The Keto Diet Podcast Ep. #055: Unknown Issues Keeping Us Sick

Unknown Issues Keeping Us Sick #healthfulpursuit #fatfueled #lowcarb #keto #ketogenic #lowcarbpaleo #theketodiet

Interview with Ali Miller, chatting about how to identify unknown health imbalances and heal your body, hormone imbalances on keto, why constant dieting isn’t good for you, and so much more.

Last week on The Keto Diet Podcast, we chatted with Dr. Anthony Jay about estrogenics and how they contribute to a lot of common health imbalances. I know that finding a way to mitigate exposure to estrogenics can be very overwhelming for most people, so instead of merely focusing on the bad, I’d like to also empower you to use the tools currently at your disposal to do the most good with what you have. Chances are, if you’ve landed here, you have some knowledge of ketogenic eating and how food can be a healing force; in some cases, food can quite literally be thy medicine.

How you use this medicine is up to you, of course, but I like to make sure that people have access to a variety of content and quality information in order to make decisions that feel good in their body and promote healing unique to their own experience. That’s why I am so happy to have Ali Miller on the show today — she’s totally brilliant and I love that she wants everyone to educate themselves so that they can make choices that will steer them towards better health.

It can be really hard to make those healing choices when you don’t know where to start; in so many cases, the cause of health imbalances is often misdiagnosed. We’ve talked about this a few times, especially in regard to excess weight — so many of you have reached out to me personally, frustrated, because you’re doing everything “right,” but the scale won’t budge. You can have the best intentions and all the discipline in the world, but if you’re overlooking the true cause of your health imbalances, better health will always be just out of reach.

In today’s podcast, our guest Ali Miller, an integrative functional medicine practitioner who has made it her mission to help people educate themselves about health imbalances and the role that nutrition can play in healing your body and restoring your health, and I chat about how to identify health imbalances and the steps you can take to heal your body.

This episode is all about how to identify the true cause of health imbalances, how keto affects hormones, and why you need to ditch the diet mindset in favor of a more healing approach.

Let’s get to the interview!

For podcast transcript, scroll down.

SHOW NOTES + LINKS

TIMESTAMPS

  • Unknown health imbalances that cause PROBLEMS but aren’t resolved by common medicine (17:11)
  • Why your hormones get WORSE on keto before they get better (24:34)
  • How your perfume is making you FAT (29:29)
  • The effect of constant dieting (35:58)

PARTNERS OF THE KETO DIET PODCAST

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TRANSCRIPT FOR THIS EPISODE

Leanne Vogel: You’re listening to Episode Number 55 of The Keto Diet Podcast. Today, we’re chatting about the unknown health imbalances that cause problems but aren’t resolved by common medicine, why your hormones get worse on keto before they get better, how your perfume is making you fat, or at least having you hit a weight plateau over and over every day, the effect of constant dieting, and more, so stay tuned.

Hey, I’m Leanne from HealthfulPursuit.com and this is The Keto Diet Podcast, where we’re busting through the restrictive mentality of a traditional ketogenic diet to uncover the life you crave. I’ve spent the last four months completely redoing my best-selling ketogenic program, The Keto Bundle. The Keto Bundle combines my two digital programs, The Keto Beginning and Fat Fueled, to provide you with clear step-by-step, how-to on successfully adapting to a ketogenic diet, avoiding common ketogenic struggles and healing your body fully and completely with a ketogenic diet.

And now it’s even bigger and richer with 65 additional pages, beautifully designed graphics, fully re-edited text, and a whole new easy-to-use format. Some of the updates include:

  • Boosted content for supporting beginners on overcoming challenges, while adapting, including how to cut out grains, reduce carbohydrates and ditching sugar for good
  • Guides on how to take action for gradual change when you’re not motivated
  • Support for adapting to keto when there are digestive issues
  • Expanded chapter on healing your imbalances with keto from autoimmunity, adrenal dysfunction, neurological health, hormones, thyroid, candida and so much more.
  • A six-week and seven-day practice to body positivity and intuitive eating practices, made to help you connect to your body
  • Metric and standard weights for all meal plans, shopping lists and recipe ingredients, as well as facts and outlines on current events affecting the ketogenic community
  • And so much more!

Head to HealthfulPursuit.com/bundle to get The Keto Bundle for 10% off with the coupon code PODCAST at checkout. This offer is only available to podcast listeners and will expire on October 31st. Again, that’s HealthfulPursuit.com/bundle and the coupon code PODCAST for 10% off.

Hey, guys. Happy Sunday. The show notes and full transcript for today’s episode can be found at HealthfulPursuit.com/podcast/e55. In those show notes, we will have links to the supplements that we chatted about and additional episodes you can listen to if you enjoy today’s podcast. The transcript is added to the post about three to five days following the initial air date of this episode. Again, the show notes are at HealthfulPursuit.com/podcast/e55, and let’s hear from one of our awesome partners.

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If you have an idea of a podcast episode or you want to submit praise over and above the review, which you can leave by going to HealthfulPursuit.com/review, you can reach me at info@ketodietpodcast.com. Those reviews are like gold to our podcast. Any time you submit a review, more people will find the show, more people will be benefited from keto, and everyone wins.

We have one announcement today, and that is that I recently relaunched my program, The Keto Bundle, and it’s better than ever. I spent the entire summer and a lot of the fall redoing, completely rewriting my two bestselling programs, The Keto Beginning and Fat Fueled. They’re completely redesigned, a bunch of new content completely rewritten, and I’m really excited to share it with you.

