Master Your Migraine: Rewiring the Brain & Holistic Healing With Dr. Elena Gross
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Hello, this is Richard Jacobs with the Finding Genius podcast. My guest today is Elena Gross. She's a neuroscientist, founder and CEO. We're going to talk about the topic of migraines and hopefully how to relieve them, maybe prevent them, maybe stop them from happening for sufferers. We'll see. She's the founder of KetoSwiss and MigraCat. I don't know if I pronounced it right. BrainVirtual, we just rebranded to call the brand BrainVirtual because it's easier to pronounce. MigraCat is quite a mouthful. Okay.

Okay, so the founder of Keto Swiss and Brain Ritual. Okay, very good. Well, welcome to the podcast. Thank you so much for being here. Yeah, tell me about your background. Why are you interested in migraines and neuroscience? You know, unfortunately, a lot of people have personal experience with stuff like that, and that's why. So I'm guessing that's what's happening with you. Yeah, so...

Everything I studied almost was due to me personally suffering from these severe headaches. So when I was around 14, I started getting these unilateral, so one-sided, very severe pulsating headaches with light started to hurt, noises hurt, smells hurt as well. So even like really sensitive to any kind of odor and... Smells hurt?

That you'd smell something and it would make your head hurt? Yeah, you smell something and it's very uncomfortable. It makes you nauseated and it almost hurts. It's hard to describe. And also the light is too bright. Any sensory input is basically too intense. It's difficult to say for somebody who has an experience. Maybe think about this being like a thousand bottles of perfume in one room, right? And you're in there. At some point, you're probably getting sick and it's too much, right? So my brain actually...

is you're very hypersensitive because your neurons, a bit like epilepsy, they fire too quickly and too much. So that can mean that just normal benign stimuli like a bright light or a fluorescent light in a hospital or a shop

All of this can be almost painful. Like when I've been in the mall, you know, those fragrance stores, I run by them because they smell so, so strong. It makes me sick. Yes, exactly that. And then if you have migraine, that can even trigger the headache after. All right. So like these fragrances and we can get into that because the fragrance is actually, it's a very interesting thing, but I'm getting ahead of myself. But I just want to add that anything that goes through your nose, in your nose, the

the blood-brain barrier that is usually protecting you quite well from toxins is broken. Otherwise, you wouldn't smell. So for you to smell, molecules actually have to get very close to the neurons so you can fire an extra potential and smell something. But that also means that there's a loophole. So toxins that make it through the air can go directly to your brain. And so that's why perfumes, and I'm going to put this right out here, perfumes are going to be the next smoking. Most people don't know yet.

have 50% of perfumes have toxic substances. And the migraineurs in that sense are the canaries in the coal mine, right? So if you run past these shops, you're doing something good for your brain, for sure. Really? So some of the chemicals in a perfume...

have negative health effects, so people that wear perfume are around it, it makes them sick over time? Yes. And well, potentially, there's always an interaction between your environment and your genetics, right? So if you are a super detoxer genetically, right, you might be able to get rid of that stuff before it accumulates in large quantities. But if you're not, and that's my case, right, if you cannot get rid of these toxins that make it into your brain and body,

as quickly as you gather more, then you're accumulating and then you will get sick. So as most of us don't know, it's better to be on the safe side than getting, I don't know, dementia or some kind of neurodegeneration later on in life. So I would definitely are on the safe side and especially with children, you know, a lot of things like ADHD, you know, autism, all of these neuro diseases, even depression, all of these things

is really increasing over the last couple of decades, right? And one of the things I strongly believe is that toxins are just more and more ubiquitous in these days, this world, right? So the last 50 or so years, we have introduced 80,000 new chemicals into the world. And not- We don't know the effects of them.

for example, and don't exactly know what they do, right? And they're out there. And then in the US, at least, the principle is, right, you first can start selling it usually, right? And only once you have gathered enough data that it's doing harm, then you have to stop selling that. And the big problem is perfumes aren't even regulated. Foods are regulated, but perfumes are not. Odors are not. And in this day and age, we expect everything to kind of last for 24 hours. Your deodorant, your

washing up liquid, your detergent. All these smells are supposed to linger around for a very long time, which means they need to be attached to more molecules that can make it into the brain. And that's like a whole topic in and of itself that we could probably talk about for 30 to 40 minutes and for the whole podcast.

But yeah, just since you asked, I wanted to say be careful on, and that's one of the pillars. One thing we'll talk about migraine, but that's good for general brain health. So a lot of things I talk about from a more personal migraine perspective actually turns out to be pretty good for the brain in general. And that's one of the pillars is definitely also about toxins and oxidative stress. So watching out for toxins in the air, in the water, in the food and so on. But yeah, maybe keeping my background quote since we're already getting into the good stuff.

