Ozempic -vs- KETO [Benefits & Side Effects] with Amanda Decker, NP

Welcome back to Monday Night Live, my friends. I have a special guest with me this evening, Amanda Decker. She's a nurse practitioner in Dixon, Tennessee. Um, you want to tell them a little bit about your practice and then we're going to talk about the differences between Ozimpic and Keto. There are some specific differences, a lot of similarities actually that people don't realize. We're going to talk about side effects. We're going to talk about positive effects. Uh we're going to talk about lawsuits that are pending. There's not any for keto. Hint right up front. Uh and we're going to talk about long-term use, uh dosage levels, all that kind of stuff when it comes to keto versus ompic. Hi, Amanda Decker. — Hi, Dr. Barry. — How are you? — I am great. I'm doing great. For those people who have not seen you on a live before, tell them a little bit about you and your practice. Yeah, hopefully most everybody has seen me before since I've been around for a little bit now, but I am a nurse practitioner, family practice nurse practitioner for over 20 years now, almost as long as him, not quite as long. Uh about a year and a half ago, I broke free from traditional medicine and started my own practice that is a cash pay practice, direct primary care model if you are familiar with that. catering to people who really want to focus on improving their health and not just keep improving pharmaceutical pockets and getting stuck on drugs for the rest of their life. — Absolutely. And you do remote uh tellahalth visits. — I do. I think I'm up to like 27 states that we're in now. — So, listen carefully. She is licensed in 27 different states and she's got them memorized. She's going to tell them tell us the list here in a second. But so if somebody what where are some states that you are licensed? — Uh so Florida was my most recent state that we added. — So you're now licensed in Florida. So if somebody's watching this from Tallahassee, — they do not have to drive to Dixon, Tennessee. They can see you. They can if they want. But they can do a remote visit with you. — Absolutely. — And you will actually be their health care provider. — Yes. — And you will take care of them, but it'll just be remote. — Absolutely. — And you can do that in 27 states. — Yep. And that's all on the website clearmed. net. uh look at the teleaalth section and it'll list out the states for you. — Yeah, Alyssa, will you type that into the chat? So, if anybody wants to copy that down, thank you very much. We have a couple of moderators tonight in our chat. They have a still a blue wrench by their name. I thought that had changed to a shield, but it's still a wrench. We got Keto Simple and we got Coach Alyssa. And uh if they see you say anything inappropriate, they will put you in timeout. But also, if they see you ask a beginner question, they'll answer your question. So if someone answers your question and they have a blue wrench, you can trust what they say because they are proper human diet certified health coaches and they know what they're talking about. They've been listening to my jaws rattle for many years and they know exactly how I'm going to answer a question. So tonight we're talking about Ozimpic. Excellent. — Versus keto. — And a lot of people if you don't study nutrition and you're not a healthc care provider, you may think just the whole premise of that is like, what do you mean Ozimpic versus keto? — Keto is a silly fat diet and Ozimpic is the greatest freaking drug ever invented by mankind. — The miracle. Now, let's first start off and give Ozimpic — its uh earned kudos because you and I both are still licensed. You practice full-time. I practice part-time, but Ozimpic absolutely is a real FDA approved medication that absolutely can have beneficial effects. — Absolutely. And full disclosure, I use it and prescribe it. So, yes. — Yes. Now, there can be some problems with that. Just like with any pharmaceutical, regardless of whether it's FDA approved or not, — there can be disastrous complications if it's used inappropriately at too high of a dose for too long of a time. All those things matter and we're going to talk about all that tonight. So the reason that we say Ozmpic versus Keto is because I believe and you may agree or disagree. I think that Ompic and Wovi and Monero and then uh the new one that's coming out that's still in phase three trials uh but you can get it on the peptide but yeah it's not FDA approved yet. So don't get froggy. I think that they in many regards are keto mimicking — pharmaceuticals because they don't do they don't have no effect on calories, — right? Calories don't count. Calories don't matter. They have no effect on your calories at all. What they do is they tweak your hormones, your hunger hormones, your satiety hormones, and that's how they work. That's exactly how keto works as well

but without side effects, would you say? — 100%. — So, let's go through a typical scenario of a patient comes to you, a new patient from Tallahass, Florida. — Okay. — And let's say that they are severely obese. Their BMI is 30 39. — Their A1C is nine. Severely type two diabetic. Okay. Now obviously they need a proper human diet. They need keto, carnivore immediately. But as a health care provider, how might you use ozic — for that person? And why? — So you want to get the A1C down and the sugar down as fast as possible because every day you spend with it up is doing damage to your body a little bit more. Every day, every minute. Uh I would and have in some instances you start out low and we'd use it just to suppress the appetite especially in the beginning while you're getting rid of some foods that you didn't need to be having and it also does stabilize the blood sugar there. A lot of providers are going to just ramp that up really fast like every three to four weeks you're going to go up on your dose. — I've never prescribed it that way. I have always stay so oimpic we go starts at 0. 25 25 milligrams once a week and I stay on that dose until we stop seeing clinical effects like your blood sugar is still out of control or we are still really struggling to get hunger things like that out you know under control because don't put more in you than you have — 100%. And in my experience tell me if you agree for many patients that 0. 25 25 a week. — A lot of people it does work — if they have any interest whatsoever in cleaning up their diet, getting rid of the jelly donuts and the Lucky Charms and the Dutch chocolate milk. — They can use that 0. 25 and have serious benefits with a not only A1C but weight loss. Now keep in mind Osimpic I don't think it's still not FDA approved for obesity or weight loss. Well, we goi the semi. That's right. The new one. Same drug but a different dosage. Yeah. Different I guess. — I don't know how they — Same dosage, different name. — How did they just got a separate patent on it. — Correct. They put a different name on it and got a separate. — That's odd. — Same thing with Monero and Zbound. — Right. They must have taken some key people at the FDA to lunch to get that because typically you can only get one FDA approval on a chemical. So you would start this person on the lowest dose as long as they were continuing to have weight loss and blood sugar reduction, A1C reduction, you would keep them right there. — Now a lot of people watching this may ask, well, why in the heck would a doctor do that rapid escalation of dosages? And I have opinions, but have you talked to any doctors that you maybe have a patients transferred from? — Why do they do that? Why do they start at a low dose but quickly go up to the max dose? Honestly, I think it's just because that's what the package insert says. That's just what they were told to do. And it hasn't been studied low dose long term. It's only been studied the way the pharmaceutical industry wanted it to be, which is titrating every three to four weeks. — Yeah. And I would think that there's some human nature in that as well because all humans know that if a little bit of something's good, more of it's going to be better. — And they want their patients to see results. Like they want them to see this huge weight loss so they're the best person ever. And so this doctor who's just a dude or a chick and still really is a little kid at heart like we all are. You know you are. I know I am. Are you a little kid at heart? — Absolutely. — 100%. So you believe if a little bit of something's good, then more is better. You're like, I'm gonna get them to the max dose immediately. That'll make me a better doctor because they'll lose weight quicker, that their A1C will come down quicker, etc. Right? And I think it's just the human nature of it. But a lot of doctors just listen to what the drug rep tells them — and what they read in the trade journals — and they're not looking at outside sources like how many people have how many lawsuits are there about this complication or that complication — for Ozimpic. And I think they should look into that stuff a little bit more. Now let's see the most common side effects that you've seen in your practice when you start somebody on this low — dose of oipic. — Nausea, vomiting, const constipation. — Nausea, vomiting, constipation. — We're not talking about poop though. — We we're going to talk about poop at some point. Yes, that is that's tradition. And so that that's what's listed in the package handout is the most common. And then also before this, before we started, I had Grock — uh do a Reddit search of the entire Reddit database. — And that's the three most common that people on Reddit say, I started Ozic and I had this side effect. Those are literally ranked just like that. — Now th that's at the low dose.