As you heard in the intro for today’s podcast, I am offering you all 10% off The Keto Bundle from now through to October 31st, 2017 with the coupon code PODCAST at HealthfulPursuit.com/bundle. When you go to HealthfulPursuit.com/bundle and you enter in that 10% coupon code, you’re going to receive The Keto Beginning and Fat Fueled, two of my programs bundled together to give you a total saving of over 30%, so that’s a complete win.

Today’s podcast guest, her name is Ali Miller. She’s an integrative functional medicine practitioner with a background in naturopathic medicine. She is a registered and licensed dietitian, certified diabetes educator, certified weight management specialist, recognized leader, speaker, educator, and advocate in her field while maintaining a full-time clinic, Naturally Nourished.

Ali has a passion to create awareness regarding the significant role diet plays in our overall health and believes everything we put in our body can contribute toward optimal health. Her Food-As-Medicine philosophy is supported by up-to-date scientific research for a functional millions through media with weekly television segments, corporate outreach and within the medical community.

Ali is just the coolest human, I can’t wait to share her work with you. Definitely head on over to her website, alimillerrd.com. She is so wonderful at explaining things on a level that we can all understand and also encouraging us to listen to our bodies and just be kinder humans to ourselves. Without further ado, let’s cut over to the interview.

Hey, Ali. What’s up?

Ali Miller: Hey, Leanne. I am pumped to be here. Thanks for having me on.

Leanne Vogel: I’m so stoked to have you here. We met at KetoCon couple of … Oh my gosh, was that a couple of months ago already? I don’t even know. It was a while ago. You were cool, really knowledgeable, and I wanted to have you on the podcast, and here you are.

Ali Miller: Here I am, manifestation.

Leanne Vogel: I love it. For listeners that may not be familiar with your work, why don’t you start off by telling us a little bit about what you do.

Ali Miller: Sure, sure. I am a registered dietitian that uses real food and food as medicine, and my background is in functional integrative medicine. I went to a Naturopathic College of Medicine, Bastyr University, and I determined from a mentor when I was going through the process of becoming a recovering vegan and all of the fun stuff that many of us have done, I determined that I wanted to go the RD route instead of the ND route so I could kind of put one foot on each bank of the river. I practice more integrative functional medicine, but I’m able to speak to the conventional allopathic field and world as well.

Leanne Vogel: I love that. Would you say with your work that because you’re seeing both sides that you can really be a detective in what bodies are saying and what things mean?

Ali Miller: Yeah, that’s one of my favorite ways of describing what I do is that I’m a detective of the body, and really, what I mean by that … Well, first off, I guess, functional integrative, medicine for those that aren’t familiar, I like to describe it as like an iceberg. Above the surface is where your doctor diagnoses your diabetes, your cancer, your rheumatoid arthritis, whatever the disease diagnostic is, but under the surface is the root cause of all the chronic conditions, and so underlying mechanisms of things like hormonal imbalance or toxicity or micro-nutritional deficiencies or inflammatory processes. These are what drive the condition, and then be as the detective of the body, what I get to do, which is so fun, with each individual client is to determine what is their Achilles’ heel? What was the chicken and egg relationship or the antecedent or triggering event that drove the dysfunction?

Even if we’re looking at inflammation, someone can present with inflammation because of leaky gut, but where did the leaky gut come from? It could’ve even stemmed all the way back from cortisol and HPA axis like adrenal imbalance, and cortisol maybe, in the beginning, was high, and so this person had a lot of anti-inflammatory hit, but then over time, like the fly on the wall, as they progress into adrenal fatigue, their cortisol drops down, and they don’t have any of that natural anti-inflammatory hormone, and now they’re dealing with chronic inflammation. We may be able to do a gut-restoration protocol, but until we heal and address the adrenals, we’re not doing that person’s body the root-cause treatment modality.

Leanne Vogel: Which is so exciting and so cool. Right?

Ali Miller: Well, yeah, because even in natural medicine, I think any medicine can get sexy, and so it’s like, I can’t tell you how many clients come to me that are like, “I’m doing a gut protocol. I’m doing a gut protocol,” and that’s great, again, but it’s like it’s just an algorithm if it’s just an algorithm, and so we have to make things individualized and speak to each individual’s level of dysfunction and their driving causes of dysfunction beyond just regulating the dysfunction itself.

Leanne Vogel: Yeah, and that work is so necessary, like massively necessary, as I’m sure you know, but I think oftentimes, we just look, and the analogy of the iceberg is so perfect, we just look at what’s on top of the water, and we rarely go deeper into what caused this problem. Looking at the entire iceberg, where does keto fall into that?

Ali Miller: I pair the ketogenic diet … I’ve been practicing ketosis therapeutically with my clinic since, let’s see, goodness gracious, what year are we in, 2009, and so the ketosis diet being, any high-fat low-carb diet is going to help with hormonal imbalance so things like PCOS. Often, when we’re talking about PCOS, there is a stress hormone influence, but there’s also a very significant insulin response. That’s why a lot of doctors in the fertility world will preemptively put a patient on Metformin or a medication that’s a diabetic medication to try to help with the insulin resistance, but keto diet can absolutely do that on its own. We can also see, in that same scenario with PCOS, the keto diet will bring down elevated DHEA because DHEA is a metabolite of building ketones, so another therapeutic mechanism or tool.

