Dr. Al Danenberg ● Nutritional Periodontist

January 20, 2020

The Carnivore Diet has been a huge and beneficial dietary change for me. I was on a Paleo-type diet for the last 6 years, and a more stringent autoimmune Paleo-type diet since I was diagnosed with bone marrow cancer in 2018. I assumed I was “fat adapted” for a long time following these eating programs. Probably that’s why I didn’t have the potential “side effects”, which I knew could be a problem with the transition to a Carnivore Diet. One initial change I noticed was more frequent urination after I went to bed. Getting up to pee every hour or two while in a peaceful slumber is not my idea of restorative sleep. Not a big deal after all, and it didn’t last for long. Another change I noticed was softer but well-formed bowel movements. (Am I getting too descriptive here?).

My research has taken me a long way from where I was before I discovered the Carnivore Diet. For example, I learned that the necessary nutrients required to thrive are “predigested” by animals and reside in their muscle, fat, and organ tissues for us to consume. And these nutrients are free of the “antinutrients” associated with raw plants. In addition, I discovered that fiber was not a critical factor for healthy gut bacteria. Along with fermentable fiber, the gut microbiome can metabolize amino acids to manufacture the necessary short chain fatty acids (SCFAs) that are vital for healthy gut function. This table identifies the SCFAs created by the gut microbiome through the fermentation of specific amino acids in the gut.

My Ketosis

While on my previous Paleo-type eating program, I didn’t know if I ever entered a state of ketosis since I never tested for that. Ketosis was not my goal until now on the Carnivore Diet. I want to be in ketosis because this may help deprive cancer cells of glucose, which is a major source for the malignant cell’s energy production.

After 6 days from starting the Carnivore Diet, my urine ketone strips showed that I was in ketosis. To my dismay, I wasn’t in ketosis two days later – and didn’t know why. As I later learned, the “fat to protein” ratio that I was consuming was a major factor, and I was out of sync with the correct ratio. I also questioned if my malignancy and my other unconventional daily cancer protocols could have something to do with staying in ketosis. So, I did some research.

I contacted a couple of MDs whom I considered experts on the Carnivore Diet. Ultimately, I found the major cause of my problem with staying in ketosis. I was eating too much protein and not enough fat. My body was making glucose from excess protein (gluconeogenesis).

In fact, the body can operate on two sources of energy – those derived from fats and those coming from carbohydrates. However, the body has a tough time fueling itself from protein only. Therefore, I must ensure I have enough quality fat to maintain a state of ketosis. The ideal fat-to-protein macronutrient ratio for the average individual on a Carnivore Diet is about a 2:1 ratio in terms of calories. However, since 1 gram of fat is equal to 9 calories and 1 gram of protein is equal to 4 calories, the same ratio could be expressed as a 1:1 ratio in terms of grams. Because of my malignancy, my goal is to maintain at least a ratio of 2:1 in terms of grams to arrive at a blood ketone level high enough to potentially starve my malignant plasma cells.

In order to arrive at this ratio, I tweaked my eating. I included two tablespoons of MCT oil in my coffee in the morning along with my heavy cream. Also, I reduced the grams of protein I ate during the course of the day. After 2 days, I was in ketosis again – confirmed with the urine keto strips as well as the Keto-Mojo Blood Ketone and Glucose Meter. Based on the stage of my multiple myeloma and the importance of maintaining muscle mass, my research suggested that I should be eating about 80-100 grams of protein daily. That would require I eat at least 160-200 grams of fat a day. This level of protein and fat would equal about 1760-2200 calories. I’ll continue using Keto-Mojo Meter so that I can begin calculating my personal Glucose Ketone Index.

Here is another important fact especially for cancer patients. Stress and prescription steroids will increase insulin resistance and gluconeogenesis resulting in a significant spike in blood glucose levels. Many cancer patients are under stress and are taking dexamethasone or prednisone along with their conventional chemotherapy treatment. This spike could last for several days after taking the corticosteroids or reducing personal stress levels. The introduction of steroids in the bloodstream could also take an individual out of ketosis. Dexamethasone is a long-acting glucocorticoid with a half-life of 36 to 72 hours and is 6 times more potent than prednisone. Prednisone is shorter acting, with a half-life of 18 to 36 hours. The effects of these meds are easy to understand, but your stress levels are far more difficult to get under control. Be aware if you are dealing with emotional stress or are prescribed steroid medications.[1],[2]

Glucose Ketone Index (GKI)

The GKI is a tool that can help monitor the relationship of the major fermentable tumor fuel (glucose) to the non-fermentable fuel (ketone bodies). Drs. Joshua Meidenbauer, Purna Mukherjee, and Thomas Seyfried have suggested the GKI goal for cancer patients is between 1-2.[3] This represents a high blood ketone level. The ideal time for me to test my blood glucose and ketone levels is about 2-3 hours after eating.

The GKI formula is simply: Glucose Level ÷ 18 ÷ Ketone Level = Glucose Ketone Index

> 9 GKI means your body hasn’t transitioned into a fat-burning state.

