Preventive and Treatment Strategies for COVID-19: Part 2

Part 1 of this series can be found here

Keep Fighting Fit

It’s only common sense to keep our bodies as healthy as we can to help us to fight off all kinds of illnesses. Obviously, we’re always going to encounter germs in our daily lives but keeping our immune systems in good condition is an excellent defense strategy. 

Follow these steps: 

  • Get enough sleep, ideally seven or eight hours each night. 
  • Try to reduce stress where you can in your life. 
  • Make sure you’re on a diet that contains plenty of plant-based antioxidants, minerals and vitamins and eat healthy food to keep your body and immune system in good shape. 
  • Make sure that you always get enough exercise whenever you can to keep everything in working order. 
  • Stop consuming all sugar
  • Stop smoking or vaping immediately. 

Wear Mask Protection

Get some N95 facemasks before supplies are gone. 

  • An N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles.
  • The ‘N95’ designation means that when subjected to careful testing, the respirator blocks at least 95% of very small (0.3 micron) test particles. If properly fitted, the filtration capabilities of N95 respirators exceed those of facemasks. However, even a properly fitted N95 respirator doesn’t completely eliminate the risk of illness or death.

N95 respirators aren’t designed for children or people with facial hair. Because a proper fit cannot be achieved on children and people with facial hair, the N95 respirator may not provide full protection.

A full list of FDA approved respirators is provided below. These might already be out of stock everywhere but put orders in regardless of the backorder. 

  • 3M™ Particulate Respirator 8612F
  • Pasture Tm F550G Respirator
  • Pasture Tm A520G Respirator

Wear Eye Protection

Transmission through the eye is a common vector for the aerosolized virus. One of the common transmissions is touching public items then touching your face and transmitting it through the eye. Frequent hand washing and excellent hygiene are paramount.

Drug treatments

General

It’s important to be aware that there are at present no antiviral treatments that are effective for the treatment of Covid-19. There are currently no vaccines available for SARS-CoV-2. The present treatment approach is for supportive care and symptom management only. If people become severely ill, vital organ function support is necessary, usually in a hospital or ICU setting. 

Here’s a link to the number of drugs that as of February 2020 were being studied for the treatment of Covid 19.

The CDC also has a site discussing antiviral medications for the flu here

Chloroquine Phosphate

A Chinese multicenter collaboration group suggested this malaria drug might be useful for the treatment of Covid-19 pneumonia. In another recently published paper, the use of hydroxychloroquine, 400 mg twice daily followed by a maintenance dose of 200mg twice daily for four days, was found to be more potent than chloroquine to inhibit SARS-CoV2. Hydroxychloroquine was also shown to have fewer side effects than chloroquine while still addressing the inflammatory cytokine storm induced by the virus. 

The recommended dose of chloroquine phosphate was 500mg twice daily for ten days. 

Alinia (Nitazoxanide)

This drug is traditionally is used as an antiparasitic and has been studied for the treatment of Middle East Respiratory Syndrome (MERS) coronavirus. This drug has been shown, in test tube studies at least, to have activity against MERS-CoV and other coronaviruses. Further studies are being undertaken to determine its true efficacy. The recommended dose was 1000mg twice daily for 10 days.

HIV Drug - Kaletra (lopinavir-ritonavir)

A 62-year-old man who became Spain’s first coronavirus patient is believed to have made a full recovery after being treated with an HIV drug called Kaletra or lopinavir-ritonavir. Miguel Ángel Benítez was admitted to the Virgen del Rocio Hospital in Seville, where he received an antiretroviral drug, which has been used to treat HIV and AIDS for over ten years. The drug was combined with interferon beta, which is a protein that prevents cells from becoming infected and is administered to multiple sclerosis patients. Santiago Moreno, head of infectious diseases at the Ramón y Cajal hospital in Madrid, said that the “SARS-CoV-2 protease is very similar to that of HIV,” using a name that sometimes refers to the novel coronavirus.

Mast Cell Activation Syndrome (MCAS

In this February 2020 article it was discussed that “Coronavirus infection (regardless of the various types of corona virus) is primarily attacked by immune cells including mast cells (MCs), which are located in the submucosa of the respiratory tract and in the nasal cavity and represent a barrier of protection against microorganisms. Virus activate MCs which release early inflammatory chemical compounds including histamine and protease; while late activation provokes the generation of pro-inflammatory IL-1 family members including IL-1 and IL-33.” The article proposes for the first time that inflammation by coronavirus may be inhibited by anti-inflammatory cytokines belonging to the IL-1 family members. 

It may be that individuals with MCAS are at higher risk for developing the serious consequences of this infection and thus may benefit from much stricter control of the mast cell activation syndrome if infected. Nebulized cromolyn and/or glutathione or n-acetyl cysteine (NAC) and/or IV Benadryl may be extremely helpful in these conditions.

Alternative Remedies

In addition to the previous suggestions, there are a number of natural substances and supplements that can be of help in lowering your risk of becoming infected with the current coronavirus. Many of these approaches are not specific treatments for the coronavirus but have been studied and referenced in the literature as having antiviral effects.

Vitamin C

It’s common knowledge that vitamin C is good for us but there have been clinical trials in China regarding the intravenous use of vitamin C to help treat patients suffering from Covid-19. A dose of between 100 and 200 mg/kg body weight (this is equal to quite a low dose of between 7.5 and 15 grams for a 180 lb person) was given to patients intravenously for three consecutive days and was very effective. There are currently three clinical trials sponsored by the Chinese government studying vitamin C. Dr. Tom Levy and Dr. Jeanne Drisko from the integrative U.S. medical community are involved in the Chinese studies. Dr. Richard Cheng MD PhD, who has been studying IV vitamin C, is suggesting the use of oral vitamin C.  The one study can be found at the clinicaltrial.gov website. High dose vitamin C at 20 grams has been used in ICUs for some time in an attempt to reduce mortality from septic shock, in one study from 40% to 4%. However, most hospitals refuse to administer IV vitamin C for viral infections since it’s not considered standard of care. It’s quite likely that these Chinese studies will place high dose IV vitamin C therapy for viral infections a part of mainstream treatment in the future.   

In the United States, doctors who have pioneered vitamin and mineral therapies have also been studying the effects of intravenous vitamin C, with a February 2020 paper being published. “Early Large Dose Intravenous Vitamin C is the Treatment of Choice for 2019-nCov Infected Pneumonia” recommends this for the treatment for pneumonia resulting from the virus. 

A recommended minimum oral daily dose of vitamin C is 2,000mg. Twice daily dosing is recommended due to the water-soluble nature of vitamin C and the fact that it’s quickly metabolized. If one wants a liposomal formulation, certain brands do provide this option or you can make your own by adding https://klinghardtinstitute.com/one or two teaspoons of Body Bio PC (phosphatidyl choline) to 2 grams of powdered vitamin C and stirring it vigorously. Divide your dose and take twice daily. Watch for diarrhea if your dose is excessive.

Vitamin D

This is also very important. It’s recommended that we have a minimum of 2,000 IU and a maximum of 10,000 IU per day. The usual daily dosage for vitamin D is 1000 IU per 25 pounds of body weight. It’s best to get vitamin D levels measured and to have serum levels in Canada between 150 and 200 nmol/l. People tend to have lower vitamin D levels in the fall and winter months due to fewer hours of sunlight. However, our bodies need vitamin D to support our immune system so we need to make sure that we’re getting enough of this vital ingredient. All the cells in our bodies have receptor sites but only two types are in every cell. These are thyroid hormone receptor sites, which are responsible for metabolism, and vitamin D receptor sides. This gives you some idea of the importance of vitamin D in maintaining our overall health and wellbeing. Research indicates that vitamin D may even be more effective than the flu vaccine when it comes to flu prevention. Consequently, it’s a good idea to include vitamin D in the fight against Covid-19.

