Dr. Anthony Chaffee provides a deep dive into the metabolic dangers of glucose consumption and the superiority of fat-based metabolism. He explains how any elevation in blood glucose above 100 mg/dL causes cumulative damage through 'area under the curve' calculations, even in insulin-sensitive individuals. The discussion reveals how elevated insulin disrupts hundreds of physiological processes, blocking testosterone production in men, estrogen in women, and growth hormone in both sexes, leading to conditions like PCOS.
The episode clarifies common misconceptions about ketosis, explaining that ketogenic metabolism isn't a 'fasting state' but rather the normal metabolic condition when not consuming carbohydrates. Dr. Anthony Chaffee addresses practical concerns about the transition period, including electrolyte management and the need for 5-7 grams of salt daily during adaptation. He explains why the body preferentially uses ketones over glucose when available, and how just one extra gram of glucose in circulation constitutes diabetes.
Key Takeaways
- Blood glucose levels above 100 mg/dL cause cumulative cellular damage even in healthy individuals, with the 'area under the curve' calculating total harm from repeated glucose spikes throughout the day
- Elevated insulin from carbohydrate consumption blocks testosterone production in men, estrogen production in women, and growth hormone in both sexes, directly causing hormonal imbalances and conditions like PCOS
- The human body preferentially uses ketones over glucose when both are available, with two-thirds of the brain running on ketones while only requiring 4 grams of glucose in total circulation for all bodily functions
- During carnivore diet adaptation, consume 5-7 grams of salt daily and increase water intake significantly to prevent cramping and maintain athletic performance as kidneys readjust to lower insulin levels
- Blood Glucose Toxicity and Insulin Damage - Why Carbohydrates Are Harmful
- PCOS and Hormone Disruption - How Insulin Blocks Sex Hormones
- Ketones vs Glucose - Understanding Non-Carbohydrate Metabolism
- Electrolyte Cramping on Carnivore - Managing Salt and Magnesium During Transition
This is an auto-generated transcript from YouTube and may contain errors or inaccuracies.
[Music] Would you say that glucose alone, not even just from like refined sugar, um, but carbohydrate ingestion period, an elevation of blood glucose is toxic to the body even if it doesn't elevate it too much. It is toxic to the body. And the thing is you have to remember is that, you know, you'll get sort of a spike and a drop. And so even if you're insulin sensitive and you know you can get that down to a normal blood sugar level quickly, um you're you're still elevating it up past a point uh that your body can really contend with the damage and and and stay on top of it. So you know, you have this sort of spike up and then it comes down, spike up and comes down, spike up, comes down. Okay. Well, it's it's it's calculus 101. What's the area under the curve? the area under the curb underneath those big spikes, you know, over where you you should have over a hundred, you know, um on your your your blood sugar levels over 100, like you know, that that's causing damage over that. Okay? So, you can calculate all of that. So, now that's not as bad as if you have insulin resistance, you have diabetes, and your blood sugar is always at 130, 140, and then it spikes up to 200, things like that. The area under the curve is much, much, much larger at that point. But it it is always causing harm, even though it comes back down again. Um, you know, I have heard that that, you know, certainly when you're you're you have high blood sugar levels, your body needs to get that out straight away and that's why your insulin goes up. The thing is is that insulin is not designed to be at that level. People think it's like, oh, you eat carbohydrates and your insulin goes up and it drives into the cells and that's a normal reaction. It's a normal reaction down here at normal physiological levels. But when you're eating super physiological levels of of blood sugar or of of glucose and it's getting super physiological levels of blood sugar, you have to raise your insulin to super physiological levels. That is a problem. If it was only that it just sort of it only drove energy into cells and all you're dealing with is that area under the curb. Okay. All right. Well, that's more manageable. But that's not what ins that's not the only thing that insulin does. Insulin is an extremely important and very busy hormone and it affects basically all of your other hormones and it affects hundreds of other physiological processes in your body and your brain. And so the simple act of elevating your insulin levels to contend with these high levels of blood sugar will get all of those physiological processes in your body and your brain completely out of balance and will completely disrupt your hormones. Which is why when people go ketogenic they go