Insulin Doctor: This Is The First Sign Of Dementia! The Shocking Link Between Keto & Brain Decline!

Nov 24, 2025
Overview

Dr. Annette Bosworth, an insulin resistance specialist, details how adopting a ketogenic diet and managing insulin levels can reverse chronic diseases, improve brain function, and enhance longevity by promoting ketone production and reducing cellular inflammation.

At a Glance
16 Insights
1h 51m Duration
24 Topics
8 Concepts

Deep Dive Analysis

Introduction to Ketogenic State and Insulin Resistance

Medicine 2.0 vs. Preventing Chronic Illness

Predicting and Reversing Chronic Illness

Impact of Eating Timing on Insulin and Aging

Understanding Insulin and Its Role in Chronic Disease

Signs of High Insulin and Insulin Resistance

Benefits of Ketones as a Fuel Source

Personal Experience and Brain Benefits of Ketosis

Ketosis and Physical Performance/Muscle Repair

Ketogenic Diet's Link to Neurodegenerative Diseases

Measuring Ketone and Glucose Levels

Cortisol's Effect on Morning Glucose Levels

The Keto Continuum: A 12-Step Process

Metabolic Differences for Men and Women on Keto

The Sardine Challenge for Ketosis

Keto Diet Macronutrients and Grocery List

Sardines and Gut Microbiome Health

Essential Supplements: Vitamin D, Magnesium, Omega-3

Exogenous Ketones: Benefits and Usage

Ketogenic Diet for Cancer Patients

Methylene Blue and Creatine for Brain Health

Natural Alternatives to GLP-1 Agonists

Maintaining Motivation on a Health Journey

Dr. Bosworth's Legal Battle and Personal Resilience

Insulin

Insulin is a hormone that transports glucose (sugar) from the bloodstream into cells for energy. When cells are full, excess glucose is stored in the liver as glycogen or converted into fat, leading to 'fluffiness' and chronic disease when in excess.

Ketogenic State

A metabolic state where the body primarily burns fat for fuel, producing ketones, instead of glucose. This occurs when carbohydrate intake is very low, and glycogen stores are depleted, leading to cleaner energy production and reduced cellular trash.

Insulin Resistance

A condition where cells become less responsive to insulin, requiring the body to produce excessive amounts of the hormone to manage blood sugar. This high insulin state can lead to chronic inflammation, fat storage, and various health problems, often without elevated blood glucose initially.

Glycogen

Glycogen is a stored form of glucose, primarily in the liver and muscles, serving as an efficient way to store sugar. The body must deplete these stores before it can switch to burning fat and producing ketones.

Dr. Boz Ratio

This is a calculation of blood glucose divided by blood ketones. A high ratio indicates that the body is primarily burning glucose and making a lot of 'trash' (inflammation), while a lower ratio suggests the body is efficiently burning fat and producing ketones.

Acanthosis Nigricans

A fancy term for velvety, darker, and thicker skin, often appearing on the back of the neck or elbow creases. It is a pathological sign of high insulin levels, not dirt, and is commonly seen in teenagers with weight gain.

Butyrate

A two-carbon fat chain that can be produced by gut bacteria from fiber or is a form of ketone (beta-hydroxybutyrate) circulating in the blood. It is important for a healthy gut microbiome and stimulates the production of GLP-1 hormones.

Exogenous Ketones

Ketones consumed externally, typically through drinks or supplements, rather than produced by the body through diet. They can provide a quick fuel source and signal the liver to increase its natural ketone production, helping to jumpstart or maintain a ketogenic state.

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What is the biggest issue with insulin resistance?

The biggest issue with insulin resistance is that it is a chronic disease maker, causing high blood pressure, cancer, and debris in the brain linked to depression, brain fog, Alzheimer's, and Parkinson's, all due to excess insulin that goes unnoticed.

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What are the scary signs that indicate excess insulin or insulin resistance?

Key signs include abdominal girth, skin tags (small mushroom-like growths in armpits or groin), velvety, darker, and thicker skin (acanthosis nigricans) on the neck or elbows, and hair loss on the toes and lower extremities.

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How can I measure my ketone levels?

Blood ketone meters are recommended for accuracy, but urine ketone strips can be used, especially early in a ketogenic journey, as excess ketones are often peed out. A blood ketone reading of 0.5 or greater, combined with a non-triple-digit blood sugar, indicates fat burning.

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How long does it take to achieve ketosis and feel its brain benefits?

For someone with significant insulin resistance, it can take up to 15 days or even longer to deplete glycogen stores and start producing ketones. For those in better metabolic shape, it might take a few days, and once adapted, one can flip back into ketosis within 12 hours after a high-carb meal.

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Does a ketogenic diet impact strength and power for athletes?

Initially, there might not be significant changes, but over time (e.g., 6 to 18 months), athletes on a ketogenic diet can experience a 20% to 50% increase in power compared to their counterparts, as muscles become more efficient at using fat for fuel, which is a longer and better source.