It has been reported by many clinicians that high doses vitamin D of 50,000 IU over three days is highly effective in treating acute viral infections. This dosing is contraindicated in any person with lymphoid malignancies and in any patient with granulomatous diseases such as sarcoidosis, where high calcium levels are an issue. Also, a relative contraindication is pregnancy. This is by no means an approved treatment for Covid 19.   

Zinc 

This has been shown to be effective in fighting infections and also supports the immune system. Zinc can help to prevent coronavirus and other viruses multiplying in the throat and nasopharynx, which is the space above the soft palate at the back of the nose connecting the nose to the mouth and allowing us to breathe through our nose. When you begin to exhibit symptoms of the illness zinc capsules can be taken several times a day. The recommended dose for zinc is between 40 and 50mg per day.

Silver 

This has also has some antibacterial and anti-viral properties. If you use an official product such as Argentyn 23 you have a clear idea of how much silver you are putting into your body and don’t run the risk of taking too much. If you have viral symptoms, the recommended dosage is one teaspoon seven times per day. However, this is only a short-term solution as there are side effects such as skin discoloration if silver is used for too long.

Andrographis 

This herb has been used in traditional Chinese medicine and Ayurveda for a long time. It’s been shown that the herb’s compounds have anti-inflammatory, antiviral, and antioxidant benefits. The herb boosts the immune system and is often employed to fight cold and flu symptoms. As a result it does have a role to play in treating the latest version of coronavirus, at least in the short term. One capsule twice a day is the recommended dose of the herbal supplement if you exhibit symptoms of the virus. There are a number of referenced articles that demonstrate its effectiveness against the influenza virus, particularly with regards to respiratory symptoms. Lyme patients with active disease may have a Herxheimer reaction as it increases lymphocyte proliferation and interleukin -2. 

Elderberry

Another natural short-term solution if you have typical flu symptoms, such as a cough, sneezing, and a runny nose, is elderberry extract taken up to six times a day. Elderberries come from the European elder tree, which is not the same as the American Elder, Elderflower, or Dwarf Elder. People believe the extract helps with the common cold, influenza, boosts the immune system, and reduces inflammation.

Calendula

Is also known as marigold and has been used as a medicinal herb for a very long time. The plant’s extracts have antiviral, antigenotoxic, and anti-inflammatory properties that can be used to treat some of the symptoms of Covid-19. 

Taraxasterol 

Also known as dandelion, this can also be used as an anti-inflammatory supplement. Dandelion also has antioxidant properties and some studies indicate that it has antiviral benefits and is good for our immune system. 

Propolis 

This is known to be a potent antiviral, particularly in animal models infected with corona virus. Dr. Ramzi Asfour, an infectious disease physician, suggests Beekeeper’s Natural propolis spray. Propolis increases cellular immune responses and has antiviral properties. Propolis can also be dispensed in a vaporizer (available from Ki Science) and has been shown to neutralize circulating mycotoxins in the air. 

CAUTION: Propolis is not to be taken if you have a Honey or Bee allergy.

Scutellaria

Most commonly known as skullcap, this is another flowering plant with medicinal qualities. It has been used to treat conditions such as respiratory infections and inflammation and have antibacterial, antiviral, and antioxidant properties. 

Artemisia annua

Also referred to as sweet wormwood this has been used in traditional medicine for some time and has been employed in medicines to treat malaria. There are some indications that the plant may also be used to treat some coronavirus symptoms, particularly the SARS related coronavirus.

Dr. Klinghardt, in his extremely informative PowerPoint presentation, has recommended placing calendula, licorice, scutalaria, andrographis, artemisia, and dandelion tinctures, calculated for their weekly dose, in a blender with 100mls of clean water and 14 grams of vitamin C powder. Add two tablespoons of liquid Body Bio PC phosphatidyl choline and blend for a few minutes. Put this mixture in a glass and keep in the fridge. Each day, drink one seventh of the dose.

Beyond Balance Herb Tinctures- IMN-V-III

This product contains 19 different herbs with antiviral and immune modulating effects, including licorice, skullcap, dandelion, and rosemary.

Peptides

Some patients have access to peptides with immunomodulating effects. I recently returned from a peptide conference in Los Angeles and the following peptides were suggested for their antiviral and immune modulatory effects.         

  • Thymosin alpha 1 - This is the most recommended peptide for immune stimulation. This should be used as a treatment adjuvant and a prophylactic and can help with many conditions beyond viral illness. The recommended daily dose in 450mcg.
  • Thymosin beta 4 - Natural killer cells are essential for defense against tumors and virus-infected cells. The cells are activated in by ONF-Gamma. This is activated by IL-18, which TB4 upregulates. Therefore, TB4 has ben studied for many Immune related diseases. Caution is warranted with cancer patients as it can increase the growth of cancers.
  • LL 37 (cathelicidin) - This peptide has broad spectrum antiviral/microbial, fungal effects. Peptides such as LL 37 are key components of innate defenses against infection, with both microbial and host defense modulatory functions. In addition to their well documented bactericidal potential, CHDP have more recently been shown to have antiviral properties. LL 37 has ben shown to be highly effective in preventing viral attachment to cells. It’s been used in several virus studies and has been anecdotally reported to work well with respiratory tract viruses.
  • Pentosan polysulfate - Polysulfates are highly potent and selective inhibitors of the in vitro replication of HIV and other enveloped viruses such as coronavirus. The anti-viral activity of polysulfates is a result of their shielding of the positively charged sites in the V3 loop of the viral envelope glycoprotein gpl120, which inhibits viral entry into cells and allows for immune clearance. The usual dose is 2mg/kg.
  • Selank - This is a variant of the immune molecule tufstin and has potent antiviral properties in addition to its neurological effects. The antiviral characteristics of Selank were evaluated both in vitro and in vivo against the influenza virus strain H3N2 and H5N1 and the type 1 and 2 Herpes virus. It was revealed that Selank might have a prophylactic effect during influenza infection and a therapeutic effect during a herpes virus infection. It could also be helpful with Covid-19.

The Hoffman Centre Programs for cold and flu treatment

We have developed a number of potential programs for acute cold and flu treatment. While the details aren’t specific to coronavirus many of the recommendations are applicable to dealing with virus that commonly infect us in the winter months. These recommendations are in no way a substitute for quick and rapid communication with your healthcare providers and the guidelines as issued via websites (like this one), previously mentioned at the beginning of this article.

Any treatment that you decide to undertake should start at the first onset of symptoms. The following instructions are to be followed for the duration of symptoms unless otherwise stated. 

Immediately stop consuming any sugar, since this paralyzes your white blood cells, the body’s first defense against illness. Make sure you also get plenty of sleep, at least between 7.5 and 8.5 hours per night. Hot apple cider vinegar baths twice a day will help to speed up the progression of the cold and reduce your fever, potentially halving the amount of time you may have symptoms. Add two cups of apple cider vinegar to a full bath of hot water and soak for twenty minutes, remembering to fully submerge your body. If the illness has affected the chest, you can steam water over the stove, add eucalyptus drops, and breathe in the vapor for some relief from your symptoms.

Please note that this treatment program is not to be undertaken if you are pregnant or breastfeeding.

Adult Dosage (age 16 and up)

Oscillococcinum is the first supplement to take at the first sign of a cold or flu. This works better for flu like symptoms (not cold symptoms) and you simply need to follow the directions on the package.