— Now, as you start to ramp up the dose, — especially quickly, you can have some significant other side effects. And what have you heard from patients that maybe came to you that were on a higher dose before? — Yeah. So, the one that I've seen more and more is bowel blockage because the constipation just gets worse and worse to the point that there's a bowel blockage which sometimes clears on its own and sometimes requires surgical intervention to correct. — That's bad to have surgery because of a bowel obstruction. And the way that oimpic slows down, just the same exact way it slows down paristtoalsis in your stomach, it slows it down in your small intestine and large intestine as well. And so if you're already somebody who tends to be constipated and then you start osimpic especially at too high of a dose you're liable to become mega constipated and in which case that can turn into a bowel obstruction — and sometimes need some physical disinfection or surgical disinfection and I know you were a nurse for a lot of years so you know how the disinfection goes there. Yeah, that's PTS 100%. Yeah, I've got a story. Oh, When I was an intern at Coington in the ER, — yeah, sometimes there's a very firm feal ball. — But then behind that — is diarrhea. And it didn't happen to me, but I witnessed it happen to my second year resident. And that's a story I'll tell in my tell- all book one of these days when I write that. Uh, now if somebody is escalated to the higher doses, Then I start, at least from my feedback online, I start hearing, oh, sulfur burps, like burps of death is a common um term that I hear. — And it basically what it does is it slows down your stomach's paristalsis. And if you don't know what paristalsis means, have you ever seen a worm crawling? You like a caterpillar or a centipede or just a earthworm? You know how it's like there's a wave that goes from head to toe or they don't have toes, head to tail, — right? — Worms are nasty. — They are. But that's parasolis. And your gut does that exact same thing. That's how it moves food through. And so if you slow that down enough, what winds up happening in your stomach, the reason you're getting sulfur burps is because the food is literally sitting there rotting. — I'm not I'm not being sarcastic. I'm not — Oh, it is. that it is literally rotting. Not in your large intestine where some food is supposed to rot. That's what it does. That's fermentation. That means rotting. But in your stomach, you're not supposed to have food rotting in your stomach. That's not supposed to happen. — And it can give you the most amazing stinky burns. And also just severe heartburn reflux. I hear that side effect a lot — because if you let's say you eat at 5:00 p. m. Typically, if you go to bed at 10, — that that's perfect. You know, all that food's already down in the small intestine by the time you go to bed. But if you're on a high dose of osimpic — sitting there, — you go you eat at 5, go to bed at 10, that food's still right there in your stomach. And so, you're at much higher risk of having reflux in the night. — I see that even on low doses sometimes when they've been on it for a long time. Like you have people say, "I've been on this for two, three years and I've been tolerating it just fine. Why all of a sudden do I have these burps coming out? It's just the length of time and the guts responding slower and slower. " — And the people that I see that just have the three common nausea, some vomiting initially and constipation — that are manageable are the people that are on low doses for a short period of time, three to six months. Has that been your experience as well? — Even though it's hard to get off of, and I'm sure we'll talk about that down the road. It's hard. — Yes, it is. It is hard to get off of now. But I also in this video I want to talk about for the people who are either allergic — just they cannot take it. The side effects were too ungodly — or the other growing set of people — who it worked great for a while — and then stop — and just stop working. Right? That's where keto comes in and that's what we're going to talk about later. So if you know somebody that was on Osimpic WGO Monero and they're like can't take it anymore, can't afford it anymore or it just stopped working even at the higher doses, you need to share this video with them. Uh either in a text message, direct message, you could share this on your favorite social media. They need to hear this information because they think, well, that's it. I'm screwed. There's nothing I can do. But there is something very powerful that you can do. So, how does keto why is it sort of the same as ozic? — Well, it acts on hormones. So, it acts on your satiety hormone. It increases your leptin, which is your hormone that helps you feel full and satisfied. It suppresses ghrelin, which is the little I call it the gremlin. You're hungry. You're hungry. Please

eat. — The way I remember the difference is gr is your h your stomach growling. — I like gremlin. — Grelin. Yeah, gremlin's good, too. I like that. So, and so grein is the hormone that tells you, "Hey, dummy, you're hungry. Go eat. " — And leptin is the hormone that tells you, "Hey, dummy, you're full. Stop eating. " — Now, if you're eating hyper palatable, ultrarocessed foods, uh, high sugar foods, sugar added foods. Very often, they design those foods to trick your leptin. And so, you don't you feel like you're not full even though leptin's going, "Dummy, stop eating. " But you can't hear it because of the ultrarocessed — habit forming foods. Um — there's effects on glucagon with both of them. Yes, — glucagon has effects on how your sugar is released and taking care of your insulin response, that type thing. Um they both improve insulin sensitivity. So if your insulin sensitivity is improved, then you're not producing as much insulin and therefore not as hungry and not storing as much body fat there. — They both decrease inflammation a little bit. I'm not sure the pathway at which that happens but — and I think the pathway is that it lowers blood sugar — it lowers insulin serum insulin — and that lowers chronic inappropriate inflammation and I also think that even people who are still eating a junk diet on — Ozimpic — they're eating less junk — therefore it's not as big of a slow poisoning insult — on their body. Does that make sense? — Yes it is. — Yeah. And so you're telling me that these pharmaceutical companies — are making multibillions of dollars each and every year — by basically just creating a drug that does what keto does. — Yeah. And even keto will slow motility through your intestines a little bit. — A little bit, but not to the point where your food rots in your stomach. Yeah. I've never ever heard somebody on keto say that. — Um, let's see. Okay. Now, let's talk about the long history of the GOP 1A. — Thanks. So the very first one that ever came out was Bietta. Was that before your time? — No, it was the same year that I started practicing. — The same year, 2005. A couple months. — Yep. And so Bietta you had to it was an injectable and you had to do it twice a day. — And it had horrendous side effects. Like hardly anybody could tolerate that. — Yes. And it was also dosed in micrograms, not milligrams. And it came I think it came in a pen. You didn't have to draw — some weird kind of twisty pin. — Very twisty. Yeah. I remember that and we got samples and all the nurses are like I want to try that but also I'm scared