Ketones & 72-Hour Fast
– My Cancer Journey –
 

Dr. Al Danenberg Nutritional Periodontist

April 11, 2021

BioSense Ketone Breath Monitor

I completed my first 48-hour, water-only fast on 3/8/21 and reported my results on my Website. In that Blog, I wrote about the benefits of fasting, cited several medical articles, suggested those who shouldn’t fast, and described my personal experience. Since I had great success, I’m making “fasting” a regular addition to my Unconventional Cancer Protocols. I want to emphasize that this is a “water-only fast” with no caloric intake.

But I am extending the fast to 72-hours. The reason: There is greater potential for autophagy to occur and for the repair of dysfunctional mitochondria and damaged immune system cells during the extended fast.

In this article, I’ll summarize:

  1. The benefits of extended fasting,
  2. My way of eating,
  3. 8 phases of a 72-hour water-only fast,
  4. My 72-hour water-only fast, and
  5. My overall experience

 

1) Summary of Benefits of Extended Fasting

  • Improved memory
  • Better concentration
  • Reduced inflammation
  • Lower blood pressure and heart rate
  • Decreased atherosclerosis
  • Cancer prevention
  • Enhanced insulin sensitivity
  • Increased fat-burning
  • Decreased hunger
  • Anti-aging effects
  • Activation of cellular cleanup (autophagy)
  • Regeneration of weakened mitochondria and immune system cells
  • Decreased nutrient supply to cancer cells, thereby inhibiting the cancer cells’ rapid growth

 

2) My Way of Eating

As you may know, I primarily eat an animal-based diet along with a few selected fruits and vegetables. This way of eating keeps me in ketosis for 6 days. Then I increase my healthy carbs and cycle out of ketosis for one day. The next day I start another 6 days of ketosis. This is my method to keep my body metabolically flexible.

The human species basically existed “in” and “out” of ketosis throughout evolution. Our Paleolithic ancestors most likely ate once or twice a day. However, they often skipped eating for days when food was scarce. Skipping meals and not eating for multiple days are also typical for most animals living in the wild. As a matter of fact, ketosis is prevalent throughout the entire animal kingdom.

In addition, when animals in the wild get sick, they stop eating, enter a state of ketosis, and focus on resting. This primal instinct reduces stress on their internal system and enhances their immune system to fight infection.

 

3) 8 Phases of a 72-Hour Water-Only Fast

Basically, there are 8 phases that occur as you progress through a 72-hour fast. Each one ushers in a biological change in the body. However, there are many factors that influence the timing of these phases. Here is an approximation of the timeline:

  1. Your body must be prepared for this extended fast. I am prepared because I eat in a way that keeps me metabolically flexible. If you tried to do a fast and still ate an unhealthy Standard American Diet, you would not do well.
  2. Around the 12-hour mark, your body begins breaking down fat cells, releasing 3 fatty acids and 1 glycerol molecule (which the liver converts to glucose).
  3. After approximately 18-hours, your liver glycogen stores become depleted, and your liver begins to create ketones.
  4. At the 24-hour mark, your individual cells begin recycling its old components and breaking down damaged proteins. This cellular cleansing is called autophagy.
  5. About 48-hours after the start of your fast, your growth hormone level increases up to five times higher than it was at the beginning of your fast.
  6. At the 54-hour mark, your insulin levels drop to its lowest level from the start of your fast. The result is that your body is becoming increasingly insulin sensitive.
  7. By the 72-hour mark, your body has been breaking down old immune cells and dysfunctional mitochondria and regenerating new ones.
  8. At the completion of the 72-hour water-only fast, you need to begin refeeding your body gently. Remember, your gut has not been digesting food for 3 days. Don’t stuff yourself!

 

4) My 72-Hour Water-Only Fast

Let me describe how I integrate my fasting with my overall eating style.

I start my 72-hour water-only fast after I end a carb cycle day. In that way, I totally switch my metabolism away from using ingested carbs as a fuel source. Once my ingested carbs and liver glycogen are becoming used up, my body begins actively breaking down fat cells. Finally, my liver starts producing significant levels of ketones.

