Episode 160: Franziska Spritzler ON Understanding Insulin Resistance & Keto Diet's Role in Diabetes Management
Jan 16, 2024Season 1Episode 160
Lorenz Manaig
In this episode, I welcome Franziska Spritzler, a renowned dietitian who specializes in ketogenic diets and low-carb diets.
She speaks about her experiences as a dietitian, how she transitioned from being a court reporter, the benefits of a ketogenic diet and the markers to watch out for to detect early signs of insulin resistance. She passionately talks about her mission to transform health and focus on conditions like diabetes, PCOS, mental health, and aging well through controlling carbohydrate intake. Apart from this, she shares a success story of a client whose life was significantly transformed with ketogenic diet.
00:00 Introduction and Guest Presentation
00:39 Beginning of the Interview with Francisca Spritzler
02:20 Francisca's Journey from Reporter to Dietitian
03:44 Francisca's Personal Experience with Low Carb Diet
05:18 Francisca's Transition to Private Practice
06:12 Early Days of Low Carb and Keto Diet
09:14 Communicating the Complexity of Low Carb and Keto
12:01 Defining the Difference Between Keto and Low Carb
16:01 Scenarios Where Keto or Low Carb Might Be More Suitable
18:42 Why Low Carb or Keto is Ideal for Managing Diabetes
20:23 Understanding Insulin Resistance and Its Impact
21:14 Identifying Early Signs of Insulin Resistance
21:31 Importance of Fasting Insulin Levels
25:17 Understanding Blood Work Changes in a Low Carb Lifestyle
27:30 Empowering Yourself with Knowledge
28:30 Adjusting Medication for Diabetes in a Low Carb Lifestyle
Save yourself that trip to the market — Instacart delivers groceries in as fast as 1 hour! They connect you with Personal Shoppers in your area to shop and deliver groceries from your favorite stores.
In this episode, I welcome Franziska Spritzler, a renowned dietitian who specializes in ketogenic diets and low-carb diets.
She speaks about her experiences as a dietitian, how she transitioned from being a court reporter, the benefits of a ketogenic diet and the markers to watch out for to detect early signs of insulin resistance. She passionately talks about her mission to transform health and focus on conditions like diabetes, PCOS, mental health, and aging well through controlling carbohydrate intake. Apart from this, she shares a success story of a client whose life was significantly transformed with ketogenic diet.
00:00 Introduction and Guest Presentation
00:39 Beginning of the Interview with Francisca Spritzler
02:20 Francisca's Journey from Reporter to Dietitian
03:44 Francisca's Personal Experience with Low Carb Diet
05:18 Francisca's Transition to Private Practice
06:12 Early Days of Low Carb and Keto Diet
09:14 Communicating the Complexity of Low Carb and Keto
12:01 Defining the Difference Between Keto and Low Carb
16:01 Scenarios Where Keto or Low Carb Might Be More Suitable
18:42 Why Low Carb or Keto is Ideal for Managing Diabetes
20:23 Understanding Insulin Resistance and Its Impact
21:14 Identifying Early Signs of Insulin Resistance
21:31 Importance of Fasting Insulin Levels
25:17 Understanding Blood Work Changes in a Low Carb Lifestyle
27:30 Empowering Yourself with Knowledge
28:30 Adjusting Medication for Diabetes in a Low Carb Lifestyle
Save yourself that trip to the market — Instacart delivers groceries in as fast as 1 hour! They connect you with Personal Shoppers in your area to shop and deliver groceries from your favorite stores.
Hey guys, welcome to the Keith on St. Coffee podcast. It is your host Kito coach Lawrence, and we got another awesome interview for you today. And this is with Francisca sprinkler. In this episode, we discussed her experiences as a dietician, the benefits of a ketogenic diet and the markers to watch out for, to detect early signs of insulin resistance. She is also so passionate about her mission and that is to help transform her client's health and focus on conditions like diabetes, DCOS, mental health, and aging. Well through a low carb approach. Without further ado guys, here is my interview with defense. Discuss for Itzler enjoy.
