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Steve Young, from Super Bowl MVP to Managing Billions – Hall of Fame 49ers Quarterback on High Performance, Reinvention, Faith, and How to Blend Dreams and Plans

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Tim Ferriss: Steve, thank you so much for making the time.

Steve Young: You bet, Tim.

Tim Ferriss: It is so nice to see you.

Steve Young: It’s an honor, man. Hopefully I can add something to the amazing stuff that you’ve done for a long time. So we’ll see. We’ll see. It’s yet to be determined.

Tim Ferriss: I’m sure that’ll be the case and I have to give you — well, first point out the pink elephant in the room. Welcome to my Temple of Tim.

Steve Young: I love it. I love it. I bow to the greatness.

Tim Ferriss: And also, this has been, for me, two or three years in the making, sort of a slow build because a friend of mine sent me a Bloomberg article about you that talked about the many chapters of Steve Young, and at that time, as is true now, I’ve been incredibly interested in people who successfully navigate these phase shifts. And I do not follow football. I have a lot of respect for football. God knows, every time I see one of the car crashes, AKA collisions, I think that one hit and I would be done. I don’t know how you guys do it.

Steve Young: It’s insane. Even now as I watch now, I’m like, “Did I actually do that?”

Tim Ferriss: It’s just remarkable how durable players are. I have no idea how you guys do it. But what I’ve been hoping to dig into is the psycho, emotional, spiritual, mental side of things and —

Steve Young: Right. That’s football, weirdly.

Tim Ferriss: That’s football.

Steve Young: Yeah. It’s crazy. We’ll go on for that for a little bit too.

Tim Ferriss: Yeah, we’ll definitely get into that. And I thought we would start — actually, I’ll start with a wave hello. I don’t think you guys know each other, but you might have had a connection decades ago. A friend of mine who’s a bit of a recluse named Josh Waitzkin. He was the basis — he would hate me to introduce him this way, but he was the basis for Searching for Bobby Fischer, the book and then the movie, the chess prodigy, and most recently he got kind of doxxed, he didn’t really want to be public about it, for working with the Celtics in the last few years with their coach. And he is a huge fan. I mentioned, he’s like, “Hey, do you have five minutes on the phone?” He texted me this morning and I said, “I can’t do it. I’m preparing for a podcast with this legend,” and I sent him a link and he goes, “Oh, I studied his game. I used to study and study and study.” He’s not a football guy.

Steve Young: I thought you were bringing it up because that was my favorite movie. Searching for Bobby Fischer was like —

Tim Ferriss: Oh, I had no idea.

Steve Young: Oh, absolutely. I thought that’s why you were saying it. It’s like how do they know? Because I’ve said it many times, and I was like, “Oh, that’s why.”

Tim Ferriss: No, I had no idea.

Steve Young: I love that. That’s a movie everyone needs to watch. It’s a compelling story.

Tim Ferriss: Super compelling, and what doesn’t get put into the movie, because it couldn’t have been put into the movie, given the timeframe, is that Josh, at his peak, effectively retired from chess because of all the attention that ended up landing on him after the success of the book and the movie, and he has navigated three or four very, very, very successful phase shifts, and so game recognizes game. He’s like, “Oh, I know Steve Young. I’ve studied Steve Young.”

Steve Young: That is weird. That’s like a full circle for me. Growing up when I was a kid, that’s a movie in high school. And people probably don’t know it. I’m glad you’re — let’s shout it out. Go see that. It’s worth it. It’s really —

Tim Ferriss: It’s amazing and the book is very good. It’s a fun subject/sore subject to chat with Josh about. But I’m going to invoke a name that was very meaningful for me in terms of writing way back in the day, and that is Stephen Covey. So could you describe meeting Stephen Covey and who Stephen Covey is?

Steve Young: So yeah, in the ’80s, ’90s, even the aughts, I guess you’d call him, he was writing books, 7 Habits books. And really I’d known his kids, but I never met him, and I was — I’ll give a little background —

Tim Ferriss: And you had known his kids through the church?

Steve Young: No, at school at BYU. I’d met them and they played football, but I’d never really met him. I have a good little background here. So I’m playing for the 49ers. Joe Montana and I had been — it’s not worth going through all that, that’s a long story, but we were on the same team and we both wanted to play and he was the king and I was this kid that wanted to — I didn’t want to just sit there. And I finally got my chance to play in 1991 and it didn’t go great, and I always joke about walking around town and how I describe it is telling people, “No, I think he did throw an incomplete pass once. I mean, I think he did lose a game. In fact, I think he’s thrown an interception or two,” because the memory of someone who’s great is only great, and here’s this kid trying to live up to all of that, and I was pouring myself into it.

I mean, I was over-kind-of-indexed on trying to figure out how to — and all I could look around was everyone who wasn’t, and how everything was my fault and everything — no matter what happened, I went anywhere, I was like, “Well, yeah, Steve Young sucks. That’s Steve Young’s problems.” I found myself, middle of the season, middling around and I noticed that I was depressed, I was miserable, and I felt like I was at the bottom of a hole. And so we lost a game against the Raiders in front of 100,000 people at the L.A. Coliseum. Jerry Rice is open in the end zone to win the game and I never — he’s literally waving and I didn’t see him. And it was just like the epitome of everything that could go bad. And so I was miserable.

I need to give you that backstory because you have to know my state of mind. I was miserable. And I got on a plane because Tuesday is day off in the NFL. So Monday night I got on a plane, went to Salt Lake City to see my brother because he was in University of Utah Med School. I was like, “Man, maybe he can, I don’t know, help me get out of this funk. I mean, this is just terrible. I’m not sleeping well. It’s just miserable.” And I walk around the town with him, he’s like, “Steve, I got two kids and broke in medical school. Your life looks sweet to me.” So he didn’t help very much. I told him I didn’t know how I was going to get to Christmas.

So I get on the plane to come back, sit down, and Steve Covey’s sitting there and he says, “Hello,” and I’m like, “Oh, my gosh, I’ve always wanted to meet you.” And he asks a simple question, “How are you doing?” And I’m in a state of mind where I was pretty vulnerable. I just told him, kind of recited everything that I just said to you and how kind of miserable I was, and I got done with it 25, 30 minutes later and he goes, “Huh. Wow. Man, I can feel that. I can feel all of that, the expectations, how tough it is to not get the help that you think that you need and things that are working against you. And man, can I ask you a couple questions?” And I go, “Yeah.” He goes, “Your owner, Eddie DeBartolo, tell me about him.” “Oh, my gosh, he’s the only owner in football that ever saw players as partners. I mean, he’s amazing,” and I went on about that.

And then he said, “What about your coach, Bill Walsh?” And he’s like, “Yeah, he’s like a guy that talks about hydration and nutrition and sleep and mental health. And you talk about partnership, no one’s doing what he’s doing. His West Coast offense, that guy is amazing.” He goes, “Yeah, I’d heard that. I’d love to meet him both, because — let me ask one last question. Is Joe Montana on the team?” I’m like, “Yeah, he’s hurt and that’s kind of the problem,” and he’s like, “Well, if you had to ask him for mentorship, go ask him questions to help your game, could you do it?” I’m like, “Yeah, I could.”

And he goes, “All right. Well, I want you to know what I do. I travel the world looking for platforms, companies, organizations that create the ability for the humans on the platform to see how good they can get and iterate and find out because that’s what life should be about. And so as I travel the world, I’m always looking for it and I’d love to talk to those guys about their platform, but I’ve got to step back, Steve, and tell you that from my perspective, the platform that you’re on, the place that you are, I think might be the greatest one that I’ve ever seen,” and I was like, “Wait, didn’t you hear me? Bro, this is miserable. Things are terrible.” But it stung me. It went through my heart. It was like, oh my gosh. My first thought was, I think I might’ve screwed this whole thing up. Oh, because to have him say that truth to me.

He goes, “Let me ask you one last question, because it’s scary.” He goes, “I always wonder if people are willing to take the chance to find out how good they are,” and I’m reflexive about it. I’m like, “Yeah, of course. I’m absolutely up for that.” And then he took a minute and he looked kind of like — he was little and bald and like a little Yoda-ish, you know what I mean?

Tim Ferriss: Yeah, I remember the About the Author photo.

Steve Young: Yeah, and so he took his finger and he kind of looked at me and said, “Then be about it,” and I was like, “Oh, my gosh.” I realized right there that the hole I was in, that I thought so many people had dug, that I had dug it. I had no idea that I dug the hole, and I had thought that everyone pushed me in and I didn’t realize that I had jumped in. And so it was that…

We can talk about victimization for a long time because it’s such an important thing to ferret out in your own life over and over again, like never stop. It was the realization that I had played the victim and had jumped in a hole, dug it and jumped in, and I’m the author of it. That’s what the shock was, like I authored this. And I remember getting off the plane as if I was transformed, and I don’t want to say it lightly. It was as if I now knew if I was going to do anything, I was going to be about this.

And I remember not sleeping well that night, but for a different reason, I thought, “Oh, my gosh, I think I’ve screwed this up enough that on Wednesday mornings when you get fired in the NFL,” and I’d heard rumors about maybe getting benched, and I’m like, “Oh, crap. Don’t tell me that I have screwed this up so bad that I don’t get a chance to go fix it.” And I screamed down at practice the next day as energized as ever like, “Just please don’t — please give me another…” And I didn’t get benched and I did play and I was about it, and it was fun because it’s like something that’s true, like truly true, like universally true. When it’s that way, it doesn’t waver. You don’t have iterations of it. It’s just true.

Tim Ferriss: You’re not second guessing.

Steve Young: I don’t have to worry about it. And he said, “People are really afraid. It’s hard to find out how good you are because you might find out you’re not very nearly as good as you thought you were, but you’ve got to make that okay and that now I’m going to be iterate and find out how good I can get.” And so it’s really about fear, and if you can lose that fear, and that’s basically what you’re dealing with is a fear-based — you’ve been fear-based. And I was like, “Oh, my gosh.” And you just wanted to exorcize it. Now it doesn’t happen overnight, but I remember soon after that season ended and the whole off-season, and so the next year we’re playing the Cowboys, they’re the best team in the league, and I think to myself, “This is where you find out, right?”

And I remember running up to Troy Aikman and we were warming up and he’s a friend and he’s a quarterback for the Cowboys, and I’m like, “Troy, it’s so great that you’re here, man, because I’m on this quest to see how good I can get and I can only find out against the best, and so I’m so glad that you’re here.” And I remember Troy looked at me like, “Freaking weirdo. What’s wrong with you?” But that’s what I was about.

And to finish the story, I think I have to finish it kind of honestly and authentically, I was MVP of the NFL that year. And you think back to being in the bottom of a hole running to my brother to see if I could get out of this depression, and it’s just amazing to me that perspective, a truthful, universally authentic fact can make that kind of difference in somebody’s life. I owe him the greatest debt because you think about angels in your life or people that show up. It was almost like It’s a Wonderful Life moment, you know what I mean? You almost think, was he really there or was I imagining this guy that’s sitting next to me? So that’s the Stephen Covey story.

Tim Ferriss: What a wild Sliding Doors moment, right? Just the happenstance of that interaction and how it changed things. It’s so remarkable to reflect on.

Steve Young: And it really never ended. Because it’s true, I now seek out that victimization in my life, watch it for other people, try to help because it’s such a nefarious common state of being and totally rationalize to — I always talk about the entropic world that we live in. It’s like super transactional, eat what you kill, sweat of your brow. It’s all the conditions of the world. Victimization feels almost rational, but it’s kind of death, and so that’s the thing that I watch in my own — I swear, and that feeds to accountability. It feeds to who authors all this? You think that someone else is authoring it, but you continue to author it and don’t take it — that’s what I was missing, right? I’m actually — and so that’s why the perspective was so powerful.

To this day, it gives me little chills. I’m so grateful because I was about to walk down a path that was going to be miserable and I would have said, “It wasn’t fair. How could anyone — this is not right. I need another chance because I want a better shot and I want people who will support me more,” or you come up with all kinds of stuff and that’s what would have happened and who knows where it may be. But yeah, great Stephen Covey, man.

Tim Ferriss: So after that realization and makes me also think about — there’s a book called Extreme Ownership written by Jocko Willink, former Navy SEAL Commander, which really also underscores this ownership, being all about it, as you put it. And I’m curious to know, after that realization, after the questions about seeking out mentorship or otherwise on the plane, what were some of the next steps? What were some of the most important changes that you made that allowed you then, a year later, to be where you were?

Steve Young: It’s like the boat that leaves the harbor, it changed the direction that you left every morning. There was a aha. It was like, “Oh, my. I can’t believe that I almost walked down this treacherous path.” And that’s why I knew it was true is because every morning I wake up and say — you didn’t have to doubt it. It was like, “Don’t play the victim. Start owning and look forward to the possibility of what you can…” My theology is about we’re here as humans to learn and grow. It can be tough and miserable, it can be all kinds of things, but that’s the underpinning of what we’re trying to do is learn and grow. Be about it again. Don’t be afraid.

It changed how I went to practice. You might not have a great practice, but own it. You might not be as strong as you thought you were. Well, freaking own it. Stop dancing around the authenticity of what you’re trying to do. And once I open myself to all that. It brings you to the moment. It brings you to the present. What can I do right now? Not what if or what possibly. And then it became a quest that was intentional every day to go find out, like it’s okay if you’re not as good as you thought you were. In fact, let’s just know. I don’t need to read the paper to have somebody tell me how I’m doing. I don’t need to wait in line at the grocery store at the checkout with the clerk and the lady with the paying, as they talk about the 49ers, waiting for the inevitable, “Well, what do you think about Steve Young?” And then waiting for the answer as if it was going to define me.

But that’s where I was, right? Before it was like, “Oh, he sucks.” I’m like, “Oh, yeah. I suck.” It’s like you’ve allowed — thinking that you’re doing it to me, I’m allowing them to do it to me because I’m not defining it. And that has stuck with me even to today where it’s a vulnerability, it’s authenticity about accountability. Where is it? Where does it lie?

I’m using football to describe a lot of stuff that are very important concepts, but it’s like when you throw an interception.

Tim Ferriss: And for people who don’t know football, what does that mean?

Steve Young: So I have the ball, I’m the quarterback. I drop back to pass to win the game, the last minute, the last seconds, the crowd is screaming with anticipation, 80,000 people, you can feel the emotion of like, “It’s happening. We’re winning this game,” and then I throw it and the other team, the defense that’s on the field, they intercept it, they take it. And there’s this moment where 80,000 people with all this anticipation is like, “Oh.” Sports is that cool because it’s hard to get those moments where they’re like binary moments where it’s like — and then the emotional swing, like to get that kind of a swing with 80,000 people, it’s kind of crazy cool. I can’t believe I’m saying that because it wasn’t that cool at the moment, but it’s crazy to feel that.

And I spent a long time with my teammates at that moment when they would look at me and say, “Hey, we watched you do this and it felt like you threw it right to them.” There’s an underpinning of it like, “We know you didn’t do it on purpose, but kind of looks like you did it.” And so as a human behavior emotion, I’m like, “Oh, I’ve got to show them that this was a mess. You turned the wrong way or you didn’t block your guy or something else happened.” Mitigation. Mitigation. I take the banner of mitigation and say, “Look at all this truth. I’m not telling you lies. I’m telling you truth. This is how it happened. Facts. Own the facts.” But I didn’t realize that there’s a truth to the mitigation, but it’s not actually useful until I turn to them and say the ball was in my hands and now it’s in their hands. That is the truest truth.

Again, if you live in mitigation, which is kind of the Stephen Covey’s — where I was living in all this truth, people saying things, people doing that, how I fell, it’s all this, but it was mitigating and it wasn’t authoring. And so when I started to breathe that back into the system, “Look, I screwed it up no matter what happened. Don’t worry about mitigation right now. I screwed it up. Let’s go fix it,” and everyone was like, “Oh. Yeah, let’s go do that. And I’m sorry that I turned the wrong way. I’m sorry that I…” And so all of a sudden —

Tim Ferriss: It’s like calm is contagious and the military ownership was contagious.

Steve Young: And so when I talk about Stephen Covey, I have to talk about my authorship, vulnerability and accountability for me and being — the quest is really to be honest with yourself, and that’s what I wasn’t doing, and so that’s — when you say, “What did you do? What were the aspects of it?” If someone here heard this and go, “I want to be about that too, how do I do it?” To me, it’s a state of being, it’s not a list of things to do.

Tim Ferriss: Right. Well, it also sounds like you were, if I’m hearing you correctly, basically out of the gate each morning. It sounds like you were reminding yourself of that underpinning truth as you went out into practice.

Steve Young: It was almost like you have to exorcize the victimization. Look, I don’t know a ton about the brain, I’m not a scientist, but little I know is that the brain’s here to keep me safe and in so many times your brain’s working against you because it’s playing the victim for you and you have to retrain kind of how you think about it.

So that’s why I say every day, you have to keep training a new thought pattern, a new way to — and it was so clear to me, it was easy. When it’s not clear and muddy, it’s harder. You’re like, “What was the point? I can’t remember,” and here comes the life. But for me, it was so clear and obvious that I was playing the victim that I think for me, it was just a state of being every morning. I might suck, but it has to be okay. It has to be whatever it is so that I don’t look anywhere else. It’s just you can author it, you can get better at it, but quit living in the muck of mitigation, I guess, is how I would say it.

Tim Ferriss: We are going to come back to some —

Steve Young: I’m sorry to riff like that. I know I can go on and on and on.

Tim Ferriss: I love riffing. This is why it’s long-form. And as a muggle, for someone who’s looking at football and I don’t understand all of the technicality behind it and the strategy, but I respect the athleticism, I look at a quarterback and I wonder if you were to try to explain it to someone like me who’s a layperson per se, what separates good from great quarterbacks? Are there any particular elements that you see consistently in great quarterbacks that are absent, not paid as much attention to or otherwise? I mean, they could be physical, but I’m wondering if anything comes to mind.

Steve Young: There’s not a long enough form for this, because I mean, people have been searching — because think about it, how many very, very smart people have been looking into college to predict who can be great in the NFL and there’s no worse results than trying to predict that. And that’s why college is not a great predictor.

Tim Ferriss: What do you think? Is it something internal, like their ability to learn in a certain way? What is it?

Steve Young: I’ve been trying to melt it down to something that people can just grab, like this is the truth. One thing’s for sure, human behavior, human mind, I don’t know what the right way to think about it, but when there’s adrenaline and focus and pressure and opposition — I mean, how many games are someone’s paid to actually screw you up physically? I’m paid to grab you and throw you to the ground and hurt you. I’m paid millions of dollars. So it’s all in that moment, in that kind of dynamic, that you now have to ferret through. And Tim, I wish everybody who loves football could stand with a helmet on, and at 6’4″, 6’3″, or whatever, 6’2″, whatever anyone like L. Russell was, 5’10”, stand there and ferret through bodies in motion, the fastest, most athletic humans on Earth on both sides, and that’s why when you talk about the difference in the NFL is the speed, it’s the athleticism.

A lot of times people’s brain can’t process that fast. They were processing fine in college, they were processing great in high school, but it’s just an elevation. Gladly for me, there’s not a super pro. I would have topped out, but I think more than anything, the quality — because there’s fundamental things. You’ve got to be able to throw the ball, you’ve got to be able to — but it’s the process of figuring out the speed and then because no one’s — in my mind, college, every receiver’s open, in the pros, nobody’s open. That’s the change. You have to now figure out how to deliver it so that it’s not open at the time you throw it, but by the time it gets there, it’s open, and I think that’s the best way to explain how — and then do it over every 30 seconds. And how many times do you throw it right at the — and then just as it leaves your hand, you get just pounded into the ground. You don’t even see it.

I mean, how many times do you hit bottom of a pile and you’re like, “How did it go?” You don’t know, and you just listen for the crowd because you’re like — if it’s home and there’s cheering, you’re like, “It worked,” and otherwise, if they’re booing you, then it’s bad. So I think it’s the processing and it’s a guile. It’s a street smart. It’s not necessarily IQ for taking a calculus test. There’s memorization, but there’s a — I don’t know. You know what I mean? You just get it, you get it and —

Tim Ferriss: I think there is a speed also associated with that, even with street smarts that I see in some of my friends in business, a certain EQ savvy. They’re very fast, like their clock speed is high.

Steve Young: And I think they’d be great quarterbacks. That’s the thing, and I think you just described it very well in other fields. I see it too, but again, even when I see it in other people, I think, “I don’t know, at that speed…” Because you don’t know until you know.

Tim Ferriss: Well, there’s also the pressure of imminent bodily harm.

Steve Young: Well, that’s what I mean. I think most humans, when things get more intense, the adrenaline runs. And when adrenaline runs, the brain focuses. It gets smaller, and it gets more focused, but yet you’re not as aware.

And so that physiology doesn’t work, because in quarterbacking, you have to expand.

Tim Ferriss: You have to have the peripheral awareness.

Steve Young: And it has to be the more present you are. Like, if you’re in your backyard, not 80,000 people watching, if this was all happening in my backyard, how would I take this in?

So I’ve noticed that the best quarterbacks have a genetic, I think it’s genetic, predisposition to when adrenaline runs, it doesn’t do the normal things for most humans.

And that’s why the quality is like, how do I test — I wish I could test for that, because I could promise you I could tell you who’s going to be great.

Tim Ferriss: Yeah. I wonder if it’s something — just thinking out loud. I interviewed someone named Alex Honnold on the podcast before he did his big run, which turned into a documentary called Free Solo, but he climbed —

Steve Young: Oh, my.

Tim Ferriss: — I think it was El Cap, I can’t remember the exact face, with no ropes.

Steve Young: That was. It’s insane.

Tim Ferriss: And so I interviewed him.

Steve Young: I can’t watch it.

Tim Ferriss: It’s too —

Steve Young: I can’t.

Tim Ferriss: My hands are sweating just talking about it.

Steve Young: I literally can’t watch it. I want to watch it. I can’t watch life and death like that.

Tim Ferriss: And his brain responds differently to —

Steve Young: Exactly.

Tim Ferriss: — the circumstances.

Steve Young: 100 percent. And that’s the only way because all of us watch it go, “Oh, no.”

Tim Ferriss: Panic and fall.

Steve Young: No way.

Tim Ferriss: That’s what happens.

Steve Young: No way. Every grip has to be life or death. No way. People think about quarterback in the NFL is like, “Whoa. How do you do it?” I was like, “Look.” Talk about what you just said, this is pinochle to —

Tim Ferriss: Might be neurologically or genetically related. Is there anything that, when you look at your trajectory, that was learnable or coachable that you absorbed by watching other people, what did you improve most at? So there’s a lot out of the box. You were successful as a younger athlete and read some great quotes from your dad about this, but you were successful as a younger athlete. You seemed to have some hardwiring out of the box that was very helpful. But you didn’t just hit the ground running in the NFL and you were top of the game. There was something that improved, or many things.

Steve Young: One fundamental thing had to happen, which was how to throw the football. It’s not intuitive. Kind of like golf. You think great golf swings when you grab a club as an adult, you’re not going to do it right. And as a kid, I grabbed a football and because I didn’t want to be embarrassed, I wanted to spin perfectly. I would spin it out of my hand and that’s how I did it. But you can’t get behind to throw it hard. And this was not something that was a deep, dark secret, but in Greenwich, Connecticut —

And some people grab it and grab a golf club, grab a football and it’s just like, “Oh, yeah, that’s how you must do it.” That’s not how I did it.

And so I got to college. I’d faked my way into playing college quarterbacking without really understanding it. And Jim McMahon was the quarterback at the time at BYU. Incredible. Second to Heisman, he was amazing.

But he was righty and I was lefty and I was like, “How does — he’s throwing it different.”

And then I realized that you have to — instead of spinning it out to spin it, you actually go the other direction using the tension, inside your arm as you hold it, and then just go in.

Tim Ferriss: Oh, wow.

Steve Young: You actually spin it. It comes out and spins, but now you can throw it with all your power.

Tim Ferriss: Right, right.

Steve Young: You’re talking about what I — I had to have that.

Tim Ferriss: Those seem — and I’ve played a bunch of sports certainly out of JP level.

Steve Young: Seems like that’d be table stakes, right?

Tim Ferriss: Well, no, it seems like rebuilding your swing in golf or something.

Steve Young: A little bit, but it was such an unlock.

Tim Ferriss: Yeah.

Steve Young: Once you felt it, and it wasn’t — golf’s even more complicated because you’ve got a stick and you’ve got —

Tim Ferriss: You’re a little divorced from feedback.

Steve Young: Right, right. But the fact that it was in my hand, once you felt it, you’re like, “Oh, my gosh.” And then what I realized is, “I can now throw it as hard as I want right there. It was this gift I had that was going to go undiscovered and all of a sudden it came out.

Tim Ferriss: Did you realize that at BYU?

Steve Young: Yes, right there.

Tim Ferriss: Okay.

Steve Young: It was my freshman year, about — I wish I would’ve written down the date. It was like November 10th.

Tim Ferriss: Okay. It was like discovering fire.

Steve Young: I was like, “Oh, fire.” Exactly. “We live!” All I did from that point on was throw the ball. I just wanted to throw it, throw it everywhere, throw it —

And what’s ironic is that the coach who was the offensive coordinator at the time, soon after, because no one knew, this is all happening. I was eighth string. I was nobody. No one knew mine, but I had figured it out, and it had clocked in. It was clocking.

And so I think, for me, he pulled me aside later in the year, and he goes, “By the way, I don’t coach lefties.” He said it to me. “I don’t coach lefties.”

And so I was moved to defense at the end of that season because LaVell Edwards, the coach, said, “Look, you’re superfast, super athletic. We have 10 quarterbacks. We want you on the field.”

And so I started in the winter, practice is winter as a safety and a defense, cornerly positioned. I couldn’t stand. I hated every second of it. As soon as practice ended, the quarterbacks would throw after practice, I’d go throw.

And in the interim, that coach who told me he wouldn’t coach lefties, took a head coaching job at San Diego State. Another coach, Ted Tollner, came in, and I’m throwing with the quarterbacks after practice. And he goes, “Steve, I thought you played quarterback.”

I go, “I do, but they told me I’m lefty, so I have to play defense.” And he goes, “That’s ridiculous. That’s stupid.” I go, “I know. It’s insane.”

And then I screamed up, “And I learned how to throw too.” So I have this thing that — and he’s like, “Let me go see if I can fix it.” So he goes in and changes it.

