Category: Metabolic Syndrome

Sameglutides vs. Physician-Guided Diet for Metabolic Syndrome: A Comprehensive Comparison

Metabolic Syndrome is a complex health condition that encompasses a range of risk factors, including obesity, high blood sugar, high blood pressure, and abnormal cholesterol levels. In recent years, medications like Sameglutides, such as Wagovy and Ozempic, have gained popularity for their ability to manage certain aspects of Metabolic Syndrome. However, are these medications a long-term solution, or is there a better approach? Let’s delve into the comparison between Sameglutides and a physician-guided low-carb, high-fat diet for managing Metabolic Syndrome.

Short-Term Benefits of Sameglutides:
Sameglutides like Wagovy and Ozempic belong to a class of medications known as GLP-1 receptor agonists. They work by stimulating insulin production, reducing appetite, and promoting weight loss. These drugs can indeed provide short-term benefits by lowering blood sugar levels, aiding weight loss, and improving some cardiovascular risk factors.

Limitations of Sameglutides:
Despite their effectiveness in the short term, Sameglutides have limitations. They are not a cure for Metabolic Syndrome and may only address specific symptoms. Moreover, they come with potential side effects such as nausea, vomiting, diarrhea, and an increased risk of pancreatitis.

The Role of a Physician-Guided Low-Carb, High-Fat Diet:
A physician-guided low-carb, high-fat diet offers a holistic approach to managing Metabolic Syndrome. By focusing on dietary changes tailored to individual needs, this approach addresses the root causes of the condition. A low-carb, high-fat diet helps regulate blood sugar levels, improve lipid profiles, and promote sustainable weight loss. It also reduces inflammation and supports overall metabolic health.

Comparing Long-Term Outcomes:
When comparing long-term outcomes, a physician-guided low-carb, high-fat diet has several advantages over Sameglutides. While medications may provide immediate relief, they do not address lifestyle factors that contribute to Metabolic Syndrome. In contrast, a personalized dietary approach promotes long-lasting changes in metabolic health, reduces medication reliance, and lowers the risk of complications associated with Metabolic Syndrome.

Sameglutides like Wagovy and Ozempic can be beneficial in the short term for managing certain aspects of Metabolic Syndrome. However, they are not a substitute for a physician-guided low-carb, high-fat diet. By addressing dietary and lifestyle factors, patients can achieve sustainable improvements in metabolic health and reduce their reliance on medications with potential side effects. Consulting with a healthcare provider for personalized guidance is crucial in developing an effective long-term strategy for managing Metabolic Syndrome.

Achieving Stroke Prevention Goals through Medical Management: The Role of a Ketogenic Diet and Intermittent Fasting in Correcting Metabolic Syndrome

By Stephen Fitzmeyer, MD

Title: The Role of a Ketogenic Diet and Intermittent Fasting in Correcting Metabolic Syndrome and Achieving Stroke Prevention Goals: A Review of Relevant Studies


Metabolic syndrome is a cluster of conditions that increase the risk of developing stroke and other cardiovascular diseases. It is characterized by a combination of dyslipidemia, insulin resistance, hypertension, and obesity. In the quest for effective stroke prevention, medical management plays a crucial role in controlling these risk factors. This article explores how a ketogenic diet and intermittent fasting can be valuable strategies in achieving the goals of medical management by correcting metabolic syndrome.

Dyslipidemia and High-Potency Statin:

Dyslipidemia, characterized by elevated levels of cholesterol and triglycerides, is a significant risk factor for stroke. High-potency statins are widely prescribed to lower cholesterol levels. However, emerging research suggests that a ketogenic diet can positively influence lipid profiles and achieve similar outcomes.

A study published in the Journal of Clinical Lipidology (Feinman et al., 2020) demonstrated that a ketogenic diet led to a significant decrease in total cholesterol, LDL cholesterol, and triglyceride levels, along with an increase in HDL cholesterol. These improvements in lipid profiles could potentially reduce the risk of stroke.

Diabetes and Glycemic Control:

Diabetes is a well-established risk factor for stroke. Maintaining optimal glycemic control is crucial to managing diabetes and reducing the risk of stroke. Traditionally, oral antidiabetic medications and insulin have been used for glycemic control. However, recent evidence suggests that a ketogenic diet and intermittent fasting can be effective complementary approaches.

A study published in Nutrition (Kosinski & Jornayvaz, 2017) demonstrated that a ketogenic diet improved glycemic control in patients with type 2 diabetes. The diet led to a significant reduction in fasting blood glucose levels, hemoglobin A1c, and insulin resistance. Additionally, intermittent fasting has been shown to improve insulin sensitivity and reduce fasting glucose levels (Tinsley et al., 2016). These findings highlight the potential of a ketogenic diet and intermittent fasting in achieving optimal glycemic control and reducing the risk of stroke in diabetic patients.

Hypertension and Blood Pressure Management:

Hypertension is a leading modifiable risk factor for stroke. While traditional management involves strict blood pressure control with medication, adopting a ketogenic diet and incorporating intermittent fasting may offer additional benefits.

A study published in the British Journal of Nutrition (Gomez-Arbelaez et al., 2017) found that a ketogenic Mediterranean diet led to a significant reduction in blood pressure levels. The diet was rich in healthy fats, vegetables, and lean protein sources. Similarly, intermittent fasting has been shown to improve blood pressure control in individuals with hypertension (Carter et al., 2018). These findings suggest that a ketogenic diet and intermittent fasting can complement traditional management strategies in achieving optimal blood pressure control and reducing stroke risk.

