Theory: Metabolic therapy is an important part of overall cancer therapy but not a cure for all cancer. Let me explain. Metabolic therapy for cancer has been championed by Professor Thomas Seyfried from Boston College in his book, Cancer as a Metabolic Disease in 2012. He validates Dr. Warburg’s theory for the origin of cancer with its monumental finding: most cancer is a singular disease of mitochondrial respiratory abnormality coupled with compensatory fermentation. The Warburg effect involves the continued fermentation of glucose in the presence of oxygen.
There has been momentum in the integrative medical community to promote this concept of metabolic therapy as a viable, safer cancer therapy with a strict ketogenic diet and “press and pulse” concept using supplements and medications to attack vulnerable, abnormal cancer cells’ mitochondrial function. I have known Dr. Seyfried for many years; we both gave talks on several occasions at medical conferences. He spoke about “Cancer is a Metabolic Disease” on cancer cell biology and ketogenic diet, and my lectures addressed dental, parasites and fungal infections connected with most chronic diseases and cancers.
Chronic inflammation has been linked to carcinogenesis by a cascade of cellular signals of cytokines, nitric oxide, transforming growth factor (TGF-beta), etc. This leads to eventual injury to mitochondrial function and mitochondrial respiratory abnormality, responsible for the development of cancer. Many underlying factors are driving inflammation; see the figure below for stresses on metabolic function of mitochondria. A calorie-restricted ketogenic diet will put more stress on cancer mitochondria and slow the progression of cancer cells’ development and metastasis. Dr. Seyfried’s book covers this in detail.
Below is a diagram adapted from Dr. Young Hee Ko, PhD of Johns Hopkins, who developed 3-Bromopyruvate (3-BP) from her lecture on multiple sources of stressors to mitochondrial abnormality and metabolic dysfunction. Eventually, cancer cells are metabolically challenged, gasping for glucose and glutamine for energy and cannot effectively use ketones for energy in the early stage of cancer.
Practice: Previously, I covered Seyfried/Warburg’s work on cancer from the point of view of the human body as a matrix of meridians; we can measure the immeasurable and invisible acupuncture meridians as described in several of my articles. These include: “Cancer is an infectious disease as if cancer is metabolic parasites” and, “Cancer is a metabolic disease as if cancer is metabolic parasites,” describing a calorie-restricted Ketogenic Diet (KD) for cancer therapy. Here are a few important tips:
A) There is no one simple cause and solution to cancer or chronic illness. A combination of factors is in play; each must be addressed in sequence. I use acupuncture meridian assessment (AMA) to help determine the underlying causes in each patient and how to address them. Today’s medicine overlooks the role of several vital factors in chronic disease and cancer: parasite infections, fungal infections, dental problems, chemical exposures, and heavy metals. The greatest resistance among patients is reluctance to follow my dental recommendations, for a combination of cost and psychological factors. In addition, dental, parasite and fungal infections impact the gut and microbiome, and can complicate diet and nutrition strategies.
B) You will not get well using one therapy alone, whether it is standard of care surgery, chemo and radiation, diet, dental procedures, detoxification, prescription drugs, supplements, homeopathy, mind-body, or electrical devices. In some cases, the standard of care can be curative or needed as a last resort. Diet and nutrition alone will not succeed in cancer and chronic illness; they must be addressed in combination with other key factors to restore a healthy biological terrain and immune system.
I have been getting a steady request for consultations from Dr. Seyfried’s online referrals and I simply cannot handle email requests for guidance and consultations without seeing patients. My evaluation consists of a hands-on evaluation including acupuncture meridian assessment (AMA) to map out disturbances in the energy flow through the meridians. My focus has been detecting two main factors that conventional academic medicine has overlooked for many years: parasite-fungal infections and dental problems driving hidden chronic inflammation. Parasites can sabotage metabolic therapy and a ketogenic diet becomes less effective. Let me explain.
This is my quick overview of a metabolic therapy diet based on Dr. Seyfried’s work and my interpretation of his recommendations. I want to thank Dr. Seyfried for reviewing this article; for more information see his blog at www.tomseyfried.com, and faculty profile at Boston College. There are also helpful materials on the website of Alicia Halakas, PA, who collaborates with Dr. Seyfried. The following recommendations are part of my Internal Medicine/Integrative Medicine practice:
- Seyfried does not claim a ketogenic diet will cure cancer, but it is important to understand that cancer cell biology and cancer cells depend largely on glucose and glutamine metabolism for survival, growth, and proliferation. Exploiting the weakness of cancer cell mitochondria by restricting caloric intake with a ketogenic diet, lowering blood glucose, and raising ketones, gives brain cancer patients with glioblastoma multiforme better survival outcomes and extends survival rates, not necessarily a cure. Most patients have significant asymptomatic dental infections and parasite infections in my clinical observation that must be addressed ASAP.
- To start a calorie-restricted ketogenic diet, you need to buy glucometer and ketone meter and start measuring glucose and ketone. Measure your blood sugar and ketone levels in the morning, before and after meals. After a while, you will get the feeling of interconnection between what you eat and your blood glucose and ketone levels. Ketone strips are rather expensive, and these can easily add up in cost.
- Start your diet slowly. You can eat two meals per day and eventually one meal per day plus small keto snacks. You may consult a dietician/nutritionist who can guide you individually. My clinic does not have an in-house dietitian and my staff are not trained to give recommendations. I have written several articles on nutritional therapy for cancer and general dietary guidelines; see for example, “Diet, nutrition, weight loss and longevity.” If you want to jumpstart a keto diet, start with a water fast for 5 days. Sugar accelerates cancer growth! It is not easy to do a 5-day fast if you are not used to fasting. I tried it, so I know!