to death to try that right and then in 2010 Vtosa — came along and so these drugs have been on the market for 20 plus years we've got a long history of using them but I would say I we don't have a long history of using them at these new — correct — dosages these are kind of turbocharged — the same market so when they were first came out it was only for diabetes it was never it wasn't even thought of to put someone who struggled with obesity on these medications. — Right. And I remember I had patients and they would lose a little weight — with buyup and then maybe a little more with Vtosa, but it wasn't a stunning amount of weight. Was that your experience as well? — Yes. Until Vtosa came out with Saxinda, which was double the dose of the Victtosa. — So they doubled the dose, right? Because if a little bit's good, more is better. Surely. Um now there's a black box block box warning on oimpic and all of the gop1 agonists. — What's that? What's that about? — Yeah. So the black box is specifically for thyroid medularary carcinoma which is a very specific thyroid cancer. It's usually inherited. If it's in your family, you're probably going to know about it because it's in your family. There's a lot of them there. Um however and you may have seen this in your research of it too in other countries who have say not the healthcare we do — right — um so they have access to data on who's been prescribed a medicine with what diagnosis I think there was one from France that did show when they pulled the data of everyone on a GLP1 and all types of thyroid cancer there was an increase in thyroid cancers interesting — um now was it this out the roof type thing Oh, and their arguments you got to weigh it with obesity increases the risk of cancers including thyroid cancer too, — right? Because our sample patient who had a BMI of 39, maybe they weighed 450 pounds and their A1C was 9 or 10. — That's also super dangerous for heart attack, stroke, and hundred other bad things. — And so a good health care provider has to weigh the risks and benefits and say, "Yeah, there's this I mean," and we have to be honest. It's there's it's a tiny risk and I don't know of any research in America that shows in humans. — Yeah. — Any increase in the thyroid sea cell it was in rats and rodents — and so it that's why the black box warning is there. I haven't seen any research in humans uh in the US but I haven't looked at the outside literature. That's impressive that you're following the literatur.

— Excellent. Very nice. And so there is a blackbox warning, but I don't think that's a huge deal. If your health care provider is aware of your family history and also you're your healthcare provider keeps your dose low and doesn't leave you on it for too long, I think that's probably a non-issue. — But when you start cranking up the dose, — you start running into some significant complications — at a rate high enough that it's a concern. — Yeah. Have you seen anybody come to you from another provider who was on a high dose that they had one of these complications? — Um pancreatitis. Is that where you're going with that? That is a huge one. The ER docs are terrified of it. Um no separate ER nurses that that's the first thing that comes to their mind after the bowel blocking. — Yep. And also all the surgeons, any surgeon says do not take a GLP1 agonist before you come in for your surgery because they do not want you to have pancreatitis. while they're there, right? Because that would destroy their — that and you can't truly empty your guts for the anesthesia — because remember we talked about the food sitting in your stomach rotting. If you're going in for surgery, you're supposed to be NPO, nothing by mouth after midnight usually they'll say or that evening. Well, if you're on a high dose of Ozimpic, you're your tummyy's still full of food. Rotting food, which would I Can you imagine the aspiration pneumonia, — that rotted food? — Yeah. I mean, you're talking no telling what kind of bugs you'd have to treat for. — You'd be in the ICU on five different IV drips. That's bad. Okay. And so gastroparesis is another one that I keep seeing more and more — case reports of and there's actually a class action lawsuit now. — 30 at least 3,500. Last time I checked, there was 3,500 plus cases. — Yeah. that this one law firm uh had patients who they're pursuing a class action lawsuit. And I know some of you guys hate lawyers. I get it. I'm, you know, I've had some bad experiences myself. — I hate doctors, too. — That's right. I don't blame you for that either. But you have to understand a lot of people think trial lawyers are they're just looking for somebody to sue, which is true. But they're not going to take a silly case or a case that's frivolous or the case — they're not going to get paid — that, right? because they get paid when you win. And if you're if it's like obvious foolishness, then they're not going to get paid. So, they're not going to take that case. And so, there's almost 4,000 cases of gastroparesis now in a class action lawsuit. That's a big deal. — It is. And I have seen that in a couple of my patients who are on that higher dose. Now, positive in the ones that I've seen after they have been off of it for about two years, it has reversed so far, but I don't know that that's across the board. — It's not. And that the class action lawsuit is people that have been off it for more than a year — that still have gastroparesis. Wow. So — that's miserable. — That's a and that's awful. If any of you guys are on Osimpic right now and you've had that food just sitting there rotting and that feeling, just imagine that turned up to 100. That's what gastroparesis is. Very often they have to puree everything that they eat. They can't eat solid food anymore. And even the pureed foods just sits there for hours and hours if not days. It's really rough. And so that's why I continue to caution people. If you're going to take Ozic, make sure you literally need it and that the benefits outweigh the risks. — But then keep it at a lower dose because you do not want that. — Uh any other serious side effects that you've been reading about or hearing about lately? I mean there's the vision things which I'm not sure how much of that is drugrelated or not because it's very sparse — right optic neuritis and then with vision loss and that's very rare. I've seen two or three case reports of that, not many. Uh but then also there's some case reports of if somebody has already has pre-existing diabetic — retinopathy — that it can make it get suddenly much worse and nobody really understands what that is. — To say in the beginning that it was because your blood sugars lowered so rapidly that it was that sudden shift in blood sugars that did it. — I don't know that I believe that but you know. — Yeah. Because when you start a really good real whole food ketogenic diet, your blood sugar comes down rather abruptly and there's there hasn't been a lot of reports of diabetic retinopathy getting worse. And actually, it usually gets better within six to 12 months when they go back to their opthalmologist and get their retina rescan. They're like, "Wow, your retina looks better. " — That's what I keep hearing. Yeah. And so, um, now let's talk about the keto part of this. Let's say let's talk to somebody who — either can't afford Ozimpic WGOI onro anymore. — They used up all the samples, all the coupons ran out and now it's just you got to get your credit card out.

