February 27, 2024 • 46 mins
In this episode of the 'Ketones and Coffee Podcast', host Lorenz has an enlightening conversation with Dr. Leslyn Keith, a certified Lymphedema and Clinical Doctorate holder in occupational therapy. Known for her extensive two-decade experience and specialty in treating lymphedema and obesity with a ketogenic diet, Dr. Keith talks about how a ketogenic lifestyle can remarkably improve individuals dealing with these conditions.
Throughout the chat, she shares numerous transformative testimonials from patients whose lives have drastically improved, particularly in terms of pain reduction and quality of life, due to this dietary approach. In addition to discussing practical practices for maintaining the ketogenic diet, Dr. Keith also reveals information on an upcoming virtual conference on nutrition in lymphatic disorders, organized by 'Lipoedema Simplified.'
00:00 Introduction and Guest Presentation
01:00 The Ketogenic Diet and Lymphedema
02:22 Personal Journey into Ketogenic Diet
02:56 The Impact of Obesity on Lymphatic Disorders
04:07 The Role of Ketogenic Diet in Treating Obesity and Lymphedema
04:50 The Success Stories of Patients
08:05 The Science Behind Ketogenic Diet and Lymphatic Disorders
12:16 The Challenges and Misunderstandings of Lymphedema and Lipedema
17:57 The Importance of Healthcare Provider Support
21:31 The Impact of Ketogenic Diet on Patients' Lives
27:32 The Role of Carbohydrates and Fat in Lymphatic Disorders
38:12 The Success Stories of Patients (Continued)
43:08 Conclusion and Final Thoughts
Connect with Dr. Leslyn Keith
leslynkeith.com
She is the author of two books (The Ketogenic Solution for Lymphatic Disorders and The Lymphatic Code) and published several articles about the efficacy of a ketogenic diet for lymphatic and fat disorders.
This Spring, our event will be April 12-14: Keto & Beyond: Customizing Your Plan to Joyful Nutrition. Speakers include low carb clinicians Dr. Georgia Ede and Dr. Tro Kalayjian and lymphatic clinician Dr. Gabriele Faerber, who uses ketogenic nutrition with her patients.
https://learn.lipedema-simp
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Hey guys, we got an interestingepisode for you today.
(00:03):
This was with Dr.
Leslie Keith.
What I love about this episodeis Dr.
Leslie shares, numeroustransformative testimonials from
patients whose lives hasdrastically improved.
We discuss her extensive twodecade experience and specialty
in treating lymphedema andobesity with a ketogenic diet.
(00:23):
I definitely learned so much onthis episode.
And I believe this episode has apotential to really help so many
people's lives who suffers fromthese issues.
Verlaine things stuff, guys.
And without further ado, here'smy interview with Dr.
Lessen Keith.
Lorenz (00:37):
Hey guys, this is Lawrence and welcome back to the
ketones and coffee podcast wherewe talk about creating a
sustainable healthy lifestylethrough the ketogenic diet.
I'm Lawrence and I'm so gratefulto have you join me on this
journey.
Every week I bring in guests whohave the knowledge and
experience to help you on yourown journey to a better health.
So excited for this guy.
Stick around.
Got an incredible guest today.
(00:58):
Dr.
Leslie Keith.
She is a certified lymphedemaand a clinical doctorate holder
in occupational therapy and witha specialization in lymphedema
and obesity.
With over two decades ofexperience, Dr.
Keith has dedicated her careerto helping individuals manage
(01:19):
lymphedema.
and obesity through the use ofthe ketogenic diet.
She brings a unique perspectiveto the discussion exploring how
a ketogenic lifestyle canbenefit individuals dealing with
lymphedema and obesity.
Dr.
Leston Keith, welcome to theKetones to Coffee podcast.
Dr. Leslyn Keith (01:38):
Thank you so much for having me.
I'm thrilled to be part of yourpodcast and your journey to
educate
Lorenz (01:45):
Awesome.
You know, I am so thrilled tohave you.
And you know, let's jump in hereinto this discussion because
lymphedema and keto, I haveheard of lymphedema.
Right.
And keto for lymphaticdisorders.
But I really haven't had anyoneon this show who really had done
the science on the topic.
So, also, you know, what aprivilege to have Dr.
(02:08):
Leslie Keith here who hasconducted numerous studies
during her pursuit of adoctorate that focused on this
topic.
So great stuff here.
I know lymphedema is such amisunderstood, misunderstood
issue.
But I want to start with.
where it all began for you.
Your practice is very specific,right?
Managing lymph, lymphaticdisorders with the ketogenic
diet.
(02:29):
I want to know what sparked thatinterest, or is there any
situation that led you into thisfield?
Dr. Leslyn Keith (02:38):
Oh yeah, definitely.
Because I was trained to treatlymphatic disorders with very
specific treatment using aspecial type of massage and
bandaging people to providecompression to try to reduce the
swelling.
Show them exercises, all thiskind of stuff.
But as probably about a decadeinto doing this treatment for
(03:01):
people with lymphatic disorders,I started noticing that by far,
majority of my patients wereobese.
And not just obese, but a lot ofthem morbidly obese.
So we're talking about BMI's of40, 50, 60.
And I had no idea what to do.
I was on that under thatparadigm of eat less, move more,
(03:24):
you know, plant based, low fatdiet, and nothing was working.
And not only that, it made theirlymphatic disorder worse.
They became more swollen.
And then the things that I wasdoing, which had been working on
someone who wasn't obese.
They weren't working so well,and there was a little bit of
(03:45):
research out there, and it wassaying that obesity made the
lymphatic disorder worse, and soI thought, okay, so now we got
to do something for the obesity,and I was at a loss, because it
didn't seem like anything wasworking.
As you know, we were just seeingmore and more people become
obese, and it seemed like theywere trying hard, but nothing
(04:05):
was working.
So I started hearing about aketogenic diet, and so my first
thought was, Oh, we'll help themwith the obesity using a
ketogenic diet, and that willmake the lymphedema better.
I mean, that's what the littlebit of research out there was
saying that if we treat theobesity, the lymphedema will be
better.
(04:25):
So I started embarking on firstusing it myself because I'm not
going to tell them to dosomething that I can't do
myself.
And, and my, I had a bunch offriends that they were all
trying it too.
What the heck?
And so we found, okay, lookslike this is doable.
It's actually very delicious.
Let's see if we can get peopleto do it.
And so I just experimentally, Isaid, you know, maybe you want
(04:49):
to try this.
And so I had a couple ofpatients that did try it and
they did lose weight and theirlymphedema got better.
Wow.
Wonderful.
And so I said, let me.
Prove this through a study and,and it really, when you go into
a study, you shouldn't beplanning on certain outcomes
happening.
You know, I went about this thetotally wrong way because I was
(05:11):
sure this was going to work.
And so I set up a study so thatI could show that this, this is
feasible.
This works.
So I needed to have a universitybacking me to do that, so I
said, well, I guess I got to getmy doctorate so I could have a
university so I could run thisstudy.
And luckily I found a program ingetting a doctorate in
(05:33):
occupational therapy that said,wherever you want to focus your
work on, go to that.
And of course, I wanted to do iton lymphedema and obesity.
So they allowed me to do that.
I put together a study.
And I actually had 10 of my pastpatients.
who had gone through the programof just the standard massage and
compression therapy and exerciseand stuff.
(05:56):
And now they were on their owntrying to manage their their
lymphedema, but they all had aBMI of over 30.
And so I invited them to be partof a program that was 12 weeks.
Once a week we would meet and wewould help them adopt a
ketogenic diet.
And then we'd look at otherlifestyle factors as well, like
stress and sleep and stuff likethat.
But the main focus was to adopta ketogenic diet.
(06:20):
Well, interestingly, six of themadopted the diet and four said,
no, can't do this.
And they were, you know, veryapologetic to me.
Leslyn, I mean, we ruined yourstudy.
We're not doing the diet.
Don't worry.
I mean, this is, this actuallymakes a comparison group.
So, albeit very small but we hadsix people who did it and four
(06:43):
who didn't.
And the results were actuallyastounding, kind of what I
expected, but even more than Iexpected.
That their swelling went down inthe group that ate
ketogenically, but not in theother group.
And, and the other groupactually got a little bit more
swollen.
The, the pain numbers, the theirability to do just daily
(07:05):
activities because their limbsize was so small.
smaller was so much better inthe ketogenic group than the
other group.
So all of the areas were.
astoundingly different andbetter in the ones that ate this
way.
So from that, I kind ofdeveloped this lifestyle program
to help my patients continue todo this because it seemed like,
(07:28):
wow, this seems like from thesmall pilots that it seems like
it's working.
Well, then an interesting thinghappened is that my patients who
did not need to lose weightsaid, well, would it be good for
me to eat that way?
I mean, is I.
Tried the diet myself and Ididn't need to lose weight, but
I enjoyed it and it seemedpretty healthy.
(07:49):
So So I had some patients thatwanted to use it and didn't need
to lose weight this is when Istarted really revising my View
of a ketogenic diet andlymphatic disorders because I
always thought it was related tojust the
Lorenz (08:04):
Mm
Dr. Leslyn Keith (08:05):
obesity but what we started finding in this
group that didn't need to loseweight is Their lymphedema was
better managed because they wererestricting carbohydrates and
eating more fat.