I started to have this odd migraine headaches. Nobody could diagnose it for at least a year. So that's odd because it's so common. And then I thought, oh, wow, there's a billion people in the world that have migraines. So it's one in seven. Surely we know what it is and what to do about it, right? The

should have been so much research on that topic. But that couldn't be further from the truth. Nobody could really tell me. And I spent two decades literally going from specialist to specialist. I tried all the things on the drug side of things like anti-epileptic drugs and so on, terrible side effects to alternative things like, you know, acupuncture and Chinese herbal medicine and whatever. But nothing really made me better. So I started studying psychology. And when I was halfway through my degree,

I was chronic. Chronic migraine meaning 20 days of migraine a month. Completely in pain. Almost all the time. Overeating medication. I was on anti-epileptic drugs that were so strong that I forgot the name of my best friend over coffee and I nearly burned down the college dorm in Oxford actually. I put on potatoes. You know, they have a lot of water. So it's...

It's incredible. And then I completely forgot that I wanted to have lunch and I went for a run. And I came back and there was smoke everywhere. You know, I almost, these potatoes were charcoal. And that's when I decided, you know, this can't be how I need to, how I have to live my life. You know, I was afraid of failing every exam. I know Oxford is tough as it is, right? But if you're on a drug, it makes you demented. It was just, it was a horrible time. But...

At the end of my degree, I stumbled across something and I think it must have been fate, procrastinating from my second master's thesis. I stumbled across the oldest treatment for epilepsy. And that turns out to be a fasting mimicking diet. Because people found out 150 plus years ago that when you put epileptic patients on a fast, the seizures are reduced drastically. But you can't fast anyone forever, right? So that's when they tried to imitate fasting in a diet. And

And today that concept has been a bit butchered sometimes, but it's generally known as a ketogenic diet because during fasting, the body produces ketone bodies as an alternative energy for the source for the brain. Meeting upon that mechanisms at the time, it

It all sounded so my very relevant. So I was amazed. There was no info back then, really. So I tried like a lot of self-experiments. Finally, when my brain was in ketosis, it was like clouds lifting. I felt like a crystal clear Swiss mountain lake. I'm now living in Switzerland, right? So it was amazing, but it was hard to adhere to. And the rest of my body felt a bit sluggish and off. So long story short, I knew I wanted to do this in my PhD.

Oxford said it's way too risky. So just finishing my bio, I did a master's in neuroscience in Oxford and then I changed to actually Switzerland, Basel in tiny Switzerland out of all places. What do you mean it's too risky? They said it's too risky because there was no data at the time that this would work, right? So in Oxford, you have to produce them. And they were like, oh, there's like, this is so new. There's no data. What if there's no results, right? Then you won't get a PhD or you need to do something else or...

So they said, no, you can't do this here. You need to do your neuroimaging on this certain drug, whatever, in migraine that was planned. And that was a tough decision for me because I had a stipend there. But I turned it down and I think it was the right decision for sure. Because in tiny Basel, Switzerland, they said if you drop Oxford and come here, you can do it as a side project.

And I did, and the data was promising. And in the end, I do have a PhD out of it. We did the first clinical trial in patients using exogenous ketone bodies in Basel, Switzerland, that resulted in a PhD, eventually the first patent. And Wendell Vardes, Roche, and so on weren't interested in doing anything about it. Even though I have zero business background and I didn't know what that even means, I eventually had the courage and found this startup.

did some more research. We had the first pattern. And then eventually, eventually, after several years in finishing the PhD,

We now just launched last June in the U.S. with a medical food. A medical food is something between a supplement and a drug. So it's safe ingredients, but against a disease, in this case migraine. All safe ingredients with research behind it where we address the metabolic shortcomings or the metabolic deficiencies, nutrient deficiencies in migraine. And this is what gave me my brain back because migraine and epilepsy are related.

So what we know was working from ketogenic diets in epilepsy, we kind of have now at least partially replicated in a product to give the brain its energy back. And for me, migraines were warning me from energy deficiency. And I have my life back now. I'm down from like 20 days to one. I was never even imagining that I could do a full time job, but now I'm doing like 150%.

Running a startup, you know, with everything that it entails. That's going cool. I'm super grateful. You know, I already won and now we want to help other patients. We're running a depression trial now because it turns out that neuropsychologic diseases have a lot in common. At least a subgroup has these metabolic energy deficiency issues. So we're now extending to mental diseases and also longevity in the future as well.

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Do you depend on, do you go on a ketogenic diet or will you just answer if I'm exogenous ketones? Yes, initially, yes. And I was traveling quite a bit because in migraine, you see, I had been on a high dose of medication for over a decade and my liver was struggling. So when you're on a strict ketogenic diet, your liver has the prominent ketone body producer, right? The primary ketone body production site.

My liver was struggling and I think it still is. So a strict ketogenic diet was not feeling right long term for me. This is when I turned to exogenous ketone bodies. So what we are using is the human identical version, the D-beta-hydroxybutyrate attached to some minerals that play a role in migraine as well, like magnesium and so on. What does that mean though? Are you supplementing with them on an empty stomach? Is it a meal replacement? Is it an additional... Yeah, great question. Great question. So...