  • Vitamin D - 50,000 IU for three days. Contraindication to use of high dose vitamin D is lymphoid malignancies, pregnancy, and granulomatous diseases such as sarcoidosis
  • Mycelized vitamin A - 100,000 IU for three days. Contraindicated in pregnancy. 
  • Vitamin C - 1 to 2g two to three times daily (titrate dose upward to bowel tolerance)
  • Astragalus Tincture - 1 dropper three times daily
  • Echinamide Anti-Cold tincture - 2ml three times daily
  • Probiomax probiotic - 1 capsule two times daily 
  • Saccharomyces Boulardii - 2 capsules twice daily
  • Garlic/allicin - 2 capsules three times daily after meals. Open the capsule in 6oz of water and let sit for two minutes before drinking.
  • Argentyn 23 colloidal silver  - 1 teaspoon three times daily in water
  • Andrographis - 2 dropperfuls twice daily in water
  • Transfer Factor Multi Immune - 2 capsules twice daily
  • DHEA - 50mg per day for two to three days will boost the immune system and fight infection. Note that this is for adults only.
  • For muscle aches take arnica and/or magnesium malate - 2 caps three times daily
  • Add anti-viral supplements such as olive leaf extract - 2 capsules three times daily, oil of oregano (brand name ADP) 2 capsules three times per day and lysine 500mg 2 capsules three times daily

IV Treatment for 3 days

  • IV vitamin C - 15 to 35g once per day. Check for G6PG enzyme deficiency first
  • Alternatively - IV Hydrogen Peroxide, once per day

Child Dosage (2 years and older)

    • Mycelized vitamin A – 10,000 IU for three days
    • Vitamin D - 10,000 IU for three days
    • Vitamin C - Between 250 and 500mg three times daily (to bowel tolerance)
    • Echinamide Anti-Cold - Between an third and a half a dropper three times daily 
    • Probiomax probiotic  - Half a capsule twice daily
    • Saccharomyces Boulardii - Half to a full capsule twice daily
    • Garlic - Half to a full capsule twice daily after meals. Open capsule in 6oz of water and let sit for two minutes before drinking. Note that it is difficult to get a child to take this.
    • Argentyn 23 colloidal silver - Half a teaspoon three times daily in water
    • Transfer Factor Multi Immune - 2 capsules daily

Maintenance and Prevention 

Remember to stop consuming any sugar immediately, since sugar paralyzes your white blood cells, which provide your body’s first defense against sickness. Make sure you get at least 7.5 to 8.5 hours of sleep each night as well. This treatment program is not for women that are pregnant or breastfeeding.

Throat Infection

  • Zinc - 30 to 50mg lozenges. The topical antimicrobial effect can be important in infections of the throat.
  • Biocidin throat spray - 2 sprays three to five times daily
  • Propolis throat spray – 5 sprays three times daily
  • Argentyn 23 throat spray- 3 sprays three times per day
  • See your doctor for a throat swab to exclude strep throat and/or mononucleosis

CAUTION: Propolis is not to be taken if you have a Honey or Bee allergy.

Nasal Irrigation

Use a Neti Pot, particular with upper respiratory infection, for three days. 

  • Place one dropper full of Nasya wash into your Neti Pot with warm water and a heaping quarter teaspoon of pure non-ionized Neti Pot Salt. 
  • Stir until salt is dissolved. 
  • Add three drops of Echinacea Anti Cold and Core Phyto Lavage to the solution. Use this to perform the nasal wash as directed by the Neti Pot instructions on the bottle.

Air Spray

  • Add a quarter teaspoon of salt to the bottom of an empty spray bottle. 
  • Add five drops of Thieves, an essential oil by Young Living, on top of the salt as this will help to dissipate it, 
  • Fill bottle with warm water. 

Now you now have an air spray that will assist in lowering counts of viruses, bacteria, and molds in the air. 

  • Spray your home, office, and other areas a couple of times a day. 
  • You can also put Thieves drops into your palms and cup your hands over your face then inhale five or six times. 
  • This will prevent you from contracting a sinus or lung infection, especially during long distance flights.

Dr. Alex Vasquez Recommendations

Dr. Alex Vasquez is an internationally recognized author, presenter, and teacher, particularly with regards to immune related disorders. He earned three doctorate degrees from fully accredited universities in the United States and has worked in various clinical facilities ranging from private boutique clinics to inpatient hospital settings. Dr. Vasquez has published 120 books, articles, letters and editorials in various magazines and peer-reviewed medical journals, including British Medical Journal, Journal of the American Medical Association, Nature Reviews Rheumatology, and Annals of the New York Academy of Sciences.

What follows are his recommendations for viral infections and are not meant to be specific treatments for any infections, particularly coronavirus. I’ve included these references for those curious patients who are always checking out protocols online.  

Antiviral

  • Powdered Glycyrrhiza Glabra - 1.5g BID for a maximum of four weeks. Works as a tea. This is a great expectorant but avoid in heart failure patients, monitor BP and potassium
  • Zinc - Between 20 and 50mg a day
  • Selenium – 400 to 600 ug per day
  • Iodoral Iodine/Iodide - 12.5mg a day for two weeks
  • Melissa officialis - Dose variable depending on formulation
  • Carica papaya leaf extract
  • Grape seed extract (see Biotics Research Bio-Cyanidins below)

Viral Anti-replication

  • SAMe - 400mg TID plus Betaine TMG 3g BID for one week
  • Methyl-Folate - 1.6mg od for one to two weeks
  • Alpha Lipoic Acid - 300 to 400mg TID plus Thiamine 100mg (or B Complex High Potency)
  • NAC - 600mg BID to TID between meals

Immunonutrition

  • Paleo-Mediterranean Diet with no refined carbohydrates 
  • Protectamin Whey Protein - 45g a day for immune dipeptides, if dairy tolerant
  • L-Glutamine powder - 9g TID between meals 
  • Vitamin A - 100,000 IU load for three to five days, then 25,000 to 50,000 IU for two weeks (not during pregnancy)
  • Vitamin D3 - 100,000 to 300,000 IU load for one dose, then 10,000 IU for ten days to increase endogenous antimicrobial peptides
  • Nordic Naturals Arctic Cod Liver Oil without vitamin D - One teaspoon TID with meals
  • Selenium - 600-800mcg/d plus 800 IU vitamin E per day
  • Melatonin - 20mg qHS
  • Ubiquinol CoQ10 - 300mg od to protect the mitochondria
  • Biotics Research KappArest - Three capsules BID as NFKB hijacked by viruses for replication
  • Biotics Research Bio-Cyanidins - One tablet BID (contains marine pine bark and grape seed extract)
  • Biotics Research UltraVir-X - One capsule TID (Red-rooted sage, Boneset, Actratylodes, Sweet Violet, Wheat Grass, Bupleurum, Astralagus, Bee Propolis, Maitake, Black Walnut, Hesperidin, Rutin)
  • Biotics Research POA-Phytolens (Cats’ Claw, Lens esculenta extract) - One capsule TID
  • Consider broad spectrum multi such as Metagenics PhytoMulti at two tablets per day (adjust dosage of Zinc and Selenium above)

CAUTION: Propolis is not to be taken if you have a Honey or Bee allergy.

Treatment and Vaccines

  • There is no vaccine currently available to combat the current coronavirus outbreak. 
  • The best advice is to protect yourself in some of the ways outlined above and avoid contact with infected individuals or locations where you might encounter potential carriers of the virus. 
  • There’s no specific antiviral treatment that’s recommended for patients with the Covid-19 virus. 
  • Those infected should receive the medical treatment required to deal with their symptoms, including care of vital organs in the most severe cases. 

In Conclusion

  • While we still don’t know everything about the current Covid-19 virus, common sense and taking precautions and preventative measures will be a great help. 
  • The feeling in the medical community is that the virus is likely to become less aggressive and less dangerous over time, as many viruses do, although this is far from certain. 
  • Many viruses adapt, mutate, and continue to live with us everyday. Time will tell if the latest threat will follow the same pattern in the coming weeks and months.

As a final note, in the current circumstances, if you’re suffering from what you’d describe as symptom similar to flu such as a cough, fever, chills, or an aching feeling in the body, please don’t visit the office. If you have an appointment we can do a phone consultation instead or even connect via zoom online. Staying at home will allow you the opportunity to recover and also reduce the likelihood that you’ll pass on the virus to others.

