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Dr. Steven Gundry Rocks The Keto Paradigm With New Revelations


Think you know everything about Keto? Get ready to be mind blown because Dr. Steven Gundry, one of the world’s top cardiothoracic surgeons and a medical director at The International Heart and Lung Institute Center for Restorative Medicine, has done it again. Dr. Steven explains that even at full ketosis in humans, we will only get 30% of our energy needs met by burning ketones. 70% has to come from free fatty acids and glucose. The weight loss from a ketogenic diet caused its fame, but listen in as Dr. Gundry pulls back the veil on what’s really happening with ketones.

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Dr. Steven Gundry Rocks The Keto Paradigm With New Revelations

If you are thinking about the 100-year heart, there is no greater authority to get you there than my guest now on this show. This is Dr. Steven Gundry. First of all, let me say hello, Dr. Gundry.

Thanks for having me on the show. I appreciate it.

It is great to have you here again. If you don’t know Dr. Gundry, I do not know where you have been. Certainly, you have not been looking at actual health. If you have only been listening to your traditional medical doctor’s opinions, you are not going to hear about Dr. Gundry but since you are here on my show, you likely have. He is one of the world’s top cardiothoracic surgeons and a pioneer in nutrition, as well as the Medical Director at the International Heart and Lung Institute and Center for Restorative Medicine in Palm Springs and also in Santa Barbara, two phenomenal locations to go visit.

He spent the last few decades studying the microbiome and now helps patients use diet nutrition as a key form of treatment. He is the author of many New York Times bestselling books, including The Plant Paradox, which was the original that changed so many people’s minds as to I thought all plants were healthy and plant-based was the way to go. Now you read The Plant Paradox. There is a paradox to the benefits of eating plants and contrary to what many people would think.

Of course, the cookbooks, then he comes up with The Longevity Paradox, The Energy Paradox, and now the book that we are going to dive into is Unlocking The Keto Code, which I have read. It is groundbreaking and whatever you think about keto. If you are into keto, you are going to learn a lot from reading Dr. Gundry’s new book.

He is also the Founder of Gundry MD, where he has got a full line of wellness products, supplements, and he is the host of The Dr. Gundry Podcast. Dr. Gundry, this is not even talking about all of your accolades as a cardiovascular surgeon, help me out here. Tell me some of your backstories. What was your interest in becoming a cardiovascular surgeon, your life as a surgeon? Tell me about your nutritional and wellness training as a cardiovascular surgeon.

I decided to become a doctor at age ten after reading a book in my grade school library called All About You, that was the day I decided to be a doctor and never looked back. I was blessed by having some great mentors in medical school, at the Medical College of Georgia in Augusta, who took me under their arms.

They were wonderful pediatric cardiologists who maybe see patients all the time. They say, “You are going to be a great pediatric cardiologist.” I said, well, “I love to find out what is wrong.” I like fixing what is wrong better. My mentor, Robert Ellison said, “You’ve got to go to the University of Michigan and get trained.” When I’ve got to the University of Michigan, I met one of the fellow residents who was the best surgeon I had ever met.

I said, “How did you get so good?” He said, “I went to the NIH and trained with Dr. Moro.” I said, “How do I do that?” He said, “Go interview.” I’m blessed by being a research fellow at the NIH for several years. I was blessed to get into the hospital for sick children at Great Ormond Street, London, England, to do my children’s heart surgery training.

Long story short, I was eventually recruited to become Professor and Chairman at Loma Linda University School of Medicine nearby here in Loma Linda, California, which is the only blue zone in the United States. Interestingly enough, I’m the only nutritionist who has spent most of his career living in a blue zone.

For patients to avoid heart surgeons in the future, we have to teach them how to eat.

I’ve got interested in nutrition when I was an undergraduate at Yale, were back in those dark ages, we could design our own major and defend a thesis very much like doing a Master’s program as an undergraduate. My thesis was that you could take a great ape manipulate its food supply, manipulate its environment, and prove that you would arrive at a human being.

After four years of research, I defended my thesis, got honors, gave it to my parents, went away, and became a famous heart surgeon. I pioneered minimally invasive heart surgery. My partner and I, Leonard Bailey, pioneered infant pediatric heart transplantation. I invented a way of protecting the heart, which is still used in almost every operation in the world, a Gundry retrograde cardioplegia catheter.