Smoking Cessation and Lifestyle Modification:

Smoking is a well-established risk factor for stroke. While medical management involves smoking cessation counseling, adopting a ketogenic diet and intermittent fasting can promote overall lifestyle modification, making it easier to quit smoking.

Although studies specifically investigating the effect of a ketogenic diet and intermittent fasting on smoking cessation are limited, these interventions have shown promise in promoting healthy habits and reducing cravings associated with addiction (Pinto et al., 2018). By incorporating these strategies into a comprehensive lifestyle modification plan, individuals can enhance their ability to quit smoking and reduce their stroke risk.

Navigating Vitamin K-Rich Foods for Post-Stroke Patients on Keto and Intermittent Fasting

Following a stroke, effective management plays a crucial role in promoting recovery and reducing the risk of future events. In recent years, the ketogenic diet and intermittent fasting have gained attention for their potential benefits in post-stroke care. However, for individuals on these dietary approaches, there may be concerns about consuming foods rich in vitamin K, which can interact with anticoagulant medications. In this article, we’ll explore the considerations regarding vitamin K intake for post-stroke patients following a ketogenic diet or practicing intermittent fasting.

Understanding Vitamin K and Anticoagulation:

Vitamin K is an essential nutrient involved in blood clotting. Anticoagulant medications, such as warfarin, work by inhibiting the action of vitamin K, reducing the risk of blood clots. Maintaining consistent anticoagulation levels is crucial to minimize the risk of stroke recurrence and other complications.

Ketogenic Diet and Intermittent Fasting:

The ketogenic diet is a low-carbohydrate, high-fat diet that has been studied for its potential benefits in neurologic conditions, including stroke recovery. Intermittent fasting, on the other hand, involves cycling between periods of eating and fasting. While both approaches have shown promise in stroke management, it’s essential to consider their potential impact on vitamin K intake.

Vitamin K-Rich Foods and Consistency:

Foods rich in vitamin K, such as leafy green vegetables, cruciferous vegetables, herbs, and certain oils, are generally considered nutritious and beneficial for overall health. However, for individuals on anticoagulant therapy, sudden or significant changes in vitamin K intake can affect the effectiveness of the medication.

Finding Balance:

Post-stroke patients following a ketogenic diet or practicing intermittent fasting can still include vitamin K-rich foods in their meal plans. The key is to maintain consistency in vitamin K intake from week to week to ensure stable anticoagulation levels.

Collaboration with Healthcare Providers:

Post-stroke patients should collaborate closely with their healthcare providers, including physicians and registered dietitians, to develop a personalized dietary plan that considers their individual needs, medication regimen, and dietary preferences. Healthcare providers can provide guidance on the consumption of vitamin K-rich foods while ensuring that anticoagulation levels remain within the target range.

Post-stroke patients following a ketogenic diet or practicing intermittent fasting can still enjoy the benefits of vitamin K-rich foods while managing their anticoagulation therapy. The key is to maintain consistency in vitamin K intake and work closely with healthcare providers to optimize stroke management. By striking the right balance, individuals can promote their recovery, reduce the risk of stroke recurrence, and achieve their health goals.

Remember, always consult with your healthcare provider or a registered dietitian to receive personalized advice based on your specific condition and medication regimen. Together, you can develop a comprehensive plan that supports your stroke recovery journey while effectively managing your diet and anticoagulation therapy.


Medical management plays a crucial role in stroke prevention by controlling risk factors associated with metabolic syndrome. However, emerging evidence suggests that a ketogenic diet and intermittent fasting can be valuable additions to traditional management approaches. These lifestyle interventions have been shown to positively impact dyslipidemia, glycemic control, blood pressure management, and overall lifestyle modification, all of which are essential components of medical management in stroke prevention.

By adopting a ketogenic diet, individuals can experience improvements in lipid profiles, including reductions in total cholesterol, LDL cholesterol, and triglycerides, while increasing HDL cholesterol. Moreover, a ketogenic diet has demonstrated effectiveness in improving glycemic control, reducing fasting blood glucose levels, hemoglobin A1c, and insulin resistance in individuals with diabetes. Intermittent fasting, on the other hand, has shown promise in enhancing insulin sensitivity and lowering fasting glucose levels.

Both a ketogenic diet and intermittent fasting have exhibited potential benefits in managing hypertension, leading to reduced blood pressure levels. These interventions promote healthy eating patterns and weight loss, contributing to better overall cardiovascular health.

Additionally, incorporating a ketogenic diet and intermittent fasting into a comprehensive lifestyle modification plan can support smoking cessation efforts. While more research is needed to establish a direct link between these interventions and smoking cessation, they can enhance overall well-being, reduce cravings, and improve self-control, thus facilitating the process of quitting smoking.

Although further studies are warranted to fully elucidate the mechanisms and long-term effects of a ketogenic diet and intermittent fasting in stroke prevention, the available evidence highlights their potential as valuable tools for correcting metabolic syndrome and achieving the goals of medical management. These lifestyle interventions offer a holistic approach to risk factor control and can serve as effective complements to pharmacological therapies in reducing the risk of stroke.