Tim Ferriss: Wow.

Steve Young: And that spring, spring ball was a month, 30 days of practice, he got two weeks for me to practice before they made a decision. And by the end of the two weeks, because of this new gift, that was it.

Tim Ferriss: Wow.

Steve Young: That was it. With that change, everything, because I was fast, I could run, I could throw it hard, I could process. The game wasn’t too fast for me. It kind of all made sense to me. I just didn’t unlock that one fundamental piece of throwing the ball.

Tim Ferriss: Yeah. It’s so fun having this conversation. I’ve been looking forward to it for so long. And before I forget, I just wanted to say again, on a very reduced junior varsity level, but I wrestled my whole life basically.

Steve Young: Oh, I have total respect. I wrestled in ninth grade.

Tim Ferriss: Yeah. It’s a tough sport.

Steve Young: I will never wrestle again.

Tim Ferriss: It is a tough sport.

Steve Young: It is brutal. There is no good news.

Tim Ferriss: No, there’s no good news.

Steve Young: I remember the first wrestling — just to break in your story, it’s like three one minute or three minute — I can’t remember how long. And so by the first one was over, I was done.

Tim Ferriss: Yeah.

Steve Young: People are in the best shape, the greatest athletes. When I see wrestlers, I tip my cap. I walk away, man. I’m like —

Tim Ferriss: It is a sufferer fest —

Steve Young: It is brutal.

Tim Ferriss: — no matter what. Just a brief digression here, but I spent a year abroad in Japan in high school, which was my first time really outside of the United States, from Long Island to Tokyo, which changed my whole life.

But I competed in judo while I was there. Then I came back for my final year of wrestling in high school, and I was doing really, really well.

But I hit a wall, and the reason I’m bringing this up is not at all to compare apples to apples.

Steve Young: No, no, but I get it. Respect.

Tim Ferriss: I somehow found a book called Mental Toughness Training for Sports by a guy named James Loehr, spelled L-O-E-H-R, who Josh Waitzkin actually also knows.

And I read that book, and the key piece of that, it talked about different approaches to mental toughness, but it had an assessment, and it asked you to give this assessment to close friends, coaches, teammates, and it just made all of your strengths and weaknesses.

It had them rate you on all of these different aspects of toughness, performance, resilience, et cetera, psychology. And once I had those report cards from all of these people, and I was able to see and accept strengths and weaknesses, and I don’t think this is unique to me, there really was a before and after.

The next practice was different, and that’s when everything hockey sticked and ended up having just an incredible season.

But to people who are listening and haven’t experienced what, say, Steve experienced on that plane ride or what I’ve experienced with that book, there really can be that flashboil before and after.

Steve Young: That’s kind of what self-help stuff does and tries to get you — and the problem is, it doesn’t, all the time, land because — I get the idea. And so I read the book — “Oh, I’ll go read the book.”

Tim Ferriss: Yeah.

Steve Young: And you read the book and go, “Oh, okay.” But the flashpoint is really, to me, the vulnerability. That’s the hard part.

Tim Ferriss: Yeah.

Steve Young: The hard part is to open up and take the risk truly, internally. And I was living this life where it’s like, “I want to be great. I want to be great. I want to be great.”

And anyone who tells me I’m not, I don’t know what to do about it, and it feels like I can’t overcome it. It’s like you have to become vulnerable. That’s how you take it in.

And so people are like, “What do I do?” I was like, “Can you start in relationships with your mom, with your siblings, the most intimate ones? Can you start to recognize the complexity of that relationship, which it always is? However you’ve defined it, it’s probably been not a great, authentic, vulnerable place. Can you start by opening up to your accountability, to your…”

Tim Ferriss: Your part in it.

Steve Young: Yeah.

Tim Ferriss: Your contribution.

Steve Young: If you want to have an aha moment, or you want to read a book and change kind of inflection point, it comes from you were open for it, you were ready for it.

And I was so desperate with Stephen Covey, but it wasn’t necessarily I was looking for it. It was because it resonated so truthfully, like, “I’m screwing this up. I am royally screwing this up, and I cannot keep screwing it up.”

And I think a lot of people at that moment go, “Oh, I’m going to keep screwing it up because I don’t want to face the other side of that.”

And that’s what Stephen Covey — remember when he said, a lot of people don’t want to know how good they are.

Tim Ferriss: Yeah.

Steve Young: I hope I’m describing it. It makes sense to my brain that unless you get to that space, you really can’t change.

Tim Ferriss: Well, the vulnerability also seems to me fundamentally accepting the possibility, almost the certainty that you’re making mistakes and part of accepting how good you are is not necessarily accepting how excellent you inevitably are, but accepting the possibility that you might be falling short in certain places.

Steve Young: And then also the grace in it, where what’s the point? Is the point to be regarded by people, or is the point to see how good you —

That’s why it goes back. Why it resonated with me is because my own theology was like, “We’re here to learn and grow. Let’s do it.”

Tim Ferriss: Yeah.

Steve Young: And part of learning and growing is, “I suck right now, but I’m not going to suck tomorrow.”

Tim Ferriss: Yeah.

Steve Young: And once you can start to get into that mode of, “That’s what I’m about,” that’s what happens. There’s a clarity that comes because now everything gets fed through that truth, and now it comes in more authentically, and it doesn’t hit the same way.

And you can go in front of 80,000 people and find a piece about it that — 80,000 people could boo you mercilessly.

It is hard, what I’m talking about, but you can be authentically say, “Look, I’d boo me too.”

Tim Ferriss: Mm-hmm. Yeah.

Steve Young: “In fact, I might just boo with you.” And it’s okay and you get into that place. I’m going to try not to get booed tomorrow, but it might be. But as long in your brain is saying the whole point is to learn and grow, then, Stephen Covey, “Be about it.” And I think that really freed me up.

Tim Ferriss: Yeah. It seems like such an important tectonic plate underneath everything else.

I want to ask you about one of those quotes from your dad that I was alluding to earlier. So this is from the Bloomberg piece and the URL has in it, “Steve Young is an athlete who’s actually good at finance,” which I just — part of me loved.

Steve Young: Backhanded compliment.

Tim Ferriss: Yeah, yeah. I just loved that. So your dad was bewildered by how well —

Steve Young: By that fact.

Tim Ferriss: Well, he was bewildered by how well you did at football at different levels. And then this last line is the one I wanted to ask you about. It says, “Honestly, Steve’s personality is probably a better fit for law or business as compared to professional athlete.” Why would he say that, do you think?

Steve Young: I think he’s referring to — look, we should talk about it.

So when I was a kid, growing up first grade, second grade, third grade, I was a kid that, when the first day of school, I would turn to my mom or dad and say, “Look, I’m not going.” And they’re like, “Why? It’s super fun.” And my brain was processing it in fear, and a new place, new people, and that seemed super scary. And that’s, I think, clinically would be called separation anxiety, and I think people listening, I’m sure they know somebody probably that had that as a kid. And so that didn’t really show up in my life, because I realized very young that I was not going to be going on vacation with my friends. I was going to be home.

Tim Ferriss: Sleepovers, not so much?

Steve Young: Not so much. But during the daytime, I was killing it. Only for context, all-state in three sports, captain, straight A’s, not because I was tiger parents or tiger person. The day was awesome. I can’t wait. It’s going to be great.

And at night, it’s like, I’m home. And I didn’t realize that how much I had of this is when I went to college and had to go through a process of geography change that was existential. And it’s hard to explain to people, because they’re like, “Going to college is awesome, man. What’s your problem? You didn’t unpack your bags the whole semester, and you kept telling me you’re just miserable? How’s that possible?” Well, it’s how my brain worked, functioned. I can’t really say much about that. That’s about it.

And I remember when I came back for Christmas, I finally got to come home, and I remember walking through the door and going, “Oh, wow, I kind of want to go back to school.” And I realized in my life, that was a huge shift for me in my — you live in your own private Idaho, all the things that you’re feeling, all the things you don’t really share, you don’t really — it’s like some of it you’re afraid to even share. And it’s like all of a sudden I realized, “It’s going to be all right, because now I have two homes.” And that was a shift that I needed.

What my dad’s describing is generally when I had to go play, there was a pattern of focus that was like, he would call hyper focus and not fun. And so he’s like, “He’s built for something else.” I think that’s what he’s referring to. But I think it comes from the roots of that, what I would call clinical part of my life, and another little internal battle, because now I see the world and I’m like, “I can’t wait to discover it.”

At some point it just flipped. The thing that was so constrictive and difficult and threatening, I remember my parents left for a couple days when I was really little at my aunt’s house, and I can still smell it, I can still feel it, the terror of them walking out. I look back, and how do you explain — that’s an insane reaction.

I remember I can still hear my brothers and sisters outside laughing with all my cousins, but that was me. Part of the authenticity is come to a place where we can look that in the eye too. That’s that.

So I think that explains my dad’s comment, like that part of me, but what he doesn’t realize is that part of me drove the intensity and the focus and the — so it’s like it’s not all bad.

Tim Ferriss: Yeah, there’s a flip side.

Steve Young: There’s a flip side. And so I would say to my dad, “Well, the way you’re looking at it, I can see why you say that, but the way I’m looking at it is like, I had to have it.”

Tim Ferriss: Was there a point where — this is going to be a strong way of putting it, but I’ve experienced this in my own life and have talked about struggles. Some of it, I think, is hereditary with generalized anxiety. I’ve had depressive episodes, which I’ve seen throughout my family, and appreciate how open you’ve been about discussing some of this.

And I’m curious at what point you realized you didn’t need that kind of monkey on your back. And specifically, I’m thinking about in the course of doing research for this, reading a New York Times piece, and it mentions Dr. James Klint and Reggie, I guess, and you approaching Reggie at one point.

I think it was after, what, three sleepless nights, something like that. And I guess I’m wondering what was happening, for people who don’t know what the context is, and then what happened afterwards that helped?

Steve Young: So that’s interesting. It’s kind of a bookend, actually type bookends between the Stephen Covey story and the Jim Klint story, because just before that, and maybe that’s what leads to the vulnerability, in the depth of what I just described and where I was in a hole and victimized and depressed, there was a game starting Thursday night.

The good news about all of that anxiousness around playing, I always slept. So it was like you could deal with it. And all of a sudden I wasn’t.

And so it was a game where people that I was near were like, “Steve, you’re a mess. You’ve got to talk to them. You can’t play.”

Tim Ferriss: Yeah.

Steve Young: And I’m like, “Oh, no, that’s not an option. We’re playing.” And I remember telling them as I left for the game in such a state, I’d probably never been quite like that. So I promised him, I said, “Look, if we win, I’ll talk to the team doctor, just tell him something’s going on. But if we lose, there’s no place to be able to make an…” You can’t —

Tim Ferriss: Make an excuse.

Steve Young: Yeah. That’s just the way my brain was working. We won. I played pretty well. I don’t suggest, by the way, that that’s how you prepare.

But after the game, I’m sitting in the training room, towel, ice pack, and I see Reggie, and he’s been around. He’d been around all the Super Bowls. He was somebody that — I promised my friends that I would do this, but I didn’t want to, and we won. So we’re good for a little while.

But I did. I pulled him aside, and I remember back in the corner of the old Candlestick Park, stuff was dripping down. It’s dank, it’s old school. And we’re in the back corner, and I kind of move away from everybody, and I’m kind of almost nose to nose.

And I’m like, “Reggie, I’m going through this thing. I don’t know what’s wrong.” I kind of explained it all. And as I’m explaining it, I see a big ball of a tear, like a big ball come out of his eye and then drop. It was kind of like, “Did I see…” And then another one.

And he hasn’t changed his face, he hasn’t changed anything. And I’m like, “Reggie, are you crying?” And he’s trying not to break. He’s like, “I dealt with so much clinical anxiety, I could hardly get through medical school.”

Tim Ferriss: That’s what he said.

Steve Young: That’s what he said. As he answered with a straight — he hadn’t changed his face at all.

“I had dealt with, and I, watching you, instinctively felt that there was something going on and I feel like I’ve — like malpractice, that this is what’s had to come to it.”

He felt this incredible pain as the team physician and qualified to maybe watch for this kind of stuff. And I’m like — I was relieved. Because I didn’t know what was going to happen. I was explaining something that was total vulnerability, total weakness it felt like.

And he’s responding like, “Oh, I blew it.” And I’m like, “Reggie, don’t worry about it, bro.” But he said, “We’re going to get the bottom of it.”

And it wasn’t maybe two days later, he sent me up to a child psychologist, psychiatrist, I’m not sure, and they gave me a test of 10 questions that would describe things that happened in your life. And that would be, if you answer yes to eight of them, then you have undiagnosed childhood separation anxiety as an adult.

And so I was nine of them. And he said, “Most people, Steve, who have this going on in their life, they’re self-medicating. They’re in the basement. But you’re the MVP of the NFL, so I think we’re just going to let you keep rolling and find your way through it.”

And I did find solace in the knowledge, recognizing what had happened. Because until that point, I had subconsciously always known that I didn’t like being at other people’s houses when I was a kid or in other places where — but my life was so full and amazing that we just made our way.

And so this was the point where, now bookended with Stephen Covey maybe three weeks later, these are pretty vital big changes that happened that I think allowed me the place to kind of find peace about it all.

Tim Ferriss: And so was the diagnosis in itself the treatment and the respect that you finally had a label to apply, a way to think about it so that it wasn’t this nebulous set of worries, or what allowed you, I guess, to go back to sleeping?

Steve Young: It was actually super cool because I didn’t think about it as a stigma. I thought about it as, “Oh, that makes sense.”

Tim Ferriss: Yeah, yeah, yeah.

Steve Young: And then as I told my parents and told my — then we found out that in my mom’s side of the family, this is a thing and explained all kinds of craziness that was going on that now we go, “Oh.”

Tim Ferriss: Now the pieces fit.

Steve Young: It paid forward, you know what I mean? So in its own way, the knowledge was the key. And then because I was so — functioning through it, it was helpful. Didn’t make playing in front of 80,000 people and trying to be a great player, it didn’t make it simple, but I think it was a piece to the puzzle for me to recognize that what I experienced as a kid, then you could kind of put it into context.

Tim Ferriss: For sure.

Steve Young: Knowledge is power, right?

Tim Ferriss: Yeah. I remember maybe it was two years ago, I wanted to do this experimental treatment that’s actually not so far from where we’re sitting.

We’re sitting here in Palo Alto, and they’re in Sunnyvale, but I was doing something called accelerated TMS.

I won’t bore you with all the details, but it’s this medical treatment, and they had to put me through all these assessments beforehand.

Steve Young: Is it red light?

Tim Ferriss: It’s called Acacia Clinic, and they apply a magnetic coil basically to your brain or to your skull.

And the long and short of it is, it produces a type of stimulation that is remarkably effective for generalized anxiety, in some cases depression, OCD.

And part of them checking the boxes for me to be able to pursue this, not just for myself, but to interview scientists about this on the podcast and hopefully present more tools to people who might be suffering.

They took me through all these different tests, and at one point, after an hour or two, they took this big pause, and they said, “You know, Tim, based on all of this, you seem to qualify for moderate to severe OCD.”

And then he paused, and the doctor was kind of nervous, and he’s like, “I know this is a lot to take in. If we need to take a break and come back tomorrow…”

And I was like, “Are you kidding me?” I was like, “It makes perfect sense.” None of my friends would be surprised.

Steve Young: Down the middle here.

Tim Ferriss: It was just like, in retrospect, yeah, it makes a lot of things click together.

Steve Young: Yeah.

Tim Ferriss: And even one of my friends later, he’s like, “Oh, man, knowing that you’ve got diagnosed makes it so much easier to put up with your OCD.”

And I was like, “Okay.” I think there’s a risk that maybe you overdefine yourself by the label, but in my case, I was just like, “Oh, okay, that’s great.”

Now I have a shorthand way to piece these things —

Steve Young: That’s exactly how it felt. It was like, “I’ve got a job to do. I’m about it. I didn’t realize how victimized I had become and how inauthentic I’d become and how all that part of it. But at least it all kind of, like you said, my friend was like, “Oh, yeah, I can see that.” My parents, my dad’s like, “I keep telling you just go have fun and you’re not having any fun.” Oh, now I get it. So that way it was useful in that way.

But look, I feel like again, what are we here to do, learn and grow? That’s okay. Let’s grow through it. And I still and to this day find myself, the anxious parts have all kind of abated, but the pattern as a kid, I’m realizing now how you achieve, how you accomplish, what’s the root of how you try to do it. And I was doing it in a fear-based way.

Tim Ferriss: Right.

Steve Young: In other words, if I worry about something that’s important to me enough, I can make it happen. It’s magical thinking in a way. If I worry and work and fret that something good will happen in my life. And if you think about all the good in your life, did it come because you worried about it? Probably that’s the wrong dynamic. But it takes, again, this vulnerability and authenticity to kind of say, over my life, I’ve now realized watching good things happen and I didn’t even worry about it.

Tim Ferriss: Yeah.

Steve Young: Something good happened and I didn’t have to author it by some crazy amount of — and so it’s like life is so crazy amazing in that way where the onion unfolded, unraveling. Learning is so powerful to your life. And again, you can’t get there unless you’re willing to say, “It’s okay.”

Tim Ferriss: Yeah.

Steve Young: It could sting.

Tim Ferriss: Yeah.

Steve Young: It could hurt. It could hurt for a while, but at least it’s what is.

Tim Ferriss: It’s real. At least it’s real.

Steve Young: Yeah.

Tim Ferriss: So Steve, I have to ask you about the following. This is the law degree. “Over the course of seven off seasons, he pursued a law degree at BYU.” Side note, this is from the Bloomberg piece, “His great, great, great grandfather was Brigham Young himself.” That’s wild. I mean, I’ve spent a lot of time in Utah. That’s maybe a whole separate chapter for another time. But why the law degree? Why did you pursue that?

Steve Young: My dad, when I was growing up, because I had a picture of Roger Staubach, who was a famous quarterback for the Dallas Cowboys on my wall. And he’d tell me, “What do you want to be when you grow up?” And I’d be like, “I want to be a quarterback, like Roger Staubach.” And he’d go, “What? That’s a great dream, son. That’s a great dream. And dreams are less than one percent chance, but dreams are important. Have a dream. I love it, have it, but that’s very unlikely. I need you to make a plan that’s 80 percent chance.” And so I would tell him, “80 percent chance I’ll fake it and tell you that I’ll go to college and then I’ll go to law school like you dad, and I’ll be a lawyer.”

Tim Ferriss: Okay. So your dad was a lawyer.

Steve Young: My dad was a lawyer.

Tim Ferriss: All right.

Steve Young: And I kind of liked what — he described law and I was like, “I think I could do that.” So then I would tell him that and he goes, “You know, I think there’s an 80 percent chance that you can do that. So that’ll be the plan. That’s a plan and now we have a dream and a plan.” He was always about that. And even he turned 90 in February and I recently asked him like, “Well, what’s the dream, Dad?” Because he’s always like — and he’d go like, “110.” He has it in his mind, that’s the dream. So then I had a dream and a plan.

So then I go to college and I end up going pro and I’m like, the dream comes true, right? I’m like, “Dad, so much for one percent, bro. It’s 100 percent now.” And then he would always say, “Well, what? Average career is three years.” And then I played for six years. And he’s like, “Well, what are you going to do the rest of your — you’re going to retire at 35 and then what? You’ve got another half of your life. What are you going to do?” So he just kept kind of putting in my head.

Tim Ferriss: Dog with a bone. Yeah.

Steve Young: Yeah. Well, it didn’t bother me because I knew it was pretty true what he was saying like, “What are you going to do with the rest of your life?” And so I don’t know how it got in my head. I look back on that as like, Tim, that’s just stupid to try to go to law school while you play. This is dumb. But I figured it out with the ABA, with the law school, because the first semester in law school is in the fall nationwide. The first year curriculum is sequential. You can’t cheat it. And they worked it out where I could audit the second semester one winter. If I passed the classes cold, then that would qualify me to come back and take the second semester, blah, blah, blah, blah.

So over seven years, six for credit semesters, I went back and what was funny now, but wasn’t funny at the time, is we went to three Super Bowls in that time, and the Super Bowl is in February, end of January, February. School starts right after the new year. So I’m showing up a month late, and no one in law school cares. You still got to do the work.

So I remember going to the parade down Market Street in San Francisco and jumping on a plane, the Delta plane back to Salt Lake City [in the] evening, and then the next morning in class. And every class, the five first, whatever class, usually five or six classes, every class is Socratic method, they walk in and they say, “Ms. Jones, can you please brief us on blah, blah, blah.” The whole day was, “Mr. Young, could you please brief us on…” So I’m just scrambling, trying — but I think I loved that in a weird way, but I look back and it was like, “What are you doing, man? What are you doing?” But one of the great — my dad was right. I’m now 25 years in private equity, and the only way I was able to cut the line being late to the party was because I had an advanced degree. That’s how I did it. And so he was right.

Tim Ferriss: Yeah, it served its purpose.

Steve Young: Dream and plan.

Tim Ferriss: All right. So you’re doing these seven off seasons, you’re flying back, parade, get on a plane, fly back next morning, “Mr. Young,” right? So you’re doing that. How do you make the hop to finance? How does that even materialize?

Steve Young: You’ve got to remember the 49ers 1988 were given land in Santa Clara by the city of Santa Clara because there was nothing going on down there to try to build a training facility and try to attract more business. And that’s funny now because Silicon Valley, you know Santa Clara, it is the epicenter of Silicon Valley. And so that’s where I worked all the years.

And so as we worked and watched the explosion of Silicon Valley and technology, we’re sitting in the locker room and there’s five or six of us, the lunch group that we would figure out, okay, look, how do we get in on all this venture investing and all this stuff that’s going on with these businesses? Guys, we’re leaving Stanford Business School, literally in the middle of class would get a text or something, and they would take the CEO job of a new startup. They’d walk out, you know what I mean? And so how do we get in the middle of it? And so we started trading access to the locker room from those guys on Sand Hill Road for venture investing. So we started to get everything they did, we gave them $50,000 of what they were doing. We’d split it up.

Tim Ferriss: How did that relationship happen?

Steve Young: Well, it was —

Tim Ferriss: Because it doesn’t seem like the Venn diagrams would totally overlap.

Steve Young: Well, no, because Doug Leone, who’s a great guy, great friend.

Tim Ferriss: Doug Leone, he’s one of the greats.

Steve Young: He was one that said, look, we didn’t make a trade. It wasn’t a transaction. It was more like, “Hey, we’d love a relationship, come in the locker room, be a part of our life and let us be a part of your life,” essentially. And he was somebody that I think really appreciated the complexity of what we were doing and the high function that we were doing. And then we obviously appreciated the high function and complexity of what he was doing. And so we shared in that. And I think that started a process. I was asked by Brian Maxwell, who’s now passed away, but he started PowerBar. That was a meal replacement for marathoners.

Tim Ferriss: I remember back in the day.

Steve Young: But for a single guy, it was meal replacement, not for a marathon, for day to day. And so I kind of got famous around the Bay Area that I was — the PowerBar, he asked me to be on the board and I was like, “Well, I’ve never done that before. I’ll try that.” The first board meeting, Larry Sonsini, one of the icons of Silicon Valley lawyers.

Tim Ferriss: This is out of Wilson Sonsini. So when I first moved, just for people who don’t recognize. So back in the day, Wilson Sonsini were kind of the connective tissue behind the scenes for Silicon Valley. They were one of the big —

Steve Young: It was the backbone of —

Tim Ferriss: That was the backbone.

Steve Young: The legal background. And then Warren Hellman of Hellman & Friedman, Warren Hellman’s like the icon of investing in the late ’90s and really his whole life. He is the icon. So there’s two of them, and I’m sitting on the board.

Tim Ferriss: I mean, your list is pretty insane.

Steve Young: Pretty insane.

Tim Ferriss: Yeah.

Steve Young: How does this happen? And so I had a guy, I’m glad this is long form, I had a friend in college who was messing around with the URLs before the internet was shut down by the government. You could go in and do — he had an algorithm where he’d put a geographic boundary around an internet search. And if you’re old enough to know in the ’90s, the internet was a mess.

Tim Ferriss: It was a mess.

Steve Young: If you put in “Palo Alto hammer,” you’d get a USSR sickle. Nothing made sense, but with this enablement, you could put in “Palo Alto hammer” and get the local Ace Hardware store. So that made it useful. And so we had that enablement. My buddy was doing it. He was like, “Can you help me?” So I take it to the board meeting and I’m like, “Hey, what do you think about this?”

And they’re like, “That works. You need to start a business that — retailers are panicked right now because their brick and mortar stores are going to be usurped by Amazon.” And late ’90s, it’s 10 years before the time, but people are thinking about it. Take this enablement to them, they can query their inventory real time and they can drop-ship it that day and someone can pick it up. It’s like it becomes your distribution point. And I’m like, oh. So we went and did that. And my longtime partner who almost 30 years together left his banking job at Morgan Stanley to be the CEO of this business called Found.com.

Tim Ferriss: What’s your partner’s name?

Steve Young: Rich Lawson.

Tim Ferriss: How did you meet — I just love these stories. And I want to just take a quick sidebar for folks because this is a great example of going to where the action is. In this sense, I just had a conversation with Bill Gurley, legendary venture capitalist.

Steve Young: Yeah. Yes.

Tim Ferriss: And he’s got a book that might be out by the time this is published, but it’s coming out soon called Runnin’ Down a Dream. And in it, he has a chapter on going to where the action is, Bob Dylan going from Minnesota to New York City. And you can kind of go down the list. And in this case, it’s like you happen to be right in the epicenter.

Steve Young: And again, I wish I was Bob Dylan and had the smarts to go from Minneapolis to the action in Silicon Valley, but I actually, luckily was already here just sitting here. I actually watched the traffic get worse and worse. Like, where’s all this traffic coming from? I used to get to work in 10 minutes, now I get to work in 30. And so you made fun of the athletic brain. It took a little while to kind of get it going, but in the end, we were in the middle of it and I found myself — so to finish that story, we start a business. Rich is the CEO. I’m the chairman backed by Accel, KKR and Bain and it was all of that. And so that’s when Warren and Larry Sonsini, Larry became a very close friend of mine, a mentor, still is. And I mean, really, still is. I mean, he’s just an amazing guy. He’s like, “Steve, I’m a lawyer. You need to go do this.” And that’s how it switched.