Lorenz (08:17):
mm
Dr. Leslyn Keith (08:18):
And so then I started looking into this more
and seeing what was out thereand it mostly was animal
studies, looking at lymphaticsand and high fat diets and stuff
like this.
And so what they were showing isthat eating fat actually
stimulates the growth oflymphatic vessels.
(08:39):
So now you have someone whomaybe had a surgery, for
instance, removed lymph nodes orhad radiation to, to to kill the
cancer.
And so it damaged theirlymphatic system, but they eat a
high fat diet and we canstimulate lymphatic vessel
growth.
Well, that's
Lorenz (08:58):
mm
Dr. Leslyn Keith (08:58):
And that might be one of the reasons why this
is so good for someone who has alymphatic disorder.
That it really is beyond just
Lorenz (09:08):
mm
Dr. Leslyn Keith (09:09):
It is also about having the healthy
lymphatic system.
And having it function betterdespite the fact that you have
some kind of lymphatic disorder.
So, I'm, I was pretty astoundedwith that and I continue to be
astounded and I really enjoyhelping people adopt this way of
eating and be able to managetheir lymphatic disorder better.
Lorenz (09:30):
Seems like such a fulfilling line of work.
And, you know, I wanna ask, whenyou said they got better, how
much better did they did theyfeel when, when they go on from
the standard treatment to aketogenic diet, how much better
did they feel?
Dr. Leslyn Keith (09:48):
So, and this is what's interesting because I
started saying to people, well,let's look at more than just the
scale.
Let's just not look at just yourweight.
And so we started looking at youknow, you use bioimpedance to
look at body composition.
So what is how much fat isthere, how much lean and how
much fluid and fluid is prettyimportant when you have a
(10:11):
swelling disorder.
And then we also were looking atlevels of pain, levels of
energy.
I had a fatigue severity scalethat I use and how much were
they impacted by their fatigue.
And so we looked at all thesethings.
I mean, it was amazing.
Okay, just look at pain and I'mgoing to give you some anecdotal
stuff first.
(10:32):
But another lymphatic disorder,lipedema.
This is fat that gets depositedjust on the lower body, and not
on the upper body.
And not only that, the fat ispainful.
So we're talking a very painfuldisorder that can be, out of
ten, ten being the worst, sevento ten.
constant pain.
(10:53):
And so, these women were using aketogenic diet and that the
shortest that I've seen is sixdays on a ketogenic diet to go
from 78 out of 10 down to
Lorenz (11:06):
Wow.
Dr. Leslyn Keith (11:07):
in six days.
Normally, it happens 2 to 4weeks, and this is before
they've lost any weight.
I mean, it was always we assumedthat it was because of the
amount of weight that was on thelower body and stressing maybe
the hips, ankles and knees that,you know, that was causing the
pain.
They wouldn't lose any weightyet, but the pain would already
(11:30):
be gone.
I mean, I just find thatastounding and it's such a huge
improvement to quality of life.
Lorenz (11:37):
I can imagine like, you know, living with that pain and
then all of a sudden, like yousaid about four, four to six
weeks.
Dr. Leslyn Keith (11:45):
Yes.
Very, very, very short time.
I mean, and you know that in theearly part of using a diet, you
can lose a lot of water weight.
So you might in that first monthlose about, you know, five to 10
pounds in that first month, justbecause of water weight, but
without any weight loss.
They were having their painseverely diminished or even
(12:09):
completely resolved.
I mean, I just found thatabsolutely astounding.
Lorenz (12:13):
hmm.
You know, I want to go, I wantto go back.
Not a lot of people, you know,understand this disease and even
the sufferers get conflictinginformation about it.
You know, some, also somedoctors that.
You know, these separatesufferers may come across with
maybe say, there's no cure.
I'm not, you know, generalizingeverybody, but you know, the
(12:35):
general idea is there's no curefor it.
Right.
So I imagine how daunting thiscan be for, for the sufferers.
If you don't mind, I would liketo discuss this topic even, even
deeper.
Typical symptoms.
What does one with lymphedemaexperience?
Well, you know, you, you talkedabout pain.
What is the current, also what'sthe current treatment you talked
(12:55):
about?
You had, you know, 10 people dothe, the study, but before that,
what, what, what was thetreatment that they were on?
Dr. Leslyn Keith (13:04):
yes, yes, yes.
And, and and there's twoconditions that I really do most
of my work on, and they,they're, they sound very
similar, but they're two reallydifferent conditions.
And one is lymphedema, L Y M PH.
edema or swelling.
So that is different from lipedema, L.
(13:27):
I.
P.
Edema.
And so lip fat.
cut part of lipids and edemaswelling.
And so they are two differentdisorders, but they both are
lymphatically based.
And so lymphedema is two maincauses that we see are either
you're born with an imperfectlyformed lymphatic system.
(13:49):
So you have swelling in variousregions of your body because the
lymphatic system cannot evacuatethat fluid.
correctly.
And so you swell.
But the other reason is forcancer treatment, that lymph
nodes and vessels are disturbedand damaged.
And then we get swelling to thatregion of the body where you had
(14:11):
the the surgery or the cancer.
And so that is very differentfrom lipidema, which is a fat
disorder, but also a lymphaticdisorder.
And this one, it is almostexclusively women.
And it is, it seems to begenetically and possibly
hormonally based because itseems to start around puberty
(14:35):
most often, but it also can betriggered at pregnancy and with
menopause.
And so the symptoms are that youget a disproportionate fat
deposition to the lower bodyfrom, and it can go from the
waist to the ankles.
But maybe it's just the hips andthe buttocks, or it might go
(14:56):
down to the knees, but it tendsto be a lower body.
But now it's we also see it alot in the arms.
But what remains largelyunaffected is that head, neck
and trunk.
And so it just it looks verydisproportionate, very obvious
when you can see that personthat has that.
But now it's also very, verypainful.
(15:18):
As we talked about, they geteasy bruising.
So bruises just show up in theareas affected by the lipidema
for unknown reasons.
And so we have this set ofsymptoms that is really there's
no blood test or there's noimaging that can say this is
lipidema.
So it makes it even harder todiagnose.
(15:40):
Also you have the healthcarecommunity that maybe is not
aware of it.
And so they say, well, thatyou're just obese and your
obesity happens in your lowerbody.
But the amazing thing that, thatthat we've discovered since it
was first.
labeled in the 1940s is thattypical weight loss measure,
(16:01):
loss measures do not work.
So, this person can diet tostarvation and can exercise six
hours a day, and, and they'll,they'll lose fat on their head,
neck, and trunk, but theaffected areas will not change
at all, at all.
And so, and they're just toldthey're not doing it enough.
(16:23):
They're not you know, they're,they're non compliant, they're
lazy, they're not doing itenough.
And so basically we're punishingthat person when they actually
have a condition they have adisorder that is poorly
recognized.
We do have now some physiciansthat are very knowledgeable
about it.
And but.
Lorenz (16:44):
Not enough.
Dr. Leslyn Keith (16:45):
of times the, the woman doesn't even know
about it.
So she doesn't even know thatshe needs to seek someone out.
I mean, this, this is what'shappened with the internet in
the last, you know, 15, 20 yearshas really helped so many people
because Women are going on theinternet and going, why do I
have fat legs?
And then lipedema is, is poppingup.
(17:07):
And so they are self diagnosingthere.
And that's mostly how, you know,we, we get people together and,
and they, they, they selfeducate about this condition.
It's not coming from the medicalcommunity because it really is.
It's only in the lymphaticcommunity of those healthcare
(17:28):
professionals that are in thatcommunity that really know
Lorenz (17:31):
Mm.
That's one good thing that cameout of the internet, right?
is you're equipping yourselfwith information, right?
Hopefully we are, you know,still like, you validate the
information, obviously look forsources that are really
credible, right?
So, so, you know, takeeverything with a grain of salt
and just you know, if I, Ialways say, you know, find
(17:53):
somebody who reversed thedisease and you'll be on the
right path.
Healthcare system, you talkedabout, you know, the pushback
and how important do you believethe support of a healthcare
provider is from, for patientslike who are pursuing the
lifestyle and nutritionalchanges, particularly in
conditions like lymphedema andobesity that partnership.
(18:16):
How important is that?
Dr. Leslyn Keith (18:19):
it is super important.
And so, I mean, now I'm part oftwo organizations, Lipoedema
Project and LipoedemaSimplified.
And we're trying to give womenthat support to make lifestyle
and dietary and other.
changes so that they can takeback control of their body and
help themselves.
(18:40):
But a lot of times we need thesupport of a health care
provider in order to partnerwith them so that their
medications need to be managed.
They usually don't have onlylipidema or lymphedema.
They typically have otherconditions as well.
And as you know, having been thespace for a while, You know, if
(19:01):
you have, for instance, type twodiabetes, you can't just go on a
ketogenic diet without havingsomeone manage your medications
carefully so that you're notover medicated for your
hypertension or your diabetes orsomething like that.
So, so we need to have thatpartnership with the health care
community.
And so, you know, there's twospaces that I'm trying to break
(19:24):
into with this information abouta ketogenic diet.
And one is to the lymphologycommunity themselves.
