Ep. 62 – Exogenous Ketones With Latt Mansor From HVMN

Ep. 62 – Exogenous Ketones With Latt Mansor From HVMN

About the Episode

Latt Mansor shares his knowledge about exogenous ketones and their applications for peak performance, health, medical therapies, and more. In the show, Latt breaks down the differences between exogenous ketones and the evolution from ketone salts to ketone esters and now ketone IQ’s R-1,3-butanediol.

Latt and Heads Up founder Dave Korsunsky share their direct experience of using exogenous ketones and the benefits they experience. While also discussing their experiences fasting and getting into a ketogenic state with endogenous ketones. You’ll learn all the the benefits and new opportunities ketogenesis has for us and the many ways to apply it in your life.

Learn more from Latt and his expertise in the wonderful world of Advanced Ketogenics.

Health & Performance Hack:
Using Sodium Bicarbonate With Exogenous Ketones Plus Carb Loading Before A Big Performance Event, Has Been Shown To Maximize Performance Capacities While Balancing Fatigue Inducing Blood Acidity Levels.

Heads Up

This podcast is brought to you by Heads Up, a web and mobile app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. (Opens in new tab)

Podcast Episode 62 Transcription

Dave Korsunsky:

Hey, everyone. Welcome back to data-driven health radio. I’m your host, Dave Korsunski. And my guest today is Latt Mansor and Latt is from a company that we’re especially excited to introduce to the heads up community. This is the first time we really talked about an exogenous ketone product on the show, even though we’ve been doing metabolic therapy for years and years and years. So I think it’s, it’s definitely long overdue. Welcome to the show.

Latt is a PhD. His PhD is in physiology, anatomy and genetics from Oxford, also a master’s in biotech from Columbia. So he’s a smart cookie. He knows a lot about metabolic therapy and a lot about how we can use exogenous ketones and other products along the journey. And we’re gonna dive into how to put these products into use in, in day to day application, both for individuals, and then also for practitioners who are working with clients or patients, depending on the type of practice you’re in how to introduce these into the program and into the protocol. And then in the spirit of data driven health radio, we’re gonna talk about how do you, how do you measure the effects of these products both acutely and then over time and how can individuals and practitioners start to see the benefits of these products in some of the diagnostic lab data, maybe the data coming back from different devices. So welcome to the show, Mr. Latt,

Latt Mansor

Thank you very much, Dave, Great to be here.

Dave Korsunsky:

Yeah. Thank you. You, you guys have been on our radar screen for a long time. You guys were the OGs in, in exogenous ketones. So you guys have been doing this for a while. Tell us just a little bit of, of the history about the company and, and how you guys really, in my opinion were first to market with this. And, and, and how did that all come about?

Latt Mansor

I think it started all the way in like 2016 where our co-founders Jeff and Michael decided to look into the science around bio hacking, cuz they were already quite big around nootropics and intermittent fasting, metabolic health. So exogenous Ketone was just the next step where, you know, how do we hack the system so that we can get all the benefits of fasting and calorie restriction or ketogenic diet without going through that sort of grueling, you know, diet or grueling, like, you know, fasting period and still get the ketones. And that was when they started doing the research and then they spoke to the University of Oxford, professor Kirin Clark got their license to market. The first keto ester in the world in 2017, I believe I didn’t join the company, unfortunately until 2019 where they already got a phase two STTR, which is a contract with the government military contract, cuz they did a phase one before showing a Exogenous ketones managed to mitigate the decline of cognitive function in hypoxia.

Latt Mansor

So then the government was like, well, you’ve, you’ve done the proof of concept. You, you’ve proven that it works. So let’s expand this research into a bigger population with more data points, again, data driven, right? This is very relevant. How do we convince everyone that this actually works, especially for military personnel who are operating in high altitude where they’re always exposed to low oxygen environments, which is hypoxia. So I came in, joined the company in 2019, became their research lead and also became their principal investigator for this particular project. So yeah, there you go. A little bit of a ketone history with HVMN

Dave Korsunsky:

Yeah, I, I recall from the early days that, while the original studies on exogenous ketones were in hypoxia environments, it did come out of military applications where they did see a big benefit in a very specific use case. And, I’ve personally been involved in the world of ketogenic therapy for a really, really long time. And I remember some of the first products and, and they’re still on the market are actually the salts and that was kind of the, those came out first. But for those who are listening and, and who have never used these products before, could you just maybe distinguish between the two in terms of the difference and, and just give us like a really basic newbie overview on exogenous ketone. And, then I’ll go into some more specific questions around how can we strategically apply these products?

Latt Mansor:

Of course. So let’s start with the definition of Ketone bodies. So Ketone bodies are essentially substrates that our body makes from fat when we are running low on sugar carbs and glycogen stores. So that is achieved via ENT fast orogenic diet. So the three main keto bodies that our body make are beta-Hydroxybutyric, aco-acetate, and acetone. The first one, beta hydroxybutyrate is the main keto body that is used for metabolism and energy. Having said that, exogenous keto is one form or another that increases the beta hydroxybutyrate levels in the body. Keto salt are essentially beta hydroxybutyrate bound with a salt, whether it’s sodium potassium, magnesium. So you have BHB bound to a salt because BHB is an acid. So it can be bound to a salt chemically, and you’re consuming the BHB directly. And then your body processes it and increases your blood BHB ketone esters on the other hand are BHB bound to a butanediol. The difference is the, the bond itself is an Esteban and that’s why it’s called ketone ester. And when you ingest ketone esters, you will then cleave the molecule into half. So you get a BHB molecule and a butanediol molecule. The BHB molecule will go directly into your bloodstream and increase your blood BHB level. While butanediol will go to your liver and gets converted into BHB as well, giving that extra boost of elevated blood BHB level.

Dave Korsunsky:

Nice. You get two for one. So

Latt Mansor:

The, exactly. So, so the difference here is that ketone salt, it can’t elevate your blood ketos level too high because you, it, while it is, it may be dose dependent, you can’t really pile up the consumption of ketone salts because it does increase the risk of GI issues with the increased salt load.

Dave Korsunsky:

Okay. That’s extremely helpful. So then hypothetically speaking, if, if you were to take a normal serving of the esters, the HVMN esters, for example, or maybe maybe a, a normal serving versus a large serving and, and you were testing your, your blood ketones with a meter, for example. When might you start to see the numbers go up, you know, in my own, just kind of like anecdotal testing it’s somewhere between 30 and 60 minutes, I’ll start seeing the curve come up. What kind of curve could I expect? Like how high would I, obviously it’s gonna be dependent on the individual.

Dave Korsunsky:

Yeah.

Latt Mansor

There’s tons of external factors. Like was the person even in ketosis before they started, et cetera, et cetera, but just general rule of rules of thumb. What are you seeing out there in terms of like, how long does it take to kick in and, and what might I see on the meter at various stages, all else being equal?

Dave Korsunsky:

So, so let me clarify this first as well. So the Ketone Ester that we talked about was pretty much our version one, and we no longer sell Ketone Esters. And right now what we have is ketone IQ, which is not a Ketone Ester. So it’s made of entirely pure R1-3 butanediol. So remember what I said about Ketone Ester it’s BHB bound with butanediol. So we took half of that and made it our currently pure R13 butanediol. And that’s what ketone IQ is. Now. The reason we, we came up with that is two twofold, right? One, we want to still keep that efficacy. And we know that, you know, from the ketone ester studies, we know that BTL does increase blood BHB two. We want to improve the taste. Oh, and the three, the third point is also price point, right?

Latt Mansor

R-1-3 Butane allow us to really scale up production and also allow us to start with a lower price point program of, of exogenous ketones here.

Dave Korsunsky:

Gotcha.

Latt Mansor

For consumption, especially for people for therapeutic health, for metabolic health and, and therapeutic users where people might have to consume it on a daily basis. So that, you know, compared to our previous ketone esters, which was $33 per dose, which is around 25 grams, it seems too expensive to have multiple dose per day or even one dose per day. Whereas now we have a $40 per hundred grams of R13 butanediol. And that is why, you know, it became much more practical option and for consumption. So in terms of elevation of blood, blood Ketones. So the curve that we have seen Ketone Ester versus ketone IQ, Ketone Esters, you will see an elevation up to three to five millimolar within half an hour, and it will stay up for about four hours depending on your activity.

