scientifically coming out, but it does seem to help burn fat with people that are not in full ketosis, but they’re taking exogenous ketones. There are benefits to that. You want to have quality exogenous ketones keep that in mind. They’re not all made equally. There’s a lot of tests that need to be done to make sure they’re good. And it does help, as I mentioned, with the glycogen synthesis. 

So they can also affect the conversion of glutamate to GABA. And remember, GABA is one of the anti-excitatory. It’s one of the calming neurotransmitters. So having some exogenous ketones in your bloodstream, it takes you from more of an excitatory state to a more calm state. And that, again, is done in most…most works have been done in animal studies. And there’s a little bit coming out in the human studies. It’s also, as I mentioned, on the epigenetics side, I’m not going to spend a lot of time for that, but the last three bullet points here are what I would consider in-depth aspects of having ketones in your bloodstream. It’s a DSLS inhibitor, meaning that it helps manages epigenetically, and it’s using a therapy called with Kabuki syndrome. So if you have any patients with Kabuki, BHB is a critical piece to their wellness program. It also has some inflammasome inhibitors, meaning that it inhibits…inflammasome is something inside your body that helps trigger inflammation. And it helps inhibit that inflammatory response in a good way, so that you don’t have runaway inflammation.

Here is a…the next slide I want to give you guys, this slide is critical to our understanding of the benefits of ketones, and what I call metabolic flexibility. Because later in this talk, and I’m going to preface that now for you all, it’s not just about being in ketosis, that was two years ago. We were getting everybody into ketosis two, three years ago. It was exciting, people were losing weight, they were experienced a lot of changes in their metabolism, etc. But when you stay in constant ketosis, and those of you that have done this practice, have done this, you’re starting to find your patients are having problems. Sometimes its initial, like the keto flu, sometimes it’s long term. 

And that’s because just ketosis by itself, is not a long-term strategy. It certainly is not. However, since that time, we’ve come up with these diet variations, these intermittent fasting protocols. When you combine all these, you can find yourself into a flexible metabolic process. So for example, I can wake up on a Monday morning and say, “You know, I want to do some…I want to get into some exercising this week that’s a little more strenuous. So I’m going to get myself into ketosis, Monday, Tuesday, and Wednesday. I’m going to leave ketosis and do a little bit of a carb hit on Thursday. And I’m going to find myself in a carb/keto state the next weekend, so that I’m kind of half and half, my blood ketones and my blood sugars are equal.” I can do that now. 

And this flexibility drives in much healthier, much healthier body, because it’s more natural, you can find yourself in ketosis. Put yourself in ketosis and take yourself out when it’s necessary, or when you feel like you want to, you know, for women, they have to come out of ketosis prior to ovulation or post ovulation, but prior to their menstruation, because hormones need carbohydrates to be manufactured. And then the whole other bigger picture to that is your microbiome. If you’re in ketosis all the time, you’re negatively affecting the microbiome in our bodies. And if that’s a term you don’t know, you have to look it up, because it’s an amazing term. But the benefits of this metabolic flexibility on this slide, briefly, ketosis, and metabolic flexibility, help with weight loss, neurological, type 2 diabetes, brain cancer. And these are well-studied benefits. 

These are clinical benefits, not just animal models. Some of these are really well-studied syndromes like Cogan and Irlen, autism, anxiety, etc. This is an amazing tool for us in the natural world, having this metabolic flexibility is amazing tool that I think everybody should take advantage of. And if you’re like me, and you’re more moderate, it doesn’t have to be extreme. You don’t have to live in ketosis, you can move yourself in and out of fasting, in and out of ketosis, you can have yourself on a restricted diet. And these all work, they all absolutely work. They’re amazing. So the clinical significance, this is kind of a follow up, you’ve now seen the clinical significance that I just had on the slide before. We want to combine that with diet variation and fasting. 

So we want to have ketosis combined with those things. We want to mix things up in a metabolic flexible way. Another benefit of having all this is what’s called autophagy. When you find yourself in a fasting state, and you’re burning fats, and you’re low on macro nutrients, your body, if you’re in that state for at least 16 hours, and it’s preferable over 24, you trigger something called autophagy. And autophagy is where inside each cell, your cells take note and they take, I guess, inventory of all the outdated, outmoded compounds inside yourself, and they recycle them. So it’s a giant recycling of old proteins, old motors, old membranes, old everything, and you recycle them into fresh, shiny, new cells. 