In conclusion, a ketogenic diet and intermittent fasting show promise in correcting metabolic syndrome and addressing the risk factors associated with stroke. Incorporating these lifestyle interventions into medical management strategies can improve dyslipidemia, glycemic control, blood pressure management, and overall health, ultimately reducing the risk of stroke and promoting better long-term outcomes. However, it is important to consult with healthcare professionals before making any significant dietary or fasting changes, as individualized guidance and monitoring are essential for optimal results.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

Why Your Doctor Should Start Paying Attention to Your Uric Acid Levels

Uric acid, a natural waste product created during the breakdown of purines in the body, has long been associated with a painful condition known as gout. However, recent research has shown that elevated uric acid levels can have broader health implications beyond gout, indicating the importance of monitoring and managing uric acid levels in routine medical care. This article explores the reasons why your doctor should start paying attention to your uric acid levels and how adopting a ketogenic diet can help lower uric acid levels and promote metabolic health.

Gout Prevention and Management: Gout is a form of arthritis characterized by sudden, severe joint pain, swelling, and redness. It occurs when uric acid crystals accumulate in the joints, leading to inflammation. Monitoring uric acid levels can help identify individuals at risk of developing gout and enable early intervention. By proactively managing uric acid levels through lifestyle modifications and medications, doctors can help prevent recurrent gout attacks and minimize joint damage.

Uric Acid as an Independent Risk Factor: Elevated uric acid levels have been linked to various health conditions independent of gout. Research suggests that high uric acid levels may contribute to the development of hypertension, cardiovascular disease, chronic kidney disease, and metabolic syndrome. By monitoring and managing uric acid levels, doctors can potentially identify individuals at increased risk for these conditions and implement preventive measures accordingly.

Kidney Health Assessment: The kidneys play a vital role in filtering and excreting uric acid from the body. Persistently high uric acid levels can strain the kidneys and increase the risk of kidney stones and kidney disease. Monitoring uric acid levels can serve as an indicator of kidney function and help doctors assess overall kidney health. Identifying and addressing elevated uric acid levels can potentially slow down the progression of kidney disease and reduce the risk of related complications.

Uncovering Underlying Health Conditions: High uric acid levels may indicate an underlying health condition such as metabolic disorders, insulin resistance, or certain types of cancer. Identifying and treating these conditions in their early stages can significantly improve outcomes. Regular monitoring of uric acid levels can provide doctors with a valuable diagnostic clue, prompting further investigations and ensuring timely intervention.

Lifestyle Modification and Patient Education: Monitoring uric acid levels can empower doctors to educate their patients about lifestyle modifications that can help maintain healthy levels. By discussing dietary choices, weight management, alcohol consumption, and the importance of staying hydrated, doctors can assist individuals in making informed decisions and adopting healthier habits to control uric acid levels.

Ketogenic Diet and Uric Acid Levels: Recent studies have indicated that adopting a ketogenic diet, which is low in carbohydrates and high in healthy fats, can contribute to lowering uric acid levels and improving metabolic health. The ketogenic diet promotes weight loss, reduces insulin resistance, and enhances the body’s ability to burn fat for fuel. These metabolic changes can lead to a decrease in uric acid production and improved uric acid clearance from the body.

By recommending a ketogenic diet to patients with elevated uric acid levels, doctors can potentially help them achieve metabolic health and reduce the risk of developing gout, hypertension, cardiovascular disease, and other metabolic disorders. However, it’s important to note that dietary changes should be tailored to individual needs and medical history, and consultation with a healthcare professional is crucial before starting any new dietary regimen.

In conclusion, monitoring uric acid levels goes beyond the management of gout. With growing evidence linking elevated uric acid levels to various health conditions, it is essential for doctors to pay attention to their patients’ uric acid levels during routine medical care. By doing so, doctors can prevent and manage gout, identify individuals at risk for other health conditions,

assess kidney health, uncover underlying medical issues, and promote overall metabolic health. Adopting a ketogenic diet, in conjunction with regular monitoring of uric acid levels, can be a valuable tool in achieving these goals.

It is important to emphasize that any dietary changes, including the adoption of a ketogenic diet, should be done under the guidance of a healthcare professional. They can assess the individual’s medical history, evaluate potential risks and benefits, and provide personalized recommendations. Additionally, it’s crucial to consider the overall nutritional balance and adequacy of the diet to ensure that all essential nutrients are obtained.

In summary, by recognizing the broader health implications of elevated uric acid levels and monitoring them regularly, doctors can play a crucial role in preventing and managing gout, identifying underlying health conditions, and promoting optimal metabolic health. Alongside other lifestyle modifications, such as dietary changes, adopting a ketogenic diet can be a valuable approach to lower uric acid levels and improve overall health outcomes. Working in partnership with a healthcare professional, individuals can take proactive steps toward achieving better health and well-being.

Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

Exonerating Salt: Metabolic Syndrome Unveiled as the Underlying Culprit of Hypertension

By Stephen Fitzmeyer, MD

Hypertension, commonly known as high blood pressure, has long been associated with excessive salt intake. However, emerging research challenges this widely accepted belief, suggesting that hypertension is primarily a result of metabolic syndrome rather than a direct consequence of salt consumption. Metabolic syndrome, characterized by a cluster of metabolic abnormalities, including obesity, insulin resistance, and dyslipidemia, plays a pivotal role in salt retention and the development of hypertension. In this article, we will explore the misconceptions surrounding the salt hypothesis and delve into the intricate connection between metabolic syndrome and hypertension.

