Epilepsy, Mood, Metabolism, & The Ketogenic Diet! - Graham Phillips, ProLongevity, UK
Learn of the evolution of the ketogenic diet, metabolic psychiatry, the treatment overlap between different diagnoses (e.g. the epilepsies and mood disorders), recommended reads, and the cognitive dissonance of many regarding the ketogenic diet. This is part 2 of 3 with the Pharmacist Who Gave Up Drugs: Graham Phillips.
Reported by Torie Robinson | Edited and produced by Carrot Cruncher Media.
Podcast
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00:00 Graham Phillips
“When you look at the disease process, you can understand it's just different aspects of the mitochondria dysfunctioning. We can see this milieu of ever worsening disease states, but there is a link; it's what we eat.”
00:14 Torie Robinson
Fellow homo sapiens! Welcome to, or welcome back to Epilepsy Sparks Insights. Now, today’s chat is part 2 of 3 with the “pharmacist who gave up drugs” – Graham Phillips – where we chat about the evolution of the ketogenic diet, metabolic psychiatry, the treatment overlaps between different diagnoses (e.g. the epilepsies and mood disorders), some recommended reads, the cognitive dissonance of many of us when it comes to a full 180 regarding our thoughts, beliefs, and what we’ve previously been taught is a “good” diet is!
Please don’t forget to like, comment and subscribe to our channel. Only about 18% of our regular viewers are actual subscribers, so if you are one of the 82% that hasn’t yet subscribed, please do do so today. Having you on board helps us with the algorithms which then promotes our channel to more people who don’t yet realise how fascinating and never ending the subject is ( should be subjectS - it’s just so diverse)!! Plus, we get to raise awareness and understanding of the epilepsies around the world. Now, onto our star: the “pharmacist who gave up drugs” and became passionate about the ketogenic diet; Graham Phillips.
01:28 Graham Phillips
So, I'm famous (or infamous depending on how you look at it) as the “pharmacist who gave up drugs”.
01:34 Torie Robinson
Could you give us some statistics on… when it comes to epilepsy, the seizures that people have as a result of epilepsy, even though they might be controlled, and how the ketogenic diet can help with that. And what's the difference between having like the advertised keto that, you know, trendy people might have versus the full on, proper, ketogenic diet.
01:55 Graham Phillips
So let me make it very clear. I'm a generalist. I'm not an epileptologist, okay, so I do not want to go outside my sphere of knowledge. So, please, everything I bear in mind, I'm kind of almost speaking as an educated lay person, not an expert.
02:11 Torie Robinson
So, don't automatically go on the ketogenic diet when you hear this.
02:15 Graham Phillips
Please, please don't do that. Please, if you're thinking about it, a) Do some research and get some support from someone who a) understands the diet and b) understands your condition, and work with your medical team. So, with all my clients, it's an absolute rule for me: I like to, and in case, because we're talking about trying something ourselves, between us, aren't we, Torie? So, it is essential to work with your medical team. I'm not here to diss the establishment. You need to find the right practitioner to work with.
There's a well-known… so we were talking early on about the Charlie Foundation, and that's quite interesting. So, broadly speaking, what they discovered at John Hopkins University, which was basically a very specific form of diet. So, the ketogenic diet has moved on a lot since then. So, there's more than one version of it. So, it's not one thing, and that's important to know. There are all sorts of subtle variations of it now and it's all about what works for you as an individual. So, there is no single ketogenic diet. There's a whole scope of different ones depending on N equals 1, right? ‘Cause you want to know… you don't want to know what works for a thousand people. You're interested in what works for me. So, that's the first point.
So, the Anti -Seizure Medication works for some people and the first drug, if that doesn't work, you try a second, a third, a fourth, and a fifth. But as you try more and more, if they don't work, your likelihood of it “succeeding”, is less. Yeah.
03:45 Torie Robinson
Yeah, goes right down.
03:47 Graham Phillips
You're also building side-effects. So, you're always trying to balance the benefits and the harms. And, you get these children with status epilepticus (and they just have a seizure and another seizure and another seizure…). They get remarkable remission rates with a keto diet. Right? Now this isn't your standard keto diet. It's probably quite an extreme for them -it's closely monitored. But the mere fact that you can see this effect tells you something.
The other thing is that we know in psychiatry… so, psychiatry is kind of vague, right? So hypertension: you can define hypertension as a certain blood pressure. Actually defining schizophrenia, depression, schizoaffective disorder, bipolar… it's a kind of syndrome, it's a constellation of symptoms. And it's… broadly you try and fit someone's symptoms into a broad diagnosis, but these are very broad.