All during the fast, I’ll drink mineral water or caffeine-free herbal teas steeped in mineral water. First thing each morning, I drink 8 ounces of SOLE water on an empty stomach. SOLE helps hydration and provides 84 trace minerals. Also, during each day of the fast, I eat a little Himalayan or Redmond salt to make sure I am getting enough minerals, especially sodium. During ketosis, the human body may need as much as 6-10 grams of healthy salt daily since insulin levels are so low. SOLE in the morning provides about 0.5 grams of sodium.

I’m very geeky, and it is important for me to know my ketone levels as I progress from burning carbs to producing ketones by my liver. I use the Ketone Breath Monitor from BioSense. It is quick, easy to use, and has been proven to be clinically reliable. The data from the Ketone Breath Monitor are uploaded and stored on the company’s App on my iPhone.

I took 4 screenshots of my fasting days from this App, which I will explain in detail shortly. The 4/1/21 screenshot shows that my ketone levels dropped to “0” ACEs after my last carb meal when I began the fast. “0” means that my body is not producing ketones and is burning only glucose as fuel.  Then, the 4/3/21 screenshot shows that my ketone level slowly rose to “28” ACEs by the end of the fast. “28” means that my liver primarily is producing large amounts of ketones for fuel. (ACEs are BioSense’s scoring system for breath ketones. Essentially, if you divide ACEs by 10, you will get an approximation of blood ketones, which are reported in mmol/L units. For example, a score of “28 ACES” is equal to a “ketone blood level of 2.8 mmol/L”.)

The following Table explains the interpretation of ketone levels measured in ACEs.

 

Below are the 4 Ketone Graphs from the BioSense App on my iPhone for each of the days of my fast. In total, these graphs tell the story of depleting my glycogen stores, entering ketosis, and maintaining a high level of ketosis for the duration of my 72-hour, water-only fast.

 

 

 

 

 

 

 

I started the fast on 3/31/21 at 5 PM. The Ketone reading was “6”. It is important for me to point out that the readings on the breath monitor (measured in ACEs) lag the actual blood ketone levels (measured in mmol/L) by approximately 1-2 hours.

Around 9 AM on 4/1/21, my ACEs were at “0”. I assume this is when my carbs and glycogen stores were becoming depleted. After 9 AM, my ketone levels began to rise slowly. I probably was in ketosis and my liver was producing ketones by 9 PM as my ACEs started to rise above “5”.

On 4/2/21, I saw a steady rise in ketosis as my ACEs continued to rise to a high of “18”.

On the last day of my 72-hour fast, 4/3/21, you can see that I was in full blown ketosis with my ACEs as high as “28” at 4:30 PM. I ended my fast at 5 PM.

 

5) My Overall Experience

In the evening on Wednesday, 3/31/21, I ate my last carb meal at 5 PM. As usual, I felt fine and went to bed around 9:30 PM.

As I began my first full day of fasting on Thursday, 4/1/21, I felt great with slight hunger. But by 4PM, I felt very hungry. Drinking some hot caffeine-free tea took the hunger away.

On Friday, 4/2/21, I had some stomach rumbling, but no real hunger any longer and no discomfort.

On Saturday, 4/3/21, there was no desire to eat. I felt tremendous energy and clarity. The slight physical discomfort I usually experience because of my past pathological fractures was not present. I probably could have continued fasting at least another day or more. But I didn’t.

All during the fast, I had no problem with bowel movements.

Compared to my 48-hour fast last month, this was far better because of the enhanced energy and clarity by the 3rd day of the fast. And I believe my body is able to repair better on the 72-hour fast. As I said, I will continue with a 72-hour water-only fast regularly and reap the medical benefits as they have been reported in many professional journals.

 

 

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5 Important Tools
for a
Robust Immune System

Dr. Al Danenberg Nutritional Periodontist

December 13, 2020

 

Image by Bruno /Germany from Pixabay

I’m obsessed with getting it right.