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Can a ketogenic diet help with neurodegenerative diseases like Alzheimer's and dementia?

Studies suggest that ketogenic diets can provide an alternative, cleaner fuel source (ketones) for the brain, boost mitochondrial function, lower inflammation, protect neurons, and improve insulin sensitivity, potentially slowing cognitive decline and showing temporary improvements in memory and cognition in early stages.

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What is the best time to eat to avoid excessive insulin production?

As one ages, it's better to consume calories earlier in the day, as eating food after 6 PM can stimulate excessive insulin production. Moving meals towards the morning and stopping eating earlier in the afternoon (e.g., 3 PM) helps manage insulin levels.

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How does cortisol affect metabolism in the morning?

When the sun rises, cortisol levels naturally increase, signaling the liver to release stored sugar (glycogen) into the bloodstream. This causes a natural rise in blood glucose in the morning, even without eating, with the amount depending on one's insulin resistance.

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Do I need to fully cut carbs to get into ketosis?

To effectively get into a ketogenic state and reverse medical problems, total carbohydrate intake should be less than 20 grams per day. Playing with 'net carbs' (total carbs minus fiber) is not recommended for those with high insulin resistance, as total carbs are what matter.

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Will a high-fat, low-carb diet negatively affect my gut microbiome diversity?

A ketogenic diet, even one focused on specific foods like sardines, can support a healthy and strong gut microbiome. The gut biome adjusts, and the production of butyrate (a two-carbon fat chain) is crucial, which can come from either fiber breakdown or circulating ketones, supporting beneficial bacteria.

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Why is Vitamin D so important, and how does it relate to insulin and weight loss?

Vitamin D is a hormone that influences every cell in the body to function optimally. If insulin is high, Vitamin D, being fat-soluble, can get 'stuck' in fat cells and not reach its target cells. Lowering insulin allows fat to mobilize, increasing circulating Vitamin D levels and improving overall health.

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Are there natural alternatives to GLP-1 agonists (like Ozempic) for reducing cravings?

Yes, natural ways to raise GLP-1 hormones and suppress appetite include losing weight (as being overweight suppresses GLP-1), consuming allulose, and increasing butyrate production through a ketogenic state or supplements. A ketogenic state naturally raises these hormones, reducing cravings without injections.

1. Prioritize Insulin Management

Focus on lowering insulin levels to reverse existing medical problems and prevent future chronic diseases, as high insulin is a primary driver of many health issues like high blood pressure, cancer, and brain degeneration.

2. Adopt a Ketogenic Diet

Reduce total carbohydrate intake to less than 20 grams daily to enter a ketogenic state, which helps burn fat, preserve muscle mass, improve brain performance, and reduce systemic inflammation.

3. Optimize Eating Timing

Shift calorie intake to earlier in the day and avoid eating late at night (e.g., after 6 PM) to prevent excessive insulin production, especially as you age, allowing your body to process food before morning cortisol rises.

4. Utilize Sardines for Ketosis

Incorporate sardines, a high-fat, high-protein, nutrient-dense, and affordable food, as a tool to quickly achieve satiety and enter a ketogenic state, potentially through a 3-day ‘sardine fast’ where you eat as much as desired.

5. Increase Dietary Fat Intake

If struggling to produce ketones despite low carb intake, actively increase consumption of healthy fats like eggs, beef, brisket, pork belly, or even butter, to provide the necessary fuel for ketone production.

6. Measure Ketone and Glucose Levels

Regularly check blood ketone levels (aim for 0.5 or greater) and blood sugar (non-triple digit) using a blood meter to confirm ketosis and monitor insulin activity; urine strips can be used as an initial, cheaper method.

7. Engage in Prolonged Fasting

For individuals with a history of high insulin (15-20 years), consider incorporating 36-72 hour fasts to significantly reset metabolism and encourage the pancreas to produce less insulin over time.

8. Understand Ketogenic Adaptation for Performance

Allow 6-18 months for muscles to fully adapt to using fat for fuel to see significant improvements in power and endurance; avoid starting a ketogenic diet immediately before a major athletic event as initial performance may decline.

9. Supplement with Vitamin D

Ensure adequate Vitamin D levels (aim for 50 or greater for optimal brain function), as this hormone is crucial for cellular health and can be trapped in fat cells by high insulin, preventing its proper utilization.

10. Supplement with Magnesium

Take magnesium daily, as it is a vital mineral required for ATP recycling and almost every enzyme in the body, and modern diets and soil often lead to widespread deficiency.

11. Consider Methylene Blue for Brain

Explore methylene blue as a powerful brain energizer that supercharges brain function and enhances mitochondrial energy, as it effectively crosses the blood-brain barrier to reach brain cells.

12. Take Creatine for Brain and Jet Lag

Supplement with creatine daily for improved focus, support for ADHD, and to mitigate jet lag (e.g., 20g after a flight, 10g in the morning, 10g at night), but be aware that it can falsely elevate kidney function test results.