Lorenz:
We have an amazing guest, Franziska Spritzler, a distinguished registered dietitian specializing in ketogenic. and low carb diet. She is a sought after speaker, author, and a leading voice in empowering individuals with her expertise on a mission to transform health as she focuses on conditions like diabetes, PCOS, mental health, and aging well through the powerful tool of Carbohydrate restrictions. She provides support for people in controlling their blood sugar, uh, for overall health and vitality. As an author, her book was featured in the Winter 2013 edition of the American Diabetes Association's Diabetes Spectrum Journal. I'm so honored and excited. Francisca Spritzler, welcome to the show.
Franziska:
Thank you very much, Lawrence. I'm so happy to be here.
Lorenz:
I'm so happy to have you on today. You know, I love your story and your, you know, passion for helping. Uh, people, you know, through sharing your stories and sharing your expertise in the subject. You know, diabetes is one of the most misunderstood phenomena, even though, uh, medicine, right, has evolved through the years and was able to manage the symptoms of, you know, what diabetes is, you know, discovery of drugs, insulin, and what have you, and, but they still fail to control the rising number of people. People who get diagnosed with diabetes. So we are treating it, but we are not doing anything to prevent it. Right. So that is why I love your practice. You know, education is the most important aspect of prevention and amazing work. I really love your work. And, but. We, before we get to that, those topics, I want to get to, you know, your story. I'm really intrigued by your journey. I take it you were once, you know, a reporter becoming a registered dietitian. Can you share with us how the transition happened? What sparked that interest and what led you down this path of exploring that connection between lifestyle and health?
Franziska:
Sure. Well, before I became a dietitian, I was a court reporter for many years. I became a dietitian and in school I learned, you know, conventional therapy for diabetes and obesity, which is, you know, eat less, move more, don't eat too much fat. Don't eat the egg yolks, just eat the egg whites, you know, very kind of low fat centric, uh, advice. And I thought this was a healthy way to eat. I was eating this way, thought I was doing okay. I definitely noticed that I was getting hungry in between meals, but I thought that was normal. Thought it was normal to snack every few hours. You know, this is what all my dietician friends did, and everyone that I worked with. But as a dietician, I worked at a large veterans, uh, medical center, teaching diabetes classes and doing one on one diabetes education as well. And I would teach people what I'd learned in school and what I was doing. I said, you can control your diabetes by eating this way. I really thought you could. And I thought that that was the best you could do was to pair that with ever increasing amounts of medication, still keeping your blood sugar under control. But in. Early 2011, uh, I got results from life insurance labs that I had done showing that my A1c was 5. 6%. Now that's still within the normal range, but it's just 1. 1 below the prediabetes. range of 5. 7 to 6. 4 and I thought that's very odd. Why is it so high when my fasting blood glucose is like around 80 or 80 between 80 and 85 which is normal. But that really meant to me if my fasting blood sugar is so low, that must mean that my blood sugar is going up a lot after meals to get an A1C like that. So I started testing my blood glucose, you know, and I began eating a very healthy diet, very balanced meals. Blood sugar was doubling after eating a meal, and it's really should not go up more than about, uh, you know, 30 milligrams per deciliter. And mine was going up, you know, more than twice as much as that. So I started experimenting with cutting back on carbs a little bit to see what would happen. And my blood sugar was better. I started doing research online and realized that the people who had the best control who had diabetes and pre diabetes were following somewhere between a very low carb to a moderately low carb diet. So I thought, wait a minute, maybe we're doing this wrong here at my diabetes clinic and other diabetes clinics around the country. So, uh, Yeah, eventually I got to eating a very low carb diet, ketogenic levels, you know, about 30 grams or less of net carbs per day. But I wasn't able to practice this at the clinic. Nobody else wanted to do this at the diet at the VA. So, I decided to go out on my own, start my own. clinic. Low carb dietitian is the name of my company and provide diabetes education and educational people who just want to improve their overall metabolic health. The other thing I noticed besides my blood sugars coming back into great control and getting an A one C of around five or less was that I wasn't hungry in between meals anymore. I could go a long time without eating and it felt great. And I loved my diet, loved eating. Regular eggs again and whole fat foods rather than the low fat foods. I've been eating for so long I felt great and I knew I could help other people by doing this. So that's you know within about six months after I and from the beginning of 2011 to Mid 2011 I made that transition and then a year and a half later. I left the VA to start my own practice
Lorenz:
Mm. You know, this was back in 2011, 2012, correct? And this makes you are the one of the first people that people see. Right. When they were look at this time, we were looking for low carb diets. You as an early adopter of the KetoJank approach, could you, you know, take us back? What, what was that like those days? What was, you know, you had your training and everything, right? But how did you find information about low carb at that point?
