Dom D'Agostino, Ph.D.: ketosis, n=1, exogenous ketones, HBOT, seizures, and cancer

**Peter Attia** (0:04)
Hey, everyone, welcome to The Peter Attia Drive. I'm your host, Peter Attia.
The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions I've gathered along the way. I've spent the last several years working with some of the most successful top performing individuals in the world. And this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com.
In this episode, I interview my good friend, Dominic D'Agostino. Dom, as he is known by, is a professor at the University of South Florida. His PhD is in neuroscience, and that's where he got his background, but Dom is probably most recognizable to people listening to this because he is certainly one of the experts on ketosis, and that's in all variants of it, so starvation ketosis, nutritional ketosis, and in particular, the use of exogenous ketones.
Gosh, Dom and I go way back. We met probably a little over five years ago and instantly formed a friendship around our obsessive N of one experiments, although I will say he is closer to winning a Darwin Award on the basis of his N of ones than I am. Couple notes about this podcast. First, this is highly technical at times. And in fact, we'll timestamp it in the show notes, but I would say roughly the first hour is even a little more technical than I had intended to go. I think part of the issue is just once I get talking with Dom about this stuff, I couldn't stop asking him questions. And I think there were times when I guess we forgot we were recording a podcast and it was just us getting really technical. I don't think it's too technical to follow if you have some background in understanding biochemistry, but we'll do our best in these show notes to make sure that we're given even the recreational user the necessary tools to follow this. Now, that said, if you get 20 minutes into this thing and you're like, I don't understand what the hell these guys are talking about, do not hesitate to skip ahead. There's a lot of stuff that gets later on into the podcast. And this is a long podcast, it's nearly three hours. There's a lot of stuff we get into at the end that I think will be kind of the stuff people really wanna know, even if they don't wanna get in the gory details. So in particular, we talk very specifically about all of the ketones. And I'm getting a lot of questions about Peter, what's the difference between a ketone ester or ketone salt? What are the mono esters? What are the di esters? Where does MCT fit into this? What about the caprylic acid? And how many should we be using? This one versus this one. And what are the advantages and disadvantages? This is going to be your dissertation level course in that subject matter. The other thing that we get into at the very end, and we almost end on this, but again, look to the timestamps for exactly where it is, is we get into what I consider one of the most interesting discussions I've ever had on what I sort of loosely describe as a metabolic oncologist playbook. So when I asked Dom about this, he had just some of the most interesting insights, and I was really impressed by the breadth and the organization of his thinking around this. Now, I want to point out something here, and I say it in the show, but it's really important for me to caveat this here.
This cannot be construed as medical advice. Dom is not a medical doctor. He doesn't pretend to be one on TV. He is a research scientist who focuses on basic and translational research. He collaborates with lots of physicians. He is involved in a number of clinical trials, but ultimately, Dom is not offering medical advice, and frankly, nor is anybody or nor should anybody be on a podcast. So this information I asked because I get asked this stuff a lot, and frankly, I don't know enough about this sort of outreaching and outlying metabolic therapies out there, but I hope that if people are listening to this and they're afflicted by cancer, which statistically speaking is obviously going to happen given that one in six people are gonna get cancer in their lifetime, I hope that if some of this stuff does scratch someone's sort of desire to understand more, that they can use some of the resources we're gonna link to to potentially identify the right places where either a clinical trial will be taking place or they could at least pursue some of these things under the appropriate medical guidance.