From all the research I’ve read and from my personal cancer journey, there is one fact that stands out above all: A robust immune system is critical for wellness.

It’s vital for healthy people; it’s vital for sick people; it’s vital for all who want to be proactive as well as those who are reactive.

A robust immune system is the ticket for fighting diseases arising from external and internal sources. It protects us from pathogens as well as our own cells which become cancerous.

I’m fixated on recreating my robust immune system and evaluating my success along the way. And I’ve assembled a toolbox – my biological measuring tools. It includes 5 biomarkers which tell me what I need to know. I’ve used these measurements to guide me on my journey to a healthier immune system.

You also can use these tools to assess your progress and success.

5 Important Tools

#1. Healthy Gum Tissue

Your mouth can tell a lot about the health of your immune system. One prominent sign is the gum tissue around your teeth. It should never bleed unless it is cut. Never!

If you were to scrub your nails with a nail brush, you should be concerned if the cuticles around your nails started bleeding. Similarly, when you brush your teeth with a toothbrush, you should be concerned if you see any bleeding. The gums are as tough and protective as are your cuticles.

However, if you have a compromised immune system, the gum tissues may become inflamed or infected (i.e., gingivitis). They then may bleed when you clean or rub them. They even may bleed spontaneously. This is a strong indication that your immune system is not functioning ideally.

An excellent method to determine if you have bleeding gums around any tooth is to use a TePe Easy Pick. This is a small, silicone brush used to clean between the teeth at the gum line.

If you see any bleeding when using the TePe Easy Pick around any tooth/gum area in your mouth, you have some form of gum disease. This suggests that you have a compromised immune system.

Here are two pictures demonstrating how to use the TePe Easy Pick between teeth at the gum/tooth margin.

 

#2. Ketone Breath Meter

Metabolic flexibility is necessary to support a responsive immune system. And ketosis is part of being metabolically flexible.

I want to be in ketosis 6 days a week and then cycle into a carb-burning mode on the 7th day. The benefits of ketosis and carb-cycling are documented in the medical literature. Travis Christofferson summarized the unique qualities of ketones in his book, Ketones: The Fourth Fuel.

To help me gauge my ketone levels and document how well I’m doing, I researched three options.

  1. Urine ketone strips are easy and inexpensive. But they are not accurate once your body begins to utilize its blood ketones efficiently and effectively.
  2. Blood ketone levels can be monitored with finger sticks using a blood ketone meter. The readings are accurate, but I would need to prick my finger several times a day, every day. Not for me! I don’t know about you, but it hurts when done repeatedly. Another drawback is that it only gives a static picture at that moment in time.
  3. A ketone breath meter recently came on the market that has clinical research to support its efficacy. It’s was created and is sold by MyBiosense. This meter is unique because it registers acetone levels that are blown out in the latter part of the exhale, which is called Deep Lung Sampling. The readings correlate to the mmol/L of blood ketone levels. Using this device, I can monitor my ketone levels as often as I want with no finger sticks! And the data is stored in the MyBiosense App on my phone for me to review.

My goal is to average a ketone level between 1.5 – 2.5 mmol/L per day while in ketosis. On my “carb” day, my ketone levels will drop below 0.5 mmol/L that day.

#3. Standard Deviation of Glycemic Variability

Glycemic variability is the up and down variations in blood glucose level. It indicates the efficiency of insulin to make glucose available as a fuel or to store it appropriately. If insulin is not effective, glucose levels will get out of control leading to diabetes and various forms of metabolic dysfunction.

Various medical papers have shown that the standard deviation of glycemic variability directly correlates with the risk of chronic disease and cancer. It is inversely correlated with the robustness of the immune system.

I want my glycemic variability to be as low as practical.

I could take finger sticks frequently using a glucometer to register my moment-in-time blood glucose level. But that would not give me a running graph 24/7. It certainly would leave me with painful fingertips. I prefer not.