And so, you essentially trigger your body, you’re going to do a cellular regeneration. And to do that, you have to find yourself in a limited state, when food is plentiful, when your patients are eating, and they’re eating 20 times a day. And they have, which by the way, statistics show that if you don’t pay attention to your metabolic flexibility and restrict, people touch food over 20 times a day. You pick it up here, you take a drink here, you snack on this, you have it in your pocket, what have you. That means your body never has a chance to say, “Hey, let’s shut down these processes, and let’s recycle everything that’s old. Let’s recycle all these old proteins. Let’s recycle old tissue, Let’s recycle old brain matter. Let’s get it all rebuild.” And to do that you have to be in a restricted and, or fasting state for intermittent periods of time. 

So it’s critical, we have these great adaptation programming built innately into our body. So by adding these into our body with increasing ketones, and doing these diet variations, you can trigger these programs inside of ourselves to do this. And we just have to say, “Restrict your eating, restrict your calories.” You know, back in the day when you guys remember, and hopefully I’m not, you know, dating myself, but when Resveratrol came out and had sirtuin genes, I was so excited about sirtuin genes, which worked by restricting calories. Well, calorie restriction is a terrible idea we found out. It’s a terrible, terrible idea. 

But time-restricted feeding, diet variation, intermittent fasting, is a brilliant way, it is the natural way of doing these things. And you’ll notice that you can get into autophagy. When I say 13 hours, it’s probably a little better to go 16 or more. It also drives up ketosis. So intermittent fasting, and these other restricted feedings drive up ketones, naturally, and then you can supplement if you’d like. And it drops all the…and it has all the other benefits that we talked about, which is freaking amazing if you guys think about this. And it’s a tool that every single practitioner on the planet can use, and they can use it so effectively, and it doesn’t have to be so extreme. 

We’ve moved away from this extreme thinking of you’re in a strictly ketosis and you’re going to stay in that for two years, you’re strictly going to do one thing or another. No, this is a much more flexible approach. And what does that look like in examples? Well, here’s some example I can give to you, daily meal timing. So intermittent fasting, so that’s eating one meal a day, eating two meals a day. The weekly timing, you do a 5-1-1 rule, where you have five days of intermittent fasting, one day, where you don’t eat at all, and then one day where you feast. Or you can do seasonally, you can rotate in and out of intermittent fasting of these diet variations on a seasonal basis. It all depends on your client. And you can do…some people start really simply with, you know, like a 5-1-1 rule. 

And they move to a 3-2-2, which is a little more restrictive, all the way up to where they fast, you know, three days a week, it is a little more extreme. But it’s really within your control and you start seeing benefits, even with one day of that week. One day of intermittent fasting a week and you start seeing benefits, inflammatory benefits, weight loss benefits, clarity, cognition, anxiety, all these things start to improve for your patients. It’s an amazing tool for you all. And now you have to ask the question, okay, is this amazing tools simple. It doesn’t require a whole lot of…I mean, it requires eating less, so the grocery bills go down. 

But what about supplements? And why am I here? Because watching and working with people over the last few years of this, there are consequences to extreme changes in people’s dietary interventions. And what we found is there is a toll when you are restricted diets, and when you are finding yourself in ketosis, you are limiting some of the micronutrients, you’re limiting the availability of certain minerals, certain vitamins, certain co-metabolites that you need, certain things you need to feed your microbiome. They’re all missing in certain diets when you’re restricting them, so we have to supplement them back. 

And I found that when protocols include some supplementary intervention, you really decrease the opportunity for people to drop their system, because they’re in pain or they’re miserable, or other issues that arise, you can keep them so much more compliant, when you supplement these other pieces, and why are we supplementing them? Because these dietary interventions and this metabolic flexibility has a severe impact on things like micronutrients that I mentioned, that autophagy has a huge demand on nutrients. When you’re rebuilding all of these things inside of your body, you need a lot of micronutrients, you may not need the macros, because that’s what triggered the autophagy. But you certainly need the micronutrients in order for all of the internal workings of the cell, all the enzymes, all the DNA rebuilding, all the RNA rebuilding, all the rebuilding of membranes that requires the micronutrients. And the best way to get those is in a supplemental way. 