Tim Ferriss: Oh, I see. He said, “I’m a lawyer.” And he’s saying that referring to —

Steve Young: He just said, “Look, your EQ and the way you look at the world…” And I had graduated in finance, so I was like, I knew enough to be, not even dangerous, but new enough to what it really was about. He said, “You need to go help people build businesses.” And that’s kind of how it switched.

Tim Ferriss: And I’m looking right over your shoulder at, looks like maybe a tweet from Rich Lawson, your partner, that says, “Very proud to break into the top 20 of 500 plus private equity firms globally in just over the decade…” Okay. So I mean, you’ve had these multiple chapters. How did you connect with Rich Lawson? That’s actually, you can see Rich Lawson right there. So perfect timing. How did you manage to —

Steve Young: Well, let’s back up because what you’re alluding to, I think, is that what we’ve been talking about really for the whole time is transition.

Tim Ferriss: Yeah, exactly.

Steve Young: And the difficulties because I love football and I was very successful at it, I run into a lot of people who played in high school and loved it. The dream, like they would give their arm to be able to, or leg to be able to play in college and keep the dream going. And I always think about how when I left the game, it wasn’t necessarily forced, but you do age out. It just sooner later, even Tom Brady aged out at 45. It’s a young man’s game. And I remember the day before, the day I retired, I was known for this thing that I had been able to do worldwide even. The next day I remember waking up and now that that’s gone.

Tim Ferriss: Now what?

Steve Young: Yeah. Yeah. And what I’ve learned about transition that leads to Rich Lawson, how I describe it, that everyone, and even the high schooler, the last day they play and it has to be put away, needs to recognize and treat it like a death, to mourn it and go through all the steps of mourning it and burying it and actually having it as a place that you can keep referring to as almost like a grave site. Because otherwise you carry it around and it never gets — you never transition. Transitioning is about actually moving from to, right? And so I’m really grateful, Roger Staubach, the poster on my wall, I got to know him. He became a friend. Like it’s insane.

Tim Ferriss: Yeah. How cool is that?

Steve Young: And he famously transitioned, probably the most successful transition in the history of the NFL.

Tim Ferriss: What did he transition to?

Steve Young: The Staubach Company was a real estate business that he was hugely, hugely successful. And I remember asking him towards the end of my career, “Roger, give me some tips.” And he goes, “Run.” I’m like, “Run? Run where?” He goes, “Just run away.” That was his tip. Because he said, “The game will never leave you, but you need to leave it. You need to move on.” And I thought that was just simple, but really important.

And I tell people today, and I really want to write a book about transition because everybody is constantly transitioning, whether they like it or not. Most of it forced, right? But if there’s an authentic, vulnerable way to transition and bury and mourn, you can wake up the next day, realize I was great at something and now I’m not even good at anything else, but you know what? I’m going to —

Tim Ferriss: Learn and grow.

Steve Young: We’re going to learn and grow.

Tim Ferriss: I’m slow, but I’m getting there. I’m only twice as dumb as I was.

Steve Young: It’s useful.

Tim Ferriss: What did mourning football look like to you? What did running from it look like and what did mourning look like?

Steve Young: It’s funny. So you lead to Rich. So as we built this business and I was still playing, I was getting ready to run, and I was already running away from it even before it was over. And I think there was a fear based, which is not necessarily the best way to do this, that if I didn’t run really fast, that it would somehow keep me from getting really clear of it all. And so I just started — we had that business and we were just running. And so he was a banker at Morgan Stanley. We took this idea that Warren and Larry had said, great, my buddy Jim Herrmann, and he said, as we went to go get financing for this business, we ran into Rich, who’s a very successful banker in Morgan Stanley, but young, recognizing everything that’s going on, and says, “You need a CEO.” And I’m like, “Yeah, you’re right. We do.”

And he says, “I’ll leave…” You’ve got to be in the late ’90s in technology. He’s like, “I’m walking out of Morgan Stanley. I’m going to be the CEO.” And so we’ve been together ever since then. And so the transition you’re talking about as far as how it — I think because of that energy around great mentors, I mean, I’m very, very lucky. I didn’t have to do it raw. I didn’t have to do it alone. I didn’t have to — that would be super difficult. I had all this mentorship, all this modeling, all this example from Roger, from everybody. So to me, it was just, can you just go enact what is obvious to go do and not —

And I really appreciate it because the game never does leave you. I traffic in memorabilia for our golf tournaments for Forever Young Foundation. And so we need constant signatures from jerseys, from players and hockey players or Hollywood. And so I, to this day, you can’t imagine how many signatures that I do as part of the memorability company and they pay me in stuff so we can use it for the tournaments. You know what I mean? And if you told me in 2025 I’d still be signing my name on Steve Young jerseys or helmets, it blows the mind, but we’re still trafficking in it because it funds the foundation and we have great golf tournaments and we make a lot of good things happen. So it’s like a virtuous cycle that we’ve got going, but —

Tim Ferriss: It seems also really fortunate. We were chatting just when we took a break briefly, and we won’t get into the details of that, but about some of the former military kind of tier one operators who are friends of mine who run into a very similar challenge. They’re the best of the best.

Steve Young: It is brutal.

Tim Ferriss: They’ve been hugely invested in, not that dissimilar in some ways from top level professional athletes.

Steve Young: 100 percent.

Tim Ferriss: And then they go from being the best at what they do to question mark or feeling they’re not good at anything. And that happens to gold medalists, or I should say just Olympians broadly.

Steve Young: It happens to the high schooler who never leaves football.

Tim Ferriss: Yeah, that’s a great point.

Steve Young: You’re talking about, there’s dramatic moments that are clear, like the SEAL team who’s the elite member, that resonates with everybody like, oh my gosh, that would be hardcore.

Tim Ferriss: You’re right though. It happens in so many other ways.

Steve Young: But the transition pattern is so common.

Tim Ferriss: Yeah. And I was thinking how incredibly fortunate it seems to me that you happen to be here because startups are a full contact sport.

Steve Young: It’s brutal.

Tim Ferriss: That is full commit, right?

Steve Young: It’s unbelievable.

Tim Ferriss: That is not a nine to five check-in, check-out, going six out of 10. This startup’s, is in a way, it just seems like a good fit in a sense, for someone who’s been in sixth gear for so long.

Steve Young: There’s a little bit of drug in it where the action — look, I talk about this with other quarterbacks that have played a long time, “What do you miss?” And you miss the opportunity to pour yourself into something. It demands. I always say there’s physical athleticism, that’s part of it. There’s emotional athletism, that’s part of it. There’s psychological. It’s every part of you is necessary to be poured in to be even good at this, if not great. And so that rigor, nothing else, even business can’t provide that. It’s nothing like it, in front of 80,000 people with a score and officials and a clock. And that’s just — it’s a really crazy, cool environment because there’s truth in it always.

Tim Ferriss: There’s a purity to it.

Steve Young: There’s a purity to it. But even in the purity of it, going back to the truest truth of accountability, you can still try to fake that it wasn’t you. Even in the most true, clear, witnessed, 80,000 witnesses just watched it. And you can listen to quarterbacks after the game, especially losing quarterbacks when they ask them what happened, try to spin what 80,000 people just witnessed, bro. Come on. And so in that way, it just tells me about human nature that if you try to spin what just happened on a football field, what are you going to try to spin in business or in your personal life?

Tim Ferriss: Or in your family.

Steve Young: Or your family. And that’s what I say when people say, “Look, I really want to change. I really want to transition to something better. I want to learn and grow authentically, truly.” You’ve got to be about it. It has to be —

Tim Ferriss: Core.

Steve Young: Core because otherwise humans in entropy with gravity and our bodies are rotting, things are going to — it’s just truth. We’ll go along with that rationale and that is a transactional path that — yeah, you’re right. It’s a rotten path and we live it all the time.

Tim Ferriss: So we’re definitely going to talk about transactional and we’re going to get into one of your books, but I’m so curious, right? So you’ve got this Morgan Stanley banker named Rich Lawson, and he’s like, “You’re going to need a CEO. Furthermore, I’m the guy.” Why say yes? What was the pitch? I mean, I love the chutzpah of it.

Steve Young: Well, I mean, think about it. I don’t know how I try to explain stuff. It’s always my dad goes, or my wife is like, “Steve, get to the point.” But Industrial Revolution, 100 years. Technology Revolution, 20 years.

Tim Ferriss: This is his dad answer.

Steve Young: It was happening right in front, right with us.

Tim Ferriss: You could see it.

Steve Young: So it was like, businesses were literally going from nothing to public in months that were now being valued at a billion — it was an insane time. So you have to put yourself in there. So why would Rich turn and see this —

Tim Ferriss: I understand why he would do it. It’s more the question of why you guys would agree to it.

Steve Young: Because we just had an idea.

Tim Ferriss: Yeah, I see. I see. You needed an — and he seemed like an operator.

Steve Young: And really, the guys that formed this and the guys that did the algorithm and the — I’m the facilitator, right? I want to be in business. I’m energized by the human kind of complex calculus in business, and so I was drawn to it, but I knew I was — I still have imposter syndrome a little bit, right? But back then, I definitely felt like I’m kind of faking my way through it. And here’s a guy that was classically trained at Harvard, went into business, went to consulting, and then now is a big banker. And to me, he’s like —

Tim Ferriss: He’s got all the pedigree.

Steve Young: — the expert. He’s expert, right? And it’s fun, the yin and yang of it all.

Tim Ferriss: What has made — I mean, I have quite a few friends. I mean, I have a lot of friends in the investing world writ large, but I have quite a few in the private equity world as well. And I mean, how long have you guys been partners now?

Steve Young: That was 1997.

Tim Ferriss: It’s been a minute.

Steve Young: Almost 30.

Tim Ferriss: Yeah, 30 years. Why has it worked? What are the —

Steve Young: Oh, it’s interesting.

Tim Ferriss: Right? Because a lot don’t.

Steve Young: None do.

Tim Ferriss: Yeah. Right. There we go.

Steve Young: First of all, I think that there was a clarity early on that the things that he’s really good at, I really am not good at. And the things that I was really good at wasn’t his strongest suit. So there’s a yin and yang kind of feel to it. And then there’s a trust that gets built that just works. It either does or doesn’t, and it gets tested. I mean, the times that in 30 years — you’ve got to be kidding me. I remember sitting in the corner, there were existential moments when it felt like, “Well, that was fun. See you later.”

Tim Ferriss: If you’re able to talk about it, what types of — how do those precipitate?

Steve Young: Well, private equity, if you think about it, it’s a really unique business because you go globally to find investors to believe that you can go now deploy capital in businesses to return significantly more over a period of time than the public equities or other bonds or anything else. And so private equity’s got this fuse of capital that has to be great, and you have to be great in kind of 10-year increments so that as you go out and you raise the money and you go do it, every few years, you’re going to have another referendum on whether you’re in business or not.

Tim Ferriss: Based on your report card.

Steve Young: Truly. And you could be out of business. And so it’s a crazy world to now try to build continuity from fund to fund and a business that reflects the values that you want. In the middle of the truth of it is like, there’s a referendum every few years and it might go away. And so when you’re getting started, like any startup, there are existential moments that feel — I look back and it probably wasn’t truly existential, but it felt it, and that builds trust or scar tissue that, to me, the most interesting people in the world have lots of scars and have found the bounty in it, the good in it. And so I think that’s how it’s worked. And we had our holiday party yesterday, last night, and here we are sitting together chopping it up, amazing what’s happened, but yet what we can do.

So it’s just Henry Kravis and George Roberts both, I’ve had the pleasure and the honor of knowing and knowing them, and that’s one of the great partnerships of all time. Two cousins that have just — and they’re still humble gentlemen, sincere. I mean, I’m inspired by both of them. And so in that way, I’m now getting old enough when we can talk about these generational relationships that are super cool. And we all had the same office. We never had separate offices. He’s like, I’m Oscar, he’s Felix, like the old couple.

You look around the room and all the helmets hanging up, that’s COVID. All the stuff I, remember I told you about the memorabilia that I traffic in, they were in the corner in a big pile. It was just a pile of crap that just keeps getting cycled through. And during COVID, he couldn’t take it. He’s like, “I’ve got to clean this place up.”

Tim Ferriss: That’s me. That would be me.

Steve Young: So I walk in after a couple of weeks being like, “What have you done? You hung up helmets around that. They all look stupid.” Because to me, as a ex-pro athlete, that’s just dumb. But to him, it’s like that’s clean. And so we have helmets.

Tim Ferriss: It looks pretty cool as a background with the camera facing this way. So HGGC, Handsome Good Guy Company, what does that stand for?

Steve Young: Historically, it was Huntsman Gay Global Capital. At the time, back in 2008, ’07, Rich and I were the younger partners, the founders, and the two older partners, Jon Huntsman and Bob Gay with Greg Benson. And Jon wanted his name on it, and Bob didn’t want his name on it. And so, but then Jon won, and so it was Huntsman Gay Global Capital.

But then Jon was selling his Huntsman chemical business, but in the 2008 credit crisis, you can read the story, it’s amazing story where Leon Black at Apollo had bought it, signed it, but then didn’t fund it because everything had gone crazy. And then what ended up happening is the transaction did not get funded. They broke it. There was a huge lawsuit, and it was a billion-dollar settlement, but the net of it was Jon Huntsman never was able to come over. So here we are raising money as Huntsman Gay Global, and we don’t have Jon. And then Bob left for full-time church service three years later. And so then we go to fund two and it’s like, we’re Huntsman Gay Global Capital. No Jon Huntsman, no Bob Gay, but you have Rich Lawson and Steve Young, what do you think? Let’s go.

Tim Ferriss: I’m so glad I asked. That’s so much better than I would —

Steve Young: So then we have the decision to make in 2012, what do we name ourselves because we can’t stay with that name? And there’s a little panic like, can we even raise a — I mean, again, existential crisis.

Tim Ferriss: Can we even raise?

Steve Young: Can we raise a fund? Let’s melt it down so at least it’s a reflection of something that was existing. And I, honestly, and everyone around the firm knows this, I can’t stand our name because HGGC is hard to say. So you stand up in a very formal setting, and you’re trying to express the values and this incredible partnership and culture that you’ve built off of the back of my previous life in football and how you have to come together. And pari passu, we can lock arms, strategic vision, we can go. And everyone here at HGGC.

Tim Ferriss: That’s a lot of syllables.

Steve Young: Yeah. So my great idea is to call it, I used to play at Candlestick Park, so it was Candlestick Ventures or Candlestick Partners, but we’ve said, we branded it. It’s worldwide.

Tim Ferriss: It stuck. It stuck.

Steve Young: It’s everything, so now we’re HGGC just because. And, it’s fine. It’s fun. It’s fun.

Tim Ferriss: So you mentioned something that actually might be a nice segue to where I was planning on going next anyway. You said left for full-time church service. And I was going to ask about faith, the role that faith not only plays in your life now, but has played. Has it changed form over time? I don’t know if it has or not, but —

Steve Young: It always does —

Tim Ferriss: But —

Steve Young: And it should.

Tim Ferriss: Yeah.

Steve Young: It’s learn and grow, right?

Tim Ferriss: Mm-hmm.

Steve Young: As a young kid, it was formative. It gave you a sense that God’s with you, like cheering you on. As a kid, I always felt like even in the hardest times, no, God’s cheering you on. I never felt this wrathful. When I read the Old Testament, I’m like, “Meh.”

Tim Ferriss: It’s pretty rough.

Steve Young: Not really. That doesn’t make sense to me.

Tim Ferriss: Leviticus doesn’t have a big smile on it.

Steve Young: And I was able as a young kid to fare it through the things that resonated and the stuff that didn’t. And so my theology is really wrapped into what I would call — being LDS is complex because it was a — you know, we claim this kind of restoration. So it was essentially a restart. And in the restart, there’s — I mean, you look back at the history in the last 200 years, it’s pretty chaotic. And so for me, I don’t have to carry all that. But the things that resonate, the things that are beautiful are really rooted in that event. So it’s like to me, it’s always resonated. It’s always been something that — and I don’t have to carry what I see as the chaotic parts of a young organization.

So in that way, I tell my wife, she got me started on really questioning and challenging the culture As a cultural experience because true faith can’t be cultural, right? It has to be rooted in something actionable that is beyond you. And so I find myself more energized than ever around faith and around the potential of organized religion and its beauty, yet recognizing how devastatingly painful and difficult and all the other parts of it. So ferreting through all that, I find myself more energized than ever at how I feel around faith and connection and relationship. Because I learned somewhere in there that if you’re not careful, you go back to what we talked about around entropy and rotting and transaction. And if you’re not careful, religion becomes like what I call Boy Scout theology, kind of go get a merit badge, do the work. It’s good work. It’s not bad work. Go get a merit badge, put it on your sash, and then wear it around town so that everyone knows what an amazing Boy Scout you are. You know what I mean? Does that make sense?

Tim Ferriss: It does make sense.

Steve Young: So that theology is productive.

Tim Ferriss: It’s like performative.

Steve Young: There’s good things that come out of it, but the relationship can’t last because it’s transactional. It is self-interested at its core and it can’t make it. So I’m super energized by the roots that really kind of like — I don’t know. I find myself every day enjoying, as I chew on the ideals of my faith, like how it keeps resonating in a way that is — we’re talking about learning and growing, right? I find myself always refining and spiritually kind of that light that I feel that I want to be around, and it doesn’t necessarily — it comes from everywhere.

I find my organized religions kind of — it’s not hoveled. It’s not insular. It makes me more curious. I can’t wait to hear when you tell me about something that you’re doing, I’m like, “Tell me more about that, man, because that’s informative to where I’m sitting.” And that’s when I know it works is when you get away from transactional, insular, hoveling, self-righteous judgment, those are all transactional words that I’ve just — you asked me a question. I’m sorry to start riffing on it, but it’s a really, I think, energizing place to be for me right now.

Tim Ferriss: Well, this is no need to apologize. I mean, this is an exploration and I wanted to ask for a number of different reasons. One of them, I mean, and this is a reflection of the antithesis of insular also in my reading of The Law of Love, your book, which was sent to me by Greg McKeown, who wrote Essentialism, and ended up listening to it.

Steve Young: Oh, man.

Tim Ferriss: And I listened to it.

Steve Young: I apologize for that.

Tim Ferriss: Well, no need to apologize, but —

Steve Young: Well, no, it was written for my LDS brothers and sisters. We’re in a place where our roots are incredibly non-transactional and yet have allowed for the rational — I shouldn’t say infection, but allowing for the transactional to actually lead in places that it needs to be excised. And so that’s the book is about, is that there’s a law governing the universe, universal law for all humans that says to see the full measure of something, you have to lose the self-interest.

And I was brought here by Bill Walsh, my coach in the 49ers who used to talk about every year he’d stand in front of the team and say, “I don’t care what play we call, I don’t care what defense we run, we’re going to win because we have shared common experiences amongst each other and an element of love for each other.” And I was like, “That’s how we’re going to win football games?” And it was actually true, right? All the way to just all elements of my marriage, my family, my relationships. It was all, as I sought the higher ground, I guess you would call it, just started to resonate and I wanted to write about it. It was my journey. It was led by my wife who I just think I’m so much better rubbing up against her every day, shoulder to shoulder.

I always say she gets the barnacles off my boat, you know what I mean? I love her for that. And so that’s, I don’t even know what the question you are. I kind of lost myself in it, but —

Tim Ferriss: Well, I’ll pick up where you just left off with respect to keeping this — not necessarily. It’s not the loss of self-interest. It’s also this collective, this love of the collective that might not be the best way to phrase it, but self-transcendence maybe would be one way to put it. How do you, how do your wife, how do you guys, your family, keep it at the forefront? Maybe it’s a question for you. How has that become more important and how do you keep it like you did the accountability after that plane ride, something that you have as a lens on a daily or weekly basis?

Steve Young: I think that’s where the theology really is important, is how you see, how you define the crazy world that we have. I mean, I just noticed the fiery orb that came through the sky again today, amazing how it just comes in and makes Palo Alto 67 degrees and perfect, you know what I mean? The things that are going on, the miracles that happen, I mean, I had breakfast, but I don’t digest my food. I don’t know the vitamins and minerals that body needs. There’s just this intelligence that’s out there that is universal and — dang, I forgot your question because I lost —

Tim Ferriss: Oh, that’s okay. No, I was just asking the law of love, how you keep that —

Steve Young: Oh, in the forefront —

Tim Ferriss: In the forefront.

Steve Young: Yeah. So typical of me, I was going to go around about —

Tim Ferriss: You can take the roundabout, the signature.

Steve Young: But I think what I was trying to say is that again, it’s an intent and it’s really about recognizing and defining, that’s where I was going, is defining the conditions of our life that I think God authored. It’s a body, there’s agency, choices to make, there’s opposition everywhere. And so with that as an ingredient, that’s our laboratory for learning and growing. It goes back to learning and growing. That’s the laboratory. So in that laboratory, as we define each other, how are we related? And so my theology is that God, mother and father, we are durable spirits inside of us that are not from this place. We take a body for learning and growing, but then when we die, there’s this physical entity of spirit that’s durable and that it’s divine so that every human is divine. So in that way, as you start to define things that are every day, how you relate with them, it’s in the definition as how you actually act.

And so if I see everyone as divine and more eternal, it’s not just like you see someone on the street and you say, “Oh, they’re in a bad spot.” I mean, that’s terrible. They chose their way. What a bad life. And it’s like, no, let’s back out and recognize that there’s a broad, big spectrum of experience and let’s see and have the curiosity for how to help those around us learn and grow as well. And because we really are related, we were all together, we all chose to take a body. And so in that theology, there’s this universality. And so if you talk about the law of love, it’s really just a fulfillment of the relationship that’s already true. So it’s not like I have to go through all kinds of mental machinations to make myself seek others as literal family. It’s in the roots, it’s in the dirt.

You and I are related in that way. You’re divine. We’re both divine, so let’s be about it. And so in that way, the intent of the law of love says the full measure of what I can get out of this life cannot be a transaction. God cannot be Santa Claus.

As much as Santa Claus is a cool idea, and that if I’m super good, I get a gift, at its root, it’s self-interested, and it can’t last. If there are durable spirits inside of us that are more in perpetual, the law that leads us cannot be self-interested because it will rot. It will rot like everything else in the — everything around us is — I look in the mirror today, Tim, it’s not going good, bro. It’s going the wrong direction. So in that way, the law of love is really about saying there is a law that is decreed from the origins of the universe that says, if I can lose the transaction, if I can lose myself and be curious about you and be curious about where you’ve been, there’s an element that’s pure in that, that you take in a different way. If you and I have a transactional relationship, it’s going to feel that way.

And there’s a lot of bounty in it, a lot of profit, there’s a lot of money run around the world, there’s a lot of fame, there’s a lot of everything. There’s a lot of goodness in many ways, but in the end, if it’s purely transactional, if my marriage is purely transactional, at some point it’s going to break. It has to, in self-interest. And so if you ask me the intent or how do you live it, you have to define — to me, the definition’s important, right? Because otherwise you’d be like, screw that.

I’ve been curious about people and I’ve been hurt and I’m done with that and I’m tired of being left behind and then the victimization shows up. We have themes, right? And all of a sudden it’s like, the world’s against me and now I’m going to —

Tim Ferriss: Look out for number one.

Steve Young: So I’m going to take my part, right? And as soon as you do that, yeah, there’s a mitigating truth to it. It all makes sense in my brain, but that’s —

Tim Ferriss: Yeah, it makes sense. Just because you can identify truths in a scene or situation, it doesn’t mean that by focusing on those particular truths, those mitigating factors, that you produce any type of durable good for yourself or others.

Steve Young: And the idea is that the full bounty of a relationship, put a religion aside again, but just put it all aside. The full bounty of a relationship is actually ironic. In an unfeigned love, care, concern, even a fairly well hello, just something that says, “I am about your wellbeing, hope you have a great day.” In that simple statement that’s not, “I’m not looking for anything. Just I truly hope you have a great day.” In that element, I believe unlocks an irony of how you actually receive a great day, if that makes sense.

And so you can’t say, “I hope you have a great day because then you’re going to help me have a great…” You can’t make it about something, then it all of a sudden devolves. Even kids, kids feel pure love from a parent. Do you want to raise your kids in a transactional way? It works for a while, but to really love them in a way that they feel, they feel it. I’m loved and I’m a screw-up and I do make that bad decision, but I know I’m loved and that changes people because it hits in a different place. And so the book is really around what I believe is the universal truth that is true for my LDS community, particularly because that’s what I’m very focused on, but it’s true everywhere.

Tim Ferriss: Yeah. Can it be implied?

Steve Young: But it’s the irony of it because we all who are trying to accomplish, that’s what we see in front of us. The better the life is, the more accomplishments, right? That’s how you show a great life. And so it’s irrational. It’s irrational to the world that we live in today. It’s irrational, yet I think it’s the unlock.

Tim Ferriss: Yeah.

Steve Young: That’s what I would put it, because people could tell me, “Screw you, Steve. That’s just ethereal, weird, crazy stuff. I know what I need to do to be happy and I’m getting it right now. It’s fine.” What I’m describing is irrational to all of that. And I’m chewing on it. Tim, I’m not an expert. I’ve been brought to it because of a quest, another Steve Covey quest, and I’m just chewing on it and I’m learning about it and yeah, that’s it.

Tim Ferriss: I’m so deeply curious about this. I did not grow up religious. I went to an Episcopal boarding school for a period of time, but I mean, that was non-denominational. So yeah, we sat in a chapel and they gave announcements, but besides that, it wasn’t terribly religious. And I don’t identify as religious in the sense of having an organized religion I adhere to. But there are also so many things that our current, let’s say, breadth of science can explain. And there are also a lot of questions that are really important and there are things that we can feel like love that are very hard to put under a microscope and provide spreadsheets for it. You can try, and there are ways to sort of torture some of these things into conforming to numbers, but at the end of the day, there’s a lot we don’t know. There’s certain questions we can’t answer. And I, for a long time, was, I would say, a pessimist disguised as a realist, if that makes any sense.

Steve Young: Sure, of course it does. Totally rational.

Tim Ferriss: Yeah, being raised around a lot of the glass-is-half-empty type of thinking that was justified and reasoned, and it made sense to me. I look out at the world, look at the cover of the newspaper, like, yep, things are bad, people are bad, and therefore A, B, and C. However, as I’ve gotten older, I’ve realized that, for instance, if you have a base assumption, let’s just say a belief that humans are divine, there’s some aspect of every human that is divine. And divine is a word that’ll make some people squirm who are listening to this.