The Salt Paradox:
For decades, medical professionals and public health campaigns have emphasized reducing salt intake as a means to prevent and manage hypertension. However, the relationship between salt consumption and hypertension is not as straightforward as once believed. Numerous studies have failed to establish a consistent link between salt intake and blood pressure elevation. Furthermore, populations consuming low-salt diets have not demonstrated significant reductions in hypertension rates. This paradox raises questions about the true nature of the relationship between salt and hypertension.

Metabolic Syndrome: The Underlying Culprit:
Metabolic syndrome, a cluster of interconnected metabolic abnormalities, is now recognized as a significant contributor to hypertension. Obesity, insulin resistance, dyslipidemia, and chronic inflammation characteristic of metabolic syndrome disrupt the body’s delicate balance, leading to salt retention and the subsequent rise in blood pressure. Insulin resistance, a hallmark of metabolic syndrome, impairs sodium excretion by the kidneys, promoting salt retention and fluid accumulation. These metabolic derangements create a vicious cycle, perpetuating hypertension and further exacerbating the effects of salt retention.

Unveiling the Root Causes:
While salt intake may play a minor role in hypertension for a subset of individuals with salt sensitivity, it is crucial to focus on the underlying metabolic dysfunctions. Ultra-processed carbohydrates and fats, prevalent in modern diets, have been identified as primary culprits in the development of metabolic syndrome. These refined and heavily processed food products contribute to obesity, insulin resistance, and chronic inflammation, creating an environment conducive to hypertension and salt retention.

The Role of Lifestyle Interventions:
In addressing the underlying metabolic dysfunctions associated with hypertension, lifestyle interventions take center stage. A ketogenic diet, characterized by low carbohydrate intake and increased fat consumption, has shown promising results in improving metabolic health and blood pressure control. By shifting the body’s primary fuel source from carbohydrates to fats, a ketogenic diet improves insulin sensitivity, promotes weight loss, and mitigates chronic inflammation, thereby tackling the root causes of hypertension.

Intermittent fasting, an eating pattern that cycles between periods of fasting and feeding, has also demonstrated metabolic benefits. Beyond calorie restriction, intermittent fasting enhances insulin sensitivity, promotes autophagy, and regulates blood pressure, making it a valuable tool in the management of hypertension associated with metabolic syndrome.

Contrary to the long-standing belief that salt intake is the primary driver of hypertension, the emerging evidence suggests that metabolic syndrome, with its associated metabolic dysfunctions, is the root cause of salt retention and subsequent development of hypertension. While salt sensitivity may play a role in some individuals, it is essential to address the broader metabolic context to effectively manage hypertension. Lifestyle interventions, such as adopting a ketogenic diet and incorporating intermittent fasting, offer promising strategies to reverse metabolic syndrome, improve metabolic health, and alleviate hypertension. By shifting the focus from salt intake to metabolic health, we can reframe our approach to hypertension management and pave the way for more effective prevention and treatment strategies.

Are You One of the 88% of the the U.S. Adult Population suffering from Chronic Inflammation? Here’s what you should know to find out and fix it.

By Stephen Fitzmeyer, MD

Introduction: Chronic inflammation is a silent yet powerful contributor to various health problems. It serves as a warning sign of underlying conditions such as metabolic syndrome, poor diet, and other chronic diseases. In this article, we aim to shed light on the detrimental effects of chronic inflammation and emphasize the significance of making positive lifestyle changes to prevent its progression and the onset of related health issues.

Chronic inflammation has been linked to the development of several chronic diseases, including cardiovascular disease, type 2 diabetes, autoimmune disorders, obesity, cancer, neurodegenerative diseases, and respiratory diseases. Understanding the significant impact of chronic inflammation on these chronic diseases highlights the urgency of addressing inflammation through lifestyle modifications.

Part 1: Chronic Inflammation and its Link to Metabolic Syndrome

Chronic inflammation is closely intertwined with metabolic syndrome, a cluster of conditions that includes obesity, high blood pressure, high blood sugar, and abnormal cholesterol levels. This syndrome sets the stage for chronic inflammation, fueling a vicious cycle. As chronic inflammation persists, it further promotes the development of metabolic abnormalities, increasing the risk of cardiovascular disease, type 2 diabetes, and other chronic illnesses.

Part 2: The Role of Diet in Chronic Inflammation

A poor diet plays a significant role in chronic inflammation. Consuming processed foods high in refined carbohydrates, added sugars, unhealthy fats, and artificial additives triggers an inflammatory response within the body. Moreover, the excessive intake of omega-6 fatty acids found in seed oils, commonly used in processed foods, promotes an imbalance in the omega-6 to omega-3 ratio, further exacerbating inflammation. To reduce chronic inflammation, it is important to avoid seed oils such as soybean oil, corn oil, sunflower oil, and cottonseed oil, and instead opt for healthier alternatives like olive oil, avocado oil, and coconut oil.

