Could This Ketosis-Based Elixir Hold The Key To Weight Loss, World Record Performances, Brain Healing and More?

Let's jump in to Today's podcast with Dr. Veach, who I'm just going to nickname right now the grandfather of ketones in this episode of the Ben Greenfield Fitness Show.

If you say that there are 5 million Alzheimer's patients in the United States and you say you want to feed them 150 grams a day, you can do the math. If you'd say that there's 600,000 Parkinsonians and you want to treat them the same way, then you've got a big market. Beta hydroxybutyrate, which is a physiologic form, causes a reduction of the mitochondrial nad and it causes an oxidation of the next site, which is Q. So you increase the redox span between NAD and Q. When you do that, you increase the energy of ATP.

He's an expert in human performance and nutrition, voted America's top personal trainer and one of the globe's most influential people in health and fitness. His show provides you with everything you need to optimize physical and mental performance. He is Ben Greenfield.

Power, speed, mobility, balance, whatever it is for you, that's the natural movement. Get out there. When you look at all the studies done, studies that have shown the greatest efficacy.

All the information you need in one place right here, right now on the Ben Greenfield Fitness Podcast.

Hey, folks, it's Ben Greenfield here. And it seems that this special kind of compound called ketones or ketone esters more specifically, seem to be taking the sports world and the biohacking world by storm. For example, Scientific American recently published an article called Ketone Based Sports Drink Promises Edge for Athletes. And in that article, they claimed an extra 2% of energy from the use of something called ketones, which would be the equivalent of 60 yards in a 30 minute row. Along with claims of a world record broken in a lab test of ketones, Cycling Weekly wrote an article about how ketones are are the new energy drink that could be the next big thing in cycling. There was an article in Tech and Innovation Daily entitled the Difference between Sports Champs and Sports Chumps. Ketones, daily Mail Online reported. Could this elixir hold the key to weight loss? Experts hope it'll also treat diabetes, epilepsy and Alzheimer's. And of course, I've also personally written and reported about my own forays into ketosis for everything from Ironman triathlon to increasing my breath hold time for free diving and spearfishing. But when it comes to ketosis and ketones and ketone esters versus ketone salts and synthetic ketones and all these terms that are thrown around these days. I know it can get confusing. And frankly, as you're going to learn today, it can be even downright dangerous to play around with a lot of these ketone supplements that are coming out on the market, unless you really know what you're getting into. So my guest today is probably the world's foremost expert on ketosis. His name is Dr. Richard Veach. He is the senior researcher and laboratory chief at the National Institutes of Health, the NIH, and he's worked for the past 47 years researching the mechanics behind things like cellular energy and homeostasis. And he's the guy who actually invented the ketone ester. So when you see all these different supplements and ketones and talk about ketosis and everything popping up in all these sports magazines and podcasts and blogs these days, Dr. Veach is the guy who was here long before this stuff all became so popular and so sexy in the media. So he and I today are going to take a really deep dive into ketosis and fill in the gaps for you, clear up some of the confusion about everything from ketone salts to synthetic ketones to ketone esters, and hopefully we're even going to get a chance to talk a little bit about this brand new anti aging supplement that everyone is touting to be the next big thing this nad. So that all being said, Dr. Veach, I'm honored to have you on the show today, and welcome to the Ben Greenfield fitness podcast.

Thank you.

So I have a question for you, and that first question is this idea behind ketones? We've talked about ketosis quite a bit on the show. Most listeners know what ketosis is, but when it comes to ketosis, people are now claiming you can get into ketosis by taking exogenous ketones, by. By consuming ketones. What exactly are are these synthetic ketones that people are. Are talking about consuming?

Well, there are two major classes that people have been taking. The first one is what they call mid chain. Before I get into that, ketosis occurs normally when a person fasts. So if you just fast for two to three days, you've got a physiologic state of ketosis, with blood levels of ketones being about 7 millimolar. So that's the evolutionary development of ketones. And only mammal, only man, does that. No other animal does that.

Really.

We developed that because we need to chase the next mammoth, and there weren't McDonald's in the beginning. And so therefore, you needed to have a source of fuel for your brain. If you made Your ketones from the muscle, you'd be dead in six days. And in fact, you can live 74 days at a normal weight, man. And so you make ketones to feed your brain. The brain is a ferocious consumer of energy, and in addition to glucose, it will use ketones. And that's really the contribution that George Cahill made. So that's the first thing to say.

So there are no other animals or mammals on the face of the planet, aside from humans, who actually can endogenously produce ketones in response to fasting?

Yeah, there's one exception that a lactating cow, where they have a huge. Let's say a Holstein cow that's producing 60 liters of milk, can get ketotic because it's a gluconeogenic burden. But that's the only other animal, and that's in different circumstances. The bear. Bear, for instance, which fasts all winter, doesn't get ketonic. It's got enough fat that it lives. It destroys the fat and uses the glycerol to make glucose. So, yes, for all intents and purposes, man is the only animal that does this. And he does that for the reasons I said, if you've got to catch the next mammoth, you've got to be able to run and chase him and kill him. And that required a special evolutionary adaptation. And that adaptation was ketones. And specifically, it made a new fuel for the brain. So that's the reason for ketosis.

And these ketones can also be used by tissues other than the brain, correct?

Yes, it can. Man can use ketones everywhere but the liver because he makes. When you. When you starve, you release free fatty acids from the fat and you send them to the liver and convert them into ketones. So the liver in man, in the rat, doesn't metabolize ketones. Now, the mouse is a bit different, which is. I bring it up because a lot of genetic studies are done on mice, and that's much more confusing, either man or the rat. But yes, only the liver. A liver can't use ketones.