As a very famous heart surgeon, I was one of those people who had inoperable coronary artery disease. I would come to visit from all over the country to try and talk people like me into operating on them, which was usually a hopeless case. There were a few of us idiots. I met a gentleman who I call Big Ed, in all my books.

He is a real guy from Miami, Florida. He was 48 years old. He had inoperable coronary artery disease. Every blood vessel was clogged up. You could not put stents in and there was not any place to put a bypass beyond a blockage because everything was clocked. He like many people would go around the country to famous centers. Everybody he visited turned him down, “Nothing we can do for you. Have a nice day.”

He did this for six months and he ended up in my office. I looked at his angiogram six months earlier. I said, “I do not like to turn down people but I agree with everybody else. I’m not going to be able to help you. Sorry.” He said, “This has been six months. I have been on a diet for these six months. I have lost 45 pounds.” He is Big Ed because he weighed 265 pounds when I met him. He had been over 300 pounds. He says, “I have gone to a health food store and taken all of these supplements.” He brings in a shopping bag of supplements.

He said, “Maybe I did something in here.” I’m scratching my professor’s beard and going, “Good for you by losing weight but it is not going to do anything in your coronary arteries. I know what you did with those supplements. You made expensive urine. You wasted all your money. I firmly believe like you probably believe because that is the way you and I were trained. You and I got a couple of hours of nutrition. This is a fat, protein, and carbohydrate, end of the lecture. Here are some vitamins that we know you need but the USDA is given the limits of these things, and have a nice day.”

Big Ed talk to me to do an angiogram of him. Lo and behold in six months’ time, this guy had cleaned out 50% of the blockages in his heart. It is gone. I had never seen and heard of anything like that. Even when we look at high-dose statin trials, we talk about a statistical significance of a 0.1% reduction in plaque burden and that is the greatest thing of all time. Yet, here is a guy who has reduced his plaque burden by 50%. The blockages are gone in six months.

I asked him to describe the diet that he was on and long story short, he read verbatim my research project at Yale University, my thesis. Primarily quite frankly, a plant-based diet but a very different plant-based diet based on evolution. I looked at his supplements and as I mentioned, “I’m famous for keeping a heart alive for heart transplants, and during heart surgery.” I was putting all sorts of funny compounds down the veins and arteries of the heart to protect them.

A lot of these compounds, he was swallowing and it never occurred to me to swallow these things. I was a big fat guy, even though I was running 30 miles a week, going to the gym for one hour every day, eating a healthy low-fat diet because everybody knows that that is what you are supposed to do. I had high cholesterol, pre-diabetes hypertension, migraine headaches, arthritis so bad. I wore braces on my knees to run. I figured that is my genetics. When I started putting myself on my own program, I lost 50 pounds my first year. Subsequently lost another 20 pounds and I have kept it off for several years.

The biggest mistake I made was people I would operate on, I put them on this program, and their diabetes, hypertension, and arthritis regressed. After about a year of doing this at Loma Linda, I had an epiphany one Friday morning looking in the mirror before I went to work. I said, “I have got this all wrong. I should not operate on people and teach them how to eat. They will avoid me in the future.” I said, “I go to teach them how to eat. I never have to operate on.” As a career choice for a heart surgeon, that is dumb, as my wife would remind me for many years.

HHS 34 Dr. Steven Gundry | Keto Paradigm
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I resigned from my position. I set up a clinic in Palm Springs and subsequently in Santa Barbara. I’m a researcher I said, “I want to go in and out to eat some certain foods. I want to send you to Costco, Trader Joe’s or The Health Food Store, and I want you to buy some supplements. I want to draw your blood every three months and let’s see what happens.”

We saw what happened. I started publishing my results at the American Heart Association and American College of Cardiology, etc. That resulted in my most famous book, The Plant Paradox, where I made the case that a lot of the healthy foods you think are good for you are killing you, and here is what to do. It spent almost a year on the New York Times bestseller list. It is still a bestseller on Amazon and the rest is history.

The cardiovascular surgeon is at the top of the health educational food chain in such notoriety. When I was a young, single cardiologist in Arizona and I’ve first got out there, I was hanging out with a guy who was a cardiovascular surgeon. I would always defer to him if we would be out in public, talking with people and maybe talking to a couple of women, I would say, “I’m the cardiologist but he is the surgeon. He is the real deal guy. He is the top gun and certainly in the heart world.”