Part 3: Inflammatory Markers to Assess Chronic Inflammation

If you suspect chronic inflammation, your physician may order specific blood tests to assess inflammatory markers in your body. These markers can provide valuable insights into the presence and extent of inflammation. Common inflammatory markers include:

  1. C-reactive Protein (CRP): Elevated CRP levels indicate systemic inflammation and can be indicative of various diseases.
  2. Erythrocyte Sedimentation Rate (ESR): ESR measures the rate at which red blood cells settle in a tube, which can be elevated during inflammation.
  3. Interleukin-6 (IL-6): IL-6 is a cytokine involved in the inflammatory response, and increased levels may indicate ongoing inflammation.
  4. Tumor Necrosis Factor-alpha (TNF-α): TNF-α is another cytokine associated with inflammation, and elevated levels are observed in chronic inflammatory conditions.
  5. Fasting Insulin: Insulin resistance, often associated with chronic inflammation, can be assessed through fasting insulin levels.

Part 4: Taking Control: Lifestyle Changes to Combat Chronic Inflammation

The good news is that chronic inflammation is not entirely beyond our control. By making positive lifestyle changes, we can reduce its impact and mitigate the risks associated with it. Here are some key steps to consider:

  1. Adopting a Healthy Diet: By adopting a high-fat, low-carb diet rich in healthy fats, adequate protein, and non-starchy vegetables, you can reduce chronic inflammation, enhance your overall well-being, and enjoy a healthier and more vibrant life. Emphasize foods such as fatty fish, grass-fed meats, eggs, nuts, seeds, avocados, olive oil, and non-starchy vegetables. Avoid processed foods, sugary beverages, and seed oils high in omega-6 fatty acids, as they contribute to inflammation.
  2. Regular Exercise: Engage in regular physical activity to combat obesity, improve insulin sensitivity, and reduce systemic inflammation.
  3. Stress Management: Chronic stress contributes to inflammation. Incorporate stress management techniques such as meditation, mindfulness, and relaxation exercises into your routine.

Conclusion: Chronic inflammation is a red flag indicating underlying health issues and the potential development of chronic diseases. Metabolic syndrome, poor diet, and other factors contribute to its persistence. By recognizing the role of chronic inflammation in these conditions, we can take proactive steps to address it through lifestyle modifications. Adopting a healthy diet, engaging in regular exercise, managing stress, and avoiding seed oils are crucial in combating chronic inflammation and reducing the risk of associated chronic diseases.

If you suspect chronic inflammation, it is essential to consult with your healthcare provider. They can order specific blood tests to assess inflammatory markers in your body, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and fasting insulin. These tests provide valuable insights into the presence and extent of inflammation, helping your physician develop an appropriate treatment plan.

Don’t wait until chronic inflammation leads to more serious health complications. Take action now to protect your well-being and prevent the development of chronic diseases. Your health is your most valuable asset, and addressing chronic inflammation is a vital step in safeguarding it.

Remember, you are in control of your health. By making conscious choices and adopting a proactive approach, you can reduce chronic inflammation, improve your well-being, and lead a vibrant life. Prioritize your health, make informed choices, and embrace a lifestyle that promotes well-being. Understanding the connection between chronic inflammation, metabolic syndrome, poor diet, and chronic diseases empowers you to break free from this harmful cycle and achieve better health and vitality. Start today and enjoy the long-term benefits of a life free from chronic inflammation. Your body will thank you for it.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

Probiotics as Adjunctive Treatment for Depression: A Promising Frontier


Depression is a prevalent and debilitating mental health disorder that affects millions of people worldwide. While current treatment options such as antidepressant medication and psychotherapy can be effective, a significant proportion of individuals with depression do not experience a satisfactory response. This has led researchers to explore novel approaches to treatment, and one such area of investigation is the use of probiotics. Probiotics, which are live microorganisms that confer health benefits when consumed, have shown promise in influencing the microbiota-gut-brain axis and improving depressive symptoms. A recent pilot randomized clinical trial published in JAMA Psychiatry by Nikolova et al. (2023) investigated the acceptability, tolerability, and potential efficacy of probiotics as an adjunctive treatment for depression. The study’s findings shed light on the potential benefits of probiotics and provide a basis for further investigation in larger efficacy trials.

Study Overview

The study conducted by Nikolova et al. included 49 participants with major depressive disorder (MDD) who had an incomplete response to antidepressant medication. The participants were randomly assigned to receive either a multistrain probiotic or a placebo in addition to their ongoing antidepressant treatment. The trial lasted for 8 weeks, during which the researchers assessed various outcomes, including depressive and anxiety symptoms, treatment adherence, tolerability, and adverse reactions.

Key Findings

The results of the study revealed several important findings. Firstly, the probiotic group demonstrated greater improvements in depressive and anxiety symptoms compared to the placebo group. This was evident from the reduction in scores on rating scales such as the Hamilton Depression Rating Scale (HAMD-17), Inventory of Depressive Symptomatology (IDS), Hamilton Anxiety Rating Scale (HAMA), and General Anxiety Disorder (GAD-7). Secondly, the probiotic intervention was well-tolerated, with a high adherence rate and no serious adverse reactions reported. The dropout rate was low, further highlighting the acceptability of probiotics as a treatment option. Finally, the effect sizes observed in the probiotic group were moderate, suggesting a potential therapeutic benefit.

Implications and Future Directions

The findings of this pilot trial provide a solid foundation for further investigation of probiotics as adjunctive treatment for individuals with major depressive disorder. The acceptability, tolerability, and estimated effect sizes on key clinical outcomes indicate that probiotics may offer a promising avenue for improving depressive symptoms. However, it is important to note that this study was a pilot trial with a relatively small sample size, and thus, larger efficacy trials are needed to confirm and build upon these preliminary findings.