Okay, got it. For the longest time, when I. Well, I first started becoming interested in ketosis, so that I would be able to do about anywhere from nine and a half to ten and a half hours of ironman racing with limited fuel sources and with less glucose burning. And I would primarily achieve that via long periods of time spent exercising with limited amounts of fuel or long periods of time spent fasting. And in the years since, I have not been doing as much ironman racing. Now, folks are Trying to, I guess the correct term would be fast track their way into ketosis by using not just things like medium chain triglycerides, which I know can get burnt, and ketones can be produced as a byproduct of their metabolism, but they're also using these synthetic ketones. What exactly is a synthetic ketone?

Well, first of all, a ketone is really composed of two major compounds, one called beta hydroxybutyrate and the other called acetoacetate. So those are ketones. People often class acetone as a ketone body, but there's very little of it and it's not really a ketone in the physiologic sense. So when we talk about artificial ketones or synthetic ketones, what I've made is a dimer monoester, which is comprised of beta hydroxybutyrate with 1,3 butane diol and a monoester. And the 1,3 butane diol is converted to beta hydroxybutyrate. So when you take this ester, all you're getting is beta hydroxybutyrate. Now there are a number of other so called artificial ketones that are being made and actually sold. One is acetoacetate, racemic butane. You don't want to use acetoacetate because it's oxidized and beta hydroxybutyrate is a reduced product. So when you eat or metabolize acetoacetate, you oxidize the NAD in the mitochondria and you actually lose an ATP. And Krebs showed this in the 80s.

And so what it sounds like you're saying is that if you were to say, purchase a sports supplement being marketed as an exogenous ketone, and if that were to contain acetoacetate, you would actually be causing oxidative damage to the mitochondria. Even though you'd be getting ketones on board, the end result would actually be cellular damage.

It would be less energy.

Less energy because there'd be a net loss of energy because you'd actually be.

Using an ATP, you'd go in. Normally the mitochondria makes three ATP. If you go acetoacetate, it misses the first one. So you can only make two. Now, if you're giving racemic butanediol, that's another matter. The body is not racemic. It uses specific isomers, in our case the R13 butanediol and the R beta hydroxybutyrate. And so you want to keep with the physiologic forms. Now, for commercial reasons, Mainly cheapness of manufacturing. People make these racemic mixtures in there to be avoided.

Now a lot of these racemic mixtures that you're talking about, if you look at the label, they'll in many cases list the ketone being used as beta hydroxybutyrate and not acetoacetate. If it's beta hydroxybutyrate, do you run into the same issues with damage to the mitochondria? If it isn't non physiologic orientation, it's non racemic orientation.

By convention, when you list a compound as beta hydroxybutyrate and don't say RRL or D or S, then you mean by definition the racemic mixture. And yes, if you're eating a racemic mixture, you cause a lot of problems. Without getting too technical, let me just put it this way. The D form of beta hydroxybutyrate, which is a physiologic form, causes a reduction of the mitochondrial nad and it causes an oxidation of the next site, which is Q. So you increase the redox span between NAD and Q. When you do that, you increase the energy of ATP. Now if you give the racemic mixture, it's metabolized, but it causes reduction at site two, so you're narrowing this redox band between NAD and Q and that gives you less energy. The same thing goes when you're using mid chain triglycerides. Only 10% of them are converted to ketone bodies and the other 90% are directly burned in the mitochondria.

It's very interesting. So it sounds like if you're consuming one of these racemic mixtures of exogenous ketones and, and all that means, for those of you listening without a chemistry background is that just means there's, there's equal amounts of kind of like the left handed and the right handed orientations of that molecule. Even if you're say measuring your, your, your blood ketone levels or measuring your, your breath ketone levels and it's showing that you're in ketosis, what you're actually experiencing on a cellular level, what you're saying would be a net loss of ATP along with oxidative damage to this, this NAD structure in the mitochondria, which I know we'll get into what that is here in a little bit, but ultimately you're creating that damage.

Yes, that's essentially correct.

And this one, three butanediol, I think you said that you guys actually created that you made this different form of ketone, this physiolo similar form of ketone in your laboratory?

Yes. In other words, if you gave the salt, let's say you gave a sodium salt, a beta hydroxybutyrate, how many grams would you have to build?

Well, physiologically, when you're fasting, you can make 150 grams of beta hydroxybutyrate a day. In order to take that much in the salt form, you have to consume about 80 grams of salt, which. There's two different ways that they define the upper limit of how much salt you should take, depending on who you are. But the American Heart association just keeps with the one that's one gram a day. So these salt forms, what they're doing is they're putting in the maximum amount of beta hydroxybutyrate that they can, but it's limited by exceeding the daily allowance of salt. So really can't put too much in. What they wind up doing is giving you a little bit of beta hydroxybutyrate and some MCT and saying, don't take this more than twice a day. And that way you only get 80% of the higher level of salt that the USDA approves.

Right. And that's actually what I've noticed. If I look at the label of a lot of these exogenous ketones, they'll say that they're a BHB salt, like, bound to sodium or calcium, and they'll contain somewhere between like, 10 and 15 grams of the ketone body bound to the salt. And what you're saying is that physiologically you're taking in that much salt when, if you look at, say, like, even, you know, not that I necessarily agree with everything that the, that the FDA recommends or the USDA recommends, but that's exceeding the recommended intake of, say, like 2 grams of salt per day by a factor of five or six.

