In this episode, I am speaking with Dr. Nasha Winters—a global healthcare authority in integrative cancer research who consults with physicians around the world, bridging ancient and naturopathic therapies with advancements in modern-day medicine. She is also the co-author of the bestselling book, The Metabolic Approach to Cancer. We will talk about cancer treatment and prevention, keto, fasting, and mitochondrial health and more.
In this podcast, Dr. Winters will cover:
The link between mitochondrial health and cancer (and how to detox in order to support the mitochondria)
Are keto diets effective for treating cancer? (Is being in ketosis really the key?)
The biggest problem with chemo for cancer treatment
The truth about what causes cancer
The little-known effectiveness of mistletoe in treating cancer
How finding your purpose affects your health and well-being
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The Metabolic Approach to Treating Cancer, with Dr. Nasha Winters – Transcript
Ari Whitten: Hey, everyone! Welcome back to The Energy Blueprint Podcast. I am your host, Ari Whitten, and today I have with me, Dr. Nasha Winters, who is a sought-after luminaria and global healthcare authority in integrative cancer research, who consults with physicians around the world. She bridges ancient therapies with advancements in modern medicine in the digital era. Dr. Nasha consults with some of the most prestigious cancer centers in the U.S. on projects, such as developing the clinical protocol for the current FDA-approved clinical trial using intravenous application of Viscum album extract—which is mistletoe—to treat advanced cancer, hyperthermia, cannabis, and the ketogenic diet, IV Vitamin C, and more. She has educated approximately 250 professionals in the clinical use of mistletoe, and has created robust educational programs for both healthcare institutions and the public on incorporating vetted integrative therapies into cancer care to enhance outcomes. She’s also a bestselling co-author of the book, The Metabolic Approach to Cancer. So welcome, Dr. Winters! Such a pleasure to have you.
Dr. Nasha Winters: Thanks, Ari! So, so glad to be here. Thank you.
Ari Whitten: Yeah! So I have to say, in prepping for this interview, I’ve been mostly focusing on the keto and the metabolic approach to cancer, and not so much the mistletoe stuff—so I’m very curious. Maybe I’ll save that one for later because I don’t want to digress right off the bat here. But let me just start off by saying, you’re a naturopathic doctor. You’ve also studied acupuncture Oriental medicine, and you obviously have a nonconventional approach—non-standard conventional approach to cancer here. I’m curious: what’s led you to this point in your career, and what led you to an interest in cancer specifically?
Dr. Nasha Winters: Sure. Well, I mean, really simple: I think most people who end up taking this path had a personal, up-close experience with something that went awry that Western medicine couldn’t know. I’m no different. At 19, almost 20 years old. I was diagnosed with terminal stage 4 ovarian cancer. It was missed over and over for about a year leading up to that diagnosis and—I think being so young at that time, everyone was sort of thinking, I was a little “histrionic”, or maybe I was overestimating my symptoms—until I landed in the hospital in the organ stage. I mean, I was in stage cancer when they finally figured it out. So, because of that, I was given no options or opportunities because I was too far gone to even have a single dose of chemo.
So for me, I had always been an inquisitive tinker. I’d always been a life learner. I was pre-med, hoping to go on a conventional medical school—that was my dream, my vision. And when that system pretty much failed me, I realized that if I’m going to die, I want to understand why I got here. And so I didn’t expect to live, didn’t expect to survive—didn’t expect to be here 28 years later. And yet I am. And I’m still learning every single day. And thanks to my own experiences, and that of tens of thousands of patients that I’ve learned from, and mentors I’ve learned from all over the world—for almost three decades—it’s become my purpose.
The metabolic approach to cancer
Ari Whitten: Very cool. So tell me about the metabolic approach to cancer. What is this all about, and why did you land on a keto diet as being a big factor in treating cancer?
Dr. Nasha Winters: Perfect. Well, when I first learned about my diagnosis, I went to a small liberal arts school in Durango, Colorado—you and I talked about that before the show—middle of nowhere; kind of a lower-funded school, so our library was a little bit dated. And in 1991, there was no Dr. Google; there was only seriously microfiche and the Dewey Decimal System. I knew I wanted to learn about the origins of cancer, and when I simply started looking into that concept, of course I ran across the actual article written—titled, “The Origin of Cancer”, which was from Otto Warburg from the 1920s, which outlined cancer as not a genetic disease—which we were already at 1990 in the throes of our research and understanding of cancer; where our focus was. But what he was saying, in his words, were that this is a metabolic process that’s happening at the level of the mitochondria, and at the level of the way the body utilizes and produces energy—just ATP.