— Or it stopped working even at the higher doses or they just had a side effect and couldn't take it. — Yeah. — How is a ketogenic diet? How is that going to basically give them all the benefits — of Ozimpic without all these terrible side effects we just talked about? — Yeah. So, we already talked about how it does control the same hormones, acts the same way in the body. Now, in fairness, a ketogenic diet does that a little slower than shooting yourself with the natural. — Yeah. So, it's happening slower, right? And if you say go on a ketogenic diet and you take an off day, guess what? all your hunger and those things are gonna come back. So, this is — Oh, if you have a little cheat day. — Yes. That's right. — There's not room for wiggle room when you use the ketogenic diet to suppress the same way that oimpic did or is doing. Um, so if you're say you're still on the drug and it stopped working, I always go back to revisit what are we doing with our protein and our fat? Are we getting enough or are you just eating so little and then all of a sudden your body has gotten used to it? Because in my opinion, that's what happens. Our body is super smart. God designed this thing in an amazing way and it gets used to everything that you put in it consistently and when you give it a hormone over and over again at a super high dose, it's just eventually going to get used to it. — So, you're no longer sensitive. But the other thing when you've eaten less and less, you're just you're not giving yourself the satiety from the protein there. And so that's where we go back and adjust — because I think the majority of people when they go on ozic or regi — their doctor doesn't mention you know we should really use this kind of as an opportunity to fix your diet because your diet sucks. Okay? And you know you just because you're onic now you're going to eat less. And so if you're living on Pepsi Cola and Ding-Dongs and Doritos, there's not a lot of protein, vitamins, minerals in those things. And so if you're eating that basically just junk, whatever ultrarocessed food, and then all of a sudden you're eating a third of the same amount, — you're gonna develop a protein deficiency. And indeed, we're starting to see case reports of that, too. They call it ozipic face. Yeah. — Oipic ozipic butt. Like literally your butt muscle just goes away because you're not eating enough protein because you're still trying to eat your old standard American diet — while on the Ompic. And that's that you're going to still going to lose weight. That's the thing that tricks people. — It's like I'm still losing weight. So — just looking at the scale, right? That's the only number they're looking at. — And the scale is an important number. It doesn't matter. But that's not the most important number at all. And so on with your patients who are on Ozimpic, do you do any kind of uh protein intake monitoring? Do you do uh maybe DEXA scans if they're losing a lot of weight to make sure it's not too much muscle? — So in the clinic, we have a bioimpeded skill. We're able to kind of measure that. It's quicker than DEXA, cheaper than DEXA, and if I'm seeing them from the start over, I'm monitoring that progress and seeing how that goes. Um, we always set a minimum protein threshold that you're supposed to hit every single day. Even when you're not hungry, you're supposed to hit that protein threshold. Even if you don't eat anything else that entire day, you're supposed to hit that protein threshold. And then I have them follow up with health coach. So, we prescribe it, then they're checking in with their health coach every couple of weeks to make sure that they are getting that and not letting other stuff slip in, too. — Perfect. Yeah. Because if I think it really ought to almost be mandatory that if a doctor's going to put you on one of these that they you ought to automatically get a nutrition referral. — Maybe — not that nutritionist or dietitians are going to say — what I'm saying is if I refer them over to the nutritionist or the dietitian the it's you're going to get the standard American balance balanced diet. — At least they're going to say stop eating the ding-dongs, Doritos, and Pepe. I think I or they would say just drink the little can of Pepsi. — Everything in moderation. That's their message is everything in moderation. And that's not going to work with these drugs. Everything in moderation is going to end you back in the same exact place where you started. — No, you know, you're right. That's so frustrating that if Yeah, that's really like your patients are trapped. If their doctor doesn't help them understand you got to use this as an opportunity to start a proper human diet. — Yeah. They're going to develop vitamin and mineral deficiencies. They're going to have muscle loss, sarcopenia after a certain amount of muscle loss. It becomes a medical problem. — Yeah, — it's a big deal. Especially if you're over 60. — It's a huge problem that can increase your risk of breaking a bone when you just have a minor fall of just not being able to do your activities of daily living without being unsteady on your feet. — Your risk of death. I mean, you get a bad pneumonia and you don't have

anything left there to preserve you. — Absolutely. Um, another side effect I hear a lot is fatigue. — Fatigue. Very, very common, which doesn't sound dangerous, — but that can really negatively affect your life. — If you're just having severe fatigue all day, every day, that can be a big deal. — And I would like to say it's just because they're eating less and going through that change. But even my patients that I monitor really closely and know that they're getting what they need in a day, fatigue is still there — 100%. And I think we do not know everything that these GOP1 agonists do in our body because we know that there are G go GLP-1 receptors in the gut — and that's how it works there. — But there are GLP-1 receptors in your kidney — and in your heart muscle and in your brain. — What are these drugs doing there? and your thyroid and your reproductive organs and — your ovaries, your testicles. What are these drugs doing there? And that's why I don't think that the research that they used to get the FDA approval, I don't think it was long enough. — Yeah. — To catch a lot of the bad things that these drugs potentially — terrifies me too about giving them to 12 year olds. Like what? Oh my word. That terrifies. — Is that what the AAP is? Yeah. So it it's now FDA approved. FDA for — and the American Academy of Pediatrics is currently saying it's fine and safe to start using at 12 years of age, but I really I think I read the other day that they're trying to get that lowered down to eight — is what I heard. Did you hear that? Yeah. I think they're So, can you imagine a little nine-year-old kid — who's overweight because their parents just feed them whatever — to be put on one of these and then I guess the expectation is they'll be on it for life. — Yeah. — Starting at age nine. And then what do you do for — Are y'all okay with that? — They want to have pregnancy later. I mean, you can't be on be pregnant. I mean, it just — Right. It just it's it boggles the mind when you think about the long-term implications of this. Uh if any of you guys have questions, we're going to start answering some questions now. — Did you see that we goi is now launching at a 7. 