It is such an epiphany moment but also where your wife would come in and say, “More than likely you are doing well financially as a cardiovascular surgeon and myself doing well financially as a cardiologist, as a senior partner in the biggest group in the State of Arizona. Number one, allow yourself to have that epiphany to say, “There is a better way and a different way to tackle cardiovascular disease and give people the best.” The financial ramifications of that jump. I’m sure myself, like you, you look in the mirror and say, “I’m about a bigger purpose than the paycheck.”

I’ve got four children and proverbially in your deathbed, you look at your shoulder and say, “I did it this way. I should have done it this way but I was worried about the money I stuck with it.” Let me ask you this. Back in the year 2000, maybe you were there, I was a fellow and down in Orlando. I saw a debate between the late Robert Atkins and Dean Ornish. They were up on stage in front of thousands of people, each staking their claim, from what I could tell those guys hated each other. There was a serious disdain for them. That was my first introduction to nutrition and even the conversation.

I was already a cardiology fellow by that point, 4 years of osteopathic medical school, 3 years internal medicine, now I’m a cardiology fellow and I hear that debate. Coming from you is such an authority to see what you have seen. I know you talk about this in your new book as well, where you talk about time-restricted feeding and how beneficial that is.

In our office and our team, we talk about the sunshine schedule, making sure you are eating certainly when it is sunny outside and laid outside. You are never eating when it is dark. My thought on this, you summed it up with your patient if we go into fasting. What about even prolonged fasting, where we do 24, 36, 72-hour fasting, and now the body is looking for food for fuel. Will it start to break down coronary artery plaque and calcifications because it needs fuel? At the end of the day, I can’t imagine the body would defer to break down brain and muscle tissue. It is going to break down fat, things that it deems unnecessary, and plaque would be part of that.

Whenever we are starving we do not care about unnecessary parts of us. I see a number of people, particularly women who go on a fairly vigorous weight reduction diet, and that can include fasting. Their hair thins out and falls out. They panic and go, “It is my thyroid.” We look at their thyroid numbers and they are fabulous. I said, “Your body is saying this is expendable. I have no need for hair. It requires protein to make so for a while, we are going to cut back on hair production because we need it for other things.”

I think the same thing holds certainly for plaque and coronary arteries. I happen to think there is even a bigger driving factor, for instance, any of us who do weights, use barbells, are married, and have a wedding ring. We develop calluses on either side of our wedding ring. Those calluses are layers of dead skin, to protect against the trauma.

One of the arguments that I learned from Michael DeBakey was that we put calluses on our coronary arteries to protect against inflammation and that callus keeps getting deposited. What I learned from Big Ed is if you no longer have a driver of inflammation, which I personally think comes from a leaky gut, there is no need for those calluses and they regressed. That is another way of looking at the same thing you are saying.

When I first met my wife who pull me out of the matrix, she open up my eyes back in 2005, and at that time, we see sickness all around us. I saw a sickness in my own father who is a cardiologist. He developed a Parkinson-like illness called progressive supranuclear palsy. My father was a cardiologist. I was following in his footsteps. When I met my wife and she said, “You have got to change all these things if you want to avoid becoming like your father.” It got my attention because how he suffered and died was cruel. My father was the first DO at the Cleveland Clinic and the University of Iowa in 1972.

“Ketones are the best clean-burning fuel” is far from the truth.

In any case, when I met my wife, that is one of the things she talked about was leaky gut. I said, “Where did you come up with that bogus chiropractic diagnosis?” She said, “Go read about it.” As that extends, it is when you went to go read about it, there was not much to read. You would talk to people, it made sense.

Over the last several years, the literature is very effusive about leaky gut and the ability to test for it now. I applaud you. What you said certainly is that if we have that leaky gut, things get into the body, the immune system activates, inflammation, oxidative stress, leaky heart, leaky brain, and so on. You talk about various things in your new book, also that as it pertains to factors that would lead to leaky gut. In your book, you break down amazingly this whole idea of ketones are not what we think they are or in the sense of how they work. It is due to this thing called mitochondrial uncoupling.

I spent about six months working on the manuscript, trying to figure out another way of saying, “Mitochondrial uncoupling.” Unfortunately, the literature is full of a description of what uncoupling mitochondria mean. I finally gave up and said, “This is what it is called and I’m going to have to stick with it. I’m going to have to explain what the heck that is.”