All the detoxification that’s happening with all this rebuilding, with all the strain on the liver, with all of the dietary changes, you’re certainly entering into what we call detoxification. When you want to classify it as that or not, it is detoxification, and that puts a huge strain, again, on your resources on all of your body’s resources, from the brain to the tips of your toes, we’re taxing the body. Now, they don’t deplete immediately, which is why certain symptoms, adverse symptoms, don’t kick in for a week, two weeks, three weeks, because as soon as you depleted your nutrients, is when you start noticing cramping, irritation, GI issues, etc. 

And we know quickly on, people have to supplement electrolytes that happens pretty quickly for a lot of people. That’s the tip of the iceberg. So the rest of my talk is to say, “Hey, guys, I love these tools, these tools can change your patients.” However, you’re very knowledgeable in this area, we have to take care of the micronutrient needs and demands. And its best to do that with supplementing these processes like autophagy and detoxification, and the microbiome to some degree. 

So I want to give you a little bit of background on where this detoxification happens. It happens in the liver, as we said, and inside the liver, it happens inside of the smooth endopac, oh man, smooth endoplasmic reticulum of the liver cells. That’s a lot. It’s a mouthful, agreed. However, it’s good for you to know that because the demands that we’re putting on the body, really localize down to the endoplasmic reticulum. And I will break that down a little bit more for you. So it’s responsible inside of each cell for phase one, phase two, lesser phase three, but the ER in the liver is responsible for phase one and phase two detox. There’s also something called peroxisomes, it’s released from the ER that manage all of this autophagy stuff we’re talking about. It manages all the hormone building, all these things that happen inside of your cell that we don’t typically think about, because we just take it for granted, these are all being impacted by our dietary choices. So all of this diet variation, and ketosis are impacting what we call the endoplasmic reticulum and the peroxisome inside of each cell. 

And I want to point out that these are the things that are happening inside the cell, where you have immunity, amino acid metabolism, viable synthesis, lipid biosynthesis, thermogenesis, reactive oxygen, so your oxidative, reductive processes and signaling. We’re not taking care of these things if we’re depleting our body at the same time. Hence, this lecture and one of my other take home messages today, we have to feed ourselves the micronutrients it needs in order for the greater approach to these diet flexibilities, metabolic flexibility, to take place in a healthy, productive, and sustainable way. We can’t sustain these diets if we don’t take care of ourselves. And our cells are so busy doing all these things, the paroxysm is going to become really busy making ketones and protecting you. If you’re not taking care of it, you’re going to run into trouble down the road. That’s kind of my side note to why we want to be interested in supplementing our diets. 

So detox and ketosis consume nutrients, they burn a lot of ATP simultaneously, right? We know that the liver is really busy putting us into ketosis, but there, it’s also really busy taking care of the detoxification process, let’s not neglect it. I’m beating that like a dead horse, but I promise you, I’ve seen it over and over in patients when they take care of the liver, take care of other detoxing processes, they find that these diets are sustainable, and compliance goes way up, way, way up with this metabolic flexibility. In fact, they’re happy, they’re much more healthy, they feel amazing, over long periods of time. 

Now we get into the business side of things. And I won’t take too much time here for you all, so that we can get into questions because I know there should be few, especially getting the speed at which I run this by you. There are a number of products that we use to help reduce the impact of getting these people into these diet variations, intermittent fasting, and ketosis. We have targeted nutrition for our body, for prepping the body, getting the body into it, and the brain subsequent to that. And then we have what we call accessory nutrition in the forms of adrenal, pituitary, neurological, liver, kidney, glucose regulation, and inflammation, etc. 

So we provide a number of steps that we’ve built up the last about four years based on these dietary interventions. And I’ve categorized them here, for those of you that are interested in looking into this deeper. When you look at a shake, shakes are going to handle most of the sustenance part of going on there. They’re going to provide fats, they’re going to provide easily accessible fats like MCTs, and other easily metabolize edible plant fats. So they’re going to provide macronutrients, we have extra cellular ketones, which can provide the ketones themselves to help push the body into ketosis when otherwise it’s being resistant. 