I use ketosis in practice for CIBO and dysbiosis, so any time we’re looking to reduce overactive bacteria in the body, I always bring patients below 60 grams, and then we’ll often take them deeper into a ketogenic protocol, and then most definitely, I use ketosis as an adjuvant with any client going through cancer treatment as well as neurological disease, so if we’re talking about Parkinson’s or MS or dementia, it’s a really powerful tool to get that higher fat therapeutic foods as the primary nourishment.

Leanne Vogel: Very awesome, very awesome, and when we think of the entire iceberg … I’m going to use, I’m probably going to use this analogy for the entire show because it’s so perfect.

Ali Miller: I like it.

Leanne Vogel: I love it. When we’re thinking of, we get diagnosed with, say, our doctor says, “You’re going to get diabetes. You gotta do something quick.” That’s above the water, and so we’re dealing with the stuff above the water, but what are some symptoms of these nutrient deficiencies and these problems before our doctor says, “You’re going to get diabetes if you don’t change something.”

Ali Miller: I also like this term of, I call it upstream versus downstream medicine. It’s this idea that how can I find a clinical trend or web, if you will, of overlap where micronutrients play a role? Anything from … Well, let’s just make up a patient. Betty or, who do you want to call our patient?

Leanne Vogel: Betty, Betty, yes. Betty. So cool.

Ali Miller: Okay, okay, Betty. Okay, Betty. Betty has, hair loss would be a big symptom of a nutrient deficiency, insomnia, which … Let’s say Betty’s a 42-year-old female, and so she has hair loss, she thinks, “Oh, it’s probably just premenopausal stuff.” She’s dealing with some insomnia, some anxiety, but maybe that’s just normal. Half of her friends are on antidepressants anyway. She’s starting to get prediabetes and has elevated blood pressure, and her cholesterol is off. That’s most people in their mid-40s.

When I’m looking at nutrients, actually all of those symptoms could be tied to a trend something like biotin. Biotin deficiency can play a huge role with hair thinning. It can drive the sleeplessness, and it can drive anxiety, and then biotin plays a role with your insulin receptors, so when biotin is too low, you’re not able to bring the glucose into your cells, so you’re going to have elevated blood sugar, and that also throws out your blood pressure.

Betty could be on like seven medications, or she could take a quality biotin supplement and eat egg yolks and stop eating only egg whites, and she could just be rocked upstream, and maybe even prevent things before they’ve reared as a deficiency.

Leanne Vogel: You make it sound so simple. Everyone needs to be as smart as Ali, and then we’ll be good. Yeah, it really is something quite magical when you look at that upstream piece.

Ali Miller: Yeah, and I mean, you can start with the therapeutic elements of a whole food diet, of course. We get a lot of nutritional density in our biological forms of foods, which is animal products, and then taking that a step further, we get the most nourishing components from those that are least processed in their whole food form, of course, but then there is strategy when we’re looking at actually treating a symptom or something that’s jumping out to maybe use a process of more what I call orthomolecular therapy, which is higher doses of nutrients to actually get you above the water, and then maintain with diet strategy.

Leanne Vogel: I can say that orthomolecular works well, you need to get over things. I took mega doses of certain nutrients and things until I was balanced out, and it helped momentously until it didn’t help anymore because I had balanced out, and then it was ready for the next doctor, but it was very, very helpful while I needed it.

More on my interview with Ali Miller after this message from one of our podcast listeners.

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What is the role of food intolerances in these sorts of treatments because, say, Betty, her hair is falling out, things are happening. When do you start looking at food as needing to be changed because it’s actually affecting a human?

Ali Miller: In my intake, when I’m in that detective role, I spend 90 minutes with a client in my first consultation, and during that time, I probably spend about 15 to 20 minutes depending on how much action there is, just talking about digestion. I mean, I ask questions like, if we’re talking about distention and bloating, does it progress throughout the day or would it be intermittent because that’s going to help me rule out, if the bloating progresses throughout the day, that’s probably your belly trying to brew beer or bake bread, and so there’s this actual fermentation that as you eat, your biome or bacteria eats what you’ve been eating, and you get that methane and carbon dioxide release, but bloating can also be a symptom of a food intolerance. That’s more when it’s irregular, and that’s often because there’s an osmotic or water-flushing.

It could be Suzy or Betty, whoever, someone has an intolerance to lettuce, and I’ve seen this clinically when I’m looking at food inflammatory panels, people can be having reactions to otherwise superfoods. Someone’s superfood is someone else’s kryptonite, and one of the symptoms we can see is irregular bloating where they call it a food baby, and they just get this significant swelling. That’s because their immune system is perceiving that antigen or that compound as a foreign invader, and it’s responding with flushing effect. It’s throwing water or inflammation at the otherwise injury to try to get that out of the body, just like with high pollen and histamine release, you would have mucus. This is a different mechanism of the body trying to push something out, and that means, beyond bloating, you could also have bowel urgency or diarrhea, or on the other end of the spectrum, they could have constipation.

There’s GI stuff as far as food tolerances, and then there’s stuff way beyond digestion like inflammation, of course, so joint pain. A lot of people, as they clean up their diet, will know when they ate something off plan, like if they have residual gluten or wheat in a sauce of a dish because they’ll have, their index finger will have inflammation or their knee or just really what seems minute reactivity can be a big symptom, especially as you’ve cleaned up your diet, so inflammatory processes that are structural. Also, muscle aches could be a symptom, dermatological flares.