Franziska:
Well, I was very lucky in that the low carb the art and science of low carbohydrate living by Jeff Bullock and Steve Finney had just been published in 2011. So I found that and online there was very little. But I found, uh, a few resources on Twitter and Facebook. Some of them are no longer around, but really that book helped me a lot. I also found one other dietician who had worked with Dr. Atkins. Her name is Valerie Goldstein. She and her husband worked with Dr. Atkins. And I found her, connected with her. But she was the only dietician at that time that I knew that supported this. All of my other dietician friends, I think, thought I was a little crazy for, for doing this. And, uh. But there was quite a bit of research already that had been done by Dr. Eric Westman and others in, you know, before, like in the early 2000s. So I did read a lot of PubMed papers, and I had that Art and Science of Low Carb Living. Also, Dr. Richard K. Bernstein for Type 1 Diabetes has a wonderful book called The Diabetes Solution, which I read cover to cover. So fortunately, there were some books out there. There weren't a lot of podcasts. There weren't a lot of websites, but I was able to find information. And then it started picking up steam within a few years. And by the time I had opened up my own clinic at the end of 2013 2014, there were a lot more people on board. But nothing like today, you know, that's 10 years ago. But still, it was, it was starting to get better already back then.
Lorenz:
Yeah, It's a lot more accessible nowadays, but, uh, if you, there's still a lot of misinformation out there. You know, low carb or keto at some point got popular, right? Maybe, you know, 2017, and now it's being labeled as fad, which is, uh, funny. But that popularity, you know, created a buzz around keto, you know, you're talking about, you know, you know, popularity around it. Although a lot of people left keto at the same time. People stayed, right? It was great for everyone because, you know, who was, you know, everyone who was looking to heal from inflammation diabetes, type 2 diabetes which is, you know, great for a lot of people, but, uh, you know, you've been helping a lot of people bridge the gap between, you know, expert knowledge and the public, right? You, you work primarily with people who doesn't have a lot of knowledge about, you know, How can I, uh, lower my blood sugar, right? Not many people can understand the science, right? And sometimes we have to make it simple, right? For a lot of people. So how do you approach communicating that complex complexity of low carbon keto and then concept to a broader audience, like your clients or, you know, regular people like,
Franziska:
Yeah, that's a great question. Well, I just, I always say, let's talk about foods and how they impact your blood sugar. And this is something I have known since my, you know, dietetic student days. We all know that carbs are the macronutrient that raises your blood sugar the most. So it really shouldn't come as too much of a surprise that if you eat fewer carbs, your blood glucose is going to be better controlled. So, but carbs are considered, you know, what your primary energy source should be. So that's the thing. It's like, well, if you're not eating carbs, what can you eat? Are you supposed to eat just protein? No, you can eat more fat. And that is almost as controversial as keeping carbs low, is increase the fat. That's where a lot of people get hung up. I'm like, well, I can't wait a minute if I cut back on carbs, I'm going to be hungry. I say, actually, you're going to be less hungry because you're going to have more stable blood sugar and insulin levels. But yes, you will need to get energy in order to, you know, in order to meet your energy needs that for movement and just for supplying your body with what it needs to function. But you'll get that. From fat and small amounts of carbs. You're not, you know, I'm not advocating for most people as zero carb diet. Some people do it and that's fine, but I, I say, you know, small amounts of carbs, preferably whole foods based that raise your blood sugar very little. And you get your energy from fat and you also need to eat enough protein to, for muscle mass, for all of the structures in your body and enzymes that need protein. To function. So I just go over the macronutrients and show them keeping your carbs level, keep your blood sugar stable, getting enough protein will keep your muscle mass and everything else working and fat will supply you with the energy that you need without raising your blood sugar. And, and then I have them test. I said, you know what? You test it. You see how your body responds when you eat, you know, 50 grams of carbon a meal versus 10 grams of carbs in a meal, and there will be a large difference, and you'll probably feel better and not get hungry as quickly if you do it that way and you fill up with fat instead. I just I make it. I try to keep it simple without using a lot of complex terminology. And it usually works.