Resources

 https://www.cdc.gov/coronavirus/2019-ncov/about/prevention.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Fprevention-treatment.html
 Courtesy of Tailor Made Pharmacy  
https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html 
 Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za ZHi 2020 Feb 20. 43:E019
https://www.ncbi.nlm.nih.gov/pubmed/32150618
 https://www.sciencedirect.com/science/article/pii/S1876034116300181
https://nypost.com/2020/03/05/coronavirus-patient-in-spain-reportedly-recovers-after-being-treated-with-hiv-drug/
https://www.ncbi.nlm.nih.gov/pubmed/32013309/
https://clinicaltrials.gov/ct2/show/NCT04264533
 http://orthomolecular.org/resources/omns/v16n11.shtml
 Epidemic Influenza and Vit D. https://www.ncbi.nlm.nih.gov/pubmed/16959053
 https://www.argentyn23.com/
 https://link.springer.com/article/10.1007/s00705-016-3166-3
 Biol Pharm Bull. 2009 Aug; 32 (8) : 1385-91
https://www.webmd.com/vitamins/ai/ingredientmono-434/elderberry
 http://insajournal.in/insaojs/index.php/proceedings/article/view/305
https://www.ncbi.nlm.nih.gov/pubmed/28480383
 Ferreira L, Effect of the ethanolic extract from green propolis on production of antibodies after immunization against canine parvovirus (CPV) and canine coronavirus (CCOV). Brazilian Journal of Veterinary Research and Animal Science 49.2 (2012):116-121. http://www.revistas.usp.br/bjvras/article/view/40267
Dr Horowitz newsletter 
 https://kiscience.com/product/propolair-propolis-diffuser-therapy-model/
 https://www.sciencedirect.com/science/article/pii/S2211383520302999
http://www.hdbiosciences.com/Download/Identification%20of%20natural%20compounds%20with%20antiviral%20activities%20against%20SARS-associated%20coronavirus.pdf
 Antiviral Research 67, No 1 (2005): 18-23
 https://klinghardtinstitute.com/
 Courtesy of Tailor Made Pharmacy.
 https://www.inflammationmastery.com/

The Ketogenic Diet – The Secret to Neuroprotection

Neuroprotection

Ever taken a trip to the grocery store only to forget why you went there in the first place? Or perhaps you have difficulty concentrating on something you usually enjoy, like reading a book. In either of these cases, you usually don’t feel as if your brain is working normally.

  • Maybe you’ve lost confidence in your mental abilities.mol
  • Maybe your doctor has dismissed your brain fog as a consequence of aging.
  • Maybe you’ve struggled with chronic migraines or cluster headaches for what feels like forever.
  • Maybe you’re apprehensive regarding a future that involves living with neurodegenerative disease.

Sound familiar?

Well, I’m here to tell you not to lose hope. There are ways in which conventional Western medicine is letting us all down. The idea of losing cognitive functions, your memory becoming poorer, or even not being able to recognize the faces of your family, is all pretty scary. Every 65 seconds a patient in the US develops Alzheimer’s disease and there’s no magic pill that cures it.

Fortunately, there’s another way.

As a functional and integrative doctor, I find the issue of cognitive decline to be on my mind regularly. My patients are concerned that they won’t be able to work, socialize, or enjoy hobbies for much longer. They even worry that they’ll have to give up on life.

However, I’m able to help them treat their neurodegenerative progression from the inside. By adopting the ketogenic diet for neurodegenerative diseases, you can change your life and turn back the clock. Dr. Dale Bredesen’s extensive research and treatments have shown that the effects of Alzheimer’s disease can be reversed with simple lifestyle changes. A modified version of the ketogenic diet is the backbone of Dr. Bredesen’s protocol and the science behind this is truly incredible.

The History of the Ketogenic Diet

While the ketogenic diet is currently very popular due to its fast and effective results related to weight loss, the diet actually started out as a medical therapy in the 1920s. Doctors saw that fasting was beneficial regarding controlling seizures in epileptic children, but restricting food was not a sustainable solution in the long term.

The doctors reasoned that when you fast, your levels of glucose and insulin drop and ketone bodies appear in your blood and urine. Ketone bodies indicate fat breakdown, so the doctors realized that a high-fat diet could build up levels of ketones that were sufficient enough to mimic the benefits of fasting, thus reducing their young patients’ seizures. Epileptic children who were prescribed the ketogenic diet did indeed stop seizing. However, the ketogenic diet never became a popularized form of therapy for epilepsy once anticonvulsant drugs were fully researched and then put into production.

The therapeutic effects of the ketogenic diet were only really rediscovered towards the end of the twentieth century. Many parents of epileptic children that were frustrated with the severe side effects of anticonvulsant drugs, and worried about the impact of seizures on their child’s cognitive abilities, did their research and decided that inducing ketosis was something that they’d like to try.

While the ketogenic diet isn’t the first option that medical practitioners explore when treating children with epilepsy, it has garnered more interest in the medical community as new and exciting applications have been discovered and research is increasingly being undertaken into the neuroprotective characteristics of the diet.

It’s important to realize that ketosis isn’t an unusual state for human beings. Infants are naturally in ketosis much of the time, since breast milk is high in medium chain triglycerides or MCT. We are naturally in ketosis during sleep, fasting and exercise as the body and brain have become accustomed to metabolic flexibility, shifting between glucose and ketones as fuel sources when the need arises. As human beings become more sedentary and accustomed to eating three meals a day with snacks, often well into the night, these diurnal and seasonal changes became a thing of the past.

What Neurological Disorders Does the Keto Diet Help Treat?

Following the ketogenic diet is often a game changer for patients suffering from:

  • Parkinson’s disease – Keto improved the condition of patients in a small study.
  • Traumatic brain injury – There has been success in an animal study, with potential for human application.
  • Epilepsy, Stroke, Migraine – All three conditions share similar characteristics, migraine patients are at an additional risk for stroke, and patients often deal with epilepsy and migraine together. Migraines and epilepsy share similar symptoms and often epilepsy medications are used to treat chronic migraines off-label. As the ketogenic diet has reduced the number of seizures for epileptics, chronic migraine patients have also experienced longer gaps between migraine attacks.
  • Chronic cluster headaches (CCH) – There has also been success for chronic cluster headache sufferers, suggesting that the anti-inflammatory nature of the ketogenic diet is particularly healing for CCH patients.
  • Autism – A ketogenic diet has had some success in reducing some symptoms of autism. One of the leading contributors of autism may be mitochondrial dysfunction and the ketogenic diet improves mitochondrial function.
  • Brain tumors – Many cancer patients have seen success with the ketogenic diet slowing down their tumor growth as several types of tumors require glucose and a very high carbohydrate diet. However, the ketogenic diet is not a one-size-fits-all remedy for cancer. Studies are ongoing.
  • Trigeminal Neuralgia – A study shows promise of relief for sufferers of this severe form of facial pain after adopting the keto diet.
  • Multiple Sclerosis – Research is ongoing, but there does seem to be potential for the keto diet to protect neurons from further damage.
  • Alzheimer’s disease – The ketogenic diet benefits Alzheimer’s disease patients because it combats insulin resistance, inflammation, gluten sensitivity, obesity, and leaky gut.

You’ll learn more about each of these subjects below.

The ketogenic lifestyle is also a fantastic solution for healthy individuals who wish to avoid neurodegenerative disease or cognitive dysfunction. The only good way to ensure better health when you’re older is to take action today. Even if you have the APOE4 gene, meaning that you’re more susceptible to developing Alzheimer’s, or have a formal diagnosis, you can benefit from the ketogenic diet. It’s never too late to start.