And let me tell you, they'vebeen very resistant.
They, they are concerned that asystem that really is
responsible for mobilizingdietary fat, they feel like if
(19:45):
that system is impaired, then wecannot be eating a bunch of fat
and burdening a system that'simpaired.
And you know, that is a, it's avalid discussion to have.
But I think that science hasshown that that system also
relies on fat to heal itself to,to work properly.
(20:08):
And we know that there areessential fats, and so you
cannot starve yourself of thosefats and expect to be healthy.
So the, the lymphology communityhas been resistant, but now
they've done, there's, in justlast five years, there's
probably about six clinicaltrials and case studies about
using ketogenic diet for.
(20:28):
lymphatic disorders.
And so it's getting moreaccepted.
And then the other communityI've gone into is the the low
carb community and the obesitymedicine conferences, because
those are the physicians or thehealthcare providers that might
see someone walk into theirclinic with lipidema or
(20:49):
lymphedema, not even knowingthat they have that diagnosis.
They're just there to get helpwith their obesity.
perhaps.
And so if that those physiciansare knowledgeable about it, and
I will tell you, the low carbcommunity has been very
accepting of that.
This These are bona fideconditions, and these are
(21:09):
something that we need to helppeople with.
So now that now the person hasthe best of both worlds, they
have someone who believes themand will accurately diagnose
them with their lymphaticdisorder.
And they also have support foradopting a ketogenic diet and
any other needs that they havefor their health.
Lorenz (21:30):
Mmm.
So I want to be able to help ourlisteners here if someone is
suffering from lymphedema orlipidema for that matter.
If they, you know, come, ifthey, you know, come forward
and, you know, speak to theirdoctor about lipidema and the
ketogenic diet or lymphedema.
(21:53):
What, what are, if the doctor isdismissive of lifestyle change
and how does that usually playout?
You know, you've, you've seen itwith, with your clients, with
your patients how, how does thatmeeting usually play out and
what, what do they need to do toconvince or maybe swayed their
(22:14):
doctor or physician on, youknow, the path, the right path
to take in that scenario.
Dr. Leslyn Keith (22:21):
Yeah.
So some physicians are swayed bymedical journal articles, but
they don't have a lot of time toread those things, those papers.
But sometimes, even if that theysee that this, the title of the
paper and that it has beenpublished in a peer reviewed
journal and the title says, youknow, a ketogenic diet
(22:44):
beneficial for, you know, X,then then they might, even
without reading the whole paper,they might be more supportive.
I will tell you just in mylittle study, my little pilot
study that I did, one of myparticipants who was.
wildly successful with reducingher pain, reducing the fat mass
on her lower body.
(23:05):
You know, a volume of the legsgoing down, all this kind of
stuff, all increased energy,decreased brain fog, all these
things happen.
And she, went back to her doctorand her doctor, who was a
vegetarian was concerned.
You know, you're eating all thatmeat and all that fat.
You know, I want to check tomake sure this is okay.
(23:26):
Did a bunch of blood work.
Did the coronary artery calciumtest did the the Doppler for the
carotid artery, did all thisstuff.
Everything come back.
Perfect.
She's like 75 years old andeverything is perfect.
All of her numbers are perfect.
And he goes, Oh, I guess youcould continue doing that.
And maybe a vegan lifestyle isnot the best thing for me.
(23:50):
I mean, and that's you know,that is.
Sometimes they have to see theproof of what happens to someone
after they use the diet.
Now, you know that we have thatsub group that is a lean mass
hyper responder, that they go ona ketogenic diet and they get
their LDL numbers, which aresupposedly the bad cholesterol,
(24:13):
that goes up really high.
And so, A doctor may look atthat and say, you know, we've
got everything else is stellar.
Everything is beautiful.
Your pain is down.
You're enjoying life.
Your weight is down.
Everything is good, but your LDLis up.
Some doctors will look at thatand say, that's a problem.
Go off of that diet.
(24:35):
But I think a lot of doctorswill look at that and say, well,
everything else is good.
So maybe you should go ahead andcontinue, but let's keep an eye
on these cholesterol numbers andsee, you know, if we need to do
anything for that, that wouldbe, I would hope for that
reaction, but there's stillplenty of physicians that are
(24:57):
very much afraid of dietary fat,very much afraid of cholesterol
numbers going up.
And so I don't know how much wecan do for that doctor.
What I have suggested is some ofmy patients who have faced that
situation.
I say, well, you know, keep thatas your primary care.
But why don't we go find a likesomeone from the Society of
(25:21):
Metabolic Health Practitionerswho uses a ketogenic diet, who
uses nutrition to help you?
Why don't we use that as aspecialist that you can have
also?
And maybe that's someone thatyou will be seeing on video
visits.
It's, you know, so, you know,not totally, you know,
abandoning your currentphysician, but let's get someone
(25:42):
else on your team that issupportive of what you've chosen
to do.
Sometimes you can't change thephysician.
Sometimes they're not going tochange.
Lorenz (25:51):
sometimes they're not going to change, and it just
takes a while for thatinformation to get relayed.
You know, they say it takesabout 10 years.
I don't know how true that is,before, you know, the
traditional conventional,conventional treatment changes.
But at least we know that thereis a cure because a lot of
(26:12):
people out there who maybe havelymphedema or lipidema, they go
online, you know, searching fora cure and they see, like, I,
Dr. Leslyn Keith (26:22):
Yeah.
And I, I, I have to, I have toclarify that this is actually
not a cure, that these areconditions that you probably
cannot cure, but we can managethem way better than we have in
the past by using diet.
Lorenz (26:38):
And
Dr. Leslyn Keith (26:38):
it's definitely you know, the
standard western diet has.
Caused obesity that compounds alymphatic disorder.
But you know, this person, thisperson has been born with a
imperfect system or they'vedeveloped a condition of
lipedema or lymphedema secondaryto something else.
(27:01):
Things are, there are someirreversible damage that's
happened and, and, but if we canstimulate some new vessel
growth, if we can facilitate thebetter transport of fluids and
fats, then we certainly canmanage it better and with less
discomfort and better quality oflife.
But at this point, even withthis spectacular diet, we can't
(27:23):
say that we
Lorenz (27:24):
yeah.
No, the reason why I said thatis because you said the pain was
seven to 10 down to zero.
I mean, that's, that's, that'spretty amazing.
And then, you know, I was, I wasreading up on some of your
studies that you've done thathigh carbohydrate intake leads
to inflammatory response of thelymphatic system.
Right.
you know, just reducingcarbohydrate intake.
(27:47):
You, you're, you're, you're nothaving any response, right?
You, meaning when you take awaycarbohydrates.
You're basically stop, stoppingthe bleeding and with, with the
help of, you know, the fat,right?
You said fat is therapeutic forthe lymphatic system and also
what's the mechanism behindthat?
I know you've talked about thata little bit, but can you
(28:10):
discuss that mechanism and how,how that works and how does, you
know, fat or maybe is itketones?
I don't know, but can youexplain that a little bit
deeper?
Dr. Leslyn Keith (28:21):
Yeah.
So, and, and on lymphlymphedema, there's no animal
model of, of lipidema.
So they use people in studies,but lymphedema, we can give mice
lymphedema.
And so quite often they're doingthese, Dietary interventions on
animals instead of humans thatcurrently there is a couple of
(28:43):
studies going on right now, onein Belgium, where they're using
live people who have lymphedema,but lymphedema, there's no
animal model for an animal thatgets this pathological fat
deposits to their lower body.
So, so they have been usinghumans.
And so a lot of the informationwe're getting on how this
happens, what happens in humansis from.
(29:06):
Those women who haveparticipated in those trials and
and also I've extrapolated a lotfrom other studies, just studies
about ketone and pain.
you know, or ketones andcognition and clarity of
thought.
So those in Alzheimer's patientsor maybe in patients who have
(29:27):
Parkinson's or variousneurological conditions.
And so we've extrapolated thatthe symptoms that we see in our
patients with lymphedema andlipidema.
And okay, it's it's similar towhat is experienced in these
other disorders, and they'rethey're getting this response.
And they're specifically, it itseems that the carbohydrate.
(29:51):
is like it's inflammatorylymphatic vessels, and it also
causes them to be more leaky.
And so when you're fewer,instead of transporting the
fluid, if you're leaking thefluid into the tissues, it's not
being evacuated.
You can see how that wouldexacerbate or at least not get
better your problem with theswelling.
And then with the fat, it's onthe my studies, it's showing
(30:14):
that The lymphatic systemactually in, in response to
eating dietary fat, we seeincreased contraction of the
vessels and they're pumping thetransporting the fluid and the
fat along faster in response toeating that fat.
There was also an interestingstudy that they wanted to see
the impact of metabolic syndromeon the lymphatic system.
(30:35):
And so, of course, they use miceand they gave them a high
fructose diet.
And so then they looked at whathappened to the lymphatic system
with that high fructose diet andthe fact that they develop
metabolic syndrome, theirlymphatic vessels were swollen
so much so inflamed and swollenthat they had 50 percent reduced
(30:56):
transport ability.
So they couldn't move fluid outof an area because they were so
swollen the vessels themselves.
And so this played out in astudy that they did with women
who had suffered breast cancer.