- Start your intake of fat to 50%, protein 30% and carbohydrates 20%. Then, start adjustment of fat and carbohydrates first, then protein. You can adjust and increase consumption of fat up to 70%, lower protein to 20% and carbohydrate to 10% based on your blood glucose and ketone levels. Unless you are highly motivated, you need a dietician or nutritionist to help you with calorie counting. The goal is to starve glucose-glutamine dependent cancer cells, and support the whole body on a calorie-restricted keto diet.
- Hair tissue mineral analysis is highly recommended in my practice. Hair tissue mineral composition and the ratios of macro-minerals (calcium, magnesium, sodium and potassium) provide a measure of your unique metabolic state for the last several months. Metabolic typing as a fast oxidizer or slow oxidizer predicts what kind of diet you need, can indicate mineral deficiencies, possible heavy metal exposures, etc. Most cancer patients have significant heavy metal toxicity and need a DMPS/EDTA chelating agent to provoke and unmask hidden heavy metal exposure, which is much more sensitive than hair tissue mineral analysis.
- Food allergy testing (IgG delayed response) is also highly recommended. You will be surprised: you might be allergic to mushrooms, asparagus or broccoli. The most common allergens are wheat, corn, soy, peanuts and dairy. You may not realize it and try to eat more when you are not feeling well, and then feel worse, and you cannot guess because it is a delayed IgG response.
- Know your glucose/ketone ratio if you are serious about metabolic diet therapy. Try to bring your sugar level below 80-90 and continue to lower the level to 60-70 and raise the blood ketone level to 3 or higher. (You need to convert blood sugar level to mmol/liter: mg/dL = 18 x mmol/L). For example: blood sugar of 100mg/dL divided by 18 will give you 5.55 mmol/L. If your ketone level is at 3, your glucose/ketone index is 5.55 divided by 3 = 1.83. The goal is to bring the glucose/ketone index below 2.0 and ideally 1.0, if possible, especially for brain tumors like glioblastoma. You may add commercial ketone supplements to achieve a better ratio. This is not easy to follow without any dietician or nutritional assistance. Different types of cancer require an individualized, modified ketogenic diet.
- Don’t be too hard on yourself if you cannot bring your blood sugar level below 80 or ketone level above 3. Intermittent fasting is another option. You still have a chance to recover from cancer by addressing other factors. Many of my patients will not commit, give up, or lose too much weight. Some are too focused on the ketogenic diet and denial on dental problems, parasite infections, and environmental toxins. Ketogenic metabolic therapy has become well-known to the public, often with unrealistic expectations. The impact of parasite infections and dental problems with cancer is relatively unknown to the public and academic medicine.
- Medications that can potentially target aerobic glycolysis include 2-deoxyglucose (2-DG), 3-bromopyruvate (3-BP), dichloroacetate and resveratrol. The “press and pulse” concept is seeking to lower glucose levels with a calorie-restricted keto diet followed by a glucose-like compound or glutamine-like compound. I have problems getting these and they are not part of my regimen. Glutamine pathway inhibition recommended by Dr. Seyfried using the glutamine analog drug, 6-diazo-5-oxo-L-norleucine (DON) is only available to researchers. I tried but cannot obtain it. The side effects can be serious; it is not recommended for general practitioners.
- You may use more natural glutamine inhibitors containing Ursolic Acid, Caffeic Acid, Hesperidin and EGCG marketed in Europe; google search for natural glutamine inhibitors. Ursolic Acid is found in Rosmarinus, Caffeic Acid is found in Propolis, Hesperidin is found in Bitter Orange and EGCG is found in Green Tea. The Keto Diet reduces tumor cell proliferation, glycolysis, inflammation, and angiogenesis in tumor cells and their microenvironment. Other potential medications targeting cancer cells include metformin and antibiotics such as doxycycline and azithromycin; antiparasitic meds e.g., ivermectin, albendazole, mebendazole, praziquantel, niclosamide; and antifungal meds, e.g. itraconazole and fluconazole.
Think Differently. All chronic diseases, cancer and neurological diseases may benefit from a modified ketogenic diet. Inflammation will improve, weight loss is expected, resulting in better management of diabetic patients and obese patients. It is not easy to follow a strict diet for prolonged periods, but it will be a good start to stabilize your metabolic state and support mitochondrial function. Don’t ignore a food allergy rotation diet and hair tissue mineral analysis for metabolic typing and vitamin and mineral replacements. To have a successful ketogenic diet, you need family support and commitment to change. I send you my encouragement to stay on course: don’t be discouraged and find a good dietician/nutritionist to guide you.
Is there a skeptics’ view of metabolic therapy for cancer? Most oncologists do not embrace it for various reasons and will discourage you from trying. Dr. Peter Pedersen of Johns Hopkins, another giant in the field of tumor mitochondria and the bioenergetics of cancer, points out that Warburg never stated that a generalized structural defect in electron transport was responsible for the origin of cancer, but rather “insufficient abnormal respiration” was responsible. But, how? The subtle differences may have profound implications for the management of cancer patients in the future. Stay tuned for more scientific debates.
My quick summary on Metabolic Therapy for Cancer is, Eat Less and You May Live Longer. Glucose and ketone level monitoring is recommended. Keep glucose levels below 80 and ketone levels above 3 to 4, and glucose/ketone ratio 2.0 or below, if possible, especially for brain tumor patients. Parasites trigger inflammation and may control your mind. They can make you crave sweets and sabotage metabolic therapy for cancer. You may want to start with parasite-fungal meds first and then you may have an easier time lowering your glucose level. In closing, if you are interested in my approach, review my website, make an appointment and see me in person. It is essential to my clinical evaluation and recommendations. I do not do teleconferences or telemedicine and cannot respond to individual emails or general questions.