Latt Mansor:

And, and that’s a very high spike because of the presence of the BHB and Beto, right? So you get both the BHB and Beto and the BHB is the quick spike. And then the b is the slower releasing spike by the liver. Whereas keto and IQ, you won’t see that huge spike in the beginning. It will start elevating within half an hour. You will still see elevation within half an hour, but I, I would say around like, you know, one minimal and then it will continue going up. We have seen, we have seen peaks at about two to three hours where it’s dose dependent as well. It goes up to like 2.5 and it will stay up if you, you know, if you’re at rest and not doing exercise or activity, it stays up above 1.0, millimolar up to six hours.

Dave Korsunsky:

Nice.

Latt Mansor:

Depending on what usage you want. So in our sort of conversations with all the researchers in Metabolic health, they want something that they can easily take without having to top up often, you know, cause obviously they’re, they’re cognizant of, of the costs as well. Something that tastes better than Ketone Esters, because they are terribly bitter. And they want something that can last, you know, elevate the blood ketone levels as long as possible so that they can reap all the benefits, you know, throughout the day. And then they can take another dose before they go to bed and just keep that ketosis.

Dave Korsunsky:

So there’s a lot of really, really incredible information that you just dropped on us there. So let’s just unpack it a little bit. Yeah. So there are different applications than it sounds like if, if you did need for a very specific use case, you know, just a shorter, higher spike for example. Yeah. Okay. And, there may be reasons to do that. Like I used to back in the days of the salts, for example, if I had a big presentation at work, for example, or I was speaking like you and I were talking about ketocon, which is right around the corner and I was giving a presentation in front of a large group, or I was doing anything where I just needed a performance edge. I would, I would pop it 60 minutes before and pretty much without failure, this was subjective. But I, I always felt like I was delivering a really, really high performance output whenever I did that.

Dave Korsunsky:

Yeah. So I was just using them as a short term performance hack, but, and I’m just sharing some examples that may be helpful for the listeners. But I also coach a lot of people. For example, I work with a number of professional poker players and they’re sitting at the table for a very long time and they need to perform at an extremely high cognitive level for a very hard, long time. They probably would not want the quick spike and then the tail off they’d want a slow burn. And then I also, we also work with a lot of people who deal with things like epilepsy, for example, or they have other issues, conditions, let’s call them where they need the long term elevation, where they may need to stay in a state of elevated ketosis for a very long periods of time. So that, that would be an application for the, a better application for the IQ.

Dave Korsunsky:

Just knowing that you’re gonna stay in the sweet spot. If you’re staying above 1.0 for up to six hours, man. It’s incredible. Yeah. So that helps me understand. And then the price point as well, like you said, if you’re using this for a medical application and you’ve gotta be taking this thing several times per day. Yeah. It’s, it’s gotta be affordable as well. So it sounds like that’s how you guys have come at it, which is how can we then optimize this thing for continuous application consistent daily use, affordable daily use and long sustained performance boost. Is that a fair assessment?

Latt Mansor:

That is a fair assessment. And in fact, you know, before this, we always thought higher is better. You know, more ketone is always better, but certain papers have actually illustrated, you know, in the past year. So that higher does not necessarily mean better because one paper says between zero to two millimolar blood BHB, you get a high oxidation of ketone. You get an elevation of oxidation, which is what we expect. But

Dave Korsunsky:

When yeah, you wanna burn them, you wanna uptake them

Latt Mansor:

When you go from two to four, that oxidation rate reduces significantly. So you get a diminishing return. So you, you still get an improved oxidation rate, but not as high as, you know, zero probably makes zero to two. Yeah. And then another paper also showed for athletes. They, when they are blood, BHB is too high. They increase their cardio respiratory stress biomarkers because they saw a decrease in BHB pH because BHB, as I said earlier, it’s an acid, right? So you are decreasing the blood pH and increasing acidity here. So what they are feeling is they are increasing their heart rate. They’re increasing their breathing rate to expel the carbon dioxide in order to buffer out their acidity. So they have a higher rate of perceived exertion without an improvement in performance. So you’re just working, granted. They did not do worse compared to placebo, but they did not improve either. But you just feel like you’re doing more work. So who won that? If you just feel like you’re doing more work, you’re not actually winning the race.

Dave Korsunsky:

That’s not biohacking. We, we wanna, we wanna feel like we’re doing less work and get better output.

Latt Mansor:

Exactly, exactly. So, so that, you know, so far there is one only one paper. So I think a lot more to unpack a lot more to investigate there. What is the sweet spot? What is the goldilocks zone of blood BHB level for performance? What is the go deluxe zone for diabetes, for, you know, glucose control, what is the goldilocks zone for best, you know, sleep performance, you know, recovery. So I think there’s so many areas now. And so many researchers are, are, are increasingly, I’m building all the interesting questions around exogenous ketones and its use cases that it’s such a, a vigorous area of, of research at the moment.

Dave Korsunsky:

Yeah. It’s incredibly exciting that, you know, it was not long ago Latt, that, that the whole world of even just putting your body into ketosis was like this novel idea, even though we’ve had this machinery since the Dawn of time. Yeah. Basically I remember just a few short years ago. Oh, wow. If I just restrict my carbohydrates or do some fasting, my body produces these magical compounds and, and that’s how the whole craze really started. And, and you get these wonderful appetite suppression benefits. I remember the first time I actually put my body into measurable ketosis, a little bit of backstory on heads up for whoever is listening. You know, I had built, I had built the dashboard basically. And as a free product that we had put out on the market, one of my early business partners and I, and the first people that really, really started using our system started seeing these people logging in 5, 6, 7, 10 times a day.

Dave Korsunsky:

And we were flattered that somebody, somebody thought that we had built something useful. So we emailed these people and they said, yeah, we’re on the keto diet. And your dashboard’s the only place I can like to record my ketones, record my blood sugar sync, my carbs, and my macros, basically from my fitness pal. And so in the olden days, you know, we used to have to do it the hard way to get these, these benefits. And, and now we have companies like yours that are basically bringing these products to market that can deliver those benefits instantly. And, and, and the amount of science and research coming into this field is incredible. We just came from the metabolic health summit, which is one of the premier scientific events of the year that are really pushing the forefront of ketogenic therapy into all kinds of different medical applications.

Dave Korsunsky:

Some of the new ones this year I saw at the event were around spinal cord injuries and, and the use cases keep expanding every year. Yeah. We’re like, we’re finding more places where this is helpful and, and.

Latt Mansor:

Now the cardiovascular disease.

Dave Korsunsky:

Yeah. And, and the tech, your technology is getting so good, you know, that it’s making this accessible to people, even for a lot of people who wanted ketone benefits in the early days, it’s still very hard for people to make the nutritional changes required when you’re heavily dependent on a Western diet and your body has been conditioned to carbohydrates for decades. You know, it honestly took me years of on and off the carb wagon before I, my body just completely became 100% metabolic flexible where I can just absolutely control it at will. But right. I remember for the first couple years, even if I fell off the wagon and had some refined flour or some, something like that, it would take me like a week or two to get back onto a low carb diet.

Dave Korsunsky:

I, I don’t, I think a lot of the reasons relate to the microbiome in addition to other reasons, but now you can use the technology of products like yours available to everyone. You know, some of the, some of the ways I’ve, I’ve seen these are especially helpful are for one people who are new to a ketogenic diet. And, and they’re trying to get into ketosis for the first time, but it’s really hard because you’re addicted to carbs or sugar or whatever, refined, whatever, you know what I mean? And, and so a few applications for anyone who’s listening are first of all, just taking them in the morning to just provide a little bit of a bridge into ketosis. Okay, I’m gonna go zero carb or low carb. I’m gonna be on the struggle bus here for a couple days until my body kicks into ketosis.

Dave Korsunsky:

You know, these are just a beautiful way to like smooth out the journey if you will. And it’ll, it’ll, it’ll provide some immediate appetite suppression, some immediate energy boost, some immediate reduction of food craving. I remember the first time I got my body into ketosis. Yeah. And I tested it with a blood ketones. It was the first time in my life where I felt like I had absolute 100% control over my food choices. Hmm. I I’d never had that level of control over craving or food in my life. And it was so pronounced that it was incredible aha moment for me. I I’d never felt that you could put my favorite food right in front of my face. And I could just push it away, like when your brain’s on ketones. That was the level of self-regulation that I had. And, and we’re all looking for that level of self-regulation, especially with food, because in many cases, food is engineered to be hyper palatable.