Steve Young: That’s fine too.

Tim Ferriss: Which is fine.

Steve Young: Totally. Again, I’m curious. I have no — my dogma is very about the human interaction, right?

Tim Ferriss: Right. So if you have that belief and it’s like, okay, people might say, “Well, I can’t be falsified, Karl Popper, blah, blah, blah, blah.” But the point of it is, does it make things better or does it make things worse? And that I’m not saying that everybody should adopt every fairytale that they want, but at the same time, there is some latitude in how you choose to view things. And if you start to entertain something that is ever present, intangible, you could call it divine, you could call it something else, sublime, you could call it wonder, you could call it awe. I mean, there are different ways to put it. I’m not saying those are all equivalent, but you begin to get more curious and you begin to see, like you said, the fact that plants eat sunlight to produce energy, it’s completely nuts.

Steve Young: It’s insane.

Tim Ferriss: Right. And when you start to really re-familiarize yourself with beginner’s eyes, looking at how incredibly improbable it is that you and I are sitting here experiencing more or less the same reality —

Steve Young: It is irrational.

Tim Ferriss: Yeah. It’s why.

Steve Young: Don’t you think it’s irrational? It’s incredibly crazy.

Tim Ferriss: It’s nuts.

Steve Young: And so look, to me, anyone that’s uncomfortable talking about religion or theology, put it aside for a second. Let’s just think about take the universal truth that I believe is universal because it’s universal. Forget about all of that. Just take it as a lived experience, the rational, transactional life that is in front of us and the results of it. Watch as you watch it politically, you watch what happens is over time, you have to separate because, and the transactional path is more fundamental. So what is happening politically today? More and more fundamental both ways because nobody is looking for — the law of love is not part of the calculus. No one’s curious. No one’s open. So it’s like, forget about religion for a second. Just politically, I’ve never seen a more divisive transactional time led by the most divisive transactional people. It’s just, it’s not that complex.

Tim Ferriss: Yeah. And you can also look at, I mean, even we’re sitting here in Silicon Valley, right? A lot of very wealthy people. And if the hope is that the list of successful transactions, and we’re going to land the plane in just a couple of minutes.

Steve Young: This is super long form.

Tim Ferriss: If people hope the list of transactions will ultimately redeem the time that they spend on this planet in life, I’ve never seen it work out, right? I’ve never seen that work. It’s just —

Steve Young: It’s testable, right? I’ve experienced it.

Tim Ferriss: The greyhound never catches the rabbit. And so this self-transcendence discussion, I just more and more feel like it’s so critical.

Steve, I know you’ve been very generous with your time. I have really enjoyed this. Is there anything else that you’d like to share or talk about before we wind to a close?

Steve Young: I will tell you, Tim, that you’re really good at this.

Tim Ferriss: Thank you.

Steve Young: Because I don’t know that I’ve ever had a conversation like this. I leave with that unsettling feeling like I’ve really shared, I’m like overshared, possibly. And I’m like, “Oh, man.” But I’m at a place in my life where I’m curious about that. It’s like I’m not worried about it. I was just like, “But thank you for a chance to put into words.” And I already feel like, oh, I wish I could have said that differently or I could have, because it was so raw in some ways. So I’ll get better at that, but I really appreciate that for me, the depth of how you took me to places that I really appreciate. I will not listen to it because it’s just too much, but I’ll get responses from people. But I just thank you for the gift of vulnerability and the gift of expressing my story. I appreciate it.

Tim Ferriss: Yeah. Thank you. I’ve really, really enjoyed it. Folks can find you on Instagram @SteveYoung, on X @SteveYoungQB. You’ve got the hggc.com website, of course. Also people should check out Forever Young Foundation and we’ll link to many other things in the show notes for everybody at tim.blog/podcast. And until next time, as I always say, folks, be just a bit kinder than is necessary to others, but also to yourself. And thanks for tuning in. Thank you, Steve.

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The post The Tim Ferris Show Transcripts: Steve Young, from Super Bowl MVP to Managing Billions — Hall of Fame 49ers Quarterback on High Performance, Reinvention, Faith, and How to Blend Dreams and Plans (#847) appeared first on The Blog of Author Tim Ferriss.

Steve Young, from Super Bowl MVP to Managing Billions — Hall of Fame 49ers Quarterback on High Performance, Reinvention, Faith, and How to Blend Dreams and Plans (#847)

2026-01-14 21:55:32

Steve Young (@steveyoung) is a Hall of Fame NFL quarterback who played professional football for more than 15 years, predominantly with the San Francisco 49ers. He was named the Most Valuable Player of Super Bowl XXIX, securing the titles of Player of the Year by Sports Illustrated and Sporting News from 1992 to 1994 and receiving the NFL’s Most Valuable Player award for 1992 and 1994.

Upon retirement, Steve held the record for the highest quarterback rating in NFL history and remains the only quarterback to clinch four consecutive NFL passing titles. Following his football career, Steve became an ESPN analyst and best-selling author and entered the world of private equity. He co-founded HGGC, a private equity firm managing more than $6.9B in capital commitments, and served as chairman of the board for HGGC portfolio companies IDERA, Integrity, and AutoAlert.

Steve is the founder and current chair of the Forever Young Foundation, an organization deeply involved in supporting children’s charities globally. He also has taken on a significant role in advancing the national women’s flag football initiative and is a former international spokesperson for the Children’s Miracle Network, a philanthropy that has successfully raised more than one billion dollars to aid children’s hospitals worldwide.

He is the author of QB: My Life Behind the Spiral and The Law of Love.

Please enjoy!

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Products, resources, and people mentioned in the interview

Steve Young, from Super Bowl MVP to Managing Billions – Hall of Fame 49ers Quarterback on High Performance, Reinvention, Faith, and How to Blend Dreams and Plans

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Transcripts

SELECTED LINKS FROM THE EPISODE

Connect with Steve Young:

HGGC | Forever Young Foundation | Twitter | Instagram

Books & Articles

The Law of Love: The Powerful Force That Opens Doors, Overcomes Obstacles, and Changes Everything by Steve Young
Steve Young Is an Athlete Who’s Actually Good at Finance | Bloomberg
49ers Great Steve Young Opens up on Mental Health and His Struggles with Anxiety | The New York Times
Essentialism: The Disciplined Pursuit of Less by Greg McKeown
Extreme Ownership: How U.S. Navy SEALs Lead and Win by Jocko Willink and Leif Babin
Mental Toughness Training for Sports: Achieving Athletic Excellence by James E. Loehr
Runnin’ Down a Dream: How to Succeed and Thrive in a Career You Actually Love by Bill Gurley
Searching for Bobby Fischer: The Father of a Prodigy Observes the World of Chess by Fred Waitzkin
The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change by Stephen R. Covey

Companies & Organizations

Movies & Documentaries

People

TIMESTAMPS

[00:00:00] Start.
[00:02:34] The full circle of Josh Waitzkin.
[00:05:47] The Stephen Covey plane ride that changed everything.
[00:11:38] Overcoming victimization: The hole you dig, then jump into.
[00:14:16] How taking ownership led Steve from rock bottom to NFL MVP in one season.
[00:21:50] Interceptions and the truest truth about accountability.
[00:26:09] What separates good from great quarterbacks: Adrenaline alchemy.
[00:31:21] Alex Honnold and the genetics of not panicking.
[00:32:14] Learning to actually throw a football at BYU.
[00:35:01] Recovering from the offensive coordinator who wouldn’t coach southpaws.
[00:37:00] The vulnerability prerequisite.
[00:42:45] Separation anxiety: Thriving by day, terrified by night.
[00:48:29] Tears in the Candlestick Park training room.
[00:52:37] The diagnosis that made the puzzle pieces fit.
[00:58:32] Dad’s philosophy: Dream (1%) and Plan (80%).
[01:01:14] Law school between Super Bowl parades.
[01:02:33] Trading locker room access for venture capital deals.
[01:08:45] Mourning old identities and heeding Roger Staubach’s transition advice: “Run.”
[01:11:49] Rich Lawson walks out of Morgan Stanley: “I’ll be the CEO.”
[01:19:05] 30 years of partnership: Yin, yang, and existential crises.
[01:23:01] HGGC: The name nobody can pronounce (and why).
[01:25:19] Faith evolution: From Boy Scout theology to something deeper.
[01:29:41] The Law of Love: Bill Walsh’s secret weapon.
[01:32:53] Divine humanity and the irony of losing self-interest.
[01:43:52] Parting thoughts.

STEVE YOUNG QUOTES FROM THE INTERVIEW

“I realized right there that the hole I was in, that I thought so many people had dug, that I had dug it. I had no idea that I dug the hole, and I had thought that everyone pushed me in and I didn’t realize that I had jumped in.”
— Steve Young

“My theology is we’re here as humans to learn and grow. It can be tough and miserable, it can be all kinds of things, but that’s the underpinning of what we’re trying to do is learn and grow. Be about it. Don’t be afraid.”
— Steve Young

“[Transformation is] a state of being. It’s not a list of things to do.”
— Steve Young

“You might not have a great practice, but own it. You might not be as strong as you thought you were. Well, freaking own it. Stop dancing around the authenticity of what you’re trying to do.”
— Steve Young

“Part of learning and growing is, ‘I suck right now, but I’m not going to suck tomorrow.’ And once you can start to get into that mode of ‘That’s what I’m about,’ that’s what happens. There’s a clarity that comes because now everything gets fed through that truth.”
— Steve Young

“I remember running up to Troy Aikman, and we were warming up, and he’s a friend, and he’s a quarterback for the Cowboys, and I’m like, ‘Troy, it’s so great that you’re here, man, because I’m on this quest to see how good I can get, and I can only find out against the best, and so I’m so glad that you’re here.’ And I remember Troy looked at me like, ‘Freaking weirdo. What’s wrong with you?’ But that’s what I was about.”
— Steve Young

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Want to hear another episode with someone who has mastered the art of reinvention and phase shifts? Listen to one of my conversations with Josh Waitzkin — the basis for the book and movie Searching for Bobby Fischer (Steve’s favorite film!) — in which we discussed the art of learning, how to cultivate empty space for creativity, learning the macro from the micro, the power of beginner’s mind, transitioning from chess prodigy to martial arts world champion, and much more.

The post Steve Young, from Super Bowl MVP to Managing Billions — Hall of Fame 49ers Quarterback on High Performance, Reinvention, Faith, and How to Blend Dreams and Plans (#847) appeared first on The Blog of Author Tim Ferriss.

The Tim Ferriss Show Transcripts: How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D’Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment) (#845)

2026-01-08 14:21:01

Please enjoy this transcript of my interview with Dr. Dominic D’Agostino (@DominicDAgosti2), a tenured associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine and a Visiting Senior Research Scientist at the Institute for Human and Machine Cognition. His research focuses on the development and testing of nutritional strategies and metabolic-based therapies for neurological disorders, cancer, and human performance optimization.

Full bio

Legal conditions/copyright information

The post The Tim Ferriss Show Transcripts: How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D’Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment) (#845) appeared first on The Blog of Author Tim Ferriss.

How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D'Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment)

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Transcripts may contain a few typos. With many episodes lasting 2+ hours, it can be difficult to catch minor errors. Enjoy!

Tim Ferriss: Dom, happy holidays. Nice to see you.

Dominic D’Agostino: Great to see you, Tim. Thanks for connecting.

Tim Ferriss: So I suggested — definitely — I suggested we hop on the phone because I have been harassing the living hell out of you with so many questions via text message. And I thought, this must be pretty annoying. So rather than answer me once, why don’t we hop on and record a bunch of the details because the details are so fascinating. And for people who are just tuning in who might not know the good doctor, D’Agostino, “Dom” Dominic, we should establish some basics. And I at this point have been quote-unquote in ketosis for 18 days now.

And we’ll dig into a lot of questions around that, tactical practical questions. But before we do, why would someone — and we can talk about what it is and so on, but first let’s just give some of the — let’s call it established benefits ideally in human studies, but could extend to animal models. And then, if there’s anything on the horizon, say in the next few years, because you’re at the cutting edge, if you think there’s anything that might plausibly be established as a benefit, what could that be?

So what would you put on the bullet list of benefits of intermittently or for extended periods of time, being in ketosis?

Dominic D’Agostino: Yeah, there are many benefits to being in ketosis and a ketogenic diet, if we’re going to go there, kind of has the benefits of fasting. And for millennia, we know the benefits of fasting, without the baggage, without the metabolic baggage. The muscle loss, the fatigue, obviously, you can’t live in that level of caloric deficit. But in regards to the practical applications of it, we know that being in a state of ketosis really quiets the mind. And I think that has major implications. And this was from centuries we knew this. And now over the past decades, this has been like a term kind of used.

And it’s backed up by experimental data to show that there’s an elevation of GABA. Obviously, it’s silencing a broad array of seizures independent of the etiology, temporal lobe seizures. Lennox-Gastaut syndrome, Dravet syndrome, rare forms of epilepsy. The ketogenic diet just quiets the brain, lowers glutamate, and elevates GABA, a brain stabilizing, calming neurotransmitter. And that’s why people gravitate towards alcohol, right? The GABA-ergic effects of alcohol and benzodiazepines.

So you can sort of, in a very gentle way, transition your physiology to a state of ketosis, which changes the neuropharmacology of your brain to sort of quiet it down. And that, I think, really echoes its broad application for metabolic psychiatry, which is everything from major depression to bipolar, to schizophrenia, to anxiety disorders, to anorexia nervosa. So that’s a very interesting and rapidly expanding application of ketosis that’s being funded largely by the Baszucki Group.

Tim Ferriss: Yeah. Had David on. And on the physical side, some folks, if they’re old enough, may remember the Atkins diet. Not saying that is what we should hold up as the necessarily the end all be all of any sense, but why would someone go on this for benefits outside of the cognitive psychiatric? Are there any other benefits that you could list off?

Dominic D’Agostino: Yeah, I think first and foremost, it’s weight loss. So it’s very satisfying to go into a state of ketosis because you do see the scale change pretty dramatically, and that’s due in part to some fluid loss associated with a reduction of fluid volume. So it does have a diuretic effect. Ketosis does, ketogenic diets and obviously fasting, and also a natriuretic effect where you dump out some sodium. Your plasma volume, your blood volume will contract a little bit.

So if you have high blood pressure, that will likely go down. So if you’re on blood pressure medication, you have to think about that. But first and foremost, it’s an effective way to get your body to lower the hormone insulin, if you have insulin resistance, and shift your metabolism to burning fats. And as we burn more and more fat, that stimulates the production of ketones, ketogenesis. And ketones have a broad array of applications, metabolic signaling epigenetic that have real world applications.

And that’s why the whole field of exogenous ketones has developed and there’s 160 or more registered clinical trials on exogenous ketones, on clinicaltrials.gov. So yeah. And I could go into each of the applications individually if we want to go there.

Tim Ferriss: Well, as we talked about before recording, and I’ll have to act as a bit of a referee for my audience because I know you can go as deep as we want down the rabbit hole into the 17 dimensions of biochemistry. So if you get possessed by the organic chemistry demons and start speaking in tongues, I’ll reign you in a little bit. However, let me perhaps provide a personal example first for folks because some of this will be familiar to people who’ve listened for a long time, maybe to other episodes of the two of us.

But a lot of it’s going to be new. But I want to establish some priors just so people are aware of what this might look like in practice. So I have experimented with the ketogenic diet, also extended fasting, and you can arrive at some similar places, but like you said, Dom, there can be some pretty heavy taxes to pay with extended fasting. The ketogenic diet, I’ve experimented with all the way back to the ’90s. Some of you weren’t even born probably who are listening, but some of you will remember the ’90s.

And I was using it specifically for mood stabilizing. This was towards the end of college, but also to lean out while building muscle on something called the cyclical ketogenic or ketogenic diet. So we’re going to get to that later in the conversation, but it was effectively, let’s call it six days of focusing on a ketogenic diet with one day or a half to three quarters of a day of glycogen depletion and then, loading with more carbohydrates, lower fat, et cetera.

The reason that the ketogenic diet became doubly interesting to me is that when I had Lyme disease the second time, which came with all sorts of co-infections like babesiosis and so on. And this isn’t chronic fatigue or depression searching for a diagnosis that is external. I feel like sometimes the cottage industry of diagnosing and treating people for quote-unquote Lyme disease can be shady at best. But in this case, I’m coming from Long Island. Everybody in my family has had tickborne disease and was credibly diagnosed.

So the second time I had Lyme, I got to a point — because I did not see the bullseye rash, assumed I did not have it, which is a mistake because sometimes you don’t see the dermatological response and you nonetheless have contracted something like Lyme disease. I ended up weeks later slurring my speech, took me minutes to get out of bed because my joints hurt so much, forgetting friends’ names. And my assistant said, “Tim, you really need to see someone. This isn’t fatigue. I’ve seen you sick. I’ve seen you tired. This is something else.”

And suffice to say, that turned into several months, even post antibiotic treatment, which I do think is important, of we could call it pseudo dementia. I mean, I really felt like I was operating at 10 percent cognitive capacity. And basically at my wit’s end, I said, “Well, what can I control? Because a lot has not done the job.” And I went into strict ketosis. What does that mean? That means that I’m consuming moderate protein, probably getting at least 50 percent of my calories from fat and keeping my carbohydrates to less than 20 grams a day probably at that point.

And within three or four days, I’d probably say around day three or four, because I wasn’t very fat adapted at the time. My body wasn’t well-trained to use fat because I wasn’t doing intermittent fasting, which we’ll come back to. And within three or four days, effectively, all of my cognitive symptoms disappeared. And I stayed in that state through nutritional ketosis for a few weeks, had complete remission of any of the cognitive symptoms plus the joint pain symptoms, and those never came back.

And I recommended that, and this is not a randomized controlled trial, but over the years, as due to various factors, we’ve had ticks growing in population, also expanding to the coasts and on the West Coast that is, and elsewhere, had three friends replicate this with ketosis after suffering various symptoms from tickborne disease. And we were texting, maybe even talking about this, but I never had a great explanation for why it worked.

I said, “I don’t know the exact mechanism. Maybe I have faulty glucose metabolism that was somehow — maybe something was impaired by the ticks and therefore I’m giving my brain this alternate fuel that it really likes ketones,” but it didn’t explain, necessarily, the durability of the changes. In brief, do you have a theory or an explanation for why that would work?

Dominic D’Agostino: Yeah. I’m glad you brought that up because quickly dozens, if not hundreds of people with tickborne diseases, including Lyme disease and all the tickborne diseases have communicated with me. And one of the patients is actually Deanna Tedone, who was diagnosed with ALS prior to 2010, and has basically been stabilized given three years to live. So I realized that it’s underdiagnosed, the tests to do that are kind of controversial with the CDC testing, the two-tiered testing, and IGeneX.

So I know I’m going off track a little bit here, but yes, I think it’s important to say that the spirochete, Borrelia, that spirochete is essentially 100 percent glycolytic. And when you limit glucose availability and glycolysis, you are targeting the energy systems of that microbe. So that’s one thing to think about. And it’s well established now. It wasn’t three years ago, but a ketogenic diet in particular, beta-hydroxybutyrate elevated in the blood, stimulates the adaptive immune response.

And that’s essentially your body’s ability to target foreign invaders and neutralize them. And that has become a rapidly growing area of interest. University of Pennsylvania, just — they’re doing CAR-T therapy and checkpoint inhibitors because of the ketogenic enhancement of the adaptive immune response. So I think that plays a role. And situationally, I have observed that you go into ketosis if you have an inflammatory process and Lyme disease is inflammatory.

But people who have shingles and herpes simplex and things like that, I have an inbox full of people that do that. And I would like to experimentally go down that direction to understand why. But I think there’s two reasons you’re targeting the energy systems and you’re augmenting the immune response to keep the spirochete in a dormant stage or maybe eradicating it in some context.

PREROLL?

Tim Ferriss: It’s really incredible on a whole lot of levels. And I’m just lucky that I had the prior experience with the ketogenic diet to even have it occur to me as a last ditch effort. And for people just to — if it wasn’t clear, I mean, you explained it clearly, but glycolytic, I’m simplifying here, but it means that something needs to eat sugar or metabolize carbohydrates to survive, right? And there are also, Dom, correct me if I’m wrong, but particular cancers that are very sensitive to being starved of glucose as well.

And for people who want more on sort of fasting ketosis as it relates to cancer, we may come back to it also, but we’ve had prior conversations about this and the benefits, some of the incredible effects of fasting prior to cancer treatments of various types.

PREROLL

So is it fair to say, do you think most of the benefits that someone would derive from fasting prior to cancer treatments, they could also get from ketosis or is it dialed back to a smaller percentage of effect?

Dominic D’Agostino: Yeah, that’s a good question. I think it requires a nuanced answer that we probably don’t have time for. But if you are overweight and your BMI, for example, is like — as many cancer patients tend to be like 28, 30, 32, a fasting or a calorically restricted ketogenic diet is the way to go. If a patient is trending towards being lighter, like a BMI, 20, 22, something like that, a eucaloric, meaning like keeping stable caloric level to maintain your weight is going to be important.

And then elevating beta-hydroxybutyrate will be important to get some of the anti-inflammatory effects and also the immune boosting effects and the neuroprotective effects going into cancer therapy because there’s people studying ketosis for chemo brain, like reversing chemo brain and like managing that. So it has a broad array of applications, not just targeting — it’s targeting the tumor growth and putting a break on it.

It’s not a cure for cancer, and I cringe when people talk about that like online, the ketogenic diet curing cancer, it does slow it down, especially if it’s highly glycolytic, which 80 percent of cancers are. And it enhances and augments the response to the standard of care that’s radiation, chemo and immune-based therapies. So we know that now.

Tim Ferriss: All right. Why have I been in ketosis for 18 days and why am I doing it a few times a year? Well, part of how I implement this does hinge and will continue to hinge on some of the answers in this conversation, because this is very self-interested. But what I have found is that for mood stabilization, and you mentioned metabolic psychiatry, and you made the introduction, I believe, Chris Palmer out of Harvard on the podcast to discuss this.

But there’s certain conditions, whether it’s depression, but even more squirrelly when you’re dealing with something like schizophrenia, for instance, or different types of bipolar, people who’ve been on dozens of medications who go into, let’s call it remission, or they no longer meet the criteria for the diagnosis of some of these things after being treated on a ketogenic diet, of one type or another.

It is astonishing. And so for my own mental health, I’ve noticed complete stabilization and without subduing the highs, right? I’ve never had mania necessarily, I’m not talking about that, but I’m not muted. I feel just calm, stable, sharp and that’s one reason in and of itself to do it for periods of time, but I seem to feel a carryover effect, also have Alzheimer’s and other neurodegenerative diseases in my family.

I have three relatives with rapidly advancing Alzheimer’s at the moment. So maybe we could talk also to how these things might intersect. But my feeling is possibly, and I’d love your input here, if I follow a ketogenic diet for a number of weeks or maybe a month and a half or something like that, I’d love to know the timing you might recommend. Let’s say I do that two or three times a year, that there could be enduring effects that have sort of a protective carryover, right?

And I also find it much easier now that I started doing intermittent — I’ve been in intermittent fasting pretty much every day for the last six months, which means I’m eating between typically 2:00 p.m. and like 8:00 or 9:00 p.m. and having two meals a day, that’s it. Not hungry at all. I haven’t eaten today, it’s 12:30 my time, I will not be hungry for another two, two and a half hours. That by itself completely revolutionized. I mean, that’s an overused word, but completely polished my insulin sensitivity and metabolic health on a bunch of levels.

My labs have never been better. My oral glucose tolerance test has never been better. And one question I have for you, which is just for Timmy, Tim, Tim, but will apply to other people is, is there an argument to be made, and maybe I’m totally off base, but that if you follow a ketogenic diet and make it work for a multi-week period of time, that you’re changing your metabolic machinery or just your body in some way that has carryover effects, even after you stop the diet, or is that me just doing some hand wavy fancy footwork as a muggle? I don’t know if there’s a there, there, but what are your thoughts?

Dominic D’Agostino: Yeah, I would say absolutely. I think the science is still working to clarify that and make it less ambiguous, the benefits that we are deriving from that. But that is kind of like one of the pitches for the fasting mimicking diet by Dr. Valter Longo, who was one of our keynote speakers at Metabolic Health Summit, and he’s presented some really compelling research on that, that opened my eyes to that five days of fasting can have — I think he presented a time, even three months of effects on sort of cardiometabolic biomarkers.

Tim Ferriss: And in his case, this would be the fast mimicking diet, so a few hundred calories a diet, of — yeah.

Dominic D’Agostino: Yeah, like 600, using his protocol of various foods, kind of gravitating towards more of a plant-based lower protein strategy. And I think that it’s promoting metabolic flexibility and ramping up fatty acid oxidation enzymes. And much like muscle memory, I think there’s a metabolic memory. So the more you stay in ketosis, the easier it gets and the more benefits you derive from it and the more that you shift your body to being more fat adapted, just like you can build your VO2.

When you build your VO2 max or you build up to like a 400-pound bench press and you take like months off and you go back and you can only do like 225 for a couple reps, it only takes like two or three months to get back, but it took you 10 years to get there. That muscle memory snaps back quick and everybody agrees that there’s this metabolic memory and I think there’s a lot of things at play, including gene programs, epigenetic regulation that comes to play.

So first and foremost is changing our mitochondrial function and mitochondrial capacity. So the number of mitochondria increase, and then when you take a break and then stimulate, get that stimulation again, that mitochondria is kind of there and it responds very rapidly.

Tim Ferriss: Yeah, thank you for that. And I mean, I want a bookmark, maybe we come back to this, but if people are trying to think about this, understanding that the science right now is maybe provisional or there’s a little bit, hypothesis worth disproving at this point, but that it seems to make sense from an evolutionary perspective that both muscle memory and metabolic memory would be a thing. Otherwise, it makes sense your body would want to adapt to be prepared for the next famine or whatever it might be, right? If there is a —

Dominic D’Agostino: I just want to say muscle memory is metabolic memory. So someone — I gave the analogy of like lifting weights, but someone who runs marathons, it’s the same scenario. They take time off and then that VO2 max quickly establishes again and it’s muscle, but it’s metabolic. So I like to use the term metabolic memory.