I think the one, kind of big one is stubborn metabolism. People that are doing everything perfect, their stress is managed, they’re sleeping, everything else is good, but they’re not losing weight. If you imagine you bump your elbow on the wall or on a table or something, you’re going to get swelling in that area, and so the cardinal sins of inflammation are heat, or temperature and that’s a part of the healing processing, fluid retention, pain, and swelling.

If the body is chronically swelled or holding this water, it’s not going to be optimized for catabolism or breakdown. It’s in this anabolic protective mode. That’s where someone that has an inflammatory response to salmon or lettuce and is eating those foods daily may get hindered metabolism, so maybe not GI, maybe not joint point, maybe not skin, but it’s just their stubborn weight loss, which is a symptom of food intolerance.

Leanne Vogel: That’s so cool that you mentioned the inflamed index finger because I started getting that probably about a year ago, and in the time I-

Ali Miller: Really?

Leanne Vogel: Yeah, it’s the coolest thing. I call it my superpower finger, and when we go out to each, specifically, because when I’m making food at home, it never happens, but when we go out to eat, and I’ve asked them, “What oils do you use? How do you make stuff?” Then they give me food, and I have a reaction, and it’s my finger that hurts. I’m like, “You lied to me.”

Ali Miller: Yeah, well, I always tell people that what’s really cool with functional medicine and empowering yourself with your connection with your body is when you from mediocre to ——, it’s not a big step. I don’t know if I’m allowed, am I allowed to ——, sorry, I just said it, but when you go from mediocre to ——, it’s like, okay, but when you go from feeling vibrant or excellent to ——, you can feel it. I mean, it’s like, it yells at you. Inflammation, we often are just dragged by the bumper of the vehicle of our body throughout life, and just, this is normal aging, but that’s not how it has to be.

Leanne Vogel: Would you say that there are any go-to quick fixes for people that are maybe experiencing, I don’t know, let’s say headaches or heartburn or nausea, or would you say it’s more of an individualized approach because that headache could be because you had refined oils or it could be because you’re sensitive to eggs or like, there’s so many pieces to everything.

Ali Miller: Yeah, I mean, it could be progesterone-related. I mean, there’s such a hormonal connection with headaches for sure, especially. I mean, my big thing I think of with just headaches is, is it cyclical, so does it follow hormones? And then I look for, yes, inflammatory food trends because that’s what it is. It’s intracranial inflammation, so it’s inflammation in your head, and I just have to throw those fancy polysyllabic words every now and then.

Leanne Vogel: Yeah, she loves those.

Ali Miller: But anyway, it’s just, it’s inflammation in your head, and so you can bring in anti-inflammatories like good quality turmeric, a good EPA, DHA, omega-3 supplement can be very helpful, as can a form of magnesium glycinate. There’s a gamut of nutritional therapeutics that can help to reduce inflammation. It can be vasodilators relax the vessels with which tension drive a headache, but then it can otherwise be the hormonal thing, and that’s where I would be digging within the individual of what are the other trends and where do you want to start to jump into the rabbit hole? That’s where it is helpful to have a clinical expert on your side because if you take 25 supplements and only three work, you’re just really making expensive urine, and so that’s not a good thing either.

Leanne Vogel: Yeah, I think the first question, what you’re saying is ask yourself is it on a cycle? Day five, six, and seven of my cycle, I’m having a headache. Well, that might be hormonal. Maybe just tracking everything so that when they do see a practitioner such as yourself, that practitioner has an idea of, “Oh, she’s getting a headache here, here’s what she’s eating,” and kind of piecing things together.

Ali Miller: Absolutely. Absolutely. Then you can work with therapeutics to blunt hormonal influence or to help with the deficiencies. They may need short-time use of bioidentical therapy, and that might be the tool, but that’s definitely something that would require advance testing to get baseline data.

Leanne Vogel: Let’s hone in on hormones because it’s like the number one thing that people always ask about and that I think there’s the most confusion about. A lot of people that are in our community think that in order to lose weight or feel better, they just need to lose the weight to feel better, and that they just need to eat less in order to lose the weight to feel better. Nine times out of ten, that’s usually not the approach that they need to take, and there’s probably something hormonally or something else going on. I’m sure you see that in your practice, too, of it’s not about the calories. There’s so much more going on underneath that iceberg. Can we chat a little bit about how maybe the issues that come up with hormone imbalancing and why food as medicine is helpful for that?

Ali Miller: Yeah, I guess with hormones, there can be foods that drive hormonal influence. The biggest first thing, I think, to talk about with hormones and food is endocrine disruptors. There’s endocrine-disrupting chemicals as an additive. Well, beyond foods, it’s in our perfumes and scents, it’s in our plastics, but it is in a lot of food ingredients. Cleaning up the diet and getting to single ingredient, hormone-free and antibiotic-free proteins and single-ingredient whole foods, which means no processed products, of course, that’s going to help to eliminate a lot of the endocrine disrupters, which are in the diet.

Those phthalates and those types of compounds, they can work more potent than a hormone, they can work less potent than a hormone, or they can work completely different than the hormone is supposed to work, but yet they dock with receptors. That’s why a lot of us have hypothyroidism or estrogen-dominance and things like that because of those endocrine disruptors.

I would say the first thing to do is start with a foundational clean diet, and then taking it a step further and actually upregulating your body’s detox processes is another huge piece of the puzzle because you don’t just remove the exposure. You have to then clean up the gunk, and we store a lot of our hormone-related compounds in our body fat. That’s actually why sometimes with keto hormones can get a little bit funky before it gets better because we’re breaking down fat at such a rapid rate.