However, a continuous glucose monitor (CGM) by NutriSense is a device that is worn for two continuous weeks. The CGM inserts a microfiber into the interstitial tissues and attaches to an inconspicuous area of the body with an adhesive. It is painless to insert and wear. But it registers glucose levels every 5 minutes, 24/7. The data is transferred to a NutriSense App, which calculates the standard deviation.

#4. Alpha Diversity of Gut Microbiome

The gut microbiome is made up of about 38 trillion microbes. Our body only has about 30 trillion human cells. We are more “microbial” than “human”!

Many studies have been published describing the variety of species in the gut. These medical papers clearly demonstrate that the greater the diversity and numbers of specific microbes, the healthier the immune system. [1],[2],[3]

A measurement including (1) the diversity of various microbial species in the gut and (2) the number of each of these species is called “Alpha Diversity”. It is generally reported as a percentile compared to the microbial ecosystem in a population of metabolically healthy individuals.

BiomeFx is a stool test marketed by Microbiome Labs and evaluated by CosmosID. Among the many biomarkers reported in this test, Alpha Diversity stands out to me as one of the most significant results.

#5. Blood Level of Vitamin D

Recently, blood levels of Vitamin D have been widely reported as important in the fight against the COVID-19 virus.[4] Previous to the Pandemic, much research has been published emphasizing the importance of adequate levels of Vitamin D to assure a robust innate and adaptive immune function.[5], [6],[7],[8]

Vitamin D is reported to …

  • Prevent excessive expression of inflammatory cytokines
  • Increase the “oxidative burst” potential of macrophages
  • Stimulate the expression of potent anti-microbial peptides, which exist in neutrophils, monocytes, natural killer cells, and in epithelial cells lining the respiratory tract where they play a major role in protecting the lung from infection
  • Affect the action of T cells, key players in adaptive immunity

My Personal Results

#1. Healthy Gum Tissues:

My gums do not bleed. I use the TePe Easy Picks every day.

If you have bleeding gums, you need to address your diet, the health of your gut microbiome, and your oral hygiene techniques. You also need to seek the services of a general dentist or a periodontist (a dentist specializing in periodontal disease).

#2. Ketones:

I stay in ketosis with my animal-based diet 6 days a week. My highest mmol/L while in ketosis has been 2.8; the lowest on those days has been 0.5. My average for 6 days running is 1.5. On my cycle day out of ketosis, I eat between 100 – 150 grams of carbs for that day, and my ketone reading drops to an average of 0.3.

#3. Glycemic Variability:

In July 2020, I wore the CGM from NutriSense for two weeks. My average standard deviation of glycemic variability for that time period was 10. Here is a table showing ranges and their interpretations:

 

#4. Alpha Diversity:

My Alpha Diversity was reported in the BiomeFx stool test I took in August 2020. The results indicated my Alpha Diversity was in the 98th percentile. That meant that 98% of metabolically healthy individuals had less variation of species and numbers of individual microbes than I had.

 

#5. 25 Hydroxy Vitamin D:

My last blood test for 25 Hydroxy Vitamin D was in 6/2020. At that time, my blood level was 89 ng/mL. and I was taking 5,000 IU of Vitamin D3 daily. I have reduced that dosage to every other day, and I’ll have another test shortly. As a cancer patient, I want to keep my Vitamin D level between 60-80 ng/mL.

Bottom Line

A robust immune system is our internal armed forces to fight the fight. My ultimate goal is to make my immune system as robust as I can. The 5 important tools I described will guide me along my path and document my success. They also will confirm that I am remaining where I want to be.

I firmly believe that my cancer journey has been as successful as it has because I have significantly improved my immune system along the way. You may find that my 5 Important Tools will help you monitor your journey to a stronger and more responsive immune system.

