Wednesday 24 July 2019

A KETOGENIC PILL FOR GLIOBLASTOMA ?

Came across this study and would love to know others' thoughts. I have been following the progress of the ketogenic (almost no carbohydrate) diet for some time and its potential value in glioblastoma and epilepsy. This study seems to show that some of the purported benefits could be achieved through a ketone ester supplement, which serves to provide the brain with its alternative non-glucose fuel source (Ketone bodies)
direct link to abstract: https://academic.oup.com/neuro-oncology/article-abstract/20/suppl_6/vi36/5154383?redirectedFrom=fulltext )

Any thoughts on this, and how it might be translated to human use?

Thanks!

10 comments:

  1. Saw this. Warburg effect. Seems encouraging! Seems a simple dietary approach! Go keto!

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  2. I'm going to be meeting with one of the authors of this abstract this week (Brent Reynolds) so I will ask him about it.

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  3. That’s great - incidentally, I emailed the very same man for more details - sat hi from me! I’m trying to make sense of the different types of ketone esters at the moment.
    Stu

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    1. Our meeting got postponed, not sure when it'll happen now, but will keep you posted if I find out anything interesting.

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  5. Any word? Keen to give KEs a try but not sure where to start.

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    1. I would try reaching out to the other co-authors Dominic D'Agostino and/or Angela Poff. They have been studying the use of exogenous ketone supplementation as a cancer therapy for awhile, and though their research has mostly been preclinical, if there was any human data they would likely know about it.

      https://www.ncbi.nlm.nih.gov/pubmed/26061868
      Non-Toxic Metabolic Management of Metastatic Cancer in VM Mice: Novel Combination of Ketogenic Diet, Ketone Supplementation, and Hyperbaric Oxygen Therapy.

      https://www.ncbi.nlm.nih.gov/pubmed/24615175
      Ketone supplementation decreases tumor cell viability and prolongs survival of mice with metastatic cancer.

      https://www.ncbi.nlm.nih.gov/pubmed/26855664
      Effects of exogenous ketone supplementation on blood ketone, glucose, triglyceride, and lipoprotein levels in Sprague-Dawley rats.







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    2. In general KE's provide only a modest boost to the needed ketosis levels when you are trying to do it to treat brain cancer. The catch for brain cancer is that there is a glucose sparing mechanism where other parts of the body will use ketones sooner than the brain in order to give the brain glucose. So theoretically you'd want to be in deep ketosis for brain cancer. Roughly in the range of glucose below 80 and ketones over 3 or 4.

      So while KE's can help some, they often only give a modest boost and only slightly reduce how strict you have to be on your diet, and they typically come with some stomach distress. MCT oil is a similar situation, though they also now have powdered mct that lets you do higher doses because it absorbs slower.

      So in general they are add on's to a keto diet and not likely something that lets you get away with eating bread :(

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    3. Interesting, sounds like you know your onions on this topic. Is this an area you have experience in? What’s the best way of exploring it further - I’ve no idea where I would find a cancer doc that would do the nutritional / bloods oversight needed?

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    4. I'm on my third 'trial' of doing keto. First 2 were sort of test runs of about a month each to try and dial it in. 3rd one was the real deal and done with RT and now ongoing CT and am up to 4 months now (so total of maybe 7 months 'on diet').

      I spent a lot of time trying to sort the science of whether it was useful or not and basically its not even close to sorted yet. So its a bit of a leap of faith.

      That said, the 'how' to do keto I've got a decent handle on. You don't need a doc, though adding metformin is a big plus and is either a doc or messing with grey market online buying. A good resource would be to check out the nutritionist Miriam Kalamian.

      A general guide:
      1) Buy an Abbot Precision extra and blood glucose and ketone strips (ebay is way cheaper and legit test strips, than buying at pharmacy). Cheaper meter/strip combos seem to not be accurate enough. When measuring prewarm your finger in hot water (cleanes and also helps blood flow so stabilizes readings).

      2) General goal is to get glucose mostly below 75 though into the 50's gets risky, and get ketones over 3 and over 9 is risky.

      3) Get a few keto cookbooks that list recipes by weights and give breakdowns of all ingredients. Get a good food scale. Must measure everything you eat. Plan on giving up restaurants, takeout, premade food, etc.

      4) Get a program like cronometer to log all food. Shoot for about 85% fat, 10% protein and 5% carbs. Meals that are too big or too many calories per day will result in a glucose spike. So I generally am slowly loosing weight and intentionally lost notable weight during radiation to sort of 'double down'.

      5) At first just do a week trying to eat roughly keto and get a general idea. Then kick in the actual diet with a 3 day water only fast. Beware the fast AND the diet cause significant drops in water retention and thus electrolyte imbalances. Simplest thing is something like Keto1000 2-3 scoops a day or make your own mix. Plus helps reinforce that you drink 4 liters of liquid a day. Google the 'Keto Flu' for more info.

      6) Drink warmed oil/broth mix a few times a day (low carb broth!). 50-150 grams of oil. It allows you to have more 'real food' meals that aren't so extremely high in fat. Light olive oil, flax oil, avocado oil and a bit of sesame oil tastes good. Add MCT oil slowly and with food. I still can only take about 20g of MCT total per day without having the runs.

      7) Track your ketones once a day and glucose a few times. Review food vs results, but note the ketones change slowly and change about a day after food changes.

      8) Iterate and adapt. Its a lot of work and as unpleasant as chemo quite honestly. But hoping it makes a real difference. It also gets a lot easier after the first month.

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