Bio-HACK-ing Chronicles Ep.2: Maybe Jimmy Moore Has Hepatic Encephelopathy

No ... this blog will not become all Jimmy Moore, all the time.  I do have some posts in the works that just need some polish ... including one on the study Ted Naiman bases his 3:1 ratios of grams protein to fat that Jimmy was following.  That said, I can't help but put together a few comments on the Drama Llama supreme's latest n=1.

This Episode's n=1 bioHACK:   

• 7 days of "Carnivore" , High Protein (mostly meat)
• 3:1 grams protein:grams fat.   
• 1.5 grams of protein per pound of lean body mass equaled 270 g protein:90 g fat.   (if you use 40% body fat, that puts his current weight at 300 ... )

RESULT:  Fail. 

If you listen at the 43 minute mark of this episode of The Keto Savage podcast, you'll see that it was Jimmy's every intention for this TO fail.

The purpose of biohacking is SUPPOSED to be about seeking out ways to improve one's overall health ... to achieve meaningful goals.  This nonsense of seeing what happens to his glucose and ketone readings here and there, ignore body weight entirely, get two insulin readings, estimate portions, etc. is all just nonsense.   He's not healing anything.  He's playing around with whatever healthy function he has left for social media likes and podcast downloads so he can sell keto stuff to earn affiliate dollars.  Sad really.

The Stunt of All Stunts!!

NOTE:  I am jumping to the punchline, and then will go fill in some of the process to save for posterity.

MAH FAT DEFICIENCY!!!!!!!!!!

Please take in all the parts of this image (it's animated but no video despite the arrow). After ONE week of 90 g fat/day (more than the average American ate back in 1970), Jimmy never misses an opportunity to sell product!

The 7-day #highprotein experiment is (mercifully!) over and it’s time to to replenish my body with healthy fat. Of course I started with everyone’s favorite #lowcarb #highfat #ketogenic F-Bomb macadamia nut butter products. Each serving contains 22g fat and only 2g protein. I had four of them (88g fat—more than I’ve had in a full day in the past week) in five minutes to start the recovery from this significant fat deficiency.

Remember that the man ate ZERO fat for two 7 day stints in the past month.  If anything was going to put him in fat deficiency it would be eating no fat.  But there's no fat deficiency.  There's no such thing as a fat deficiency.  Eating 90g per day is no where near deficiency, it's EXCESS for many.  Jimmy's body has PLENTY of fatty acids.   (I'm comforted to see that in arenas where he can't delete, delete, delete, Jimmy is getting lambasted for this nonsense from LCHFers.)

Snarfing 88g of basically pure fat in 5 minutes is eating disordered.  Plain and simple.  I wish for his sake Jimmy would see this and seek the professional help he needs in this regard.

OHHHHH the Hypoglycemia!!!

Here's a composite of a few complaints Jimmy had from his high protein "low fat" diet.  

When he had blood drawn for an insulin test (before and after consuming some 125g protein) he reported: 

One of the other patients waiting in the lobby area at LabCorp to get blood drawn for her own test asked if I was okay because she could tell I was dizzy, disoriented, and disturbed. 

So the well documented "chocolate cake effect"^* never happened.

*Protein equals chocolate cake, and causes a similar glucose spike due to gluconeogenesis when you eat too much.

Was Jimmy experiencing hypoglycemia?  Anyone else, I might not even question it.  But this is a man who set out to prove a point, with preconceived notions as to what would happen.  He didn't experience ANY effects of hypoglycemia with the exact same blood sugars -- claims to have felt fantastic -- because his ketones were higher (but nowhere near the level at which they would make meaningful differences for providing energy to replace glucose!).  Claimed the same glucose level (didn't report ketones) a few days earlier was evidence of healing from his insulin resistance.   Jimmy's hypoglycemia could be nothing more than a combo of self-fulfilling prophecy / placebo effect / confirmation bias.  Whatever.

Then in a conversation on Facebook, someone mentioned that this could be more than hystrionics ... and ... well ... what if he's not used to eating a lot of protein and so his body has a problem processing that much.   My mind naturally went to Jimmy's overtaxed liver and compromised kidneys ...  Turns out, it's a thing! (Not saying it is what's going on, but the symptoms and causes line up!)

Hepatic Encephalopathy 

The text of the pertinent parts:

Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). ... People with severe liver damage often suffer from HE. ... Common causes of chronic liver disease are:

• Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). 