And it’s also good to do it when you’re starting a dietary intermittent fast or a time-restricted fasting. Having exogenous ketones, or extra cellular ketones around, helps drive that with the body, so helps you get into ketosis faster. It also helps you coming out of ketosis. As you’re coming out, you can supplement ketones, and you don’t feel the shock of going into a more of a carbohydrate diet. And I want you to remember this, it’s when to trigger autophagy after the fasting, some of the nutrients you want to provide are during the feast cycle. So coming out of the fast and starting the feast is really where the value of some of the supplementation happens, because during the feast cycle is when all the rebuilding happens. 

So all the breakdown, all the throwing away at the trash happens, cellularly speaking, during the fast. As soon as you feast again, it’s when all the body cells start to rebuild. If you don’t provide amazing nutrition during the first feast cycle, you’re doing yourself a disservice. The body is not getting what it needs during the feast phase. So remember, the feast is every bit as critical as the fast. And that’s something I think people don’t always recognize during this process. And then, of course, during the detox phase, we’ve got to provide the body with phase one, phase two pieces to support phase one and phase two and phase three detoxification. 

And if those words aren’t clear, you can look them up, they’re well-defined processes in the body, especially the liver. And they involve things like methylation, peroxisome, mitochondria, and so on. These phases help you rid yourself of all this breakdown products you’ve got during the fast. And you want to support that process as a clinician, and you want to support it both during the fast and then, of course, ramp it up during the feast cycle. 

So we have something called the Ketabo-Shake, and it supports all parts of this and what we did in a critical way as we made this Ketabo-Shake with really high fat content. So it’s one of the highest fat content shakes on the market. And we’ve, of course, did grass-fed finished fats, and it’s high in a complex number of fats, which is also unique. We use both organic coconut, the butter, the grass-fed finished butter, and then chia, borage, hemp, and phospatidyl choline oils, those are oils we use to raise that fat level up. And then we use collagen as the protein because it does not stimulate insulin. Collagen is one of the few proteins that don’t stimulate insulin. And then, of course, with this entire thing, you have a low carbohydrate, high fat to protein. And that will support any ketogenic or diet variation meal supplementation is what that amounts to. 

And then, of course, you can add to that things like extracellular ketones to help drive, getting in and getting out of ketosis or just as a support. I occasionally will use extra cellular ketones during the day, when I don’t want to snack on something. If I just want to have ketones circulating in my body, I will use extracellular ketones, even if I’m not in full ketosis, to drive that burning of ketones in my body. When I don’t feel like I want try anything else, I won’t have more ketone burning. You can do it in the middle of the day, even though you’re not in full ketosis. You can do it when you’re getting ready to go workout. With men, women tend to be fine doing it before and after, men tend to benefit after a workout by providing these ketones, etc. 

That’s kind of an anecdotal what’s happening just in the athletic realm of study, in human athletics, but it’s again, the science is growing and it’s easy to read about. That’s extracellular ketones. If we take it one step further, and this is a particular interest of my own research, is the microbiome can be severely changed by any long term aggressive dietary plan, which is another reason why I’m such a fan of our new metabolic flexibility programs where we can be in and out of ketosis, we can do some fasting, we can do intermittent fasting, time restricted, all of these names I’m throwing at you, are all very well-defined protocols. 

And furthermore, they don’t destroy our microbiome, which is central to our health. And you add to that, if you take certain fibers, they don’t take you out of ketosis, but they feed the microbiome. So those of you that use these technologies and use these tools in your clinic, remember, you can put your patients on some fiber, good fibers, that helps maintain the microbiome. And it does not in any way shape or interfere with ketosis, it does not take them out of ketosis, furthermore, or ruin any intermittent fasting, or dietary variation. Furthermore, many fibers are converted into ketones anyway by your microbiome. So it’s really a win-win. 

And I wanted to point that out today, because people get afraid of fiber thinking it’s going to create a carb load, and it does not. Not all fibers are created equal, but many fibers are very, very beneficial in these dietary interventions. So when do you know if you’re in ketosis? Quick tools, you guys certainly take advantage of the tools out there. I like the blood ketone meter, and they’ll do blood and sugar simultaneously. So you know whether or not, you’re more in glycolysis versus ketosis. And many people I’ve talked to that are brilliant in this area, Dr. D’Agostino was one of them, he finds himself in a 50/50 situation, a good part of the week, where he has as much ketone in his blood as he does sugar. So he’s a 50/50, you know, metabolizer, and that’s amazing, it’s amazing place to be. 