Yes. At least. You can't really do that. Your cardiologist will go mad.

Interesting. And, oh, and by the way, for those of you who thought Dr. Veach's voice just significantly changed and that he has this magic voice changing power, that was not Dr. Veach just speaking. That was Bill, who's there with Dr. Veach. And what is your role, Bill, by the way? Are you Dr. Veach's assistant or.

I've had Parkinson's for 16 years, and I was helped quite a bit by ketones, and I wanted to understand it. So about five years ago, I started corresponding with Dr. Veach. He seemed to be the only one who knew what was going on. So that's my relationship to Dr. Beach.

I might just add that you're interested in the effects of ketones on the energy that you produce. Let's say for an athlete, a second major effect of ketones, or the metabolism of ketones, is to produce free radicals. And it does that by reducing a factor, not nad, but nadp. And in Bill's case, the cause of Parkinson's is oxidation in the basal ganglia. And Bill, when he first came to me, was taking dopa carbidopa, an MAO inhibitor, an inhibitor of a methylation enzyme, and an agonist of dopa. None of this held him. You get a little ketotic, he looks perfectly normal. And this is done because you've reduced the oxidative stress on the midbrain, and in which case, that's the etiology of Parkinson's. And so.

So you've essentially reversed much of Bill's Parkinson's by shifting his brain from glucose utilization and the production of free radicals from glucose utilization to purely relying upon ketones as an energy source.

Absolutely. That's the essence of it.

And the type of ketones that Bill is using is not a beta hydroxybutyrite salt. He's using something like a 1, 3 butanediol.

No, he's using two forms. He's using a coffee drink where you're just taking fat and making ketone. You could also take the ketone esters, but that takes some approval from fda.

So is this fat? Is this the same thing as you would find in something like, say, bulletproof coffee? Is that what you're.

That's right.

Okay.

Exactly. It's the same sort of stuff you'd use Dr. Seyford uses in his cancer patients.

So, like. Like a C8 form of. Of a medium chain triglyceride.

That's right. It's not ideal, but you can do it without FDA approval.

And you're saying that that would be far safer than him being on one of these exogenous ketone sources, such as a beta hydroxybutyrate salt.

Yeah, no, that. We really couldn't do that.

Okay.

Unsafe.

Okay, gotcha. Now, this butanediol, this ketone, would the appropriate term be a ketone ester?

It's a ketone alcohol.

Okay?

Ketone alcohol. It's just the alcohol form of beta hydroxybutyrate.

Why not just take that? I mean, why wouldn't you take what you've got there in the lab and make it into a powder or into something that people could use as an.

Alternative to a salt if you want to get the ketone levels. Let's say we want to duplicate Cahill's starvation levels. We want to get you up to 7 millimolar ketones. 13 Butane Diol is an alcohol. When we give it to you as an ester, it's rapidly converted and to beta hydroxybutyrate. If we gave you just the pure 13 butane Diol, you'd get drunk.

Okay. So you have to figure out how to convert it into a form in which it's not accompanied by this alcohol.

Yeah. All we're trying to do is not give salt because we've told you why we can't give that. We're giving essentially a mole of ketones a day. If we gave you a mole of acid, in the acid form, you'd become acidotic. So we can't do that. So we have to give you an ester, and we give you an ester that one half of which is the ketone body itself and the other is a compound which is rapidly converted to a ketone body. So you're getting nothing but ketones. We could give you, say, glycerol ester. Well, then you'd have too much glycerol, and then if you had diabetes, your glucose would go up. In fact, when you take ester, we're talking about, the glucose goes down and the insulin goes down. So you can't just use any ester. You really. You can't fool Mother Nature's the AD sets. You want to give. If you're giving ketones, you want to give ketones you don't want to give.

Okay, gotcha.

What is the enzyme processor to be converted to?

Beta alcohol dehydrogenase.

So it's the same thing that converts ethanol?

Yes, absolutely. Same thing.

Is 13 butane Diol found naturally in your body?

Yes, it can be formed if you're very reduced and you get ketotic, you form a small amount of 13 butane diol because you reduce it with NADPH. So, yes.

This isn't something that the body isn't used to.

No.

Something that it has enzymes.

It was. Butane diol was first used as a pig food by Marion Keys and University of Nebraska, and she got it from celanese. Now, that was a semic mixture that was in the 70s, but it actually isn't. You actually make 13 butane down small amounts. So it and beta hydroxybutyrate are normal products. So you would expect no toxicity from these compounds.

So both of these form mirror images and you have to get the right form of both of them.

That's right. It's just. You said it right. It's just like your hand. You've got a right hand and a left hand. These compounds are right handed or left handed. And you've got to use the right hand. You've got to use the proper hand. Not the right hand, the proper hand.

Now, from what I understand, it can be extremely, extremely expensive to actually create a non racemic, non salt version of a ketone in the form that you're saying you'd actually have to take to get into true ketosis without damage. Why is it so expensive?

If we had the production with the sources that we are trying to get it from, it would be about $12 a kilo. In other words, very, very cheap. But for this you need industrial production and you really need this from agricultural sources like corn or sugar cane. You can't make it from the normal chemical companies. You've got to get, you know, we are sitting on the largest mutable source of carbon bonds in the world in the Midwest. And it's called corn. And that's what you want to use because then it's just cheap.

So, so why wouldn't you use corn?

What's the barrier companies that do it?

Okay, so they won't allow you to use their corn to create these salts.