Once you have liver damage, episodes of worsening brain function may be triggered by: 

• Less body fluids (dehydration)

• Eating too much protein 

• Low potassium or sodium levels ...

• Kidney problems ...

Disorders that can appear similar to HE may include:

• Alcohol intoxication ...

I include this last one because this is how Jimmy describes himself!  

It's quite possible that his symptoms were simply from hypoglycemia, and it's possible that this could be due to an overtaxed liver alone.  With all the fasting and chronic carb deprivation, his liver has been working overtime making ketones and glucose.  Now with it having to detoxify all the ammonia generated when metabolizing all the extra protein, it could be as simple as his liver not having the capacity to make enough glucose.

However if his liver is compromised (e.g. he has NAFLD) then it may also be having a hard time just keeping up with normal multi-tasking.  Even a normal liver may need an adjustment period to handle 270g of protein.   Given what we see in rodents on a chronic high fat/low protein diet, and Jimmy's degree of abdominal obesity, it's not a far-fetched idea were Jimmy to have NAFLD.  

It's also a good bet that were he to see an actual doctor about his issues, Jimmy would be diagnosed with chronic kidney disease.  

I think Hepatic Encephalopathy makes for a plausible explanation for Jimmy's symptoms.  His liver needed to pump out ketones, glucose and detoxify a ton of ammonia from excessive protein consumption.  A sluggish liver may be having a hard time meeting glucose demands while converting ammonia to urea fast enough, and the kidneys are having to clear more than usual urea and maintain blood pH in the face of elevated ammonia.  And his poor brain ...

If I were him, rather than engaging in more inane experiments just to test the limits of his poor organs, I'd take note of my body's less than optimal response to this latest one and get my kidneys sorted out.  His diet was extreme, but it was ONLY for one week, it wasn't anything approximating low fat, and he's so far from any starvation/fat deficiency let's not even laugh at that one.

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NOTE:  The rest of this is a hodge podge (some repeats) of this experiment.  Maybe someone searches and lands here and is forewarned off following Jimmy's antics.

Preserving Some of the Saga for Posterity:

Jimmy Moore first tried to make this latest installment as taking on the burgeoning tribe of "carnivore" zero-carbers in the #LCHF/keto community.  

I’m about to embark on another ambitious yet uncertain 7-day experiment to see what happens to me when I consume an all meat-based, higher protein diet. There’s a whole lot of bro science out there from so-called “keto” groups that just tell you to load up on meat and all your health will be solid, but I wanted my testing of this concept to be more scientifically conducted with medical doctors who are actually doing this and using it with their patients.

After this he mentions Dr. Shawn Baker (who revealed less than stellar health markers on a recent Wobb Rolf podcast)  and Dr. Ted Naiman (who is big on the protein, but I see lots of veggies in his various memes and social media). 

To get people to listen to yet another stupid podcast, Dr. John Limansky -- the Keto Hacking MD (lame) -- joined him on this.  Can you just not even wait for what hacking hijinx this dynamic duo will try next?  LOL.  

So off to Costco Jimmy went to hunt his disgusting lean meat as the focus of the experiment shifted to all the bad things all of that protein would bring to his keto nirvana of healthfulness. 

My first question on this HACK is what happened between March 27 and four days later -- March 31st BEFORE any change in diet?  

 

and now that NIGHT

People were questioning why I would put myself through two 7-day periods of #fasting over a span of three weeks and I responded that I’m aiming to heal my #insulinresistance. On the eve of beginning a 7-day #highprotein experiment, my blood glucose is showing incredible signs of robust healing and improved insulin sensitivity from the cell regeneration that the #fast experiments brought on. The Freestyle Libre popped a 57 #bloodglucose level—WITHOUT FASTING! This gives me hope that I’m moving in a positive direction with my #health goals. #progress #healthy.

In case you missed it, Jimmy Moore is lauding how his FBG is 57.  Also, you can see from his CGM data there that his BG was up in the 70s earlier in the day.  And yet, no nonsense about hypoglycemia (and no ketone reading). 

These are NOT usual BG readings for Mr. Moore unless he's extended fasting.  They aren't glucose readings one should be boasting over as evidence of good health either.  This idea that lower is ALWAYS better is ill-conceived at best.   Yet all was well the next morning (April Fools?)

