Why are carb cravings so hard to break? @DominicDAgosti2 explains how ketosis quiets the brain’s reward response to sugar and carbohydrates. @AnnetteBosworth, who treated addiction before she taught ketogenic diets, explains why carbs bring relief instead of joy, and why that keeps the cycle going. In the full episode of The Metabolic Link, they also explore: • What did Dr. Boz observe when using low-dose tirzepatide in patients already in ketosis? • What happened to her class’s morning fasting numbers after a 72-hour sardine fast? • Why might blood pressure medications need reassessment when starting a ketogenic diet? • Why does she emphasize physician involvement for participants taking prescription medications? Have a question for Dr. Boz? Join her free live Q&A on Zoom, Wednesday, October 14 at 9 AM PT / 12 PM ET. No membership required. Register at live.metabolicinitiative.com.

One person’s numbers tell one story. @AnnetteBosworth tracks 200 people at once. In her live, 21-day online ketogenic class, participants track their glucose and ketone levels using shared dashboards that Dr. Boz monitors in real time. Following a 72-hour sardine fast, she observed some of the class’s best morning fasting numbers the very next day. In the full episode of The Metabolic Link, hosted by @DominicDAgosti2, they explore: • What did Dr. Boz observe when using low-dose tirzepatide in patients already in ketosis? • What does “relief, not joy” reveal about carbohydrate addiction? • Why might blood pressure medications need reassessment when starting a ketogenic diet? • Why does she emphasize physician involvement for participants taking prescription medications? Have a question for Dr. Boz? Join her free live Q&A on Zoom, Wednesday, October 14 at 9 AM PT / 12 PM ET. No membership required. Register at live.metabolicinitiative.com

What happens when an internist teaches ketogenic nutrition to 200 students at the same time and tracks every one of their glucose and ketone readings on shared dashboards? @AnnetteBosworth is an internal medicine physician and the author of ANYWAY YOU CAN and ketoCONTINUUM. After leaving corporate medicine she rebuilt her practice around ketone metabolic therapy, first with her own patients and now through a live 21-day class where small groups of ten work with coaches who have done the diet themselves. In this episode she walks @DominicDAgosti2 through what that model has taught her: why every student does a 72-hour sardine fast and the changes she has observed in morning glucose and ketone readings the day after, how she started a medically supervised group already in ketosis on 0.6 mg of tirzepatide once weekly (approximately one-quarter of the labeled 2.5 mg starting dose) and her report that roughly nine in ten stayed at that dose, and why she asks every participant to keep their own physician involved as blood pressure medications may need reassessment in the first week. The conversation also covers the six-week ketogenic trial she ran with her mother during a leukemia recurrence, why she treats carbohydrate cravings the way she treated addiction in her clinic, and the free weekly support groups that classes from her first cohort still attend. Questions Answered in This Episode: • What has Dr. Boz observed during her 72-hour sardine challenges? • What did Dr. Boz observe when using low-dose tirzepatide in patients already in ketosis? • What does "relief, not joy" reveal about carbohydrate addiction? • Why can blood pressure medications require reassessment when starting a ketogenic diet? • Why does she emphasize physician involvement when participants take prescription medications? • Why does she combine group coaching with glucose and ketone tracking? Viewers will come away with a practical picture of ketone metabolic therapy as it is actually delivered: the protocol, the monitoring, the medication monitoring and reassessment, and the community structure that keeps people in it.

What if the uterus is an end organ, responding to insulin and inflammation the same way the heart, kidneys, and liver do? Dr. Andréa Salcedo is a board-certified OBGYN (DO, MPH, FACOG) and associate professor at Loma Linda University School of Medicine whose research and clinical practice, which she calls conscious gynecology, examine gynecologic disease through a metabolic lens. In this episode she walks through the evidence that uterine fibroids share progenitor cells with atherosclerotic plaque, why she now teaches residents that fibroids are cardiovascular disease of the uterus, and how high insulin acts at the level of the brain stem to block ovulation. The conversation also covers her clinical observations on fasting insulin thresholds by body type, the renaming of PCOS to PMOS, what hormonal contraceptives do and do not treat, the role of chronic stress and adversity in gynecologic disease, and the four insulin-resistant transitions of a woman's life. Questions Answered in This Episode: • Why are uterine fibroids being reframed as cardiovascular disease of the uterus? • Can the menstrual cycle function as a metabolic vital sign? • How does insulin, acting as a stress hormone, shut down ovulation? • Is there an optimal fasting insulin for reproductive health, and does body type change the answer? • What does the shift from PCOS to PMOS change for diagnosis and treatment? • What happens to insulin resistance in perimenopause, and was the Women's Health Initiative misread? Viewers will come away with a physiological framework that treats heavy periods, fibroids, irregular cycles, and PCOS as early signals of metabolic dysfunction rather than isolated hormone problems.

Ketogenic and low-carbohydrate diets often focus on a specific carbohydrate target: keep your net carbs under 30 grams. But as registered dietitian and certified diabetes educator @LowCarbRD demonstrates in this presentation from Metabolic Health Summit, a carbohydrate target is not a therapy. Effective implementation means a full assessment of medical history, medications, labs, food preferences, lifestyle, and the motivation that will carry a patient through year one and beyond. Spritzler specializes in low-carbohydrate and ketogenic nutrition and has extensive experience helping people use these approaches to improve metabolic health. The creator of lowcarbdietitian.com, she walks through the practical decisions clinicians face: when a ketogenic diet is warranted versus a more flexible low-carbohydrate approach, why she recommends 1.2 to 1.8 grams of protein per kilogram rather than the RDA's 0.8, how to manage medication adjustments for patients at risk of hypoglycemia or hypotension, and how to handle electrolytes, carbohydrate counting, sweeteners, and plant-based variations without losing the patient along the way. Questions Answered in This Episode: • What actually separates a ketogenic diet from a low-carbohydrate diet, and when does the difference matter? • Why is the protein RDA too low for long-term metabolic health, and what range does Spritzler recommend instead? • Who should avoid ketogenic diets entirely, and why are most contraindications manageable with closer supervision? • How should medications be monitored and adjusted when a patient begins carbohydrate restriction? • Should patients count net carbs or total carbs, and why are packaged "net carb" labels unreliable? • Can a ketogenic diet be done as a vegetarian or vegan? A practice-tested blueprint for turning carbohydrate restriction from a prescription into a therapy patients can sustain.