They had lymph nodes removed.
They got lymphedema in their armon the side of their breast
(31:16):
cancer.
And then they wanted to put theminto a weight loss study and see
how the weight loss affectedtheir this is the amount of
swelling they had in their armand every other time they had
tried this, you know, just kindof losing a low fat, low calorie
diet, they lost weight and theirarm got smaller.
Well, this particular study,they used a meal replacement and
(31:40):
that meal replacement, and Iwon't name the brand, but that
meal replacement was highfructose, I guess, in order to
make the shake taste reallygood, they needed to really
sweeten it up.
So it was high fructose.
And so the women who use thisall lost weight.
But their arms and get smaller.
And the the researchers weretotally dumbfounded.
(32:03):
They did not know why thathappened.
And I, my theory is that thathigh fructose was so
inflammatory to those vesselsthat even though they lost
weight, those vessels wereswollen and they couldn't
evacuate the fluid out of theswollen arm.
And so therefore the swellingdidn't go down.
So we're looking at this It'sthis combination of reducing the
(32:26):
carbohydrate, reducing theinflammation and the leakiness
of the vessels at the same timeof having the beneficial effects
of fat in our diet for all thebeneficial effects, but also the
beneficial effects that it hason lymphatic system and it's
functioning.
And it just is this perfect wayof eating for someone who has a
lymphatic disorder.
Lorenz (32:47):
this women probably swear by the ketogenic diet by
now, right?
When,
Dr. Leslyn Keith (32:52):
Well, you know, it pretty much the, the,
the women with lipidema we havea Facebook group with over 14,
000 women who are using it's aketo lifestyle for lipidema and
they're like, okay, I know thisworks.
Now I need to tweak it so thatit works for me.
I happen to be, for instance, asan example, if, if I'm allergic
(33:15):
to shrimp.
Okay, well, I'm not going tohave shrimp be one of my animal
sourced foods.
I need to or I don't findpleasure in eating pork or or
it's for my religion.
I don't want to eat, you know,certain foods.
So now we need to make itindividualized with that person
within that framework ofreducing carbs and increasing
(33:36):
fat intake.
How do we make it work for yousocially, culturally just your
taste buds?
So this, if this is somethingyou're going to do the rest of
your life,
Lorenz (33:47):
which they have to, right?
They have to do it the rest oftheir life.
Dr. Leslyn Keith (33:51):
exactly, exactly.
So we need to make it work for,for the individual if it's going
to be something that they'regoing to adopt the rest of their
life.
Lorenz (33:59):
Is that something that's part of the program that you
offer?
Dr. Leslyn Keith (34:05):
Yeah, so, so what we do with Lipoedema
Simplified is that we offervarious classes and support
groups and stuff like that toeven like the Facebook group,
just, you know, people postingquestions and how do I do this?
And what do you guys think?
And, you know, people are, areoffering suggestions.
We do have a twice a year, wealso have.
(34:27):
A virtual three day event wherewe have expert speakers and we
also have people who have theconditions, lymphedema, lipedema
themselves and talk about theirjourney.
And we talk about all aspects ofthe condition and all suggested
ways of, of improving your careand treatment.
(34:48):
But the one coming up in Aprilspecifically going to be
focusing on nutrition and.
We're pretty sold on ketogenicnutrition.
So, so we have several expertspeakers and patients that are
all going to be talking aboutthe benefits of using a
ketogenic diet for lipidema andlymphedema.
Lorenz (35:08):
I would talk about that.
When, when, when is thathappening?
Dr. Leslyn Keith (35:12):
So what's happening?
I'm going to make sure I get thedates right here.
It is happening April 12 to 14just in, in, you know, about two
months.
It's going to be virtual.
We'll have a link so people cango and learn more and, and
register.
So it's a Friday, Saturday andSunday, and we have speakers in
(35:33):
the, the lymphological.
space, but also in the ketospace.
So some people that yourlisteners, your viewers may know
about is, for instance, like drGeorgia eat, who is a
psychiatrist who uses ketogenicdiet to help with mental health.
(35:56):
And there is, I mean, when youtalk about particularly people
who have lymphatic disorders,there's a lot of body
dysmorphia.
Your body is not shaped likeeverybody else.
You're dealing with fat bias,stuff like that.
So So we feel like Georgia isgoing to really help with that.
We also have Dr Tro Collegianwho's going to be speaking.
(36:17):
And a lot of, you know, him as,as part of the obesity medicine
space.
And then in the live, thelogical world dr Gabrielle
Farber is in Germany and she hashad a clinic for boy, 15, 20
years.
And she's already been treatinglymphatic disorders.
With diet, she actually has adegree also in nutrition and she
(36:41):
realized that this way of eatingwas superior.
And so, unbeknownst to me, Ithought I was all alone talking
about using keto for lymphaticdisorders when I first was
getting my doctorate in 20 13 to2015 and but she'd been doing
this way before and already beendoing it.
And so, we love having her speakand talk about what's happened
(37:02):
with her clinic and the pushbackthat she gets and in, in Germany
talking about, you know, havingpeople use this way of eating as
you know, I mean, it's, it'sthis plant-based.
low fat, low calorie is it'staken over the world.
(37:23):
And so it's there.
There is a lot of pushback whenwe say there might be a better
way,
Lorenz (37:28):
Yeah.
You know, these people haven'tknown a life without pain and
now they do, right.
Living without pain and, andpeople who go plant based
usually it's.
They try it.
They will try it.
But you know, it would take ayear or two.
And then they figure out thatit's doing something to their
body.
And, and hopefully they find away out and find a way back to
(37:51):
really feeling good.
Right.
And that's, that's the bestthing.
Living without pain.
Right.
That's the best thing.
You know, it's such a.
It sounds like it's such a greatevent, right, to join.
If you guys are interested,listeners, it will be linked
down in the description boxbelow so you guys can check that
out.
(38:11):
Awesome.
Well, I want to ask you.
If what stands out when, when Iask you, if there's any story
that you can talk about todaythat has really caught your
attention, like a patient thatgot better, any story that comes
(38:33):
to mind.
Dr. Leslyn Keith (38:36):
Oh, yeah.
And there's many.
So, and the person who had hertremendous pain resolved in six
pain six days was You know,something that did just, I mean,
when she presented at one of ourpast conferences, I mean, there
wasn't a dry eye out therebecause that was just so
astounding.
But I think about another one ofmy patients who did this,
(39:00):
decided to do this way ofeating.
She was the one who had a veganphysician.
And she came to me and she feltlike she was ready for a
wheelchair.
Her pain was so severe and herlegs were large.
It was keeping her from inenjoyment of life.
She was not able to walk on thebeach.
She was not able to garden.
(39:21):
She loved doing gardeningactivities.
She had some younggrandchildren.
She felt like she could notspend time with them and do
activities with them.
And so she said, well, let's,let's give it a try.
So, so she and her husband, whowas very, very supportive.
And probably would benefit fromeating that way himself.
(39:41):
They both came in and startedusing the way of that way of
eating.
And I did lots of measurementsof success.
As I was telling you before, wedid body composition.
We of course did weight, but wealso measured her legs.
to see what the, what the sizechange.
We looked at pain.
We looked at brain fog andcognition depression, all these
(40:05):
other measures.
And Georgia was justspectacular.
Just looking at her because Ihave a before after picture of
her and I've quite often withher permission used her before
after in my presentations.
And I will tell you that whenpeople see her after, and this
was after about maybe a year anda half of using the diet, they
(40:29):
would gasp because she justbesides that you can see that
she was smaller, more slim.
But she just looked, there was aglow about her, a happiness.
She was back to gardening, backto doing activities with her
grandchildren.
She told me that she knew thather brain fog was gone because
she went to the airport and shehad to go by herself.
(40:51):
And she had to it was atransfer, so she had to go to
walk to another gate before shewould have to have a wheelchair
to get to the other gate.
She walked to the other gate,but not only that.
She found the other gate on herown, which she said, this was
not something that she couldhave done before because of the
amount of brain fog.
And so, she just, that enjoymentof her life and that she
(41:14):
convinced her, her veganvegetarian physician, this was
all good.
And he was rethinking what hewas doing.
I have this wonderful afterpicture of her that she kind of
dyed her.
her hair blue.
And I mean, you could just seethat she was she was in this
place where she just felt sohappy, joyful.
It changed her life.
(41:36):
And and she said, you know, shetold her doctor, I hope you'll
support me on this because I'mnot changing.
I'm going to do this way therest of my life.
And so, I hope you'll you'll bewith me as I continue to do
that.
And he has, he has stayed withher.
So that's good.
Lorenz (41:51):
There's no wonder why you're so passionate about what
you're doing.
It's just helping, you know,women you know, not just reduce
the pain, right, but they'regaining their life back as, as,
as
Dr. Leslyn Keith (42:03):
Yes.
Yes.
Lorenz (42:04):
you talk about so eloquently, so.
Well, thank you so much forcoming on and sharing that story
with us today.
And also your story and sharingall the insights about this
topic that is really, you know,like I said, misunderstood a lot
of people are suffering outthere.
And if you're listening rightnow Here's some examples.
You said there's a lot ofexamples that really people
(42:26):
who've turned their life around,right.