And you can do it, you know, you want to do it at certain times, in the mornings, it is good. You can do and plus, you can test foods. This is one way of testing whether or not a food throws you out. So if you eat something, and then two hours later, test your blood sugar. If you if you’re out of ketosis, what you ate was too, easily accessible sugar, right? Or even the fiber, I mentioned, you can take certain fibers then measure your blood levels of ketones and find, “Oh, wow, I’ve kicked myself out of ketosis.” That’s not a good fiber. That’s not a fiber that I want to use during my ketosis cycle. So it’s a really good…it’s a cheap, simple tool, and you can send your patients home with it. And it’s quite nice to deal with. And I know I really went through this quickly for you guys. 

So I hope you have a lot of questions. And again, you can re-listen to it, but we’ve come to the end of this whole thing. And, of course, we have our own offer for you all to take advantage of because we love our supplements. And we love how we can change practitioner’s way of thinking as well as change their clinics through a lot of science and research we’ve done as well as. It’s a lot of trial and error. We’ve spent…we did not get into the ketosis and diet variation, or intermittent fasting world until it became a metabolic flexibility. I was not interested in just a single diet like ketones, or Atkins or anything else for that matter. 

But as soon as people started to understand that we could be more dynamic, and we would do something called metabolic flexibility, that’s when we as a company said, “You know, that is something we can get behind, because it addresses full health needs, it addresses already important circadian rhythms we go through from day-to-day, month-to-month, year-to-year. It handles our diet, it pushes you to be more flexible, it pushes you to be in ketosis some days and be in glucose just like other days. You know, burning your glycogen is burning sugar, burning carbs. It doesn’t hurt the microbiome when we do these kinds of variations. 

And it matches the way our genetics work, or genetics is we have certain foods available to us right now, in the fall, we’ll have different foods available to us. In the winter, we have other foods available to us. It drives these rhythms that we can get behind. And that’s when it’s successful. And that’s when it’s sustainable. So that really, is how we tie up everything in our world and why we love this new metabolic flexibility and the supplements that drive the health of the cell and the health of the liver during any of these processes. And that’s really where we find our strengths right now. That being said, I bring it to a close and hopefully you guys have some questions, and I appreciate your time.

Rick: Thank you, Dr. Morris. This has been great, extremely informative. We’ve been collecting some questions from our audience. And we’d like to get to a few of them now. First off, a doctor asked, “Do ketones replace carbs in this process?”

Dr. Morris: Yes, great question. So they do. When you find yourself in full ketosis, so that means that you’re no longer eating carbs, you’re eating just fats and proteins, and even lower protein, by the way, because some proteins can be converted into sugar, but when you do find yourself in ketosis, so we call it physiologic ketosis, where you’re not supplementing, but you’re actually in ketosis through systemically, through your body, that you burn, you’re just burning ketones. Everywhere, you’re burning them in the muscle, you’re burning into the brain, you’re burning in the heart, you’re almost strictly burning ketones. There is a caveat to that. You’re always producing a low level of sugar through the gluconeogenesis for critical tissues that rely on sugar. 

So you’re not…there’s never a time where you’re only burning ketones, but there are parts of your body that still remain and produce sugars. But the vast majority of your tissues when you’re in ketosis are burning ketones. When you’re doing supplemental ketones, you can be supplementing ketones and not being ketosis, and you’re going to be burning both ketones and sugar during those periods. You’re going to be burning both carbs and ketones in that period of time. And there used to be a fear that that’s very confusing for the body. 

So early research, you know, we were thinking, “Okay, if you’re going to supplement ketones, but you’re not in ketosis, are you going to confuse the body because now you’re burning sugars and ketones?” Turns out, current research shows that’s not confusing to your body, your body knows what to do, and you can burn them both. And there’s benefits in those stages, and there’s also benefits in being in full ketosis. And there’s benefits and being in and out of ketosis. You know, there is benefits all the way along the spectrum.

Rick: Thank you. Appreciate that. And another question from doctor, “Are ketogenic diets all beneficial? There’s a number of diets, which one is different and how do they differ?”