Neuroprotective and Disease-Modifying Effects of the Ketogenic Diet

There are a number of ways in which following a ketogenic diet can protect your brain and even reverse neurodegenerative disease. By severely restricting your carbohydrate intake, reducing protein, exercising regularly, and increasing your consumption of good fats, you encourage your body to look for an alternative energy source to sugars and carbohydrates. If you eat to a calorie deficit, your body begins breaking down fat stores and inducing a state known as ketosis. The brain prefers ketones to glucose as they cross the blood-brain barrier much easier since they don’t rely on transport proteins. They also produce less in the way of free radicals or oxidative damage, the key biochemical process underlying most forms of chronic disease including neuroinflammation and neurodegeneration. However, if you’re eating to maintain your existing weight, the fat is supplied purely through your diet.

The Power of the Humble Ketone

Most of your body can use the fat stores or dietary fat to power your cells. However, your brain and the central nervous system can’t access this energy in the same way. As a result, your liver breaks down the fatty acids and a by-product of this chemical process are ketones. These are your body’s alternative energy source.

Ketones are made up of acetone, acetoacetate, and beta-hydroxybutyrate.

Ketone bodies are capable of crossing the blood-brain barrier and are the only source of energy the brain can use that can replace glucose made from carbohydrates. As such, ketones can fuel up to 75% of the energy needed by your brain. The other 25% or more of your energy continues to be fueled by glucose, but it’s glucose that’s made by your body from the few carbs that you do eat and also by your protein sources.

Ketones are an amazing form of energy for your body and have a host of benefits for your metabolism and health.

Concentrating on neuroprotection, here’s a list of ketosis brain benefits:

  • Ketones are water-soluble and cross the blood-brain barrier in proportion to your blood levels. Consequently, they can compensate for an existing neurological disorder where there’s a regional brain glucose deficiency. It’s been observed that studies show reduction in glucose utilization in the Alzheimer regions of the brain in the temporal and frontal lobes long before cognition declines. This is due to insulin resistance, a concept that’s well described a little later.
  • When the cells of your body, and specifically those of your brain, convert ketones into adenosine triphosphate (ATP) via the mitochondria, ATP generation is markedly improved in mitochondria that are fed ketones. The keto diet improves the efficiency of your brain cells.
  • Ketones inhibit reproduction of the HDAC enzymes, which protect and repair the neurons that make up your double-stranded DNA. Ketones therefore have a powerful role to play in epigenetics and future research may potentially shed light on how they protect your brain.
  • The beta-hydroxybutyrate in ketones suppresses your NLRP3 inflammasome, reducing inflammation in your body. The mechanism is pivotal in the development of Alzheimer’s disease and related brain tissue damage. In animal studies, beta-hydroxybutyrate was found to suppress oxidative stress, protecting the integrity of the DNA and overall health.

What Is Insulin Resistance and Why Is It a Problem?

Normally, the insulin hormone is produced by the pancreas. Insulin joins your bloodstream to regulate the amount of glucose in your blood. In a healthy individual, when the insulin detects too much glucose in your blood, it signals muscles, tissues, and your liver to absorb the glucose.

The glucose is then converted into ATP, ready to be used as cellular energy or broken down by your liver. The levels of glucose in your bloodstream need to be controlled because they can be toxic at high levels.

When you have insulin resistance, which is often a precursor to diabetes, your body ignores or resists the insulin signal to absorb glucose. The levels of glucose build up and your pancreas creates more and more insulin in order to trigger glucose regulation.

Obviously, any condition that may lead to diabetes is a concern, but insulin resistance also has an impact on your neurological health. Sugar is a known inflammatory and inflammation can disrupt the careful balance of your blood-brain barrier.

More crucially, insulin is a signaller that aids neural cell survival. If there are high levels of insulin in your bloodstream, the amount of insulin should be reduced and your body needs several enzymes to break it down.

One enzyme called insulin-degrading enzyme (IDE) can break down insulin. However, if it’s responsible for working on an overabundance of insulin, the enzyme can’t be used to degrade amyloid beta. Amyloid beta in the brain contributes to Alzheimer’s disease.

However, if you increase your insulin sensitivity, it’s possible to reduce your chances of developing Alzheimer’s disease. Ketones also modulate your neurons by reducing glutamate toxicity and inhibiting gamma-aminobutyric acidergic (GABAergic) effects, limiting seizures if you’re epileptic.

The Mind-Gut Connection

In integrative and functional medicine approaches, it’s understood just how important the health of the gut is in relation to achieving optimal overall health. Understanding the connection between your brain and your gut microbiome is crucial to maximizing the neuroprotective conditions of the ketogenic diet. Sugar causes inflammation and can trigger conditions such as leaky gut. Eating whole foods and reducing your carbohydrates and processed food intake helps to heal your gut. Improving your gut microbiome actually improves your cognitive abilities as well

Keto Helps You Sleep Deeply

A lower-carb diet, such as the ketogenic diet, may help reduce your symptoms of sleep apnea or other sleep airway disorders. Quality of sleep and deep REM sleep are crucial for keeping your brain healthy.

An airway sleeping disorder usually results in your brain not receiving enough oxygen at night. The effect of a lack of oxygen is that your brain can’t fall into a deeper sleep and your brain is unable to perform certain neuroprotective tasks, such as autophagy where old cell components are recycled.

The recent discovery of the glymphatic system in the brain is of great interest to researchers examining neurodegenerative diseases. The glymphatic system only works while you’re asleep and removes excess fluid and waste products from the brain and spinal column tissues. Amyloid beta proteins are a form of waste in the brain that the glymphatic system deals with. Links have been established between these proteins, your cholesterol levels, and the lymphatic system in regard to neurodegenerative diseases.

The glymphatic system also delivers central building block nutrients, some of which are used in improving your cognitive functions. Unfortunately, with sleep apnoea your body is unable to undertake these functions, leading to neurodegeneration.

Ketogenic Basics: Macronutrients and Keeping Track

Macronutrients are another term for the basic food groups:

  • Protein
  • Fat
  • Carbohydrates

Both the standard American diet and calorie restrictive low-fat diet are heavily slanted toward the consumption of carbohydrates. In the ketogenic diet, the values are flipped on their head. On the keto diet, you aim for a high-fat intake, medium to low amounts of protein, and low levels of carbohydrates. A good rule of thumb is to not eat foods with a glycemic index of more than 35. Here is a link to a food glycemic index database that should be useful.

The original ketogenic diet for epileptic children focused on a 4:1 ratio, or four parts fat to one part carbohydrates and protein. However, this is at the extreme end of the ketogenic diet and is usually too difficult to attempt at home.

Generally, you should aim for your intake to be:

  • 60-75% fat
  • 15-35% protein
  • 5-10% of carbohydrates, although the lower the carbohydrates, the better.

Use a quality online ketogenic calculator to adjust your macros. This one has options for eating to maintain weight, lose weight, or gain weight.

To track whether your body is in the state of ketosis that’s creating ketones and using them as your body’s main source of energy, it’s advisable that you invest in a good ketone and glucose meter. By using it, you can keep an eye on what foods your body responds to after a meal. Tracking your ketones through beta-hydroxybutyrate levels in your blood is the most accurate way to keep tabs on whether you’re in ketosis. Unfortunately, ketone breathalyzers or keto sticks aren’t accurate enough to be reliable.

Ketogenic Neuroprotective Basics: The Diet

PLENTY OF VEGGIES AND FRUIT

Although an outsider may think the mainstream version of the ketogenic diet is mostly made up of bacon, the focus is actually on plant-based foods to promote the diet’s neuroprotective benefits. While it’s true that many vegetables contain high amounts of carbohydrates, these are usually tempered by fiber and the resistant starches that are found in complex carbohydrates.

Your body has a harder time breaking down complex carbohydrates, so they don’t raise your glycemic index so sharply. Simple carbohydrates, on the other hand, are sugars or carbohydrates that break down easily into glucose.

Here’s a guide to vegetables and fruit on a neuroprotective ketogenic food plan:

Eat frequently:

The majority of the diet should consist of organic, non-GMO, seasonal, local, colorful, deeply pigmented non-starchy vegetables with a limited amount of starchy vegetables.