2 milligram dose? — Yes. Huge increase. — Like 2. 4 and now we're at 7. 2. — It's a tripling of the dose. Yeah. And so let's be very clear about this. And I think I'm on very stable ground saying that there is zero — long-term research — on the safety of taking any of these drugs at that crazy high dose. And the pharm pharmaceutical companies are doing this because that's going to first of all extend their patent. — Yes. — They'll make more money. Yes. — But also people are going to lose weight like they've got cancer. — Yeah. because you it that's just going to turn off your GI — and you just won't eat at all. So you'll lose weight. Oh yeah, you'll lose weight. But I mean it's how do they not know this is this going to lead somewhere bad? — I don't know that they may know. care because they're chasing the number of today which is get everybody to lose weight because all they see is all right obesity, diabetes, bad things and leads to all these other chronic issues. They're not seeing past to what is our cure — right — creating — right? Yeah, it's so frustrating. Here's Eddie. There was a question last week about diverticulitis and fiber, but I didn't catch what someone should take instead of fiber for constipation. Uh fatty meat. And then if you need a little bit of help with constipation, there's always magnesium citrate, which you can buy at any pharmacy or on Amazon. uh there's you have no need for fiber especially if you have ulcerative colitis — or Crohn's disease or IBS IBD you probably need to stop the fiber if not decrease it drastically — and then you just eat fatty meat and you take a little mag citrate if you need it — yeah maybe a little MCT oil if you really are — struggling yeah MCT oil or you can just eat a stick of butter that's what some of the influencer gals do — here's oh he changed his name curious to know what oimpic does to one's microbiome. Have you read any research on that? Because I think that's an excellent question. — It's an excellent question and I don't know that I've seen any research on it. — I can guarantee you, I can bet everything that it does affect the microbiome, but I don't know that anybody's researching that. That's a great question. I'll look that up after this live — and I might do a YouTube video on that. That's very good question and it's if you haven't seen any research and I haven't seen any research, — it's probably not much research out there about that — and microbiome research is kind of hard because it's still not clear what is a good microbiome. So, — 100%. Yes. Yeah. If anybody pretends they know they've got the microbiome figured out, you can hit the unfollow button because they do not. I promise you. Vicki says, "I heard a lot of complaining the Armor thyroid is made in Germany now and not as good. Is this true? " Maybe. I'm not sure where they make it. Uh but keep in mind there's two or three other desiccated thyroid

products that you can prescribe if the armor is not working for you. — They're all getting harder to prescribe. — They are. And you know, for a minute the federal government — I know. I think that's why they're getting harder. It's just — they said they're going to ban them all. And then I I know uh I reached out to a few people and then a bunch of other providers reached out and said, "Hey, you got to keep at least one on the market because there are women who depend on that and a few men. " — Uh but yeah, and so now they're not talking about banning it anymore. I haven't heard any more talk about that. — Here is Jeff's wife. Dr. Barry, can you please tell me about your AI chat? uh isn't can you talk to it the same way you talk to chat GPT okay so inside of our PhD community and I was going to bring this up later but since you asked the question I'll answer it we have Dr. Berry AI. — Oh, — have you heard of him? — Is he smarter than you? — No, he he's exactly as smart as me. — And so what we did with this, this is not chat GPT or Claude or Grock or Gemini. This is our proprietary uh large language model that has been trained on every one of my YouTube videos. — Okay? — Every YouTube or radio interview I've ever done, okay? every question I've ever been asked. — All three of my books, Lies My Doctor Told Me, Common Sense Labs, and Kicking Ass. — And then also some really good books that I love like uh Dr. Ben Bickman's Why We Get Sick — and several others like that it's been trained on those. And so that's available if you join the PhD community at the plus level. — The chat Dr. Barry AI, which inside the group they're calling it the Barry bot. I don't really like that, but that's that seems like that's what's gonna it's going to be called is the Barrybot. At 3:30 in the morning, if you're having some insomnia and you can't sleep, you can literally be asking Dr. Barry AI questions — and it will answer your questions just like I would answer them. And — if there's a video where I talked about that, not only will it answer your question, but it'll give you the timestamp of that video. Okay? Okay. — So, you can then go and click that and it'll take you straight to minute 47 in that video where I talk about that. It's — pretty awesome. — Do you ever ask yourself questions? — Yes, I we've me and Misha and all the coaches, we've asked it hundreds and hundreds of questions and also anytime somebody has a problem with it, we get a notification so that we can fix it. Okay. And I'd say about once a week somebody askked it a question that it's like uh and it we get a flag and then we can go in and train it and then from then on it's got that. So love it. — It's really nice and people we see all the questions and somebody today asked it. — What was that question that somebody asked the AI? I can't remember but it was it's like yeah it's not really for that. Uh, but if you have any medical any nutrition question, it answers just exactly like I would answer even when I'm in bed asleep. — Does it answer questions about like your family like Granny Berry and things like that? — I don't think so. — That's in your videos. — I don't think so, but maybe it might know a little about Granny Barry. Anybody in the PhD tribe, you should ask it about Granny Barry. Granny Berry is watching tonight, by the way. So, please say hi to Granny Barry and tell her where you're watching from in the comments. She loves it when you guys do that. Hey, Granny Barry. Love you. This is not Nisha. And we're Nisha's fine. She's in there. We're not divorced. It's fine. Don't worry. — Granny Berry jumps to conclusions sometimes. Okay. Here's David. Been carnivore for nine months. I use chronometer to track nutrients and found vitamin E and B1 were always very low. Uh if you don't eat enough pork and eat enough fatty meat and fatty fish, you can have problems with these. I've been supplementing both. Do I need to supplement E? I would not supplement E. I watch my YouTube video called the seven vitamin E rich foods and you'll get plenty of vitamin D in your diet. Some, and this doesn't happen to everybody. Some people can just eat beef, butter, bacon, and eggs. That's it. — And never develop a single vitamin deficiency, including vitamin C for years, 10 years, 20, 30 years. They just eat beef. My friend Kelly Hogan's been eating nothing but beef for 15 years. — Vitamin C is fine. Everybody's like, "How is that possible? " I would opine that we don't know everything about vitamin C. I have several theories, but I can't prove them. — But there's risk with too much vitamin E, like — with a supplement. Yes. Yeah. Please do not take a vitamin E or vitamin A supplement. Do not do it. They are fat soluble and they can build up in your system and cause really, really bad problems. Vitamin E, vitamin A. Do not take a supplement. Very, very good point. This is I don't know who this is. — Mountain Living — 120 pounds lost on carnivore. Sharing