This product is now called Brain Ritual and it basically has over 30 ingredients. One of them is this beta-hydroxybutyrate that makes up about 50% of the formulation. But then we also have all the micronutrients, electrolytes, antioxidants and all this other good stuff, trace minerals that our foods and soils can be deprived of and that play a role in migraine. All in one sachet. So it's a sachet you dissolve in water. And now how you take it depends a bit on how strong

strong your gastrointestinal tract is right so it's a lot of nutrients and minerals so if you're sensitive you shouldn't be drinking it on an empty stomach because that will probably cause diarrhea but then you would take it with or after food if you have a strong stomach and after some like ramping up and getting used to it you can also take it on an empty stomach fasting it also depends on on your your goals and your dietary can you intermittent fast then of course you can take it five

fasted. So with exogenous ketone bodies makes fasting maybe a little bit easier. If you are sensitive and you can't fast because you still have chronic migraines, then maybe don't. You can also sip it throughout the day. It's very stable in water. So you can just mix it in the morning and then have a couple of sips while you get through the day. At current it's orange flavor, but we also have different flavors coming up very soon.

I'd encourage you to do a no-flavor one, because I did a lot of exactos ketones for a while, and the flavor ones are horrifically disgusting. You had to have a large volume of them. So what I would do is I would get this one called Keto Force, which had no flavor. It was even worse. But what? You were...

I put a little bit of lemon juice in it and a little bit of water. So it was the size of a shot, like two ounces. And that I could go goop and get down, even though it was disgusting. And I didn't have to drink eight ounces or 12 ounces. So, you know, you add that to your product mix so people can do that. Yeah. So these products were still racemic. What does that mean? So it has...

molecules that have different functional groups, they're basically handed. So even your hands have the same ingredients, they have the same fingers, right? You can never, in space, you can never align them.

So you can never put your two hands, even if you now are trying, right? You can never put them on top of each other so they have the same orientation. They always have a different orientation in space and that's true for molecules as well. Now in the case of ketone bodies, this is certainly true. And if you want to make them the cheapest way synthetically, you will get 50% of the left, like the left hand and 50% of the right hand of the molecule. In the body,

The most predominant one is the right-handed one. Now, it turns out that this racemic mix tastes much worse than the more human, humanly present right-handed molecule. So I think you might have keto force was tasting quite horrible for sure. I remember that version. Some of those are also very synthetically sweetened and stuff. If you try our versions, I think the flavoring is much better these days. It's not perfect.

perfectly delicious, but it's certainly not like Keto Force or other products where you can't tolerate it. I mean, taste is subjective. Some love it, some don't like it, but it's certainly not as bad as a ketone ester or a very early brew. But what I'm saying is if something doesn't taste good and you have to have a lot of it, you know, you got to try to make it taste as good as possible so people can, they don't throw up. But in something truly horrible, you want to have a minimum amount of liquid as possible. So that's why like...

at both ends of the spectrum. Some people I've seen, like myself, if it's a little bit of liquid, I'd rather that and it's awful rather than a lot of it and it's like, you know. So it's just...

That's true. Now with ours, it's subjective how much flavor you want and how much sweetness. So what you can also do if it's too intense, you can just put it in one liter of water because it's not disgusting, but it may be too intense. And then some people find it more palatable. But going forward, once we're maybe a little more than a small startup and have a bit more funds and sales, we can also put it into capsules and then it's like no flavor at all.

But I don't know, would you would you swallow 10 capsules a day or? That becomes another problem. That's why I'm suggesting, you know, for your product in the future, if you do no flavor, but minimal amount of water again, and maybe like a little bit of lemon juice, it's enough for it's like a disgusting margarita, but you can get it down and it's not as bad, you know? Again, like if you tell me if you gave me the trade off between something that tastes awful, that

That's only two ounces versus something that tastes just bad. Eight ounces, I'd rather do the awful, you know, just to get it out of the way with a chaser or something, you know. And you can totally put it even in like a shot, even the current version, right? You decide how much water. If you want to chug it and you just put very little in, totally up to you. That's an option as well. And it's a good option. Actually, we should put that into our advice for people that really don't like the flavor. We also suggest adding lemon or ginger juice or some tart juices really help and having it cold.

But just putting a shot, downing it is probably a very good idea as well. When should people have it though? Before they eat, after they eat? You know, what if they're going to eat a keto type meal? Okay, but what if they want ice cream and, you know, they're eating sugar, but they have the ketones with it. Wouldn't it be counterproductive? Like when should it be consumed? Yeah, that's a good question. Now with the carbs, the study we did was actually on a normal Western diet and they had carbs alongside it. Whether...

This is the ideal state to do for years. It's a bit unclear. So what we know is that it lowers blood glucose, which raises the question, is it better to have ice cream and no brain ritual or ketone bodies, right?