Tim Ferriss: Metabolic memory. Okay. Yeah, metabolic memory. So just so people know where I am at the moment and actually, yeah, I’ll just tell people what I’m doing because I know they’re probably getting itchy for some just like, what does this look like in practice? And then, I want to talk a bit about how ketosis or the ketogenic diet may or may not be helpful for maybe not treating, maybe treating. I’ve certainly seen some interesting effects in some of my relatives when I give them exogenous ketones where suddenly their sentences are three or four times longer, 30 minutes later, which is wild to see.

But in terms of prevention or staving off the onset of some of these diseases, I’d love to hear your perspective. But let me tell people what I’ve been doing for the last few months, and especially in the last 18 days. So for the last whatever it is, I think I mentioned six months, I’ve been doing intermittent fasting. And that was after hearing a conversation between Dr. Rhonda Patrick, who I’m a big fan of, and Mark Mattson, M-A-T-T-S-O-N, who’s done a lot of research related to intermittent fasting.

And the key piece for me, because you see all of these different types of intermittent fasting, all of these different ways to do time restricted feeding, and I am going to paraphrase here. So Mark, I apologize if I’m getting this wrong or oversimplifying, but in effect, it’s important that you fast, this means no calories, or we could talk about pure fat, but let’s just assume you’re not consuming any calories for 16 hours because you want to deplete your liver of glycogen. And once you deplete your liver of glycogen, your body experiences this metabolic switching.

And I’ve certainly felt this just doing intermittent fasting where my meals contain carbohydrates later, that around the end of that fasting period, boom, something switches and my mind is sharper, right? And then when I got to the point of going into the ketogenic diet this time and also a few months ago, because I was doing the intermittent fasting, and it took me about a week and a half for my body to get comfortable with that, at which point it was no problem.

But I was a little pissy, a little irritable for a little while, a little foggy. And then when I went into the ketogenic diet this time, it was the easiest transition I’ve ever had. I did not have any fogginess, I did not have low energy, I did not have what some people might call the kind of keto flu adaptive period, which seems to be pretty remediated or addressed with electrolytes for a lot of people, but it was incredibly easy.

Just straight into the ketogenic diet with no problem because I was already doing the intermittent fasting.

And then for 18 days, I’ve been having two meals a day and you’ve recommended a few that sound frankly pretty disgusting, but that are actually really easy, like two cans of canned mackerel with about two tablespoons, 30 milliliters of MCT oil plus apple cider vinegar with some salt and pepper. It’s actually delicious. I just love mackerel.

There it is. Yeah, you’ve got your apple cider vinegar right there.

Dominic D’Agostino: Cheap stuff you can get on Amazon. Yeah.

Tim Ferriss: Yeah. For people who might think, “Oh, wow, this is what for fancy people who can do all sorts of expensive things in their diet,” we’re talking about like, how much does that meal cost, three bucks?

Dominic D’Agostino: Yeah, a dollar a can for that Chicken of the Sea. And literally you get almost a pound of mackerel, and this is like third-party tested very low chub mackerel, the little mackerel, less —

Tim Ferriss: Yeah.

Dominic D’Agostino: So yeah, you got like a $1.50 for almost a pound of mackerel that you can get that for. And the omega-3s are off the charts, the heavy metals are low. I consume pounds of this stuff and I’ve gotten my blood and my hair heavy metals tested and it’s like super low, like non-detected. So I wouldn’t worry about that. People have questions about cost and heavy metals and that’s a non-issue for me.

Tim Ferriss: Yeah. And maybe you could mention, I’ll put links in the show notes as well, but since we’re on the topic, any brands that you default to, that you like. And that chub mackerel piece for folks, that detail is important because they’re a mackerel of many different sizes.

Dominic D’Agostino: Yeah. King mackerel is kind of high. This is Chicken of the Sea. So if you want to do the budget, you buy the case, the more you buy and then Amazon subscription and then, it goes on sale. You can actually get it for like less than a dollar a can. And I do the same with Chicken of the Sea jack mackerel or yeah, just chub mackerel or jack mackerel. So they’re both small fish. And I kind of like the King Oscar brand too.

Tim Ferriss: Yeah.

Dominic D’Agostino: That’s a little bit more pricey and Seasons brand is pretty good too, but I mean, it’s like as cheap as dog food. I mean, we buy some pretty fancy like freeze dry, we don’t buy the kibble stuff, but when you run the numbers and we buy —

Tim Ferriss: It’s very inexpensive.

Dominic D’Agostino: Cases of eggs for like 120 per — if you do like eggs, fish, beef and also turkey, you can get turkeys for under a dollar a pound, the whole turkey.

Tim Ferriss: Yeah, and just for people who are like, “Oh, my God, I can’t believe you guys are eating mackerel mixed with oil and vinegar in a dog bowl.” That’s not all you can eat. There’s more that you can eat. You can have, like, chicken with cheese on it. You can have vegetables. There are certain things you have to watch out for, so you’re not whacking yourself out of ketosis. But in my particular case, I don’t mind — and the fact of the matter is when I wrote The 4-Hour Body, people were like, “Oh, my God, you want us to repeat the same meals over and over again?”

I’m like, “What did you have for breakfast the last five days?” And they ate the same thing. You’re just swapping out to fall meals. So my first meal is something typically pretty small, like the macro I explained, and then I have a big meal. I might have some more protein in between, but it’s like yesterday I had lamb chops that were delicious with some vegetables made in an air fryer, no problem. And later on, I might have a rib eye on a big — chopped up on a big gigantic salad with some other stuff added to it.

But that’s about it. You have to be careful with the macadamia nuts. Those things will creep up on you. But that is in effect the diet, right? And I’m doing my training, I’m doing my rehab, I’m doing my zone two. I do find them a little, let’s say lower performance when I’m in ketosis, but what I wanted to talk about is maybe a false negative that I’ve experienced and I’ll explain what that is. So how do you know if you’re — and I keep putting this in quotation marks like quote unquote in ketosis, right?

Because most people are, or maybe all people are producing some level of ketones. So there are different concentrations that you can measure with a finger prick just like you would look at glucose. And at least with the finger prick, I think that’s measuring what you mentioned earlier as being so beneficial in a lot of studies, the beta-hydroxybutyrate, BHB. I also have — because I wanted to run this tracking, a G7 Dexcom continuous glucose monitor on one arm and then a SiBio.

Apologies if I’m not pronouncing that correctly, continuous ketone monitor on the other arm, and I’m wearing an Oura ring when I sleep to see how all of this affects my sleep architecture and everything else.

So I’m gathering all of this, but then I noticed something really weird, which I’ve texted you about because I keep feeling like I’m failing at keto. I feel great. I feel sharp. And yet when I look at not just the continuous glucose monitor, but even with the finger prick, because you do have to often calibrate these things, right? Don’t assume that your continuous monitors are accurate. You want to calibrate them.

But I’m looking at the numbers. And for instance, my girlfriend freaked out the other night because my phone started screaming. I had earplugs in because I didn’t hear it. And it was critical medical alert or whatever the code red was because my glucose was 69, I suppose.

It’s gotten quite a bit lower on ketosis, but usually hovers somewhere between 65 and 80. And my ketones were 0.2 millimolars. Now, when we’ve talked in prior conversations about what kind of target you might aim for, it seems like between 1.2 and two millimolars is anxiolytic, lowers anxiety and then you’re looking for this ratio.

You could talk about this, but the GKI, there’s a ratio of glucose to ketones. And I look at those numbers and I’m like, “This makes no sense to me because I’m not getting enough glucose to function well.

And if I’m basing it off of the Keto-Mojo finger prick, even the Precision Xtra from Abbott or my continuous ketone monitor, I’m not getting any ketones either if you’re taking it at face value. So how am I functioning?

How would you answer that? Because I don’t think I’d be the only person who feels like they’re doing something wrong if they run into this, but how would you interpret this?

Dominic D’Agostino: Yeah, I would definitely say you’re running lean. And I think what you’ve done in your OGTT test is really good. I think you had messaged that.

Tim Ferriss: Yeah, and the OGTT for folks is just that oral glucose tolerance test where you drink a bunch of dextrose water and then they take your blood every 30 minutes for two hours to see how you’re responding to it.

Dominic D’Agostino: Yeah. The biggest metabolic lever would be you have enhanced insulin sensitivity. And I think that has been the focus. For example, Ben Bikman wrote a book on this and doing hundreds of podcasts on insulin resistance, reversing insulin resistance and low carb ketogenic being effective for that.

So that, first and foremost, your insulin sensitivity is very high. Your fat oxidation is really high and your glucose disposal is high. And if you’re in a caloric deficit, your ketone uptake is very high. We see this quite convincingly.

In older rats where we gavage, where we tube feed the rats and they’re older, the ketones get to toxic levels. Whereas a younger metabolically fit rodent will dispose of it very quickly. Same with a couch potato human, same with an elite level athlete. So you have very rapid —

So when you measure ketones in the blood, that’s a function of ketone production and ketone utilization. And you could have two to five times higher ketone utilization with high metabolic fitness. And that’s due in part to ketolytic enzymes, you up-regulate the MCT transporters, that could be two, or in rodents, two or three times higher.

I haven’t done that personally and we have some data in humans we haven’t published yet, but that is a real thing and I think that you’re experiencing. Also, if you’re in a caloric deficit, there’s less spillover.

I just bought an antique motorcycle and it’s got a carburetor and the float sticks a little bit and it always drips out the carburetor when I’m running it. And when I stop and it’s pouring out the carburetor. So there’s spillover of fuel, right? But when I’m running it’s running lean because I’m using the fuel that’s going to the carburetor.

And the same analogy here is that if, for example, it might be good to just sit in one spot and relax and maybe eat a little bit of surplus calories or even eat a little bit of carbs. And what you’ll see often is your ketones spike up.

So I remember some of my highest ketone levels ever is when I consumed carbohydrates after I was fasting or in a state of ketone. It jumped up to five, six, seven, and I was like, “What is going on here?” But the glucose in that context is ketone sparing, but the glucose will also shut off ketogenesis so it’ll tank afterwards.

Tim Ferriss: Yeah, afterwards. Yeah, okay. So it sounds like then because of probably the intermittent fasting in large part, I would think, if my insulin sensitivity is high enough, that can be paired with higher ketone utilization.

So if on the assembly line of my body, right, they’re producing 10 units of ketones. If I didn’t have good ketone utilization and it was my first rodeo with ketosis, let’s just say, or a ketogenic diet, the finger prick might pick up all 10 of those units.

I’m simplifying here, right? But if I have high ketone utilization and my body’s quickly using eight of those, especially in a caloric deficit, then it’s only measuring two and I’m getting the false negative that I’m not actually producing ketones in the first place.

Is that a fair, very, very simplified description?

Dominic D’Agostino: Yeah. And you’re not measuring tissue levels of ketones, which we have done too, even in the brain, and that can shoot up really high.

So that’s also, and I’ve done this with Peter Attia too, we were measuring blood and then breath, and it seems like when we were in a caloric deficit fasting, our ketones were really low in the blood.

Low is one to two, but we were really deep into fasting, whereas our breath ketones were maxing out the meters. So the breath ketones in this — we concluded that after a lot of testing that the breath ketones were almost a better indicator of ketosis, a more accurate, I guess you could say, in a caloric deficit.

Because when you’re in a caloric deficit, you just have very high ketone disposal uptake into the tissues.

Tim Ferriss: It looks like a breathalyzer, right? So is that measuring, what is it, acetoacetate? No, I’m just trying to repeat words that I’ve heard once or twice, but it’s not BHB.

Dominic D’Agostino: Acetone.

Tim Ferriss: Acetone. God dammit. All right. I know I was close. It was a 50/50.

Dominic D’Agostino: It comes from the spontaneous decarboxylation of acetoacetate. We’ll spit out about 20 percent of the acetoacetate will kick off to acetone and then you can measure it.

Tim Ferriss: I got it.

Dominic D’Agostino: We’ve measured blood levels of each, and it’s very tricky to do that, but we’ve done it in the lab.

Tim Ferriss: All right. Here’s another practical, tactical question for you because I’ve gone back and forth on this and Uncle ChatGPT has confused the shit out of me so maybe you can help resolve it. Gluconeogenesis and protein intake, right? So you consume, what is it, between 240 grams of protein a day, something like that? Is that roughly?

Dominic D’Agostino: Yeah, on active days. On less active days, if I’m just behind my computer all day, maybe closer to 180, 200, but yeah.

Tim Ferriss: And people might have picked up when Dom was casually throwing around like, “When you’ve been squatting 400 and you take a break and then you go back and you only can squat 300 pounds.” Dom’s a pretty big guy who’s also deadlifted 500 pounds for 10 reps before, after fasting for a week.

So he and I are not the same size, but nonetheless, I’m trying to figure out on one hand how much protein I can eat without my liver taking excess protein amino acids and turning it into glucose, right?

And depending on what I look at, and I have looked at sources outside of ChatGPT, on one hand, there are folks who say, “Don’t worry about it. If you’re consuming enough fat, you really don’t have to worry about it.”

And then there are other folks who are like, “Watch out, watch out. If you consume more than X number of grams at a given meal, you can very easily knock yourself out of ketosis,” which would, if that’s true, be maybe an alternate explanation for why I’m getting these low readings, if I’m having a small meal around 3:00 and then a gigantic meal later on.

How should I and how should listeners think about this?

Dominic D’Agostino: Yeah. So if you were to consume protein in the form of liquid, for example, like whey or something like that, then the rapid entry of amino acids into your bloodstream from your small intestine will shut off ketosis.

So fat and fiber and salt, because your pyloric sphincter will basically be pretty tight until your —

Tim Ferriss: Talking dirty, Dom.

Dominic D’Agostino: Pyloric sphincter is where your stomach connects to your small intestine, if you have a very fatty, salty, high fiber meal, that entryway, we call that the sphincter, it’s the pyloric sphincter, will remain shut until the contents of your stomach become isotonic.

Which means that your body has to give up water and it’s got to churn it and break it down. So you could delay gastric absorption simply with fat, fiber, and salt is pretty good too. You could do ketone salts or just salt electrolytes.

So that will delay the entry of amino acids or protein into the small intestine and thus amino acids into the bloodstream. And that’s the major regulator of ketosis having an impact on insulin and also having impact on gluconeogenesis to that rate of entry. And if you can slow that down, you see nothing on the CGM and your ketosis levels can basically stay.

You could further augment that by using MCT oil with the protein and the fiber. And so if you have long chain fats from a fatty steak and MCT oil and then fiber. And that could be insoluble fiber is pretty good to soluble and insoluble, that can slow the entry of amino acids and essentially buffer the gluconeogenic response.

Tim Ferriss: So let’s say I was stuck in San Francisco late. I’m just taking a rare trip over here, which is a pretty exciting time to be here with all of the mania with AI going on. But I mean, everyone’s kind of drunk on the Kool-Aid, but that’s a separate story.

I got trapped downtown because didn’t want to deal with traffic and blah, blah, blah, blah, blah. So I ended up having a huge bunless double cheeseburger. Gigantic, this thing, I did not expect it to be as big as it was, right?

And so I go online to try to figure out what the protein content of this thing might be. And it’s 80 grams of protein, right? But plenty of fat, certainly. Tons of fat, salty AF, plenty of salt, right? Not a lot of fiber, we’ll give that one a pass. Should I be worried about something like that knocking me out of ketosis?

Dominic D’Agostino: I think you need to measure. So I’m default back to everybody’s a unique metabolic entity, but if you eat that and your activity level is high and you’re in a bit of a caloric deficit and you were to have that and not overdo it on the total calories.

I know my body. I know my body, I could stay in ketosis, but if you have that oversatiated feeling — so we have neurons, we have neuronal pathways to and from the liver and to and from the gut. We call that afferent and efferent signaling in the enteric nervous system.

And a big meal will basically tell your brain that you had a big meal. And independent, I talked about the amino acids going into the bloodstream kicking you out of ketosis. But there’s also this, when you have stretch receptors and you have the big full meal in your gut, then that could actually tell your brain to activate the sympathetic nervous system.

And then that, by virtue of spilling out catecholamines can basically, we’re talking adrenaline, epinephrine, things like that, that can further augment and enhance gluconeogenesis.

Tim Ferriss: Okay. Let me just translate that for a second. So people wake up. Cortisol has developed this bad reputation among a lot of online influencers, but you really need cortisol, right? So when you wake up in the morning and you see a bit of a glucose spike, it’s actually important to get your ass up and moving.

If you’re in ketosis, it’s a different thing, right? So if I’m hearing you correctly, outside of how people think about digestion, blood sugar, insulin, et cetera, that just based on stretching your stomach, et cetera, with these mechanoreceptors, taking the inputs, that that signals to the brain, it’s go time.

So let’s basically get things moving with these hormones and that could in and of itself then trigger the liver to produce more glucose or liberate more glycogen, I guess.

Dominic D’Agostino: Yeah. It can. It’s above and beyond what you normally eat. If you train your body to that size meal, but it also activates other gut hormones like cholecystokinin, that’s called CCK, and other things that can then activate the parasympathetic nervous system that comes in a little bit after.

At the same time, it bifurcates, but then the parasympathetic nervous system is relax, digest, rest and relax, digest. So that comes in after. So you might see a blip and make you feel stimulated.

Also, all the salt, if it’s a salty meal, it’s going to expand your plasma volume. Your blood volume will increase and that can increase your blood pressure a little bit and that can activate your sympathetic nervous system.

So it’s always good to go take a walk after a big meal.

Tim Ferriss: Yeah. I do that.

Dominic D’Agostino: Not like a strenuous — not like go squat and deadlift, but just yeah. Even a 10, 15, ideally a 20-minute brisk walk is really good after a big meal.

Tim Ferriss: Yep. Now let me ask you this on the walk timing. So when I have a big meal, and I will say, I think I have trained my body to have big meals. What the exact response is, I can only give you subjectively what I feel and I can give you what the monitors show, right? But I typically feel pretty good.

However, if I have a big meal, whether this is in ketosis or otherwise, I don’t see the biggest spike until something like, depends on the meal, right? But 60 to 90 minutes later, that’s when I see the spike. So should I do the walk at 60 to 90 minutes, or should I do the walk right after the meal? When should I actually time the walk?

Dominic D’Agostino: So you eat a meal, you go walk, and then you see the rise 60 to 90 minutes after, or is that independent of the walk?

Tim Ferriss: Independent of the walk. Yeah.

Dominic D’Agostino: Okay. So you’re not walking, but you see the rise 60 to 90 minutes later. So I’m saying that you might not see that rise 60 or 90 minutes later because —

Tim Ferriss: If you did it right after the meal?

Dominic D’Agostino: Yeah, just because a little bit goes a long way. So just like walking, actually doing some stretching and walking too, it activates the glucose four, the GLUT4 transporters. So that’s an insulin independent. So less insulin is dumped, greater glucose uptake.

And you’re also using the sympathetic nervous system mobilization of glucose through gluconeogenesis during that walk. So it then attenuates the buffering of ketogenesis, and a very short walk can go a long way.

Tim Ferriss: Yeah. Okay, cool. Is it GLUT4? GLUT4? How do you pronounce that? I don’t know. How do people say that?

Dominic D’Agostino: I say GLUT. I say GLUT4.

Tim Ferriss: Okay. All right, GLUT4.

Dominic D’Agostino: People say GLUT. Yeah, yeah.

Tim Ferriss: Yeah. For the OGs in the audience, go back and look for GLUT4 in The 4-Hour Body. It’s in there.

So the other measurement question I want to ask you about, which is these continuous glucose and ketone monitors are not designed for someone like me, right? They’re developed presumably, I don’t know about the keto monitor, but in the case of glucose to help people with serious conditions not end up in very serious situations, right?

So when I am looking at my ketone levels, like right now I feel very sharp. I had some KetoStart, you know this well. Exogenous ketone salt-based product not too long ago, just in hot water with a little bit of MCT oil. This was, I guess, an hour, hour and a half ago, but I’m at 0.4 millimolars.

And I guess what I’m saying is whether I have a huge meal or I’m fasting as I am right now, my range is basically 0.1 to 0.4 95 percent of the time. There are a few outlier cases. If I’m just doing a YOLO, as many grams as possible exogenous ketone party, then maybe I can goose it, but we can talk about this.

Once it gets past a certain point, then I might spike insulin and have a subsequent crash. But I guess what I’m trying to say in brief is my range for the most part is 0.1 to 0.4, regardless of whether I’m fasting or eating a gigantic double cheeseburger. So I’m not really sure how to determine what effect it’s having.

I can watch the glucose, but right now I’m 0.4 millimolars of concentration on the SciBio. And as we’ve talked about, maybe the Precision Xtra would give me an extra 0.1 or 0.2, but they’ve been pretty close so far.

And then ever since my cheat meal, we had this experiment, right? I wanted to see if I did a workout and then had one or two cheat meals last Saturday. It is now Thursday, but my glucose right now is 103, right, which is higher than the week prior, but it goes around. It moves around, right? Last night it was probably 70 something.

Do you have any suggestions for how to read the tea leaves or is it mostly just subjective feel? I mean, still thinking about the size of the meal, right? But I guess what I’m saying is, if my device is telling me as it is right now, 0.4, fat not burning. You’re almost not burning fat at the moment, not in ketone. It’s very chastising.

So if I’m to believe this by the letter of the law on the screen, I’m failing at ketosis, right? Any thoughts on how to read the tea leaves here?

Dominic D’Agostino: Well, I would ignore that. I think that’s an app in the process of being developed, the fat —

Tim Ferriss: Yeah.

Dominic D’Agostino: You would need whole body metabolomics to really answer that question if you’re in fat burning or do metabolic cart and look at respiratory quotient or whatever. But subjectively, if you feel good —

We have seen an athlete, especially more advanced athletes that, and we do a very strict, strict keto macros and everything that basically with a bunch of athletes with 0.8 is about as high as we get, and that’s the average across.

Sometimes you get guys 2.5, 2.6 every day. And the same guy with the same essentially metabolic phenotype will be running 0.4 or 0.3. He could potentially just have greater ketone utilization. So I think it would be important to measure your blood. So a continuous ketone monitor measures interstitial — that can be different. The SciBio, I think it’s a great device. It’s very versatile. I can jump in and out of salt water. The thing stays on me. It’s almost more reliable than a CGM. But I did notice, and I’ve probably used about 50 of these devices that the first week, is pretty accurate and then it tapers off, the sensitivity.

And this is a known limitation of the technology is that essentially the enzyme-based sensor system tends to just — and you could get around that conceivably just by having the ability in the app to calibrate it.

So if you were to measure it and the continuous ketone monitor is measuring 1.0, but your blood ketones is 2.0 that you should be able to calibrate it like you can with a Dexcom. So they acknowledged that at the company and they said, “Yes, we realize that that would fix the problem,” but that’s not a feature of the app yet.

Tim Ferriss: They do have in events, they have blood ketone on the bottom right. I just don’t know if it actually calibrates it. It may just record the blood ketone at this point.

Dominic D’Agostino: It does not have the ability to calibrate it to my knowledge.

Tim Ferriss: I inputted one measurement on the Keto-Mojo and it didn’t seem to change it, right? The number stayed the same. So I think it’s just logging it because you can do that with a glucometer.

Dominic D’Agostino: Well, you can do it with Dexcom, but not Abbott.

Tim Ferriss: Dexcom. Okay.

Dominic D’Agostino: That’s a problem with the Abbott FreeStyle too. And that’s the feedback I gave them because I put these devices on, it’s reading me 130, but I measure I’m like 80, literally 50. Because —

Tim Ferriss: Wow.

Dominic D’Agostino: — if you are lean and it’s stuck in your muscle instead of your adipose tissue, the glucose levels are going to be higher, especially when —

Tim Ferriss: Wow.

Dominic D’Agostino: — you work out and stuff. So I’ve noticed this and that’s for me, so that’s why the Dexcom is very nice because I can calibrate it too, and I consistently show that. And that was a major issue I had.

Tim Ferriss: Let me hop in also and just tell folks this is not going to be very quantifiable, but for what it’s worth. Part of my reason I avoided intermittent fasting for so long is that I thought I would not be able to get sufficient protein or caloric intake and that I would lose a bunch of muscle mass.

I was dead wrong about that. I was very, very wrong. If anything, it seems to have enhanced my ability to put on muscle per calorie or per gram of protein ingested. And so I admit I was totally wrong about that.

Furthermore, on this ketogenic diet where I’ve historically found it pretty hard to put on muscle or — I mean, I shouldn’t say keep muscle because I’m only doing it for a few weeks, but I have been astonished by having one small meal. I’ll have some oxtail soup after this with some veggies and obviously oxtail. It’s a whole separate story.

And then I’ll go out and have another meal probably in three or four hours, which will be a much bigger meal. And just with that, and I am watching some of the grams of protein intake and so on, but I have not, looking in the mirror and looking at the weights that I’m putting up in the gym, I don’t feel like I have lost any muscle and I feel like I have leaned out.

Some of that’s losing fluid, but I’ve been really impressed with how little relative to what I used to do in college, taking weight gainers and just all this garbage, how little it actually takes to at least maintain muscle mass.

But I do have a question for you, which I’ve never really been able to answer to my satisfaction, and it relates to rabbit starvation. So for people who don’t know what that is, you could probably give a better description, but if you’ve ever watched the show Alone, Alone is probably the only reality TV show that I love to watch.

seasons six and seven in particular are outstanding for folks. But what you’ll notice is that if people are trying to survive in the wilderness to outlast everyone else, that’s what the show is. You get to pick a handful of items, you get dropped off, you don’t get to choose where you’re dropped, and then you just need to survive for as long as possible.

Sometimes it’s 100 days, sometimes it’s last man or woman standing. If somebody is only eating lean protein like rabbits, they will waste away. They will not last. They will have to get yanked out for medical reasons, and that might seem strange to people.

My question though is on a ketogenic diet specifically, can you just consume leaner protein and then rely on body fat for the fat? And some people are like, “Yeah, everybody knows that doesn’t work.” But I really want to understand why that’s the case, right?

Because I understand dietary fat dampens insulin response, right? Or at least that’s my understanding. Maybe there’s a rate limiting step in how much body fat you can break down and use, right? And who knows if that’s mediated by the kidneys or who the hell, liver, I don’t know, right?

I guess it would probably be liver, but I’d love to hear your take on it, right? Because certainly in the past, I and lots of people reading The 4-Hour Body have been able to lose more body fat than they are told they are capable of losing, as measured through DEXA scans and other things.

Can you do a moderate fat or low fat protein-based keto diet if your goal in part is to lose body fat, or does that backfire?