especially carnivore because uh plants have hormonal disruptors as well. You get rid of the hormonal disruptors and you're dropping your insulin down. So you have normal sort of baseline u metabolic hormonal physiology. You see people's, you know, insulin blocks estrogen production in women. It blocks the testosterone in men. It blocks growth hormone both men and women. So when you get rid of all that, you'll see testosterone improve in men. You'll see estrogen improving in women. you'll you'll uh it's you'll insulin high insulin levels are the leading cause of PCOS polycystic ovarian syndrome because it blocks a conversion of testosterone into estrogen in women's ovaries and so now you're getting too high of testosterone too low estrogen you get the flip of that in men and it's blocking growth hormone in both so you get there's complete imbalance and so I I've tested thousands of people's blood tests when they when they're just on a normal standard diet or even a vegetarian diet or a clean omnivore diet and then you put them onto a clean whole foods, ketogenic, carnivore diet, massive improvements in in their hormones, their metabolic system, and their nutritional status. So, um, you know, there there is that argument that, you know, when you have your blood sugar up, your body desperately needs to get that out. And when insulin goes up, it sort of changes how your body is is able to use um different energy sources. And so, because it's just desperately trying to get this out of your system. However, if you have somebody who has whatever on their blood sugar and there are ketones available, your tissues will preferentially use the ketones. It's just that when your insulin is up, it suppresses ketones. So, you can't make them. So, you don't have them. But, you know, they've done studies like if you look at like people giving exogenous ketones and you have blood sugar available, you don't have ketones available. you give them exogenous ketones, your brain will take up those ketones, your heart will take up those ketones, your your um intestines will take up the ketones, your muscles will take up the ketones, right? And so that's actually a preference. You know, your body wants that. Now, you get really super physiological that's going to sort of changing, right? Your body's really going to try to suppress um uh ketones so you can get rid of all these carbohydrates as quickly as possible. And there can be competition for, you know, the energy dynamics. you know, people talk about the randle cycle and things like there's a very complex um pathway. It's sort of very little understood for most people. Um and it's not something that I'm even like fully fully um on top of because I just sort of sidestep it and just be like, well, just don't eat carbs and doesn't matter, you know. And um so you know when we do know that when you have when when you're in a in a sort of so-called fasting state now I you know you mentioned how I don't think that is a fasting state call like a ketogenic diet called a fasting mimicking. No it's not fasting is mimicking the metabolic state that you should be in all the time and so you're in that metabolic state whenever you eat anything on earth except for carbohydrates. So I eat you know 5,000 calories in ribeye. I'm not fasting. Whatever you can say about my metabolism, it's not a fasting metabolism, right? And so fasting just mimics that. All fasting does is you're just not you're not it's not that you're not eating and that's why you're in that metabolic state. You're not eating carbohydrates and raising your insulin, that's why you're in that metabolic state. So if you just don't eat carbohydrates and eat anything else on Earth, you will still be in that metabolic state. So in fact, it's it's now switching. It's not even being called a fasting metabolism or or a fed metabolism, fed and fasting metabolism, which is what it was 24 years ago when I took biochemistry. My my niece just took biochemistry at the University of Washington in Seattle. And um and she was telling me like, "Yeah, they don't call it that anymore. It's just called a carbohydrate metabolism and a non-carbohydrate metabolism, which is much more accurate." And um and so in a non-carbohydrate metabolism, you're making ketones, but that's not but it's not I think ketosis is is a bad name for it, too, because the the defining principle of it is not just that you have ketones. It's that you're able to make ketones, a but you're accessing your fat stores. That's the main defining principle. You either can access your fat stores or you can't. And so that's the metabolic state difference. Your insulin is down low. So you're you have all these different metabolic changes happening that are normal and you're not suppressing all of these things. And one of those things is ketone production. But that's not the only thing. That's just one small part of this broad picture. So when you're in that state, in that non-carbohydrate state, you make ketones, but you also make blood