Or is it better to have ketone bodies and ice cream, even though it's not chronic, natural chronic state, but your blood sugar is still lower than it would without it? And there's one state in nature where this would have happened, right? So you would have high glucose, high insulin and high ketone bodies if we think 10,000 plus years ago when you're starving and

And you're running away from a tiger. So in that instance, you have everything elevated. And that's where you're mentally the sharpest. So I can tell from my own experiments, like if you ever have a race or an exam or something where you need to function on your best cognitive function, right? Then it's actually interesting to combine exogenous ketone bodies with some sources of carbs. We see that also in professional athletes, right?

Trials were not positive anymore. If they would in the race or whatever, they would just use the ketones. You would have to have some sort of carbs as well. So ketones

So ketone bodies burn the best or fat burns the best in the presence of some carbs or glucose. That's just a fact. That's not, I mean, you're not always chronically running away from a tiger, right? Why would that happen? I thought that, you know, like everyone, when they talk about ketones, they always talk about switching from one type of, you know, metabolism to another. And that's wrong. That's wrong because you're not, I mean, it's just, it's just a metaphor, right? Because you are switching from the male. You are...

But you're always doing both at the same time. They never tell you that if you don't have glucose, you're dead. You're always burning glucose and ketone bodies at the same time. Your brain needs 30 to 40% of energy from glucose always if you're starving or not. So the body can make some glucose for that reason, right? You always need both. You will always do both, but you may be switching from, let's say, the main...

caloric or the main ATP production may come from fat rather than from carbohydrates, for example. So you're switching maybe the main source, but you're always doing both at the same time. Always. So that's interesting. You do a lot. Like, how are you not...

doing either or. No, you're always doing both. No, the question is, well, if you're on a standard American diet, you also will most likely, not always, but most of us would still produce a minuscule amount of ketone bodies, even on a high carb diet. So even in that instance, you're doing both, but very limited and maybe not in an adequate way. So

And you are on ketone bodies and glucose at the same time? Absolutely, yes. 100%. What you're really doing is you're just changing the ratio of ketones to glucose at a given time. So have you dialed that back and forth to see what's the optimal? Are there multiple set points? Exactly.

That will give you a different function. Yeah, excellent question. And that you can do with exogenous ketones, right? If you do it with diet, it's very hard to control the ratio because you don't know. So there's so many things that will change endogenous production. If you're stressed, if you haven't slept, if you have a virus, right? Your body will inhibit ketone body production because cortisol goes up. Whenever cortisol or adrenaline go up, then blood glucose goes up, right?

And so there's so many things, or even you might be reacting to dairy or even if it's cheese, right, on a ketogenic diet. There's so many things that may impact how much ketone bodies you are making and actually using. With exogenous ketones, you can change the ratio.

Now, what's the optimal ratio? I would always recommend that. This shouldn't sound like I'm recommending ice cream and ketone bodies together, right? The safest way is to not eat those at the same time. I always recommend a low glycemic index whole foods diet, right? Eat real food whenever you can.

Now, I'm not against that sweet potato or those fruit or if you can tolerate it, right? Everyone's slightly different. So whatever is best for you, but certainly whole foods. Now, with ketone bodies, I think it depends. If you are a perfect carbohydrate burner...

and you've genetically adapted to live on whole food carbs and that's fine maybe you don't get any benefit of a surplus of ketones at all right so your ratio is maybe 95 carbs and 5 ketone bodies anybody does fine with that i mean that's wrong because you will still get some energy from fatty acids so let's ignore that right just in terms of that ratio that's oversimplified i just want to say that some nerds that are listening to the genius podcast might call me out otherwise

But then it depends, like, how much does your brain and your cells actually, how much have they adapted to glucose metabolism? And if you have problems with the glucose transport or maybe fighting the oxidative stress that's produced when you burn glucose or glucose absorption, maybe with insulin, insulin resistance, right? There's so many different pathways where glucose metabolism could be suboptimal. And this can be genetically or acquired.

And then you want to, that energy deficiency that results, you might want to replace with ketone bodies. Now, for some persons, say a mild migraine patient, very infrequent migraines, that might be 7%. For a severe dementia patient that has type 3 diabetes in the brain, you know, insulin resistance, that number might go up to 60% that we need to replace, you know? So I think it's going to be a very, very big continuum on...

depending on genetics and environment of a given person. And maybe someday we'll get there that a person can tweak how much of exogenous ketones they're taking instead of the glucose for the brain. So ideally, these should be taken right before a meal or right after a meal? Like what, any difference post-prandial or pre-prandial? Yeah, so absorption is fine either way. It depends on how...

how robust your GI tract is. Because there's a lot of nutrients and ketone bodies and minerals, they also have a light laxative effect. So if you're very sensitive, don't take it before meal because then you'll get diarrhea. Then just take it after meal or sip it throughout the day. If you have a robust stomach, you're used to nutrients or you've titrated in, if you adapted to these ingredients, then you can also take it faster in the morning, no problem. So I can take it whenever it doesn't mess me up. But the good news is that absorption is really good

irrespective of whether you take it before or after a meal. It doesn't matter. So you can really... You said it brought down your migraines. And I know that, you know, we'll talk about cancer later, but at least for migraines, did you notice that it worked either way? Or like, what was the protocol that worked for you? Yeah. So to be honest, for me, I was very quickly, maybe at the beginning, but I was very quickly adapting to the nutrient load.