I spent quite a fun time in the book talking about how the mitochondria, particularly the electron transport chain. I’m sure your readers already know the mitochondria are the energy-producing organelles in almost all of ourselves. They were engulfed bacteria that were engulfed two billion years ago that took up residence in ourselves. They have unique abilities and their own DNA. They can grow and divide within a cell without the cell dividing, which is important to understand the effect of ketones and uncoupling.

Making energy and ATP is very hard, dangerous work. It involves energizing electrons and protons pushing them down a gauntlet within the inner mitochondrial called the electron transport chain. I call it the Mito Club in the book. It is the hottest place to be for Millennials and Gen Z-ers. You are looking to go to the Mito club to club to couple with a partner with the hopes of leaving the club for exciting times later that night and maybe in the future. You are trying to couple up.

In this club, we are trying to couple protons with oxygen molecules. That coupling generates ATP as this couple leaves the back door of the Mito Club and that generates ATP. It is pretty cool. Unfortunately, there are also lots of other people that want a couple. Electrons would love to couple with oxygen as well. When electrons are coupled with oxygen, you get free radicals and reactive oxygen species, which are pretty dangerous characters.

We have a unique antioxidant system in mitochondria, bouncers in a club that tries to keep this level of craziness under control. One of the interesting things I learned in researching this is there are only two mitochondrial antioxidants. One of them surprises everybody and it is melatonin, the sleep hormone. I argue in the book that we should stop considering melatonin, the sleep hormone, and consider it the most effective mitochondrial antioxidant there is, and number two, glutathione.

All the other things we call antioxidants like vitamin C and vitamin E. They have not only no influence on mitochondrial antioxidant status but may be harmful. That is another subject. Things are steamy in the club. Things get out of hand. There are hormones raging. There are beer and other mixed drinks. People are drunk. Punches are being thrown and there has to be a way to release this pressure. There are only so many people who are going to couple up.

We have a unique design that was discovered in 1978, that there should be emergency exits in mitochondria. We could blow off pressure in the mitochondria to protect the mitochondria from damage like a pressure cooker. It has a release valve. When the pressure in the pressure cooker gets too high, the steam starts escaping and it escapes until the pressure is under control again. My mother blew up a pressure cooker when I was growing up. It was exciting. I still remember it everywhere on the ceiling. Those were the good old days.

We now know that we have these pressure release valves and they are controlled by what is called uncoupling proteins. We have five pressure release valves. We uncouple protons from oxygen so that we don’t make as much ATP as possible. What’s surprising is at rest, you and me, 30% of all the fuel entering our mitochondria to produce ATP never makes it into ATP production but is instead uncoupled and released through these pressure release valves.

HHS 34 Dr. Steven Gundry | Keto Paradigm
The Plant Paradox: The Hidden Dangers in “Healthy” Foods That Cause Disease and Weight Gain (The Plant Paradox, 1)

You say, “What a stupid design, a foreign animal that you’ve got to eat 30% more calories to generate the amount of ATP, why? We do not do things stupidly.” It turns out that when we release these pressure valves, it generates heat and we are warm-blooded animals. Heat production is part of that. Cold-blooded animals are not coldblooded. They still have to have a basal temperature. Even cold-blooded animals use mitochondrial uncoupling to generate heat.

One of the best examples is most people now know about brown fat. It is brown and it is heat-producing fat. It has so many mitochondria that when we look at it under the microscope, it looks brown because it is densely packed with mitochondria. These guys uncouple aggressively, create heat, and wasted calories. That is a long-winded way of saying, “What do ketones do?”

I have a fun time showing some quotes from well-known keto experts published quotes, and I don’t give their names out to protect my friends, “Ketones are the perfect fuel. Glucose is a dirty fuel. Ketones are clean-burning fuels. The liver loves ketones. When you become keto-adapted, you become an efficient fat burner.” Nothing could be further from the truth.

Ketones are produced, number one, when we are starving. When we are starving, we normally would release free fatty acids from our fat cells, which can be used as fuel by every cell in our body with one exception, free fatty acids or big fat lipid molecules that are fat-soluble. They can’t get through the blood-brain barrier into our brain. They can but it is a slow process.

What happens is if we are lucky, these free fatty acids go to our liver. The liver converts them into short-chain fatty acids, which are water-soluble called ketones or ketone bodies. The liver can’t use ketones the liver throws them out back into circulation where they get through the blood-brain barrier and the brain can temporarily use ketones to hold the lines, stay alive until better times arrive.

