63 Comments

Every other driver becomes an idiot, when you don’t leave home on time. And driving 80-85 mph on the freeway? That’s endangering lives, and, frankly, not impressive.

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We did leave on time. A little early, even. And got there late despite not encountering particularly heavy traffic. We were held up by what appeared to be brain dead drivers in all lanes.

I think I meant the comment below for you. I inadvertently appended it to another comment that had nothing to do with traffic:

"Obviously you've never driven freeways in Los Angeles. Or other parts of California. Drivers fly. And if you don't go 80-85, you get left behind. That's the typical flow-of-traffic speed here if traffic is light."

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Dear Karen, we're glad you could take time to chide others for their assumed failure to live up to your standard of excellence. Thank you.

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To the contrary, Dr. Eades is right about the way people drive in southern California. My brother-in-law lives in Goleta, not far from Montecito, and I can tell you that traffic there is absolutely brain dead.

But the problem isn't speeding, the problem is a lack of lane discipline. When you're not passing, you should always stay in the right-most lane. No exceptions and independent of how fast you're going. That's the law in my state and in most states, I think. But many Americans simply ignore that part of the law on freeways.

A couple of years ago, we took a driving trip around Israel. The average traffic speed on Israeli motorways is routinely 80 MPH or so. But the traffic there flows very safely and smoothly because Israeli drivers practice good lane discipline. They keep to the right unless they're overtaking another vehicle. (I've noticed the same lane discipline on British motorways where they keep to the left.)

The difference between Israel and the U.S. was amazing. At one point, we were on a 4-lane highway approaching 2 lanes merging from the right. Here in the U.S., that would've meant a mile of stop-n-go traffic.

But in Israel, it only meant that traffic slowed a little (to 65-70 MPH) for the merging vehicles and there was no back-up at all.

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Wow! Get me to Israel. Driving there sounds like a dream.

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I think you missed my point. I wasn’t saying that people didn’t drive like that in SoCal. I was addressing the fact that Dr. Eades was complaining about the traffic & other drivers, when his lateness was actually his own fault. He knows all about the California traffic, driving habits, etc.

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I haven't counted the words, but your posts feel shorter since you joined Substack.

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I haven't counted the words myself. But they don't feel any shorter to write on Substack than they did on the other platform.

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1. Thanks for another good post. The ketogenic diet section bears re-reading by me.

2. M.E. wrote: "click on the view online link in the upper right" You can certainly do it that way.

Or you can simply click the "Arrow #101" title, which is also a direct link to substack.

3. ChatGTP is an *amazing* accomplishment. But it's amazing because its natural language interface is so good. As an analogy, 10-year-olds are amazing in the same way. They can understand when you speak and they can respond in meaningful ways (when in the right mood :-).

But I don't expect ChatGTP to know anything, just as I don't expect a 10 y.o. to know very much. ChatGTP is most certainly not a software Oracle That Knows All, like the omniscient COMPUTER that Mr. Spock & Cap'n Kirk used in '60s StarTrek episodes. ChatGTP doesn't "think" beyond understanding questions and formulating replies. Its responses are based on whatever knowledge it gets from its sources. Hence the mealy-mouthed responses to your vaccine questions.

So is ChatGTP reliable? It's only as reliable as its consensus-built sources are. It can't give a better answer than the best human answer, in other words. And since the efficacy and side-effects of COVID vaccines are still being debated, I wouldn't rely on ChatGTP for information about vaccines. We'd might as well ask it, "What's the best form of government?"

The best overall analogy for ChatGTP is to imagine an Encyclopedia Britannica that understands ordinary questions. Or imagine a natural language interface for web searches. The information you get from either of those is only as good as its authors have made it. In this regard, ChatGTP is yet another example of the G.I.G.O. rule: garbage in, garbage out.

All that said, a good friend of mine has been playing around with ChatGTP both to analyze and to generate computer code. My friend had written some code to calculate lunar ephemerides a couple of years ago. When he submitted that code to ChatGTP, it correctly identified the code's purpose, and without comments in the code or any other hints. What ChatGTP can do in the software realm is revolutionary.