Pain to zero people who haveliving with pain you know,
upwards of seven to 10, right.
And, and now living with.
You with no pain.
So it's really amazing to hearabout these stories and just
really giving a lot of peoplehope.
And so I want to thank you forcoming on and I want to give you
(42:47):
your flowers.
And you're doing such an amazingjob with, with, with, with your
program with, you know, helpinga lot of these women turn their
life around.
So I want to thank you.
Thank you.
Thank you for coming on andsharing your story today.
Dr. Leslyn Keith (43:01):
Thank you so much for your interest in this
and it's been wonderful beinghere chatting with you.
Lorenz (43:05):
Thank you.
All right.
Have a great day.
Bye bye.
Thank you for joining me foranother episode of the ketones
and coffee podcast with Dr.
Leslie and Keith, as we discussthe role of the ketogenic diet
in managing lymphedema andobesity and the role of
carbohydrates and fat inlymphatic disorders, I have
provided links to the doctorless than Keith's work and her
(43:26):
socials, PC the show.
No captions below.
If you're learning from orenjoying the podcast, please
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And you can also leave us up tofive star reviews on both
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If you have questions, pleasereach out to me on Instagram or
a new website at keto.
Coach lawrence.com.
Hey guys, we got an interestingepisode for you today.
(00:03):
This was with Dr.
Leslie Keith.
What I love about this episodeis Dr.
Leslie shares, numeroustransformative testimonials from
patients whose lives hasdrastically improved.
We discuss her extensive twodecade experience and specialty
in treating lymphedema andobesity with a ketogenic diet.
(00:23):
I definitely learned so much onthis episode.
And I believe this episode has apotential to really help so many
people's lives who suffers fromthese issues.
Verlaine things stuff, guys.
And without further ado, here'smy interview with Dr.
Lessen Keith.
Lorenz (00:37):
Hey guys, this is Lawrence and welcome back to the
ketones and coffee podcast wherewe talk about creating a
sustainable healthy lifestylethrough the ketogenic diet.
I'm Lawrence and I'm so gratefulto have you join me on this
journey.
Every week I bring in guests whohave the knowledge and
experience to help you on yourown journey to a better health.
So excited for this guy.
Stick around.
Got an incredible guest today.
(00:58):
Dr.
Leslie Keith.
She is a certified lymphedemaand a clinical doctorate holder
in occupational therapy and witha specialization in lymphedema
and obesity.
With over two decades ofexperience, Dr.
Keith has dedicated her careerto helping individuals manage
(01:19):
lymphedema.
and obesity through the use ofthe ketogenic diet.
She brings a unique perspectiveto the discussion exploring how
a ketogenic lifestyle canbenefit individuals dealing with
lymphedema and obesity.
Dr.
Leston Keith, welcome to theKetones to Coffee podcast.
Dr. Leslyn Keith (01:38):
Thank you so much for having me.
I'm thrilled to be part of yourpodcast and your journey to
educate
Lorenz (01:45):
Awesome.
You know, I am so thrilled tohave you.
And you know, let's jump in hereinto this discussion because
lymphedema and keto, I haveheard of lymphedema.
Right.
And keto for lymphaticdisorders.
But I really haven't had anyoneon this show who really had done
the science on the topic.
So, also, you know, what aprivilege to have Dr.
(02:08):
Leslie Keith here who hasconducted numerous studies
during her pursuit of adoctorate that focused on this
topic.
So great stuff here.
I know lymphedema is such amisunderstood, misunderstood
issue.
But I want to start with.
where it all began for you.
Your practice is very specific,right?
Managing lymph, lymphaticdisorders with the ketogenic
diet.
(02:29):
I want to know what sparked thatinterest, or is there any
situation that led you into thisfield?
Dr. Leslyn Keith (02:38):
Oh yeah, definitely.
Because I was trained to treatlymphatic disorders with very
specific treatment using aspecial type of massage and
bandaging people to providecompression to try to reduce the
swelling.
Show them exercises, all thiskind of stuff.
But as probably about a decadeinto doing this treatment for
(03:01):
people with lymphatic disorders,I started noticing that by far,
majority of my patients wereobese.
And not just obese, but a lot ofthem morbidly obese.
So we're talking about BMI's of40, 50, 60.
And I had no idea what to do.
I was on that under thatparadigm of eat less, move more,
(03:24):
you know, plant based, low fatdiet, and nothing was working.
And not only that, it made theirlymphatic disorder worse.
They became more swollen.
And then the things that I wasdoing, which had been working on
someone who wasn't obese.
They weren't working so well,and there was a little bit of
(03:45):
research out there, and it wassaying that obesity made the
lymphatic disorder worse, and soI thought, okay, so now we got
to do something for the obesity,and I was at a loss, because it
didn't seem like anything wasworking.
As you know, we were just seeingmore and more people become
obese, and it seemed like theywere trying hard, but nothing
(04:05):
was working.
So I started hearing about aketogenic diet, and so my first
thought was, Oh, we'll help themwith the obesity using a
ketogenic diet, and that willmake the lymphedema better.
I mean, that's what the littlebit of research out there was
saying that if we treat theobesity, the lymphedema will be
better.
(04:25):
So I started embarking on firstusing it myself because I'm not
going to tell them to dosomething that I can't do
myself.
And, and my, I had a bunch offriends that they were all
trying it too.
What the heck?
And so we found, okay, lookslike this is doable.
It's actually very delicious.
Let's see if we can get peopleto do it.
And so I just experimentally, Isaid, you know, maybe you want
(04:49):
to try this.
And so I had a couple ofpatients that did try it and
they did lose weight and theirlymphedema got better.
Wow.
Wonderful.
And so I said, let me.
Prove this through a study and,and it really, when you go into
a study, you shouldn't beplanning on certain outcomes
happening.
You know, I went about this thetotally wrong way because I was
(05:11):
sure this was going to work.
And so I set up a study so thatI could show that this, this is
feasible.
This works.
So I needed to have a universitybacking me to do that, so I
said, well, I guess I got to getmy doctorate so I could have a
university so I could run thisstudy.
And luckily I found a program ingetting a doctorate in
(05:33):
occupational therapy that said,wherever you want to focus your
work on, go to that.
And of course, I wanted to do iton lymphedema and obesity.
So they allowed me to do that.
I put together a study.
And I actually had 10 of my pastpatients.
who had gone through the programof just the standard massage and
compression therapy and exerciseand stuff.
(05:56):
And now they were on their owntrying to manage their their
lymphedema, but they all had aBMI of over 30.
And so I invited them to be partof a program that was 12 weeks.
Once a week we would meet and wewould help them adopt a
ketogenic diet.
And then we'd look at otherlifestyle factors as well, like
stress and sleep and stuff likethat.
But the main focus was to adopta ketogenic diet.
(06:20):
Well, interestingly, six of themadopted the diet and four said,
no, can't do this.
And they were, you know, veryapologetic to me.
Leslyn, I mean, we ruined yourstudy.
We're not doing the diet.
Don't worry.
I mean, this is, this actuallymakes a comparison group.
So, albeit very small but we hadsix people who did it and four
(06:43):
who didn't.
And the results were actuallyastounding, kind of what I
expected, but even more than Iexpected.
That their swelling went down inthe group that ate
ketogenically, but not in theother group.
And, and the other groupactually got a little bit more
swollen.
The, the pain numbers, the theirability to do just daily
(07:05):
activities because their limbsize was so small.
smaller was so much better inthe ketogenic group than the
other group.
So all of the areas were.
astoundingly different andbetter in the ones that ate this
way.
So from that, I kind ofdeveloped this lifestyle program
to help my patients continue todo this because it seemed like,
(07:28):
wow, this seems like from thesmall pilots that it seems like
it's working.
Well, then an interesting thinghappened is that my patients who
did not need to lose weightsaid, well, would it be good for
me to eat that way?
I mean, is I.
Tried the diet myself and Ididn't need to lose weight, but
I enjoyed it and it seemedpretty healthy.
(07:49):
So So I had some patients thatwanted to use it and didn't need
to lose weight this is when Istarted really revising my View
of a ketogenic diet andlymphatic disorders because I
always thought it was related tojust the
Lorenz (08:04):
Mm
Dr. Leslyn Keith (08:05):
obesity but what we started finding in this
group that didn't need to loseweight is Their lymphedema was
better managed because they wererestricting carbohydrates and
eating more fat.
Lorenz (08:17):
mm
Dr. Leslyn Keith (08:18):
And so then I started looking into this more
and seeing what was out thereand it mostly was animal
studies, looking at lymphaticsand and high fat diets and stuff
like this.
And so what they were showing isthat eating fat actually
stimulates the growth oflymphatic vessels.
(08:39):
So now you have someone whomaybe had a surgery, for
instance, removed lymph nodes orhad radiation to, to to kill the
cancer.
And so it damaged theirlymphatic system, but they eat a
high fat diet and we canstimulate lymphatic vessel
growth.
Well, that's
Lorenz (08:58):
mm
Dr. Leslyn Keith (08:58):
And that might be one of the reasons why this
is so good for someone who has alymphatic disorder.
That it really is beyond just
Lorenz (09:08):
mm
Dr. Leslyn Keith (09:09):
It is also about having the healthy
lymphatic system.