6-9 GKI demonstrates a low level of ketosis. This is appropriate for those who want to lose weight or maintain optimal health.

3-6 GKI demonstrates moderate levels of ketosis. This is appropriate for addressing many common metabolic diseases, including insulin resistance, type 2 diabetes, or obesity.

1-2 GKI is a high level of ketosis and appropriate for cancer patients.

Food Shopping

Shopping for my new eating program has been a breeze. Everything I need is located in isolated peripheral areas of my healthy grocery stores or from my local farmers’ market. When it comes to cost, properly raised animal products are more expensive than other foods. Yet I don’t need to buy any plant foods or processed foods. That makes a difference at the checkout register. And I have less grocery bags to carry.

As for organ meats, I continue to enjoy my homemade bone broth, chicken liver, oxtails and occasionally sweetbreads when they are available. But to assure I get my daily intake of essential nutrients, I take capsules of freeze-dried Bone Marrow[4] as well as Organ Complex[5] – both supplements are sourced from grass-feed cattle in New Zealand and are available from Enviromedica. The Organ Complex consists of desiccated heart, liver, kidney, and pancreas.

Overall Health Benefits

The Carnivore Diet provides a noteworthy benefit for the gut, the mouth, and the overall health of the body. Since there are no refined carbohydrates or sugars, this diet encourages a healthy mouth without tooth decay or periodontal disease.

The first beneficial effect of no carbs is the creation of a healthy balance of gut bacteria. The healthy gut bacteria are capable of creating important short chain fatty acids from available amino acids instead of plant fiber. A healthy gut encourages a healthy immune system with no chronic systemic inflammation. The mouth responds by maintaining a healthy balance of its own garden of bacteria with no competition from processed carbohydrates.

Bottom line – potentially excellent medical and dental visits. Maybe the Carnivore Diet could represent the best medical and dental insurance you could purchase. It’s worth looking into.

My Cancer Biomarkers

My cancer biomarkers have been improving significantly. But I can’t attribute these results to the Carnivore Diet. These biomarkers were improving dramatically after I started the human-derived immunotherapy infusions on November 12, 2019. However, I confidently can say that my increased energy level and fat loss, without any muscle-mass loss, are directly related to the Carnivore Diet. In addition, I have read several case reports of cancer patients who have experienced remission and healing of their cancers directly related to the Carnivore Diet. Those published results have encouraged me to continue with this way of eating.

Updated Personal Carnivore Diet

Intermittent fasting, which is part of my current diet – easier to do on an Animal-Based Diet because proteins and fats are more satiating

Pastured animal meats, their healthy fats, and organs (including skin, cartilage and collagenous parts)

Wild caught seafood – especially sardines with bone-in and skin-on, salmon, shrimp, mussels, and salmon roe

Butter and tallow from grass-fed and pastured cattle (both provide additional fat to improve my fat-to-protein ratio)

Triple-cream cheeses (examples: triple-cream brie and St. Nuage to provide high fat-to-protein ratio of 4:1 with no carbs)

Pastured chicken eggs

Homemade bone broth

Spices, sea salt, and herbs for flavor

Filtered water or natural spring water for drinking

Two cups of organic coffee with raw heavy cream and organic MCT oil in the morning (cream and MCT oil provide additional fat to improve my fat-to-protein ratio)

Freeze-dried Bone Marrow and Organ Complex – (supplements from Enviromedica)

1 teaspoon of Himalayan salt (for sodium and trace minerals) and 1/4 teaspoon of kelp granules (for iodine) added to a glass of water in the morning

Maintain ketosis and monitor GKI – (ideal GKI for cancer is between 1-2)

Where from Here?

I will continue the Carnivore Diet indefinitely and strive for a GKI between 1-2. As I said, I’ve learned that 2-3 hours after a meal is the ideal time to measure my glucose and ketone levels, which I will record at least 3-4 times a week.

My infusions of Darzalex (immunotherapy to specifically kill malignant plasma cells) require approximately 20 individual appointments at the Cancer Clinic. I have had 9 infusions so far, and I will continue until treatment is completed. I also will continue my monthly subcutaneous injections of XGEVA (targeted monoclonal antibody) to assist the strengthening of my skeleton.

I’m not waiting for double-blind human studies to be published by medical researchers who ultimately may tell me the Carnivore Diet is the ideal diet for cancer patients. If that day ever came, it would be at least 5-10 years from now. Individuals who have my prognosis have a lifespan measured in months – not years.

Let’s be serious! Waiting for science to prove what I am doing right now might never happen while I’m alive. In essence, I’m my own study of N=1, and I am more than OK with that. My attitude is excellent, and my goal always has been to maintain a quality of life for all of my remaining time on earth. I actively am making lasting memories for me, my wife, and my immediate family.

“Someone said that God gave us memories so that we might have roses in December.”

James Matthew Barrie,

author of Peter Pan

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112077/

[2] https://www.ncbi.nlm.nih.gov/pubmed/31025151

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367849/?report=classic

[4] https://shop.enviromedica.com/pastured-bone-marrow

[5] https://shop.enviromedica.com/pastured-organ-complex