Lorenz:
yeah, no, and you know CGM monitors are accessible to everyone now, and that's a really great tool for people to know and really monitor their own blood sugar levels when they would eat something, right? It was, it was, it's a lot easier for them to understand, okay, these are the foods that are raising my blood sugar. And without even you having to define it because they are experiencing it themselves. Before we get into the nitty gritty though, I want us to define the difference between, you know, keto and low carb because a lot of times these are, you know, interchangeable. So, uh, with, you know, people outside of keto, they get really confused. They think it's the same, right? But it's totally different in my opinion, not because not a lot of low carb, not all low carbs are ketogenic. So let's define it for those people who are maybe curious, which one should they do, or is it keto? Is it low carb? And what are the correct approaches for both, do you think?
Franziska:
Okay, well, there's a lot of variation among people in terms of what's best for someone. But a ketogenic diet is high in fat, moderate in protein, and very low in carbs. And the purpose of a ketogenic diet is to get into nutritional ketosis. And nutritional ketosis is defined as having blood ketone levels, beta hydroxybutyrate levels of 0. 5 to about 3, maybe 4, maybe 5, you know, depending on the person. a low carb diet can be anywhere from, oh, the amount of carbs that you eat on a ketogenic diet varies. Some people will need to be very strict and stay under 20 grams a day. Other people will be able to eat 30 or 40 grams of
Lorenz:
And that's depending on their metabolic health, right?
Franziska:
Exactly. Their metabolic health sometimes their age or how other disease states that they have really just depends. Also it's, it's pretty rigid. I mean, it is high in fat. That's a ketogenic diet. A low carb diet can be high in fat or it can be moderate in fat. It can be high in protein or moderate in protein, and it can have anywhere from very low carbs to more moderate carbs. And most people who follow a low carb diet, will not have those beta hydroxybutyrate levels of 0. 5 or above. Occasionally they may have those levels if they go for a long time without eating or they have a day where they eat a lot fewer carbs. But both of these can be effective for blood sugar control and losing weight. But the ketogenic diet can be. more effective for certain conditions. Definitely neurological conditions like epilepsy and certain cancers. Sometimes mental health disorders. People really need to be in a level of ketosis, you know, 0. 5 or maybe higher 123 to get the benefits. But other people can do really well on just a low carb diet where they have You know, maybe higher ketones. An average person has almost no ketones except for when they wake up in the morning after sleeping. It might be about 0. 1, but very low levels of ketones on a low carb diet and having stable blood sugar can still provide a lot of metabolic benefits. And to know which one's best, you kind of have to try them out. Unless you're doing therapeutic ketosis for a medical condition like epilepsy or cancer, and you want those, I really think it's best to try it out. And some people do best cyclically going, you know, low carb most of the time and ketogenic occasionally, or the opposite ketogenic most of the time and having short periods of a little higher carb intake. So really depends on the person. And as I said, the level of carbs that you can eat and stay in ketosis is going to vary depending on your metabolic health. Maybe the types of carbs you choose as well. And Yeah, so that's, that's kind of the difference. So definitely not all ketogenic diets are low carb. It is a large umbrella though. Low carb can encompass also like ketogenic levels of carbs.
Lorenz:
Yeah. That's where people, you know, make the mistake of, you know, all low carb is keto or, or what, what's the difference. And, you know, you can also, there's, there's, uh, there's tools to, uh, To measure, uh, ketone levels and you can, you can, you know, buy it online and it's accessible to everybody. But what are the specific scenarios where one might be more suitable, uh, keto might be suitable to that person or low carb might be suitable? Can you give us examples of what those scenarios might be?
