By playing, you agree to uListen's Terms and Privacy Policy and YouTube's Terms of Service.
Peter Attia MD#05 - Dom D’Agostino, Ph.D.: ketosis, n=1, exogenous ketones, HBOT, seizures, and cancer
Summaries, chapters, transcripts, and FAQs on this page are made by uListen, not YouTube.
At a glance
WHAT IT’S REALLY ABOUT
Dom D'Agostino explains ketosis, exogenous ketones, hyperbaric oxygen, seizures and cancer metabolism
- D'Agostino describes how building a hyperbaric microscope for Navy-funded oxygen toxicity seizure research led him to see cancer cells die under hyperbaric oxygen and to notice that beta-hydroxybutyrate slowed their growth in culture.
- The conversation covers ketone physiology in detail, from Cahill's 40-day fasting studies and brain fuel partitioning to how MCTs, ketone salts, and ketone esters raise blood ketones and why racemic versus pure D forms matter.
- D'Agostino reports that the ketone ester he works with, which raises BHB and acetoacetate roughly one-to-one, had anti-seizure effects in his animal models, while elevating BHB alone did not, and that exogenous ketones lower blood glucose.
- D'Agostino lays out a 'press-pulse' cancer framework, using a glucose ketone index of one to two as the continuous press and tools like hyperbaric oxygen, IV vitamin C, and glycolytic inhibitors as intermittent pulses, with repeated disclaimers that this is not medical advice.
- He closes by saying his thinking has shifted from ketones as an alternative fuel toward ketones as epigenetic signaling molecules acting through HDAC inhibition, citing a Kabuki syndrome mouse model.
IDEAS WORTH REMEMBERING
5 ideasCancer cells are vulnerable to excess oxidative stress.
D'Agostino saw glioblastoma cells produce far more superoxide under hyperbaric oxygen and die, which he explains as pushing cells that rely on elevated reactive oxygen species past their antioxidant capacity.
Ketones can serve as the brain's main fuel during fasting.
In Cahill's 40-day fasts, after about ten days BHB supplied roughly 60% of brain energy and acetoacetate about 10%, with glucose providing around a third.
MCTs are a cheaper, food-based route to ketones.
D'Agostino calls MCTs the 'poor man's ketone ester': they go straight to the liver via the portal circulation and are rapidly oxidized, and he built his tolerance up to about 150 ml a day.
The form of ketone matters for seizure effects.
D'Agostino says pure BHB did not show anti-seizure effects in his models, whereas a ketone ester delivering BHB and acetoacetate about one-to-one did, which is why he considers acetoacetate necessary.
Keto-adapted people clear ketones quickly.
He proposes a 'ketone tolerance test' analogous to a glucose tolerance test, noting that fat-adapted athletes dispose of ketones fast while less fit people can spike to five or six millimolar from one dose.
WORDS WORTH SAVING
5 quotesMCTs are kind of like the poor man's ketone ester, right? So they are, they're, they're found in nature, they're versatile, you can incorporate them into food.
— Dom D’Agostino
I think mitochondrial health and mitochondrial vitality would be the ultimate tumor suppressor.
— Dom D’Agostino
I would say the ketogenic potency is inversely proportional to taste.
— Dom D’Agostino
The therapy that I'm describing, if the patient goes into it, they're gonna come out of it stronger than they were going into it.
— Dom D’Agostino
Every day I feel like I'm getting dumber because the rate at which I'm being exposed to new information is exceeding the rate at which I'm assimilating it.
— Peter Attia
High quality AI-generated summary created from speaker-labeled transcript.