 

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906406/

[2] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200728

[3] https://www.frontiersin.org/articles/10.3389/fmicb.2016.00455/full

[4] https://articles.mercola.com/sites/articles/archive/2020/12/11/do-vitamin-d-supplements-help-prevent-respiratory-tract-infections.aspx?ui=baff764f733a1f4f602b56b0683839cc74ea77293ab586e40b1b7b0b93d42111&cid_source=dnl&cid_medium=email&cid_content=art1HL&cid=20201211&mid=DM744365&rid=1032114513

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166406/

[6] https://health.ucsd.edu/news/releases/pages/2018-06-15-greater-levels-of-vitamin-d-associated-with-decreased-risk-of-breast-cancer.aspx

[7] https://www.mdpi.com/2072-6643/12/4/1140

[8] https://www.mdpi.com/2072-6643/12/5/1248

 

 

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Why I Eat Carnivore?
– Ketones & Metabolic Flexibility –

Dr. Al Danenberg Nutritional Periodontist

September 13, 2020

 

Carnivore Diet Foods

 

I Eat a Carnivore Diet Because:

  • I have cancer
     
  • It reduces dietary carbohydrates to minimal levels and allows my body to enter ketosis and become metabolically flexible
     
  • When I am in ketosis, my body uses ketones as a clean burning fuel with less production of free radicals and less dependence on insulin
     
  • Restricting glucose prevents growth of some cancer cells[1]
     
  • Most cancer cells are unable to effectively use ketones for energy[2],[3]
     
  • By keeping carbs and insulin low, I improve my natural antioxidant capacity and reduce the fluctuations in my blood glucose levels (i.e. glycemic variability)
     
  • A low glycemic variability is a biomarker for improved function of the immune system[4]
     
  • A robust immune system can help my body heal from cancer

 

My Carnivore Diet

If you have been following my cancer journey since I was diagnosed in September 2018, you know that my diet has played a key role in my health. Diet is one of the critical elements in my Unconventional Cancer Protocols.

 

I started a Paleo-type diet about 6 years before I was diagnosed in September 2018. My Paleo style of eating allowed me to become fat adapted. When I was diagnosed with IgA Kappa Light Chain Multiple Myeloma, I changed my Paleo-type diet to a modified Paleo Autoimmune Diet. Basically, I eliminated pasteurized dairy, nightshades, nuts and seeds from my way of eating. But after doing some additional due diligence, I tweaked my diet on 1/1/20 to start a strict Carnivore Diet. At that time, I eliminated all plants. The reason was abundantly clear to me after doing my research.

 

As I documented in my Blog in January, individual case reports of a strict animal-based diet showed profound beneficial effects for cancer patients. Specifically, the Paleomedicina Medical Clinic[5] in Budapest, Hungary identified that ketosis along with an intact gut epithelial barrier were vital factors in resolving or reducing the progression of many malignances.

 

 

Ketosis & Ketones

My body went into ketosis about two weeks after I reduced my carbohydrate level to less than 10 grams a day. I also increased my fat-to-protein ratio to 2:l measured in grams.

 

The science reported by the Paleomedicina Clinic and by Dr. Paul Saladino[6] proved that the Carnivore Diet provided all the nutrients my body required in a biologically available form. In addition, this animal-based way of eating eliminated all plants that contained antinutrients. Antinutrients are substances that might damage my gut microbiome, the mucus layer in my gut, and the epithelial barrier that prevents toxic substances from entering the circulatory system from the gut lumen. These include phytates, lectins, and oxalates.

 

With carbohydrates at extremely low levels, fat levels high, and protein levels moderate, my insulin levels remained low. Low insulin tells fat cells to breakdown triglycerides, which are the stored body fat. Triglycerides are broken down in the fat cells into fatty acids and glycerol, both of which then enter the circulation. The free fatty acids bind to serum albumin in the blood stream, which carries the free fatty acids to the tissues that need energy. Glycerol is absorbed by the liver, where it is converted into glucose.

 

With insulin levels low, fatty acids are converted in the liver into ketones (called acetoacetate and later beta-hydroxybutyrate). Ketones are released into the bloodstream and are a preferred and efficient fuel for cells to burn. In addition, ketones can cross the blood-brain barrier and are available as fuel for the brain.