Franziska:
Sure. Well, as I said, like people with neurological issues, epilepsy, Parkinson's disease, Alzheimer's as I said, for many people, and we're learning more and more about this, but many people with bipolar disorder or other mental health conditions may. Do better on a ketogenic diet where they have sustained ketosis, nutritional ketosis, uh, and I would say that also people with diabetes and prediabetes may do better at that ketogenic level. Now, we don't have head to head studies comparing someone eating 50 grams of carb. Or 60 grams of carb compared to 20, so we don't know, but based on clinical experience, you know, doctors and also anecdotal experience, it seems that keeping your carb intake very low may be more likely to, you know, have you get your diabetes or prediabetes into remission or reverse that. Also people with polycystic ovary syndrome, a lot of women, you know, that's very insulin resistant condition in which hormones are dysregulated. There's a lot of, uh, hyperandrogenism going on being in a ketogenic state may. Be more beneficial for reversing that condition and helping women restore their reproductive function. So, but, but a low carb diet, I will say that a low carb diet has also been shown to be helpful in clinical studies for all of these conditions. So it really does, uh, I think take some experimentation to find what level of carb intake works best for you and what level of ketosis you need to be in. Some people can be in that low level. Between 0. 5 and 1 and get great benefits on appetite suppression. I kind of want to say appetite regulation. Somebody pointed that out. It can suppress appetite, but in some cases it can just regulate your appetite so that you're, you know, you're not completely, uh, don't want to eat, but you have more normal. Uh, you're, you're fullness cues and satiety signals. Sometimes ketones can help you do that. So there's a lot of power in ketones. I think it can be very beneficial. Some people though, find it difficult to stay that low carb all the time. Other people find it no problem at all. So that's part of it too, is how can you do this? Can you sustain this long term? So that's going to also factor into which one is best for
Lorenz:
yeah, you know, I always say the best way that the way the best way to do it is the best is the way that will get you to do it. That's how I always say yeah you know, you talked about diabetes, you know, I want to get into that the heart of the topic here and why a low carb or keto approach is considered ideal for managing diabetes and prediabetes. What are, you know, specific mechanisms that are, that make it more effective in controlling blood sugar levels than others.
Franziska:
Yeah. Well, when you eat carbohydrates, your blood sugar is going to increase, and that is going to prompt your pancreas to produce insulin. If you have type 2 diabetes, your cells are resistant to insulin's effects, so it's actually going to overproduce insulin to counteract that. insulin resistance that's going on. So you're gonna have high levels of insulin, which can cause you to, uh, store more body fat. It can cause inflammation in the body. So eating a lot of carbs for someone with type 2 diabetes or prediabetes, it's just going to exacerbate the condition. It can also, uh, for someone who has early, is early diagnosed with diabetes or prediabetes, it can increase the progression of the disease. cutting back on carbs and eating a ketogenic or very low carb diet can have the opposite response. It can help to reverse the process because blood sugar is no longer going up very much. You need very little insulin when your blood sugar doesn't rise too much. So you aren't going to get that compensatory. release, which exacerbates the insulin resistance. So you've got high levels of insulin. It's, it's kind of a vicious cycle. When you have high levels of insulin, you become more insulin resistant, which causes your pancreas to produce more insulin. So it's it's always. Best to cut back on carbs and for someone with diabetes or Prediabetes or another insulin condition at resistant condition like PCOS or fatty liver disease Metabolic syndrome. There are many insulin resistant conditions out there. All of them can be benefit can benefit by cutting back on carbs
Lorenz:
Yeah. And this is why it's important to work with someone who is an expert at, you know, controlling blood sugar levels or reversing insulin resistance and, you know, conditions like type 2 diabetes and PCOS. One of the aspects of your expertise that stand out. is managing these conditions and interpreting changes in blood work on and low carb diets, right? What are some of the markers for our listeners that they should watch out for so that they can detect any sign of, uh, early insulin resistance? You know, let's define those markers for them so that maybe they can start. You know, paying attention to those markers.
Franziska:
Sure. Well, one of the biggest ones that can be hard to get from, not every doctor orders it, is a fasting insulin. I love to get a fasting insulin level so that we can see what their baseline fasting insulin is. Sometimes blood sugar may not be that high, but fasting insulin is very high to keep that blood sugar under control. It's usually in early diabetes or pre diabetes that we see that. So fasting insulin Hemoglobin A1c, which is about a two to three month average of your blood glucose levels at all times, not just the fasting insulin. And, you know, as I said, mine was 5. 6. And, and for somebody, and I had normal insulin levels, but somebody with 5. 6 could have very elevated insulin levels keeping their insulin, uh, in order to keep the blood sugar at that level. Fasting blood glucose. Should ideally be under a hundred, actually ideally even lower than that. But you know anything over a hundred would be a warning sign. Because diabetes isn't diagnosed, type 2 diabetes, until fasting blood glucose is 126 or above. So if it's over a hundred that's already pre diabetes levels, but a lot of doctors won't tell people until it gets really a lot closer to diabetes. And that is a big issue. I see is the doctors don't do anything about it until it's, I don't want to say it's too late because it's never too late, but until the disease has progressed. So that's an early warning sign right there is blood sugar, high triglyceride levels. Many people with insulin levels with insulin resistance are going to see high triglyceride levels in their blood. And that's, you know, it can go all the way up to 150 and still be considered normal, but really it should be under 100 milligrams per deciliter for, for triglycerides. And, and actually ideally even lower than that, but anything over 100, I would be looking at and, uh, HDL cholesterol. So that's quote unquote, the good cholesterol that tends to be lower in people with insulin resistance and diabetes. So, again, markers are different and I'm just realizing as I'm talking to you that you're in Canada and that maybe these markers are different there. I'm not sure. So you maybe can, like, hyperimpose that on what I'm saying, uh, with the millimoles because I don't know what they are. But HDL for men. should be above 50 and for women should be above 60. So if it's lower than that, that can be an indication that you have some insulin resistance going on.