What we know is a lot of the anti-seizure drugs are also used as mood stabilising drugs.
04:53 Torie Robinson
Yeah Lamotrigine, for instance,
04:54 Graham Phillips
And they're also used for migraine. So, we already know that diet affects epilepsy. We already know that the drugs that we use to treat epilepsy are also used to treat other forms of psychiatric disorder. And we already know that these things are all kind of mixed up.
05:12 Torie Robinson
And this is why we were saying - and this is my opinion - but they're all part of the same disease or condition. It's your same organ, right? Why are we treating them so separately? Why is everything so siloed?
05:25 Graham Phillips
Exactly. So, you know, we think of cardiovascular disease and dementia and cancer as completely different diseases. Symptomatically, they are. If you look at the underlying disease process, what's going on in the cells and in the mitochondria within cells, they're remarkably similar. And that's why if you can get your metabolism working properly and get your engine fueling properly, with the right fuel, so, many of these symptoms go away. And it's not just in these other diseases. The ones that we tend to dread, right, it always used to be cancer. And now the one that everyone dreads is dementia. But actually the fastest growing neurological disorder is Parkinson's disease.
06:13 Torie Robinson
Interesting, the fastest growing? Because it's certainly not one of the most common, it's one of the ones most spoken of...
06:19 Graham Phillips
It's increasingly so. And we also know that people with Parkinson's disease, within 10 years, a lot of them end up with dementia. When you look at the disease process, you can understand it's just different aspects of the mitochondria dysfunctioning.
All of these things come together right, so, you kind of, we can see this milieu of ever worsening disease states, but there is a link: it's what we eat. So, if you kind of take this broad hypothesis that it's all about cell metabolism, and if you see that diet… we know that diet affects mood and hunger and wellbeing, and if you think about the complexity of metabolism and fueling your bodies… And the fact we already know that many of the drugs that are used to treat epilepsy are also used for mood disorders... And we've known this for 100 years, this is not new. It all starts to make kind of sense, doesn't it?
07:17 Torie Robinson
Yeah, gosh, this does get awfully political and, you know, it becomes about money...
07:21 Graham Phillips
It is about money!
07:22 Torie Robinson
Yeah, how do we fund things? And I know, like, lots of people might not necessarily be aware of this, but it, it is, yeah, it's about politics and money and who, who controls what? A lot of the time. Um, even in, you know, countries which have, uh, government, uh, funded healthcare, it's… You can't create this healthcare without funding. And it's also about looking at things both short and long -term within, you know… how long may a government official be in power for or how long is a prime minister or president… how long is their term and what can they achieve in, like, four years, right?
08:02 Graham Phillips
It's the electoral cycle. Exactly. Yeah.
08:05 Torie Robinson
Despite all the negative stuff we've spoken about, we do still tend to live for a few decades and... I mean… and I've brought up in a few talks, like, we have to be looking at things a little bit more long-term.
08:18 Graham Phillips
If you're interested in this stuff, I'm a trustee of a UK charity called the Public Health Collaboration. And it's a charity devoted to improving the nation's metabolic health. And we're part of an international collaboration. So, we know that it's kind of David and Goliath odds because you're up against Big Food on one hand and Big Pharma on the other. But if you look at, for example, many people may have come across Dr. David Unwin, he's a GP and he has got some of the lowest spend on prescribing in his area. And he's busy reversing people's diabetes. So, he's saving the NHS all that money that you can then reinvest in other ways of working. So, there are plenty of us doing that stuff that we could show how we don't necessarily need more money in the NHS. We just need to spend it more wisely. Which is not me saying we should tear -apart the NHS. I love the NHS. I'm passionate about it. I think it needs redirecting. And we need to re-educate health professionals around prevention because we don't learn it, right?
We're all taught, broadly, the same thing, which is identify the symptoms and then address the symptoms with drugs. No health professionals are really taught much about nutrition or exercise or sleep. All of our expertise is around - in the case of the doctors, the diagnosis, in the case of the pharmacists, the use of the medication.
09:48 Torie Robinson
Say you have PTSD or ongoing, you know, depression or, you know, emotional disorder as a result of, say, abuse when you were younger. If we could stop that abuse from occurring, that's what we'd do, rather than people developing a condition or disease as a result of it.
10:06 Graham Phillips
I mean, that's true: if we had more money to invest in all of that, right?
10:09 Torie Robinson
Yeah!