Dave Korsunsky:

Right. That’s how food companies exist and not all food companies, but, but a lot of food is engineered to be as tasty as possible. So you got food companies, building stuff to make it as hard as possible to resist. Yeah. Right. Irresistible, that’s their job. But, but, but what defenses do we have, we need to make sure that we have the self-regulation to resist said food. So even just getting it to Ketosis for the first time, but it was hard. It’s like, I’d never restricted carbs before I like, what does 20 grams even mean? It’s like, you know, for the average Joe, that there’s a, there’s a pretty big cognitive hurdle just to even figure out keto, honestly like, okay. So how do I figure out this whole macros thing? And like, I gotta read all the labels and yeah. Make sure there’s no hidden carbs. You’re, it’s a big leap for a lot of people. So what do you think of that first use case Latt, lot where it’s just like, this is a nice baby step into the world and it’ll make it easier for you to learn this whole thing and, and have some success. Is that fair assessment of the use case?

Latt Mansor:

Absolutely. I mean, we have been saying that to, you know, on our website and our FAQ as well. Like it, it serves as a bridge to people who want to be in ketogenic diet, cuz a lot of questions came about when customers ask, can I take ketone IQ if I’m not on ketogenic diet? And we are like, absolutely. You know, that’s the whole point of exogenous ketones is so that you can have the benefit of ketones regardless of the diet that you’re on and based on your own use cases and based on whatever goal you’re trying to achieve. And if you are trying to go into ketogenic diet, as you said, you know, you might struggle for a bit. You might, you know, you might have to reevaluate your relationship with food, your relationship with carbs. And you know, this will provide that, that appetite suppression that, you know, food craving suppression as well as, you know, if you are intermittent fasting, for example, that also helps in giving you energy throughout the day.

Latt Mansor:

Now granted what I tell people is like it, it does contain calories. So if you are doing intermittent fasting for autophagy, then it does break your fast because it contains calories. But if you’re doing intermittent fasting to get into ketosis or to lose or to calorie restrict yourself, then this could prove to be quite supplementary to your fasting regime because it does provide you with clean energy. It doesn’t have any carbs. It gives you mental clarity, but on top of that, it powers through, it powers you through the day without having a full blown meal.

Dave Korsunsky:

So what’s the next use case that’s really interesting is assisting with fasting, you know, for a lot of people, it’s just a miserable concept. You know what I mean? In general. Yeah. I’m at the point now where I actually love it. I feel so good after 36 hours into a fast. It’s amazing. I actually feel better than when I’m eating food, but it’s taken me a while to get there. You know, just the psychological idea of fasting. It’s a little uncomfortable, I’m hungry. So it’s also a really nice compliment to intermittent fasting where you may want to go 12, 18, 24 hours and use this throughout the experience. Just kind of like grease the skids a little bit as well. 

Latt Mansor:

Yeah.

Dave Korsunsky:

So that’s kind of the second one I wanted to call out was like as a compliment to fasting, I use that I do a lot of three day water fasting and I’m not in, I’m not maniacal about being completely zero carb, like a little bit of exogenous ketones I can tolerate, they actually make the experience better. It’s like, you’re already flying really high when you’re doing extended fasting and, and you’re on ketones and this just makes it better, but a, a bridge and a as a adjunct therapy to fasting, whether it’s intermittent fasting, I’d call that a shorter term type of a thing, 1824, or you’re doing extended multiple day. I think it’s another beautiful way to integrate this type of product. Would you agree? Yeah.

Latt Mansor:

Yeah, I would agree. But the only caveat, like I said, it really depends on the goal of the fast as well. Sure. Yeah. Like if you’re doing Autophagy you don’t want to have any calories in because you’re forcing your body to recognize that it’s in survival mode. Hence you don’t want to put any calories in, it’s gonna go into survival mode and it’ll start cleaning itself out of autophagy, reusing recycling and, and, and eliminating whatever waste that is in your body.

Dave Korsunsky:

Cool. Okay. So we’ve covered it just like a bridge into ketosis. We’ve talked a little bit about intermittent fasting. I think another area that would be really interesting to talk about is how can they help with, with glucose control? So, I mean, there would be obvious benefits. This is just my layman’s interpretation of it and you can correct me, but if I’m using, if I’m using an, an exogenous ketone product, I’m, I’m naturally gonna have increased ability to self-regulate my food choices. I’m naturally gonna have a little bit of appetite suppression. And just, just by default, it’s gonna help me make better choices and lower glucose, but are there other applications where even if I am making a bad choice and I have the ketones in me, do they somehow kind of cancel out the postprandial blood sugar or something like that. Can you educate us on, on how those things fit together?

Dave Korsunsky:

That’s a very interesting question. And it is an area that is still very new in research, probably in the past 2, 2, 3 years, professor Jonathan Little from university of British Columbia published three papers. At least I think she probably published more now, but the initial three papers were on acute use of Ketone Esters in healthy individuals, acute use of Ketone Esters in obese individuals and then use of keto Naster for 14 days in obese individuals. And all of them looked at, you know, insulin, blood glucose and all that. And they took it, you know, after they had food. So post prendale, beautiful. And they saw consistently there is a slight drop of glucose after they consume exogenous keto. Now exogenous, keto, meaning Ketone Ester, and so far keto, I’ve also shown the same pattern. I don’t believe ke salt has the same effect.

Latt Mansor:

I don’t know if it’s because it doesn’t raise the blood BHB high enough because the hypothesis around why blood glucose is going down blunted blunted a little bit. So the hypothesis around it is that if your blood BHB is high enough, it somewhat gives the signal to the liver to temporarily seize or downregulate gluconeogenesis, which is to produce its own glucose within, within your own body. Because your body’s saying that, Hey, you know, you’ve got enough stuff straight in the body to create energy. Now, why don’t you dial down the gluconeogenesis a little bit? So that is the, the, the theory, the hypothesis so far, but we haven’t really explored into, you know, confirming that or, or validating that. But surely, you know, it certainly has a place for people who, you know, want to go back, say, say you are on ketogenic diet and, and you were invited to a birthday party, you had a piece of cake, you know, you had a high glucose.

Latt Mansor:

Now you wanna go back into ketosis really quickly and you wanna lower your blood glucose, take a shot of, of ketone IQ. That’s why I usually do sort of cheating, but at the same time, like it does bridge that, that keto, ketone ketosis much quicker. And on top of that, I dunno if you, you feel like for me personally, if I have been on a low carb diet for a bit, and if I introduce quite a large amount of carbs and glucose, I have that glucose crash. Like I just feel very lethargic. I just want to have an app having a shot of ketone IQ actually stops that for me. Yeah. So, you know, I think it, it, it really depends on individuals and, and, you know, on another like point to prove the effect of, of ketones in, in, in glucose control and in diabetes as well. I mean, Verta health has been doing, you know, tremendous work in using a ketogenic diet to treat diabetes. But granted we know that, you know, ketogenic diet is naturally low, very low restricted in, in carbs anyway. So you are already restricting in carbs and then, you know, to add ketogenesis and, and ketosis on top of that is just a bonus.

Dave Korsunsky:

Yeah. You, you brought out Verta, it’s such an incredible example where they’re, they’re bringing ketogenic therapy into the standard of care, which is really cool. Just, just tangentially. Do you know if they’re using ex exogenous ketones in their protocols?

Latt Mansor:

No, no, they are. They are not at the moment.

Dave Korsunsky:

That would be pretty sweet. That’s a nice partnership opportunity there. AB absolutely. You guys are right down the street.

Latt Mansor:

Yes. And I did talk to no Dr. Steve Finney and he, he gave me a challenge essentially because, and he has a point and, and, you know, we here at HVMM, we always stand for the transparency and we stand for the science and we stand for a win-win situation for both the company and for the people. So Steve posts a challenge that, you know, he said, how much ketones can my body create in a day? Right. He said about like 75 to a hundred grams. And that is free from your ketogenic diet exogenous ketones can you make it free? Right. How am I going to compete with ketogenesis with endogenous ketones? If you, you can just use it as, you know, use ketogenic diet versus a fair point, ketone IQ. It’s just a matter of cost. Yeah. And, and, and I can always argue about the adherence, right?