Lorenz:
You know when you said the doctors might not raise a flag on those numbers before you become pre diabetic or type 2, full type 2? You know my dad, he's been going to the same doctor and never, never really raised a flag for his Type for pre diabetes, like when he got diagnosed, he, he got diagnosed with full on type two. So, you know, that's why it's really important to really empower yourself with these information and know these markers. If, if you have to take control of your own health, right? No. Write these down, go back to what what Francisca said about these markers, write them down so that you, you can empower yourself with this information and you can now go to your doctor, maybe ask, so they had to ask for the fasting insulin levels, right?
Franziska:
hmm. They'll need to ask for it. Some doctors do it themselves.
Lorenz:
Okay.
Franziska:
But if they don't order it, because you'll see what they order. It's on the list. You ask them to add a fasting insulin level.
Lorenz:
All right. Awesome. Awesome. That's great information for a lot of people who really, you know, wouldn't know otherwise if they didn't hear it from anywhere, right? So this is great information to take down, to take. Take notes of this because this is really important. Yeah, so once they are, uh, low carb or keto, what can they expect in terms of blood work changes when transitioning to a low carb lifestyle? All right. Well, people get so confused with cholesterol and fat. No, I don't know. We talked about that earlier. But what, what will be the changes in, uh, blood, uh, chemistry or blood work changes, uh, as they transition to keto or low carb?
Franziska:
yeah, well, they should definitely see their fasting blood glucose go down right away and their blood glucose after meals So that isn't something that's tested at the lab Usually you can do an oral glucose tolerance test where they give you a big load of sugar and they test your blood sugar every Hour, but I don't recommend that women who are pregnant have to go through that But, uh, basically your blood sugar will be much lower after meals and should be lower as you're fasting blood glucose. Your A1c should improve. You can have an A1c done three months after you start and it should have gone down. If you've gone from eating, you know, a higher carb diet to a low carb diet, you'll see an improvement in that. The fasting insulin should also go down. anD, you know, fasting insulin levels, sometimes they're flagged not until they're like close to 20, uh, units. I like to see it under 10, ideally even lower than that, but under 10 would be a good starting point if you have a lot of insulin resistance to shoot to stay under 10 and then eventually get to under 5. But that's something that can come down pretty quickly. So all of these markers that we talked about before should change within just a few months of starting a ketogenic diet.
Lorenz:
That's a
Franziska:
happens quickly. Yeah, absolutely.
Lorenz:
That's the power of the ketogenic lifestyle, right? If, if you just get over the hump of just starting, and I know there's a lot of misinformation out there, that's why you gotta really, if you do have these conditions, type 2, pre diabetic, PCOS, you have to work with somebody that knows how to properly do a well formulated ketogenic diet, a whole foods ketogenic diet, because there's a lot of, uh, You know, versions of keto that are really can be unhealthy for you if, you know, if you're doing, if done wrong, right? So if you are, if you are somebody who have these conditions, please work with somebody, work with, you know, Francisca, work with somebody who knows how to reverse these conditions, work with an expert so that you're empowered would be in, they will educate you on what. What you really have, right? Because at the end of the day, like, it's all about learning about what you have. I mean, I always tell this to people, right? You have to know what you have. You have to know if you have type 2 diabetes, what does that mean? What does that, uh, entail? How do you reverse it? How did you get it in the first, first of all, right. It's really, you know, empowering yourself with these information and by you subscribing to podcasts like, like this, you know, helps, helps your health yourself, you know, if somebody asks you about about. When you, when you do reverse this condition, if someone asks you about this, you, you are empowered with these, with, with the knowledge, right? And which is really can take you a long way. I want to ask you, medication adjustment for individuals currently on medication for diabetes, let's say, how do you approach, uh, you know, potential adjustment when they adapt a low carb lifestyle?
