Results of ketosis in a severe COVID-19 ARDS stricken intubated patient

UPDATE: 12/07/2020
The following scientific journal article explains in detail why our experiment dramatically improved oxygen demand.  It also suggests the use of ketone esters which just last week were tried in a new study with almost identical results but instead of waiting 18 hours with fasting, showed improvement in half an hour.

Short videos with background on why the above paper was written:

New ongoing study to watch:

Summary

This is just an N-of-1 last resort experiment we did in hope of saving my wife Analiza Scholes after her ICU doctors/pulmonologists had lost hope and had no other options available in saving her from Acute Respiratory Distress Syndrome (ARDS) brought on by COVID-19.  We did see remarkable improvements/reduction in her oxygen demand within 24 hours and significant improvement in her blood gas numbers which were better than we had seen in over 2 weeks. That gave renewed hope in her survival. However, she had been having issues with low blood pressure and eventually passed away on November 29, 2020 due to the medication no longer being effective.  I'm not recommending anything, just putting this out for scientific knowledge in the hope it can be used to help improve treatment in the future and give ideas on possible ways to avoid the onset of ARDS. Please make your own conclusions, I'm not a healthcare professional and these are just my opinions.

Why this experiment?

My wife was in isolation so I could not visit the first 21 days.  Doctors gave a convalescence plasma early on and that did appear to stop the virus but the damage was done.  She tested negative twice so they were able to move her to a room in the ICU where I could visit. I essentially lived there by her side for the next two weeks.

I've been working with data for 35 years in my career in software development and support. So I look at data and trends. It's been obvious since Spring of 2020 that coronavirus/COVID-19 is hitting the metabolically broken populations the hardest. I've long noticed in my drives through Southern Utah & Arizona that the Native American population is very hard hit by diabetes and other processed food diseases. Analiza is from the Philippines and I noticed that few of the men live much beyond the age of fifty and diabetes is rampant. Age also plays a part but I suspect that's only because it takes time for this metabolic damage to occur. It's just faster in some populations. 

Five years ago I switched to a ketogenic diet and now mainly eat a hunter-gatherer style fatty meat & non-starchy vegetable diet.  My health has dramatically improved in many ways which I can cover in other articles.  I saw immediate changes in disease resistance and healing and over the years many lifelong issues have been going away.  I've always had respiratory issues when I would catch a cold or flu virus.  I've had no respiratory issues in the last five years and even my exercise-induced asthma has disappeared.  

When I saw the food drip being given in the ICU, I had my daughter Alessandra look up the macronutrients and we realized even though it was labeled high-protein, carbohydrates were dominant. This immediately raised concerns in my mind that the food may be working against the patient's recovery.  I voiced my concerns with the doctor but he admitted they don't get much training in nutrition and rely on the nutritionists. They did bring in their nutritionist/dietician but from her education the belief is strong that the human body requires carbohydrates to survive and heal. They did change the feed to lower carbs and they increased protein.  This did help her glucose readings but we saw no improvement in oxygen demand.

Analiza was in the ICU for a total of five weeks. Near the end of week four the doctor for that week said he'd reached a dead end with what he could do and that it appears she will not survive.  A new doctor was coming on shift on Sunday so we hoped for improvement and to see if the next pulmonologist had new ideas.  The new doctor did have some impressive skills with the ventilator and we got her fluctuating between a precarious 85 to 100 percent oxygen (O2) and a high pressure of 15 PEEP.  She had to be on heavy sedation and paralytic drugs for her body to tolerate the ventilator doing the work for her. Even rolling her on her side was life-threatening with her O2 demand jumping to 100% and sometimes a high 80's % saturation.  At that point the nurses and respiratory therapists could hear the lungs were "clacking" and getting stiff.  We tried proning which did help earlier on but this time it almost killed her. Proning is putting the patient face down for 16 hours and then on their back for 8 hours. This has statistically been shown to help improve O2 demand and thus increase the chance of survival.