Cruciferous vegetables – These contain sulfur, an important building block for production of amino acids, especially glutathione, which is the main brain antioxidant. These types of vegetables are ideally consumed after being lightly sautéed at medium heat or lightly steamed.

  • Alliums (onion family -shallots, garlic, leeks)
  • Brassicas (cabbage, broccoli, Brussel sprouts, bok choy, cauliflower)

Leafy green vegetables – These are at the top of the list for the ketogenic diet. They contain high levels of nutrients beneficial to your brain health, such as vitamins, minerals, polyphenols, carotenoids.

  • Spinach (caution if histaminic and high oxalates)
  • Kale (caution if high oxalates
  • Lettuce

Mushrooms – These contain sulfur and beta-D-glucan, which may help the reversal of cognitive decline through immune enhancing effects. There are many varieties, including Portobello, shitake, reishi, oyster, and white button mushrooms. Add them to sauces, stews, and for flavour when cooking other vegetables.

Resistant starches – The good bacteria in your gut microbiome can feast on resistant starches and fibre and they excrete short-chain fatty acids crucial for your wellbeing.

  • Rutabagas
  • Parsnips
  • Sweet potatoes
  • Green bananas

Herbs and spices – These contain antiviral and antimicrobial properties and are an essential part of a ketogenic diet. This extensive list includes ginger, turmeric, basil, bay leave, chives, cilantro cinnamon, coriander, cumin, lavender, marjoram, mint, oregano, parsley, rosemary, saffron, sage, thyme and more. Herbs and spices have been widely studied to determine their medicinal properties.

Nuts and Seeds – These are rich in vital brain protective nutrients and contain excellent sources of fat, protein, vitamins, minerals, and fibre. These should be raw, fresh, organic, and soaked if possible, thus reducing lectins and phytates. Use dry, roasted nuts where possible if you’re unable to roast them yourself. Roast at low temperatures (77-104 degrees C) while frequently turning the nuts during the process. Nuts that have already been roasted in added oils are usually rancid and oxidized, increasing the risk of inflammation. All nuts and seeds should be stored in the freezer or refrigerator to retain maximum freshness.

Eat sometimes:

Starchy vegetables

  • White potatoes (caution if high histaminic and sensitive to nightshades and not usually advised)
  • Corn (not the best food due to it being high glycemic, moldy, or GMO, amongst other issues)
  • Squash

Nightshades – These inflammatory vegetables contain solanine, a toxin that plants produce to deter animals from eating them. Solanine can stimulate the acetylcholine neurotransmitter in your brain and nervous system. For most people, this is of no concern, but for a patient facing early-onset Alzheimer’s disease, an imbalance in neurotransmitters can complicate matters.

  • Peppers (caution if high histaminic and pain syndromes)
  • Tomatoes (caution if high histaminic and pain syndromes)
  • Eggplant (caution if high histaminic and pain syndromes)

Legumes – Eat these with caution as legumes can raise glucose levels in the blood and shouldn’t be eaten in the early weeks of adopting the ketogenic diet. Depending on the severity of your insulin resistance, you may not be able to eat them.

  • Peas
  • Beans

Fruits – Small berries contain polyphenol compounds that can play a role in reducing cognitive decline:

  • Wild berries such as blueberries have been extensively studied for their antioxidant effects on brain health
  • Avocado is high in fibre, nutrients and beneficial fats
  • Olives
  • Lemons and limes (caution if high histaminic)

CONTROL YOUR PROTEIN

You may find it easy to go overboard with animal-based protein when beginning the ketogenic diet, but it’s crucial to calculate your daily allowance of protein. It’s advisable to employ the one gram of protein for each kg of your weight equation. For example, if you weigh 80kg you can consume up to 80g of protein per day.

Eating protein to excess ensures that some protein is converted to glucose, increasing the levels of insulin in your bloodstream. Think of your controlled amount of protein in the same way as when your ancestors would share a part of the communal hunting kill, only eating a small part of the animal. The rest of the time it was possible to get enough protein through plant-based food sources and this remains true today.

As much as possible, ensure that the protein you eat is organic, grass fed, grass finished, hormone and antibiotic free, and that the animals are not subjected to the stresses and toxins of concentrated feeding operations. To prevent muscle wasting, ensure weight training and weight bearing exercises are incorporated into your routine.

On a neuroprotective ketogenic diet, vegetarians need to get their protein from vegetables, nuts, seeds, tempeh, and beans. However, these are often incomplete proteins and vegetarians will need to supplement with omega-3’s, vitamin B’s, Vitamin D, and choline.

Eat frequently:

Oily fish – These are rich in Omega-3 and Omega-6 and both are excellent for brain health. Farmed fish or shrimp should be avoided. The least contaminated fish, which are smaller and don’t live as long, are known as the SMASH fish.

  • Salmon – The least contaminated are wild Alaskan and sock-eye
  • Mackerel – Fish from the United States and Canada is low in mercury, whereas King and Spanish mackerel are high in mercury
  • Anchovies
  • Sardines – Canned sardines are high in histamine and Pacific sardines are the best.
  • Herring

Free range eggs – These are full of protein and good fats, especially choline, which is a key nutrient for acetylcholine, the main neurotransmitter for memory. However, eggs can trigger a histamine response so caution may be warranted.

Eat sometimes:

  • Grass-fed beef – This is an acceptable occasional treat, but it’s incredibly easy to go over your protein allowance with a good steak.
  • Free-range chicken – While fantastic as part of a salad this shouldn’t be the main focus of the meal.
  • Meats are generally considered as a condiment, not as a main course.

Avoid eating:

Processed meats often contain hidden sugars, histamine, wheat, gluten, and other inflammatory ingredients.

  • Salami
  • Chorizo
  • Shaped ham
  • Bologna

Fish containing high levels of mercury, since this is known to cause cognitive decline.

  • Tuna
  • Shark
  • Swordfish

Dairy can be highly inflammatory as the lectin in dairy can irritate the gut, so dairy should be avoided as much as possible.

  • Milk
  • Cheese
  • Cream
  • Yoghurt

Alcohol is a known neurotoxicant and solvent and should be avoided, especially if you have the APOE4 gene. Alcohol will slow down fat loss in those patients that use the ketogenic diet for weight loss reasons. Many alcohol drinks such as beer, wine, cocktails, mixers, and flavoured liquors contain carbohydrates. Alcohol is ethanol, which is easily broken down into sugar.

Peanuts are a legume known to be moldy and inflammatory. If you’ve been exposed to mold, download my mold exposure guide here.

GOOD FATS VERSUS. BAD

Although the ketogenic diet is high in fat, not all fats are created equally. Developing an awareness of the different varieties of fat and what foods are good sources of fat ensures that you’ll find it easier to maintain the neuroprotective ketogenic diet in the long term.

Eat frequently:

Monounsaturated fatty acids (MFUA)

  • Avocados, avocado oil
  • Olives, extra virgin olive oil
  • Nuts and seeds, although be careful of walnuts, pecans and peanuts if high histaminic. Many nuts are also moldy
  • Walnuts have been associated with brain health but must be eaten raw. Macadamias are similarly highly desirable for maintaining brain health

Polyunsaturated fatty acids (PUFA) that include Omega-3 and Omega-6.

  • Seed oils such as walnut oil, macadamia oil, or sesame oil
  • Cod liver oil
  • Algae
  • Chia seeds
  • Fish, nuts, and seeds

Saturated fatty acids (SFA)

  • Animal fats are great for this but can be highly reactive in histaminic patients
  • Butter from grass-fed goats, sheep, or A2 cows, although in small amounts as dairy this is an inflammatory
  • Coconut oil
  • MCT oil
  • Free range eggs

Cocoa butter and nuts

  • The fat in chocolate comes from cocoa butter and is made up of equal amounts of oleic acid, a heart-healthy monounsaturated fat also found in olive oil, stearic and palmitic acids, which are forms of saturated fat.
  • They also contain flavanols and have four times the antioxidant properties of dark chocolate.
  • Dark chocolate (over 86%), also has brain health properties.