Here we go! It’s the start of my 7-day #lowcarb #highprotein experiment with Dr. @JohnLimanskyMD testing the 3:1 protein to fat ratio promoted by Dr. @TedNaiman to show the leverage of using #protein in your health and fat loss goals. Using his formula, I need 270g protein and only 90g fat daily with minimal carbohydrate intake to test this theory. I’ll be tracking and reporting everything that happens. I started off with strong #bloodsugar and blood #ketone levels of 71 mg/dL and 1.4 mmol/L respectively.

My first plate of food (see photo) contained 118g protein and 65g fat which means I gotta eat a LOT more lean meats later today to reach my quota. Hoo boy!!! This is gonna be a challenge. Wish me luck. This might suck a little. #biohacking #n1 #ialreadymissmyfat

Let's get a couple of things out there before we continue on here!

• Jimmy's 90 grams of fat and 270 grams of protein works out to  ~1900 calories at 43% fat and 57% protein.  
• IN NO WORLD IS 90 GRAMS OF FAT AT 43% OF ENERGY INTAKE "LOW"
• 90 grams of fat is more than NHANES averages back to the first survey in the early 1970s.
• 65 grams of fat in a meal is more than that in a Big Mac and large fries meal with room for an extra tablespoon of butter.

The next day the OH NOES HYPOGLYCEMIA nonsense began!  After stuffing himself with a half pound of 90/10 beef and a pound of shrimp, Jimmy reports

It took me a long time to finish that meal and I started feeling spacey, slightly dizzy, and even hungry(!) within an hour after eating. By two hours postprandial (after eating), my #bloodglucose level dropped 18 points from baseline. Several people said, “isn’t that good?” No, it’s not. It’s a very clear insulin surge dropping the #bloodsugar that much that fast.

His BG dropped from 76 to 58 (not saying that's good, but ...) while his ketones were 0.8 and he claims the above symptoms and flushing.  Even goes on to say how this is different than the same BG with only double the ketones.  Sorry, that's not how this works Jimmy. 

And OHHHHH the hypoglycemia!!!

One of the other patients waiting in the lobby area at LabCorp to get blood drawn for her own test asked if I was okay because she could tell I was dizzy, disoriented, and disturbed. She asked the phlebotomist to please get me first. That was very kind of her because I didn’t feel well at all. ... Then I had to drive home to record the beginning of tomorrow’s KetoHacking MD Podcast

Well at least we know he puts the safety of those on the roads of Spartanburg above his needs.  Oh wait ...   The above quote refers to Jimmy getting an insulin test before and after consuming 125g protein.  Oh the horrors, his fasting insulin was 14.2 and it "surged" to 20.6 after the protein meal.  The musings of #LCHF-raudsters aside, this is all perfectly normal.  Yes the fasting level is a bit high, but considering he's around 350 lbs (it's anyone's guess at this point, easily still over 300 even after two weeks of fasting) that's not bad.  The "surge" of insulin is still within normal lab ranges for basal insulin levels. 

So what to make of Jimmy's glucose levels?  For starters, let me state that I don't put much credence into anything Jimmy reports or any of his experiments.   For months into his 2012 keto n=1, Jimmy was taking berberine in order to get his fasting glucose levels down.  He has shared (without comment) an HbA1c as high as 6 (carb binge?)   You just don't know.  What I do wonder is what he did between March 27 (FBG 106) and March 31 (FBG 63).  Such wild changes in FBG are not normal.  If they are due to all the fasting and such, then this is an indication that he should NOT be fasting as this is stressing his body.  That glucose level of 57 he prized as evidence of "healing"????? ABSURD.  

And so we have the possibility of hepatic encephalopathy!  

One more time for good measure, 

MAH FAT DEFICIENCY!!!!!!!!!!

Please take in all the parts of this image (it's animated but no video despite the arrow). After ONE week of 90 g fat/day (more than the average American ate back in 1970), Jimmy never misses an opportunity to sell product!

The 7-day #highprotein experiment is (mercifully!) over and it’s time to to replenish my body with healthy fat. Of course I started with everyone’s favorite #lowcarb #highfat #ketogenic F-Bomb macadamia nut butter products. Each serving contains 22g fat and only 2g protein. I had four of them (88g fat—more than I’ve had in a full day in the past week) in five minutes to start the recovery from this significant fat deficiency.

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Pre-publish development:  There's a podcast and going to be another one discussing the results for Jimmy and Dr. Limansky.  If I get to have a listen, I'll either update this post or add another episode to this series.