Latt Mansor:

They have been proving that, you know, there’s quite high adherence amongst the people and they’ve published these papers. So one point to argue is, okay, adherence. What if some people, you know, the exogenous ketones might give these people some form of flexibility in ketogenic diet. It will allow them to at least have a bit of carbs. And then it boils down to the end user. Do they even want that flexibility? Or do they actually want a strict regime where they stuck to their ketogenic diet? So there’s still a lot of work to be done here to really optimize the final product of ketone IQ we can always, and we always do

Dave Korsunsky:

So already iterating on the product just based on the way you’ve kind of forked it from the original.

Latt Mansor:

Absolutely. I mean, they can, it can always be cheaper. It can always taste better. It can always act better. It can always be more efficacious. It’s science, it’s technology, right? Whatever data there’s other that’s, that’s the great point here that that’s the perk of my job is to be able to have these kind of conversations with all the researchers around the world who are doing research in different areas, but all involving both endogenous and exogenous ketones and really understand where the state of the art is and where the current state of science around ketones is. And, and that is very important because then we know where to steer our product towards, you know, what is actually proving to work, what molecule is actually proving to, what do people actually want? Do they want a big spike and then a drop, or do they want something that lasts as long as possible before they top up another dose? You know, do they want something that, you know, is between X and Y range of blood BHB? Or do they want a general, like anything above 0.5? So all those questions have always been asked consistently within our company and me as a research lead also, you know, it’s my job to go out there and find all these resources to be able to answer them to both internal and, and external parties.

Dave Korsunsky:

So you get to keep your hands in, all the different pies out there, all the research being done. You’re just kind of looking across the landscape and looking at what are the different types of studies coming out? What are the different demands from consumers? You guys have a huge direct to consumer business, a fantastic brand out of the market. So you’re obviously hearing it from the individuals who are using it, all the biohackers, all the people using ketogenic therapy. Then you’ve got the research aspect. Where, where is that going? How do, how do these products fit in? So you get to look across the landscape and then you’re bringing that feedback back into the product team. Is that correct?

Latt Mansor:

That is definitely a privilege. I’m very grateful to have.

Dave Korsunsky:

Cool. Let’s talk about high performance applications. I, I mentioned one example earlier where you have a use case around someone who is sitting at a poker table with some of the top players in the world going, you know, head, head to head, for example, long days, that would be one application sport, high performance sport. That’s a different type of application where it may not be sustained long term, unless it’s an endurance type of an event, for example. Yeah. So what are you guys seeing out there? What’s the state of the art in, in using these products in, in high performance applications, any specific nuggets you wanna share with us?

Latt Mansor:

Sure. I mean, exogenous ketones have been used very ubiquitously in enduring sports, especially in triathlon, in cycling and in the Tour de France. You know, they had a whole article published on how cyclists in the Tour de France used Keyes from the history of men before. So that was really big. And, you know, are

Dave Korsunsky:

They are allowed in this day and age? sorry to interrupt you. Is this, is this permitted in, in, in competitive sport?

Latt Mansor:

Yes, it is because all our products are also third party tested for band, substance and compliance. So all of that is covered. Usually athletes, they will ask for it and we’ll send them, you know, ask them what back they have, all the certificates everything is done. And obviously, we have the FDA grass as well, which is generally recognized as safe. So we get all the paperwork covered. And as I said, you know, earlier we are all about, you know, transparency and science and making sure that people are getting what we say they’re getting. So for endurance wise, we, we have seen papers and, and studies that showed improvement when faster. So that was the big paper in 2016 and some metabolism that showed 2% improvement when the cyclists were faster. And then another group repeated that study with fed cyclists because they were like, well, you know, no, one’s gonna go into a race faster.

Latt Mansor:

So let’s replicate a more ecological setting here. So they saw no, no improvement in the fed group. And then they repeat that again. But this time, knowing that the increase in blood BHB decreases blood pH and, and increased acidity, they added sodium by carbon and that improved performance by 5%. So, the current understanding of the protocol is that balancing or buffering the intake of Ketone Esters with Sodo by carbonate did improve performance in endurance athletes. Now people ask, how does that apply or translate into keto IQ? What I tell people is that keto IQ does not spike in blood be that high. And in fact, it’s a much slower releasing, slow burn. Yeah, slow burn. So you possibly don’t have to buffer it because it doesn’t go to that level. And it, it, because our blood, our body obviously, you know, in homeostasis balances and buffers itself out.

Latt Mansor:

So it gives the body time to, to balance that, that acidity out. And hopefully, you know, that way we can already see an improvement in performance without having to, to either be fasted nor having a sodium by carbonate buffer. So currently we are running a study with the University of north Georgia to replicate the use of Ketone Ester in cognitive and physical performance. But this time using keto IQ, hopefully the data data, data collection will be complete in August. And we are looking to present at the national strength and conditioning association conference next year, hopefully with that data as well.

Dave Korsunsky:

Cool. So you’ve got endurance athletes, and I think that was really kind of, you know, just going back to the old Steve Finney books, the art and science of low-carb living, the art and science of low-carb performance. It was really these ultra endurance athletes who had really put keto on the map because they had gone through a full four week fat adaptation, probably a little longer than that, even before competition. So yeah, this is not a matter of where they said, Hey, I’m just gonna carb restrict for a couple days before the competition and go in, they had car restricted and been in a ketosis for up to four plus weeks where according to the books, if my knowledge is still accurate, that that’s a full adaptation of every cell in the body, you know, weeks of, of ketosis. And then yeah, they went into the endurance ultra endurance race in this prime state and, and were not dependent on any type of external fueling at all like the gels and whatever the other people were using. And, and they had extremely successful

Latt Mansor:

Outcome. And, and I might, I might want to add as well that these protocols that I just mentioned for endurance athletes and endurance exercise is that they have been taking exogenous ketones, but also they have been taking their standardized fueling strategies, which means about 60 grams or one gram per one gram of carbs per kilogram or body weight per hour. So that’s what they have been using. So they’re using essentially a hybrid fuel gotcha system where they have both carbs and ketones. And somehow we have also shown that that system itself does have a glycogen sparing effect. And that is also what pushes these endurance cyclists or endurance athletes a bit further. And then the same group that used sodium by carbon to buffer the acidity of Ketone Esters. They also did another study to look at, to look at overreaching symptoms and recovery. So for a three weeks study, they gave the cyclist ketones and proteins and carbs after their workout, as well as before bed. And they saw an improvement of 15% work output at the end of three, the third week. So, you know, to me, that compounding factor of, of using it for recovery is definitely very significant.

Dave Korsunsky:

Well, it’s interesting that you’re starting to see hybrid strategies that that’s new to me where you’re using the exogenous keto, but you’re also taking 50 to 60 grams of carbs per day. And, and what you’re saying is that those protocols can deliver equal levels of performance relative to someone who has been purely ketogenic. Am I understanding that right?

Dave Korsunsky:

Yeah. Yeah. So, that’s a whole, that’s a whole idea. And the benefits of Exogen keto is that you totally, you don’t need to, you get the best of both worlds diet, you get the best of both worlds. So you can’t. So there, it is not a possible physiological state where your body has both carbs and ketones to, to choose from,

Dave Korsunsky:

Well, not in the natural world, but there is now exactly,

Latt Mansor:

Exactly. So this creates that. And, and what we have seen is that that gives your body because your body will just, you know, choose whatever that it can burn and it burns more efficiently. And that has been proven to really give your body the advantage to, to go further or go faster. And that is exactly why when athletes start using ketone IQ for performance, we always tell them to use it together with carbs because, you know, one dose of, of ketone IQ is like, what 70 calories, it’s impossible for it to sustain your whole, you know, endurance race, right? You are burning your own, your own storage. And if you are already on a ketogenic diet, you barely have any glycogen in your body. So you are burning your other, your fat storage and all that. And if the process of conversion is like lipolysis and all of that does not catch up to your activity, you’re just gonna bunk out.