sugar. So your blood sugar will always be normal. In fact, you'll be have much better blood sugar control, be much more stable. you know, as like a diabetic will be much more stable uh on a CGM uh when you're on a ketogenic state, when you're on a ketogenic diet, a non-carbohydrate metabolism. Uh but everybody will have have better um um blood sugar levels. And so when you're in that state and you now you're making ketones, you know, your brain preferentially runs on those ketones. And people like, well, that's an alternate backup s, you know, source just when you're starving. But again, you're not starving, you know, it's just you're not eating carbohydrates and now your body's running on those ketones. And in fact, um you can give people exogenous ketones and the brain will take up those ketones, right? In in lie of the carbohydrates. So even though you have so so just because you're making ketones, it doesn't change anything. Oh, you need to do that as a backup energy source. That would only be the case if you had no blood sugar. If your blood sugar was zero, but your blood sugar is not zero. when you're in a non-carbohydrate metabolism, you make blood sugar. Blood sugar is 84 all the time, you know, or or in other parts of the world, 4.5 just bam, right there. Right. And um and so it's perfect. So you're making all the blood sugar you need, but now you have ketones available as well. And your brain is choosing the ketones over the blood sugar. You have blood sugar available, but twothirds of your brain will only run on ketones. There are parts of your brain that will still run on glucose, but it's a much smaller amount. Um, at any given time you only have four grams of glucose in your entire circulatory system. And that's all the glucose your body needs for every single physiological process of your body and your brain, right? Just four grams. That's it. And and you'll replenish that as you go, but you you only have about four grams in in normal non-diabetic levels. Diabetes is just one extra gram. One extra gram is diabetes. And so one extra gram is a toxic dose of glucose to your body. your body responds to as a toxin by trying to detoxify by raising your blood by by raising your insulin. And so just one extra gram is diabetes. And yet we're eating hundreds of grams of carbohydrates a day. And we think that that's good for and our body's desperately trying to keep this under four grams. And and eventually it can't. And again, you're getting that area under the curve. You're getting those spikes. Hey everyone, really happy to announce a new sponsor for the show for everybody down in Australia. It's Stockman Steaks, who are delivering high quality grass-fed and finished pasture-raised beef and other meats, flash frozen, and vacuum sealed to your door. Something I've been enjoying a lot of myself recently as well. They also have a great range of specialty items such as highfat keto mints and carnivore beef and organs mints with liver, kidneys, and beef heart as well. So, use code chaffy today for a free order of beef mints or another specialty gift along with your order at stockmanstakess.com.au and I'll see you over there. Thanks, guys. Yeah, there's a lot of problems uh with that. But, um you know, it's yeah, when you're when you're eating carbohydrates, it's toxic to your body and your body is trying to get rid of that. But, at the same time, carbohydrates are not the the primary fuel source. when your when your brain and your body have ketones available, they preferentially go for the ketones as well. Um, you know, like I said, you know, ketones freely pass through passive passive transport um through the placenta into babies. You know, 51% 54% of the calories in breast milk are from fat. So, what do you think that where do you think that's going? That's turning into ketones. It's turning into fat oxidization. So the predominant um energy source for kids even though there is carboh there are carbohydrates in milk the predominant energy source is fat and so that's going to be fat oxidization to to give those kids that energy. So that that's our that's our predominant and primary energy source for all of our tissue pretty much. You know, there's there are some exceptions, but predominant um yeah, predominantly it's it's fat oxidization and ketones. I agree. I agree. You mentioned PCOS, and that's one of the reasons why I fell into ketogenic diets in the past was because I was dealing with some women that um they were infertile, they couldn't get pregnant. Uh and what I noticed with women with PCOS was they would have facial hair. So they would grow facial hair, too many androgens, and then men, they would develop gynecomastia, they would get tins, essentially, man boobs. Yeah. So that was a real light bulb moment for me. I was like, "Oh this is like it's almost flip-flopping the sex hormones right here. This is a problem." And then you also mentioned um electrolytes earlier. This has probably been the only thing that I've run into issues with, so