The Brain Tumor On Keto
The experts say nobody knows how to treat a brain tumor, and that the prognosis in most cases is dire. But I can point to a number of things that people are being told to do, and a number of things that people aren't being told to do, that science and logic suggests, impact on a brain tumor situation. For starters, I wouldn't 'go keto', no matter how many famous surgeons recommended it to me.
Why do I say that? Because there genuinely are Doctors and scientists and all sorts of health gurus out there recommending to people facing this kind of situation, to go on a ketogenic diet. I personally know of some situations that did not go well, but regardless of that, there is very good quality science pointing to the fact that it’s a terrible idea. Maybe even the worst of ideas.
For starters, here’s a study from this year which basically says that when you quit sugar (or when sugar is made unavailable for other reasons which I will go into a little further down), brain tumor cells start feeding more on ketones and fat, and the worse the situation, the more likely it is that fat, rather than glucose, is the fuel source. It straight out says that keto diets make fatty acids more available for the tumor to feed on. Say no more, but I’m going to anyway.
Glioblastoma Utilizes Fatty Acids and Ketone Bodies for Growth Allowing Progression during Ketogenic Diet Therapy; iScience. 2020 Sep 25; 23(9): 101453.
Our study suggests that when glucose levels are diminished, GBM [Glioblastoma] cells may adapt by partially shifting their metabolism toward ketone body and fatty acid oxidation…the KD had at best no effect or…a significantly detrimental effect…Lipid levels in malignant gliomas are reportedly higher than in normal brain tissues…FAs [fatty acids] can be used as an energy substrate to support GBM cell growth…FAO [fatty acid oxidation]…results in the production of acetyl-CoA…GBMs are reliant on FAO to sustain proliferation and…acyl-CoA…promotes this process…much of the acetyl-CoA produced by malignant gliomas is derived from sources other than glucose, highlighting FAO as a potentially critical component of brain tumor metabolism…the KD [ketogenic diet]…results in increased FA availability with the potential to be taken up and utilized by the tumor..
Here’s another study saying similar things, although they fail to mention that there are some easy ways to make FAO less available, so that the glioma cells can’t get what they are so heavily reliant on. I will talk about those things in a bit, but obviously one of them is to not quit sugar, or starve yourself, say with fasting.
Glioma cells survival depends both on fatty acid oxidation and on functional carnitine transport by SLC22A5; July 2020 Journal of Neurochemistry.
Gliomas are the most common primary malignant brain tumor in adults, but current treatment for glioblastoma multiforme (GBM) is insufficient…Inhibition of carnitine transport…led to inhibition of FAO…This led to reduced viability and increased apoptosis in glioma cells…These observations suggest that the survival of glioma cells is heavily reliant on…FAO…
So is all fat made equal when it comes to glioma cells being hungry? Maybe, but I don’t think so for a lot of reasons, and one of them is that the breakdown products of the PUFAs appear to be something that’s always around with the most serious brain tumor situations. Lipid peroxidation, as mentioned below, is something that only happens to the PUFAs
Lipid peroxidation in patients with brain tumor; Int J Neurosci . 2006 Aug;116(8):937-43.
Free oxygen radicals (FOR) are thought to take part in oncogenesis and cellular differentiation…Mean serum MDA levels…were significantly higher for both glial and meningiomal tumor cases when compared to controls…lipid peroxidation…as assessed by MDA, catalase, and GSH-Px were increased in patients with brain tumors…
In fact, when you start looking into it, you begin to realise that the oxidative stress, free radical damage, carcinogenic, mutagenic, kind of scenario, is a polyunsaturated fat decomposition scenario, and you genuinely don’t need to have lots of PUFAs, if any at all, in a healthy system. I know that’s a controversial thing to say, but there, I said it.
The Delicate Equilibrium between Oxidants and Antioxidants in Brain Glioma; Curr Neuropharmacol. 2019 Apr; 17(4): 342–351.
It has been extensively described lipid peroxidation as an early biomarker of oxidative damage because of the wider propagation of free radicals associated with it. The elevated oxidative stress in cells can lead to modification of a number of cellular targets and cause cell damage and death and thereby it has been associated with carcinogenesis…peroxidation of…lipids with the generation of peroxides…decompose to multiple mutagenic aldehyde products as malondialdehyde (MDA) which is used as a marker of oxidative stress…MDA is…produced from…polyunsaturated fatty acids…patients with high-grade tumor had higher MDA levels both in sera and tissue samples…
Then there’s lactate, which again is something that rises when sugar is low, when stress and inflammation is high and ongoing, and when the PUFAs and their breakdown products are floating around interfering with the ability of the cell to use the glucose that is available. The PUFAs can make it so that even though you have sugar, you can’t use it properly, and lactate levels go up.
The PUFAs aren’t the only thing in the environment that can promote the cancer metabolism, but we’re talking about keto diets and fat at the moment, and they are central to that. Even if your keto diet doesn’t use PUFAs, when you go keto, you release the PUFAs stored in your tissue, into the blood stream, making them more available to the tumor and surrounding tumor environment.
Serum lactate levels are associated with glioma malignancy grade; Clin Neurol Neurosurg . 2019 Nov;186:105546.
Recent studies have suggested that high grade gliomas are associated with elevated serum lactate concentrations…high grade gliomas had significantly higher lactate concentration…This study reinforces the role of serum lactate as a potential biomarker of brain tumors malignancy…
And then there’s glutamine, which apart from the other things that happen to your metabolism when the PUFAs and their breakdown products are abundant (and when lack of sugar pushes up all the stress promoting inflammatory factors), becomes more available under stressful catabolic conditions, like a ketogenic state. Glutamine is basically highly addictive, for brain tumors I mean.
Glutamine Addiction In Gliomas; Neurochem Res . 2017 Jun;42(6):1735-1746.
Cancer cells develop and succeed by shifting to different metabolic programs compared with their normal cell counterparts. One of the classical hallmarks of cancer cells is their higher glycolysis rate and lactate production even in the presence of abundant O2 (Warburg effect). Another common metabolic feature of cancer cells is a high rate of glutamine (Gln) consumption normally exceeding their biosynthetic and energetic needs…we provided an updated overview of glutamine addiction in glioma, the most prevalent type of brain tumor.
And finally, here’s a little study that shows that during the fasted, ketogenic state, ketones like BHB and lactate levels in the brain, go up significantly. Lucky for brain tumours, they like ketones and lactate being around. I’m sure you’ll find the PUFAs breakdown products are there in the brain in abundance too, not to mention nitric oxide and estrogen and serotonin and endotoxin, and other stress and inflammation related things.
Human Brain β-Hydroxybutyrate and Lactate Increase in Fasting-Induced Ketosis; Volume: 20 issue: 10, page(s): 1502-1507; October 1, 2000; Journal of Cerebral Blood Flow & Metabolism.
…recent observation of…brain β-hydroxybutyrate (BHB) in children on the ketogenic diet…show that brain BHB rises significantly…with ketosis. We have found that both brain BHB and lactate increase…The increase in lactate concentration…may arise as a consequence of reduced metabolic lactate clearance caused by a shift from pyruvate to ketone oxidation.
I’m no doctor, and I don’t give medical advice, but if you’re worried about cancer, and somebody tells you that you should quit sugar and eat more of the “anti inflammatory heart protective PUFAs”, or even the ‘scary’ (joking) saturated fats, like coconut oil and butter, maybe have a think about what some of the studies above are alluding to, because it’s possible you can do a lot to help yourself survive cancer, or maybe even prevent it in the first place.