Welcome to the qualys a subscriber exclusive podcast of qualities is just a shorthand slang for a qualification round, which is something you do prior to the race just a little bit quicker qualities podcast features episodes that are short and we're hoping for less than ten minutes each which highlight the best questions topics tactics Etc discussed on previous episodes of the drive. We recognize many of you as new listeners to the podcast may not have the time to go back and listen to every episode and those of you have already listened may have forgotten. So the new episodes of the qualities are going to be released Tuesday through Friday and they're going to be published exclusively on our private subscriber only podcast feed now occasionally, we're going to release quality episodes in the main feed, which is what you're about to hear. Now if you enjoy these episodes and if you're interested in hearing more as well as receiving all of the other subscriber exclusive content, which is growing by the month, you can visit us at Peter tmz.com forward slash subscribe.
That further delay. I hope you enjoy today's quali.
I think the floor is kind of is interesting as well because for me, it's really do you find that protein catabolism is functionally affected when you do a longer term fast. I mean again, I'm
not doing granular enough measurements to know right? So it's very crude. What am I doing? I'll take a picture of myself every day in the mirror to sort of very grossly assess muscle mass measuring blood urea nitrogen and all the nonsense we can measure but I can't really measure protein catabolism.
Right? Would you want to sure?
Yeah, I would love to do a seven-day fast in an environment where I could have a muscle biopsy and a fat biopsy every single day complete metabolomic complete proteomics. I mean complete sequencing of everything imaginable. I mean I would kill to do that and amazingly I would do it in a heartbeat. It's not trivial to get an Institutional review board to approve that just getting
RV to do that is not the easiest thing in the world, but I don't know and maybe when I'm done with the book and I have a little bit more free time, maybe I'll go back to visiting that but but that's been a high priority of mine for probably three years, which is because also I want to sort of look at signatures of vltava G and other things like that. I think that fasting is just such a powerful tool that it kind of I think of it is one of the most powerful drugs we have in the entire toolbox of medicine and yet I'm frustrated that I don't know the dose of the drug to give this is one of those drugs where there's a sort of hormesis and maybe different doses work in different settings. It's like imagine you're some doctor walking around in your white coat with your little black bag and your stethoscope and someone hands you a bottle of pills and says, this is the single most valuable drug you have and you're like, oh God, thank you. How much do I give don't know? What's the dose? I don't know which patients do I give it to anyone can take it? Yeah, but that's how impotent I feel with this tool.
All and as interesting as it is to talk about this drug and that drug and all of these really amazing cool things like right in the middle of our face is this awesome thing that we don't really understand enough about
yeah, and I think that really prevents doctors because we are so we want to be quantitative. I think for example, do you deal with a lot of autoimmunity know? So yeah, so I think there's a huge amount of anecdotal literature out there and I think there's some randomized trials now that are experimenting with it, but both with kind of an anti-inflammatory diet that you're just doing a strict Elimination Diet or fasting I think most autoimmune conditions at least the ones that are relapsing-remitting. So you're not having like
irreversible not lupus every day that you're alive.
Right? Right. I have really good responses to fasting. I put most of my patients on some form of fast and then time restricted feeding versus fasting. When do you consider a fast start and going to bed hungry?
You're no I don't use the term intermittent fasting for anything that's in the time restricted domain. So I consider a fast doesn't really begin until 36 hours 48 hours in that room. So yet one meal a day is still in my mind just time restricted feeding but not intermittent fasting right greed and I agree with you just to empirically I've seen I always feel like the inflammation dissipate from my body when I'm
fasting and do you measure cortisol levels during a
fast I have I don't really get much value out of spot cortisol levels in the blood. It's not that helpful. But I've done urinary cortisol collections during the fast and I actually did it once I did not see a big increase. I didn't see much of a change which surprised me because in this is way TMI, I think I even mentioned this once on social media, but if there's really one thing about fasting that sucks, it's my body odor becomes unbearable and it's not the acetone in my breath and if you don't like it is literally perspiration. It just it's not like I'm perspiring much but it stinks and I can't figure it out because I'm
Like kind of a lucky person like I don't really have body odor. I don't even wear deodorant most of the time but when I'm fasting I have to wear deodorant and I even noticed by the end of the day like goodness what's going on and I've never understood is that a cortisol thing like what other sort of endocrine issues or changing during a fast that lead to that?
Yeah by the way listeners. You're welcome for me doing the the table switch. Dr. Peter
idea. I hope you enjoyed today's quali now sit tight for that legal disclaimer. This podcast is for General informational purposes only and does not constitute the practice of medicine nursing or other professional health care services, including the givings of medical advice and note no doctor-patient relationship is formed the use of this information and the materials link to the podcast is at the users own risk. The content of this podcast is not intended to be a substitute for professional medical advice diagnosis or treatment users should not disregard or delay in obtaining medical advice for any
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