Dr. Morris: That’s another great question. In fact, I should have hit on that. No, they’re not all created equal. In fact, when you’re doing a ketogenic diet, you need to be super considerate of your fat intake. It needs to be healthy, clean plant fats, and animal fats. Meaning that you can’t just consume the high trans-fat, the high, you know, the very well processed fats, that’s a big no, no. Good clean plant and animal fats from good clean sources, grass-fed beef fat, if you can, pour sign, you know, grass-fed grass finished, and the plant fats should be as organic as you can get them. If you get them locally at your local markets and things where you have some history with the local farmers, that’s even better. That has to be good clean fats.

People think, “Okay, I’m just going to eat all these fats and all this crappy protein and I’m going to be in ketosis.” You will get into ketosis, but it’s highly toxic, which means you’ve just stressed the liver beyond and those people are finding, they’re crashing, they’re hitting all these walls, they’re hitting all these problems, their hormones are taking a dive, especially with women, you know, having all these all these terrible outcomes, symptomatically. Clean fats, clean proteins, and when you introduce carbs, and when you’re coming back into your feast cycle, do a ton of clean, clean foods coming out. Turn to clean vegetables and so on, so that you can come out in a clean way as well. Because remember, these diets, these ketosis, they’re driving a lot of detoxification, especially if you’re in autophagy as well. You got a lot of stuff circulating your blood that you need to get rid of carefully. So the cleaner, the better, the dirty fat and protein diets, it’s horrible. Yeah, good clean eating.

Rick: That’s great. Thank you. And another question. What are exogenous ketones, and do those come from all products or come from the outside?

Dr. Morris: So exogenous ketones are ketones that we can now…that are now manufactured, and they’re just made from, as you can see, they’re just made from small chain fatty acids. And the most common being the beta-hydroxybutyrate. So your body makes them when you’re in ketosis, but we can now buy them as a supplement. So you can take an exogenous ketone, and we have one, and you can supplement your diet. It takes about, you know, you eat about 10 grams a day to replace a meal, or to push ketosis when you’re trying to either get in or when you’re fasting. You can supplement ketones when you’re fasting, and it doesn’t change the fast. If you supplement a carb while you’re fasting, it changes the dynamic of the fast. The ketones don’t. Ketones support a fast because while you’re fasting, you naturally get into ketosis. 

That’s they go hand in hand. So you can take exogenous ketones, I oftentimes take them while I’m fasting because they help they help my satiety, and they don’t inhibit my fasting. They maintain my fast protocol. And furthermore, they can also help push you into autophagy if you stay in your fast long enough. But they’re kind of combined, and there…and again, check the quality. I’ve tested over 20 different ketone manufacturers and they don’t all come with the same quality. So make sure you when you buy ketones, that you buy the quality ketones, because they don’t all come with the same quality. They’re not all manufactured by the same kind of companies. But they’re exogenous, so you can use them as a dietary supplement in certain ways. Meal replacements boost your energy during a fast, etc.

Rick: Thank you. And one final question. And you’ve touched on this already with the exogenous ketones, but how do you get endogenous ketones versus exogenous.

Dr. Morris: Endogenous only come from restricting your diet to a high fat, low protein, zero carb or essentially no carb diet. When you stay on a diet that is almost 70% fat, at least 70% fat, 20/20 to, or less percent protein, and then, of course, less than 10% carb, your body has to start what’s called fat adaptation, meaning that you’re no longer feeding on carbohydrates. And as soon as the liver glycogen is gone, which takes, you know, least 14, 15, 16 hours for some people. Once you deplete the liver stores of sugar, etc. you now, can start burning fat as the primary fuel source and your primary fat fuel source are ketones. Those are called endogenous ketones. You’ve triggered your metabolism into doing that. Exogenous ketones, of course, the supplements you can buy and add to your dietary intake.

Rick: That’s great. Thank you very much. And for those of you that want to take advantage of this offer you see on your screen, if you have a pen or pencil, I’m going to give you the number to call at 800-445-4647 extension 120. And again, that’s 800-445-4647 extension 120. And at this time, I’d like to thank our sponsor Systemic Formulas and Dr. Shayne Morris, for today’s webinar, and thank everyone for attending. Remember this webinar including our speakers, PowerPoint presentation has been recorded, and we will alert you when the webinar is available online. Thank you again for attending and we look forward to seeing you next time. Have a great day.

Dr. Morris: Fantastic. Thank you.