When you’re using fat as fuel, you’re actually upregulating the release of a lot of the, not only endocrine-disrupting compounds, but just toxins that were stored somewhat, what your body thought, safe in the fat. Now you’re starting to shake the tree and activate a lot of this. It’s important to actually support both phase one and phase two of your detox processes in your body.

Leanne Vogel: Are there other ways that people can detoxify, like near infrared sauna, I’m guessing would be a good one. Are there other things that people can do to shake that tree and get things out of there?

Ali Miller: Yeah, yeah. Once you start to lose body fat, you’re swimming in more toxins, and so you need to upregulate your liver and kidney function. There’s actually two biochemical processes in detox. One is the activation of toxins, this is like awakening to those that were dormant and stored. It requires a process called hydroxylation, but a lot of nutrients that we look at is antioxidants and sulfur compounds. We’re talking about things like turmeric. We’re talking your cruciferous vegetables like cauliflower, broccoli, Brussels sprouts, kale. We’re talking about bitters that activate bile flow from your liver because that’s what keeps the blood flow circulating and being cleansed. Things like dandelion greens, Bragg’s Apple Cider Vinegar, using lemon. Those all upregulate our liver flow, which helps with stagnation and activation.

Then phase two is actually even more important than phase one, and that’s the encapsulation and excretion. This is where we really are focused more even heavily on the sulfur compounds, the things like glutathione and N-Acetyl Cysteine. They might be big words, but basically foods that also have the sulfur cruciferous compounds like your Brussels, your cruciferous cauliflower, and then also getting enough animal protein in the diet. N-Acetyl Cysteine is really high, for instance, in egg yolks and red meat, and so definitely not going to get a therapeutic biochemical detox with a juice cleanse. You do need to eat real food. I do recommend to do a detox therapeutically with supplements about quarterly, especially if you’re on an active body fat loss so that you do change the oil in your tank of your body, if you will.

Leanne Vogel: Beautiful, and just so happens that last episode, Episode 54 of the podcast, we chatted with Dr. Jay all about endocrine disruptors and how to-

Ali Miller: Oh, awesome.

Leanne Vogel: … rid your body of them and … I mean, I’m terrified to go to the grocery store right now. I’m having to deal with all of this because he was talking about how grass-fed, grass-finished meat is your best, and even though the meat might be hormone-free, the food that these cattle are eating create the hormones. I mean, it’s just crazy, so I mean, you could really, really go down the rabbit hole, but I think the first step is just cutting out all the extra stuff that you can, like drinking out of plastics. Those can make such a huge outcome, but a lot of people think, when they think weight loss, they don’t think hormones, and they definitely don’t think, “The perfume I’m spraying on my neck every day is causing me to gain weight.”

Ali Miller: Yeah. Yeah, it’s wild. I work with a lot of women that work in the cosmetic field, and so that’s their job, and they’re constantly exposed, and so I have them all on my Cellular Antiox because it’s a high glutathione and it helps with respiratory antioxidant distress. It’s like, “You guys are just breathing this stuff in. You need to take this.” Sometimes it’s preventative and sometimes it’s proactive, but it’s important, definitely.

Leanne Vogel: Let’s chat a little bit about stress, anxiety, adrenals because that’s another thing, I think, that’s sort of underneath the water of the iceberg that a lot of people don’t really focus on.

Ali Miller: Yes, and that throws hormones off, I think as probably the most popular reason of why hormones are off. We tend to go more androgenic, just connecting it to hormones and into the adrenal piece, we tend to go more androgenic, meaning that the body is either in fight or flight or rest and digest. In rest and digest is also where reproduce lives, and so if we’re in fight or flight mode, our ovaries are downregulated and our pituitary turns up the adrenals on crazy high demand.

The pituitary, I guess going back, there’s this process of fight or flight called the HPA axis. This is the hypothalamus and pituitary, which are both in the brain, and then the adrenals, which sit above our kidneys. When we’re talking about anxiety and/or adrenal fatigue, we’re usually looking at an imbalance on the piece of the adrenal, but it could be any of the pieces of that HPA axis.

Starting with our hypothalamus, I mean, we get hypothalamic dysfunction from caloric over-restriction, which happens a lot with the dieting mentality, having a difficult time regulating satiety or what is satisfaction. Hypothalamic dysfunction can be seen in circadian rhythms that are off, so sleep cycles being thrown off. Our hypothalamus makes our thyroid releasing hormone, so it’s already intimately hitting our metabolism. The pituitary is like the control center that decides, again, whether we’re going into the rest and reproduce ovarian sexual hormone production of progesterone and estrogen or whether we’re going to upregulate our adrenals. That’s what’s going to drive more of the cortisol and the dopamine, the norepinephrine and epinephrine.

The adrenals with cortisol make that primary stress responsive hormone, which itself tells the body to store fat, and itself can be very excitatory. I mean, running on adrenaline is that chutzpah that we can pick up a car in an emergency. When our cortisol is up, that can drive excessive epinephrine, which is, in layman’s terms, our adrenaline.
We can be, what is the … we can be stress and wired or we can be stressed and tired, and both of them can be a pathology of adrenal insufficiency or adrenal over activity. We could have low cortisol, but too high of epinephrine, so our adrenaline’s really high, but we’re flat-lined with cortisol, or we could have high of both, and they’re going to present differently in the individual.

Leanne Vogel: Which is so interesting, and something that you mentioned, the dieting mentality causes issues with our adrenals, our thyroid, which-

Ali Miller: Totally.