 

 

Cycling In & Out Of Ketosis

My goal is to maintain metabolic flexibility. Metabolic flexibility is when the body can switch back and forth between burning fat or carbohydrates as fuel based on their availability. By being metabolically flexible, I rarely have any food cravings. I eat when I’m hungry, and I drink when I’m thirsty.

 

I practice intermittent fasting along with cycling in and out of ketosis to improve my metabolic flexibility. Cycling gets my body used to using the fuel that’s available.

 

To maintain metabolic flexibility, I cycle about every 7 days. I decrease the amount of fat I eat and increase my carbohydrate intake to about 100 -150 grams once a week. To do this, I eat plants that are low in phytates, oxalates, and lectins as well as some raw honey during the course of a day. The benefit of cycling out of ketosis about once a week is to stimulate my insulin production to activate pathways to repair my body.[7]

 

 

Ketosis and Antioxidant Efficiency[8]

Beta-hydroxybutyrate, the most studied ketone body, has been shown to reduce the excessive production of free radicals. It also improves the creation of energy in the mitochondria of the cells in the body. In addition, ketones stimulate our own cell’s ability to produce endogenous antioxidants.

 

 

Immune System and Cancer[9]

The immune system protects the body against bacteria, viruses, parasites, and toxins. It also fights disease-causing changes in the body, such as cancer cells. So, a robust immune system is critical for health and healing.  However, cancer can weaken the immune system, and conventional cancer treatment can weaken the immune system further.

 

Cancer can weaken the immune system by creating systemic inflammation and by spreading into the bone marrow. Since bone marrow makes blood cells for the immune system, a malignancy spreading into the bone marrow will decrease the production of healthy blood cells.

 

Specific cancer treatments also can weaken the immune system by decreasing the number of white blood cells made in the bone marrow. Some of the cancer treatments that will weaken the immune system are:

 

  • Chemotherapy
  • Targeted cancer drugs
  • Radiation therapy
  • High dose steroids

 

If possible, someone with cancer should do everything in his or her power to improve the immune system. A robust immune system has the ability to recognize cancer cells as abnormal and kill them.

 

 

Glycemic Variability as a Biomarker

I wrote two Blogs where I described the benefits of monitoring my glycemic variability (GV) over a 2-week span (HERE, HERE). The data collected through the use of a continuous glucose monitor (CGM) will provide a record of the fluctuations of tissue glucose 24/7. The GV can suggest the robustness of your immune system and your future risk for metabolic and chronic diseases. The statistical measurement of the fluctuation of glucose levels is called the standard deviation (SD). The SD of GV is a relatively new biomarker. It may be one of the most important biomarkers that a proactive individual should know. If the SD were not in a healthy range, the individual could take steps to improve his or her diet and other environmental factors that could improve glycemic variability, thereby improving the immune system.

 

Here is a table that suggests an interpretation of the SD of GV[10],[11]:

 

Standard Deviation of Glycemic Variability

 

My Bottom Line

My Carnivore Diet is one of my Unconventional Cancer Protocols. It has been a significant factor for me to improve my immune system to help my body heal from cancer.

 

 

[1] https://www.cell.com/cell-reports/fulltext/S2211-1247(19)30924-6?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211124719309246%3Fshowall%3Dtrue

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235292/

[3] https://cancerandmetabolism.biomedcentral.com/articles/10.1186/s40170-018-0180-9

[4] https://cardiab.biomedcentral.com/articles/10.1186/s12933-020-01085-6

[5] https://paleomedicina.com/en/#blog

[6] https://carnivoremd.com/podcast/

[7] https://www.ncbi.nlm.nih.gov/books/NBK525983/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5981249/#sec5-antioxidants-07-00063title

[9] https://www.cancerresearchuk.org/about-cancer/what-is-cancer/body-systems-and-cancer/the-immune-system-and-cancer

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455369/#!po=34.6154

[11] https://diabetes.diabetesjournals.org/content/67/Supplement_1/1542-P

 

 

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