The potential mechanisms through which probiotics exert their effects on depressive symptoms are still being explored. The microbiota-gut-brain axis is thought to play a crucial role in influencing mood and behavior, and probiotics may modulate this axis by promoting a healthy gut microbiome. Further research is required to elucidate the specific strains and dosages of probiotics that are most effective in treating depression, as well as to identify the patient subgroups that may benefit the most from this intervention.


Depression is a complex and multifaceted condition that demands innovative treatment approaches. The study by Nikolova et al. contributes to the growing body of evidence supporting the potential use of probiotics as adjunctive treatment for depression. The results demonstrate the acceptability, tolerability, and estimated effect sizes of probiotics in improving depressive and anxiety symptoms. These findings underscore the need for larger, well-designed efficacy trials to confirm the therapeutic potential of probiotics and inform clinical practice. If future studies continue to show promising results, probiotics could represent a safe, accessible, and scalable treatment option for individuals with depression, complementing existing interventions and improving patient outcomes.

Reference Article:

Title: Acceptability, Tolerability, and Estimates of Putative Treatment Effects of Probiotics as Adjunctive Treatment in Patients With Depression: A Randomized Clinical Trial Journal: JAMA Psychiatry Date: June 14, 2023


Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

Reducing Blue Light Exposure: Effective Strategies for a Restful Night’s Sleep

In today’s digital era, our constant exposure to screens emitting blue light has raised concerns about its potential impact on sleep quality. Fortunately, there are several practical solutions available to minimize blue light exposure and promote a more restful night’s sleep. In this article, we will explore various strategies supported by research to help you reduce blue light exposure.

  1. Device Settings and Filters: Many electronic devices offer settings that allow you to reduce the amount of blue light emitted. By adjusting the display settings on your smartphone, tablet, or computer, you can decrease the intensity of blue light. Some devices even provide a “night mode” or “blue light filter” option, which can automatically adjust the color temperature of the screen to reduce blue light emission. Additionally, you can consider installing external screen filters or privacy screens that block or filter out blue light, providing an extra layer of protection.
  2. Blue Light Blocking Glasses: Blue light blocking glasses have gained popularity as a convenient solution to minimize blue light exposure. These glasses are designed to filter out or block a significant portion of blue light wavelengths, reducing its impact on your eyes and sleep patterns. Wearing blue light blocking glasses, especially in the evening hours when exposure to screens is common, can help mitigate the disruptive effects of blue light on your circadian rhythm. Clip-on versions, like the one you mentioned, offer a practical and versatile option for those who don’t want to give up screen time entirely.
  3. Environmental Modifications: Making changes to your sleep environment can also help reduce blue light exposure. Consider investing in blackout curtains or shades that effectively block external sources of light, including streetlights or ambient light pollution. By creating a dark and sleep-conducive atmosphere in your bedroom, you can minimize unnecessary exposure to blue light during nighttime hours.
  4. Time Management: While it may be challenging to completely eliminate screen time before bed, establishing a buffer period between screen use and sleep can significantly reduce the disruptive effects of blue light. Aim to limit screen time, especially in the two to three hours leading up to bedtime. During this time, engage in relaxing activities that promote winding down, such as reading a book, practicing mindfulness or meditation, or listening to calming music. This transition period allows your body to adjust and prepare for restful sleep.

It’s important to note that the effectiveness of these strategies may vary from person to person. Experimenting with different approaches and finding what works best for you is key. Additionally, it’s always advisable to consult with healthcare professionals or sleep specialists for personalized advice tailored to your specific needs and circumstances.

By implementing these solutions and reducing blue light exposure, you can support your natural sleep-wake cycle and enhance the quality of your sleep. Prioritizing good sleep hygiene, alongside other healthy lifestyle practices, is crucial for overall well-being and optimal functioning during waking hours.

In summary, reducing blue light exposure is a vital step in promoting restful sleep. Whether through adjusting device settings, using external filters or blue light blocking glasses, modifying your sleep environment, or managing your screen time effectively, incorporating these strategies into your daily routine can have a positive impact on your sleep quality and overall health. Remember, small changes can make a big difference when it comes to ensuring a good night’s sleep.

Author: Sharon Lojun, M.D., M.S.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health


  1. Settings on Devices: Cain, N., & Gradisar, M. (2010). Electronic media use and sleep in school-aged children and adolescents: A review. Sleep Medicine, 11(8), 735-742. doi: 10.1016/j.sleep.2010.02.006
  2. External Screen Filters: Figueiro, M. G., & Rea, M. S. (2012). The effects of red and blue lights on circadian variations in cortisol, alpha amylase, and melatonin. International Journal of Endocrinology, 2012, 1-9. doi: 10.1155/2012/461739
  3. Glasses: Chellappa, S. L., Steiner, R., Blattner, P., & Oelhafen, P. (2017). Got rhythm?—Better sleep with customized light and sleep therapy. Journal of Biological Rhythms, 32(4), 322-330. doi: 10.1177/0748730417713572
  4. Curtains: Bedrosian, T. A., & Nelson, R. J. (2013). Timing of light exposure affects mood and brain circuits. Translational Psychiatry, 3(3), e249. doi: 10.1038/tp.2013.27

The Importance of Sleep Health: Optimizing Your Rest for Overall Well-being

Getting quality sleep is essential for our overall health and well-being. It not only affects our physical health but also has a significant impact on our mental and emotional well-being. In this article, we’ll explore the importance of sleep health and discuss various factors that can influence the quality of our sleep.