Well, these, these people, I don't want to get too personal, but these people are used to making tank carts full of ethanol or one or high fructose corn syrup. They're not pharmacology. They also pay themselves. Rather, the board pays themselves rather generous salaries. And why change with some nutty baggy pants biochemist comes in there and starts jumping up and down.

Yeah, it just seems, I guess perhaps the market is somewhat small. We're not talking about something like the market for say whey protein or the market for something like, you know, like wine. These, these ketones, you know, they, they still seem to kind of fly under the radar in terms of their use.

And so I actually, that market isn't small. If you really say, if you say that there are 5 million Alzheimer's patients in the United States and you say you want to feed them 150 grams a day. You can do the math.

Yeah, that's true.

If you say that there's 600,000 Parkinsonians and you want to treat them the same way, then you've got a big market. If you say there are 33 million obese people in the United States with type 2 diabetes and you want to get them ketotic. So the markets actually are not small at all.

So what can we do? How can we actually accelerate the ability to create an absorbable, usable form of ketones? That's not damaging.

The engineers that run these things understand it perfectly. And the problem is to get the boards of directors who are not. These are fermentation processes. If the board of directors has no scientists or has an accountant ahead of it, these are difficult terms. So the best way to do it is find someone with more diplomatic skill than me and to convince people that run these companies to do this. We really need it.

Well, tell me the names of the companies and I'll start making some phone calls. We'll be fair.

The companies are quite aware of this.

Okay.

They're a little bit gun shy. They just spent a half a billion dollars making this biodegradable plastic and turned out that the plastic bags shredded.

They couldn't sell it. They couldn't sell it. I don't want to get in. I already have too many enemies.

Okay, all right. Well, we will make more enemies. But in the meantime, if there's anything that myself or my listeners can do to help move this along, because it sounds like it'd be good for a lot of people, including Bill, that have access to this stuff on a relatively affordable basis.

Absolutely. And there are other things. For instance, people say I'm amyotrophic, glabosclerosis. They have a death sentence in two years. So this is not fooling around. I mean, most people are going to die.

Now, what about cancer? I recently read a book about the metabolic theory of cancer in which it was proposed that cancer is not necessarily a genetic issue, but is instead or it is a genetic issue, but a big, big part of that genetic issue is the cell going into a state of glycolysis or production of lactic acid. Even if it's. If it has oxygen available to it and if it's able to metabolize in an aerobic state, this cell isn't doing so. It's burning up a bunch of glucose for fuel. And I've seen talk about the potential therapeutic use, use of ketones in a state like that. Would that be another application, do you think?

Well, cancer is an extremely complex and disparate disease state. And what you're quoting is the so called Warburg hypothesis. And there are a certain number of cancers that do exactly what you say. They glycolize and don't use their mitochondria even in the presence of oxygen. But that's not True of all of them, and it's not universally true.

So there are some cancers that would respond favorably to the presence of ketones or ketosis or fasting and others that would not. And that particular scenario might aggravate?

I don't think it would aggravate, but it certainly wouldn't help.

What would be an example of a cancer? Do you know off the top of your head that an example of a cancer that ketosis may actually be favorable for?

Well, some of the brain tumors.

Okay.

All right.

My brother in law was traveling in Sri Lanka in January and noticed that his peripheral vision started to go. Got into a doctor and they examined him a CT and it turned out that he had a two and a half, about the size of a golf ball tumor in his oxygen occipital lobe. They rushed him back to Sweden and it turned out that he had glioblastoma. This is a pretty much a death sentence. A very short time.

Yeah. The lifespan in glioblastoma is about 12 to 14 months.

So there was a person who did some research with mice, I forget her name, but what she did was she took glioma cancer cell, a human glioma cancer cell, and put it into mice. But she also modified them with the bioluminescent compound and so you can actually see the tumors without sacrificing the mice. Sacrificing mice. She fed the mice just regular food and they died in about 30 days. She fed them on a ketogenic diet and they lasted about four or five days longer. She fed them on a normal diet, treated them with radiation, they lasted about five or six days longer. She fed them on the combination of ketogenic diet, gave them radiation and the tumors went away. And they all lived, pretty much most of them lived two and a half years. They were sacrificed at their normal lifespan and none of them had any tumors left. Now with glioblastoma, Joe Biden's son had this just so happened that my sister and her husband ran into a doctor in Sweden from Italy who's working on it. And he's found that almost 99% of the glioblastomas have cytomegalovirus. So what may be happening is that the cytomegalovirus stays in the brain and causes other tumors degenerate and that's why it's so difficult to cure. He thinks that if he had gotten a hold of Joe Biden's son, he would still be alive today. So anyway, to make a long story short, my brother in law has been on this ketogenic diet, religiously, he gets his blood PHP levels up to sometimes off the scale 8 and keeps his glucose levels extremely low, down 80. And we have high hopes for this treatment. And I'll just have to keep you informed. That plus the combination of retroviral drugs to knock out the cytomegalovirus. But cancer is very complex. Can't just give people hope that if they.

I would modify that. We don't have, I wouldn't say high hopes. We have, we hope mightily. But in general, as Bill said, this is a death sentence. So if you can do anything to retard glioblastoma, it's a plus. And normally they're dead, they say in 12 to 14 months. So we'll see as time goes on whether we've done anything to prolong this man's life. We hope so.