There was nothing in that article about ketogenic diet; there was nothing out there about this. It was just saying, “Hey, your mitochondria are damaged. They’re not breathing well. They’re not processing energy well.” And so I started to figure out ways at that time of, how am I going to restore the function of my mitochondria? It was plain and simple. So fast forward all those years, my first approach—because the only information out there on diet at the time was Dr. Gerson. Also from the 1940s, he actually did take the original Gerson Therapy. He did take a metabolic approach. He was also seeing cancer as a metabolic disease. And the original Gerson actually included a lot of raw liver, a lot of green juice above the ground, low carbohydrate, green juices—not the carrot and apple juice and the vegan-sort of mantra that’s sort of out there around it today—so it’s been kind of bastardized over the decades—but he was understanding that you could sort of starve different metabolic processes at the mitochondrial level, even back then, and have really good success.
It definitely slowed down some processes for me, but because I already came into it so malnourished from both being a vegetarian since I was 16—which means I ate iceberg lettuce and Velveeta cheese—to suddenly realizing I was not giving myself any real fuel, any good fuel. It was a huge upgrade in my system of the types of foods I started to incorporate into my diet. It would take me many years into medical school, into the early to mid-90s, where I started learning more about just biochemistry, pathophysiology—the basics of this—to realize that there were a lot of ways to sort of take care of your mitochondria. Not just on fuel sources of your food, but in fasting and in not lowering your oxidative stress load and “taking out the garbage”, if you will, of toxicant exposures and different nutrients to support that, such as the Inositol Cysteine, ubiquinol, etc.
So I started learning about that in my early career, but it wasn’t actually until I hit my very first week of private practice in 2000, when I had a patient roll in in a wheelchair, who came in for end-of-life care, who wanted me to use my Chinese medicine acupuncture for pain management, who was given days to live from a glioblastoma that he’d already been battling on his own for some time. It was to the point where his skull was bulging out, he was wheelchair-bound, he was in a diaper, he couldn’t talk—and the pain was overwhelming. So I had no expectation of this man to survive much more for a few days, versus now what became 18 months beyond that moment. And why I incorporated—kind of went back through my mental filing system—and incorporated a ketogenic diet, which at that point had never utilized in practice outside of with epilepsy, he was having terrible seizures that were not responding to meds. So because he was so far gone, he couldn’t eat. And when we did, we’re able to sneak in some food—we did it just with that. So basically we had him on what Seyfried today would call, a “calorie-restricted ketogenic diet”, without knowing better. This is in 2000, and this man, within days, stopped having seizures, and stabilized his process, and ended up getting out of the wheelchair, getting out the diaper, talking, communicating—and we were able to start doing other things. No one expected that—myself first.
So fast forward into some [inaudible] and devouring everything I could, and it led me into this approach. Now I will tell you, in 2000, there was no way, as a naturopathic doctor practicing in an unlicensed state, that I was going to say I was using the ketogenic diet in the treatment of cancer. Even today saying that, you get in trouble. But in 2000, you really got in trouble.
So I basically—as I’ve always said—I don’t treat cancer; I treat patients that are dealing with this process. And I help restore their metabolic flexibility to help return them back to the pre-seen and evolutionary way our mitochondrial energy-use was meant to be. And that might be pre-intermittent fasting; that might be through a high-fat/low-carbohydrate diet; that might, even in some situations, be a pure carnivore diet for a period of time; and it might even be times when I would use exogenous ketones for whatever reason—basically to help kind of push the edge, or push the body to a point to create a therapeutic environment that enhances outcomes and relationships with other therapies, be it chemo, radiation, or IV Vitamin C and mistletoe, or any other therapies. So I have been able to hone this craft for almost three decades, applied first to myself and then to others. And luckily, people like Dr. Seyfried’s book came out in what, 2010, 2011—that was sort of like, allowing me to “come out of the closet”, and other books in this realm that now we have, I think, worked 26 clinical trials on cancer alone in the United States, on ketogenic diets, in cancer care, and many more worldwide. So I’ve had really good success with a lot of patients that were given, relatively, short expiration dates that are still alive and thriving and telling the story.