Latt Mansor:

Right? So that’s where, you know, the hybrid fuel system is, is quite helpful because it lets your body balance itself out as well as it gives your body time to decide, okay, am I burning the glycogen now, am I, am I mobilizing all the fats now while I’m burning the glycogen or, you know, am I am running the ketones and all of that. And on top of that one thing that most people, because when these studies are published, they look at performance, they look at glycogen sparing, they look at muscle metabolism. Another point is also the subjective feeling of cognition like cognitive. I love the benefits. So that is another really profound effect of Exogen ketones that I have experienced is that when you are at the verge of passing out, you are so fatigued. And the only thing that is pushing you forward is your mental strength and resilience.

Latt Mansor:

This puts me in that zone and, and really gives me that, that clear thinking process where I can just, just hyper focus on one thing. And that is especially useful for, for me, going weightlifting, for example, and, and strength training, because I’m not going for the marathon, I’m not going for the endurance, right? So I, I can’t measure, you know, how long can I burn the substrate for, but instead it gives me that mental focus that, okay, I’m gonna do this heavy lift, get into the, into the zone, engage whatever muscle groups that I need to engage, make sure my form is correct. You know, I’m alert to everything. I can feel everything and, and do it correctly.

Dave Korsunsky:

Yeah. I love that. So I also really love the idea of having this flexibility to do a hybrid strategy. It doesn’t mean that you can smack back a few donuts and a pizza, but what does mean is you might have some really nutrient dense carbohydrate sources, for example, sweet potato, as an example, or, or other like the, the highest quality carbohydrate sources so that you get the benefit. And, and those have other benefits around just hormonal health and other things where you can still really give the, the amount of carbohydrates in the body to keep hormone levels optimal, do do long, long term ketogenic diets, maybe reduce a lot of the downside of, of long term keto, if, if that’s what you wanna do. So knowing that you can layer that in, and now you have a world where you can have both fuels in the body, which was largely impossible up until this type of product came to market.

Dave Korsunsky:

So it’s interesting to see that these hybrid strategies are coming out. I wanna just talk a little bit more about performance applications and then just recap it here for everybody. So if, if I’m understanding things, let’s just recap. So if, if I just want to use them acutely, right. I haven’t been following a ketogenic diet at all, but I wanna use these for a, you know, big presentation at a conference or something like that. Just acute applications. I carry this in my backpack with me everywhere. So like everybody listening needs to have a couple bottles of these in the backpack at all times. And you can just use them acutely, like, yeah, I need to snap in my focus for a couple hours. I’m a little lethargic, or I have a big performance event coming up. I play competitive tennis here. I’ll take them before I play a competitive sport.

Dave Korsunsky:

So there’s those acute applications. You can also use them. It sounds like if you are already in a state of ketosis and, and you want to perhaps amplify the effects of that, of that state. So you’d have the body producing exogenous ketone, maybe you’re at a low level of nutritional ketosis, 0.5 millimeters millimolars or something like that. And this can give you that little push, you know, up into like maybe the 1.5 LAR range. And then if you’re, if you’re already in a very, very deep state of therapeutic ketosis, maybe you’ve been fasting for several days, or maybe you’re on a, a cancer protocol or an epilepsy protocol where you have to be in a therapeutic ketosis, which is gonna be like a glucose keto to an index, like less than three I’ve even pushed mine less than one before, which is super intense. I would imagine that. Would you recommend it in that use case as well? Or you are already so deep that you wouldn’t recommend it. What’s the best practice there?

Latt Mansor:

So what we have seen, interestingly enough, unlike ketone esters, ketone IQ, if you’re already in a deep state of ketosis, let’s say you are already at two, right? It doesn’t increase your, it, it’s not directly proportionate to, it’s

Dave Korsunsky:

Not just gonna double it. 

Latt Mansor:

For example, it’s not gonna double. It’s gonna,

Dave Korsunsky:

Your body will regulate it somehow.

Latt Mansor:

Exactly because it’s being gate capped by your liver. So your liver is gonna have the signal that says, you know, your blood keto is quite high now. So it will. So what we have seen is like the person with, you know, 2.3, you know, 2.4, they’ll go up to 2.5 or six. And then now what does the ketone IQ do then? You know, people also like, why do I need it? It actually prolongs that period of high, high ketosis. Cool. So, so depending on what your goals are, you know, if, if you think at two millimolar, that’s more than enough, what you need, you already have the mental focus, you already have the energy, or if you are, you know, fasting and you are low energy, but you have high ketosis, then maybe one shot will, will give you that, that boost of energy. Right. Cool. Because there are calories going in. So even though you are creating your own ketones, this one is external calories that you’re putting in that would essentially, you know, create energy and vitality.

Dave Korsunsky:

Yeah. I, I also think it’s important that, that we mentioned for people listening, that you can test yourself if you’ve never tested ketones before, you know, that was something that even a few short years ago, I remember the days where we had to like scour the web for test strips from Australia, cause the precision extra strips in the us here were like $5 a strip. You know, it wasn’t that long ago that that was the, the, the, the state. I remember ordering on my ketones strips on eBay from pharmacies in Australia. They were like, I could get ’em for like a dollar 20th strip or a dollar 40th strip cuz in the us for lots of reasons, we don’t need to get into, you know, the companies could charge $5 a strip. Now we’re at the point where it’s like, I don’t know, it’s like down to pennies on the dollar to test ketones.

Dave Korsunsky:

So if you’ve never tested, that’s actually one of the most rewarding parts about this whole thing. Yeah. And you can get really, really good keto meters on the market nowadays. And, that’ll give you some really accurate biofeedback that you’re doing things correctly and you can start to see how the product is changing your metabolic profile, your blood sugar and your ketones. So lots of easy ways and affordable ways to test lots of incredible products. Like HVMN that are out on the market. Now that just have incredible benefits across the board, you know, EE provides just out of the box benefits of ketogenic therapy for people who are new or people who really struggle even to get into ketosis. And then on the other side of it, there’s the medical applications. And then there’s also the high performance applications and, and it just keeps getting better and better.

Dave Korsunsky:

And what tools are accessible, these are not expensive tools. These are not cost prohibitive. These are tools available to anyone who’s really interested in being their best self every single day, unlocking the secrets of your body’s performance. It’s just something that is incredibly exciting. So Latt in closing here, are there any recommendations you would give for people who are just starting out here or, or maybe if you could share some of your, the top resources on your website for people who wanna learn more and just, if, if they’re listening, how do they, how do they get started here, cuz I’m sure we’ve peaked to curiosity, not just of our end users on the system, but if you are one of the practitioners on the heads up platform, working with clients on metabolic therapy and, and you’re working with people who, you know, may struggle with a ketogenic diet or who need extra help or who want to use these in fasting, I use them with people I work with in high performance applications. It’s just an awesome performance hack. And if you’re a high performance coach on our system, layering this into the stack, incredible. So lots of ways to infuse these into different programs and protocols out there, but what’s the best way Latt for people to get access to your product? And if you could maybe share like your top one or two resources out there that you’d recommend to people to read or watch to learn more. Yeah, that’d

Latt Mansor:

Be awesome. I mean our website HVMN.com. We have a lot, I mean, I personally worked on that myself. We have, you know, on the KETONE science page itself, we have all the resources and all the citations, all the studies that showed, you know, the, the benefits of exogenous ketones under the FAQ sections, we have different use cases, especially for advanced use cases. Either you are, you know, using it for athletic performance, you’re using it for recovery or you’re using up metabolic health. You know, the dosing guidance, all of them, are available either in the FAQs or in, in the help section of health center @ hvmn.com and feel free to follow me as well on Twitter and Instagram at Latt Mansor.

Dave Korsunsky:

That’s amazing. You’ve got me sold. I was going old school. I like the slow burn. You know what I mean? I think that’s actually gonna be a better use case for me personally. And, and the clients I work with. That’s not to say it’s for everybody, but the clients I work with, they need that long, slow, continuous, like, just keep me above 1.0 for six hours. That is money. Yeah. So please, please keep iterating on the product. I know you guys have been really at the forefront of this science for years. You guys were really first on the market with this type of stuff. There may have been some other ones, but you guys really are first to bring it to the mainstream, to the masses. So keep doing all of the amazing work that you guys are doing. Yeah. We’re, we’re very grateful that you shared your expertise with us here today and there’ll be more coming between heads up and HVMN and the near future. So stay tuned and thank you Latt. We’re very grateful.