And having it function betterdespite the fact that you have
some kind of lymphatic disorder.
So, I'm, I was pretty astoundedwith that and I continue to be
astounded and I really enjoyhelping people adopt this way of
eating and be able to managetheir lymphatic disorder better.
Lorenz (09:30):
Seems like such a fulfilling line of work.
And, you know, I wanna ask, whenyou said they got better, how
much better did they did theyfeel when, when they go on from
the standard treatment to aketogenic diet, how much better
did they feel?
Dr. Leslyn Keith (09:48):
So, and this is what's interesting because I
started saying to people, well,let's look at more than just the
scale.
Let's just not look at just yourweight.
And so we started looking at youknow, you use bioimpedance to
look at body composition.
So what is how much fat isthere, how much lean and how
much fluid and fluid is prettyimportant when you have a
(10:11):
swelling disorder.
And then we also were looking atlevels of pain, levels of
energy.
I had a fatigue severity scalethat I use and how much were
they impacted by their fatigue.
And so we looked at all thesethings.
I mean, it was amazing.
Okay, just look at pain and I'mgoing to give you some anecdotal
stuff first.
(10:32):
But another lymphatic disorder,lipedema.
This is fat that gets depositedjust on the lower body, and not
on the upper body.
And not only that, the fat ispainful.
So we're talking a very painfuldisorder that can be, out of
ten, ten being the worst, sevento ten.
constant pain.
(10:53):
And so, these women were using aketogenic diet and that the
shortest that I've seen is sixdays on a ketogenic diet to go
from 78 out of 10 down to
Lorenz (11:06):
Wow.
Dr. Leslyn Keith (11:07):
in six days.
Normally, it happens 2 to 4weeks, and this is before
they've lost any weight.
I mean, it was always we assumedthat it was because of the
amount of weight that was on thelower body and stressing maybe
the hips, ankles and knees that,you know, that was causing the
pain.
They wouldn't lose any weightyet, but the pain would already
(11:30):
be gone.
I mean, I just find thatastounding and it's such a huge
improvement to quality of life.
Lorenz (11:37):
I can imagine like, you know, living with that pain and
then all of a sudden, like yousaid about four, four to six
weeks.
Dr. Leslyn Keith (11:45):
Yes.
Very, very, very short time.
I mean, and you know that in theearly part of using a diet, you
can lose a lot of water weight.
So you might in that first monthlose about, you know, five to 10
pounds in that first month, justbecause of water weight, but
without any weight loss.
They were having their painseverely diminished or even
(12:09):
completely resolved.
I mean, I just found thatabsolutely astounding.
Lorenz (12:13):
hmm.
You know, I want to go, I wantto go back.
Not a lot of people, you know,understand this disease and even
the sufferers get conflictinginformation about it.
You know, some, also somedoctors that.
You know, these separatesufferers may come across with
maybe say, there's no cure.
I'm not, you know, generalizingeverybody, but you know, the
(12:35):
general idea is there's no curefor it.
Right.
So I imagine how daunting thiscan be for, for the sufferers.
If you don't mind, I would liketo discuss this topic even, even
deeper.
Typical symptoms.
What does one with lymphedemaexperience?
Well, you know, you, you talkedabout pain.
What is the current, also what'sthe current treatment you talked
(12:55):
about?
You had, you know, 10 people dothe, the study, but before that,
what, what, what was thetreatment that they were on?
Dr. Leslyn Keith (13:04):
yes, yes, yes.
And, and and there's twoconditions that I really do most
of my work on, and they,they're, they sound very
similar, but they're two reallydifferent conditions.
And one is lymphedema, L Y M PH.
edema or swelling.
So that is different from lipedema, L.
(13:27):
I.
P.
Edema.
And so lip fat.
cut part of lipids and edemaswelling.
And so they are two differentdisorders, but they both are
lymphatically based.
And so lymphedema is two maincauses that we see are either
you're born with an imperfectlyformed lymphatic system.
(13:49):
So you have swelling in variousregions of your body because the
lymphatic system cannot evacuatethat fluid.
correctly.
And so you swell.
But the other reason is forcancer treatment, that lymph
nodes and vessels are disturbedand damaged.
And then we get swelling to thatregion of the body where you had
(14:11):
the the surgery or the cancer.
And so that is very differentfrom lipidema, which is a fat
disorder, but also a lymphaticdisorder.
And this one, it is almostexclusively women.
And it is, it seems to begenetically and possibly
hormonally based because itseems to start around puberty
(14:35):
most often, but it also can betriggered at pregnancy and with
menopause.
And so the symptoms are that youget a disproportionate fat
deposition to the lower bodyfrom, and it can go from the
waist to the ankles.
But maybe it's just the hips andthe buttocks, or it might go
(14:56):
down to the knees, but it tendsto be a lower body.
But now it's we also see it alot in the arms.
But what remains largelyunaffected is that head, neck
and trunk.
And so it just it looks verydisproportionate, very obvious
when you can see that personthat has that.
But now it's also very, verypainful.
(15:18):
As we talked about, they geteasy bruising.
So bruises just show up in theareas affected by the lipidema
for unknown reasons.
And so we have this set ofsymptoms that is really there's
no blood test or there's noimaging that can say this is
lipidema.
So it makes it even harder todiagnose.
(15:40):
Also you have the healthcarecommunity that maybe is not
aware of it.
And so they say, well, thatyou're just obese and your
obesity happens in your lowerbody.
But the amazing thing that, thatthat we've discovered since it
was first.
labeled in the 1940s is thattypical weight loss measure,
(16:01):
loss measures do not work.
So, this person can diet tostarvation and can exercise six
hours a day, and, and they'll,they'll lose fat on their head,
neck, and trunk, but theaffected areas will not change
at all, at all.
And so, and they're just toldthey're not doing it enough.
(16:23):
They're not you know, they're,they're non compliant, they're
lazy, they're not doing itenough.
And so basically we're punishingthat person when they actually
have a condition they have adisorder that is poorly
recognized.
We do have now some physiciansthat are very knowledgeable
about it.
And but.
Lorenz (16:44):
Not enough.
Dr. Leslyn Keith (16:45):
of times the, the woman doesn't even know
about it.
So she doesn't even know thatshe needs to seek someone out.
I mean, this, this is what'shappened with the internet in
the last, you know, 15, 20 yearshas really helped so many people
because Women are going on theinternet and going, why do I
have fat legs?
And then lipedema is, is poppingup.
(17:07):
And so they are self diagnosingthere.
And that's mostly how, you know,we, we get people together and,
and they, they, they selfeducate about this condition.
It's not coming from the medicalcommunity because it really is.
It's only in the lymphaticcommunity of those healthcare
(17:28):
professionals that are in thatcommunity that really know
Lorenz (17:31):
Mm.
That's one good thing that cameout of the internet, right?
is you're equipping yourselfwith information, right?
Hopefully we are, you know,still like, you validate the
information, obviously look forsources that are really
credible, right?
So, so, you know, takeeverything with a grain of salt
and just you know, if I, Ialways say, you know, find
(17:53):
somebody who reversed thedisease and you'll be on the
right path.
Healthcare system, you talkedabout, you know, the pushback
and how important do you believethe support of a healthcare
provider is from, for patientslike who are pursuing the
lifestyle and nutritionalchanges, particularly in
conditions like lymphedema andobesity that partnership.
(18:16):
How important is that?
Dr. Leslyn Keith (18:19):
it is super important.
And so, I mean, now I'm part oftwo organizations, Lipoedema
Project and LipoedemaSimplified.
And we're trying to give womenthat support to make lifestyle
and dietary and other.
changes so that they can takeback control of their body and
help themselves.
(18:40):
But a lot of times we need thesupport of a health care
provider in order to partnerwith them so that their
medications need to be managed.
They usually don't have onlylipidema or lymphedema.
They typically have otherconditions as well.
And as you know, having been thespace for a while, You know, if
(19:01):
you have, for instance, type twodiabetes, you can't just go on a
ketogenic diet without havingsomeone manage your medications
carefully so that you're notover medicated for your
hypertension or your diabetes orsomething like that.
So, so we need to have thatpartnership with the health care
community.
And so, you know, there's twospaces that I'm trying to break
(19:24):
into with this information abouta ketogenic diet.
And one is to the lymphologycommunity themselves.
And let me tell you, they'vebeen very resistant.
They, they are concerned that asystem that really is
responsible for mobilizingdietary fat, they feel like if
(19:45):
that system is impaired, then wecannot be eating a bunch of fat
and burdening a system that'simpaired.
And you know, that is a, it's avalid discussion to have.
But I think that science hasshown that that system also
relies on fat to heal itself to,to work properly.
(20:08):
And we know that there areessential fats, and so you
cannot starve yourself of thosefats and expect to be healthy.
So the, the lymphology communityhas been resistant, but now
they've done, there's, in justlast five years, there's
probably about six clinicaltrials and case studies about
using ketogenic diet for.
(20:28):
lymphatic disorders.
And so it's getting moreaccepted.
And then the other communityI've gone into is the the low
carb community and the obesitymedicine conferences, because
those are the physicians or thehealthcare providers that might
see someone walk into theirclinic with lipidema or
(20:49):
lymphedema, not even knowingthat they have that diagnosis.