10:06 Graham Phillips
Why does it happen? Why does it continue? Well, we haven't got the resources available to really address the problem. What's interesting though is even in those cases where there's... So, a lot of mental health illnesses are regarded as idiopathic, it apparently comes from nowhere! In the cases of the more specific examples you're talking about, you can say, well, it's the result of life experience. What's interesting is even in those cases, when you improve diet their mood improves and their resilience improves and their ability to deal with everything improves.
10:48 Torie Robinson
When you improve a person's mental health, say they have an epilepsy as well, I mean, it's clear in many: you will actually reduce seizure frequency. If you can reduce a person's anxiety, I mean, you know, that's a really common trigger.
11:02 Graham Phillips
Yeah, yeah.
11:02 Torie Robinson
If you can reduce a person's depression, they'll often, well, with both anxiety and depression, they'll often sleep better. And if you sleep better, you often...right?!
11:13 Graham Phillips
Yes.
11:13 Torie Robinson
This is what I've actually been, I mean, I'm in therapy and I've said to people (or said to myself really) “I know that if I improve my mental health and I try and chill a bit, if I get more exercise, if I eat better, I will sleep better. And I know I'll be better taking my drugs and I will have fewer seizures.”. That's, and it's a bit, it's that broader picture that needs to be looked at.
11:33 Graham Phillips
100%, there's a complete revolution going on in psychiatry at the moment called metabolic psychiatry. And Erin, my colleague Erin, who's a specialist was due to join us, but unfortunately couldn't make the episode. But I, you know, we could put some links, but there's literally a quiet revolution going on in mental health at the moment where there… and there are published studies. So, these are high level scientists, Harvard psychiatrists and so on, publishing proper data now about how if you improve someone's diet, their bipolar disorder can be either massively improved or even their symptoms can be resolved. And there's a fascinating study. So, there are two books I highly recommend if you're interested. One is by Chris Palmer called Brain Energy, and he explains in proper science the whole mitochondrial dysfunction, energy dysfunction, how that plays into everything. And one by Georgia Ede, Change Your Diet, Change Your Mind. We've done podcasts on both of these, so people want to learn a bit more. And, there's a whole international movement going on - including in the UK - where we're starting to do proper clinical trials using various forms of the ketogenic diet as a therapeutic ketogenic diet. We're talking about a medical intervention here (not a fad-diet) seeing if we can then resolve people's symptoms. And as our symptoms resolve, we can deprescribe their medication.
13:09 Torie Robinson
You're making me think… it's like giving up fags can reduce your risk of lung cancer and other types of cancer. So, you look at the cause and reduce the likelihood of developing symptoms,
13:23 Graham Phillips
One of the things that struck me, Torie, at this first meeting and then we had this chat, you didn't just describe the symptoms of epilepsy, you also described other psychological, psychiatric symptoms.
13:34 Torie Robinson
And I think I said also, I don't… those psychiatric symptoms I see as a symptom also of the epilepsy.
13:41 Graham Phillips
If you think about brain disorder, where you’ve got some cells underreacting and other brain cells overreacting. And maybe some cells move because they're not functioning very well, they might be moving from underreacting to reacting normally to overreacting. And it won't be all cells. It'll be some cells within the brain doing one thing and other cells. You could see how this could play out in a really complex series of different symptoms. And you could see how that might play out into, well “Why are my symptoms this week so different from my symptoms last week?”.
These kind of mixed syndromes, to say with a lot of the psychological syndromes, you know, as I say, they're these broad constellation of symptoms and you try and fit somebody into a diagnosis, but these things are not absolute, they're relative. And often people have multiple diagnoses or their diagnosis changes over time. And actually, I'm, there's, maybe put a link, there's a fascinating series on YouTube by a young woman living with schizophrenia
14:53 Torie Robinson
Oh, she's amazing!
14:55 Graham Phillips
…and she describes her journey.
14:57 Torie Robinson
Yeah, yeah, yeah, she's a flipping star! And sorry, before we came to talking about this, I don't know, like a year or two ago, I started watching her episodes. Talk about an inspiring person. Wow.
15:06 Graham Phillips
And I think it's very brave and she describes her life course and what's going on. And she's now working with her team and with a metabolic psychologist. And she's hugely improved her symptoms and she's gradually reducing her medication at the same time.
15:24 Torie Robinson
And I did notice, though, that she did an episode quite recently about some people's “not-so-positive2 reactions to her talking about the ketogenic diet.
15:55 Graham Phillips
Yeah.
15:55 Torie Robinson
Some people see that as a negative. What do you think?