So I was not religiously taking it either before or after. I tried to take some in the morning and afternoon, but I wouldn't religiously follow it like always before or after. Sometimes I would put it in my bottle and take it to work, you know, or take it to uni. And then I'd have half of it before and half of it after breakfast.

Sometimes I'm at home on weekends, right? I would maybe sip it throughout the morning or I would chug it before I leave, right? It didn't matter, but I would have to do it in a sense religiously that for me personally, for two and a half years, I had to be in some degree of ketosis every day. Otherwise, the migraine came back full force. So I tried to stop and or go on a high carb diet and stop the exogenous ketone bodies and the micronutrients and so on. And the migraines came back.

like pretty quickly. Now interestingly after two and a half years I do no longer need to take it even though I'm on like a low GI I eat carbs. I occasionally take it to fill up my reserves to retain metabolic flexibility so my body still knows what ketone bodies are and if I'm like stressed or if I need to

perform better or just because I know it's good for me, I still take it, but nowhere religiously. Just what was important for me is that I really needed to take it every day, ideally twice a day to keep the migraines at bay in my case, or to support my brain energy. Now that you have this product though, what feedback are you getting from the users of it? What seems to be the ideal protocol for people? Are there multiple or just one? Yeah, so there is...

The answer is it really depends. Now, it was designed to be taken twice a day, morning and afternoon. Now, some can take it whenever because they're robust, but some really have gastrointestinal issues and those are the ones that take it after the meal or they sip it through the day. And we have some that are either so gastrointestinal sensitive that only take one sachet and they

And they do okay. And we have some that are more like light frequency myoviners that also only take it once a day or they take one sachet half in the morning, half in the afternoon. What seems to be very common is that you need to ramp it up. So we recommend that you do three days with just half a sachet. Then you do two halves morning and afternoon for another three to four days.

then you do one and a half and then when you're fine then then you go to the full tomb sachet so that's something that's also not important for everyone but important for quite a few people to give your body a chance to get used to everything because you have to remember most western people today the last time they've had quiescent bodies in their system is when they were born and maybe during the time they were breastfed if they were breastfed and that at least that was my case and after that

We'll put on a Western diet. We don't make any ketone bodies at all. So the body takes some time to press the transport system, the enzymes, that we can use those molecules again. It's all still there, right? But it's a bit like an IKEA manual for ketone bodies, transporters and enzymes and so on. They're all stuck together if you haven't used them in 30 years or whatever it may be, right? So then you need to slowly unwind.

unglue the pages to finally find the right instructions to, and in this case, like the genetics, right, to basically be able to produce that again in sufficient quantities. So that's the keto adaptation period that you might have heard before. Who should have this and who should not? Sounds like migraine sufferers, so help them. But, you know, are there any people that should not do this for whatever reason? Yeah, that's an excellent question. And nothing works for everyone, right?

So we say one thing that we found in our research is that there may be a subgroup of migraine that we term metabolic migraine. These are the subgroups where the migraine is warning them. Pain is always a warning signal, right? So we need to figure out what is it warning you from. And in some patients, it's warning you from either a lack of micronutrients or antioxidants or an energy deficiency or too much oxidative stress. We call these metabolic migraineurs. And

designed for them. Now, who shouldn't have this? Basically, um,

And this metabolic migraine is what the product is designed for, where a root cause of their migraine is suboptimal energy metabolism or nutrient deficiency, right? Or molecular deficiency, not enough energy in the brain, too much oxidative stress. These are the people that are responders. Now, from our research, this is around 30 to 40 percent of migraine patients. So not everyone, but then even for the ones where

This is not a poor problem. It's just good for you ingredients, right? So you basically do something good for yourself or your brain in any case. But if your migraines are mainly hormonal, so they appear just before your period only, right? And nowhere else, you might be better off seeing a bioidentical hormone specialist, for example. Now, who shouldn't take this product? If you have uncontrolled type 1 diabetes and you're often in very high ketosis due to not having any insulin, this isn't a good idea.