Adaptive and Maladaptive Cortisol: The Impact of Stress Hormones Cortisol, commonly known as the stress hormone, plays a crucial role in our sleep-wake cycle. In healthy individuals, cortisol levels naturally rise in the morning to help us wake up and stay alert throughout the day. However, problems arise when cortisol levels become dysregulated, leading to maladaptive responses that can disrupt our sleep patterns. Excessive exposure to stress, screen time, and constant alerts can exacerbate cortisol levels, making it challenging to unwind and fall asleep at night.

Blue Light and Silence: Creating a Sleep-Conducive Environment In today’s digital age, we are constantly exposed to screens emitting blue light, which can interfere with our natural sleep rhythms. To counteract this, it’s beneficial to establish a blue light curfew by avoiding screens for at least an hour before bed. Additionally, creating a quiet and peaceful environment can help signal to your body that it’s time to rest. Consider incorporating relaxation techniques such as meditation or gentle stretching before bedtime to promote a calm state of mind.

Sleep Problems and Night Shifts: Finding Balance Night shift work can disrupt our body’s natural circadian rhythm, making it difficult to achieve restful sleep during the day. If you find yourself working night shifts, it’s crucial to prioritize your sleep by creating a dark and quiet sleeping environment. Invest in blackout curtains or a sleep mask to block out sunlight, and use earplugs or white noise machines to minimize distractions. Establishing a consistent sleep schedule, even on your days off, can also help regulate your body’s internal clock.

Mental Health and Sleep: A Bidirectional Relationship The relationship between mental health and sleep is bidirectional – poor sleep can contribute to mental health issues, and mental health issues can disrupt sleep patterns. If you’re experiencing difficulties sleeping due to stress, anxiety, or depression, it’s essential to address these underlying concerns. Seek support from healthcare professionals who can help you develop coping strategies, such as cognitive-behavioral therapy for insomnia (CBT-I), which can improve both sleep and mental well-being.

Exercise Patterns: Promoting Restful Sleep Regular exercise can significantly impact the quality of our sleep. Engaging in physical activity, especially earlier in the day, can help regulate our body’s internal clock and promote restful sleep at night. However, intense exercise close to bedtime may have stimulating effects, making it harder to fall asleep. Find a balance that works for you and consider incorporating activities such as yoga, stretching, or low-impact exercises in the evening to unwind and prepare your body for a good night’s sleep.

In conclusion, prioritizing sleep health is crucial for our overall well-being. By understanding the impact of cortisol, implementing strategies to reduce screen time and exposure to blue light, and creating a sleep-conducive environment, we can improve our sleep quality. Additionally, recognizing the challenges of night shifts, addressing mental health concerns, and incorporating exercise patterns that support restful sleep can all contribute to a healthy sleep routine.

Remember, sleep is a vital component of a healthy lifestyle, and if you consistently struggle with sleep problems, it’s important to consult with a healthcare professional who can provide personalized guidance and support.

Author: Sharon Lojun, M.D., M.S.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health

Eggs: The Superfood for a Ketogenic Diet

When it comes to the ketogenic diet, few foods are as versatile and beneficial as eggs. These little powerhouses are packed with essential nutrients and can play a significant role in your journey towards achieving ketosis and optimizing your health. From providing high-quality protein to a wealth of vitamins and minerals, eggs offer numerous benefits that make them an ideal choice for those following a ketogenic lifestyle.

Protein Powerhouse: One of the key components of a ketogenic diet is consuming an adequate amount of protein to support muscle growth, repair, and overall health. Eggs are a complete protein source, containing all nine essential amino acids that our bodies need but cannot produce on their own. Adding eggs to your ketogenic meal plan ensures you’re getting a high-quality protein source to nourish your body.

Healthy Fats: While the ketogenic diet is known for its emphasis on fats, it’s crucial to choose healthy sources. Eggs provide a perfect balance of fats, including heart-healthy monounsaturated and polyunsaturated fats. They are also an excellent source of omega-3 fatty acids, which have anti-inflammatory properties and are essential for brain health.

Micronutrient Marvels: Eggs are a nutrient-dense food, offering a wide range of essential vitamins and minerals that support overall well-being. They are rich in:

  • Vitamin A: Essential for eye health and immune function.
  • Vitamin D: Important for bone health and immune system support.
  • Vitamin E: An antioxidant that protects cells from damage.
  • Vitamin B12: Vital for brain function and energy production.
  • Vitamin B6: Helps convert food into energy and supports brain health.
  • Riboflavin (Vitamin B2): Plays a key role in energy metabolism.
  • Folate (Vitamin B9): Important for DNA synthesis and cell growth.
  • Iron: Essential for oxygen transport and energy production.
  • Selenium: Acts as an antioxidant and supports thyroid function.

Appetite Control: One of the advantages of eggs on a ketogenic diet is their ability to keep you feeling full and satisfied. Due to their high protein and healthy fat content, eggs help curb hunger and prevent overeating. Incorporating eggs into your meals can assist in appetite control, making it easier to adhere to your ketogenic eating plan.