Genetically vs. Environmentally-induced cancer
Ari Whitten: Wow. Okay, so I want to step back real quick here, and cover some basics around cancer. You’ve mentioned a lot of things that I want to delve into, but mitochondria in particular. So one thing to start with—where that’s somewhat of a contentious topic is: there’s lots of people talking now about mitochondrial dysfunction in the context of cancer—which I’m happy to see, and I think there’s lots of good evidence to support that. But there’s also some people—very hardcore, conventional medical people—who very much insist that lifestyle and environment play very little role in cancer development, and that it’s all just genetics. So what is your take on that? So, genetics versus environment, first of all. And then, what proportion of cancers do you think are actually genetic versus environmentally-induced?
Dr. Nasha Winters: I think it’s a perfect question, and ironically where they’re duking it out the most on this topic of whether it’s just bad luck versus a terrain problem—a metabolic problem—is happening at the campus of Harvard, for instance. Vogelstein and his team down one end of the hallway are saying, “It’s just bad luck, it’s all genetics, you don’t have a choice, you have no control over this.” Frankly, he’s batshit crazy. I don’t know. When you cannot look at the data in front of you, for instance—with the nuclear-swamping studies, right? Where you take the DNA hardware—the hard drive of a cell is in its nuclei—and if you can take a cancer cell and a healthy cell, and you can take the hard drive out of the cancer cell and put it into a healthy cell—if this was truly a genetic disease—you would turn that cell into a cancer cell.
What we’ve actually seen over and over, multiple times, for many years, including people like Mina Bissell—who is someone in the cancer research world that I had been following for decades—we’re able to say actually, the swimming pool in which that nuclei is flopping about in, is where the magic is happening: the cytoplasm—or what she calls “the extracellular matrix”, and what I call is “the terrain”. So basically, if you take the hard-wired database—the nuclei of a cancer cell—and you put it into healthy cytoplasm of a healthy cell, you basically dismantle that bomb right away. It may still have a cancer phenotype or potential, but it doesn’t do anything. It’s just deflated, right? And the same—it goes to truth: if you take the good healthy nuclei and you put it in a cytoplasm of a cancer cell, you turn that nuclei on to behave like a cancer.
And so, that starts to tell you that this is much more related to what we put in on and around us. It is taking much more direction from the circulating goo that surrounds our mitochondria, surrounds our cells—around the cell itself—as well as, gives us more hope that we can do something about the treatment and prevention. I don’t think we should throw both babies out with the water. I wish that the day would come more to the midline of yes, about 5% of the time, there are some unfortunate, very destructive, very difficult-to-change genetic issues. But that’s very, very rare. And the rest of the time, depending on which studies you look at, 90-95% of the time, we have a lot more control and changing that cytoplasmic jelly, and changing the outcome of our genetic expression by what we are empowered to do.
Ari Whitten: So basically what you’re saying is, this is a problem of “dysfunctional goo”.
Dr. Nasha Winters: There it is! I think we’re done! I think we’re good.
Environmental lifestyle causes that promote the development of cancer
Ari Whitten: Okay. So let’s talk about what are some of those environmental lifestyle causes of that “terrain”—that extracellular environment—becoming toxic or pathological, and promoting the development of cancer. What are those factors?
Dr. Nasha Winters: Perfect. So in my almost-30 years, I’ve kind of—I mean, there’s a lot of factors—but I’ve kind of put into 10 major categories. I call it, “The Terrain Ten”. And so what those Terrain Ten—what those 10 categories are affecting, is what I call “mitochondrial buckets”. So the health, the expression, the number of, and the quality of the functioning aspects of your mitochondria—those little energy producers—are 100% dependent on what we put into them, what information we feed them. Whether it’s from food, air, water, thoughts, people, toxicants, you name it—goes in and affects that “bucket”. So the 10 major issues are epigenetics, which is where we kind of started with this conversation.