Avoid eating:

Trans fats and synthetic hydrogenated fats result in raised low-density lipoprotein (LDL) cholesterol levels. High levels of LDL cholesterol can occur at the onset of Alzheimer’s disease in middle age.

  • Avoid all seed, grain, bean and partially hydrogenated oils such as soy, corn, canola, peanut, sunflower oil, safflower (usually adulterated with oleic acid mix), cottonseed, and palm kernel.
  • Avoid all foods processed with trans fats such as crackers, cookies, cakes, chips, microwave popcorn, frozen dinners, pizza, creamers, margarine, cool whip, and fast food.

Testing for fats

With regards to fatty acid intake, it’s best not to engage in a guessing game regarding which fats you need in what ratios. It’s advisable to conduct the Kennedy Krieger fatty acids analysis through a company called Body Bio. In this way, your exact fatty acid dietary deficiencies and excesses can be measured and managed effectively through the correct ratios of biologically active fats, either through food, cooking, or supplementation. Phosphatidyl choline is an essential fat for cardiovascular, mitochondrial, and cognitive health and the levels are best measured before embarking on an extensive therapeutic fatty acid regime.

Saturated fats and cardiovascular risk

People with the ApoE4 gene need to be cautious when using increased amounts of saturated fats, as these are known to raise LDL particle number and APOB, a lipoprotein associated with increased cardiovascular disease. Although the increased saturated fats may increase cognitive health, in the long term it may lead to increased cardiovascular risk factors that are not beneficial. Therefore, it is advised that one monitors one’s cardiovascular risk factors including but not limited to APOB, oxidised LDL, LDL particle number and size, and HDL particle number and size. Increased saturated fats are known to lower triglycerides, increase HDL, and shift LDL particle size from the smaller dangerous particle size to the more advantageous larger ‘fluffy’ type, which is known to be cardioprotective.

Cooking Methods

The way you cook your food is almost as important as the food you choose to eat. Many everyday methods of cooking food can result in advanced glycation end products (AGE). These glycotoxins are produced when there’s a reaction between protein or fat and sugars, so AGEs can instigate inflammation and are bad news for brain health.

Methods to use:

  • Vegetables prepared raw
  • Steaming
  • Boiling
  • Marinating in lemon, lime, or vinegar (caution if histaminic)

 Methods to avoid:

  • Roasting
  • Broiling
  • Frying
  • Grilling

Fats to cook with:

  • Choose oils with a high smoking point, such as avocado, coconut, ghee, and animal fat

Foods to Avoid and Why

GRAINS AND GLUTEN

Grains are dense in carbohydrates, contain lectins that are known to be associated with ‘leaky gut’, phytates, and enzyme inhibitors. Gluten is a known inflammatory agent, especially when it provokes an autoimmune inflammatory response to brain proteins such as myelin and tubulin. Foods to avoid include:

  • Wheat
  • Barley
  • Oats
  • Corn
  • Rye
  • Soy
  • Flour
  • Bread
  • Polenta
  • Pasta
  • Tortilla wraps
  • Noodles
  • Rice
  • Nachos
  • Popcorn
  • Crackers

DAIRY 

Dairy foods are inflammatory particularly as the dairy cows in the United States are A1 cows that produce a protein similar to lectin. A2 cows do not contain these lectins. Furthermore, casein and whey, the two milk proteins, are frequently cross-reactive with gluten.

SUGARY OR CARBOHYDRATE LADEN FOOD

The glycemic index is too high with these types of foods:

  • Agave
  • Alcohol
  • Cane sugar
  • Candy
  • Cookies
  • Cake
  • Dessert
  • Fries
  • Fruit juices
  • High fructose corn syrup
  • Honey
  • Ice cream
  • Maple syrup
  • Pastries
  • Pizza
  • Potato chips
  • Soda
  • Anything containing sugar

PROCESSED FOODS 

  • Microwave dinners
  • Convenience food
  • Anything out of a packet

FRUIT WITH HIGH GLYCEMIC INDEX

  • Melon
  • Pineapple
  • Yellow bananas
  • Grapes
  • Cherries
  • Apricots
  • Mango

Food Intolerances and allergies – All patients that are using the ketogenic diet for cognitive health should be extensively tested for food sensitivities, gut ecology and permeability, leaky blood brain, and antibodies to brain proteins (detected using Cyrex labs 2, 10x, 12 and 20).

Different Ketogenic Diets 

STANDARD KETOGENIC DIET (SKD)

This diet is typically recommended for most people and is very effective. The diet focuses on high consumption of:

  • Healthy fats (70% of your diet)
  • Moderate protein (25% of your diet)
  • Very little carbohydrates (5% of your diet)

Keep in mind that there’s no set limit to the fat because energy requirements vary from person to person, depending on their daily physical activities. The majority of your calories still need to come from fats and you still need to limit your consumption of carbohydrates and protein for your diet to become a standard ketogenic one.

TARGETED KETOGENIC DIET (TKD)

This is generally geared towards fitness enthusiasts. In this approach, you eat the entirety of your allocated carbohydrates for the day in one meal, around 30 to 60 minutes before engaging in exercise.

With this diet the idea is to use the energy provided by the carbohydrates effectively before it disrupts ketosis. You eat carbs that are easily digestible with a high glycemic index to avoid upsetting your stomach. When you’re done exercising, increase your intake of protein to help with muscle recovery then continue consuming your fats afterward.

CYCLIC KETOGENIC DIET (CKD)

This one is generally focused more on athletes and body builders

Cycling between a normal ketogenic diet, followed by a set number of days of high carbohydrate consumption, also known as “carbo-loading”

The diet takes advantage of the carbohydrates to replenish the glycogen lost from your muscles during athletic activity or working out. This usually consists of five days of SKD, followed by two days of carb-loading. During the ketogenic cycle, carbohydrate consumption is around 50 grams, but when you reach the carb-loading cycle, the amount jumps to 450-600 grams.

This method isn’t recommended for people that don’t have a high rate of physical activity.

HIGH-PROTEIN KETOGENIC DIET

This method is a variant of SKD, in which you increase the ratio of protein consumption to 10% and reduce your healthy fat consumption by 10%. In a study involving obese men that tried this method, researchers noted that it helped reduce their hunger and lowered their food intake significantly, resulting in weight loss.

If you’re overweight or obese, this diet may help you initially, before you can transition to SKD after you normalize your weight.

RESTRICTED KETOGENIC DIET

As mentioned earlier, ketogenic diet can be an effective weapon against cancer. For this method to be effective, you need to be on a restricted ketogenic diet. By restricting your carbohydrate and calorie intake, your body loses glycogen and starts producing the ketones that your healthy cells can use as energy. Cancer cells are unable to use these ketones and starve to death.

Meal Examples

1st Meal

  • 4 to 5 cups of organic vegetables
  • Some limited starchy vegetables, such as sweet potato
  • One or two pasteurized eggs, lightly cooked or poached
  • Olive oil, MCT oil, or ghee as a dip for the vegetables
  • Use of spices, herbs, and sea salt for flavouring

2nd Meal

  • Organic, seasonal vegetables, either as a salad or lightly steamed
  • Small serving of fish or chicken
  • Healthy fats such as avocado, olives, nuts or seeds, and/or olive oil
  • Seasonings such as herbs, spices, and sea salt

Snack example

  • Coconut yoghurt or coconut milk kefir
  • Blueberries
  • Walnuts, almonds, or macadamias
  • Cocoa nibs
  • Coconut flakes
  • Stevia

Shake example

  • 2 tablespoons of Body Bio phosphatidyl choline
  • 1 tablespoon of Body Bio balanced oil
  • 1 tablespoon of MCT oil
  • 1 scoop of amino acid powder
  • Lions mane, turmeric, and /or mushroom powder
  • Stevia and vanilla to add flavour

Please note that the above ratios would be determined based on a fatty acid test

Neuroprotective Keto: Fasting and Exercising

Fasting and exercising aren’t optional when undergoing the ketogenic diet for neuroprotection. The good news is that neither has to be conducted to the extreme on order to get results.