If you have any inborn metabolism diseases, inborn disorders of fat metabolism, for example, not for you either, but that you would know. That's very rare. And if you have severe kidney failure, also not for you because of all the minerals in there. So those are the main contraindications. And then ideally, I mean, a medical food is ideally taken under medical supervision. So I don't know what drugs people are on. Sometimes for thyroid, you have to take it away 30 minutes from thyroid medication, so

So you don't inhibit the absorption. So if you're on medication or you have any other difficulties, it's always better, no matter, even with like supplement, right? It's always better to talk to your doctor if you make any drastic changes or introduce anything that could have an interaction with any of your diseases or your medications that you're taking. What about the liver? So I guess you're saying most people's livers are not used to making ketones at all. What happens when you start taking this stuff? Does it...

I don't know. Does it even further suppress ketone production because the body says we're getting in exogenously, we don't need to make it? Or what happens? That's a great question. So, well, personally, the ingredients in Brain Ritual are designed in such a way that they're human identical and ready to go. So your liver does not need to do much. A lot of supplements or products with nutrients have cheap and

inactive versions of minerals, vitamins, electrolytes, and so on. So your liver still needs to do some work. We try to avoid that. So your liver should be in the clear.

Now, is there a negative feedback loop like with hormones? There is, yes. But you have to get to a really high level. So you have to go to about 5 millimole in the blood for your body to turn on insulin. Secretion and insulin then inhibits endogenous ketone body production. Now, with our products, single dose, you get to around 1, right? So on average, right? And this is also...

It varies a lot on how much you absorb it and how quickly you get into your cells and so on. But let's say on average one millimole, that means nowhere close to inhibiting your own production. Yeah, it's not easy to get above like one, one and a half millimoles with diet.

Or with even the exogenous ketones, like you got to take a lot. Exactly. And by the time you take so much, you will throw up and you get so much diarrhea, you know? I mean, it's almost impossible to overdose. I'm not going to suggest to try, anyone try this, right? So please don't. But yeah, it's very hard to kill yourself with exogenous ketone bodies. It's easier to do that with ibuprofen, to be honest. And so I think that these are quite safe. They have a mechanism of controlling. But

But say if you have an uncontrolled type 1 diabetes, right, where you're not making insulin and your insulin pump is broken and you're already endogenously at 6, 7 or whatever, don't want to put another millimole on top of that. That's why we say if your type 1 diabetes is not under control, maybe don't do it. What do people experience, you know, once they take it in their first few minutes, maybe the first half hour? No. On average, what we found is that it takes about

about two weeks, two to three weeks for migraineurs, for the average migraineur to feel a difference. This is the time you need to build up, as we said, like all this genetic changes, transport system. For people that have been in ketosis before or that have lactate present, right, so they already have the transporters and enzymes, they can

they can already feel the first sachet actually. So we had patients even take it acutely, which it wasn't designed for, that have been in ketosis via diet or otherwise. And they basically, the migraine was gone in like two hours. We've had those. We've had people with headache actually experience a very similar thing, or even with headaches during an infection where they reported a positive response. Now these are anecdotal data, right? We want to say that we

We've had people where it takes a bit longer, but we've had literally chronic migraine patients that have been migraine-free for eight weeks in a row. We've had somebody with migraine and bipolar reporting that bipolar got better as well. We have a depressed person getting off all of her antidepressant medication. These are rare, right? These are just anecdotes of people that are writing us from the extreme cases.

But we also had one diabetic patient that was able to go off all her diabetes medications, probably because of the blood sugar lowering effect and maybe improvements of metabolism. So these are just some side effects that we see or some side anecdotal data on people that...

have something else than migraine, but it's mainly formulated, it is formulated for migraine and that's the only indication that we are selling it for yet. I know it's hard because each indication needs separate clinical trials. So like progression versus migraine versus what about cancer? You know, from ketogenic diet has been spoken about for cancer. Do you

Do you think that this may have a positive impact on it? Yeah, so cancer is always hard to comment on. So when you are on traditional cancer medications, one thing that happens is you're increasing oxidative stress, for sure. So you want to kill the cancer, but you also kind of want to keep your healthy cells alive. So this can be an issue. Now, MycoCat or Brain Ritual, as the product's called now, has a lot of micronutrients in there that can...

definitely probably help the healthy cells battle with this oxidative stress and give them extra nutrients but i'm not sure it may also potentially fuel the cancer a bit on the other hand we have so this is kind of a this is somewhere where you have to be yeah the risk benefit is it's always hard with cancer but on the other side you have blood sugar lowering most cancers that's

Not all, but most cancers cannot metabolize ketone bodies. So you have an alternative energy for your healthy cells while you reduce the glucose that the cancers are primarily relying on. So in that sense, exogenous ketone bodies I know have been used, have been used quite successfully, but not as a single solution. This is more as support, right? To lower blood sugar further, to get ketone body levels up higher, to help with the side effects of maybe radiation or chemotherapy and so

It's depending on the cancer. You have to say that. That's for sure. And you do want to with cancer. It's not like with these neuropsychiatric diseases, it's in part an energy deficiency that we're treating, right? So I don't think everybody has to be on a very strict ketogenic diet. Now with cancer...