Leanne Vogel: … causes us to store fat more easily. I’m guessing that that in and of itself should make people care, but why are these things so important? Why is the thyroid important? What do we care about our adrenals? What happens if we continue down on this dieting mentality where our hypothalamus is being affected and all these things are happening?

Ali Miller: They all play telephone. This is a synergy. This is a symphony within our body, and so all of these signals are telling different glands different things, and then when the gland has an imbalanced response, that creates this entire vibrational influence throughout the rest of the body.

Like I mentioned, cortisol in excess has anti-inflammatory influence, so that’s why in the medical field, you may hear of people that take a Prednisone pack or a cortisone pack for a respiratory infection or, let’s say, an arthritis flare, or they’ll get a cortisone injection a joint that’s causing a lot of pain, but like anything in the body, everything goes hyper before it goes hypo.

It goes like the fly on the wall. Buzz, buzz, buzz, and then the slam and crash. In that high state of cortisol, we have no inflammation, but we’re totally in a high-fat storage, but then in the low state of cortisol, we tend to have chronic inflammatory cascades. The immune system is regulated by this too. When the inflammation goes on high alert, the immune system starts to go into autoimmune attack because it’s not sure. It’s like there’s so much fire in the body, the immune system is like, “I don’t know what’s causing this drama. I’m just going to target you, thyroid. Hashimoto’s.” That’s how I imagine it literally happening because of the inflammatory cascades. With autoimmune disease, the immune system starts to attack itself.

Then in the low inflammatory state of high cortisol, the immune system is downregulated and then it doesn’t detect foreign invaders like cancer, so there’s always a synergy. We don’t want to overshoot, we don’t want to undershoot, and the adrenals can be a piece of that hyper or hypo immune response based on inflammation, really.

Leanne Vogel: You’re so smart. I just, I love listening to you speak because it all makes so much sense. What I really, really enjoy about you coming on the show today is that you make it very accessible to people, and everything you said-

Ali Miller: Oh, thank you.

Leanne Vogel: … I’m sure everyone understood, and they’re like, “Okay, so this dieting mentality might not be so great for me. There are all these things happening. I’m trying to lose weight. This isn’t working. I’ve been stuck at a plateau for three months. Oh my gosh, the perfume I’m putting on my neck is probably making me fat. What do I do?” What are the steps that somebody can take when they’ve realized they’ve had this aha moment right now listening to you-

Ali Miller: I hope so.

Leanne Vogel: … and they’re like, “What do I do? I’m on this dieting track. I’ve been eating 1,100 calories for the last 10 years, and if it eat 1,500 even, or if I boost up my fat or my eggs or I’m doing these things, I’m going to be eating more, and then I’m just going to get bigger.”

Ali Miller: Right, so it’s-

Leanne Vogel: What do we do?

Ali Miller: Mellow out, man. I mean, no, right, you know, but easier said than done, I’m sure, but we can’t out-science nature is the first thing. I think that the whole bio hack movement is cool in theory, but just buying blue-blocker glasses for your working at 1:00 a.m., just stop working at 1:00 a.m. It’s like, getting back to the basics of shutting down and trying to find some synergy within your circadian rhythm. A lot of that comes back to finding this bliss factor and relationship of what resonates within your body, practicing gratitude, finding breath.

I work a lot with my clients with mantras, honestly, because it’s like the connection of mind-body within nourishment can be so powerful, and so … I’ll often pitch things. We’ll use dichotomous concepts like, “I take in nourishment, I exhale anxiety,” let’s say, as an example, or if someone’s very anxious-prone with their weight and metabolism, we’ll say, “I take in thermogenesis,” or, “I’m breathing in fire, I’m exhaling cool.” It’s like that, to them, is this visual relationship of creating this caloric burn, this furnace within their body, but I really like to find more of a synergy of what is this that we want to embody and what is this that we want to release, or a mantra of, “I’m taking the steps to nourish my body, I trust my body is doing its work, and I trust my body will get where it needs to be.”

It’s just this kind of release because I find that we get this tightly-wound rubber band when mental health and stress and anxiety hinders then our metabolic health. That can take us so far, Leanne, I mean, even to having inflammatory food responses, even into autoimmune disease because even going into the mechanics of digestion, when we’re in fight or flight mode or type A stressed mode, we only make like a quarter of the amount of digestive enzymes as we do in a relaxed state, so we really shouldn’t be eating. It’s finding a way to make peace with nourishment, first and foremost, and create that space and the altar to nourish the body, I think, is a super important piece of the puzzle.

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You mentioned mantras, and something that I did, especially when I said, “You know what? Screw this dieting mentality. I’m not doing this anymore,” every time I ate, I would have a lot of anxiety because I would be eating and not tracking or eating things that I, “shouldn’t be eating,” for example, an egg yolk. It was mortifying. It was really challenging, so every time I would eat or I would have anxiety, I would breathe in and out and say, “I’m nourishing my body, I’m nourishing my soul,” and I would say that like five billion times a day. How do you incorporate a mantra practice, maybe for-

Ali Miller: Yeah, I love that.

Leanne Vogel: … people that are like, “How? What do you mantra? What is that?”

Ali Miller: Yeah, hippy voodoo.

Leanne Vogel: Yeah, yeah, exactly.