Dominic D’Agostino: Yeah, just not indefinitely. So when I did the ketogenic diet for a year, I was cruising at about 300 to 320 grams of fat, sometimes 350 grams of fat per day. And then just experimenting, I would throw in a two days per week of protein veggies with about 50 to 100 grams of fat.

And in those days of dropping to 300 plus grams of fat to 50 to 100 grams of fat, after two days, I swore I lost two percent body fat and I would just transition back. So I would just periodically throw in protein veggie days. I would cruise on keto and then periodically titrate in the protein veggie days to assist body composition alterations.

So if I kept that going, I could get pretty dramatic, almost scary lean to where it happened very fast. It’s almost keto trains your fat metabolism and then if you just start titrating in, it’s just pulling fat out.

And I think my body really liked throwing in the veggies with the fiber seemed to help with the gut health and I would do that twice a week and it’s pretty dramatic.

Tim Ferriss: Why not do it seven days a week? What happens when you try to do it for more?

Dominic D’Agostino: If the idea is to stay in ketosis, it was really hard for me to stay in ketosis if I do protein veggies. After two days, I would be out, but my metabolism would be cranking.

Tim Ferriss: Mechanistically, why is that the case? Why doesn’t your body just break down more body fat?

Dominic D’Agostino: Yeah, because, well, it’s taking body fat exogenously and endogenously and I think the more fat going to the liver and the more fat that’s in circulation, it gets shuttled to the liver and then that’s stimulating beta oxidation in the liver. You just have a greater fat pool.

But actually, I think, the day that I would do protein veggie days and then the day I would jump back into ketosis, I would see this big ramp up in ketones that day. Whereas if I did like a cheat day and just ate a lot of carbohydrates, it took me two or three days to get back into ketosis.

But if I just did like protein and veggies and cruised back into ketosis, then I would rapidly get back into ketosis and just give my body a break from the fat. But I think just that short amount of time really stimulates mobilization of fat from your body because your body is used to getting it exogenously, and then you’re pulling more fat off.

But yeah, I think on the protein veggie days, I’m getting higher amounts of calories from protein. So that has a bit of an anti-ketogenic effect. And then shifting back into ketosis on that third day, I always had probably the best ketone numbers for the week.

Tim Ferriss: Yeah. I don’t want to beat this dead horse too long, but I’d love to just hear you riff on this a little bit more because I guess in my mind I’m thinking, well, on your protein veggie-only days, if you’re getting enough protein, not enough protein to satisfy all of your resting metabolic rate, like you’re hypocaloric, but you’re getting enough protein to not lose muscle, why wouldn’t the body just break down the fat that it needs to continue producing ketones, right?

So I’m trying to avoid the gluconeogenesis problem where you’re having like 200 grams at a meal with no fat to offset it, but if you’re having smaller amounts that are slowly digested, but it’s just enough to keep you from losing muscle mass, maybe you’re doing some weight training to help with that or whatever, then I guess what I’m trying to figure out is why the dietary fat is so important? Because I think of the body, right? It’s like each pound of stored body fat is what?

Dominic D’Agostino: 3,600.

Tim Ferriss: All right. So 3,600 calories, that’s a decent amount of calories, right? And for somebody who’s, let’s just say you’re 150 pounds, 10 percent body fat, okay, you got 15 times 3,600, you got plenty of body fat to go around.

So it would seem to be enough to do a few weeks of ketosis that is low fat, higher protein, but not enough protein to necessarily be hammering your liver with gluconeogenesis if you’re dividing it up, slowly digested protein. Some people are going to be really annoyed with me dragging this out so long, but why is dietary fat so important?

Dominic D’Agostino: Because I mean, that’s the fuel that you are using, you coax your body into using. And I should probably add a little bit of context to my protein veggie days. So I would go from like 125 grams of protein to like 300 grams of protein.

Tim Ferriss: Right, right.

Dominic D’Agostino: That’s a pretty big bolus of protein.

Tim Ferriss: That’s a lot, yeah.

Dominic D’Agostino: And if one was to go a hundred grams of protein or whatever, and then bump it up to like 170 or 200 or something, they may not kick out of ketosis. But I remember just lower ketones, but not out of — I was still in ketosis, but typically how I think I did it like my protein veggie days were following like a heavy deadlift or squat workout.

So the thinking was that I’m recovering for those two days and the extra amino acids and proteins and mTOR activation is sort of assisting in recovery and regeneration and skeletal muscle protein synthesis. And then I would kind of go back. I calculated it in that way. So yeah, I like double the protein on the protein veggie days, but my calories were about the same or maybe a little bit lower.

Tim Ferriss: Yeah. I need a SiBio if you’re listening, please allow me to calibrate this with a finger prick because I need a little more range. I need a little more range than 0.01 to 0.04 for me to be able to read this type of thing effectively, right? Because technically, if I’m reading this as it is, I’m never in ketosis. I shouldn’t say never, that’s not true. But in any case, it would not be nice to be able to calibrate.

Let’s come back to something I promised that I would ask about, which is neurodegenerative disease, Alzheimer’s, et cetera. Could the ketogenic diet benefit people with these conditions? And just as important, certainly for me personally, could this, is it plausible that there’s a mechanism by which the ketogenic diet regularly done could help delay the onset of any of these diseases? Or am I just Pollyanna hoping for a pie in the sky?

Dominic D’Agostino: Yeah. I think that’s a question we don’t have an unambiguous answer to, but I think all the science points into the direction that if you improve upon and optimize your cardiometabolic — I like to say cardioimmunometabolic biomarkers, instead of cardiometabolic biomarkers because if you can lower, for example, your insulin and keep that between two to six, and if you lower your hsCRP below 0.6 and then optimize your hemoglobin A1C or glucose. And I think also, and I’ve talked about this with Rhonda Patrick and other people, too, that if you measure your omega-3 fatty acids and look at your omega-3 to 6 ratio, I think that’s going to be a biomarker that’s probably going to end up in standard blood work because it’s so compelling, the data behind it.

And you also measure your B12, too. I think that’s important. People coming into the Alzheimer’s center that can present as flat-out Alzheimer’s disease and then you correct their B12, a B12 deficiency will cause brain atrophy, and that could be reverse with B12.

So the things that if you’re following ketone metabolic therapy, it’s impacting the things that we know are driving age-related chronic diseases, and then obviously one of them is Alzheimer’s. So the level of inflammation, hsCRP now is probably more atherogenic than LDL. There’s probably people selling statins that don’t want to hear that, but we know that the data is emerging on that now. So lower insulin, lower inflammation —

Tim Ferriss: And that’s an inflammatory marker, right? The C-reactive protein. What does the HS stand for or what is that?

Dominic D’Agostino: High-sensitivity C-reactive protein.

Tim Ferriss: High-sensitivity.

Dominic D’Agostino: Yeah. So it measures in that lower range. And I used to trend to like two to two to three, like my early CRP, hsCRP when I was like on a high carb, I only had it measured twice when I was on like a high-carb diet, but since I’ve been keto, it’s like either non-detectable or like 0.2. Or when I did extreme environment research on myself, then I could bump it up a little bit. And when I had a bacterial or viral gastroenteritis, it shot through the roof because it activated your immune system. But generally that hsCRP is a big driver.

I used to laugh at it and be like, “Ah, it’s this nonsensitive thing.” But now like all the data is pointing to the direction that we need to add that to that.

And your omega-3 status, your B12, make sure you don’t have any deficiencies because that could lead to sort of rapid progression to Alzheimer’s disease, your magnesium levels.

But also just in general like exercise, the biggest metabolic lever and your body weight, body composition.

Get DEXA scans. I know it might be good for you to do a DEXA scan with your keto experiments, too. So I was doing once a year, but now I end up doing like three or four times a year because I do these mini experiments to see how acutely some of the things are impacting my body composition because I just get antsy for like an answer to that.

But it’s a long-winded explanation to just basically say that your metabolic health is tightly linked to your brain health and can dramatically delay the onset of Alzheimer’s disease. Not that you’re going to get it or reverse it altogether before something else gets you in the end. Yep.

Tim Ferriss: Well, I mean, the metabolic health piece, just to underscore that, I mean, one of my relatives in question, APOE 3/3, I understand that’s not the only risk factor, but there’s something just seemed to be missing because the decline was so precipitous. It didn’t map to any patient data or clinical data that a number of doctors, who are also researchers I was working with, had seen. Also because this person, this relative had been assessed four or five years prior and did not show any indication of predisposition to a rapid decline.

And I’m APOE 3/4, again, recognizing there are other factors at play, but when she just kind of disintegrated, there are a few things that came to light. Number one is her local GP had basically missed severe metabolic dysfunction for years. And I can’t remember the reference range, but like insulin, let’s call it upper bound of 12. I’m making this up, but you’ll get the idea. And she was like 43, right? It was just absolutely atrocious.

Dominic D’Agostino: And her body weight and just general composition?

Tim Ferriss: I mean, poor body composition. Yeah. Poor body composition, very little exercise despite my best efforts, misbehaves horribly, dietarily, not morbidly obese, but certainly —

Dominic D’Agostino: Smoking, alcohol, other drugs?

Tim Ferriss: No smoking or alcohol.

But here’s the other piece that, so she had been diagnosed with stage one breast cancer, had a lumpectomy, was removed, late 70s was put on an estrogen, I think it’s an estrogen blocker called letrozole.

And I looked at this and I spoke to a friend of mine who was a radio-oncologist and she said it is very poorly tolerated by most women from a cognitive perspective, like they get smashed by and large.

Dominic D’Agostino: Guys, too, by the way. Guys who take —

Tim Ferriss: Okay. Yeah, guys do.

Dominic D’Agostino: — aromatase inhibitors, yeah, for like TRT and things like that. It’s not a good thing to do.

Tim Ferriss: Yep, yeah. So I was looking at it and I mean, it’s upsetting that I’m the one who has to kind of find these things, but it’s like, okay, well, we think about the oncologist’s role. It’s to prevent my mom from dying of cancer. That’s the directive, right? But if she were 30 and had later stage cancer that was really aggressive, it’s one thing, but she’s late 70s, stage one, all cancer removed, and so got her off of the letrozole with the cooperation and after discussions with doctors and almost saw an immediate turnaround within a handful of weeks after the washout period and everything.

But it seems to, I mean, look, I’m not an MD. I don’t play one on the internet, but it seems to have done some real damage. I mean, there’s the metabolic piece that is very non-trivial, but the acceleration of decline was just so absurd over the course of a handful of months, terrifying to see.

But I guess I’m laying this all in, not necessarily to explore this particular case because I’ve got a lot of people on it for all of my relatives, but it’s just to say that my — like I am not going quietly into the night with something like Alzheimer’s, right? And so what I’m trying to figure out for myself, I’d be curious to hear your perspective.

I will be honest, I find keto pretty goddamn boring. I don’t find it to be the most diverse diet in the world. I don’t really want to do it all year round. I also have some maybe compromising cardiac elements. I’m a cholesterol hyper-absorber, so I do use — again, guys, talk to your doc. Don’t just copy me, but it’s like I’m using Repatha, taking ezetimibe. I have been also taking Nexlizet, but that might end up being redundant, the bempedoic acid with the Repatha.

That is a long way of saying I’ve got to keep an eye on the heart stuff because neurodegenerative disease and cardiovascular disease is what kills everybody in my family. So for a lot of reasons, I don’t want to do keto all year, but I’m trying to figure out what is the sort of minimal effective dose that — and I know we’re going to have to probably take a couple of speculative leaps here, but just as a working hypothesis, what does a minimum effective dose of following a strict ketogenic diet look like for me?

Assuming the rest of the time I’m still doing intermittent fasting, I’m not eating a lot of refined carbohydrates, but how might you suggest that I think about that? Because I don’t know what the durability of kind of keto memory, like metabolic memory is. So I’m trying to figure out like can I get away with two, three to four-week periods a year where there’s some carryover of like cancer-protective — our last conversation we kind of talked about thinking about ketones as hormones, but in terms of neuroprotective, anti-inflammatory, yada, yada, yada, what are your thoughts?

Dominic D’Agostino: Yeah. Well, I think in your context it’s hard to say, like to give absolutes, but I would say you can get 80 percent of the benefits with a low-carb diet. Low-carb meaning 100 grams a day, just fibrous, non-starch, non-sugar carbs, low-carb Mediterranean, if you want to call it that.

And then periodically, maybe one week out of a month, get into a deeper state of ketosis and at higher is not better. We know that from the research. When ketones get into that two, three, four, five millimolar range, that creates energy toxicity and something we call reductive stress, and that is not good.

I did not know this before getting into this kind of research, but the sweet spot seems to be between one and two for therapeutic ketosis, unless you’re metabolically managing a disorder that’s highly responsive to a ketogenic diet like neurometabolic diseases.

And some of the things that we actually study need to be in the two to three millimolar. And oxygen toxicity needs to be like four to five because it’s a — very powerful seizures. But one to two seems to be the sweet spots for metabolic management of many different things and also just general metabolic health.

And I think what you’d be doing, just doing low-carb and periodic ketosis is just enhancing your metabolic flexibility and maybe increasing the diversity of food that you’re eating to prevent micronutrient deficiencies, too.

I am of the opinion that plants are good for you to eat broccoli, asparagus, salads, colorful vegetables, things like that, that kind of fit into a pattern of eating that we’ve known. Even things like lentils are probably good. Lentils actually have like zero CGM response to me, but I —

Tim Ferriss: Really?

Dominic D’Agostino: Yeah, lentils seems to like, skyrocket other people that I know. I’m like completely flat.

Tim Ferriss: I’m like somewhere in between. Yeah, I’m somewhere in between.

Dominic D’Agostino: Okay. Like completely flat. I don’t know. Maybe it’s the time of day that I have them at dinner, then I always go take a walk, but it’s like no bump at all in my CGM.

And I think that’s where CGM comes into play and we can do a personal precision engineered diet, if you will, and it gives us insight into the types of foods and the amount of foods that we can eat. And I think that’s going to be really important information.

And I know there’s a lot of people harping on, because another study came out on CGMs provide no benefit at all to the non-diabetic. And I’ve had this conversation with people actually at a big event and people that were type 2 diabetics and I asked them just flat-out, I just went around the table and just saying, “If you’re type 2 diabetic, when you were diagnosed like three years ago, if you were to be giving a CGM five years before that, or even one year before that, do you think you would’ve been diagnosed with type 2 diabetes?” And they said no.

They said once they got type 2 diabetes and got a CGM, it gave them the awareness. I mean, you can ask anyone who has flat-out over type 2 diabetes and just ask them the question, “Hey, if you were given a CGM a year or two in advance and you understood the impact of foods.” So I think a CGM is going to be important for delaying that Alzheimer’s disease. And if you have loved ones, Tim and your family, that I think you would encourage them to slap on a CGM and get some insight into what they’re eating.

But it’s also forcing them to exercise because we’re talking about diet here, but just getting out and doing a brisk walk 20, 30 minutes a day can go a long way. Resistance exercise, I’m a little biased towards that, but muscle is like an endocrine organ that produces hormones and various molecules that are neuroprotective and muscle is tightly linked to brain size and, of course, your waist and your visceral fat.

I would also encourage them to get a DEXA scan and gamify it and say, every year I’m going to get a DEXA scan and every year like I do, I just kind of create a lot of stress for myself to beat my DEXA scan every year and get their friends involved, make it like a social event. Everybody goes and gets their DEXA and then every year you go back and just try to beat your scores. But I mean, these are low-hanging fruit kind of things people should be doing.

Tim Ferriss: Yeah. Let me, I think probably fair to say, make sure you consistently hydrate for any of these things like a DEXA scan.

I do have a follow-up question. So also on the exercise piece, people can look up something called klotho, K-L-O-T-H-O. There’s a lot more that comes of exercise like BDNF and all these various things. There’s a book called Spark that covers some of it, but it’s very outdated, but check out klotho. There are a lot of good reasons to exercise. Thinking of muscle like an endocrine organ, that’s a really good way to put it.

My question to you was, you mentioned, say, one week per month going to more of a lower carb or ketotic state. How would you think about the benefits of one week per month? Assuming that the rest of the time I’m behaving, most of the time with a lower carbohydrate Mediterranean diet, let’s just say, okay, one week per month, every three months or three weeks, like contiguous weeks once a quarter. Do you feel like one of those is superior to the other?

Dominic D’Agostino: Not really. I think whatever pattern works best, I think you would gain benefits for both. That would be an interesting experiment to do.

Tim Ferriss: I’m just thinking about the lead time to get into a properly ketogenic state. If I’m going from some carbohydrate to ketosis, I’m just — we could talk about things that might accelerate it, but if it takes me two days to get there or three days and then I only have kind of four days in the sweet spot, these are things running through my mind. I’m just curious to get your take.

Dominic D’Agostino: Yeah. The one-week intervention for the month, my kind of opinion is that it could be pretty aggressive. Like you cut calories 50 percent the first two days and then cruise into it, so you’re really cranking ketones by the end of the week. And then you’re also cruising into it from what should be like a low-carb diet. So you should have that metabolic flexibility to kind of seamlessly transition into that ketosis state. And you could do intermittent fasting with mild caloric restriction for the first two days to ramp up ketones.

Alternatively, if your schedule permits and like your work schedule, you have like three weeks where you need to really dig deep into a research project or something and ketosis seems to give you that cognitive flow or boost, then that might situationally fit into your schedule. And I definitely have periods of time where I do that, especially like if my wife is traveling or something like that, or on a research project or something, I just like, okay, I clean the house of certain foods and then I just prepare.

I mean, simple things like that, too, I know just from the clinical ketogenic world is that if you have a family member that stocks the shelves with certain foods that can trigger and cause food noise, then that could really hamper your compliance to that. But you want to prepare the house, or if you’re going into a one week or you’re going into a three week, prepare the house and just make sure that you could do. Of course, you could just call Uber Eats and get anything delivered, but you want to kind of have the house prepared for that and mentally prepare for it.

Tim Ferriss: So for you, personally, if you had some hereditary gnarliness, if you look back at your family tree and you’re like, ooh, whether it’s a bunch of cancer or a bunch of neurodegenerative stuff, maybe bit of both, who knows, would you be more inclined to do the one week per month, just for you personally or yeah, one week per month?

Dominic D’Agostino: Yeah. And I would shoot to get a glucose ketone index of like one to two for at least three days out of that week. So really do a fairly aggressive ketone metabolic therapy intervention, kind of even think about it as like a prescription intervention, just like Valter Longo’s diet is a prescription medical therapy, right?

So I would shoot to achieve a glucose ketone index of one to two for three days. And everything that we’ve seen in the lab that I’ve seen sort of on paper, of course, people aren’t out there measuring the autophagosome like P62 and other things, but that you are achieving a level of autophagy and that’s also stimulating many of the benefits of ketosis, not just ketones as an energy source, but you’re getting many of the robust signaling effects and really adapting your metabolism to fat and ketone sort of oxidation that has long-term benefits that can go at least three weeks.

So I’m convinced of that. So you get benefits for three weeks, reset one week, benefits for three weeks, reset one week so you’re always kind of getting — whereas if you do three weeks and then take a period of time off, I’m not totally convinced that those benefits are going to span that amount of timeframe. That’s my thinking.

Tim Ferriss: And you mentioned people can find calculators out there and actually a lot of the devices will try to provide this to you. Actually, is that true? I guess they would have to have both data streams, so probably not, but the GKI.

So the glucose ketone index, you can find calculators for this, but fact-check this, since this is AI overview from Google, I wanted to just take a look at it. Divide your blood glucose level by your ketone level. If your glucose is milligrams per deciliter, common in the US, you first divide it by 18, this is an important step, to convert it to millimolars per liter, matching the ketone units, then perform the division. So you can figure this out very easily. And that is the GKI that you were mentioning of a one to two.

What might that look like just offhand? I’m very not known for my quick mental arithmetic on the podcast, but what would a GKI of, say, one or two look like in terms of the readout on the glucose, on the glucometer and the readout on the finger prick for the millimolars for ketones? What would be an example?

Dominic D’Agostino: If people are like don’t want to do the millimolar concentration of glucose, if your glucose is 80 and then your ketones are two millimolar, that would be, you are right into that one to two kind of the glucose ketone index of one to two, you’ll be between that level.

If you could bring your glucose down to like 18, so like 68, 70 and get your ketones up to three, so that would be a GKI of one. So that’s pretty hard to achieve, but relatively definitely doable with exogenous ketones and MCT and things like that. I think what’s totally feasible is getting your glucose down to like 80, 80 to 85 in that range and getting your ketones at the end of the one-week fast up to two and maintaining that. So that would be kind of achieving that GKI of two.

Tim Ferriss: I think I’m probably saying what I wish to be true, which is that my insulin sensitivity has improved a lot in the last certainly year in particular, and that is to explain in part, or maybe wholly, the lower readout on the ketone meters.

But part of the reason I have confidence in that is that I’m using the same devices that I used to use. And back in the day, I would have much higher millimolar readouts.

Of course, I have new strips. I did, at least to the extent that I can, for the continuous monitors, I’ve done calibration for the CGM at least, the glucose monitor, but that presents a problem. Even if that is, “Good news, Tim Ferriss, you’re not failing at keto. You’ve actually just made yourself a lot healthier with intermittent fasting and other things,” it still presents a problem for me to figure out if I am in that GKI sweet spot.

So how would you suggest I try to figure that out? Is there a way to measure my ketone uptake and, therefore, modify the equation such that I factor that in somehow? Like there’s a multiplier of the readout on the finger prick or something like that? How would you handle that?

Dominic D’Agostino: Yeah. Let me look real quick.

Tim Ferriss: Dom is looking into his Santa’s workshop of various metabolic devices.

Dominic D’Agostino: Yeah. So I have a lot of different devices. So one is the Keto-Mojo device here.

Tim Ferriss: Yep, that’s the one I have. Yeah, I’ve got the Keto-Mojo.

Dominic D’Agostino: Okay. So that, I mean, you could just calibrate it such that it reads in millimolar concentration in glucose and ketones, and it actually gives you, this is the GKI version. It’ll just spit out the GKI.

Tim Ferriss: Oh, you know what? I do have the GKI because you’re right, the Keto-Mojo also measures glucose.

I guess what I’m asking for myself is since my readouts are so low, presumably as a placeholder due to improved insulin sensitivity and ketone utilization, I’m going to fail if I’m just using the glucose and the ketone strips for the Keto-Mojo. Because right now, if it’s telling me that I’m at 0.4 millimolars, and I can tell you subjectively, I do not feel like I’m at 0.4. I feel like I’ve got a lot more juice and a lot more gas in the tank.

Is there a way to, whether it’s on paper or otherwise, account for the increased ketone utilization? I mean, it’d be great for me just to verify that somehow, but then whether I can verify it or not, if I wanted to try to determine during that week, like if I’m hitting my target GKI, how would you suggest that someone like me do that if I’m just not getting the numbers necessary to make the regular math work?

Dominic D’Agostino: So one to two is a high bar, I guess, a GKI of one to two. And I think we’ve had this conversation back and forth with this group that we’re working with in the cancer community.

The Society for Integrative Metabolic Oncology is a group that we’re discussing the GKI, and Thomas Seyfried is very adamant about, like, getting to one to two. But I give pushback and say one to four is if you look at the published literature, one to four is absolutely 100 percent therapeutic across not only cancer, but also like seizures and everything. So I’m going to expand that range to a one to four.

So what does that mean? That would mean that your glucose level can be upwards of 80. And so you could have a glucose level of 75 to 80, and then get your ketone levels to one, and that would be a GKI of one essentially if you don’t have the glucose calibration for that. Or that would be a GKI of four, rather. And it would be really rare, if not impossible, for anyone in the general population eating to even achieve a GKI of like 5 to 10. So that’s indicative of high fat oxidation, ketone production, and I think that you’re getting a lot of therapeutic benefits. Also, a millimolar concentration of one in your blood represents a 10 percent available energy for your brain. And also the Keto-Mojo devices measuring D-beta-hydroxybutyrate. And if you’re doing supplementation with racemic D and L, then you’re not picking up the L. So that could be a factor too if you’re using racemic ketone salts.

And there’s a number of publications that have already happened and some in the pipeline basically showing that elevate hydroxybutyrate takes about 4 to 5 times longer to metabolize. So that’s in circulation more. And also like, if you’re on a ketogenic diet for reasons we don’t fully understand and we are to rip out the heart, about 34 to 40 percent of the ketone in the heart is elevate hydroxybutyrate. And we don’t know why it converts the D to the L, but it serves a function that — the groups that have done the research are convinced it’s not an energetic, but it’s actually impacting cardiac output and reducing peripheral vascular resistance, maybe at the glycocalyx. So I don’t want to go down that rabbit hole. But basically, it’s like if your heart is pumping against pressure and think of it as like a garden hose and you take the kink out of the garden hose, the elevate hydroxybutyrate is taking the kink out of the garden hose of your vascular endothelium and then that’s also in your brain. So you have better blood flow to your brain.

I mean, there’s tons of data out there showing an increase in brain blood flow with beta-hydroxybutyrate and the L trends better to increasing that blood flow. We do a Doppler blood flow measurement on various wound healing things that we’ve done in the lab. I mean, a lot of people have vascular dementia, right?

Tim Ferriss: Yep.

Dominic D’Agostino: So there’s different types of dementia, and it might be not like completely one or the other. And the metabolic phenotype of dementia could be vascular. You get a restriction of oxygen and energy to the brain. My point is that one millimolar of beta-hydroxybutyrate in circulation has an energetic effect and it also has a pronounced effect on the vascular endothelium to increase blood flow and circulation. So you are getting a benefit.

Tim Ferriss: I’ve never had this experience in ketosis before where these levels have been this low. It’s so bizarre. And yet, let’s say, back in the day before the intermittent fasting, and it’s pretty much the lever that I pulled that I think changed things. Prior to that, I could tell you probably within 60 minutes of hitting 0.7 millimolars on the precision extra. Like I knew when my brain clicked past that point. And I did years and years and years of this stuff. I think as much as I like to measure things, I should just assume, right? If I’m having a bowl of mackerel dog food with MCT oil and apple cider vinegar and salt and pepper, then having a meal later that effectively has close to zero carbohydrates, if I’m doing that for almost three weeks, there doesn’t seem to be a physiological option C for failure, right?