we are treating a surplus of energy. So the cancer cell, it need to be, I know starvation is a bit simple, but they need to be, we need to deprive them of glucose. So in cancer, you absolutely need to be on a low carb ketogenic diet. When you have exogenous ketones,

or ketones in general, or exogenous, how does it become competitive with glucose uptake? And if so, how? There must be a way to do it, you know, again, before or after the meal. I don't know. There must be some way to do it where it'd be more competitive than otherwise. There is a competition when it comes to what is burned first, right? In the gut and elsewhere, they have different transport system. But there is absolutely a hierarchy of what is burned first, right? And then whatever...

you have access is put into fat stores. So interestingly, there is research to suggest that ketone bodies are in the brain, the preferred energy source. So the brain will prevent, preferentially burn the ketone bodies first and then more of the glucose. I mean, there's always some parallel, right? But it seems like ketone bodies are preferred for brain and potentially for the heart. Now, in terms of uptake in the gut, it's a good question. I think there's different

Mostly the uptake is different transport system. So you can probably take them up together. But what ketone bodies do, and this is why they're so potent here, is they seem to inhibit gluconeogenesis in the liver. Gluconeogenesis is when we make new glucose, right? So it's turning off our own glucose production, which then lowers glucose levels, even though the same amount is coming in from the outside. So this is good, but...

If you still eat high amount of carbs, it won't be good enough for the cancer. Because the cancer will ferment foods. So they will ferment carbohydrates and they will ferment glucose and they will ferment glutamine as well. What does that mean? A healthy cell makes most of the energy in the so-called mitochondria, which are the powerhouse of the cells, ancient bacteria, right? So there you shuttle your fatty acid, your ketone body or your glucose into that and then you make...

If you're healthy, 36 ATPs out of that. There's an ancient way to also make energy, which is what cancer cells mostly do. And that's called glycolysis, which means we're just splitting up glucose inside of the cell, not the mitochondria, in the cytoplasm. And we have a net positive of around 4 ATP. It's much less energy effective, which is why cancer people also oftentimes lose weight because these cancer cells...

They really eat a lot of glucose so they can eat what they want. They don't get weight, but the cancer cell is growing fast. So if you use ketone bodies, they cannot be burned in the cytoplasm, the hetero, in the mitochondria, which in many cancer cells, that's broken. So the cancer cell will thrive on glucose and glutamine.

the amino acids. So that's why it's, in my opinion, mostly necessary to really cut down on carbohydrates and glucose when you have cancer. And then exogenous may be an additional tool for sure to drop glucose even lower and get more energy for the other healthy cells. Well, for the average person, maybe the best plan, if they don't have cancer, but just for health, is to do this with every meal. Have a little bit of the ketones with every meal. So when the carbs are present,

There's also the ketones present. What's your note on that protocol? Or have it between meals, right? So that you are lowering the glucose and you have a period where you are basically more ketotic and then you have a period where you rely on carbs more. So

So you keep that metabolic flexibility. You have some states where you're burning more carbohydrates and you have some states where you have a degree of ketosis, which I think if you're healthy enough, that's what we were like 10,000 years back, right? We would have enough micronutrients because the water was still mineral water, you know, the spring water. You

You would have all the right nutrients still in your plants and in your fruit, vegetables, whatever, with a different world. And you would naturally have times where you have fruit and roots and whatever available. And then you would have times where you have more meat and fat and maybe some leaves or whatever available in winter. So I think that our ancestors would go out of periods of time

ketosis and carbohydrate metabolism very easily. And that's what metabolic flexibility really is. So as an analogy, we could say 10,000 plus years back, we would all be hybrid cars. We could use electricity and petrol whenever we needed to. We could switch back and forth, whatever was there, right? Today, we're all electric cars. We all rely on glucose only. We

We need to find a plug every like two, three hours. We can't store energy very well and we're super inflexible. And that's, I think, what needs to be changed. We need to bring, in general, we need to even, I think most, not all people, some are perfectly doing

doing perfectly well with glucose metabolism mainly. But I think most of us or many of us should bring back at least some periods of where ketone bodies are present. And this can be done with intermittent fasting. You know, you do this 16-8, maybe have some ketones there, or you could have some ketones in between meals if you're healthy, right? Or you could have some low-carb. Some people do like a low-carb breakfast, right? Have

You have your eggs and bacon, and then you only introduce carbs in the evening or at lunchtime. Or you have a couple of days a week where you have less carbs so that you gain this metabolic flexibility back. For those that are pretty broken, it's really hard to do that. So that's where like the crutch brain ritual comes in, right? Or exogenous ketones in general. Because you need to relearn everything. I wasn't, even like when I was fasting...

I wasn't getting in ketosis forever because my body didn't remember how to make any of this stuff. If you have real trouble fasting, right, I would say don't force yourself. Ease into it. Listen to your body. Maybe add some exogenous ketones at first for your body to re-acclimatize and remember, right? And then it should get easier over time. Well, maybe it's not forgetting. Maybe the metabolic pathways are methylated over or something. Exactly there.