The original ketogenic diet was discovered and named in the Mayo Clinic in the 1930s as a treatment for seizure disorders in kids. Sadly, it was noted that kids who had severe seizure disorders were in a postictal state many times were starving. When they were having all these seizures, the more they were not eating. Their seizures abated until they started eating again and their seizures came right back.

Smart researchers at Boston and Mayo said, “There is something about these kids starving that is turning off their seizures. They stuck upon ketone bodies.” The original ketogenic diet was an 80% fat diet at 10% carbohydrate diet and a 10% protein diet. It was quite miraculous in treating childhood seizures. This was before Dilantin, Phenobarb, and all the other ones. It did great up until these drugs came along and the diet fell by the wayside. Why? It’s because of those of us who have kids and now grandkids are hard to get a kid not to eat carbohydrates. Kids are carbohydrates seeking missiles, it is hard to stop them and that was one of the downsides of the diet.

Fast forward to the ‘80s and ‘90s, when a lot of kids did not do well on anti-seizure medications, they struggled in school, their brains did not work. People said, “What if we used a different form of fat?” That is MCT oil, Medium-Chain Triglycerides. They are unique. They are absorbed directly from our gut and go to the liver directly where they are converted automatically into ketones.

What was amazing was you could put kids on an MCT oil diet, much less fat, far more carbohydrates, far more proteins, and you get the same effect as if they were eating a high fat ketogenic diet. Why? The MCTs automatically produce ketones, even if the kids were eating a lot of carbohydrates. I joke, and I’m not recommending this, you could eat a fresh fruit salad, please do not and have a couple of tablespoons of MCT oil. You will generate ketones despite being overwhelmed by glucose and fructose from the fruit.

I have been having my patients do a ketogenic diet for cancer, dementia, diabetes, pre-diabetes, and it has been very effective. Yet, it was based on an MCT oil-based diet and quite a lot of carbohydrates. If you look at my ketogenic diet, there are a lot of carbs in that diet and yet it was effective. I could show that people were in ketosis. I went back and I was like, “I’m so stupid.” These ketones are doing something completely different than what I thought. When you start looking at how ketones work, you realize that ketones were not the super fuel that all of us were taught.

That work from Harvard by Dr. George Cahill, Dr. Owens, and from the NIH by Dr. Beech, show that even at full ketosis in humans, we will only get 30% of our energy needs met by burning ketones. Seventy percent has to come from free fatty acids and also glucose. Even at full ketosis, the brain will only use 60% or 70% to get its needs met by ketones, and it still needs 30% to 40% glucose as fuel.

Even at full ketosis in humans, we will only get 30% of our energy needs met by burning ketones.

The idea that these are super fuel, sorry it’s not true. They are doing something super cool, what is that? In a roundabout way, what they do is they are signaling compounds. They are signaling molecules that tell mitochondria to aggressively uncouple, joining oxygen to protons, to make ATP. One of the real epiphanies in this search was a small paper written by Dr. Martin Brand in the year 2000. The paper is called Uncoupling to Survive.

I recommend all your readers to dig up the paper, google it, it is easy to find. He makes the ludicrous statement, which is true. If you are starving to death, the only thing we are saving is your mitochondria because your mitochondria make energy. If the mitochondria die, who cares about anything else? You are dead.

Mitochondria, if ketones are present, will be told to protect themselves at all costs. Since making ATP is damaging to mitochondria, he showed that you would anticipate that starvation and ketones would tell mitochondria to aggressively uncouple, blow-off pressure to protect themselves. In the process of which you would tell mitochondria to make more of themselves to divide, to handle the workload.

What do I mean by that? We could hook one dog to a dog sled and the dog to pull the sled. He would not do very well at it but it gets the job done. You do not have to feed one dog. On the other hand, you could hook six dogs to a dog sled. Each dog would have to do six of the work that that single dog did, and you go a lot farther but the dogs would have to eat more than that single dog.

What he said was each mitochondria would have to do a whole lot less work. He will get damaged less but you had to recruit lots of more mitochondria to help with the workload. You could produce the same ATP that you would but each dog would have far less. The consequence is you would become fuel-wasting. The weight loss from a ketogenic diet is because mitochondria are wasting fuel and I use the analogy, you become a Ferrari rather than a Toyota Prius.