15:38 Graham Phillips
It's interesting, isn't it, that… I think… my view is this is cognitive dissonance. If you've been taught for a lifetime that black is white… and medicine's very hierarchical. Like, when I was at university, we were just taught things as absolute facts, like gravity, right? Who's going to challenge gravity? You'd be, you know, it's like being a flat -earther. Who's going to say, no, the earth is flat, right? I mean, you could say the earth is flat, everyone would think you're mad, so you wouldn't say it. So, a lot of the medical orthodoxy is taught in a very hierarchical way, it may not be challenged, it's an absolute law. That isn't how science works!
16:19 Torie Robinson
Right!
16:20 Graham Phillips
Science works in a completely different way. The fundamental principle of science is: this is the best answer we've got so far. But it's not absolute and it can always be challenged, right? So, if you want to challenge gravity, you can go back to first principles, challenge gravity, and who knows what, you might actually come up with a slightly different version that's a bit closer to the truth.
16:45 Torie Robinson
Right, and the best people would say “I can't say I like being contradicted, but wow, that's amazing.”
16:51 Graham Phillips
In science, we acknowledge uncertainty. It's that science, the whole evolution of science is debate and argument, not certainty, acknowledging that this is the best theory. And the best scientists spend their life trying to knock down their own theories.
17:07 Torie Robinson
Mm -hmm!
17:08 Graham Phillips
In politics, it goes exactly the reverse, right? In politics, it's all absolute, right? And, you know, politicians who change their minds are pilloried.
17:18 Torie Robinson
Yeah, and how crazy is that?!
17:21 Graham Phillips
Well, when the evidence changes, I change my mind: that's science. But politicians are not allowed to. Of course, politicians ultimately run things and make those decisions…
17:28 Torie Robinson
Assuming they change their minds for the right reason though, of course. Sometimes let's go into corruption, but...
17:33 Graham Phillips
The way that the system works is they're not allowed to change their minds because then they're seen as inconsistent. And why would we believe anything you say? Well, when the facts change, my mind changes. So, we've kind of got our paradigms all mixed up.
And politics and medicine have got very mixed up because there's so many vested interests, right? So the big corporations that dominate food and medicine don't want you to challenge it with a different paradigm. So, they'll fight like hell for it. So, that's what we're up against.
18:07 Torie Robinson
This is - again, a generalisation - but… I would be very interested to see… imagine if we manage to get around that and families and patients try something new that's not gonna be dangerous, but just try something new and see what happens with the help of a clinician who knows all about your condition or diseases. Which may be plural and that's something to consider as well.
18:31 Graham Phillips
So, as you said, you've concentrated on your sleep and you've had multiple benefits
18:37 Torie Robinson
Although I will say, and this is actually going to kind of turn things around a bit, my sleep in the end was really helped by a certain drug. So, I had to weigh things up and say, okay, this is actually going to help me sleep. What are the potential negative impacts of that and do things weigh up? And you know, is it worth me taking this small amount? And it was. And I can… but I can see that I know what I'm doing and I do weigh things up and measure things constantly, you know, because things change in life. But, and that's part of medicine, isn't it? It's weighing things up.
19:14 Graham Phillips
It's the benefits and the harms, but it's always n equals 1. It should be about the individual, not about a clinical trial. You might be interested in the generality of what the clinical trial showed but you're interested in what's the benefit to me, and what's the harm to me, and what's the risk benefit relation ratio for me, not a thousand people. And so, it should all be about personalisation.
19:39 Torie Robinson
Thank you to Graham for our second instalment regarding the potential impacts of the ketogenic diet! Please remember that this episode is not clinical advice - if you or someone you know is considering the ketogenic diet as a treatment for anything (or even just a chance in diet overall), please run it past your GP or medical specialist first!
If you haven’t already, don’t forget to like, comment, and subscribe to the channel, share the episode with your friends/colleagues, and see you in next week’s episode where in part 3 of 3, Graham and I will chat about implementing the ketogenic diet!
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Graham Phillips is the founder of ProLongevity and has been a successful Pharmacist for over 35 years. His purpose is to help people to live a longer, healthier lives.
Graham turned his back on drugs after seeing more and more of his patients getting sick and staying sick, with medication partly masking the issues but not solving them.
ProLongevity, is an approach that combines unique biological data and precision nutrition with health professional support, to hold back the tide of diabesity, and help people transform their metabolic health without the use of medication.
Graham’s aim is to change the way that we approach healthcare in the UK using data, precision nutrition and health professional support to empower individuals to live longer, happier, healthier lives. Importantly, ProLongevity’s approach can reduce the cost and resource burden across the NHS from preventable metabolic diseases.
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X/Twitter: grahamsphillips
LinkedIn: graham-phillips
YouTube: @ProLongevity
ProLongevity: prolongevity.co.uk