maybe you can clear this up. Energy's through the roof. Um, I'm not dealing with like some knee pain that I was having before when I ditched the last little bit of fruit. It literally felt like the tissue around this joint was sticky. So, I don't know if that was actual just glycation or if I was dealing some uh with some oxalate dumping. But the major issue for me, I know when you're transitioning to a ketogenic diet, your insulin is going to come down. You're going to be excreting more water, more sodium as well. Cramping. I get some really nasty like leg cramps or even like in my triceps. I was doing some bench pressing earlier today and these are pretty intense cramping and then also some palpitations which once I started implementing some more magnesium in my diet or supplementing a little bit more cuz I've heard that people like uh Bella, they don't salt their food. I believe that you've mentioned that you don't salt your food either. Is there an initial period when people are transitioning into a carnivore or a ketogenic approach where they may need to supplement with some electrolytes? Yeah. Yeah. So, that that's a good point is that, you know, like I I sort of alluded to that in the Supernova trial where they it was sort of a flawed study. They only gave people sort of a week or so to a week or two to sort of adapt and they tested them and um and that they they had electrolyte imbalances and things like that. That's where that comes from. So insulin is um is uh influential to your um sodium reabsorption in your microtubules in your kidneys. And so that affects these these sort of um uh these receptors that that then will draw in more or less sodium. And so but the thing is it's a balance, you know. I mean the thing is if you get hyperinetriic meaning that your sodium levels are too high because you're eating a whole bunch of carbs your insulin is just going higher and higher and higher past physiological state. I mean you're not born in with insulin resistance. You know I've had patients that have had you know u you know 5 10 times the normal limit of fasting uh insulin levels and then you know when they eat it's going to jump up more than that. So obviously at one point they weren't making that amount of insulin. It's not like they had like an insulinoma, a tumor, just pumping out too much insulin their entire life. Um, not in this case anyway. And um, and so that's obviously something their body had to adapt to. Now, if if their body wasn't able to adjust and their insulin was going higher and higher and higher and you're just sucking in more and more sodium and their body wasn't able to do anything about that and excrete more and and you know, you know, sort of um you know, match that that that sort of inappropriate reabsorption of of sodium and be able to excrete the right amount of sodium, you die. You'd be dead, right? Because hyperutriia, high sodium levels will kill you. Get very confused. your brain starts to shut off and you get go into a coma, have seizures and die, right? So, that's really important to have have normal homeostasis. It's extremely important for your for your electrolytes to be in in a certain range. And um and so if your insulin is sort of going up steadily over the years, your body your kidneys are sort of adapting to that and they're going to excrete more sodium as a result of that. Okay. So, what happens when you go into a ketogenic diet? you know, you're not slowly coming down over years and decades, right? It's a it's a sharper transition. And so, you sort of pulling the rug out from under your kidneys. You sort of think it like that. It's a sharp change. And I find actually that most people do just fine that their their kidneys will adapt and um and will sort of change over. Now, you can lose too much though because if your all of a sudden your insulin is just dropping, you know, quite quickly and and your body's not quite adapted back the other way around. It's it's going to take a bit of transition time, you can think of that as part of, you know, being keto adapted. Um, that can make a difference and, you know, normal people just living a normal life may not really notice it. You know, call it a keto flu. People sort of feel a bit off for a couple of weeks or something like that. That can be part of that. It's also withdrawals. withdrawing from sugar, withdrawing from carbs, and getting these plant toxins out of your system. You're going to have a withdrawal effect from that as well. But it can also be from from electrolytes, and you can have too low of electrolytes. You can lose uh too much sodium. Water follows sodium. And so, if you're losing too much sodium, you're also going to lose too much water, and you're going to dehydrate yourself. That's typically where the cramps come from. It's not necessarily that you're you're actually clinically low on your on your electrolytes. It's that you lost the electrolytes and you lost water with that. And so having a bit more electrolytes, replacing that and