You were born with this deck of cards, but you have the ability to change the way you play the game. So you can change and play your hand differently. That’s very empowering. We’re now able to even show that you are likely being influenced by at least 4 generations, if not 12—from some recent studies—upstream from you. Also shows that you have the impact to have your own genetic line impact 4-12 generations below you. So if it’s been in your family lineage that everyone’s had cancer, why don’t you be the game changer? Why don’t you change it for yourself and for those who come after you?
Number two: the metabolic “teeter-totter”, which is about what fuel we choose to give those cells. What has happened since the 1850s, we’ve all gotten stuck in sugar-burning mode. So we were all low-carb, roughly, before the 1850s, until we started to really—in the Western world—until we started to mill flour and sugar, and put it in everything. So we had about 30% of our chloric intake from carbohydrates. But since then, we have about 70-80% of our nutrient intake is carbohydrates. That’s a big, big shift in a very short period of time. And that is like putting a package of sugar in your gas tank. You can still drive down the road, but you’re stuttering and you’ll eventually break down the side. It also oxidizes us—causes all kinds of stress and damage to the cells and the surrounding tissues around those cells. So sugar is really a big problem in the “bucket” —one of the primary ones in my opinion. The third one—
Ari Whitten: Can I—I know you’re in a flow here, but just real quick—I’m curious on some of the data points that you said there.
Dr. Nasha Winters: Yeah, please.
Ari Whitten: As far as before the 1850s being lower-carb, I’m curious about what data you’re referring to there? But also I’m under the impression that now the standard American diet is something like, I think, 33% fat, like 50 or 55% carbs, and then whatever the remainder is 20 something % protein.
Dr. Nasha Winters: That [planetary] realm is very realm is a hopeful, hopeful realm. That’s sort of the average, but the outliers are what we’re always talking about in disease. So apologies for interrupting, but just to…
Ari Whitten: Well, I think what you just said could explain the discrepancy, if you’re saying that maybe the most likely people to get cancer or get chronic disease are ones who have 70 or 75% carbohydrate diets, mostly refined processed foods.
Dr. Nasha Winters: Right. Or even, I mean, in my world, because I’ve been—at this point in my career—I’ve seen well over 10,000 patients, and I’ve looked at well over a couple of hundred thousand data points on these individuals, to know that even those super healthy vegetarians not eating anything processed, or coming at me with an average of 450-600 grams a day of carbohydrate—I mean, it’s insane. I was in that camp for many years and it took me a long time to crawl out of that. So even our idea of a heart-healthy breakfast is a bowl of Cheerios with skimmed milk, and a side of orange juice, and a piece of toast—I mean, that’s three days’ worth of sugar intake per even a registered dietician!
Ari Whitten: Sure. And I certainly wouldn’t argue with you about consumption of refined and processed carbs and sugars and that sort of thing. However, there is—as far as the statistic about prior to 1850—there’s lots of hunter-gatherer tribes all over the world that eat carb-based diets: the Tarahumara Indians, the Kuna, the Tsimane, the Hadza, the Tukisenta in Papua New Guinea, the [Kidivans], and the South Pacific, and on and on and on—and there aren’t cancer epidemics. Even obesity and diabetes and cardiovascular disease is almost nonexistent in these cultures. So I think the percentage of carbohydrate of the diet doesn’t seem to be the critical factor; it seems to be the processing of the diet.
Dr. Nasha Winters: Well, hopefully you caught a very specific languaging that I used there, which was, “in westernized cultures”.
Ari Whitten: Okay.
Dr. Nasha Winters: Okay. That was a very post-industrialized food revolution, which is not happening in those tribal cultural places you’re talking about.
Ari Whitten: Agreed.
Dr. Nasha Winters: And you’re right, it is but one drop in the big “mitochondrial bucket”, of which we have many others that those tribal environments have not been exposed to, or at least historically—although we’re doing a good job catching them up right up with us for other reasons. But no, you’re 100%. I’m glad you re-clarified that point because I’m 100% in agreement with that.
Ari Whitten: Cool. Well, I’ll let you carry on with the lists, I’m sorry to—
Dr. Nasha Winters: No, that was really important pieces that can restore up contention, so I’m really glad you cleared that up before we have to do it later. So that’s good!