4. A few newsletters back, one of your readers submitted images of fraternity & sorority members that she'd found on the web. I didn't mention it at the time, but the site the reader sent you / us to is very similar to ChatGTP.

The purpose of that site was to generate images based on natural language input. For example, you might tell it: "show me a cat riding a bicycle" or "show me a red moon, a blue moon, and a yellow moon in orbit" and it would respond with images of those things. Sites like these are called "AI text to image" and here's an example of one: https://deepai.org/machine-learning-model/text2img

My point is that ChatGTP responds to text by generating text. The AI text-to-image sites respond to text by generating images. But they're both doing the same type of natural language interpretation to determine how to respond. And again, the amazing thing about the AI-image site is not its artistry; the amazing thing is the site's ability to understand your text requests.

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I agree. It is amazing. I need to fool with it a little more.

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More about ChatGTP in this Wall Street Journal article: "I Entered a Pun Competition. My Jokes Were Written by an AI Chatbot."

See https://www.wsj.com/articles/chatgpt-ai-chatbot-punderdome-jokes-11670602696?st=ti0hsq1v79enlh2&reflink=desktopwebshare_permalink

This link isn't paywalled so non-subscribers can read.

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Dr., the results on ketone bodies improving ejection fracture is quite interesting. I've read you a long time but I don't recall you talking much about Vitamin E. The Shute brothers (Canadian doctors practicing between the 1930s and 1970s) used vit E to great effect in treating CAD. I'll point you to their book at the internet archive (hard to find a real copy anymore).

https://archive.org/details/drwilfrideshutes00shut/page/100/mode/2up

Check out chapter 7 of that book (Dr. Wilfrid E. Shute's Complete Updated Vitamin E Book) adnd you'll see the research that was performed decades ago proving vit E is an antithrombin, antioxidant (which it's primarily known for now), amongst other characteristics. It's antioxidant properties are probably as effective as the ketone bodies... they'd be an interesting one-two punch where ketones improve flow and vit E reduces the tissue's needs for oxygen (alternately, it binds with PUFA to prevent its oxidation thereby sparing more oxygen for the tissues).

Anyway, fascinating stuff that we don't hear nearly enough about. My cardiologist laughs at me when I talk to him about vit E, vit C, Dr. Kendrick's "The Clot Thickens" with its alternate hypthesis, etc. Yes, yes, I should find a new one but I fear most of them worship at the altar of the lipid hypothesis exclusively. Sigh.

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Maybe, but I seriously doubt any form of vitamin E could increase the ejection fraction as much as ketones did as presented in the paper.

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Here’s a little typo for you: “The paper mainly discusses the affect that ketones have on the endothelium” - “affect” should be “effect”.

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All fixed. Thanks.

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No -I think Mike had it right. Here's the rule:

affect is a verb that means to impact or influence something, and effect is a noun that means a result or consequence of an action.

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Exactly. The way Dr. Mike used it, it's a noun, and should be "effect".

To wax pedantic for a moment, "effect" can be a verb in the sense that "he effected his escape from prison".

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You are right! I always think of effect as only a verb - and affect as the noun. Got that wrong - for lo these many years!!

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Heh! You wouldn't believe how long it took me to finally memorize the correct spelling of Tuesday. :-)

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I have heard (not sure where) that the heart muscle prefers to run on ketones vs glucose, and will preferentially take ketones from the blood before other parts of the body get a chance ..? And that maybe angina heart pain is similar to the lactic acid build up in muscles after exertion and being forced to run on glucose vs ketones? Not sure if that’s the case or not, but just thought I’d put it out there for discussion 😀. Loving the newsletter - have been following since it had no name. 🥰

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Yep, according to work by Richard Veech, the heart operates about 25 percent more efficiently on ketones than it does on glucose.

I don't think angina is a consequence of lactic acid build up. Probably more a lack of oxygenated blood. But I'm willing to be re-educated.