13. Use Exogenous Ketones as Catalyst

When trying to re-enter ketosis or for individuals with chronic insulin resistance, consume exogenous ketones to jumpstart the liver’s natural ketone production and provide immediate fuel for the brain and body.

14. Boost Natural Appetite Suppression

Promote the natural production of GLP-1 hormones by losing weight and consuming butyrate (found in ketones) or allulose, which can help reduce cravings and suppress appetite without injections.

15. Cultivate Deep Motivation

Identify your deepest ‘why’—your core insecurities, past failures, or life purpose—to sustain long-term health changes, moving beyond short-term, crisis-driven motivation.

16. Practice Daily Devotion

Engage in a daily spiritual practice, such as scripture reading and prayer, to center yourself, find inner peace, and build a strong foundation for navigating life’s challenges and tough days.

Fiber is for farting.

Dr. Annette Bosworth

One bite of food after 6 o'clock is worth 10 bites of food before noon.

Dr. Annette Bosworth

You cannot make a ketone if your insulin's high.

Dr. Annette Bosworth

Burning ketones is an antioxidant state. It is a, and it's in the space where you need it, which is inside that cell.

Dr. Annette Bosworth

When you put the sugar back in, the swelling goes back into their brain. Insulin and water flood the body. And it's almost like a minor concussion.

Dr. Annette Bosworth

The amount of benefit that people get from sardines versus whatever might be in that can, I tell patients not to worry about it.

Dr. Annette Bosworth

Your current physiological environment, so your current, the current state of your body was the single biggest predictor of your outcomes.

Steven Bartlett

Methylene blue, it's old as dirt, so nobody's making money on it, but it is a dye. And so if you swallow it, you'll pee blue, but it's also a bridge for how to help mitochondria move fuel along.

Dr. Annette Bosworth

When you're looking at using this powerful hormone, okay, and use it for a short time, use it for a long time, what are the rules? These are brand new.

Dr. Annette Bosworth

Keto Continuum: 12 Steps to Get Into a Consistent Ketogenic State

Dr. Annette Bosworth
  1. Stage 1 (Beginner): Eating every 2-3 hours (where most people start if they fall off the wagon).
  2. Stage 2: Cut total carbs to 20 grams or less per day, measure urine ketones daily.
  3. Stage 3: Ride the wave of ketone production, allowing fat-based hormones to resurrect.
  4. Stage 4: Experience a 'magical moment' of skipping a meal (typically by day 10 for average person).
  5. Stage 5 (Time-Restricted Eating): Implement a 16:8 eating window (16 hours fasting, 8 hours eating).
  6. Stage 6: Gradually slide down the eating window by an hour at a time.
  7. Stage 7: Progress to a 23:1 eating window (23 hours fasting, 1 hour eating).
  8. Stage 8: Shift eating window towards sunrise, stopping eating late at night.
  9. Stage 9 (Prolonged Fasting): 36-hour fast.
  10. Stage 10 (Prolonged Fasting): 48-hour fast.
  11. Stage 11 (Prolonged Fasting): 72-hour fast.
  12. Stage 12: Consistently take out the trash by maintaining a ketogenic state.

Sardine Challenge (Intense Ketogenic Reset)

Dr. Annette Bosworth
  1. On day 6 of an advanced ketogenic diet, eat only sardines for the next three days.
  2. There is no eating window; eat as much as desired.
  3. Consume sardines in oil for higher fat and protein content, making them easier to eat.
  4. Aim to feel satiety and fullness throughout the challenge.
Less than 20 total grams per day
Carbohydrate intake to begin a ketogenic diet For medical-grade ketogenic diet to reverse problems, not 'lazy keto'.
0.5 or greater
Ketone level for being in ketosis In combination with non-triple-digit blood sugar.
Within 12 hours
Time for Dr. Bosworth to flip back into ketosis After a high-carb meal, due to being in better metabolic shape.
20% more at 6 months, almost 50% more at 18 months
Increase in power for soldiers on ketogenic diet Compared to counterparts, due to muscles training to use fat.
3 weeks
Time for Down syndrome patient to show brain improvement on keto Diagnosed with Alzheimer's, started saying three-syllable words for the first time.
$60-$70
Cost of a ketone and glucose meter kit Includes about 50 strips for simultaneous ketone and glucose measurement.
83
Dr. Bosworth's blood glucose reading Considered good, not low.
1.7
Dr. Bosworth's blood ketone reading Indicates strong fat burning.
88
Jack's blood glucose reading Not too bad.
0.1
Jack's blood ketone reading Indicates running off glucose, making 'trash'.
100 days
Duration of Jane's sardine-only diet Resulted in significant health improvements and emotional breakthroughs.
From 30s-40s to 105-108
Jane's Vitamin D level increase on sardine diet Without supplementation, due to lowered insulin mobilizing fat-stored Vitamin D.
20 grams after flight, 10g morning/10g night
Creatine dosage for jet lag To augment sleep reset.
70%
Reduction in mother's cancer numbers on keto In 6 weeks, compared to 30% expected from chemotherapy.