They're just there to get helpwith their obesity.
perhaps.
And so if that those physiciansare knowledgeable about it, and
I will tell you, the low carbcommunity has been very
accepting of that.
This These are bona fideconditions, and these are
(21:09):
something that we need to helppeople with.
So now that now the person hasthe best of both worlds, they
have someone who believes themand will accurately diagnose
them with their lymphaticdisorder.
And they also have support foradopting a ketogenic diet and
any other needs that they havefor their health.
Lorenz (21:30):
Mmm.
So I want to be able to help ourlisteners here if someone is
suffering from lymphedema orlipidema for that matter.
If they, you know, come, ifthey, you know, come forward
and, you know, speak to theirdoctor about lipidema and the
ketogenic diet or lymphedema.
(21:53):
What, what are, if the doctor isdismissive of lifestyle change
and how does that usually playout?
You know, you've, you've seen itwith, with your clients, with
your patients how, how does thatmeeting usually play out and
what, what do they need to do toconvince or maybe swayed their
(22:14):
doctor or physician on, youknow, the path, the right path
to take in that scenario.
Dr. Leslyn Keith (22:21):
Yeah.
So some physicians are swayed bymedical journal articles, but
they don't have a lot of time toread those things, those papers.
But sometimes, even if that theysee that this, the title of the
paper and that it has beenpublished in a peer reviewed
journal and the title says, youknow, a ketogenic diet
(22:44):
beneficial for, you know, X,then then they might, even
without reading the whole paper,they might be more supportive.
I will tell you just in mylittle study, my little pilot
study that I did, one of myparticipants who was.
wildly successful with reducingher pain, reducing the fat mass
on her lower body.
(23:05):
You know, a volume of the legsgoing down, all this kind of
stuff, all increased energy,decreased brain fog, all these
things happen.
And she, went back to her doctorand her doctor, who was a
vegetarian was concerned.
You know, you're eating all thatmeat and all that fat.
You know, I want to check tomake sure this is okay.
(23:26):
Did a bunch of blood work.
Did the coronary artery calciumtest did the the Doppler for the
carotid artery, did all thisstuff.
Everything come back.
Perfect.
She's like 75 years old andeverything is perfect.
All of her numbers are perfect.
And he goes, Oh, I guess youcould continue doing that.
And maybe a vegan lifestyle isnot the best thing for me.
(23:50):
I mean, and that's you know,that is.
Sometimes they have to see theproof of what happens to someone
after they use the diet.
Now, you know that we have thatsub group that is a lean mass
hyper responder, that they go ona ketogenic diet and they get
their LDL numbers, which aresupposedly the bad cholesterol,
(24:13):
that goes up really high.
And so, A doctor may look atthat and say, you know, we've
got everything else is stellar.
Everything is beautiful.
Your pain is down.
You're enjoying life.
Your weight is down.
Everything is good, but your LDLis up.
Some doctors will look at thatand say, that's a problem.
Go off of that diet.
(24:35):
But I think a lot of doctorswill look at that and say, well,
everything else is good.
So maybe you should go ahead andcontinue, but let's keep an eye
on these cholesterol numbers andsee, you know, if we need to do
anything for that, that wouldbe, I would hope for that
reaction, but there's stillplenty of physicians that are
(24:57):
very much afraid of dietary fat,very much afraid of cholesterol
numbers going up.
And so I don't know how much wecan do for that doctor.
What I have suggested is some ofmy patients who have faced that
situation.
I say, well, you know, keep thatas your primary care.
But why don't we go find a likesomeone from the Society of
(25:21):
Metabolic Health Practitionerswho uses a ketogenic diet, who
uses nutrition to help you?
Why don't we use that as aspecialist that you can have
also?
And maybe that's someone thatyou will be seeing on video
visits.
It's, you know, so, you know,not totally, you know,
abandoning your currentphysician, but let's get someone
(25:42):
else on your team that issupportive of what you've chosen
to do.
Sometimes you can't change thephysician.
Sometimes they're not going tochange.
Lorenz (25:51):
sometimes they're not going to change, and it just
takes a while for thatinformation to get relayed.
You know, they say it takesabout 10 years.
I don't know how true that is,before, you know, the
traditional conventional,conventional treatment changes.
But at least we know that thereis a cure because a lot of
(26:12):
people out there who maybe havelymphedema or lipidema, they go
online, you know, searching fora cure and they see, like, I,
Dr. Leslyn Keith (26:22):
Yeah.
And I, I, I have to, I have toclarify that this is actually
not a cure, that these areconditions that you probably
cannot cure, but we can managethem way better than we have in
the past by using diet.
Lorenz (26:38):
And
Dr. Leslyn Keith (26:38):
it's definitely you know, the
standard western diet has.
Caused obesity that compounds alymphatic disorder.
But you know, this person, thisperson has been born with a
imperfect system or they'vedeveloped a condition of
lipedema or lymphedema secondaryto something else.
(27:01):
Things are, there are someirreversible damage that's
happened and, and, but if we canstimulate some new vessel
growth, if we can facilitate thebetter transport of fluids and
fats, then we certainly canmanage it better and with less
discomfort and better quality oflife.
But at this point, even withthis spectacular diet, we can't
(27:23):
say that we
Lorenz (27:24):
yeah.
No, the reason why I said thatis because you said the pain was
seven to 10 down to zero.
I mean, that's, that's, that'spretty amazing.
And then, you know, I was, I wasreading up on some of your
studies that you've done thathigh carbohydrate intake leads
to inflammatory response of thelymphatic system.
Right.
you know, just reducingcarbohydrate intake.
(27:47):
You, you're, you're, you're nothaving any response, right?
You, meaning when you take awaycarbohydrates.
You're basically stop, stoppingthe bleeding and with, with the
help of, you know, the fat,right?
You said fat is therapeutic forthe lymphatic system and also
what's the mechanism behindthat?
I know you've talked about thata little bit, but can you
(28:10):
discuss that mechanism and how,how that works and how does, you
know, fat or maybe is itketones?
I don't know, but can youexplain that a little bit
deeper?
Dr. Leslyn Keith (28:21):
Yeah.
So, and, and on lymphlymphedema, there's no animal
model of, of lipidema.
So they use people in studies,but lymphedema, we can give mice
lymphedema.
And so quite often they're doingthese, Dietary interventions on
animals instead of humans thatcurrently there is a couple of
(28:43):
studies going on right now, onein Belgium, where they're using
live people who have lymphedema,but lymphedema, there's no
animal model for an animal thatgets this pathological fat
deposits to their lower body.
So, so they have been usinghumans.
And so a lot of the informationwe're getting on how this
happens, what happens in humansis from.
(29:06):
Those women who haveparticipated in those trials and
and also I've extrapolated a lotfrom other studies, just studies
about ketone and pain.
you know, or ketones andcognition and clarity of
thought.
So those in Alzheimer's patientsor maybe in patients who have
(29:27):
Parkinson's or variousneurological conditions.
And so we've extrapolated thatthe symptoms that we see in our
patients with lymphedema andlipidema.
And okay, it's it's similar towhat is experienced in these
other disorders, and they'rethey're getting this response.
And they're specifically, it itseems that the carbohydrate.
(29:51):
is like it's inflammatorylymphatic vessels, and it also
causes them to be more leaky.
And so when you're fewer,instead of transporting the
fluid, if you're leaking thefluid into the tissues, it's not
being evacuated.
You can see how that wouldexacerbate or at least not get
better your problem with theswelling.
And then with the fat, it's onthe my studies, it's showing
(30:14):
that The lymphatic systemactually in, in response to
eating dietary fat, we seeincreased contraction of the
vessels and they're pumping thetransporting the fluid and the
fat along faster in response toeating that fat.
There was also an interestingstudy that they wanted to see
the impact of metabolic syndromeon the lymphatic system.
(30:35):
And so, of course, they use miceand they gave them a high
fructose diet.
And so then they looked at whathappened to the lymphatic system
with that high fructose diet andthe fact that they develop
metabolic syndrome, theirlymphatic vessels were swollen
so much so inflamed and swollenthat they had 50 percent reduced
(30:56):
transport ability.
So they couldn't move fluid outof an area because they were so
swollen the vessels themselves.
And so this played out in astudy that they did with women
who had suffered breast cancer.
They had lymph nodes removed.
They got lymphedema in their armon the side of their breast
(31:16):
cancer.
And then they wanted to put theminto a weight loss study and see
how the weight loss affectedtheir this is the amount of
swelling they had in their armand every other time they had
tried this, you know, just kindof losing a low fat, low calorie
diet, they lost weight and theirarm got smaller.
Well, this particular study,they used a meal replacement and
(31:40):
that meal replacement, and Iwon't name the brand, but that
meal replacement was highfructose, I guess, in order to
make the shake taste reallygood, they needed to really
sweeten it up.
So it was high fructose.
And so the women who use thisall lost weight.
But their arms and get smaller.
And the the researchers weretotally dumbfounded.
(32:03):
They did not know why thathappened.
And I, my theory is that thathigh fructose was so
inflammatory to those vesselsthat even though they lost
weight, those vessels wereswollen and they couldn't
evacuate the fluid out of theswollen arm.
And so therefore the swellingdidn't go down.