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I'm a long time reader, Dr. Mike, but sometimes your first world problems (not being able to drive your Tesla 85 miles an hour on the freeway) strike me as rather tone deaf.

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Nah, just keeping up with traffic here.

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This may be the first argument I've seen for exogenous ketones that makes sense.

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Problem is, you'd have to drink them all the time. Much easier to just follow a ketogenic diet, I would think.

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Obviously you've never driven freeways in Los Angeles. Or other parts of California. Drivers fly. And if you don't go 80-85, you get left behind. That's the typical flow-of-traffic speed here if traffic is light.

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I think you replied to the wrong comment here...

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I think I did, too. I must be as brain dead as some of the drivers I've been griping about.

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any projections as to a publication date for Protein Power 2.0 - eagerly awaiting it

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No date yet. I've got a couple of projects I've got to get done before I can get back to it.

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I'd love to know more about the ejection fraction improvement with BHB. Does one need to keep their ketones at that level all the time? I have left-ventricular non-compaction and while I'm currently (and have always been) asymptomatic and quite healthy (mine was discovered only upon imaging after sister and mom were symptomatic and diagnosed with it), I have seen my ejection fraction decline by 7% (from 70% to 63%) in the past two years and this bothers me. I'm not keto but definitely high protein+low carb. Curious if focusing on ketosis more could improve my EJ or at the very least slow its decline. Updating my echo and cardiac MRI tomorrow so this was a timely email!

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Based on this paper, you might be able to increase you EF if you can get your ketone levels to ~3.0 mM/. I just heard back from a doctor friend today, who told me he had successfully treated three cases of heart failure with a ketogenic diet.

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Thank you! I guess my question is how long one must keep it there? And isn't maintaining ketone levels that high long-term difficult? I thought that once fat-adapted, measuring high ketones becomes increasingly difficult since you burn them so fast/efficiently. Plus, ketogenic for me would mean less protein and as a menopausal woman who strength trains, protein is my savior :(

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You can get plenty of protein on a ketogenic diet. Protein turns to glucose only if you need it to. It's a pull phenomenon, not a push. In other words, a bit more protein won't bump your blood sugar and take you out of ketosis.

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Sorry for the late comment. Just now reading. The bitchute video makes my blood boil. I hope plenty of people of influence are now working on uncovering all the cover ups the past 3 years. And yes I’ve known several who probably wouldn’t have died if they had received HDC early and NOT received RDV in the hospital. What a waste.

Working on converting my elderly parents to Keto. Dad with afib, spinal stenosis and now Parkinson’s. Seeing some results that they are attributing to Levadopa. But I think the diet changes are helping just as much.

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Do you think there is some degree of heart damage sustained with every dose of the vaccine? Unfortunately I had two doses of the modera vaccine before going low carb and waking up to the horrible healthcare bs.

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It's difficult to say at this point. Which is why I think it is abominable that they released this vaccine without doing way, way more testing for long-term problems with it. If we were talking about an epidemic of Ebola where mortality 50-70 percent, then maybe rushing to inject everyone and his brother might be understandable. But for a disease with a mortality rate about the same as the flu?!?!

The spike protein attaches to the ACE 2 receptor, which is all over the vascular system. So it isn't far fetched to think the vaccines might be causing all kinds of vascular problems.

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So the drivers who actually comply with the traffic laws are the vax brain idiots. It’s the Dr Eades of the world, who treat traffic laws as a mere suggestion, and believe it’s simply up to them which traffic laws they should comply with and which ones they are free to ignore; those are the right thinking folks. I thought a doctor would be aware of the tremendous toll in death and injuries traffic accidents produce on an annual basis. And the two major causes of traffic fatalities - intoxicated driving and driving at EXCESSIVE speed. First do no harm, good doctor. If it’s perfectly okay for you to violate a traffic law, what of the drivers who choose to ignore stop signs & traffic lights. That okay too? . Why don’t you sit down and calculate just exactly how much time you save by speeding and putting others in harms way - it’s minimal, especially in Southern Cal. Try leaving a bit earlier. And by all means stop denigrating that portion of the population who choose to follow the laws.