I do not think I have read that before and other keto theory books and whatnot. To me, that never jived as a long-term solution. I wrote my book in 2015 called The Paleo Cardiologist. Another friend of mine, Bill Schindler wrote the book called Eat like a Human. He is a PhD researcher on the East Coast. What he talks about is how we can take any foods and make them healthier versions of themselves like our ancestors did. That plays with a lot of your recommendations and recipes to up a lot more options than people going extreme, keto or jumping into a carnivore approach.

To me, the healthiest food on the planet is seafood. I know you are a Loma Linda guy when you talk about the Seventh-day Adventist and all the vegans who want to try it out. Look at these vegans over here, the people who lived the longest were the women who ate seafood. Eating lots of seafood plays a lot to what you are saying, certainly, as you talk in the book about the essential fatty acids.

You are talking about extremely complicated concepts, even to the cardiovascular surgeon and a cardiologist when you start diving into quantum biology and quantum physics but you have made it simple to understand with your analogies of the Mito Club, the bouncers, and the patrons. For those of you who are reading and are thinking this is a lot, Dr. Gundry goes a long way towards simplifying it, and then he gets us right into the useful tips and strategies.

There are many other things you can use to uncoupled mitochondria. That information is all fantastic. Let me ask you real quick, I believe your approach is you are not into using coconut oil and talk about coconut oil because that is where MCTs are located. Talk about coconut oil and some of these other exogenous ketone products that sprung up all over.

I’ve got very interested in the APOE4 genotype as a heart surgery because we have known and you as a cardiologist know that the APOE4, not only are predisposed to dementia or Alzheimer’s but are also predisposed to coronary artery disease, vascular disease, in general. I’ve got very interested in coming in that direction of learning about the mischief of the APOE4 gene.

HHS 34 Dr. Steven Gundry | Keto Paradigm
When the mRNA vaccines came out, the predictive value of having a heart attack in the next five years doubled in most people.

My good friend, Dr. Dale Bredesen, who wrote The End of Alzheimer’s, approaches the APOE4 from a neurology standpoint. It is funny we have become good friends because he came at it from one direction for the brain. I came at it from the heart. When we first were introduced a number of years ago, I said, “Dr. Bredesen, I’m a big fan. I have read everything.”

In the APOE4, both of us are interested in the effect of certain fat-saturated fats on increasing small dense LDLs and increasing the oxidation of small dense LDLs. I hope everyone realizes that the cholesterol theory of heart disease is just a theory. There are multiple other good theories of our disease. Some of which I like better than the cholesterol theory.

If you like the cholesterol theory of heart disease, we should be attuned to whether or not cholesterol particles are oxidized, whether they are rusty or rancid. I noticed through the years that my patients who ate a lot of saturated fats, including coconut oil, had much higher numbers of small dense LDLs, regardless of what else they were eating. It would also oxidize their cholesterol.

Coconut oil was often right up there on the top of the things I ban. You are correct. The ketogenic parts of MCTs, particularly the C8 and the C10 are a small portion of coconut oil. The nice thing about MCTs is that they have no effect on changing cholesterol profiles because they are handled in a different way than this large C12, lauric acid, which constitutes a great deal of coconut oil.

That was an epiphany for me a number of years ago when I put my insulin-resistant folks on my ketogenic diet with MCTs. Low and behold, it did not have an effect on oxidation. They’ve got better and they did not have an effect on small dense LDLs. They are very different. The more people can use a C8, the better. If they get a mixture of C8 and C10, they are great but C12 has no effect. How about C6? Unfortunately, C6 smells like goats and it is pretty nasty. It is the answer to your second question.

The nice thing about MCTs, as I talk about in the book, the vast majority of people in the United States are insulin resistant and have no metabolic flexibility. If they go on a high-fat, low-carb ketogenic diet, it may take them 2, 3 to 4 weeks to drop their insulin levels low enough that they can begin to liberate free fatty acids from fat. This is where the keto flu come from. You can’t get to all that fat. The beauty of MCTs is that you can generate ketones even in the presence of insulin resistance, and that can keep your brain going until you finally do pre-liberate free fatty acids.

The ketone products, the ketone esters, and I have tried them all. They are pretty doggone nasty. I pretty much have to hold your nose to do the shot and they are expensive. The ketone salts are cheaper. They are fairly flavorful the way they are constituted but to get the continuous ketone effect, you have got to take these multiple times a day and you are going to get a pretty impressive sodium load by the end of the day if you were taking enough of them. I talk about them in the book. They are a quick start option but for the money and the power, you are better off with MCTs.