Fasting is an effective way to stimulate ketogenesis, the process that produces ketones. Fasting also enables autophagy, as discussed above in the section about sleeping. Autophagy is an advantageous function that removes damaged proteins from the brain, protecting it from a dangerous build-up. Fasting has also been shown to have a number of other health benefits, including improved cardiovascular health, reduced cancer risk, increasing longevity (by increasing the sirtuin gene) and repairing damaged DNA.

Here are the easiest ways to incorporate fasting into your daily routine, without feeling like you’re missing out or that you’re going to be hungry:

  • Fast between the end of your dinner and your breakfast the next day. Aim for twelve hours without snacking. Individuals with the APOE4 gene may need to increase the fasting state for sixteen hours.
  • Make sure you eat your evening meal early so that you have a minimum of three to four hours between your evening meal and going to sleep.
  • Your body’s calorie burning clock is most effective in the morning and least effective at night. You don’t need food for energy at night so by eating less at that time you induce a fat burning state that helps prepare your body for detoxification and repair.
  • Water, black tea, or coffee are all allowed during the fast, particularly in the early morning. Stevia may be used as a sweetener

Remember that once you are fully in ketosis you won’t experience hunger pangs in the same way. In fact, you may be able to go even longer between meals.

Exercise is crucial for neuroprotection as it helps reduce insulin resistance, aids ketosis, and reduces stress. A combination of aerobic exercise and weight training can improve your sleep at night via vascular function in your brain and protect the hippocampus, which can often shrink in those suffering with Alzheimer’s disease. Start slowly and build your way up to a full program of activity.

Individuals with insulin resistance may have a harder time inducing ketosis and may suffer from carbohydrate cravings. Ask your doctor to measure your insulin, fasting glucose, and hemoglobin A1c levels. HbA1c is a measurement of your average glucose levels over three months. Using high dose medium chain triglyceride fats (MCT) or coconut fats assists in helping you overcome sugar cravings and glycotoxicity. One has to increase these fats slowly and use fat digesting enzymes containing lipase and emulsification aids such as ox-bile to initially assist in the increased fat load. Another way to combat the initial sugar cravings is to increase fats in your diet such as nuts and seeds, avocado, or non-starchy vegetables cooked in ghee, coconut, or avocado oil.

Neuroprotective Keto: Supplementation

As mentioned above in the section about the mind-gut connection, your brain and gut have a special relationship. In order to achieve neuroprotection, it’s necessary to heal your gut by encouraging your good bacteria to take charge. The best way to improve your gut microbiome is to take probiotics and prebiotics.

Probiotics contain the good bacteria that are able to take carbohydrates and convert them into lactic acid, which suppresses your bad bacteria. Probiotic should be used with caution if histaminic but include:

  • Kombucha
  • Miso
  • Pickled vegetables
  • Yogurt (unsweetened)
  • Kefir from coconut
  • Kimchi
  • Sauerkraut
  • Tempeh

Prebiotics comprise food that’s indigestible for you, but it can be digested in your colon by your good bacteria. The bacteria break probiotics down into materials that aid the maintenance of your gut. Many of the resistant starches and fibrous plants listed above count as prebiotics.

Here are a few further examples of prebiotic supplements:

  • Organic psyllium seed husks
  • Plantain
  • Green banana starch
  • Inulin
  • Acacia fibre

When you begin the ketogenic diet it takes a few days to achieve ketosis. In the meantime, you may experience some side effects, often referred to as ‘keto-flu’ by some people. With this condition, patients often experience:

  • Feeling run down
  • Brain fog
  • Headaches
  • Fatigue
  • Abdominal pain
  • Constipation
  • Diarrhea
  • Poor mood
  • Muscle cramps

All of these symptoms are perfectly normal, considering that you’re detoxing from sugar, training your body to run off ketones, and often experiencing the loss of electrolytes and dehydration. However, there are ways to combat this as follows:

  • Caffeine dehydrates you so you need to drink plenty of water to reduce dehydration symptoms, such as fatigue or headaches.
  • While iodized table salt is usually considered something that’s best avoided, increasing your intake of high mineral sea salt improves your water retention and replenishes your salt levels.
  • Supplement with magnesium in liquid form and foods rich in potassium, such as avocado, nuts, mushrooms, leafy salads, and bone broth.

You’ll discover that following the ketogenic diet is extremely rewarding because you’ll begin to feel some benefits within weeks. However, it may take at least six months to begin to feel the full advantages when attempting to reverse cognitive decline. The ketogenic diet tweaked to improve neuroprotection is a powerful tool in your quest for optimal health. Too often we treat the symptoms of disease when we could have headed off the condition years or decades earlier. Your body is amazing and can reverse the impact of poor diet, stress, and sometimes even genetics if you make the necessary changes.

What do you have to lose? Schedule an appointment at the Hoffman Centre For Integrative and Functional Medicine and get started with the ketogenic diet today.

Resources:

  1. https://www.alz.org/alzheimers-dementia/facts-figures
  2. https://www.ncbi.nlm.nih.gov/pubmed/25324467
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/
  4. https://www.ncbi.nlm.nih.gov/pubmed/29359959
  5. https://link.springer.com/article/10.1007/s11936-013-0236-7
  6. https://www.ncbi.nlm.nih.gov/pubmed/28527061
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759386/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074854/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110522/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816269/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4709725/
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044446/
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937039/
  14. https://www.ncbi.nlm.nih.gov/pubmed/14769489
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937039/
  16. https://www.ncbi.nlm.nih.gov/pubmed/24140022
  17. https://www.ncbi.nlm.nih.gov/pubmed/29697540
  18. https://www.ncbi.nlm.nih.gov/pubmed/25686106
  19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193914/
  20. https://www.ncbi.nlm.nih.gov/pubmed/23223453
  21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5671587/
  22. https://www.ncbi.nlm.nih.gov/pubmed/16266773
  23. https://www.ncbi.nlm.nih.gov/pubmed/28372330
  24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559698/
  25. https://www.ncbi.nlm.nih.gov/pubmed/29361967
  26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2647148/
  27. https://www.ncbi.nlm.nih.gov/pubmed/28466758
  28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347443/
  29. https://www.glycemicindex.com/foodSearch.php
  30. https://keto-calculator.ankerl.com/
  31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372091/
  32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211071/
  33. http://www.pnas.org/content/108/7/3017
  34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821835/
  35. Mercola A Beginner’s Guide to the Ketogenic Diet: An Effective Way of Optimizing Your Health
  36. https://www.apollohealthco.com/dr-bredesen/ Dr Bredesen’s ReCODE Report Nutritional Guidelines Ketoflex 12/3
  37. https://bodybio.com/
  38. Organic Creamed Coconut – www.earthschoice.ca
  39. Quality Nuts and Seeds  – www.ranchovignola.com and https://nuts.com/nuts/pili
  40. Quality Olive Oil – www.rawelements.ca
  41. Nut pods unsweetened coffee creamer – www.naturamarket.ca
  42. MCT emulsified coffee creamer – www.onnit.com
  43. Exogenous ketone powder – www.perfectketo.com (salted chocolate caramel flavor is best)
  44. Ketone and glucose meter – www.keto-mojo.com
  45. Humanly raised Certified organic beef, pork, turkey, chicken, and eggs https://www.sunworksfarm.com/certified-organic-beef/     (Bush Lane Organics/ Community Natural Foods/ Amaranth Whole Foods/ Planet Organics-chicken & eggs mainly, other meats can be ordered). Also TK Ranch meats at https://tkranch.com/