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I guess I didn't make myself clear in what I wrote. The people I was talking about were not driving at the speed limit, while I was trying to fly along at a high rate of speed. These folks were driving 5-15 mph UNDER the speed limit, which is practically unheard of here. When I drive, I like to get with the flow of traffic, which in the LA area is 80-85 mph when the freeway isn't crowded. At that rate, I'm not passing anyone, and no one is passing me. Traffic just flows along nicely.

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One time when I was driving with the flow of traffic, I encountered a big radar operation. They pulled all of us over and we all got tickets.

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Well okay but you specifically wrote as well about “the jerks” driving at 65 mph. I had spent more time on the 101 than I care to remember, and I don’t recall ever seeing a traffic sign stating a maximum speed limit of 65 or whatever the individual driver deems the flow of traffic to be. Try trotting that argument out in traffic court. As well, having spent too much time on the LA freeways I have never observed multiple drivers traveling well below the speed limit. I have observed on many occasions drivers (myself included) who are running late, perceiving that everybody else on the road is an idiot, driving too slow etc etc. But maybe the radar gun you carry tells a different story.

A car driving down the freeway blows a tire. Who is more likely to maintain control, and reduce the chance of putting others in harms way, the driver traveling at 85mph or the jerk driving at 65? And BTW, if you are driving in the exact same fashion as you did “back in the day”, you might want to re think things. I’m not a doctor, but I believe the reflexes, reaction time etc are considerably different for a 40 year old verses a 70 year old.. But again my main objection is referring to a driver who sees a posted speed maximum, and complies with that law, being referred to as a jerk.

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You wrote >>As well, having spent too much time on the LA freeways I have never observed multiple drivers traveling well below the speed limit.<<

You are making my case. The day my kid and I drove down there, they were all over the freeway.

And I don't recall seeing a speed limit on the 101 (other than when work is being done). I would assume it is 70-75 mph, but I couldn't swear to it. I can tell you I've flown by (80-85 mph) multiple CHP officers parked on the side of the road without ever getting a ticket, but I was always in the flow of traffic, i.e., everyone was going at that speed.

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Driving under the speed limit in the fast lane is the #1 cause of accidents on the interstate

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I haven't seen any data proving that. But, then, I haven't looked for it. I certainly wouldn't be surprised. What I wonder is why people do it? Passive aggressive? I can't stand to have people backed up behind me--or at least I don't think I could stand it. It's never really happened. Whenever I'm flying down the road at whatever speed, and someone comes roaring up behind me, I simply move over and allow him/her to pass. What's the issue with that? Why can't everyone do that? Passive aggressive?!?! Who knows?

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Regarding the Trump quote about hydroxychloroquine. Not only did it not help his case that it was Trump, but also he's just so terrible about regurgitating facts he may have heard, that he made it sound really stupid. Thereby making it even easier to make fun of him and his recommendation.

Disclosure: even as a recovering liberal, I still loathe Trump.

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However inarticulately he put it, it is the press's job to dig into the facts, not just knee-jerk go the other way.

I thought Trump governed as a moderate Republican. Too many people were put off by his personality to grasp that.

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Absolutely the press abdicated its responsibility there. I was just pointing out that Trump's statements about it made it really easy to make fun of him. Actually the only Facebook post I made that was taken down (two years after the fact!) was a funny satirical meme about drinking bleach.

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If Trump had said two plus two equals four, the press would have found some way to revile him. Strangely enough, Trump's loss in 2020, driven in great part by a crazed and dishonest press, has ended up causing all of them huge declines in subscribers and viewers. Now they're all confronted with massive layoffs. Had Trump been re-elected, I have no doubt they would still be going strong.

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You asked for typo alerts. Here are some phrases that need fixing:

'Other than breath oxygen from a cylinder' (should be breathe)

'he quit to go college'

'Her dad asked my why '

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All fixed. Thanks.

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