your channel on my channel and people are liking it. Yeah. I mean, it just imagine if you knew somebody who is now 120 pounds lighter than they used to be. — You' probably listen to them when it comes to what you should eat and what you should avoid, right? So, thank you very much for doing that. Thanks for the super chat. Here's Andy plays games. I know gastroparesis can be improved with keto. I have seen this, but I don't think it's 100%. Uh, but would oimpic slow peristalsis compound the problem until the improvement with keto can help? It could. Yes, absolutely. And that's one of the main worrisome side effects that I really worry about people taking the higher doses. — Yeah, that's a big no for me, a red flag of prescribing it. we will find alternatives if you're still having any symptoms of gastroparesis at all. — So if you have a patient and they start having the classic symptoms of gastroparesis, you might want to tell the most common uh symptoms so people can know what to look for because I bet you out of these 2,300 people. I bet two or 300 are on oyic right now. — Yes. So it usually starts as fullness in your belly. Like it just feels full and then the nauseousness kicks in. You almost always vomit frequently after eating. pain usually kicks in as well because your stomach's trying to move it through and it just can't. Um I see more as like um peptic ulcers and things like that with it because your acid is just eating away and not getting moved down. — Yep. And so there's a spectrum of paristalsis. Some people can have what Amanda just described, but that can become so severe that your food just doesn't move at all. — Yeah. — It can be really disastrously like lifeending bad. you get a tube and they suck it out. — You get a PEG tube and then you it's just it's really bad. — So, uh yeah, if you're starting to have those symptoms of gastroparesis, what would you do if you had a patient who really started exhibiting significant gastroparesis? — Yes. So, we're immediately going on a liquid diet. We're immediately going to be stopping the medication. Um sometimes I would use a little reglin or something like that just to kind of help speed the motility and get them some temporary relief. — Yep. But I can Andy's exactly right. I've seen hundreds and hundreds of people who were previously maybe following the American Diabetes Association diet, right? And their A1C was still 10, 11, 12. And so you intimated earlier that anytime your blood sugar is high, you're doing damage everywhere. And we think about the heart arteries, kidneys, the eyes, but it's doing damage to the nerves in your stomach. A lot of people have diabetic neuropathy in their feet, legs. it. That's This is basically diabetic neuropathy of the stomach. Yeah. — That's what gastroparesis is. And when it gets bad enough, your stomach just says, "Screw it. I'm not digesting anymore. — Done. — I'm done. " And so, yeah. So, that's a big deal. If they really start to have those symptoms, you take that very seriously. And I think that's — exemplary practice. Here's Transorian. Lucy is thyroid replacement therapy made testosterone — with cotton. Oh, I'm sorry. What did I say? thyroid testosterone replacement therapy made with uh cottonseed oil bad for me when I'm on keto carnivore. — I think that the depo testosterone I think it uses a and it's a purified modified I think it's estrified eststerified as well. It's not just they don't just squeeze cotton seeds and then put it in the shot. I think it's fine because you're injecting such a tiny amount. First of all, you're not eating it at max. You're going to be injecting what? Not even a cc really, but maybe a cc maxc a week. — A cc a week of cotton seed and it's literally purified. And I mean I think it's not a big deal at all. A lot of people get hung up on little tiny details like that. I don't think that's a big deal. Now, if you're still eating a can of Crisco a week, uh which used to be made of cotton seed oil, now they say it's a vegetable oil blend. Did you know that Crisco the what vegetable seed oils they use is proprietary? — Literally says vegetable seed oil blend. — So you can't know which ones — you can call them. I think they're like, "Yeah, we don't give out that information. " So that's worrisome. — But I don't think this is a big deal. Now, let's go back over here and see if we got any questions. — But if you think it is, like if he feels like it's increasing inflammation, you could go to a compounded pharmacy potentially. Absolutely. Um and get an injectable one. It's done in more like an olive oil type thing. I've seen that once or go to a topical version and just bypass the injection all together. — Bypass that all together. Here's an interesting question from Lady Rya. — Can Metformin cause gastroparesis as well? — It's not the same drug, right? Yeah, definitely not the same drug. Not even in the same drug class. — Yeah, — I've never — No, because I mean I usually think of

metformin speeding things up. Diarrhea is your number one side effect of that. What I would say is it's probably the diabetes that you're using the metformin for, not the metformin. In that case, — here's another one, guys. This is Jammer Rules. Jammer Rules has got a good YouTube channel. Beef butter, bacon, and eggs saved my life. Lost 165 pounds, — reverse type two diabetes, A1C is now 5. 