Franziska:
Yeah, that's very important. I was going to bring that up if you didn't ask me. So I'm glad you did ask me that will need to be adjusted by a prescribing clinician, which I am not. I am a dietitian. I cannot do that for you, but you need to work with a doctor. who can. Sometimes doctors will take you off of certain diabetes medications right away when you start a ketogenic diet. Like sulfonylurea drugs, which are glipizide, glyburide, glimepiride in the U. S. at least because these cause your pancreas to produce insulin. If your pancreas is still capable of doing that. Also, if you're taking insulin, doctors may either, uh, reduce the amount of insulin or, uh, discontinue it altogether. Metformin is a medication you can continue to take on a ketogenic diet. Many medications you can continue to take on a ketogenic diet. They work together. But you still want to tell your doctor. that you're on a ketogenic diet. And if you have any other conditions that, uh, that you're not a hundred percent sure a ketogenic diet would work with almost any diet. Almost any condition you can do a ketogenic diet safely, but there are some that may need some adjustment. Like if you have like advanced kidney disease, you may need some adjustments. Because typically when you start a ketogenic diet, you need to add sodium and perhaps potassium and magnesium. But if you have poor kidney function, you need to maybe adjust the amounts of those electrolytes that you add. So some of these things, you know, really will I can help them as a dietician, but there are also some medication adjustments that will need to be handled by their doctor or, or their prescribing clinician.
Lorenz:
Yeah, and you know, if for some reason your doctor doesn't Doesn't, it's not for ketogenic diet, low carb. There's a, uh, there's a, website diet doctor that, uh, you can locate a nearest doctor, nearest low carb doctor around your area. Right? It's diet doctor.com. So that, that's really important to know. Well, yeah. Thank you so much. You, you know, nutrients, I wanna talk about nutrients on keto,'cause nutrients comes up, uh, a lot with. Keto and low carb, right? Do I need supplementation on this diet, right? What is the advice in terms of getting essential nutrients on keto?
Franziska:
Okay. That's a great question. I would say that. Anyone, if they want to, can take an optional multivitamin, multimineral with no more than 100 percent of the RDA. Micro, I mean, I'm sorry, megadoses of even water soluble vitamins can be dangerous. We used to think that they couldn't build up in your body, but I have seen cases of people who take mega doses of vitamin B6, end up with some nerve damage, usually temporary, but it mimics multiple sclerosis, uh, symptoms where people think they're having numbness and tingling. But it's just because their vitamin B levels are too high in their blood and that's from taking supplements. You can't do that with food. There's no way that you can eat enough food to bring on that type of toxicity. So a optional multivitamin. with no more than 100 percent of the RDA for any nutrient. And aside from that, it will all be based on the person. Some people may need to supplement depending on their diet. They may need to supplement with magnesium. A lot of people are low in magnesium, whether they follow a ketogenic diet or not. There just aren't a lot of foods that contain magnesium. The soil that we have is not magnesium rich the way it used to be. So, supplementing with magnesium glycinate, Because that's a well absorbed form, it will not cause. Lose stools and other digestive issues. Vitamin D. A lot of people have very low vitamin D levels. That's another thing your doctor should check. And this isn't just specific to diabetes. This is for everyone. Many people are low in vitamin D. I know you live in Toronto and it's cold up there. Through the winter you're getting very little
Lorenz:
Yeah, no
Franziska:
Even down here in Florida. Yeah. Right. Even I've been in Florida and we're in a sunshine all the time. I still need to supplement vitamin D. So that's something where you get a baseline level and see where your vitamin D is and then you can supplement and have it monitored. You know, some people need to take very high doses of vitamin D to stay within the optimal range and others don't. And there is some vitamin D in food, but not very much. Even fatty fish, which is one of the best sources most people still will need to, I won't say most people, many people will still need to supplement, even if they eat a lot of fatty fish. And get sunshine, that's the other thing. Some people really convert. The vitamin D in their body uh, to the active form better than others when exposed to the sun. So the vitamin D is one. What else might people need to take? The others like calcium. If somebody doesn't have a dairy, you know, include dairy on their diet. It can be tough to meet your calcium needs, especially if you're an older female who has high calcium needs after menopause. So, calcium might be something you need to supplement. But generally speaking a well formulated ketogenic diet if you are eating You know, adequate amounts of protein foods and you know, usually some kind of leafy green vegetables and other vegetables. You will get all the nutrients you need without eating, you know, the high, the high carb foods that people think are sometimes necessary, like having citrus for vitamin C or bananas for potassium. You can get those nutrients in other foods. If you're eating. a well balanced, uh, ketogenic diet.