The Experiment

Since the doctors had no more options, I again brought up the idea of putting her into ketosis, so she would be burning primarily ketones instead of glucose. The doctor said he had no other options so we could try anything.  So, we developed a plan of a 72 hour fast and then start feeding a home feed formulation made from fish head soup that would be high in fat, protein and low in carbohydrates to keep Analiza in a state of ketosis.

My daughters Melinda & Alessandra got together with my son Derek who is a registered dietician and developed a ketogenic food formulation, which we began feeding after the fast was completed.

Results

After 18 hours after days of no improvement in O2 demand, her saturation started creeping higher. Within 24 hours she was able to go from a demand of 85% O2 down to 70% O2. By the end of the fast we had her at 55% O2.  Also her blood gas results showed big improvements with the PF Ratio moving from 50's to 136 and then 137 the next day.  pO2 and pCO2 also showed improvement.

The doctors then had the nursing staff & respiratory therapists continue working on weaning her from the high ventilator settings and this gave some renewed hope in recovery.

The hospital's infectious disease expert did come talk to me that Analiza was still at extreme risk of infection due to the lung scaring and that even if she recovers it was likely another infection would take her soon.  There was also risks due to all the sedation, paralytics and blood pressure medications of something going wrong.  Having seen the huge therapeutic and immune system benefits of this diet for myself, I still was optimistic.

I had been warned earlier that patients can become resistant to the medications that help boost blood pressure. Analiza was on the highest settings. Sadly on the 4th day of this experiment her blood pressure dropped to zero and she passed in my arms.

Personal thoughts on prevention

It appears the ARDS cytokine storm that destroys lungs needs glucose to drive it (see studies below). Blood glucose is driven off any intake of carbohydrates other than fiber.  ARDS can happen with many illnesses but is more prevalent in COVID-19.  If I felt flu or cold symptoms coming on, I would immediately stop eating anything that spikes blood glucose and do not resume carbs until symptoms, including fatigue, are completely gone. Foods to avoid: All grains, fruit, honey, sugar, corn syrup, potatoes, carrots, crackers, candy, etc.  I also avoid all unnatural fats that were not available 100 years ago, as most are inflammatory. Beware the sugars and manufactured oils are put in almost everything.  Try buying sausage without sugar.  You'll almost always find dextrose or other terms for sugar on the package.

Evidence suggests that humans evolved or were designed for a hunter-gatherer diet.  This applies both if you believe in evolution or in an Abrahamic religion where Adam & Eve were kicked out of the Garden of Eden and then forced to wander searching and hunting for food.  Our bodies are adapted or designed for that diet. Hunter-gatherer societies prized fatty meats and gave the lean to the dogs. Fruits, berries & honey provided sugar which spikes insulin and tells your body to store fat.  These sweet foods generally are seasonal and precede hard times so gave our ancestors the ability to put away fat so we could fast long periods of time.  In current times we eat high carbohydrates all year-round in vastly higher quantities than our forbearers.  This leads to many metabolic diseases that put our health at risk and does put you more at risk to viral diseases.

Resources

Note to professional researchers:  I am open to releasing my wife's medical records if it would benefit related research in developing improved treatment protocols.

What is ARDS?

What is ketosis and is it safe?

What is proning?

Convalescent Plasma Therapy

Ketogenesis restains aging-induced exacerbation of COVID in a mouse model

Induction of ketosis as a potential therapeutic option to limit hyperglycemia and prevent cytokine storm in COVID-19

Ketogenic parenteral nutrition in 17 pediatric patients with epilepsy



Analiza Banez Scholes
Nov 24, 1972 - Nov 29, 2020

Comments

  1. My deepest sympathies on your devastating loss, and I appreciate you sharing your experience. I think your advice is sound and may help some people. Again, my sincere condolences.

    ReplyDelete
  2. Deepest condolences!
    Thanks and greatly appreciative for sharing, stay strong!!!