Latt Mansor:

Thank you for having me. Thank you.

Ep. 60 – Integrating the Oura Ring into your Functional Medicine Practice with Dr. Sachin Patel

Ep. 60 – Integrating the Oura Ring into your Functional Medicine Practice with Dr. Sachin Patel

About the Episode

Dr. Sachin Patel of The Living Proof Institute and Perfect Practice Mentorship sits down with Dave Korsunsky to discuss how Dr. Patel implements the Oura Ring into his practice. The pair dive into their favorite metrics to monitor, how to build a successful practice, and how each of them got into functional medicine.

“Getting people more parasympathetic heals and it helps restore the function of all of their organ systems. It also restores blood flow to those organ systems.”

– Dr. Sachin Patel

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

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Living Proof Institute

The Living Proof Institute offers personal and corporate health solutions. Our goal is to improve the health and wellness of our community by improving the health of its citizens. Our mission is accomplished by patient education, dietary and lifestyle consulting, exercise prescription, and advanced functional laboratory testing.

Perfect Practice Mentorship

Perfect Practice is a world-class personal, professional, and practice development mentorship. Our mission is to provide simple, practical and affordable growth tools to help functional medicine practitioners and coaches deliver transformational care for their clients.


Dr. Sachin Patel

Sachin is a father, husband, philanthropist, functional medicine practice success coach, international speaker, and best-selling author whose philosophy is that, “The doctor of the future is the patient.” 

He founded The Living Proof Institute and coaches practitioners all over the world on how to step into their power and profoundly serve their communities.

And, he has taught thousands of functional medicine professionals how to start, grow, and scale their practices.

Sign Up For The Future Webinar With Dr. Sachin Patel & The Heads Up Team.

Show Notes

(2:10) Dave talks about how practices can use wearable technology to benefit their patients. Practices can get rapid feedback, personalized programs, and more.

(3:15) Dr. Patel started as a chiropractor for sports, soft tissue, and repetitive strain injuries. He ended up on the news, which resulted in more than 50 people calling his practices. All of these people had chronic health issues, as opposed to soft tissue injuries. This led Dr. Patel to functional medicine.

(3:43) Dr. Patel started the Living Proof Institute in Cincinnati, Ohio. The institute helps people get to the root cause using functional medicine, lifestyle, medicine, and mindset to help them heal.

(3:56) He moved back to Toronto to start another clinic. Other practices started reaching out to him about how he built his own practice. This led Dr. Patel to coaching. His goal is to establish a movement to create and deploy an army of practitioners that are making the world a better place and using technology in a responsible way to enhance their clinical outcomes.

(5:37) Dave reflects on how a functional doctor helped him identify the root cause of his health issues. This led him to move off of the Western diet and ignited a series of personal health changes.

(7:04) Dr. Patel shares how he grew up eating a bunch of grains as a vegetarian. He started removing gluten and dairy from his diet. This included meat substitutes which were stitched together with gluten.

(8:07) He would wake up tired, stiff, and achy every morning. He had major digestive issues. After altering his diet, his skin cleared up and many of his issues disappeared. He has now been gluten free for over a decade.

(9:44) Dave discusses how he is also now an early morning person.

(10:22) Dave shares how understanding Oura Ring metrics on himself now helps him interpret the data of his loved one’s through Heads Up.

(11:45) Dr. Patel met Harpreet Rai (CEO of Oura Ring) at Genius Network. This led him to invite Oura to come to Dr. Patel’s in-person event, which resulted in dozens of practitioners ordering rings.

(12:22) In Ontario, Dr. Patel had to figure out what claims he could make regarding his messaging. He decided to focus on vitality and health optimization.

(13:13) Dr. Patel realized that boards would go after practitioners requesting testing. Dr. Patel wanted to create a program that doesn’t use testing. 

(14:44) Dr. Patel wants patients to become their own doctor by having data. People who were put on a lifestyle design program were getting amazing results in 3-6 weeks. They got off their meds, lost 20-60 pounds, and transformed their health before getting tests done.

(15:44) By improving lifestyle and environment, there’s collateral benefit to their entire family. They want to teach the figurehead in the household how to create an environment of health in the home.

(16:17) In one family, a woman lost 27 pounds, the husband lost 45 pounds, and the daughter lost 27 pounds. Dr. Patel doesn’t want skinnier versions of people, but healthier versions of people.

(17:12) Dr. Patel focuses on heart rate variability (HRV). HRV correlates to bone health, muscle health, brain health, immune system function, digestive function, and other systems in the body. He tracks HRV through the Oura Ring.

(18:01) Dr. Patel gets 50-100 Oura Ring sizing kits delivered directly to his practice at a time. He includes a sizing kit in each client’s welcome package.

(19:11) Dave discusses the limitations of working within the Canadian system. Dave’s sister is a naturopathic doctor in Winnipeg and she can’t order labs for her patients, even a simple Vitamin D test.

(21:38) Dave talks about why it’s a great idea for Dr. Patel to stock the sizing kits for his clients to reduce friction when ordering the Oura Ring.

(23:50) Dave believes combining metrics and using that for engagement opportunities is the best approach for practices.

(24:36) Dr. Patel discusses how they use a health coach. Their patients can do a daily check. They can submit a journal entry, log their weight, hydration, bowel movements, sleep scores, and any other questions they may have.

(25:24) Dr. Patel’s practice shares patient progress, oftentimes through Heads Up Health Reports, during follow up meetings. The practice focuses primarily on sleep and HRV. The patient shares information the ring can’t tell them and Heads Up gives them information that the patient can’t tell them.

(26:53) Practices don’t need to be perfect to get started. You learn things and make improvements along the way.

(28:19) Dr. Patel enjoys gamifying within his community. He can hold sleep score contests with his clients.

(28:52) Dave talks about how the Heads Up employees all have their Oura Rings connected and a Slack Channel to discuss their scores. 

(29:59) Dave goes over some of the best metrics to monitor using the Oura Ring. These metrics include resting heart rate, temperature deviation, HRV, the actual readiness score, the respiration rate, and the sleep score. Temperature deviation can be a precursor to pending illness. Respiration rate can indicate impending illness and level of cardiovascular health.

(32:11) You can’t cheat heart rate variability. It shows how somebody is handling a stressful situation. Dr. Patel uses HRV as a measure of resilience. HRV is a good measure of parasympathetic tone; a good indicator of how well we’re recovering, repairing, and regenerating.

(34:50) Sleep is one of the most important things that we do. It is the most parasympathetic thing that we do. The Oura Ring shows how well protocols and recommendations are working.

(36:10) Dr. Patel had a friend who couldn’t sleep and Dr. Patel recommended that he turn off all artificial lighting after the sun goes down. His friend felt better, but the Oura Ring showed him the value within the data.

(37:18) Dr. Patel also focuses on respiratory rate. He uses a nose strip, mouth tape, and proper positioning when he sleeps.

(37:45) Dave tries to think about the central nervous system when he prioritizes his help. He turns the lights down early before bed and views it as the goal of meditation.

(39:07) Changing how you consume alcohol or cannabis can help with sleep onset. Water can also be used as an excellent source of relaxation therapy.

(40:28) The key to Dr. Patel’s program is to pair your nervous system with the activity that you are trying to accomplish. 

(41:18) Bob Rakowski shared a study that measured blood flow in extreme athletes. A sprinter, in a very fight or flight state, is sending only 5% of his blood flow to his liver and kidneys when he’s in that state. At rest, they send 50% to those organs.

(41:46) If you want someone to detox better, the key is to increase blood flow and nutrients to the organ system so they can function properly. By healing your parasympathetic system, that helps restore function and blood flow to their organ systems.

Your digestive system works better when you’re parasympathetic. Instead of changing your diet, slow down, chew your meal, enjoy it, and be grateful for it. Western culture views food as an inconvenience.

Our digestive system is most effective in mid-day when the sun is in the highest position (not necessarily noon). That’s when you should have your biggest meal. The most parasympathetic thing you can do right after that is take a nap and digest that meal, instead of going to exercise immediately after.

