What if you got cancer today? Tim Ferriss Asks Dom D’Agostino

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Recently Tim Ferriss got together with Dom D’Agostino to discuss cancer prevention. The question asked was simple – What if you got cancer today? Dom is currently doing cutting edge research into the effect of things like fasting, ketosis, and metformin on cancer cells.

During the interview, Tim poses a fascinating question…

“What if you found yourself with an aggressive form of cancer, what steps would you take?”

The hypothetical “what if you got cancer today” question was interesting because it allowed Dom to speculate on treatments that could take years to be verified. Scientific research can be frustrating because often scientists “know” stuff 5 – 10 years ahead of the concepts gaining public consensus.

The first thing Dom says is that if the doctor suggests you need something like chemotherapy… do it. Everything that follows would be supplemental, and not a replacement:

What if you got cancer today? – Dom’s 5 Step Protocol:

1. Eat a ketogenic diet, and maintain high levels of ketones. The longer you stay in ketosis, the better tumor suppression you get. Also, ketosis has shown protect the body against the negative effects of chemotherapy and speed up recovery after sessions.
2. Fast. Fasting is the quickest way to get into ketosis, and it promotes the body’s natural garbage clearing and healing mechanisms. He suggests ideally fasting during the day and then eating a ketogenic diet in the evening.
3. Supplement exogenous ketones, 2 – 4 times per day. That means products such as medium-chain triglycerides (Dom likes Quest MCT Oil Powder) and coconut oil (make sure its cold-pressed virgin oil). They can help with the on-ramp to ketosis (helping avoid the initial stress on the body). Then once in ketosis, it can allow you to reach higher levels of ketone readings, which boost ones feeling of wellbeing and improve the body’s tumor-suppressing abilities.
4. Take metformin to the point its causing side effects. He suggests titrating it, which means to start low (500mg)… and increase to the point you get some GI discomfort, back off slightly, and then stay there. Metformin works by suppressing glucose production in the liver. This lowers the body’s overall levels of glucose.
5. Supplement Dichloroacetate – This activates a particular metabolic pathway called pyruvate dehydrogenize complex, and for reasons we don’t completely understand, it can cause cancer cells to die (apoptosis). Start at about 10mg per kg and don’t go above 50mg per kg. At 50mg per kg, or thereabouts, you start to damage the nerves (peripheral neuropathy).

While the above is a quick summary, I’d highly recommend listening to the full podcast. Tim poses the “What if you got cancer today?” question at 1hr 46m 20s into the podcast if you want to skip to that bit.

Additionally, there are lots of great takeaways from the discussion for those without cancer.

The core prevention techniques are fasting (intermittent and longer fasts) plus ketosis.

Ideally, you would maintain a ketogenic diet, but Dom also posits research suggesting foods and supplements high in ketones can be beneficial, even on a non-ketogenic diet.

“The FDA may see ketones as a drug. I see them as a fourth macronutrient. You have fats, proteins, and carbs. Ketones are an energy-containing molecule.”

– Dom D’Agostino

Dom’s Q&A

Since writing this, I emailed Dom a couple of questions I had stemming from the podcast. He was kind enough to write back, and the answers are below:

Question 1 – How best to use fasting to remove pre-cancerous cells?

Preamble: Dom suggested that its possible to use fasting to trigger our bodies’ natural garbage clearing mechanisms (autophagy) in order to clean up pre-cancerous cells. He suggested doing this at regular intervals.

Question: How long do the fasts need to be to achieve this effect, and how many times each year would be optimal?

Dom’s Answer: I would fast until you reach the metabolic zone (ketones up to the level of glucose) and sustain that for at least 24-48 hours.  This would put tremendous stress on existing or precancerous cells.

3 days minimum and 3 times per year is a good starting point, but it may differ between people. What’s clear is that it gets easier with each attempt. I’m in touch with cancer patients doing this and they have stayed in remission and feel great.

-> If you’re interested in using fasting to remove pre-cancerous cells I’d suggest reading through Tim Ferriss’ protocol for a fast from Friday eve to Sunday eve. He has formulated a method to make it as painless + efficient as possible.

Question 2 – You mentioned dairy increasing your LDL count – which dairy products do you still consume?

Dom’s Answer: I have a mild allergy to dairy protein, so I minimize intake.  In people that have no allergies, I think small amounts of dairy are fine.  Having a half-pound of cheese/day is probably not ideal though, and there are always people that go crazy with dairy on a ketogenic diet and complain they are not losing weight.

Heavy cream, sour cream, and butter in large amounts increased my LDL (and LDL-p). Simply replacing the heavy cream with coconut cream and cutting my sour cream consumption in half (to 2 servings/day) caused the LDL to go back down.

Question 3 – When it comes to artificial sweeteners – are there any types that you suggest to avoid?

Dom’s Answer: I use small amounts of stevia and erythritol, and typically avoid all others.

Question 4 – When it comes to ‘ketones on the go’ do you have any recommendations. Ideally, things you can throw in a bag and they will survive warm temperature?

Dom’s Answer: MCT Oil Powder (Quest), sardines (packed in olive oil, not vegetable oil) & macadamia nuts are my travel staples.

Next Steps…

A key component for entering and maintaining ketosis is a ketone tester. The golden standard in these, as used by experts such as Tim Ferriss and Jimmy Moore is the Abott Precision Xtra. These are used to measure the level of ketones in your blood. The main use-cases are:

• For checking to see if you’ve entered ketosis. You might think “if I just stop eating carbs, eventually I will enter ketosis”. That’s true, but it misses one key point. Very often people start to feel bad after they drop carbs from their diet, and then they quit thinking it will be like this continuously. What has actually happened is that the blood glucose level has decreased dramatically, but ketone levels haven’t risen high enough to take over and allow them to feel better. Using a ketone meter allows you to keep track, and ensure you reach adequate levels of ketosis before giving up.
• For checking how certain foods affect your body’s ketone levels (not everyone is the same). In particular which foods kick you straight out of ketosis, and which foods allow you to reach high ketone levels – the holy grail of ketosis.

For more info on this protocol, check out the full podcast or read Dom’s Chapter in Tim Ferriss’ book Tools of Titans.

If you enjoyed this article’s analysis of the scary question of “what if you got cancer today” then check out this article on Tim Ferriss’ fasting protocol in order to gain more insight into the world of fasting and ketosis, as well as other articles on biohacking and health hacking.

And if you’re looking for more articles about fasting, diet programs, and keto recipes, check out these other great articles!

• Keto Turnip Chorizo Soup
• 14 Best Keto Egg Breakfast Recipes
• How Intermittent Fasting Works
• Where to Start With Intermittent Fasting
• Intermittent Fasting and Exercise – The Truth