Interesting. So from cancer to Alzheimer's to Ms. And a variety of issues, along with the ability to be able to, for example, prolong sports performance in the face of limited calories. I mean, there's a ton of therapeutic medical uses of ketones, a lot of exercise uses of ketones. So a question that I have for you is, so if this true ketone ester that you talked about is actually a salt from free non racemic ketone that replicates the actual fuel that the body is producing during times of restricted calories, is there any reason to not just say, hey, eat less, pardon the expression, eat less damn food, throw in some intermittent fasting, drink more of the MCTS or a C8 in your coffee, or eat a diet that is c skewed greatly towards fat production and simply leave it at that?

Well, I would say that in general that's true, except I would say convert entirely to the ketone ester. In other words, in the patients that I treated with Alzheimer's for about six years, if you give mid chain and ketones, you're losing some of the effect of coenzyme Q that I talked about about before. So you really would be better off just taking the ketone esters if we could get them. The mid chain is simply stopgap aid that you can do at the present time because they're easily available and there's no restrictions on them. But from a biochemical point of view, they're far from ideal.

Okay, got it. Now, in terms of ketones, I think we've probably kicked the horse to death that a ketone ester is going to be favorable to a ketone salt for a lot of the reasons that we just talked about. But right now the fact of the matter is it's just way too freaking expensive to produce. And so folks will want to engage in calorie restriction and the use of, you know, things like Bill has right now, like this ca. But what about this idea behind nad, which has come up a few times and which I've, I've seen all over the headlines recently in terms of like Scientific American, for example, recently did an article about reversing age with nad. And nad Nicotinamide adenine dinucleotide, for those of you who want to impress people at cocktail parties, is something we've known about for a long time, but I never until recently saw people talk, talking about using it to mimic anti aging and to mimic exactly what it is. We were just talking about calorie restriction. So where does NAD fit in here? And do you think that these companies that are now beginning to market NAD as a supplement are actually providing something valuable to the general public?

NAD is, what you're doing with ketone bodies is reducing the NAD in the mitochondrial. So it's right at the center of this. So if you're going to make 50 kilos of ATP a day, you're going to need 15 kilos of NAD to do that. And so it's at the heart now in regard to aging. The best work that's been done on that has been done in nematodes. It's been done in California by a woman named. What's the woman's name in California works on nematodes. I can't. Mary. Anyway, she was at UC San Francisco. Now she's down at the Google. What's her name? We can't remember.

So she's been working on like nematodes, like the roundworms.

Yeah. Yes. And if you look at the effects of giving ketone making animals rats ketotic, with ketone ester, you lower their insulin, you lower their blood glucose, you lower their cholesterol, you increase their energy, you decrease their appetite and they lose weight. So most of the effects that you associate with the disease of aging, you've reversed. Now the mechanisms of aging are like cancer are complex. We're actually beginning to work on that now. And the idea that you can feed NAD and reverse aging is unlikely for the reasons I told you if you need.

Because of how much you'd have to take.

Yeah, you'd have to take 15 kilos. And this is the same reason that ketones work in, in free radical disease. I can feed you all the vitamin C in the world and you won't do anything. If I let you generate the NADPH by ketones, you reduce all the things you want to and Bill quits shaking. Now that's the sort of argument that Krebs and Linus Pauling got into maybe 20 years ago, where Linus Pauling was arguing that people should take massive doses of vitamin C. It's not, in fact true. And finally one day Krebs just wrote him a letter and said, please quit writing about that which you do not understand. And I think Craig was quite right and Pauline didn't understand it and it doesn't work.

So megadosing with vitamin C is not something that you're a fan of.

Well, I'm an opponent. If you take a large dose of vitamin C, you'll produce kidney stones and diabetics. Krebs has written about this. No megadose of vitamin C can be actually dangerous.

Interesting.

And it's not going to do what Pauling thought or advocated it was going to do. Just not true. Pauling was a chemist, Krebs was a biochemist.

There's a difference.

Why is it that so many alternative medical physicians, and I've even seen MDs, do this as well. They'll prescribe like high dose vitamin C for immune system issues or for infections or for fighting high amounts of oxidation.

Without making more enemies. My medical colleagues are very well educated and they do silly, stupid things. And there's absolutely no basis to say that you can reduce something by feeding vitamin C. Just no basis for this at all. The fact that they do it, doctors used to bleed people too.

Yeah. You know, with this NAD issue, what the claim is is that with the use of a single dose in NAD or single dose of nad, you can get what they describe as a statistically significant increase in NAD levels. That's what these companies that are now producing, I believe Chromadex is the name of a company that's trying to come out with like a new NAD drug. Now, I would imagine that they're not saying a single dose is 15 kilos. So what is it that they're missing here? What component of it, of the use of NAD supplementation is it that they're wrong about?

Well, I have no doubt that if you gave a large dose of nad, you would increase the tissue levels of NAD in the, in the tissue you're looking at. You're not interested in the nad, you're interested in the ratio, you're interested in the redox state, you're interested in NAD to nadh Ratio. Now, that has not changed by feeding nad. So all the operational things we're talking about is changing the redox state of the NAD couple, like we're changing the redox state of the Q couple. And by redox state, I mean the potential to donate hydrogen. And so just increasing the NAD won't do anything. It lets a lot of people advocate feeding people Q. You've read this uncertainly. And if you increase Q, Britain chant showed years ago that the biggest source of free radicals is Q semiquinone, a half oxidized form of Q. And so if you're feeding people Q, you're actually making more free radicals.

And the use of an NAD supplement would be the equivalent of feeding someone.

Q. Oh, not the equivalent, but essentially worthless.

It would be very similar to it. And just for our listeners to clarify, what is Q again?