(43:24) Dave noticed that he should eat his biggest meal around 3pm.

(46:26) Dr. Patel noticed that food choices, meal timing, and stress affect HRV. You can’t eliminate stress, but you can change how they interpret it. If somebody’s HRV is not responsive, he starts to look into trauma. There may be something that is keeping them in a sympathetic state despite the fact that their physical health is improving.

(48:36) There are many things that are easily modifiable in our day-to-day life; our environment, lighting before bedtime, ambient bedroom temperature, meal timing, and meal choices.

(49:06) When you want to move on to the next level, you look at things that are psychospiritual including stressors in relationships with others and yourself.

(49:36) Dave and Dr. Patel discuss the power of plant medicines. Dr. Patel had a patient who had a 30% permanent improvement in their HRV score after a psilocybin ceremony.

(50:55) In Dave’s personal experience, if his HRV numbers are in the 50s, he feels there is nothing that he can’t accomplish. He also makes sure that he doesn’t overtrain.

(53:04) Dr. Patel looks at how long it takes him to sink into resting heart rate and calibrates his day accordingly. Sometimes our body will tell us one thing, but our mind can always tell us something else. He gives himself permission to override the data and choose how he feels about the day.

(55:40) Dr. Patel gives insight into how patients respond to remote patient monitoring. When he tells people that they offer remote patient monitoring, it serves as a filtration process. People who don’t like to be measured won’t want to sign up.

(57:03) Dave likes wearable technology and biometric data in the clinical setting because it holds both the patient and the practitioner accountable.

(58:40) Remote patient monitoring validates practitioners’ processes. It is evidence that their program works. There are practitioners that make big claims, but don’t have evidence to back that up. There are patients who say they’re doing certain things that may not be.

(1:01:23) The top three metrics that Dr. Patel personally lives by are HRV, fasting insulin, and high sensitivity CRP. HRV is instant biofeedback. Insulin resistance is a major predictor of many issues in your body or longevity. Fasting insulin shows how someone’s managing their metabolism, blood sugar. High sensitivity CRP is an inflammation marker.

References

Living Proof Institute

Perfect Practice Mentorship Program

Harpreet Rai

Dr. Bob Rakowski

Mymetabolicreset.ca

Sign Up For The Future Webinar With Dr. Patel & The Heads Up Health Team

Ep. 59 – Integrative and Functional Nutrition with Dr. Sheila Dean from the IFNA

Ep. 59 – Integrative and Functional Nutrition with Dr. Sheila Dean from the IFNA

Dr. Sheila Dean of the Integrative and Functional Nutrition Academy dives into how she started IFNA, what the academy’s courses teach, functional nutrition, becoming a VA vendor,  and where conventional and integrative medicine differ. She covers all this and more with Heads Up founder Dave Korsunsky.

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

START TRACKING!

“It’s not just about Sheila Dean in private practice, but it’s about empowering and educating as many nutrition healthcare professionals as possible to get out there and to do this.” – Dr. Sheila Dean

Integrative and Functional Nutrition Academy

The Integrative and Functional Nutrition Academy (IFNA) is one of the most respected online functional nutrition training and mentoring programs in the industry. It was founded by two of the nation’s premier integrative medicine nutritionists, Dr. Dean and Kathie Swift MS.

Consisting of 5 tracks with 33 modules, the IFNA program teaches leading-edge, evidence-based, whole systems approaches to patient care.  This emerging medical nutrition model focuses on identifying root causes and imbalances to significantly improve health outcomes and combines the very best of modern science, clinical wisdom, and critical thinking.

Click to enroll in IFNA

 

Dr. Sheila Dean

Dr. Sheila Dean, DSc, RDN, LDN, IFMCP is a registered and licensed dietitian nutritionist, board certified integrative and functional medicine certified practitioner, clinical nutritionist, and exercise physiologist. She was a Certified Diabetes Educator with the NCDBE for 15 years.

She received her undergraduate training through Rutgers University, completed her internship and graduate training with University of Rhode Island and Brown University’s teaching hospitals, received doctoral training in nutritional genomics and pharmacology through the University of Medicine and Dentistry of New Jersey (UMDNJ) and completed her Doctorate of Science degree through Hawthorn University. 

Dr. Dean has received advanced training in functional medicine and nutritional biochemistry through the Institute for Functional Medicine and is a board certified IFM practitioner. She has also worked with the Duke University Medical Center’s Endocrinology and Metabolism Disorders Clinic and the Joslin Center for Diabetes as a certified diabetes educator.

She’s served as the consulting sports nutritionist for the Philadelphia Phillies, has consulted for the Tampa Bay Buccaneers, the Toronto Blue Jays and was the media spokesperson and columnist for the Ironman Institute and is the author of Nutrition & Endurance: Where Do I Begin? (Meyer & Meyer Publishing).

 

In this episode:

(2:13) Dr. Dean discusses her background being a dietician for 30 years. Around 2000, she became disillusioned with the field and was exposed to functional medicine. After her research, she concluded that this was a field she was excited to join.

(4:29) Dr. Dean started incorporating her functional medicine knowledge into her practice. The types of patients who went to see her began to expand.

(5:26) Dr. Dean and Kathie Swift were constantly being called and texted by people asking for training. IFNA launched in 2015.

(6:54) Dave reflects on Dr. Dean’s journey and how she created her functional nutrition business.

(8:04) Dr. Dean and Kathie felt that dieticians were pretty ignored. They wanted to create a program for dieticians.

(9:30) Dr. Dean dives into her functional nutrition program and what people will learn from it. IFNA teaches people a specialized area. There are 33 modules and it takes about a year to finish. There are nine components. Track 1 covers everything from food is medicine, conventional labs, functional blood chemistry interpretation, dietary supplements, the science, and the art. Track 2 gets into all the different systems areas. Track 3 is about the application and building your own private practice. There is a track dedicated to therapeutic elimination diets. The final track, Track 5, is dedicated to case studies.

(15:35) Dr. Dean says the ideal scenario for her students is for them to setup an integrative-based practice. IFNA are VA vendors, so they have a contract with the government that pays for the all the programs that their VA dieticians go through.

(17:59) Dr. Dean believes that asking questions about root cause analysis is the foundation of trying to understand how to restore health and function.

(19:20) Dave narrows in on the issues with the standard American diet and lack of education for children.

(21:01) Dr. Dean and Kathie are focused on empowering as many functional nutrition healthcare professionals as possible. Heads Up Health’s mission is to give certified professionals the remote ability to measure and analyze how patients are doing.

(25:19) Conventional and integrative communities agree that autoimmunity is a condition where the immune system is hyper vigilant and maybe attacking its own tissue. The difference in the communities lies in the way the issue is handled. Once the patient is stabilizied, Dr. Dean thinks the physician should figure out or outsource the patient to somebody who will figure out the underlying issue.

(29:39) Dr. Dean cautions practitioners not to replace a drug with a supplement.

(31:51) If you take a personalized approach, there isn’t one or two panels that you need take. But, a really good overall panel is a nutra eval. It looks at many different biomarkers related to nutritional status.

(34:05) STAIN is an acronym used by IFNA. Stress, Toxins, Adverse food reaction, Infection, and Nutritional deficiency. Dr. Dean gives examples for each type. 

(37:52) Dave shares how he discovered an infection in his microbiome that showed up in a test once he started working with a functional doctor.

(40:06) Medications can cause nutritional deficiencies. Magnesium and CoQ10 can typically be depleted by medications.

(43:48) Dr. Dean says it is key for functional nutrition practitioners to track data and stay organized.

References

IFNA

Dr. Sheila Dean: LinkedIn | IFNA 

Kathie Swift

Ep. 58 – Designing Functional Health Protocols with Dr. Alex Keller from Fullscript

Ep. 58 – Designing Functional Health Protocols with Dr. Alex Keller from Fullscript

By using artificial intelligence with a human element, practitioners can design a functional health protocol that will allow patients to maintain their treatment plans.

Fullscript’s Dr. Alex Keller and Heads Up Founder Dave Korsunsky discuss how to deliver an entertaining and informative patient healthcare experience. Allowing patients to interact with and understand their data from their remote patient monitoring tools will drive them to stick to treatment plans long-term.