replacing with water will help you sort of rehydrate yourself and sort of retain some of that water. And um and so yes, some people people find that one thing that a telltale you can feel pretty rotten or or maybe not have as much of an athletic performance as you normally would. You can try adding in some salt and certainly increasing your water. That's that's the key there um is increasing your water. Um and see how that that affects you. Um, but also you uh people find that they actually get hypoalmic, meaning that their their blood volume goes down a bit because there's less water in there. They're just dehydrated. And so if you stand up too quickly, you know, you get that sort of a head rush, it can happen much more frequently. And so if you're standing up and you're regularly getting like, oh, sort of a dizzy, lightheaded, you you're almost certainly dehydrated uh because of lack of electrolytes. So add in the electrolytes, add in more water in particular. Most people find that um just adding in the water, just drinking a lot more water when you start getting cramps will will solve that. If you drink, you know, you can get Yeah. So that'll that'll cover 98% of people. So the first thing to do is just drink more water, right? There is the 2% though where um it could be could be like an electrolyte imbalance. You actually have to supplement with significant amount of electrolytes. Like if you if you're too low in your magnesium, that that can cause cramping. Serum levels of of magnesium are extremely inaccurate. your serum only has about 1% of your your total magnesium in your body. The rest of it's being sequestered, your cells, your bones, etc. And so what's in your bloodstream is not necessarily indicative of what's in the rest of your body. Um, you know, it's like an analogy that I heard someone uh use was if you took a 100 people and you ask them how much money was in their wallet, that doesn't tell them how much they have in the bank or their investments or what they what they owe on their house, right? It's just what they have in their wallet. you're not going to be able to to distinguish, you know, what what their net worth is, right? Uh based on that. So, uh that's sort of like looking at your magnesium levels in your serum. A better way of doing that is looking at your red blood cell levels of magnesium where they actually break open the red blood cells and look at how much magnesium is in the cells. And that's more closely related to the rest of magnesium that's in your other cells and in the rest of your body. And um that's more accurate. Still not very accurate, but you can just trial and error. you know, if you if your RBC level is is suboptimal. And because most of these reference ranges are brought up, but they're just averages for the community. They're not actually an optimal reference range. That's why if you go to every single lab owned by a different company in your own town, they will have different reference ranges because it's a different group of people came in that they made an average from. And it's not healthy people they're looking at. They're just looking at any random person that came in for a blood test that walks through that door. Some will say, "Okay, well, we we have normal BMI and and people with normal BMI and people with um, you know, between this age range or something like that, but even then, you have normal BMI and still have diabetes, cancer, autoimmunity, and all these other sorts of things and nutritional deficiencies and all that sort of stuff. You have a you have a normal weight 25year-old vegan. I I I would not use their B12 levels to get an average because they're going to be deficient, you know, unless they're copiously supplementing, right? And even then, they're probably still low. Hey guys, just want to take a second to thank our sponsor at Carnivore Bar. I don't promote many products because honestly, all you need to be healthy is to just eat meat. 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So typically you sort of you want to aim a aim for the high end of normal if not even a little bit above on certain things and depending on the on the reference range but um there are optimal reference ranges that have been looked at um and um and so that those are the ones I use um in my practice but you know if you are sort of below those optimal reference ranges you could try taking magnesium see how it makes you feel certainly in the first few weeks um being you know aware that that you could be low on salt and that could be um impacting your energy levels and and especially athletic performance. So, if you're an athlete, I always just tell people just to salt to taste and usually your body will tell you, you know, how much to to do, but if you're finding that you don't you're not getting you're sort of a bit flat and you're sort of, you know, cramping or whatever, you know, a more water, but b um you could need more salt than that. So, some studies have shown on ketogenic diets, especially in