It’s like, what’s my body going to do? It has to be doing something because I’m not getting the dietary carbohydrate, and I’m not just mainlining whey protein isolate all day. So, I think I’ll probably just have to trust in the process because if I do have the increased ketone utilization and I’m just somewhere between 0.2 and 0.4 millimolars, for the most point, or for the most part, I just don’t think that the math might be really hard even to hit the GKI of four. But it’s like, if you’re following the process, I guess you’re following the process, right?

Dominic D’Agostino: I say trust the process and also think about — I’m talking about like blood biomarkers, but let’s talk about physical metrics that could be considered biomarkers, right?

So for me, it’s all about the numbers. Like my lab books and stuff like that have numbers in the lab, but also training. It’s like, I know exactly what I’m going to do going into the next workout and it’s all about X amount of weight for X amount of reps. So you can also do that with various brain training apps where you can do reaction time. So for our NASA NEEMO experiments where we’re in an extreme environment and we’re working with astronauts, we’re assessing reaction time, decision making, risk taking, where like this balloon blows up and you don’t know when it’s going to blow up, but you have to stop. It’s like a weird risk game.

So we have this whole metric of testing cognitive function, reaction time and things like that. So there are things that you could do even with an app-based thing to assess that, and I think that would be a good thing. We have a massive NIH grant at University of South Florida on brain training games and assessing performance on that. Alzheimer’s was in my family, I would basically be doing everything possible, physical training, dietary metabolic training with nutrition, supplementation, and also brain training.

And brain training games, and we use Joggle, the NIH Toolbox, I mean, we have like about six or eight different types of tests that we do to get a very objective measure of cognitive function. And I think it would be good to establish that now and then get your baseline just like we’re doing a DEXA for body composition, and then test that every six months. And then do it in the absence and presence of being in ketosis. So I would suggest something like that.

Tim Ferriss: Yeah. I have time blocked out in my calendar this Friday to do a whole battery of cognitive testing. And again, this is not super precise, but having tracked myself for so long and developed a water fuel for certain types of performance, zone two feels a lot easier right now, a lot easier than usual. And coming back to your prior comments. And then, I would say, I’m using software right now. At some point I’ll be able to talk more about this, but to basically train my visual processing to compensate for presbyopia, it is crazy, some of the effects that this stuff has. But it also is very much indirectly a measure of reaction speed, and they see some really cool carryover effects. And my speed in terms of time to completion for four bouts, like modules of tasks has just gone up and up and up since I’ve sort of been in extended ketosis. Again, that’s very easy for me to see. So folks who are listening, I’ll have more to share on that later, but it’s pretty mind-blowing stuff.

So Dom, a few things have come up that I would love to chat about because I get these questions all the time, which relate to exogenous ketones. And people have heard this term, exogenous, endogenous. It’s very fancy talk and a tuxedo for outside the body, in the body, right? I’m simplifying here, but the easy way to remember exogenous is exoskeleton, right? It’s like a skeleton on the outside of your body. Exogenous ketones, ketones that you’re taking from outside and putting inside. People always ask, and I know you have a dog in the fight here, so I want to recognize that too. But how should people think about supplemental ketones? And are there any warnings or disclaimers that you want to add to that, right?

Because this is a topic du jour. I think there’s probably no biological free lunch if people are going to be mainlining fruity pebbles and eating tons of carbohydrates, maybe not a great idea to eat tons of exogenous ketones. I don’t know, I’d be curious to get your take on that. But what’s the good, the bad, and the ugly of exogenous ketones? Where should people go? How should they think about it?

Dominic D’Agostino: The things to consider would be when you’re thinking about a ketone supplement to think about palatability. If it doesn’t taste okay, you’re not going to consume it. I would, but most people won’t. Palatability, tolerability, if it gives you disaster pants or it makes you nauseous or something. So palatability, tolerability, and then the next one, the third one would be the pharmacokinetics. So you want something that when you consume it, that it has an ideal pharmacokinetics, meaning it’s not going to spike up in 30 minutes and be out of your system in like an hour or two.

Tim Ferriss: Yeah. Pharmacokinetics is like the stock chart for something you put in your body, right? In this case, right?

Dominic D’Agostino: Yeah, yeah. And that’s important because if you have a very rapid rate of rise of ketones, that can trigger an insulin response. And what I’ve observed, if I’m cruising in ketosis and I take a large dose of a ketone ester, it shoots my ketones up real high and it’s back down within like two hours, but it also kicks out insulin and that shuts off my own ketone production. Then I’m hypoketotic and hypoglycemic from the insulin. And that can create an energy deficit in the brain.

Tim Ferriss: How long does that last for you?

Dominic D’Agostino: And it lasts in the context of consuming, for example, a ketone ester by itself. But if you consume the ketone ester with MCT, if you could tolerate that, you could buffer that response to some extent, or you take it with food or something, or you could avert that by different ketone formulations and we could talk about that. But I just want to move down, so you got palatability, tolerability, pharmacokinetic properties, and you also have toxicity. So that would be the four things that you need to consider when sort of selecting an exogenous ketone. And those things differ depending upon if you’re using it acutely, like in a medical situation, or it’s like a daily thing that you want to take every day for prevention, right?

Tim Ferriss: Yeah, let’s talk about toxicity first.

Dominic D’Agostino: Toxicity is probably the most important too.

Tim Ferriss: Yeah. Let’s, for the time being, not talk about the acute medical delivery. Let’s talk about recreational/better said layperson use, right? This is as a dietary supplement. So could you speak to the toxicity piece?

Dominic D’Agostino: Yeah. Well, what we observed about 10 years ago was that formulations that contained 1,3-Butanediol, that includes an ester. I have a lot of patents on and I have actually ongoing experiments with 1,3-Butanediol by itself is a ketogenic agent and that can have toxicity when used chronically. 1,3-Butanediol is an alcohol dimer and it gets metabolized through alcohol dehydrogenase and aldehyde dehydrogenase. Aldehyde dehydrogenase kicks out a beta-hydroxybutyrate aldehyde that can be toxic.

Tim Ferriss: How is it toxic? What are its toxic effects?

Dominic D’Agostino: Yeah. So alcohol dehydrogenase uses NAD, consumes NAD as its function, right? So it can basically deplete the liver of NAD. And aldehyde dehydrogenase also consumes up NAD and it rapidly depletes, for example, the liver, the hepatocytes of ATP. So we know that there’s a paper coming out that’ll show that in our lab we’ve seen therapeutic effects in certain contexts, but when delivered acutely. But when consumed chronically, when we go beyond our experimental window and give these things chronically as like a lifestyle, exogenous ketone. And then we sacrifice the animals and then we do blood work and we look at the liver, we see signs that are scary, right? And this could be inflammation in the liver, TNF-α, sinusoidal dilation, sort of like gaps in the liver, fatty liver, a number of different things start to surface. And that’s pretty much just due to metabolizing something that’s considered a toxin to the body, 1,3-Butanediol.

It’s a very versatile drug. 1,3-Butanediol by itself is more toxic than 1,3-Butanediol based ketone esters. So you have the ketone monoester, which is technically the millimolar concentration. You have 51 percent of a ketone monoester is 1,3-Butanediol. So it hydrolyzed in the liver, gets into circulation. Still over 50 percent of that is 1,3-Butanediol. That kind of needs to be detoxified, but 1,3-Butanediol does get broken down to beta-hydroxybutyrate. The diester is about 35 percent 1,3-Butanediol. So, I see these as potentially problematic.

Tim Ferriss: The diester is what percentage?

Dominic D’Agostino: A ketone diester, which would be 11,3-Butanediol with two ketones on it. We use acetyl acetate on each, that’s 35 percent of that molecule is 1,3-Butanediol in circulation.

Tim Ferriss: I got it.

Dominic D’Agostino: And then the beta-hydroxybutyrate monoester is 51 percent 1,3-Butanediol in circulation. So this can become problematic when it’s used as like a supplement and a lifestyle thing like day in and day out.

Tim Ferriss: Can you translate from the animal models to humans, do you think, right? Because we all know, humans are not just big furry mice, right? Do you think it translates, right? And this might be just like a precautionary measure where it’s like, “Well…” Like pending additional studies, let’s hit pause in a sense. But if it were to translate, do you have any idea what type of dosing per day or per week with which we might see this toxicity in humans, right?

Dominic D’Agostino: Yeah. So there is a paucity of data, and there’s a deficiency of data on the use of these agents 1,3-Butanediol that are long-term studies. The only study that I’m aware of is a case report with Dr. Mary Newport’s husband, Steve, and then there’s a 28-day study that used 25 grams.

Tim Ferriss: 25 grams.

Dominic D’Agostino: 25 grams per day, yeah.

Tim Ferriss: Oh, shit.

Dominic D’Agostino: And that produces like 0.1 to 1 millimolar. But what I have done is I took the R-1,3-Butanediol and then the racemic 1,3-Butanediol at different time points. And I basically dosed it for two weeks to keep my ketone levels at two millimolar, which would be like a therapeutic. And when you do that, what you will see, and I — well, I was going to say, I tell people that go ahead and do it, but maybe don’t do this. But when you take something like 1,3-Butanediol at a dose, which for me requires 30 milliliters three times per day to keep at two millimolar throughout the course of the day. If you do that for two weeks and then you test your transaminases, so that would be AST, ALT, and GGT, they will go up, so that’s a clear indication that — so we’ve done this in animals and fed it at a pretty high level, and we did not see transaminases going up.

Tim Ferriss: So transaminases are what people could think of as liver enzymes on their blood panels, right? ALT. Is GGT typically tested?

Dominic D’Agostino: GGT is like the wild carb, but what’s good about GGT is it’s the canary in the coal mine. It will go up before ALT and AST. If you expect someone has a problem with alcohol and they say they’re not drinking and you want to figure out if they’re drinking or not, say, “Hey, can I see your blood work and make sure the doctor adds GGT just to get a better,” and that’s elevated and your AST are not. The only things that’ll really shoot up GGT is like alcohol. And also the size of the red blood cell too can be if they’re like larger, that’s an indication like someone’s drinking too much alcohol. And it could be just like two or three glasses a day, but that will elevate GGT. So we observed that transaminases actually didn’t go up in our animals fed. The ketone esters or 1,3-Butanediol chronically, but when we pulled the livers out and then looked at the livers, then we saw things that concerned us. And we published this recently.

And it’s good to know when someone has non-alcoholic fatty liver disease, they can have normal transaminases but have a necrotic liver.

Tim Ferriss: Yuck. I did not know that. It’s terrifying.

Dominic D’Agostino: Yeah, yeah. I mean, you look very closely at ALT longitudinally and that creeps up, but you basically have to do like a CT scan or a high resolution ultrasound of the liver. And basically, you could just take a subset of the American population that trends to be overweight and you do some liver scans and you find that they can have overt fatty liver disease and have completely normal transaminases are just trending up, right?

Tim Ferriss: Mm-hmm.

Dominic D’Agostino: So my liver enzymes tend to trend a little bit higher just because I eat a lot of protein. So with 1,3-Butanediol and 1,3-Butanediol based ketone esters, you have a problem with tolerability, palatability, potentially feasible pharmacokinetics and also toxicity. So it almost like checks all the boxes in a negative way. So the field is trending towards non 1,3-Butanediol based exogenous ketones, and that could be free acids, it could be a triester with glycerol and also the ketone electrolyte salts, but you could also avert part of this just by formulation. The issue is that companies have one molecule and then they test that one molecule, but you could — I think formulation is the way to go. And companies don’t want to hear that because they have all their IP in one molecule. But we’ve always been a formulation kind of based lab, and always saw that these things always have drawbacks when used as a monotherapy, but when you start combining them together, that’s when you get better therapeutic effects.

Tim Ferriss: Got the hounds out there. Hopefully, not next to the gators. We won’t spend any time on this, but I just wanted to tell people that before we start recording, you’re telling me that you caught a 10-foot alligator that was trying to eat your dogs and then you pinned it down and taped its mouth and then measured its glucose and ketones. Turns out that alligator had a pretty good GKI, but that’s a story for another time. So only in the things that Dom would do category that stand out, but we’re talking about a lot of terms that are likely unfamiliar to folks. I don’t want to throw anybody under the bus here, but people should do their homework. 1,3-Butanediol is very, very, very common. It’s very inexpensive, or relatively inexpensive to produce. So just keep an eye out for 1,3-Butanediol. If this is of interest to you, I have no investment in any ketone supplement company or anything.

I do not have a stake in this, but I would like to ask a couple of things. So I have experimented, as you know, with ketone monoester, diester, ketone salts, I’ve played with everything, and I’ve found the diester to cause quite a bit of intestinal discomfort, to put it mildly, at least the first one or two times. I will say for folks, if at first you don’t succeed, meaning you have to run to the toilet. You may acclimate to it, which I did in that case, but I felt subjectively less and less effect. I seem to develop tolerance very quickly. I don’t know why that would be the case, but I seem to experience it. The ketone monoester, which is the 1,3-Butanediol bound to BHB, if I understand it correctly, right? I do like that. I like the subjective feeling of it, but if that’s only at about 11 milliliters.

If I take 25 plus, speaking to your pharmacokinetics, right? Like the stock pops and then it drops and then I feel very tired and often feel more anxiety. It seems to prompt in me more anxiety. I mean, look, we got to talk about this. Not that it invalidates what you’re saying in any way, but your wife runs a company that sells ketone salts, which I also I’ve been using most consistently. Keto’s Therapy, people can check it out. But on the ketone monoester, what I’m wondering is if I’m only taking, let’s say, 11 milliliters once or twice a day, and I’m taking it alongside MCT oil, where would you put the risk analysis on something like that?

Dominic D’Agostino: I would say, the risk is very minimal for a healthy person. So I have a super healthy liver. I even take N-acetylcysteine, alpha-lipoic acid, all these things. So I was surprised to see sort of liver climbing. What we see in our older animals is that they are selectively vulnerable to 1,3-Butanediol toxicity from acutely and also chronically. So for a normal healthy person, especially someone that’s sort of really good metabolic health and liver function and they don’t drink or drugs that compromise the liver, I would say upwards of 1,3-Butanediol 20 to 20 milliliters a day is probably where you want to cap it and maybe not do it every day. 1,3-Butanediol based ketone ester would do that, but you can also probably achieve and maintain the same level of ketosis with a ketone salt, a beta-hydroxybutyrate salt.

And I do like the idea of a D and the L, the two enantiomers, which is a conversation that you may or may not want to have. So the L is basically like, it’s packaged beta-hydroxybutyrate in the time release form and it has some signaling effects. And then you have free acids too that are coming up on the market, and various liposomal formulations. I’m not sure if they’re commercially available yet, but these are some things in the pipeline. But yeah, 1,3-Butanediol based monoester, I think there’s good data behind it. I think the science that’s published is biased under the direction because that was the molecule that a lot of companies associate with, and then they test that molecule in and of itself as a monotherapy. And I am of the opinion that things are definitely optimized. You could avert a lot of the problems just by formulation.

Tim Ferriss: How does the MCT oil help? I guess basically it makes the ramp up more gradual. Is that the effect that the sort of co-consumption of the MCT oil has?

Dominic D’Agostino: Yeah. It delays gastric absorption for one thing, but it’s also stimulating your endogenous production. So the MCT goes to the liver, not through like chylomicrons, it goes right to the liver and stimulates your body’s ketone production. And I think that’s important. It’s almost like training your liver to ramp up fat oxidation, and it’s almost like exercising your liver to stimulate it. What we’ve also observed, and we published on that, like a large dose of MCT, when you take the liver out and look at it, there’s globules of fat all in the liver.

Tim Ferriss: Oh, that sounds bad.

Dominic D’Agostino: Well, we see a fatty liver, but we did not see evidence of necrosis, but we did see some inflammatory markers.

Tim Ferriss: Necrosis is dead tissue, dead cells.

Dominic D’Agostino: Yeah. Yeah, we did not see that, but we saw signs. We saw sinusoidal dilation and TNF-α was elevated and some other things to suggest that large doses of MCT. And if you do the human equivalence, it would be like me taking upwards of like 80 to 100 milliliters per day. So that’s a lot.

Tim Ferriss: Although, it’s not that much though, right? I mean, because 30 milliliters is like two tablespoons, is that roughly, right? So it’s like six tablespoons. If you’re just squirting it into your coffee, it’s not hard to necessarily get above a hundred. It’s actually pretty easy. So where would you recommend capping MCT consumption? I’ll get rid of my camel back with the MCT oil in it, but where would you recommend capping the MCT consumption?

Dominic D’Agostino: The studies that were done showing benefits is like 20 milliliters per day, but they only did a single dose, which is weird, but that was the old Axona studies. And like 80 percent of people tolerated that, 20 percent didn’t. But I’m of the opinion that 20 milliliters twice per day would be perfectly fine for essentially most people that can tolerate that. And you’re going to have probably about 30 percent or more that can, but MCT is much more tolerable when you take it with a meal. So if you take MCT on empty stomach, prepare to be closer to a bathroom, right? So yeah.

Tim Ferriss: Yeah. Of all the disgusting things that I have consumed in my life, and I’ve had a lot, right? I mean, I’ve tried early prototypes of some of the esters and all sorts of stuff. I’m not going to say it was a Piña Colada, but I was fine with it. MCT oil to this day, I just find so absolutely revolting. I don’t know if it’s the neutrality and the mouth feel, but mixed with the mackerel and that apple cider vinegar, it sounds so disgusting. My friend almost puked in his mouth yesterday when I was describing it. It’s actually really good. I’m just a sucker for mackerel. I’ll take mackerel over sardines all day long, but — let’s see here… So I think we’ve covered a lot of the exogenous ketones. I’ll just pull this from our text thread because I think it might be a question on some people’s minds.

As I was trying to troubleshoot my apparent failure mode with ketosis because of my low numbers, I asked you, is there any argument to be made that I should have a ketogenic breakfast instead of intermittent fasting? Could it be that I’m causing problems with exogenous ketones, right? Am I delaying potentially the onset of my own ketosis? Is it like TRT, right? If you’re taking exogenous, remember that word, if you’re injecting or rubbing on or swallowing testosterone, it’s like your Leydig cells are pretty smart. That’s the reason your balls turn into Raisinets is because it’s like, “Cool, we don’t have to make that anymore.” So I thought, am I shooting myself in the foot by taking exogenous ketones? And it sounds like a little bit goes a long way, but like most things, in excess, it becomes its opposite, right? It becomes a hindrance and makes it problematic. Is that fair to say?

Dominic D’Agostino: Yeah. We’ve only seen the anti-endogenous ketosis effect with 1,3-Butanediol or 1,3-Butanediol-based ketone esters, and that is due in part to their potency and also the rapid elevation of ketones seem to have an insulin effect that can double or triple insulin. And even if we elevate ketones to the same level with a salt, we don’t see that spike up in insulin. So that could be coming into play with your low ketones if you are consuming the monoester.

Tim Ferriss: Not much. Every once in a while, like before exercise, because I might not mind the spike, but I’m not consuming a ton. Yeah.

Dominic D’Agostino: But the breakfast, I’m of the opinion that protein loading in the morning, actually when you first wake up, and I think Donald Layman and maybe Stu Phillips would also agree with this, and maybe Layne Norton too, the protein guys in the camp, is that protein in the morning kind of amps up your metabolism throughout the rest of the day. And I think if you abstain from eating during the day, you tend to get the munchies later in the day and you tend to overeat, whereas if you have a protein-heavy meal in the morning with high fat, then that can sort of rev up your metabolism for a good part of the day. But then again, some people, me included, my mind is not as sharp when I have —

Tim Ferriss: Well, that’s the thing. That’s the thing, right?

Dominic D’Agostino: Yeah.

Tim Ferriss: Yeah, I would say that, I mean, for 15 years, the sort of 30 grams within 30 minutes of waking up has been this sort of easy to remember heuristic that I’ve recommended for folks and that, if I am not intermittent fasting, that’s also what I do, but I’ve become so addicted to the mental sharpness that it’s just like, man, I know that if, for instance, if I want to do three hours of writing, I do not want to have food immediately prior to that.

Dominic D’Agostino: Yeah.

Tim Ferriss: But I would say, I’m also at a point, I think, where throwing up really heavy weight for me and getting as big and strong as possible is just not — it’s less of a priority than it once was, after shoulder surgeries and elbow surgeries and various things. Not that I want to be the skinniest guy in the room, but —

Okay. It sounds like the pharmacokinetics are maybe to blame with the associated spike in insulin for some of the issues you might run into if you’re taking the 1,3-Butanediol-based products.

Dominic D’Agostino: It can be, and I suspect it is, and I’ve kind of proven with myself that’s the case, but it also can be mitigated in part by mixing, taking it with a meal or taking it with MCT. But then you get the — it is metabolized, like 30 milliliters of 1,3-Butanediol is kind of like 30 milliliters of ethanol.

Tim Ferriss: Yeah.

Dominic D’Agostino: And then 1,3-Butanediol can create dependence and it also can create — you get withdrawal. So it’s establishing literature. There’s several publications just showing that with 1,3-Butanediol will produce dependency, and when you abruptly stop 1,3-Butanediol after consuming it for a period of time, there’s essentially alcohol withdrawal from that.

Tim Ferriss: What are the symptoms of that? I mean, imagine you don’t get DT, right? You’re not getting shakes or anything, are you? But, I mean, what happens?

Dominic D’Agostino: Yeah, it is, I mean, it’s like classical kind of ethanol withdrawal, maybe not quite as dramatic, but the glycols or diol alcohols do have a GABAergic effect, so you’re doing that. And yeah, I mean, it’s well established it has narcotic-like properties and that kind of stymied its use as a synthetic food for space flight. Well, I think that the palatability also factored into that, but also in the literature, it notes a narcotic effect of this and then the animal studies and really showed dependency and withdrawal.

Tim Ferriss: Just to give a reiteration of that, I mean, the 1,3-Butanediol-based stuff is also sold as an alcohol replacement. So of course, being the idiot that I am, not idiot, just like I’m eager to experiment here and there if it’s not going to kill me, and so I thought, “You know what? I don’t want to drink tonight.” I remember where I was. I was in Upstate New York, about to go to a restaurant with a friend. I knew he would want to drink, and then I wanted to be able to say, “Hey, I already had this ahead of time. Don’t worry. We’re on the same level.”

And I chugged a small can. It wasn’t, in terms of liquid volume, a lot, right? I don’t know, six ounces, eight ounces. And I felt like I could barely walk to the bathroom. I was smashed. It was, like almost knocked a glass off the table. I was like, “Holy shit, I did not do this risk assessment properly. Thank God I’m not about to get into a car,” because it took a little while to wear off. So that narcotic effect is really, it’s not always subtle.

Dominic D’Agostino: I made jello shots. I made 1,3-Butanediol jello shots. And before we made the ketone esters in 2009, Patrick Arnold and I kind of formulated this.

Tim Ferriss: Patrick Arnold. So people who don’t recognize Patrick, listen to my conversation with him from years ago, but if you know BALCO or remember when Barry Bonds grew a few head sizes or any of that stuff, anyway, Patrick’s got some stories.

Dominic D’Agostino: Yeah.

Tim Ferriss: So the jello shots, so what happened with the jello shots?

Dominic D’Agostino: Yeah. Well, that was the way to get it down because 1,3-Butanediol is so nasty, right? So you could basically just warm up pure 1,3-Butanediol in a pot and then add cherry-flavored sugar-free jello and then stir it up and then pour it into like a cookie pan and then cut it into cubes, which you get 20 milliliters per jello shot, and make it pretty strong so it’s like firm jello, and I would just hit like two or three of them and just be buzzing. And I talk about it, like 1,3-Butanediol can be fun and it’s a lesser of two evils when we’re talking about ethanol. So I actually tried to file a patent for the use of 1,3-Butanediol for alcohol withdrawal and things like that. But actually, there was some prior art on that, and this is many years ago, but I actually do think it could be part used by people if they could transition off of ethanol, potentially use that, but there are other ways to get off alcohol. I’m not advocating for that.

But my concern, is why I’m talking about it now too, is that I know there’s older people out there with dementia, perhaps Alzheimer’s disease, that if they’re consuming 1,3-Butanediol as a ketogenic supplement, it’s going to make you dizzy. It’s going to decrease your stability, like it’s going to make you potentially fall, break your hip. And then when you’re older, your liver, your ability to detoxify alcohol, an 80-year-old only has like 20 or 30 percent of the capacity to do that. So the same amount of 1,3-Butanediol for a 20-year-old is going to be like three to five times harder on your liver as we age, right? And people note that, like as you age, you just can’t tolerate the same amount of alcohol.

Tim Ferriss: Yeah.

Dominic D’Agostino: So I think these things, the 1,3-Butanediol-based supplements, the straight up 1,3-Butanediol and 1,3-Butanediol-based ketone esters are problematic for the age population that I think some of these products or companies are targeting. And I say that not only as a scientist, but because of the volume of emails that I get on that. People were like, “I got super buzzed. I didn’t know what happened.” And some people are very sensitive to it, like I gave my wife — she can’t tolerate alcohol at all and she took a shot glass of the stuff and she could not believe that it was a legal supplement to sell.

And now this will probably interest a lot of people, so they’ll probably go out and buy it, but I’m just saying like if you’re sensitive to alcohol, you’re going to get overly buzzed, and my concern is that, hey, if you want to use it for recreational, that’s your thing and maybe it’s better than alcohol, but for older people, a large dose of 1,3-Butanediol is problematic from a narcotic, from just the potential for just getting drunk, just straight up drunk. And Dr. Veech told me that a long time ago, I was like, because I was trying to get the ester from him and I was like, “What if I just use 1,3-Butanediol?” It’s like, “You’ll get drunk.” So it’s like he instilled that, that, “Do not do that.” That’s what he said.

Tim Ferriss: And Veech was the co-inventor, is that fair to say, of the bonded monoester that was funded in part by, was it the DOD or DARPA?

Dominic D’Agostino: DARPA.

Tim Ferriss: DARPA and then patented at Oxford. Is that right? Am I getting my facts straight or am I getting things mixed up?

Dominic D’Agostino: Yeah. Well, Oxford sort of acquired the IP and made a company out of it, but we have to credit Dr. Richard Veech, who passed away a few years ago, for the conception of a ketone ester for just — Dr. Veech was the student of Hans Kreb.

Tim Ferriss: Kreb of Krebs cycle?

Dominic D’Agostino: Krebs cycle, yes.

Tim Ferriss: That’s wild. Wow.

Dominic D’Agostino: Yeah.