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

START TRACKING!

Dr. Alex Keller

Dr. Alex Keller is a practicing naturopathic doctor in Ottawa, Canada and the Medical Director at Fullscript. As Medical Director, he oversees the Integrative Medical Advisory team (IMAT) and the development of educational content for practitioners across North America.

He is a graduate of the University of Ottawa with an HBSc in Health Sciences and Psychology. Although originally planning to attend conventional medical school, Alex shifted direction and completed a degree in naturopathic medicine at the Canadian College of Naturopathic Medicine. The shift followed a three-month internship at a rural Kenyan hospital where he worked with doctors who used local food to successfully treat patients, after which he felt compelled to practice a nutrition-oriented system of medicine. Today, he blends an evidence-based functional approach to care with his experience as an organic farmer and a passion for anthropology to serve as an expert in traditional and integrative medicine. 

About Fullscript

Fullscript supports practitioners focusing on prevention and the connected, underlying causes of a patient’s symptoms. Thousands of integrative and functional health professionals are pushing for a shift to a more proactive perspective on lifestyle, patient care, and all of medicine.

These practitioners are on a mission to provide lifelong care that helps people discover and rediscover wellness for the rest of their lives. It’s Fullscript’s mission to support them — to help people get better. From practitioners to patients, partners, and colleagues, we build frictionless technology and personalized experiences to support those on their wellness journeys, whatever that means to them.

 

In this episode:

(1:50) A discussion around how medical professionals can design a functional health protocol for each patient and how you can track that functional health protocol through remote patient monitoring.

(6:33) Dave talks about taking the funnel concept of running a company and applying that to a medical protocol. Are patients opening the products? Are they even buying them.

(8:59) Providing patients with objective data will help them stick to the recommended treatment plan. 

(11:16) How patients who have not fulfilled the treatment plan got tripped up on simple tasks like opening the plan within the email.

(12:51) Dr. Alex Keller’s team has a human care team to help clients with following the treatment plan. This team helps patients interpret the plan and ensure that patients stick to the functional health protocol.

(14:59) Platforms like Heads Up Health that track biofeedback measures like heart rate variability (HRV) help to motivate patients. Patients can become discouraged if they don’t notice symptoms improving short-term, but seeing the data of the changes happening within the body assists in making the patient maintain compliance.

(16:44) Gamifying the healthcare experience can help facilitate behavioral change. 

(18:27) Blood glucose and HRV are great biofeedback markers to look for in patients within the first week of treatment.

(21:03) Dave gives a step-by-step analysis of how patients can understand their metabolic markers.

Step 1: Give patients an actionable target.

Step 2: Design a functional health protocol and set the second stage of the funnel.

Step 3: Confirm the person actually opens the email.

(22:30) Dr. Alex Keller does not see many integrative practices including a device that can do biofeedback collection (like a continuous glucose monitor). He gives diet, lifestyle, and supplement protocols. He also can tell patients to track blood values, biofeedback, and/or other markers.

(24:19) Dave talks about how patients develop awareness by using CGMs and platforms like Heads Up.

(28:26) Dr. Alex Keller discusses how the challenge in his field is what kind of standardization there will be. There are so many products that it can be overwhelming for somebody looking to track their biomarkers. Tracking the data with platforms like Heads Up can be used for large data-driven studies. Use Fullscript to initiate that process.

(32:49) Developing large data studies can help set treatment plans by aggregating data. The basic standard has been blood tests for the last decade. The next step forward could be much more in-depth.

(37:00) Keeping patients engaged in tracking will help them stay on their functional health protocol. It encourages the patient to maintain behavioral change and the practitioner can call the patient if they start to fall off the path.

(42:25) Dave discusses how using technology and AI could help scale the remote patient monitoring functional health protocol. AI can also be used to flag patients to their practitioners or lifestyle coaches.

(46:23) Dr. Alex Keller believes that AI will never replace humanity, but it can be used to help inform decisions. By including automated reminders in Fullscript, it helps keep patients on their treatment plans. His focus is to arm practitioners with tools to provide better user experiences for patients.

(49:21) Dave agrees that you need to combine AI and the human element. He sees positive change is happening with the new CPT codes and the payer system.

References

Fullscript

Dr. Alex Keller: LinkedIn | Instagram | Personal Website | Fullscript Website

Ep. 57 – Simplify Functional Lab Testing with Rupa Health

Ep. 57 – Simplify Functional Lab Testing with Rupa Health

Are you a practitioner looking for an easier way to conduct functional medicine lab testing? 

Tara Viswanathan, Co-Founder and CEO of Rupa Health, discusses with Heads Up’s Dave Korsunsky how her company simplifies this process for medical professionals.

Dave and Tara also talk about why they believe root cause medicine will eventually become the standard of care, how Rupa Health and Heads Up are educating practitioners, and the origins of Rupa Health.

Rupa Health is a company that focuses on making the lab testing process easier for practitioners, so they have more time to focus on patient care.

Tara Viswanathan graduated with a Master’s Degree in Management Science and Engineering. She achieved her Bachelor’s Degree in Finance and Operations Management at Pennsylvania University. Tara previously did product consulting for consumer health startups.

Functional Medicine

Functional medicine focuses on the biological systems in the body. A single diagnosis can have multiple causes. Ultimately, the purpose of functional medicine is to identify and treat the root cause of the disease. 

Heads Up

This podcast is brought to you by Heads Up, a web app designed to help both individuals and health practitioners centrally track the vital health data that matters. Instantly synchronize your (or your clients’) medical records, connect favorite health devices and apps, and use the data to optimize your health (and that of your clients).

Click on the button below to start your free 30-day trial. Or, read on for more information about our latest podcast episode!

START TRACKING!

“I’ve had complete conviction in the fact that root cause medicine is going to become the standard of care.”

– Tara Viswanathan

Follow Tara:

Twitter @TaraViswanathan

LinkedIn Tara Viswanathan

 

In this podcast you’ll learn:

(2:25) How Dave and Tara became interested in health through their careers in technology. 

(3:57) How Rupa Health makes functional lab testing easier. The company has over 2,000 different tests that healthcare practitioners can order within minutes. Rupa Health manages the entire patient experience including support with phlebotomy, specialized instructions, and 24-hour customer support.

(5:40) Rupa Health supports everybody from solo, independent acupuncturists to small private practices to large hospital systems. Tara breaks down how a practitioner can enroll and ease the burden of ordering patient tests.

(7:33) Patients have access to 3-month payment plans through Rupa.

(9:13) The benefits of stool testing. Dave jokes about his experience presenting the Bristol Stool Chart at a conference.

(10:12) The information you can learn from checking your urine and stool.

(11:04) Rupa Health began in January 2020. Within months the company spread to clinics in 47 states. The company is continuously releasing new features.

(12:34) Tara believes root cause medicine is going to become the standard of care. Tara wants to enable all practitioners to be able to pursue root cause medicine. Rupa first built a matching service to help pair patients with practitioners. The company then built a clinic, discovered the issues with lab testing, and decided to shut down the clinic and focus solely on lab testing.

(14:50) One of the main issues with functional labs is that many of them do not have any web-based APIs (Application Programming Interface) to pull from. These labs and patients are stuck with a bunch of PDF files. Rupa Health has helped to build services around these facilities’ current systems.

(19:00) Rupa can help doctors process all of their lab tests without having to learn everything step-by-step.

(20:10) Root cause medicine can be the future of medicine. Root causes can be microbiome environment, heavy metal toxin exposure, and more.

(22:23) Remote patient monitoring is becoming widely accepted and there are now reimbursements from the payer system. Commercial insurance covers most microbiome testing.

(24:14) Rupa Health is working on helping educate practitioners through Rupa University. These courses teach practitioners how to understand and interpret lab testing. Heads Up Health has also launched Heads Up University, which aims to serve a similar purpose.

(25:49) Dave and Tara are super involved as patients when interacting with their doctors.

(26:43) Tara’s advice to practitioners is, “It’s not easy, but it’s worth it.” You can reach out to Tara at tarav@rupahealth.com where she can explain Rupa Health to you in more detail.

 

References

Rupa Health

Bristol Stool Chart

Rupa University

Electronic Medical Records (EMRs) for Functional Medical Practices