Lorenz:
There you go, guys. There's a lot of information here. You know, You know, there's a lot of tips that we, you know, that Francisco has shared here today and, you know, thank you so much for, for coming on today and sharing your story. But before I let you go, I want you to, you know, maybe share a success story for our, Listeners here, some examples of individuals you work with, maybe who's had diabetes management significantly improved. If you can share any of that, uh, for our listeners. Mm-Hmm.
Franziska:
Um, yes, I had one woman who contacted me after seeing a TED Talk by dr. Sarah Hallberg, who unfortunately passed away in 2022. You, I'm sure you're familiar with her. She had a TED Talk that was viral. This woman had saw that types head talk back in 2015 and contacted me. She said, I'm obese. I have diabetes. I was just diagnosed with type 2 diabetes. My A1C is 10 percent and I want to reverse it. And I saw this Dr. Hallberg and she was talking about a ketogenic diet. Can you help me? And she happened to live where I lived in California at the time. So I saw her and she was able to get her A1C into normal. Level because this was so early on, you know, she was diagnosed hadn't been to a doctor in a while But her a1c was very high by following a ketogenic diet She got her a1c down to in the fives within just I want to say it wasn't even six months I think it was four months. It wasn't by three months, but it was with within a like four month period amazing results She loved the way she was eating. I will say that she did, she lost weight, but she got a little frustrated that her weight loss wasn't as dramatic as her, uh, reversing her diabetes. And that is one thing. Weight loss takes a lot longer. If you have a lot of weight to lose, it's not going to happen overnight. You kind of have to hang in there. The blood sugar changes will happen immediately or very close to immediately. The weight loss is going to be a journey where you can lose a lot, you know, or initially you lose quite a bit and then it slows down. So that's just something hang in there. It will happen, but really focus on metabolic health. The fact that your blood sugar and insulin levels are so much better controlled that you're giving yourself a much better quality of life and the weight loss will come. Just be patient. There's going to be peaks and valleys on that journey.
Lorenz:
You know, it's really miracle work that you're doing out here. Thank you so much for sharing that story. That lovely story that you know, me hopefully will resonate with a lot of people, you know, I, my dad is type two diabetic, my mom's pre diabetic, and, you know, I've been helping them with, uh, managing their symptoms, obviously. But, uh, you know, it's really great to really hear somebody that actually reversed type two diabetes, insulin resistance, and, uh, really. great for, you know, for a lot of people giving a lot of people hope. Uh, Francisca, if you can share Where they went, where can people find you? Where can people, how can people work with you?
Franziska:
Absolutely. So you can find me on social media. I'm on Twitter. Slow carb already. I think low carb dietitian on Facebook and Instagram. And I have a website, lowcarbdietitian. com. And I have a YouTube channel, Low Carb Dietitian, I think it's called.
Lorenz:
Well,
Franziska:
and you can find me on any of those.
Lorenz:
we'll link it down in the description box below. So you guys can check out, check that out and work with Francisca. Thank you so much for coming on. Once again, for sharing your story. We love your story and we love the insights that you share with us today. So thank you so much,
Franziska:
Thank you very much, Lorenz. I enjoyed it.
Lorenz:
Thank you. All right. Bye bye.
Thank you for joining me for another episode of the ketones in coffee podcast with Francisco wrestler in understanding insulin resistance and its impact, and also understanding the mechanisms of low carb or keto for managing diabetes. I have provided links to prince Cisco's work and their socials. Please see the show note, captions below. If you're learning from or enjoying the podcast, please subscribe to wherever you listen to your podcast, which is a zero cost weight support the podcast. And you can also leave us up to five star reviews on both Spotify and apple. If you have questions, please reach out to me on Instagram or on our website at keto coach. lawrence.com.