I went to Dr. Veech’s lab at the NIH. I saw the whole ketone process, I tested different things. We were in communication, and I think he was a very colorful character and he had an amazing mind. We disagreed, we agreed to disagree on some things, but I consider him a mentor of mine, and I think we all owe a lot. I don’t think exogenous ketones may even not exist. Well, Henri Brunengraber and some other people, Sami Hashim developed the triester. So there was other people in this space, but he really advanced the science and ultimately the application of exogenous ketones and I think has written extensively about it. I mean, these things were around for a long time, and I think as science advances, we have more information and then we can — I have pivoted away from these things, although we still use them in some experiments. I published some really nice data on 1,3-Butanediol, actually even in cancer studies too, but at the same time, I realized that the negative effects, I can pivot away from that. We have other molecules in development now.

Tim Ferriss: So I know as I’m watching things get dark on the East Coast for you that we’ll wrap up in just a few minutes. But in brief, you mentioned fat, salt, fiber as things that can be helpful for slowing, I guess, gastric emptying of these meals that I’m having. And I’m curious for you, on a ketogenic diet, what are your favorite sources of fiber, supplemental or in whole food form?

Dominic D’Agostino: Whole food form. I like broccoli, and I buy broccoli florets, and then I cut the tip of the floret off, and I have a bowl of that and I give the stalk and stuff to my dogs and I chop it up for their fiber. So that’s something that I do, I don’t know, just to get a higher dose of broccoli. But broccoli, and then wild blueberries that has about half of the sugar and more fiber. They’re about a quarter of the size of like the huge blueberries you buy at, like, Walmart. But so wild blueberries, I like apples because they have a certain fiber called pectin in it. Some people that have a problem with fiber can’t digest pectin or they get gassy, so it’s on the FODMAP list or whatever. But wild blueberries, just green vegetables in general, but I like broccoli, and apples are pretty much something I have every day.

Tim Ferriss: Now, the wild blueberries, I just want to really underline wild for people because that is not what you’re necessarily going to get at your local grocery store that’s been optimized to be as sweet as —

Dominic D’Agostino: No. They’re in Publix. So I can get them in Publix down here. And I think, I don’t know, actually I think they’re in Walmart too. I think you can go to Walmart, and I think you might have to sneak around for them, but there’s like a brand, they have wild raspberries and blueberries and blackberries together. I forget the name of the brand, but they come in like big two or three-pound bags too.

Tim Ferriss: How much can you eat of apples or berries before undoing all the good metabolic work that you’re doing in ketosis, right? Because even, for instance, we’ve talked about how easy it is, and it really is easy as long as you’re pretty simple to please dietarily, to, say, travel for keto, right? So you just pack a bunch of canned sardines, mackerel, maybe some oysters, and macadamia nuts, and you’re kind of good to go, like these things are pretty calorically dense. But the macadamia nuts, I was looking at the bag the other day because it’s one of the few kind of crunchy things that I feel like I can eat aside from some of these vegetables, and I was like, “Wow, if you go whole hog in the macadamia nuts, you can rack up the carbs after a while.” What about apples and berries? Where’s your cutoff point for yourself?

Dominic D’Agostino: Well, macadamia nuts actually have that three-to-one to four-to-one ratio of fat to — so they are pretty high in fat, but like cashews and then like almonds and other nuts. I like walnuts too, I forgot to mention. So I have walnuts, a small organic apples we buy, wild blueberries, and broccoli pretty much every day, and all that together ends up being about 60 to 70 grams of carbs, but one third of the carbs is fiber, so it’s essentially non-glycemic. I haven’t had any of that today, but I tend to have that at dinner and then my snack at nighttime. So everything that I just mentioned, the carbs. But I don’t think about it as undoing like ketosis, and I do think my glucose tank is always like maybe 10 or 20 percent full, so I’m always running kind of low on glucose, and on some days I’m more active.

Tim Ferriss: What’s your height and weight, Dom, at the moment?

Dominic D’Agostino: Six foot, 220, and I’ve been, give or take, five pounds for years now, yeah. So just always cruise at like 220. Yeah.

Tim Ferriss: Yeah. I mean —

Dominic D’Agostino: 100 kilograms.

Tim Ferriss: Yeah, good body composition. That is a lot of muscle for people who are not watching the video. I’m just trying to set the maybe context for what your tolerance might be for grams of carbohydrates.

Dominic D’Agostino: I have pretty good tolerance for carbs now, but I think I have good tolerance more now because I’ve titrated some carbs back in, because I did go probably at least five years on like very low, like clinical ketogenic. And I did end up losing like almost like 18 pounds of like lean body mass, and then I took a year off in 2018, when we bought our farm. I was very busy on the farm. Then I bought weights and just have it on the farm. And then I’ve been doing DEXA. My last DEXA, it was 218, but under — I was like 9.8 percent body fat, like still under 10 percent. But I gained muscle when I got back into lifting and just did the heavy compound movements again. I don’t go super crazy on the weight, but I do train hard. But —

Tim Ferriss: You found the addition of the carbohydrates to be beneficial, that slightly higher quantity of carbohydrates?

Dominic D’Agostino: Yeah. I’ve added more carbs back in over the years, and that has helped me maintain my body weight. And I like eating those foods. I enjoy those foods. I think they have beneficial fiber, phytonutrients, other micronutrients that I think are beneficial. And I can maintain a level of ketosis about 0.5 to 1.5 day in and day out eating those foods every day. And I do titrate in like the MCTs and I get like one or two packets of KetoStart of day, maybe up to three if I’m traveling, but that’s my normal protocol and that has optimized all my biomarkers. I actually got full blood work today. Kind of waiting for that to come back to see. It should be interesting. I was inadvertently took something that I thought was laced with something, some gummies I told you about, but —

Tim Ferriss: People are going to assume. When people hear gummies, they assume it’s THC, but this was what, theanine and magnesium? It should have been really innocuous, right? Is that right?

Dominic D’Agostino: Yeah. Theanine and magnesium, my wife bought it at Marshalls. We both took two. We woke up in the morning and she says,” I’m dizzy.” She’s asking me, “What did you give me last night?” I was like, “I didn’t give you anything.” Because sometimes I give her stuff. I tried to get up, fell flat on the floor. Both of us could not walk. We were both completely incapacitated. I called the Poison Control Center. And yeah, so basically I’ve been running around to different labs, and now I’m doing forensics, so do something. I’m still buzzed —

Tim Ferriss: Wow. Really?

Dominic D’Agostino: — so if I don’t seem like myself, because I’m still buzzed 48 hours later. So we took something —

Tim Ferriss: That is wild.

Dominic D’Agostino: We had the spinnies, and even this morning I woke up, I had the spinnies walking to — so whatever it was, it was pretty powerful. And I have a little bit of a back injury from about a week ago, and I don’t have any pain from that. So I think whatever it is, I’m thinking potentially a fentanyl derivative or something, but —

Tim Ferriss: Yikes, that’s terrifying.

Dominic D’Agostino: My wife does not drink, she doesn’t use any drugs, so she was pretty much really floored by this.

Tim Ferriss: Wow. Did you go back and buy some more of them to send off to get analyzed?

Dominic D’Agostino: Well, I have it. Yeah. So I collected my urine, my wife collected her urine, and then I’m doing the necessary blood work, and I’ve contacted a forensic lab, and we have doctors involved in all this now.

Tim Ferriss: Wow. Dosed the wrong guy. Or the right guy, because you imagine like what if that had been a 80-year-old woman sleeping on the second floor. I mean, that’s dangerous.

Dominic D’Agostino: Absolutely. Yep, absolutely. I just took two and I’m a pretty big guy and everything, but if a little kid took two or four or five — so obviously, I don’t know, the company, and the company you can find it on Amazon, mixed it up and it’s laced with something or they just put high concentration THC and I kind of know what, but this is, we’re talking 48 hours later and I’m still feeling it.

Tim Ferriss: That’s wild.

Dominic D’Agostino: I’m super curious with my blood work, so I’m waiting for that to come in. Be careful, people out there because —

Tim Ferriss: Be careful of those gummies, folks.

Dominic D’Agostino: Yeah. Not regulated.

Tim Ferriss: Yeah. Dom, is there anything else you would like to mention or anywhere you’d like to point people before we wind this to a close?

Dominic D’Agostino: I don’t think so. I mean, we talked a lot about like sardine fasting and everything, I think, before.

Tim Ferriss: In the prior conversation, yeah.

Dominic D’Agostino: Yeah, yeah. I’d like to credit to Dr. Annette Bosworth, Dr. Boz, because, I mean, I’ve kind of came up with this idea, but it got traction, and I think she has — a lot of people that email me about sardine fasting heard it from Dr. Boz, and she’s amplified the message with millions of YouTube followers. But she kind of took an idea and actually put it into practice and amplified it through a lot of people, and then those people emailed me about it, so that amplified and secured my knowledge. “Yes, okay, these benefits are…” And now she’s been on like Diary of a CEO podcast, I think, and some other podcasts.

So I’d also like to mention, I’m testing today even, there’s a company coming out, I don’t know if I can mention or not, but I will, Medifoodz. And for years, there’s no whole food-based ketogenic diet prescription foods. So I have no association with the company, I’m just testing their product, but they’re called Medifoodz. And

Tim Ferriss: How do you spell that? M-E-T-I? M-E-T —

Dominic D’Agostino: M-E-D-I-F-O-O-

Tim Ferriss: Oh, Medi. I got it. Medifoodz.

Dominic D’Agostino: Yeah, Medifoodz. With a Z. And I got to tell you, these are like gourmet foods, and then they hit the macros of a modified ketogenic diet. And we talked about if someone says the ketogenic diet is not palatable, they have to see these foods. They’re prescription whole food. There’s other companies that tried to do this, and they even got like the packaging is like compostable, like it looks like plastic, but I could throw it in my garden and it breaks down. I’m very impressed with this. I just mentioned that because I just got these foods yesterday and I was really impressed, but other companies have not been so impressive. So Medifoodz is pretty impressive. And Quest Nutrition tried to do this a while back and I think their foods were good, but they got a new CEO and just phased it out.

But I like the idea of a prescription, whole food, ketogenic diet that potentially a doctor could write a prescription. And a week of foods could be sent to the patients. I’ve been questioning why someone has not done this, but I know the margins are very small in the food world, so it’s hard to kind of get that up and running.

Tim Ferriss: I mean, they could take the approach that a lot of companies take, a lot of tech startups take, like Uber, Tesla, et cetera, you sell in the beginning for much higher price to people who are willing to pay that. You use that to subsidize the R&D or the scale necessary to then offer, right? Instead of Uber Black, you have UberX, and similarly for a lot of companies. I mean, I would pay for this, right? And yeah, I wouldn’t say totally price-insensitive, but I’m willing to pay for convenience because there does come a point where I’ve had enough canned mackerel and salads with rib eye that I would love to have something else in any case. So I will check out Medifoodz.

Let’s see. Dom, are you active on social anywhere? Should people find you anywhere online?

Dominic D’Agostino: Yeah, I’m not too active, but I try to jump on about once or twice a week, and I cap my social to maybe an hour a week.

Tim Ferriss: Yep. Smart man.

Dominic D’Agostino: I try to respond back to things, yeah. Kind of delete the apps from my phone or some of them, but I repost things and try to acknowledge some questions and stuff people have on this, and then I collect questions and then — we have our own podcast, the Metabolic Link Podcast. And we have a Metabolic Initiative Platform which has ACCME accreditation, so it’s like you can get CME credits from it. So that has been a project that we’re working on and trying to advance everything we’re talking about into human application through that.

Tim Ferriss: Yeah. Beautiful. Well, I’m trying to think of any other links. Are there any other links that you want to mention? And we’ll stick these all in the show notes as well for people.

Dominic D’Agostino: Yeah. Ketonutrition.org. No products. I don’t sell anything. So ketonutrition.org information website, the Metabolic Link Podcast, and the Metabolic Health Initiative Education Platform are like the three biggies, I think.

Tim Ferriss: Beautiful. We will link to all those things for people listening as well as — God save — People who help me do the show notes, they’re going to have a lot to dig through, but we will link to everything that we can find a link for at tim.blog/podcast. Just search Dominic, and this will be the most recent episode. I mean, we may have some in the future, so you’ll find it.

And Dom, thank you so much for taking the time, man. Always great to see you.

Dominic D’Agostino: My pleasure. Thank you, Tim, for having me. Appreciate it. Good seeing you.Tim Ferriss: Yeah. And everybody, as per always, thanks for tuning in, and until next time, be just a bit kinder to others and also to yourself, especially if you might be self-flagellating yourself over not hitting your GKIs, like yours truly. All right. Take care, everybody.

DUE TO SOME HEADACHES IN THE PAST, PLEASE NOTE LEGAL CONDITIONS:

How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D’Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment) (#845)

2026-01-07 08:10:19

Dr. Dominic D’Agostino (@DominicDAgosti2) is a tenured associate professor in the Department of Molecular Pharmacology and Physiology at the University of South Florida Morsani College of Medicine and a Visiting Senior Research Scientist at the Institute for Human and Machine Cognition.

He teaches medical neuroscience, physiology, nutrition, and neuropharmacology, and his research focuses on the development and testing of nutritional strategies and metabolic-based therapies for neurological disorders, cancer, and human performance optimization. His work spans both basic science and human clinical trials.

He has a strong personal interest in environmental medicine and enhancing the safety and resilience of military personnel and astronauts. In this capacity, he served as a research investigator and crew member on NASA’s Extreme Environment Mission Operations. His research has been supported by the Office of Naval Research, the Department of Defense, the National Institutes of Health, private organizations, and nonprofit foundations.

He earned his B.S. in Nutritional Science and Biological Sciences from Rutgers University in 1998, followed by a predoctoral fellowship in Neuroscience and Physiology at Rutgers and the University of Medicine and Dentistry of New Jersey. He then completed postdoctoral training in Neuroscience at Wright State University’s Boonshoft School of Medicine in 2004 and at the University of South Florida Morsani College of Medicine in 2006.

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How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D'Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment)

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Transcripts

SELECTED LINKS FROM THE EPISODE

Connect with Dominic D’Agostino:

KetoNutrition.org | Facebook | Twitter | University of South Florida

Dr. Dominic D’Agostino’s Past Appearances

Dr. Dominic D’Agostino — All Things Ketones, How to Protect the Brain and Boost Cognition, Sardine Fasting, Diet Rules, Revisiting Metformin and Melatonin, and More | The Tim Ferriss Show #825
Dom D’Agostino on Disease Prevention, Cancer, and Living Longer | The Tim Ferriss Show #188
Dom D’Agostino — The Power of the Ketogenic Diet | The Tim Ferriss Show #172
Dom D’Agostino on Fasting, Ketosis, and the End of Cancer | The Tim Ferriss Show #117

Devices & Wearables

Abbott FreeStyle
Abbott Precision Xtra Glucose Monitor
Breath Ketone Meter / Breathalyzer
CGM (Continuous Glucose Monitor)
DEXA Scan (Dual-Energy X-Ray Absorptiometry)
Dexcom
Glucometer (Glucose Meter)
Keto-Mojo (Blood Glucose/Ketone Meter with GKI Calculation)
Metabolic Cart
Oura Ring
SiBio (Continuous Ketone Monitor)

Products, Brands, & Services

Books

The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman by Timothy Ferriss
Spark: The Revolutionary New Science of Exercise and the Brain by John J. Ratey, MD and Eric Hagerman

Lab Tests, Biomarkers, & Metrics

Supplements, Compounds, and Terms

1,3-Butanediol
- Divergent Hepatic Outcomes of Chronic Ketone Supplementation: Ketone Salts Preserve Liver Health While Ketone Esters and Precursors Drive Inflammation and Steatosis | Pharmaceuticals
- Effects of Acute and Chronic 1,3-Butanediol Treatment on Central Nervous System Function: A Comparison with Ethanol | Journal of Pharmacology and Experimental Therapeutics
- An Open-Label, Acute Clinical Trial in Adults to Assess Ketone Levels, Gastrointestinal Tolerability, and Sleepiness Following Consumption of (R)-1,3-Butanediol (Avela) | Frontiers in Physiology
- Physiologic, Metabolic, and Toxicologic Profile of 1,3-Butanediol | Journal of Pharmacology and Experimental Therapeutics
Acetoacetate
Acetone
Atkins Diet
BHB (Beta-Hydroxybutyrate)
Borrelia
Bullseye Rash
Caloric Deficit / Caloric Restriction
CAR-T Therapy
Checkpoint Inhibitors
CCK (Cholecystokinin)
Cyclical Ketogenic Diet
Enantiomers
Eucaloric Diet
Exogenous Ketones
Fat Adaptation
Fasting-Mimicking Diet
FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols)
Formulation
GABA (Gamma-Aminobutyric Acid)
Gastric Absorption
Gastric Emptying
GKI (Glucose Ketone Index)
GNG (Gluconeogenesis)
GLUT4 (Glucose Transporter Type 4)
Glycolytic
Intermittent Fasting
IGeneX (Lyme)
Isotonic
Ketone Esters
- Oral Administration of a Novel, Synthetic Ketogenic Compound Elevates Blood Beta-Hydroxybutyrate Levels in Mice in Both Fasted and Fed Conditions | Nutrients
- Tolerability and Safety of a Novel Ketogenic Ester, Bis-Hexanoyl (R)-1,3-Butanediol: A Randomized Controlled Trial in Healthy Adults | Nutrients
Ketone Salts
- BHB Supplements: The Ultimate Guide to Exogenous Ketones | PricePlow
Ketosis
Klotho
Krebs Cycle
Low-Carb Mediterranean Diet
Lyme Disease
MCT (Medium-Chain Triglyceride) Oil
Metabolic Flexibility
Metabolic Memory
Metabolic Psychiatry
Metabolic Switching
Monotherapy
Palatability
Pharmacokinetics
Protein Veggie Days
Racemic Ketones
- Why Do We Need Both D-BHB and L-BHB? | KetoNutrition
Sardine Fasting
Tolerability
Two-Tier Testing (Lyme)

People

Organizations & Institutions

TIMESTAMPS

[00:00:00] Start.
[00:04:37] Ketosis benefits: Quieting the mind, GABA elevation, metabolic psychiatry.
[00:09:24] My Lyme disease story: Pseudo-dementia reversed in 3-4 days of ketosis.
[00:13:50] Spirochetes are glycolytic: Starve the bug, boost the immune response.
[00:19:20] Ketosis and cancer: Slowing glycolytic tumors, enhancing standard care.
[00:20:50] My 18-day keto experiment: Mood stabilization, Alzheimer’s prevention hopes.
[00:23:19] Metabolic memory: Carryover effects and Valter Longo’s fasting mimicking research.
[00:27:11] Intermittent fasting as keto on-ramp: My 2-8 p.m. eating window.
[00:29:15] Dom’s budget keto meal: Canned mackerel, MCT oil, apple cider vinegar.
[00:33:28] My ketone measurement paradox: Feeling sharp at 0.2 mM readings.
[00:36:56] The carburetor analogy: Ketone production vs. utilization explained.
[00:38:43] Breath ketones vs. blood ketones: Better indicator in caloric deficit.
[00:39:47] Gluconeogenesis fears: Fat, fiber, and salt to slow protein absorption.
[00:45:25] The bunless double cheeseburger question: 80 grams of protein in one sitting.
[00:49:03] Post-meal walking and GLUT4 activation: Timing your glucose disposal.
[00:51:02] CGM and ketone monitor limitations: When your devices gaslight you.
[00:58:05] Rabbit starvation and protein-veggie days: Why your body won’t bankroll its own ketosis.
[01:05:44] Alzheimer’s prevention: Biomarkers, B12, hsCRP, and metabolic health.
[01:09:40] My family history: Letrozole, metabolic dysfunction, and rapid cognitive decline.
[01:13:17] Minimum effective dose: 80% of benefits from low-carb Mediterranean.
[01:18:56] One week per month protocol: Aggressive calorie cut to ramp ketones.
[01:23:12] GKI sweet spot: Target 1-4, aim for 1-2 during intensive weeks.
[01:36:22] Exogenous ketones 101: Palatability, tolerability, pharmacokinetics, toxicity.
[01:39:21] 1,3-Butanediol warnings: Liver toxicity, NAD depletion, dependency risk.
[01:54:22] Intermittent fasting vs. ketogenic breakfast.
[01:59:09] My accidental intoxication story.
[02:03:23] Dr. Veech tribute: Student of Hans Krebs, ketone ester pioneer.
[02:05:08] Fiber on keto: Wild blueberries, broccoli, apples, walnuts.
[02:09:58] The tainted gummies incident: Dom’s forensic investigation underway.
[02:13:08] Thanks to Dr. Boz and Medifoodz.
[02:16:19] Parting thoughts.

DOMINIC D’AGOSTINO QUOTES FROM THE INTERVIEW

“We know that being in a state of ketosis really quiets the mind, … and that, I think, really echoes its broad application for metabolic psychiatry, which is everything from major depression to bipolar to schizophrenia to anxiety disorders to anorexia nervosa.”
— Dominic D’Agostino

“Much like muscle memory, I think there’s a metabolic memory. So the more you stay in ketosis, the easier it gets and the more benefits you derive from it and the more that you shift your body to being more fat adapted—just like you can build your VO2.”
— Dominic D’Agostino

“[The ketogenic diet] is not a cure for cancer, and I cringe when people talk about that online. [But] it does slow it down, especially if it’s highly glycolytic, which 80% of cancers are.”
— Dominic D’Agostino

“I think you can get 80% of the benefits [of ketosis] with a low-carb diet—low-carb meaning 100 grams a day, just fibrous, non-starch, non-sugar carbs, low-carb Mediterranean, if you want to call it that.”
— Dominic D’Agostino

“Resistance exercise—I’m a little biased towards that. But muscle is like an endocrine organ that produces hormones and various molecules that are neuroprotective, and muscle is tightly linked to brain size and, of course, your waist and your visceral fat.”
— Dominic D’Agostino

“My concern … is that I know there’s older people out there with dementia, perhaps Alzheimer’s disease, that if they’re consuming 1,3-Butanediol as a ketogenic supplement, it’s going to make you dizzy. It’s going to decrease your stability, it’s going to make you potentially fall, break your hip.”
— Dominic D’Agostino

Podcasts & Media

Relevant Resources

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Want to hear the last time Dominic D’Agostino was on the podcast? Listen to our conversation here, in which we discussed ketones and neuroprotection, sardine fasting, glucose ketone index for autophagy tracking, cholesterol hyperabsorption, melatonin myths, metabolic psychiatry, hyperbaric oxygen therapy, metformin versus berberine, and much more.

The post How to Use Ketosis for Enhanced Mood, Cognition, and Long-Term Brain Protection — A Practical and Tactical Guide with Dr. Dominic D’Agostino (Plus: Deconstructing Tim’s Latest Keto Experiment) (#845) appeared first on The Blog of Author Tim Ferriss.

The Single Decision

2026-01-03 05:12:41

Coach Sommer is a former U.S. National Team gymnastics coach and the creator of GymnasticBodies. This personal email sent to me, which I reread often, was so good that I had to include it in Tools of Titans. Make the one big decision.

Enter Coach Sommer…

Hi Tim,

Patience. Far too soon to expect strength improvements. Strength improvements [for a movement like this] take a minimum of 6 weeks. Any perceived improvements prior to that are simply the result of improved synaptic facilitation. In plain English, the central nervous system simply became more efficient at that particular movement with practice. This is, however, not to be confused with actual strength gains.

Dealing with the temporary frustration of not making progress is an integral part of the path towards excellence. In fact, it is essential and something that every single elite athlete has had to learn to deal with. If the pursuit of excellence was easy, everyone would do it.

In fact, this impatience in dealing with frustration is the primary reason that most people fail to achieve their goals. Unreasonable expectations timewise, resulting in unnecessary frustration, due to a perceived feeling of failure. Achieving the extraordinary is not a linear process.

The secret is to show up, do the work, and go home.

A blue collar work ethic married to indomitable will. It is literally that simple. Nothing interferes. Nothing can sway you from your purpose. Once the decision is made, simply refuse to budge. Refuse to compromise.

And accept that quality long-term results require quality long-term focus. No emotion. No drama. No beating yourself up over small bumps in the road. Learn to enjoy and appreciate the process. This is especially important because you are going to spend far more time on the actual journey than with those all too brief moments of triumph at the end.

Certainly celebrate the moments of triumph when they occur. More importantly, learn from defeats when they happen. In fact, if you are not encountering defeat on a fairly regular basis, you are not trying hard enough. And absolutely refuse to accept less than your best.

Throw out a timeline. It will take what it takes.

If the commitment is to a long-term goal and not to a series of smaller intermediate goals, then only one decision needs to be made and adhered to. Clear, simple, straightforward. Much easier to maintain than having to make small decision after small decision to stay the course when dealing with each step along the way. This provides far too many opportunities to inadvertently drift from your chosen goal. The single decision is one of the most powerful tools in the toolbox.

The post The Single Decision appeared first on The Blog of Author Tim Ferriss.

The Story Behind EpiPen, The Rise of Food Allergies, and What Doctors Got Wrong (#842)

2025-12-31 07:01:53

This time around, we have an experimental format, featuring the first episode of a brand-new podcast launching next week, Drug Story. I rarely feature episodes from other shows, but I think this one is well worth your time. It changed how I think about allergies, especially as someone who carries an EpiPen and has wondered: why on earth have food allergies seemed to skyrocket in the last few decades?

Drug Story is a podcast that tells the story of the disease business, one drug at a time. Each episode explores one disease and one drug, and it kicks off with EpiPen and food allergies. A quick teaser: What if I told you that a well-meaning medical recommendation may have caused millions of kids to develop food allergies?

Make sure to subscribe to Drug Story on Apple Podcasts, Spotify, or wherever you get your podcasts. You can also simply go to DrugStory.co to learn more.

The host is Thomas Goetz. He is a senior impact fellow at the University of California Berkeley School of Public Health, and much earlier, Thomas was the executive editor at WIRED, which he led to a dozen National Magazine Awards from 2001 to 2013. His writing has been repeatedly selected for the Best American Science Writing and Best Technology Writing anthologies.

P.S. To help you kick off 2026, I recommend checking out Henry Shukman, a past podcast guest and one of the few in the world authorized to teach Sanbo Zen. Henry’s app, The Way, has changed my life. I’ve been using it daily, often twice a day, and it’s lowered my anxiety more than I thought possible. For 30 free sessions, just visit thewayapp.com/Tim. No credit card required.

Please enjoy!