4, — restored my eyesight. Now, let's talk about that a little more in a second because that's not going to happen for everybody. no longer have sleep apnea that I can't tell you how many people I know that started either keto, keto or carnivore and wound up selling their CPAP on eBay, — which you can probably do that because there's still a shortage on some brands. — Just they don't need it anymore. They sold it on eBay. Uh what else did this guy do? Male, two meals a day, no fruit, no veggies, no snacking, no carbs, no sweets. — I love this. Now, let's go back to the It saved his eyesight or improved his eyesight. If the reason for your failing eyesight is retinopathy, then absolutely your vision can improve on keto, keto or carnival. Absolutely. Because your retina has a great blood supply. Now, if the reason your vision is deteriorating is because of a cataract, that's it. It's going to take years because the cataract, unlike the retina, has a has no blood supply actually. It just is fed through diffusion. And so I have had a few people say my cataract got less severe year over year, but I've never had anybody say my cataract went away. And I think that it just takes too long. I think maybe after 20 years, but who's going to wait 20 years to see if your cataract gets better? So yeah, in some cases people's they can decrease the prescription of their eyeglasses. Uh in some cases they don't need their glasses anymore at all. We've heard this hundreds of times. uh anecdotally and so this doesn't surprise me at all. Uh Christie Christ and Christie wanted to give us the ICD10 code for diabetic gastroparesis. There you go. So if anybody wants that to have their doctor order a test, there's the ICD10 code. Did you have that memorized? Let me tell you, let me tell you how many years I I wrote down and typed in the CPT codes. — The other night, Misha's dad came over and his he gets a lot of ear wax. And so I got my stuff out and I cleaned his ear wax out — and as soon as I got done, the number 669210 popped in my head. — That would be an ICD9 then, not a 10, right? — Well, that's a CPT code. Yeah, But that so I could bill. So I would use a 25 modifier and put a 69210. Then I could bill for the seramin disinfection in addition to an office visit. — That's how many years I did that. — That freaked me out with that. I was like, "Oh my god. " Yeah, that's in there still. It's like — we remember that seems like something that would leave so something else could take its place. — But it's like the snap crackle pop rice krispie song. Once you I say that now you're singing it in your head. It's still in there. It's crazy, right? All right. Let's see if I can find some more questions. Ask your questions right now, guys. Yeah, Jamar Rule says he doesn't wear glasses anymore, and I know that he's he's older than his late 30s now. I don't know exactly uh how old he is. Uh yeah, Steadfast. I am writing a book right now called In Search of the Proper Human Diet and I've got about 22 chapters written 800 citations. — Wow. — Uh that are going to be in the work, you know, in the back in the work cited — but because I'm trying to make this as scientifically based as possible. Uh but basically when you combine nutrition and medicine with archaeology, anthropology and paleo anthropology, it becomes very obvious what a proper human diet should consist of and what it should not consist of. It becomes very obvious very quickly. Very interesting. Okay, here's a question. Please explain high cholesterol while consuming carnivore diet. you. Have you got an hour? So, if you're eating a diet and I want you to jump in here. If you're eating a diet that makes your A1C go to normal — and makes your insulin level triglycerides go to normal and makes your HDL cholesterol HSCP — go back to normal. Uh-huh. — I could care less what that diet does to your LDL cholesterol or your total cholesterol or your APOB

— because and here's why. I've got a YouTube video called How Not to Die of a Heart Attach. In that video, I talk about the research that shows very clearly the hazard ratios of having type two diabetes. How dangerous is that? Versus having high LDL cholesterol. And if you just listen to your doctor, you would think, "Oh, LDL cholesterol. That's the by far the most dangerous. " Because that's all my damn doctor wants to talk about. Like I could go in with a bone sticking out and they'd be like, "You need to start taking Crestor right now. " — Yeah. — Have y'all had that experience with your doctor? Like no matter what you go in for, the conversation comes around to you need Crestor Lipur Zore. Has that happened to you? Because I hear that all the time. So do you agree with that? Is that how you practice? What if uh Bart Willoughby came to you and said, "I'm eating carnivore. I've lost all this weight. I feel amazing. I'm off my uh CPAP. I no longer have sleep apnnea. type two diabetes, but my LDL cholesterol went up. " Well, how would you counsel? — So, I we look at the numbers together. That's what we do. We sit down and look at all those markers that have improved and look at our overall risk. And knowing that most risk calculators take LDL not even into account whatsoever. We go get a CAC, how much plaque is there to start with? Because if you don't have much plaque to start with, why do I worry about it right now? And just recheck that in two years. It's arming with data. — Yes. — To go back and feel comfortable — because I think an elevated LDL cholesterol might be a tiny risk factor for heart attack. in the plaque. What the hell is there? — It might be. But I know for a fact that having high blood sugar, high insulin, high E1C, that is a proven huge risk factor for heart attack and stroke. So my analogy is I've got a shotgun and a BB gun. I pump the BB gun 10 times. I'm going to shoot you with one of them. Which one do you want? And most people say, I'll take the BB gun because it's not going to kill me, but the shotgun's going to kill me. So that's how I want you to think of pre-diabetes, type two diabetes versus high LDL cholesterol. I don't think it's a big deal, especially in women because the research in women is even more equivocal than in men. In women, basically, the higher a woman's total cholesterol is, the longer she lives and the less likely she is to develop cancer. That's what the research shows. And so for all you women out there, I do not care if your total cholesterol is high. In fact, huzzah, congratulations that That's just how foolish the research is when you really start to dig into it. Let's see if we've got any more good questions here. Here is golf coach Marv ketoore for two and a half years, but my triglycerides won't go down. Okay. Still around 115. Marv. — Yeah. Okay, honey. friend. Triglycerides of 115 are normal. You You're winning and didn't even know it. Okay, you're what we call in the biz worried well. — Yeah, — you're fine. F triglycerides of 115, that's good. You win. You're normal. Anything under 150 is normal. Now, some people on keto, or carnivore, they'll get it down to 50, 60, 70, 80. But, you know, that doesn't have to be your goal. As long as your triglycerides are under 149, I'm happy. Are you happy? — Mhm. — We're happy, Mark. We're happy for you. My HDL has gone up uh to 44 from 39. — And that's a slowmoving number. — It moves very slowly. Sometimes it can take two or three years. — And anytime you're sick or something like that, it's going to take a hit downwards. You got to work your way back up. — And some people just genetically I'm with you, Marv. I have just a genetically lower — uh HDL, but now mine is up above. I think it was 47 last time I checked it. So 44 is way the heck better than 39. Uh I would just keep checking it every 3 months. Let's see. Your total cholesterol 286, LDL 217, April bead 1466. Quit drinking a year ago, too. Good. Uh your triglycerides are normal, Marv. You win. — Yep. — Go play a round of golf. Quit worrying about it. Okay. Here's Martha. Are these labs dangerous for my liver? doc says they are high and to cut fat because you know fat in your diet that really bad things — uh have been steadily climbing over the past year bun 27 so that's a kidney lab kind of an indirect kidney lab uh your a is high at 43 that's definitely high uh your annion gap is 16. 3 that's barely high then your bun toratinine ratio which is another pseudo kidney marker is 32 I wouldn't worry about that or the bu at all. And your ALT is also high at