    ReplyDelete
  3. The Lord bless and keep you in this time. Hopefully what you've discovered can be used to help others.

    ReplyDelete
  4. Aww, I’m so sorry to hear of your wife’s passing. I wish, hope and pray that something can be learned from this....if anything, to understand the power of therapeutic ketosis. ❤️

    ReplyDelete
  5. Thank you kuya David for loving my sister unto her last breath. You were the only beside her during those difficult time. Love you bro! I will always love you Ana ❤

    ReplyDelete
  6. Firstly, my condolences on your loss.
    Secondly, would you be interested in being interviewed by The Salt Lake Tribune, as part of our coverage of the COVID-19 pandemic and the people whose lives it has touched? We'd like to talk to you about your wife's life and about this experiment? My email is spmeans@sltrib.com. Thank you in advance for your time.
    Sincerely,
    Sean P. Means,
    The Salt Lake Tribune

    ReplyDelete
    Replies
    1. Good article, thank you.
      https://www.sltrib.com/news/2020/12/11/more-than-utahns-lost/

      One correction, improvement started in 18 hours.

      Delete
  7. Sorry about your loss. I shared your info with Dr, James Dinicolantonio is awesome look him up. Maybe you'll hear back from him.

    ReplyDelete
    Replies
    1. Thank you. I have heard of him. Hopefully he or one of the other health professional podcasters will look into this and even get in touch with the researchers in this area who are getting the same results. I'd like to see this become common knowledge sooner not later.

      Delete
  8. Sorry for your loss.
    As an ICU nurse and fellow low-zero carb advocate I find your experiment extremely fascinating. Your son is a dietitian? What does he think about this woe. It would be very interesting if he could develop a low carb version of the tube feeds that we use for intubated patients.

    ReplyDelete
    Replies
    1. Yes, he's a registered dietician and is now in medical school. He was originally skeptical of my diet obsession but he's seen the results. He looked at their medical school curriculum and there is only 6 hours on diet and nutrition scheduled. There is definitly a gap between both what doctors are taught and dieticians. Dieticians consider this "fringe" and are only taught from the paradigm of the modern diet.

      My daughters made a salmon head soup and he gave them instructions on how to blend it for the tube feed. It worked but we did get some fat separation at the top. We were thinking to try egg yolks as a binder on the next batch. I've also got a nephew who is in food science. Might be worth getting them together. Thanks.

      Delete
  9. I'm really sorry about your wife. I heard what happened through Skyler's podcast.

    The question of ketosis and ketones as the optimum fuel source for healthy humans has been researched a ton...much more than most people realize. I started down this journey for my blood sugar and found it work on my blood pressure as well (completely unexpectedly).

    Here's a list of videos, podcasts, etc. I think you'd be interested in:

    Dr. Mary Newport on ketones and Alzheimer's https://aneighborschoice.com/dr-mary-newport-md-on-fighting-alzheimers-and-other-neuro-disorders-with-keto/

    Dr. Dominic D'Agostino (Italian) on cancer and ketosis https://aneighborschoice.com/dr-dominic-dagostino-on-new-keto-nutrition-breakthroughs/

    Dr. Thomas Seyfried on cancer as a metabolic disease (not a genetic abnormality) https://www.youtube.com/watch?v=XFcq6Zb4hlg

    Professor Ian Bloom on the fake news of low fat high carb diets https://www.youtube.com/watch?v=0r9aq-nKgFc&t=741s

    All this evidence seems to me to implicate the agricultural/medical establishment on causing chronic health problems and focusing on pharmaceuticals as the solution to their problem-reaction-solution cycle.

    ReplyDelete
    Replies
    1. Thank you. Your last sentence nails it. I'm seeing tons of individuals getting drastic health improvements but the medical establishment is generally still blind to it.

      Delete
  10. I am very sorry for your loss. Thank you so much for sharing this information.

    ReplyDelete
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