#219: William Curtis- Parkinson’s Disease, Fasting & the Keto Diet

 

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Related Interview: Fran Llosa shares tips about testing blood ketones and supplementing with different types of exogenous ketone types

Key Takeaways

 

01:55 Journalist Bill Curtis has had Parkinson’s since 2000. As predicted, he was dramatically affected 10 years later with advanced Parkinson’s. He lost his job and was unable to work/write. He also had fatigue. When he walked he had a short distorted gait. His tremor exceeded 4 inches on both sides. The drugs he took only worked occasionally. He also had dystonia, the tensing of muscles, and urinary incontinence. They were classic symptoms of advanced Parkinson’s. Now the only symptom he has is a slight tremor.

04:48 Within about 2 hours of eating carbs, Bill will begin to shake and feel rigid. He doesn’t get the full on symptoms he had before. Through neuroplasticity, he has achieved improvement. The dopaminergic neuron inside your brain is up to 4.1 meters long. It has 2.5 million mitochondria. Those mitochondria live less than a month. You need to make 30,000 new mitochondria each day to replace those that die. Ketones protect the mitochondria and prevent their wide-spread destruction. He is more resilient. Bill now has 53% improvements in UPDRS (unified Parkinson's disease rating scale).

07:38 Bill was in an exercise program. In an attempt to enhance the effects of the program, he fasted overnight and had nothing for breakfast before the workout. His theory was that this would raise his ketone levels, make BDNF and benefit his brain. He found it alleviated his profound fatigue. In his experimentation, he found that carbs reversed the improvement.

11:27 Fasting helped with the fatigue, but there were many more symptoms that were not reversed. Bill continued researching. He wrote to Dr. Veech about ketones and found that ketones are not the solution for everything. He was told not to recommend this keto treatment to people with balance issues, as the lower blood sugar may exacerbate those issues.

13:02 Bill exercised fasted every day for a year. He lost weight, but eventually, it stopped working. As you become fit, you make fewer ketones.

15:04 Dr. Veech suggested that Bill try Bulletproof Coffee after the night fast. Nearly all of his symptoms abated at the end of the first hour. In advanced Parkinson’s one often gets one hour of being “on”/clear neural functionality. At the end of the first day, Bill had been “on” all day. The next day he ate some carbs and within 2 hours he was no longer “on”.

19:36 The military has been experimenting with Dr. Veech’s ketone ester. In mouse studies, a single dose of ketone ester 24 hours after radiation exposure, decreased the death rate by 50%.

22:26 A therapeutic ketogenic diet is one with 80 to 90% of your food as fat. Bill has devised 4 levels of ketosis. One is an overnight fast with a form of fatty coffee in the morning. The next level is this plus limiting your carbohydrates and protein. The third level is a ketogenic diet.  The fourth level includes ketone ester. Ketone ester allows Bill to lift weights without a buildup of lactic acid. Ketone bodies go straight into your mitochondria and you make lactic acid in smaller amounts.

30:33 Within the first 10 days of taking ketone ester, Bill no longer had urinary incontinence.

32:07 There is data that an elevation of uric acid it will delay the onset of Parkinson’s. If you have Parkinson’s, and your uric acid levels are higher, you decline more slowly. Uric acid chelates iron, attaching the iron molecule and preventing it from killing mitochondria. Iron is toxic to dopaminergic neurons. Beta hydroxybutyrate co-correlates with uric acid. When you excrete uric acid, you are in competition with excreting acetoacetate and beta hydroxybutyrate. When you experience high levels of ketones/BHB, uric acid levels elevate exponentially.

36:14 BHB allows you to make more dopamine, serotonin, adrenaline, noradrenaline and nitric oxide. BHB affects your cell’s battery, NADPH. The H is donated as a hydride ion, having 2 electrons and 1 proton. This is the source of your body’s electrons. The cells battery, NADPH, changes the ratio of tetrahydrobiopterin BH4 to BH2.  You will get more BH4. You will adhere more hydrogens in the form of hydride ions and electrons. Making more tetrahydrobiopterin, you increase the formation of dopamine. People with Parkinson’s are lacking dopamine. Dopamine supplementation wears off much quicker than ketones/BHB.

38:00 In advanced Parkinson’s neurotransmitters are negatively impacted. With ketosis, you are making serotonin, noradrenaline, adrenaline, dopamine and nitric oxide synthase. Nitric oxide synthase is tied to the tetrahydrobiopterin, positively impacting vascular flow, urinary incontinence and erectile dysfunction.

38:52 Every antioxidant has to be recharged with an electron from NADPH, directly or indirectly.  NADPH is the big battery in your cells. By supplementing with vitamin C, vitamin E, NAD, and BH4, you are installing small rechargeable batteries and doing nothing to recharge them.

39:50 Beta hydroxybutyrate raises NADPH levels using isocitrate dehydrogenase in the cytoplasm, outside of the mitochondria. In order to get the substrate isocitrate out of the mitochondria, you inhibit downstream from making citrate and increase the amount upstream, using isocitrate carriers that allow isocitrate out and takes malate in.

42:24 NADPH in the mitochondria does not correlate with the NADPH in the cytosol. We should measure the cytosolic NADPH. The ratio of free cytosolic NADPH elevates with the ingestion of ketones. This cannot be seen with measurements of total NADPH.

44:09 NADPH voltage is dependent upon the relative concentrations. More equals more resilience. The voltage is determined by the relative amounts of NADPH to NADP. Your NADPH voltage is what determines the acceptability of vitamin C or vitamin E. If your NADPH is low, many things won’t run well. There is no at home test, nor a simple lab test to measure cytosolic NADPH.

48:52 Dismutase does not get its electrons from the battery. It does this by taking 2 molecules of superoxide, oxidizing one and reducing the other. It allows dismutase to be independent of NADPH for recharge. This can affect all of the antioxidant systems. You can also affect the inflammation system if the voltage of NADPH is not sustained. There is also feedback between nitric oxide synthase and HIF1-alpha (hypoxia-inducible factor). If you don’t destroy HIF1-alpha, it will shut down oxidative phosphorylation and it will also cause growth factors to be produced. HIF1-alpha is turned on by hypoxia or reactive oxygen species.

52:59 You have the ability to use ketones to restore ischemia–reperfusion and turn off inflammation. If you have inflammation, it is not the initial redox oxidative damage that messes you up. It is the ongoing inflammation. Shutting this down can make a huge difference.

54:08 NADPH controls inflammation. A study showed that wound healing is helped with nitric oxide, which opens capillaries and increases blood flow. Measuring the voltage of NADPH is a missing component of much research.

55:04 Dr. Veech found that treating Alzheimer’s mouse models with beta hydroxybutyrate kept them from accumulating beta amyloid deposits. Controlling the sulfhydryl relationships in proteins, can keep them from mis-folding. Dr. Veech also treated nerve cells with BHB and found that Paraquat and MPP+ did not kill them.

58:03 Bill believes that TBI will respond very well to BHB, as evidenced by people close to him with head injuries. Inflammation was designed to kill cells that are having problems. Studies take a great deal of money and pharmaceutical companies are the ones with money for studies.

01:02:41 Bill has created an online course to help people help each other. You need a cook, a coach, a nutritionist and a doctor.

01:04:36 Bill still takes his Parkinson’s medications. Ketosis helps with symptoms. Work with your doctor.