Q is the second site after in the mitochondria. You start with NADH and you go the next site where you next, Your next ATP site 2 is Q semiquinone or, sorry, Q quinod, coenzyme. Q.

Right.

So it's the next transport form in the mitochondria.

So we're talking about it being synonymous to Coq 10.

Yes, exactly.

Okay, got it.

That all of the antioxidants work is that they have an active form and an inactive form. When they are active, they're actually going to take on a free radical and become a free radical themselves. Now, the reason that they aren't as harmful is that they have ways of distributing that electron and holding it that the hydroxyl radical, for instance, couldn't be able to do because it's so reactive in such a small structure. But once they say vitamin C has gone from the active state to the inactive state by quenching one hydroxyl radical, you need to recharge that vitamin C. What Dr. Veech is saying is that NADP is the recharger of every antioxidant. So taking, taking vitamin C by itself would be like eating rechargeable batteries without the battery recharge.

Well, look, I gotcha.

The negative, the most negative potential in the cell, the NAD. NAD, that's minus 0.42 volts. All the other ascorbic acid is plus 10. So all the other redox couples, which there are many, are all slaves to this most negative couple, which is the NADP couple. So all the other things Q, everything is a slave to that. So if you keep that reduced, then you're going to destroy free radicals and you're going to.

And the magic of why beta hydroxybutyrate works is it's going to change the ratio of NADH to NAD in the mitochondria. It's also going to change the ratio of NADPH to NADP in the cytosol. And by doing that, it recharges all of the antioxidants and does all these things that NAD is supposed to be claimed to be doing, but it does it in a much more effective way.

Without producing an actual free radical.

Decreased. And, you know, this was all Krebs and I worked this 60s.

Okay, so you would, you would not. If you had your way, you would not use nad, you would not use vitamin C, and you would not use any ketone salt due to the potential for production of free radicals, mitochondrial damage, and also excessive intake of sodium and or calcium, and the potential for everything from calcification to kidney stones and hypertension.

Okay, yes, that's right. I wouldn't use any of those.

Now, you did mention, of course, so far that you do like the use of MCTS or C8. Is there, in your opinion? Because I was recently at a conference where there were a bunch of people drinking this fatty coffee, but they were there next to their big cup of coffee. They had eggs, bacon, berries, muffins, et cetera. And my opinion, my advice to them was either do the coffee by itself without anything at all, or just eat the food by itself, but don't do both together because the potential for excessive calorie intake and the potential for fat oxidation from high blood glucose combined with high amounts of fat intake. What's your take on the best time to actually use something like C8 or MCT if you were going to use that to generate ketones or to mimic a somewhat fasted state while still keeping some calories on board.

Well, let's take the case of Bill, since he's here. He really can't get along without adequate level of blood ketone bodies. And right now, for administrative reasons having to do with FDA and whatnot, we can't give him the ester. So the only thing we can do is give him the mid chain. It's far from ideal, but it. It'll work as a stopgap.

Okay, if I could just interject that I have sort of a sensitive system for testing the effects of mixing, as you say. Said a lot of food for breakfast with the coffee, and if I eat anything else with the coffee, it does not work at all to relieve my symptoms. So I'm suggesting that because I have Parkinson's, it's a very. It's like having your own canary be able to test whether your theory works or not. You're absolutely right.

Yeah.

That I would say if you're trying to, to prevent the degenerative diseases by taking, say, coconut oil, using it for meals and eating a lot of fruits and things, that is probably having no effect.

Yeah. Bill one day went out to dinner and he had a big slab of cheesecake and he was a wreck the next day. So destroy the effect of ketosis. So you're quite right. You don't want a high glucose.

Okay, got it. Dr. Veece, do you use supplements? Do you do it like, if you were going to use something for anti aging, for example, like what would, what would be your recommendations or what would you yourself use based off the research that you've seen? Because it seems like you're. You're pretty steeped in the research a lot.

I'd take a normal vitamin pill that you get at the giant food, and if I could get hold of them, I'd take the ketone esters and that's all I do.

And that's it. Not. What about like fish oil or anything like that?

Oh, yeah, you can take that. That won't hurt you.

Yeah.

You know, the PUFAs have been. If, if you're a neonate and don't get enough pufa in your breast milk, then it has definite effects. To see PUFAs working in things like traumatic brain injury, there's no evidence. Mega studies don't show much effect, but they're not harmful.

Now, from what I understand, like darpa and I've heard about, like, different Tour de France cycling teams. I know you guys got some DARPA funding for your group. I've heard about professional cycling teams using, using ketones as like a brand new fuel. There were some of those headlines that I read off in the intro to our podcast. Can you tell me a little bit about the DARPA funding that your group received and what you wound up doing with that?

Well, actually, the man that gave us that in charge of that project was Dr. Joseph Politsky. He actually was an ironman marathoner. He gave us the task of making a new diet for their special forces that would increase their physical performance and not impair their cognitive function. And we did that. This ketone ester that we made took us several years. We came up with this thing. And in fact, in rats, in the profused rat heart, working perfused rat heart, we could increase the energy production by the heart by 28%. And as I said, I told Henry Lardy, who's professor of entomology at University of Wisconsin, I said, we've increased the efficiency of ATP production in the heart by 28%. He said, I don't believe you. I said, okay, what number do you want me to change? We're only doing joules. We're doing pressure and volume now. That's joules. So we're increasing the energy now in the athletes. You don't, there's a lot of wasted energy when you're actually running. Dr. Clark I think can get 2% increase, which makes a difference if you're a roar. And one of the people ran the Olympic set an Olympic record. And I, oh, the only other thing I'd say is our primary purpose doing this was to make a new fuel for our special forces. And also we have some medical uses.