They're not completely forgotten. They're just hidden. And yeah, it's the pages are stuck together. Something you might want to look at is evaluate, get a baseline microbiome on somebody and then have them take this for a while. Because you said like two weeks for some people to get acclimatized.

It could be that what's happening is it takes two weeks for certain bacteria to appear in the gut. Because of the ketones, and maybe there's a short-chain fatty acid or some metabolite they're producing that allows this to work. So you might want to look at what's happening to the microbiome as you've been on this for a while. Super interesting, because actually there's some research in epilepsy that suggests that the success of a ketogenic diet in epilepsy is to a very large extent

extent dependent on changes on the microbiome. So it's really one of the key drivers of the effect is that the microbiome adapts. And what is interesting is that beta-hydroxybutyrate, the main ingredient of brain ritual, their ketone body, is very close to butyrate. Butyrate is that short-chain fatty acids that a healthy gut bacteria produces for the brain and that also the endothelial cells of the gut lining and also needs to function well. They need that as an energy source, right?

So in that sense, it may very well be that there's very positive effects on the microbiome that we haven't studied personally, but that I know are taking place in children with epilepsy on a ketogenic diet, for example, and I think also in other patient populations that have been studied. So this may very well be part of the effect.

And the microbiome potential, because the microbiome is a factory, it's good, right? It's a factory for bioactive vitamins, short-chain fatty acids, so for nutrients for the brain. So a lot of nutrients that the brain needs are actually made in the gut.

Is ketone metabolism understood? You know, what are the, you know, the products that it breaks down into? Like the, you know, all the steps of it. I mean, oxidative phosphorylation fermentation seemed to be understood, but again, what about ketone metabolism? Maybe there it would point to, oh, look, there

There's this molecule that cleaves it and makes the butyrate. So it like dovetails into that normal path of what the brain needs. Is it fully understood? I mean, we do know, I think one pathway is how it's like turned into this coenzyme A and then that's not my speciality and then burn the Krebs cycle, right? The C's are taking off and then in the end it's CO2 and water. But there may be a pathway exactly as you say, right, where it's like maybe

Maybe the hydroxy group is taken off somewhere and it's turning to butyrate. Who knows? Could be true. I mean, maybe somebody knows. If anybody listening does, I would be interested to hear that as well.

Well, I'm sure I don't know, but that doesn't mean it doesn't, it's not possible. Or we as humans don't know, or as the field. So it's a good point. And it's really just a field that has gained interest in the last 10 or so years, right? Dominic D'Agostino was one of the first ones. He was my external PhD supervisor in 2004. I've interviewed Dom. He's a great character. Oh, you know Dom? Yeah, I met him at a metabolic health summit and I've interviewed him a few times. Hey, I was a speaker there.

a couple of years back and I was there from the first one. First one. Still packing boxes, you know. I was in the back helping. I know Angela Poff quite well. Yep. I met all of them. How cool. Yeah, and Patrick Arnold, right? He was the one who gave me the first exogenous ketone buddies. Keto Kana at the time. Yeah, that's right. That's why I asked Dom to try Keto Force. Because I said, is there one with no flavor? He's like, you're not going to like it, but try it. Yes. Oh, God. Yeah, Keto Force was...

At the time, the worst in terms of flavor. Keto Kano was easier to ingest, even not delicious. Oh, great. You know Dom, Angela, Metabolic. Yeah, I will definitely... Last one was the only one I missed because it was sick. But most likely... Yeah, I met Thomas Seyfried there and a whole bunch of peoples. Oh, would you like that kind of thing? I'm not sure that's a place. You should come to Keto Life in Switzerland. It's the most beautiful keto and metabolism conference that...

you'll ever be at in St. Moritz. I'm sure you'd love it. I mean, it's worth far travel. That does sound great though. Yeah. I'll ask you about that offline. That's excellent. Yeah. For right now, we're out of time, but it's great talking to you. So where can people get these products? You know, let's point them to where they can go shop. They need help. Yeah. So the products are available at brainritual.com. Fairly easy. But then also Instagram.

If you want to just learn more about metabolism and migraine, migraine metabolism, what oxidative stress is, what you can do, I developed like a four-pillar model on how to improve metabolism and migraine with or without. I mean, the spring ritual feeds into these four pillars, but complete free information. I made a YouTube course. There's a paper on how to do that in lay people's language. So hopefully easy to understand. You can find all of this at drelenagrowes.com.

So my name dot com. And yeah, there's a lot of free information. And also I'm on Instagram and all the social medias with lots of information completely free. So either the brain ritual or that will give you some information. Well, very good. Well, it's been great to talk to you. And thank you so much for coming on. I appreciate it. It was great to talk to you, too. Thank you so much. It was a pleasure. If you like this podcast, please click the link in the description to subscribe and review us on iTunes.

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