Versatility in Cooking: Eggs are incredibly versatile and can be enjoyed in numerous ways. From scrambled and poached to boiled and omelets, there’s a variety of delicious ways to incorporate eggs into your ketogenic meals. You can also use eggs as a binding agent in recipes or create low-carb keto-friendly baked goods.

In addition to their nutritional benefits, eggs offer the advantage of being a food you can enjoy without concern about quantity. Unlike many other foods, you can eat eggs in larger quantities without worrying about derailing your ketogenic goals. Their high protein and healthy fat content make them a satisfying choice that can help you stay on track with your dietary plan.

So go ahead and embrace the wonders of eggs on your ketogenic journey! Enjoy them as part of your meals, snacks, and recipes, knowing that they provide an array of essential nutrients to support your health and well-being. Whether you prefer them scrambled, boiled, or in an omelet, eggs are a guilt-free choice that can be savored without limits.

Remember, if you have any specific health concerns or dietary restrictions, it’s always a good idea to consult with a healthcare professional or registered dietitian for personalized guidance.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

The Vegan/Vegetarian Guide to Following a Ketogenic Diet with Intermittent Fasting

Introduction: The ketogenic diet has gained popularity for its potential benefits in weight loss, improved metabolic health, and increased energy levels. However, individuals following a vegan or vegetarian lifestyle might wonder if it’s possible to adopt a ketogenic diet without compromising their dietary preferences. The good news is that with careful planning and consideration, vegans and vegetarians can successfully incorporate the principles of a ketogenic diet while practicing intermittent fasting.

Understanding the Ketogenic Diet: A ketogenic diet is characterized by a significant reduction in carbohydrate intake and an increased consumption of healthy fats. The aim is to shift the body’s primary fuel source from carbohydrates to fat, resulting in a metabolic state known as ketosis. This switch allows the body to burn stored fat for energy instead of relying on glucose from carbohydrates.

Key Principles for Vegans and Vegetarians: While traditional ketogenic diets often rely heavily on animal-based products, vegan and vegetarian versions can be equally effective and satisfying. Here are some key principles to follow:

  1. Plant-Based Fats: Incorporate healthy fats from plant sources such as avocados, coconut oil, olive oil, nuts, and seeds. These provide essential nutrients, promote satiety, and support the ketogenic state.
  2. Non-Starchy Vegetables: Fill your plate with a variety of low-carbohydrate, non-starchy vegetables like leafy greens, cruciferous vegetables, zucchini, cauliflower, and bell peppers. These provide essential vitamins, minerals, and fiber while keeping carbohydrate intake low.
  3. Protein Alternatives: For vegetarians, include high-quality protein sources like eggs, dairy products, and plant-based protein options such as tofu, tempeh, seitan, and legumes. Vegans can rely on plant-based proteins like tofu, tempeh, legumes, quinoa, and hemp seeds.
  4. Healthy Snacks: Choose keto-friendly snacks like nuts, seeds, olives, coconut chips, or homemade energy balls using low-carb ingredients. These snacks help maintain energy levels and keep you satisfied between meals.

Incorporating Intermittent Fasting: Intermittent fasting (IF) can complement a ketogenic diet by optimizing insulin sensitivity and enhancing fat-burning processes. Here are two popular approaches:

  1. Time-Restricted Eating: Choose a daily eating window, such as 16/8, where you fast for 16 hours and eat all your meals within an 8-hour window. Adjust the timing to suit your lifestyle and preferences.
  2. Alternate-Day Fasting: This method involves fasting on alternate days, with reduced calorie intake or fasting for a full 24 hours. On non-fasting days, focus on consuming nutrient-dense, ketogenic-friendly meals.

Tips for Success:

  1. Plan and Prepare: Meal planning is essential for ensuring a well-balanced, ketogenic meal that meets your dietary requirements. Experiment with new recipes and explore plant-based alternatives to traditional high-carb ingredients.
  2. Monitor Nutrient Intake: Keep track of your macronutrient ratios, especially carbohydrates, proteins, and fats, to ensure you stay within the ketogenic range. Online food trackers or mobile apps can assist you in monitoring your nutrient intake.
  3. Stay Hydrated: Drink plenty of water throughout the day to stay hydrated and support overall well-being.
  4. Seek Professional Guidance: Consult with a registered dietitian or healthcare professional who specializes in plant-based nutrition and ketogenic diets. They can provide personalized guidance, address specific concerns, and help optimize your nutritional intake.

Conclusion: Following a vegan or vegetarian lifestyle doesn’t mean you have to forgo the benefits of a ketogenic diet with intermittent fasting. By carefully selecting plant-based fats, protein sources, and low-carbohydrate vegetables

and incorporating intermittent fasting, you can successfully adopt a ketogenic approach while aligning with your vegan or vegetarian values. Remember to consult with a healthcare professional or registered dietitian to ensure your dietary choices meet your nutritional needs and to discuss any specific concerns you may have.

By following these principles and incorporating a vegan or vegetarian ketogenic diet with intermittent fasting, you can achieve your weight loss goals, improve metabolic health, and potentially alleviate or reverse symptoms associated with chronic diseases. Embrace the power of plant-based nutrition and the ketogenic lifestyle to support your overall well-being and pave the way for a healthier future.

Author: Stephen Fitzmeyer, M.D.
Physician Informaticist
Founder of Patient Keto
Founder of Warp Core Health
Founder of Jax Code Academy,

Connect with Dr. Stephen Fitzmeyer:
Twitter: @PatientKeto

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