I came across the word berberine and I talk about berberine. It is like whenever somebody has any health ailments, whether it is prostate cancer, dementia or sarcoidosis, whatever it may be, you get into and you search berberine, that diagnosis, it comes up. I love the fact that you talk about berberine as a mitochondrial on the coupler. I thought that was fantastic.

A lot of people call berberine a poor man’s metformin. In a lot of ways and it acts very similar to metformin. Interestingly enough metformin in and of itself is a mitochondrial and coupler. Things keep coming around uncoupling mitochondria.

I would reverse that. Metformin is the poor man’s berberine, from what I can tell.

The cholesterol theory of heart disease is just a theory, and there are multiple other good theories of our disease.

I certainly have a lot of colleagues in longevity that take metformin. I take berberine and I do a lot of other tricks. I do not have a problem with my friends taking metformin but it seems to me, there are better ways to do this.

When I have gone to some of these bigger meetings and you hear some of these speakers, they almost talk about their pharmaceutical cocktail for anti-aging. There has got to be a better way. Hopefully, you and I would agree that when you are making comments like that, about you take berberine versus your colleagues, we take the pharmaceutical that we are in agreement that, “Our bodies are built to last. If you give it what it needs, take away, what it does not, we are good to go.”

For everybody who reading, we talked about Dr. Gundry’s book, Unlocking the Keto Code. It is available starting in March of 2022. Go grab that, give it to someone that you love. My whole team is going to read your book because there has phenomenal information. When you thought you knew everything about keto, it turns out, you know nothing about keto. That is what the book is great for.

Let’s get into a little controversy again. I’m sure you publish a study. The study is where you are looking at a large number of patients and the effects of the COVID shots and inflammation by a certain form of test. What was your interest in doing that study? What were the results? What were the ramifications of your findings?

We use a test that has been clinically validated that the clean clinic uses as well called the PULS Test. The PULS says, “Gives a five-year risk of having the acute coronary syndrome, unstable angina, heart attack, needing a stent or a bypass.” It is clinically validated, the Cleveland Clinic uses it. I have been using it for many years.

This test when the mRNA vaccines came out, my PA and I noticed that all of a sudden, this predictive value of having a heart attack in the next five years doubled in most people. When we looked at the various markers that this test measures, three distinct markers went up 95% of people who got the mRNA vaccines. One was a marker IL-16, which looks at inflammation on the surface of blood vessels. Another one is called the human hepatocyte growth factor, which has nothing to do with the liver. It has to do with myocardial inflammation and another one called FAS. These all three went up.

When the second shot came in and they went up even higher. It was consistent across the board. Interestingly enough, we did not see it very much with the Johnson & Johnson vaccine, which is a different technology. We started tracking this and we tracked it for about a year. I said, “This is scary. Somebody has to say something about this.”

On the last day to submit the abstract to the annual meeting of the American Heart Association, I pulled the trigger and submitted my abstract. I did it in a way that I thought they would reject it. I did not have any statistics in the paper. I thought, “For sure, the lack of statistics would put a red flag on it, they would reject it and I could live with myself. I tried to tell people.” Low and behold, the program committee accepted for presentation and I’m going, “Great.” We’ve got published, and immediately the anti-vax community went hog-wild. It became the paper that proved what everybody was trying to say.

I became best friends with Robert F. Kennedy Jr but that is another story. The day after it was published, the American Heart Association put a red flag on the paper saying, “There are some questions about this paper and we are going to remove it until the questions are resolved. It had to do with a couple of misspellings.” I write all my own papers and abstracts. I do spell check and sometimes spell check miss.

We have two proofreaders, me and my editor, and we still misspellings. It is pretty hilarious. That is why they flagged it. They wrote me a letter and from the chairman of the program committee said, “You have to answer all these questions in 24 hours or we are pulling the paper.” I’m going, “This is pretty impressive.”

I answered all their questions. I said, “I’m not some Joe blow practicing restorative medicine. I used to be on the program committee of the American Heart Association and the American College of Cardiology. I know how this system works. I graded papers. I was a professor and chairman. I’m not the bad guy here. We are supposed to do no harm.” The American Heart Association is supposed to look out for the hearts of people. I said, “I’m sorry that this is what it says but that is why we need to go forward.” I tone them down. They say, “We’ve got to damp down this language.”