51. So yeah, definitely your liver enzymes are high. — So what would you do if Martha came to your clinic and said, "Hey, I've been eating uh did she say she'd been eating? " No, she didn't say she's eating any kind of diet. — So maybe she's just eating a standard American. I don't know. So how what would you how what would your workup be? — So we're going to talk about her diet, but I'm also probably going to get a GGT. Are we have any blockage? the GGGT is assessing for how your bile is moving through your liver. Um maybe get a liver ultrasound. Is there any change to the texture of your liver? Do you have cerosis? Because even if you're eating great right now, it doesn't mean that your body fixed everything from the years before. — Exactly. — We're going to assess alcohol intake. We're going to look — Yes. With that a being high. Yeah. We're going to talk about alcohol. — We're going to assess your um Oh goodness. Do you take Tylenol on a regular basis for your arthritis pain or something like that? How many supplements are there? — Also, ibuprofen. Any of the Tylenol is the one that we always think of, but any of the anti-inflammatories that are over the counter, if you take enough of them, they can elevate your liver enzymes. Ibuprofen, Motrin, a leave, neproxin, all of them, even aspirin if you take too much. Now, another two weird labs that have worked for me in the past, very rarely, but is I always if when I see this and they're like, I'm not drinking. I always check a hepatitis panel — because I've caught a few people that have no symptoms and have chronic hepatitis C, have no symptoms. And then also on HIV, I caught a guy one time that had undiagnosed HIV that was affecting his liver. Uh, and then I would also I usually check I never found anybody with it, but I would always check an RPR because syphilis is the great impersonator. It can be any literally anything whatsoever. — And then I guess an ANA as well as different autoimmune 100%. Yes. but the the GGGT and the liver scan of some type. And then if there's any abnormality on that, maybe a referral to GI for a liver biopsy because especially if you told me, hey, I'm eating real whole food keto, not keto bread and keto cake and keto cookies, but like meat and veg, and your liver enzymes are still elevated like this. That's that'd be worrisome that there's something else going on that we haven't diagnosed. Yeah. the BUN and the BU and creatinine. It's quite common for those to be slightly elevated on people consuming more protein. It's not a dangerous thing. Is your eGFR okay? Is your creatinine okay? — Exactly. So Martha, pull out your lab sheet and look at a lab called EGFR or GFR. Sometimes they'll say GFR calc uh and then also your creatinine. If they're normal, your kidneys are fine. Carry on. Ah, how can I find a carnivore friendly doctor in Dallas, Texas? — So, Texas is on my list to work on right now. I'm working on Arkansas and Illinois. Those are my next two states and Texas is coming right after there. But until then, you can go to the Society of Metabolic Health Practitioners and look at their website and see if there's somebody there. — Yep. And also, I have a YouTube video called How to Find a Low Low Low Low Low Carb Keto Doctor Near You. And some of the databases that I've got listed no longer work, but there's still the Society for Metabolic Health Practitioners, they have a worldwide database. So, even if you don't live in America, you can put in your zip code or your zip zone or whatever you have in other countries and it'll tell you the nearest low carb, keto, carnivore friendly doctor is here. Now, what Nisha and I have been increasingly saying is, "Why do you think you need a carniv a carnivore duck? " — Because I need a full panel. Just kidding. — Well, you need to get licensed in Texas. — I'm working on it. But reality is I only got like 20 more slots until my panels are full. — Right. And so if you So rattle off some of the states that you can think of. She's certiced in 27. — Yes. I know we got Kentucky because that's right near my border. West Virginia, um, mama, — Massachusetts, Iowa, Florida, Idaho, Florida, — uh, Illinois. No, Illinois. I'm working on this is really bad. Kansas. — How put a raised hand symbol in the comments if you think that Amanda Decker should know all the states. — Other stuff that needs some comment. — You have it on your phone, Amanda Decker. — I don't even know. I feel like you should have it on your phone, don't you? — Look, I got it right here. — Oh, okay. — Maybe. — Maybe get it to open. — So, what I would say, Cow Dog, one, I love the handle, by the way, is you just need a doctor to check lab work. Okay? And then if you're on any prescription you can't get off of, you need a doctor to write your refills. You do not need a carnivore doctor or a keto doctor. What you need to do is just find a doctor. It can be literally a dock in the box. You

can go to a wellness clinic at Walgreens and they can order any lab or any test that you're going to need. If you really want a doctor who you can ask questions about the carnivore diet, you can join our PhD community. Now, I won't be your legal doctor, but I am a doctor with 23 years of experience. I'm still board certified and licensed in Tennessee and not in all those states, but in Tennessee. But I can answer your questions about diet and nutrition and I can give you a list of questions to ask your doctor when you go see your doctor. But you know, I don't think you need a carnivore doctor. Okay. — You can ask the Berrybot. — They can you can Yeah, you can literally ask Dr. Barry AI. Okay. Here's the states that she is licensed in currently. Read them out. — Okay. Arizona, Colorado, Connecticut, Delaware, Florida, Idaho, Iowa, Kentucky, Kansas, Maine, Maryland, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Rhode Island, South Dakota, Tennessee, Utah, Vermont, West Virginia, Washington State, and Wyoming. — That's it. And so if you're in any of those states, you go to clearpathmed. net. — Yep. — Not. com. net and you can sign up and she can be your virtual online healthcare provider. How cool is that? All right, guys. That's it. That's the hour. Thanks so much for hanging out. We'll be back next week to do something else educational, fun, and exciting. I'll be back with Nisha, I think, next week, unless — she divorces me, Granny Barry, because you know, — third Monday of the month. — It's the third Monday. Yeah, I may still be back. Anyway, thanks for hanging out. It's not too late to share this. Click the share button right now because we talked about stuff that there's millions of people that really their health would benefit if they knew this, but they don't know because you haven't shared it