Ali Miller: I often explain to people. It’s like building your bicep. You would do reps to build a muscle. This is what you’re doing, and you’re recording over the negative self-talk that sings so loudly. That’s the chatter in the silent space that has been recorded as a tape reel for your entire life, so you have to, maybe not the level of cognitive behavior where you’re rewinding and reworking sentence structure but you have to, with intention and purpose, include the positivity until it becomes passive. It will feel super forced and a little bit like, I always think of Stuart Smalls from Saturday Night Live like in the early ’90s where it was like the “I’m good enough, I’m smart enough, and gosh darn it, people like me,” in front of the mirror, but it’s like, it does, it feels silly.

I always tell clients to do it out loud though at least five times a day and to try to have a ritual or a time association. I think with food works really nice because it’s like every time before you sit down. I can even get my guys that aren’t as emotionally connected maybe to do it when I explain the biochemical mechanics of like, “Okay, this is actually going to change how your vagus nerve responds, instead of going sympathetic, we will pull you into parasympathetic within five mantras, and this can be seen with breath patterns, and we’re going to rev your digestive juices so you can absorb more of those amino acids in your grass-fed steak.”

I think that it makes a huge difference, and people start to get outcomes with that application, and then it starts to come passive, and it’s less of a job or purposeful. It’s passive. The mind osmotically just is there, and that’s when you’re in cruise control.

Leanne Vogel: Amazing. I can totally say that the voodoo stuff works. I mean, it’s a good balance. It’s always nice to have different tools in your toolkit, and then you can decide, “No, that’s too crazy for me,” or, “I’m doing that,” or maybe years later, you’d be like, “Oh, shoot. Here I am again, talking about mantras. Maybe I should give it a try.”

Ali Miller: Yeah, yeah, and like, Joe, bless his heart, eating a steak salad or whatever, Joe might also need to take a digestive enzyme before his lunch, this is why this can be a great synergy of building up with the deficiencies, supporting the need, but then also working with this … That’s the third step, or I guess the most sustainable element wellness is that mind-body connection, and so you have to do both the proactive preventative, the intervention elements, but then also the synergy piece of connecting the “what is” of all of this and the intention and purpose behind all of it.

Leanne Vogel: Amazing. We’ve chatted about hormones, we’ve chatted about stress. We talked a little bit about the gut, but I’d love to chat a little bit more about it because it’s one of those other things that people, again, they see the tip of the iceberg, they’re not paying attention to what could be going on, which is usually either hormones or gut or both or they’re tied together so closely. Why does the gut get imbalanced and how can we fix it and knowing-

Ali Miller: Oh, gosh.

Leanne Vogel: … that it’s going to be a slow process.

Ali Miller: Okay, next episode.

Leanne Vogel: Yeah, no, totally. Coles Notes version.

Ali Miller: Right, there’s such awesome research on … we’re just learning so much more about the role of the microbiome and our gut bacteria. Three to five pounds of each individual’s body is made up of bacteria. Your bowel movement that you’re having is 90-plus percent bacteria by mass, and the bacteria in our body produces most of our serotonin, which is our feel-good neurotransmitter, as well as GABA, which is a natural anti-anxiety as well.

There’s neurological and mood influences of our gut bacteria. There is, of course, digestive and absorption influences of our gut bacteria. Our gut bacteria can actually fight against cancer cells and upregulate our immune system and fight against autoimmune disease to the point that we’re even looking into things like fecal transplant, of course, taking the stool of a healthy individual and transplanting that into one’s body that has significant or severe dysbiosis or a bacterial imbalance.

We can have different levels of dysbiosis. I work at my clinic, I have a Beat the Bloat, it’s called Beat the Bloat eBook, and it goes through a protocol and has a candida quiz, which goes through 30 different questions that you can talk about last time you’ve used antibiotics, if you’ve had any thrush, any bloating or distention, any other symptoms of dysbiosis. It walks you through some of the question and answer elements of where you might be at a starting bank.

When we’re talking about the gut, we always need to remove the irritant, so we want to get in there and plow the field. A ketogenic diet or a very low carbohydrate diet can be beneficial because it removes a lot of the fermentable compounds. Based on your bacteria state, if you’re eating a high-fiber, high-prebiotic diet, even keto-friendly foods like asparagus, artichoke, onions, some of these higher FODMAP or fermentable foods, these can drive dysbiosis or imbalance of bacteria if it’s already present in the gut.
When I go through a gut protocol, I actually starve off the bacteria by reducing the prebiotics and bringing down all carbohydrates, and then I use strategic antifungal and antimicrobial compounds for a six-week process to basically plow the garden beds.
Then just as important as the removal is the replenishment, and so we strategically will reseed, or pollinate, if you will, good bacteria strains. I definitely recommend, as a baseline, looking at a 50/50 blend of lacto and bifido bacteria as a baseline before getting into all of these big synergy probiotics supplements that are out there, the ones that use the soil-based organisms and have 11-plus strains.

Starting with a 50/50 blend tends to be a really good step when you’re dealing with gut rehab or dysbiosis because it helps to create at least the foundational strains that are the most well-researched, and then you can use your ferments and your dietary probiotics to get more of the multi focus, so your kefir and your krauts and your miso and those types of foods, gut shot and other ferments, and that’s going to help to further pollinate. Then you want to bring in those prebiotic fibers to keep the bacteria viable and living, but that’s once you’ve reset.

Leanne Vogel: Gut shots are the best, like I couldn’t live without them. If people don’t know what that is, correct me if I’m wrong, but the gut shot is just the sauerkraut juice, right?

Ali Miller: Yeah, yeah.

Leanne Vogel: That’s what you’re talking about? Yeah.

Ali Miller: Totally.