So we're looking at this It'sthis combination of reducing the
(32:26):
carbohydrate, reducing theinflammation and the leakiness
of the vessels at the same timeof having the beneficial effects
of fat in our diet for all thebeneficial effects, but also the
beneficial effects that it hason lymphatic system and it's
functioning.
And it just is this perfect wayof eating for someone who has a
lymphatic disorder.
Lorenz (32:47):
this women probably swear by the ketogenic diet by
now, right?
When,
Dr. Leslyn Keith (32:52):
Well, you know, it pretty much the, the,
the women with lipidema we havea Facebook group with over 14,
000 women who are using it's aketo lifestyle for lipidema and
they're like, okay, I know thisworks.
Now I need to tweak it so thatit works for me.
I happen to be, for instance, asan example, if, if I'm allergic
(33:15):
to shrimp.
Okay, well, I'm not going tohave shrimp be one of my animal
sourced foods.
I need to or I don't findpleasure in eating pork or or
it's for my religion.
I don't want to eat, you know,certain foods.
So now we need to make itindividualized with that person
within that framework ofreducing carbs and increasing
(33:36):
fat intake.
How do we make it work for yousocially, culturally just your
taste buds?
So this, if this is somethingyou're going to do the rest of
your life,
Lorenz (33:47):
which they have to, right?
They have to do it the rest oftheir life.
Dr. Leslyn Keith (33:51):
exactly, exactly.
So we need to make it work for,for the individual if it's going
to be something that they'regoing to adopt the rest of their
life.
Lorenz (33:59):
Is that something that's part of the program that you
offer?
Dr. Leslyn Keith (34:05):
Yeah, so, so what we do with Lipoedema
Simplified is that we offervarious classes and support
groups and stuff like that toeven like the Facebook group,
just, you know, people postingquestions and how do I do this?
And what do you guys think?
And, you know, people are, areoffering suggestions.
We do have a twice a year, wealso have.
(34:27):
A virtual three day event wherewe have expert speakers and we
also have people who have theconditions, lymphedema, lipedema
themselves and talk about theirjourney.
And we talk about all aspects ofthe condition and all suggested
ways of, of improving your careand treatment.
(34:48):
But the one coming up in Aprilspecifically going to be
focusing on nutrition and.
We're pretty sold on ketogenicnutrition.
So, so we have several expertspeakers and patients that are
all going to be talking aboutthe benefits of using a
ketogenic diet for lipidema andlymphedema.
Lorenz (35:08):
I would talk about that.
When, when, when is thathappening?
Dr. Leslyn Keith (35:12):
So what's happening?
I'm going to make sure I get thedates right here.
It is happening April 12 to 14just in, in, you know, about two
months.
It's going to be virtual.
We'll have a link so people cango and learn more and, and
register.
So it's a Friday, Saturday andSunday, and we have speakers in
(35:33):
the, the lymphological.
space, but also in the ketospace.
So some people that yourlisteners, your viewers may know
about is, for instance, like drGeorgia eat, who is a
psychiatrist who uses ketogenicdiet to help with mental health.
(35:56):
And there is, I mean, when youtalk about particularly people
who have lymphatic disorders,there's a lot of body
dysmorphia.
Your body is not shaped likeeverybody else.
You're dealing with fat bias,stuff like that.
So So we feel like Georgia isgoing to really help with that.
We also have Dr Tro Collegianwho's going to be speaking.
(36:17):
And a lot of, you know, him as,as part of the obesity medicine
space.
And then in the live, thelogical world dr Gabrielle
Farber is in Germany and she hashad a clinic for boy, 15, 20
years.
And she's already been treatinglymphatic disorders.
With diet, she actually has adegree also in nutrition and she
(36:41):
realized that this way of eatingwas superior.
And so, unbeknownst to me, Ithought I was all alone talking
about using keto for lymphaticdisorders when I first was
getting my doctorate in 20 13 to2015 and but she'd been doing
this way before and already beendoing it.
And so, we love having her speakand talk about what's happened
(37:02):
with her clinic and the pushbackthat she gets and in, in Germany
talking about, you know, havingpeople use this way of eating as
you know, I mean, it's, it'sthis plant-based.
low fat, low calorie is it'staken over the world.
(37:23):
And so it's there.
There is a lot of pushback whenwe say there might be a better
way,
Lorenz (37:28):
Yeah.
You know, these people haven'tknown a life without pain and
now they do, right.
Living without pain and, andpeople who go plant based
usually it's.
They try it.
They will try it.
But you know, it would take ayear or two.
And then they figure out thatit's doing something to their
body.
And, and hopefully they find away out and find a way back to
(37:51):
really feeling good.
Right.
And that's, that's the bestthing.
Living without pain.
Right.
That's the best thing.
You know, it's such a.
It sounds like it's such a greatevent, right, to join.
If you guys are interested,listeners, it will be linked
down in the description boxbelow so you guys can check that
out.
(38:11):
Awesome.
Well, I want to ask you.
If what stands out when, when Iask you, if there's any story
that you can talk about todaythat has really caught your
attention, like a patient thatgot better, any story that comes
(38:33):
to mind.
Dr. Leslyn Keith (38:36):
Oh, yeah.
And there's many.
So, and the person who had hertremendous pain resolved in six
pain six days was You know,something that did just, I mean,
when she presented at one of ourpast conferences, I mean, there
wasn't a dry eye out therebecause that was just so
astounding.
But I think about another one ofmy patients who did this,
(39:00):
decided to do this way ofeating.
She was the one who had a veganphysician.
And she came to me and she feltlike she was ready for a
wheelchair.
Her pain was so severe and herlegs were large.
It was keeping her from inenjoyment of life.
She was not able to walk on thebeach.
She was not able to garden.
(39:21):
She loved doing gardeningactivities.
She had some younggrandchildren.
She felt like she could notspend time with them and do
activities with them.
And so she said, well, let's,let's give it a try.
So, so she and her husband, whowas very, very supportive.
And probably would benefit fromeating that way himself.
(39:41):
They both came in and startedusing the way of that way of
eating.
And I did lots of measurementsof success.
As I was telling you before, wedid body composition.
We of course did weight, but wealso measured her legs.
to see what the, what the sizechange.
We looked at pain.
We looked at brain fog andcognition depression, all these
(40:05):
other measures.
And Georgia was justspectacular.
Just looking at her because Ihave a before after picture of
her and I've quite often withher permission used her before
after in my presentations.
And I will tell you that whenpeople see her after, and this
was after about maybe a year anda half of using the diet, they
(40:29):
would gasp because she justbesides that you can see that
she was smaller, more slim.
But she just looked, there was aglow about her, a happiness.
She was back to gardening, backto doing activities with her
grandchildren.
She told me that she knew thather brain fog was gone because
she went to the airport and shehad to go by herself.
(40:51):
And she had to it was atransfer, so she had to go to
walk to another gate before shewould have to have a wheelchair
to get to the other gate.
She walked to the other gate,but not only that.
She found the other gate on herown, which she said, this was
not something that she couldhave done before because of the
amount of brain fog.
And so, she just, that enjoymentof her life and that she
(41:14):
convinced her, her veganvegetarian physician, this was
all good.
And he was rethinking what hewas doing.
I have this wonderful afterpicture of her that she kind of
dyed her.
her hair blue.
And I mean, you could just seethat she was she was in this
place where she just felt sohappy, joyful.
It changed her life.
(41:36):
And and she said, you know, shetold her doctor, I hope you'll
support me on this because I'mnot changing.
I'm going to do this way therest of my life.
And so, I hope you'll you'll bewith me as I continue to do
that.
And he has, he has stayed withher.
So that's good.
Lorenz (41:51):
There's no wonder why you're so passionate about what
you're doing.
It's just helping, you know,women you know, not just reduce
the pain, right, but they'regaining their life back as, as,
as
Dr. Leslyn Keith (42:03):
Yes.
Yes.
Lorenz (42:04):
you talk about so eloquently, so.
Well, thank you so much forcoming on and sharing that story
with us today.
And also your story and sharingall the insights about this
topic that is really, you know,like I said, misunderstood a lot
of people are suffering outthere.
And if you're listening rightnow Here's some examples.
You said there's a lot ofexamples that really people
(42:26):
who've turned their life around,right.
Pain to zero people who haveliving with pain you know,
upwards of seven to 10, right.
And, and now living with.
You with no pain.
So it's really amazing to hearabout these stories and just
really giving a lot of peoplehope.
And so I want to thank you forcoming on and I want to give you
(42:47):
your flowers.
And you're doing such an amazingjob with, with, with, with your
program with, you know, helpinga lot of these women turn their
life around.
So I want to thank you.
Thank you.
Thank you for coming on andsharing your story today.
Dr. Leslyn Keith (43:01):
Thank you so much for your interest in this
and it's been wonderful beinghere chatting with you.
Lorenz (43:05):
Thank you.
All right.
Have a great day.
Bye bye.
Thank you for joining me foranother episode of the ketones
and coffee podcast with Dr.
Leslie and Keith, as we discussthe role of the ketogenic diet
in managing lymphedema andobesity and the role of
carbohydrates and fat inlymphatic disorders, I have
provided links to the doctorless than Keith's work and her
(43:26):
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