HHS 34 Dr. Steven Gundry | Keto Paradigm
When it comes to the prevention side of things, medical doctors graduated from training with zero knowledge in actual prevention.

I get a cold cold call from the CEO of the PULS Test, who is a physician. He says, “I saw your paper. Thank you very much. We had a paper in progress that serves exactly the same thing with all of our patients across all the various people who use this. Thank you so much for publishing this because now the heat is off of us but I wanted to assure you that you are correct. This is exactly what we see. It should be as no surprise because you are telling the body to produce the spike protein, which is the inflammatory protein that causes the cytokine storm. It should be of no surprise to anybody.”

I went back to the American Heart Association as Chairman. We became good friends. I said, “He will send you the data. We’ve got to let people know.” He said, “No. That is not our job. The FDA and the CDC are looking out for people’s effects. That is not your job and it is not my job. You either need to dilute this paper to nothing or we are pulling it.”

This went on for about three weeks, and finally, we arrived at a diluted paper that at least got the point out. I had called the guy from PULS and said, “What is the deal? Why is this pushback?” He said, “Are you that dumb? Where do you think the funding from the American Heart Association comes from? Where do you think this professor’s funding comes from?” I said, “Please do not tell me.” There was tremendous pushback on this.

As you come through the pages of any of these medical journals. Every other page is an advertisement from a pharmaceutical company. The American Heart Association and the American College of Cardiology, if it is not to protect the public interest, what is their mandate? They only exist at this point in time probably for the last 100 years to put forth the efforts of pharmaceutical companies. I applaud you for sticking your neck out there for that paper.

Most of my patients and clients did not get any shot but for those who did not get my memo, we saw two strokes, cardiac arrest, a myocardial infarction, whenever you stimulate inflammation, you are going to see a lot of AFib, PACs, PVCs, we saw a ton of that. One of my best friends from medical school is the Head of Cancer at a well-known East Coast institution. He came down with Bell’s palsy. A 51-year-old guy, face dramatically affected. He still refuses to believe that is what it was from. Yet, I showed him whether it is in a vaccine, adverse events, reporting system about Bell’s palsy.

He sends me an article showing that the risk of getting Bell’s with higher in COVID patients than those who got the shots. In that same article, they talk about the randomized trial that showed seven cases of Bell’s in the vaccine group, one in the control group. Not statistically significant. Even though the author’s commented that this needs to look into but I said to my buddy who thought he was sending me an article saying, “COVID is worse.” I sent him back. I said, “7 versus 1. In any case, I appreciate you putting it out there and sticking your head out. You’ve got a friend over here, that is for sure.”

Dr. Steven Gundry, I could talk to you for hours. There has so much to unpack. I did not even go into how I had loved to insult cardiovascular surgeons and other cardiologists. We could do that at another time. I think you will agree. There is a time and a place for emergency medicine, trauma, and certain things we can’t do.

When it comes to the prevention side of things, all of us medical doctors graduated from our training with zero knowledge and actual prevention. When you talked about nutrition, you talked in your book about sleep. We talked about sunshine, environmental toxins, pollutants, the pandemic of mold micro toxicity, and bio mental toxins, the pesticides, all of these things. The more you and I get to educate people, the better. Thank you for being on this episode.

Thanks for having me. I appreciate it, Jack. Good luck with your efforts. We will be out there fighting the good fight, hopefully.

Thank you so much, Dr. Steven Gundry. Everyone, thank you for reading. We will come back with more information for you to help you on your path to the 100-year heart. Be well.

About Dr. Steven Gundry

HHS 34 Dr. Steven Gundry | Keto Paradigm

Dr. Gundry is one of the world’s top cardiothoracic surgeons and a pioneer in nutrition, as well as medical director at The International Heart and Lung Institute Center for Restorative Medicine. He has spent the last two decades studying the microbiome and now helps patients use diet and nutrition as a key form of treatment. He is author of many New York times bestselling books including The Plant Paradox, and The Plant Paradox Cookbook, and The Longevity Paradox: How to Die Young at a Ripe Old Age and The Energy Paradox: What to Do When Your Get-Up-and-Go Has Got Up and Gone. He will be releasing Unlocking the Keto Code March 8, 2022, which offers a new take on the keto diet that debunks common myths and shows readers how to reap the rewards of keto with less restriction. He also is the founder of GundryMD, a line of wellness products and supplements and host of The Dr. Gundry Podcast.

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.


Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.