Leanne Vogel: It’s so good. Farmhouse Culture started creating them, I would say maybe a year, year and a half ago because they were hearing that their customers were saving the sauerkraut juice in their jars, and they were like, “Let’s just make a product,” so now you can just go to the store and get sauerkraut juice. When I’m traveling, being on book tours and signings and just everything, I always goes go Whole Foods and grab a jar, and I’m drinking it constantly. It’s so good, it just makes my belly feel so good.

Ali Miller: I love the beet, the beet ginger one.

Leanne Vogel: Me too.

Ali Miller: It’s interesting, if you don’t respond well to probiotic foods, so if any listeners are like, “Oh my gosh, I tried that, and I gained like three inches of bloat or I had a bowel response,” that is a cardinal sign of dysbiosis. If you have a bad army set up in your tank and you throw a really potent, good troop in there, you’re going to have a battle. If you don’t respond well to probiotic foods, that’s definitely a turn-point way to know that you need to do a bacterial cleanse.

Leanne Vogel: That’s so true because maybe, I would say eight years ago, my gut was so bad. I couldn’t even do gelatin because it would hurt so badly. It’s taken me a very long time to get here. I couldn’t do sauerkraut or real pickles or none of that, but now, it’s totally fine, so it just takes-

Ali Miller: That’s amazing.

Leanne Vogel: … time. The patience.

Ali Miller: Yeah. Yes, yes.

Leanne Vogel: What about for candida? There’s a lot of questions about candida and keto. Am I right in assuming that ketones, if too elevated, can feed off candida just like too much sugar can?

Ali Miller: There was a study that looked at that; however, with that being said … A, just like, I know you spoke to listeners, you want to be at a therapeutic nutritional state of ketosis, so excess of anything is not a good thing, and so a ketogenic diet doesn’t mean max out your ketone production, which is also why I’m not a huge fan of using exogenous ketones when you are therapeutically using food as medicine, and so yes, an excess abundance of ketones can feed candida, but a lot of the foods in a ketogenic diet like extra virgin coconut oil, which most people are doing pretty ad lib pretty high amounts of have monolaurin and lauric acid, really potent antifungal and antimicrobial compounds and caprylic acid. I actually use caprylic acid capsules therapeutically with many people in a cleanse. It’s one of the strongest. It was compared in a research study to Diflucan, an antifungal medication.

If you’re eating a ketogenic diet by just whole foods and you’re not maxing out to produce as many ketones bodies as you can get your body to make, I see no concern, and actually, like I said, I start my patients on a 60-gram restriction, so not even fully ketogenic, and then see how they feel ketogenic just to bring down the glycemic index and to starve off the glucose and sugar, which is what the candidiasis is really thriving on.

Yeast loves sugar, first and foremost, but it’s tricky just like any bacteria or resistant-compound, and it will find alternative fuels, so you want to hit it multifactorial. You also want to hit it with other antifungals like oil of oregano. You also want to be strategic with how you’re implementing the diet timing. There’s so many factors to get best outcomes, but I am not concerned about a ketogenic diet causing or maintaining candida overgrowth.

Leanne Vogel: Amazing. You said 60 grams. Is that 60 grams of total carbs? I missed that part.

Ali Miller: Yeah, so, one of … That’s just starting with Joe Schmoe off the street who might be eating standard American diet. I start them at 60 grams of carb restriction, which is usually pretty strict, and then we tip into ketosis during the cleanse. Some people get through the cleanse, and then they play keto post.

Leanne Vogel: Yeah, love it. Oh my gosh. I just learned so much about all the things. Where can people find you?

Ali Miller: My website is alimillerrd.com, so it’s A-L-I-M-I-L-L-E-R-R-D dot com, and we have all sorts of fun stuff on there. I have a blog. I have a section called books and programs. I have a detox eBook, I have a cancer eBook and the Beat the Bloat candida/dysbiosis eBook, and then I have an actual printed cookbook called Naturally Nourished under there as well.

Leanne Vogel: Amazing, and we’ll include all of those links in the show notes, which you guys can find at HealthfulPursuit.com/podcast/e55, and we add the transcript to the post about three to five days following the initial air date of this episode.
Ali, thanks again for coming on the show. It was great hanging out with you again.

Ali Miller: Thanks for having me Leanne. It’s my pleasure.

Leanne Vogel: And that does it for another episode of The Keto Diet Podcast. Thanks for listening in. You can follow me on Instagram by searching Healthful Pursuit, where you’ll find daily keto eats and other fun things. And check out all of my keto supportive programs, bundles, guides and other cool things over at HealthfulPursuit.com/shop, and I’ll see you next Sunday. Bye.

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  1. Ali by far has been the best specialist you’ve interviewed to date. She was so informative and I learned so much from her. I will be researching what she had to say further and also following her site. Thanks for the good work!

  2. Hi Leanne,
    I need clarification on someting in your book. You say that the rocket fuel lattes don’t count as food during intermittent fasting, but how can that be if there are fat, calories and protein in them? I was told that anything over 4 calories is considered food for digestion in your body. Can you clarify, because I love my lattes in the morning, but don’t want to break my fast. Thanks and LOVE YOUR BOOK!!!!

    • Hey! I answer this question in this post under the “answers to your rocket fuel latte questions” section below the recipe. I’m so happy you’re loving my book!

    • Are you asking how to eat keto with those allergies? If so, you can eat seeds instead of nuts! You can also check out chapter 7 in Fat Fueled for more tips on how to thrive without nuts, coconut, and avocado on keto.

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