But at this point, that fuel that you developed, that one that allowed the product perfused rat heart to be 28 or to produce 28 more energy. This, this runs us up against that same wall we were talking about before where this is the non racemic, non salt version of the ketone that you're giving this rat.

That's right, that's right. And, and it will work. But you know, if I had, if I had a couple of tons of this stuff, giving it to a bunch of athletes would be the last thing I'd do. I'd give it to the ALS and to the Parkinson's, the Alzheimer's first, because the athletes can, sure they do better on stuff, but they can get along without it. Some of these diseases can't get along without it. And so in a field of shortage, you deal with the women and children first.

We've had a lot of listeners speaking of diseases like this write in and ask about Alzheimer's. And I know that Dr. Mary Newport, for example has a website called coconutketones.com and she wrote a book called Alzheimer's Disease. What if there was a cure when it comes to Alzheimer's? Do you think that it's the same issue that these non racemic version of ketones would be what's necessary? Or what do you think about Dr. Mary Newport's use of basically, basically just coconut oil?

Well, Dr. Newport called me, I and she first she, she knew about ketones. Dr. Newport was a neonatologist, he's a well trained physician and her husband had had 16 years of Alzheimer's going downhill and she tried him on ketones and he showed a slight positive response for maybe a couple of months that then quit and lost the response. And so at that point, we had to put him on the ketone esters. And he was on that for about five or six years. He subsequently died in January. And I think part of the reason was that either we didn't give him enough or didn't have enough or the disease progressed and we didn't stop, but.

And he was literally just getting them from your lab.

That's correct. Made in my lab by Todd King.

Something we didn't know at the time is that.

Yeah, well. And Dr. Newport was giving it with coconut oil because, bless her heart, she thought if something's good, part of it.

Was, what was she doing?

Well, she was feeding coconut oil at the same time as she was feeding Esther. Okay, I don't want to go. I don't want to be critical of Dr. Newport. She did heroic duty. I mean, this guy was really severely impaired. And so. And she kept him alive. He would have been dead six years before he did die if it weren't for her and her care. And that's the only thing that kept him alive. If for some reason, Todd couldn't make the ketones, he just totally fell apart.

Okay, so when it comes to whether or not coconut oil can truly work for curing Alzheimer's, as some may claim, really what it comes down to is that it would turn out that ketone esters would hold much more promise than just overdosing with coconut oil.

Yes. Dr. Newport gets hundreds of emails, and she doesn't want to put out that there's no hope. And so it's sort of like Bill with the mid chain. No alternative. You could try it. Is it ideal? No, it's not ideal.

Now, I've used ketones before, like I mentioned, for, you know, these ketone salts, at least for, you know, while free diving, you know, and that. That was based off a discussion with Dominique d' Agostino about an increase in breath hold time and a reversal of hypoprofen fusion to brain tissue in rat models. So I figured it'd be at least worth a try. And I've also used them for cycling, for example, mixed with MCT oil in a bottle. And I've written articles about this, by the way. Everything that we're talking about I'll link to if you go to BenGreenfieldFitness.com veatch that's BenGreenfieldFitness.com V E E C H. You can access all the show notes for everything that we're discussing. But Dr. Veach. I found that although it did indeed increase my ketone production, it's not too friendly to the gut. These ketone salts, can the same be said for ketone esters? Are they difficult to digest? Could they lead to gut distress?

I hesitate. Certain people can take them without any problem. I for instance, because I was giving them to Mary Dubara, I took them just to see if it's going to kill anybody. Didn't kill me.

Sounds like a safe self experiment.

Well, they certainly are aversive in taste. So the athletes, it doesn't matter. The special force, it doesn't matter. If you're dealing with demanded patients, it's a very big problem because they won't take something that tastes bad.

Right.

So we're working on getting rid of that bad taste. In general, I recommend taking the ketone esters in the morning, late afternoon. I don't recommend taking them and then laying down immediately. You can get some degree of esophagitis or reflux if you take these late at night. So.

Okay, gotcha. Now you mentioned that in many cases many of the therapeutic effects of ketosis are seen of around 7 millimolar, which is quite high. You know, even when I'm fast that I'm generally around one to three. And if I combine fasting with exercise, I'll get in that 3 to 7 range. But it's, it's difficult, you know that we're talking about like a two hour bike ride in an overnight fasted state. Now in terms of measuring that number, there are a variety of different ketone measuring devices that are out there. Everything from the fingertip pricking for the blood measurement to urinary measurements, which I know have fallen quite out of favor due to them showing simply unmetabolized ketones, to my understanding. But then there's breath testing. Do you experiment with different forms of measuring ketones and if so, what have you found to be best or most user friendly?

Well, the only thing that we really tested extensively, unfortunately is the Abbott. What's it called? Abbott.

They call it a keto.

Yeah, and that is quite accurate. There was a, another stick that was.

I will say that it won't detect the racemic. If you have a racemic mixture that's a mixture of both the right handed and the left handed forms, it only detects the biologically active form. So you could potentially poison yourself by thinking that you're at point you're at 7 millimolar when actually you're at 14. Because the test kit only measures the D form of beta hydroxy.

Some of these kits don't work. For instance, another person that's an athlete was the taking high fat and. And he kept getting high glucose and it worried me. But in fact, it was just a stick. Was a stick that came from cvs and I don't know what it was, but it didn't give accurate glucose. So.