athletes, that during that transition period, that adaptation period, um you might need as much as 5 to 7 g of salt per day to to account for that um uh electrolyte loss and replace that as well. So, uh yeah, some people do and you just sort of play it by ear. I usually tell people just to salt to taste. Me, salting to taste is no salt at this point. It just doesn't taste good to me anymore. or it just tastes too salty, which sort of sucks because like I don't can't really eat bacon anymore because it just tastes way too salty. Yeah, it sucks. I was that one that one was a was a a hard loss for me. But um you know, early on I salted much more than that. I I salted pretty liberally. A lot of people, you know, Bella, she learned this from the long-term carnivore people and like the they used to call it zero carb before it was called carnivore was called zero carb. Um, it's really just zero plant. And um, and uh, they their teaching was no salt at all because it can actually change your hunger signals. You can actually overeat and it can taste good even when your body doesn't want it and you overeat and things like that and you can have other sort of problems. It's not going to really cause blood pressure issues for most people. It's not going to cause heart failure or any other sort of um, stuff that has been sort of um, implicated in is that that's not really the case. There are some people that are a bit sensitive and and you'll notice that you know they have some salt and their blood sugar or blood pressure will pop up. When people are hypoalmic and their blood pressure is low, we give them salt water saline and things like that to bolster up their their blood pressure and things and you give them soluble. It will increase their blood blood pressure and things like that. So, you know, there's that effect. But, you know, typically people won't get, you know, hypertensive to the point that they need medications just from from adding salt to taste typically, but there are there are people that are salt sensitive like that. Um, but uh but yeah, that's a pretty typical one. And so, Bella would have done that that way and just no salt whatsoever. You might run into transition issues. Eventually, your kidneys will adapt and will be able to balance out how much sodium goes out. Because, you know, again, if you get that balance wrong and you get hyperin treatment because you're pulling in too much because the insulin, your kidneys just can't adapt that direction. You'll die. Now, if they're adapted that way, they'll have to be able to adapt back because if your insulin goes down again, well, then you're going to get hyponetriic and you'll die then, too. So your body is able to to uh readjust and adapt, but it can take time. And so, especially early on, if you're finding that you have a performance drop or energy levels or cramping or whatever, try it. You know, keep keep electrolytes in mind. And keep in mind that you may need 5 to 7 g of salt a day, which is, you know, it's a lot. It's not a small amount. and uh and you know that almost everyone is is deficient in magnesium certainly below uh what I would call an optimal level even if you're in the reference range you're not according to that reference range deficient I you know I would not see people in in optimal reference ranges typically even when they supplement there are a lot of anti-nutrients you know fitic acid you know lectins tannins oxalates all these things will block and bind to different vitamins minerals and nutrients and stop you from absorbing them so a lot of people are are getting uh low amounts of magnesium absorption uh because of that. Caffeine will get into your bloodstream and strip out magnesium from your blood and strip it out of your body. So, and it will also dehydrate you. So, you know, drinking coffee or tea and taking caffeine, which a lot of people do when they're working out to give them a bit of a of a boost pre-workout, that's a perfect storm for cramps because it's not only going to strip your magnesium out, it's going to dehydrate you. So dehydration, low magnesium is, you know, yeah, you you're just sort of begging for cramps at that point. So if anybody's taking um caffeine or coffee, tea, etc. like that, I always tell them you need to be on a on a supplement because I I see so many people when they go on carnivore, everybody starts off below um an optimal range, I would say. Uh but then then it comes up. It can take months and months and months to come up even with optimal nutrition. But when they're drinking coffee and tea and using caffeine or using caffeine, I I I see it, you know, it's very difficult for them to get into optimal range even with supplementation. I almost never do. Strictest medical definition, fructose is a drug, whether we consider that a drug or not. I mean, in fact, cocaine and ladum and morphine, things like that, you could go to the drugstore and buy these drugs. He didn't need a prescription for a lot of these things for for a long time. and