But. But at cvs, for example, you can get these precision extra blood ketone strips made by my other.

They sell something else. It's cheaper.

Okay.

And I gotcha.

Yeah, I don't. I don't know the name of the other. What about these. These breath testing devices? Like ketones?

No, they're based on acetone and that's a byproduct. That small amount that you're getting, that doesn't tell you anything.

So.

No.

Do you think it's coincidence? Because I've tested with precision extra blood and with breath ketone monitors and I've found there to be pretty decent correlation. Do you think that's just chances or is it really only acetone that the breath is measuring?

It's only acetone. But you did an experiment. You're way ahead of me, so I should shut up.

Okay. Yeah. It was my impression that there are a few of them. There are some that are basically like tubes that you breathe into and then you break a little ampoule. And that does indeed measure acetone. But there's another one called a ketonics breath testing device that, that actually seems to correlate well to blood measurements. But I was just curious if you'd ever actually tested something like that.

I don't know anything about it. You're way ahead of me. I don't.

Okay, I'll send you information. The only reason I like it is when I'm out exercising and stuff. A lot of times, just constantly pricking my finger can be annoying versus breathing into this breath ketone monitor.

If it works, it's good. The only reason I don't like Abbott, it costs a lot and I wish it were cheaper, but from a. From a. We've calibrated it and it works. We've calibrated against enzymatic tests in the lab and it's pretty accurate.

Now, one last question for you. We have folks like, and I don't know if you're familiar with, for example, Dr. Peter Attia or, or Dr. Dominique D' Agostino or a lot of these people that are out there doing research on things like performance and the use of ketones or the use of ketosis. For example, in Dom's case, to reduce the damage done to divers, for example, who are breath holding for long periods of time. In your opinion, based off of what you've discovered so far, would you say that at this point, point where the research and the available supplements and synthetic ketones stand, that these type of folks would be best incorporating fasting with something like C8 and Bill's approach versus the use of salts until these esters actually become available? Is that basically what the takeaway is here?

Yes, I agree. And I think Dr. Attia, he. This does fasting, I think. Does he do mid chain too?

I don't know if he uses exogenous ketones. I know he does fasting and some amount of carbohydrate restriction.

Yeah, well, that'll give you ketosis. And yes, I would think that it would be best to avoid the salts and it would also be best to avoid. There are some esters that are, as I said, are acetoacetate and racemic 1, 3 butanediol, and those should be.

Be avoided all together.

So.

Okay, gotcha.

You're chasing Chris from up a hill and you're wondering why he's pulling away from you. Because he's on Dr. Beach's. Esther, maybe I'm not seeing nice.

There's a secret sauce, you're on the.

Receipt mixture or something that has acetoacetate, which is like the spent form of the fuel. You're gonna have a hard time catching up to Chris.

Dr. Veach, what's a typical breakfast for you?

Well, I don't really eat breakfast. I'm quite old and I don't need calories. So I eat some toast with peanut butter and jam for breakfast, which would.

Definitely not be like a ketotic high.

Not at all. Not at all.

So you yourself do not try to keep yourself in a state of ketosis?

No, not really. For many years. I took the ketone ester just to see what it would do. And that'll get you ketotic. But I'm, you know, I, I don't need to be an athlete. I don't, I don't go on these ultramarathons.

So what about for disease prevention? Are you concerned at all about like glycation, end products or fluctuations and blood sugar, things like that?

Yes, and I think also for general prevention of, you know, when you get to my age, the incidence of Alzheimer's is quite high. And so, yes, for the prevention of cognitive impairment, prevention of Parkinson's, and probably the prevention of aging, it would Be a value.

Yeah. Eventually for you to switch to having an avocado with some olive oil for.

That's right. That's right. There you go.

I'll send you some recipes. I'll send you my avocado chocolate pudding recipe. It's fantastic.

Well, I have people that work with me that are devotees of that. It also takes a lot of time.

Yeah.

And I don't have that much time. I'm in the lab by 6:30 and so I just don't.

You can just make a big, big batch of chocolate pudding. I fat chocolate pudding to keep throwing the lab. Well, I know I've kept you for a while here and this has been fascinating to hear the take of an actual ketone researcher on ketones rather than what pop culture and the media and supplement companies might say about them. So certainly plenty of fuel, pun intended for thought here. I look forward to seeing how these true ketone esters and their availability progresses. And again, anything that myself or my listeners can do to help make that happen, feel free to reach out. We've got kind of a big army of folks listening in who can do things like write letters or make phone calls if it would be helpful because it sounds like this could help a lot of people if these things became more commercially available.

Absolutely. We can't make enough. And it would be. There are a lot of people that actually need these things like that.

Yeah.

Thank you for your time.

Yeah. Thank you for coming on. And again, if you're listening, you can go to BenGreenfieldFitness.com Veach that's BenGreenfieldFitness.com V E E C H and I'll link to Dr. Veech's website along with some of the other things we talked about like the book on Alzheimer's disease and this C8 form of oil. These articles that I was talking about about NAD and the anti aging NAD fad and oh so much more ketone goodness. So Dr. Veach and Bill, thanks so much for coming on the show.

Pleasure.

Thank you.

All right, folks, this is Ben Greenfield signing out from BenGreenfieldFitness.com have a healthy week.

You've been listening to the Ben Greenfield Fitness Podcast. Go to Ben Greenfield greenfieldfitness.com for even more cutting edge fitness and performance advice.

It.