Dr. Nasha Winters: The third piece of—hopefully—is the awareness that we’re all living in a toxic soup. That’s where it was alluding to the fact that these kind of distant tribal communities didn’t have these exposures, but now you can’t get away from it pretty much. When we’re ingesting in a credit card a month around the world, things in our food, our air, our water—it’s pretty sad of some of the endocrine disruption there, when places like India that had been living on a diet that’s [pulsed on] legumes and grains for millennia, who are now dying from the very diet that sustained them—not because of those foods, but because of the chemicals being dumped on to those foods. These are the places that are changing the game that we have to learn to adapt to in our modern times. So toxicants are huge.
There are so many—what, 60-80,000 new chemicals have been introduced to our world since the 1960s, of which less than a few hundred had been really thoroughly tested. And none of them, until recently—an IARC study, couple of years ago, started looking at the cumulative effect of those, because you can look at them individually and you’re like, “Well, that’s relatively benign.” But when you start to bring them together is when you started to get some pretty toxic soups. And then I even categorized, in the realm of toxic exposures, some things that we are seeing more and more because of its direct implications on oxidative stress or the creation, of oxidative stress in the body, or things like EMS. Again, not going away. So how do we live with, and over-moderate, and use—transform those exposures to help keep ourselves doing fine. But you can’t kind of get away from 5g rolling out across the world at this point.
And then the fourth one is a biggie. This also follows our sort of food lineage, in that we’ve monocrop our food—which has monocropped our microbiome. Diversity is the key to our resilience and our health and wellbeing. When you get down to just a few handfuls of these microorganisms, you become way more susceptible to a lot of disease processes. And as a naturopathic doctor, I’ve been saying, “the gut, the gut, the gut” for years, “the microbiome” for years, and kind of laughed at by my conventional colleagues. And yet today, microbiome study is one of the fastest and most interesting elements of scientific research out there! We know now that you don’t respond to certain chemotherapeutics if you’ve had antibiotics within two months of starting chemo, or that if you have low Bifido/Bifidus in your GI tract, immune therapies often won’t work in your gut. We’re now understanding even our response to our life-saving medicines is altered by what’s going on in our gut. So microbiome is really, really changed greatly since the industrial food revolution.
And then we move into immune system. This is a biggie, because you can use a beautiful cytotoxic reduction—tumor reduction therapies, chemo surgery, radiation—but you will never remove every microscopic cell, nor should you, because we all have cancer all the time. What keeps it in check is the immune system and its ability to recognize, respond, and then remember what it’s being exposed to. And if you end up with somebody with chronic illnesses, you’ve lost at least one of those three Rs, if not all of them. And that’s where we’d really gotten into trouble. So we can see things like vitamin D synthesis, for instance, is a big issue. When I’ve tested my population that are dealing with cancer, everybody’s low in vitamin D and everyone’s been made to be terrified of the sun, and everyone’s wiping away their vitamin D with their saponification of detergents they’re putting on their skin.
It takes three days to synthesize vitamin D into your skin, and so I’m always telling my patients to just use soap on pits and parts and, kind of just use the scour—good ol’ water and rubbage. Get that out of there. But these are just—these small things are different. Plus, we got so freaked out from eating lard and pastured animals and eggs, that we’ve also lost a really viable source of our vitamin D. And vitamin D is also dependent on your Omega-3 and Omega-6 ratios and having a good fat base, for it to be made bioavailable. So we’ve done a lot of damage to our immune system simply by some industry-driven dietary changes that have infiltrated the industrial world. And now it’s picking up momentum worldwide.
And then for the last five biggies: inflammation. I think that kind of speaks for itself. Circulation and angiogenesis, all in one category around. If you aren’t moving your body, you’re not oxygenating your tissues well. If your blood gets thick and sticky, it becomes like a jungle gym for the cancer cells to move around the building on—things like that. And how many of us are poorly profused, or either under-working out or over-working out, which both lead to oxidative stress patterns, which also create issues in your vasculature changes. And then we get into hormones, which unfortunately, that little credit card we eat every month doesn’t help. Or the glyphosates are being exposed to, and the air, soil, and water isn’t helping—but it’s messing with our hormone system in a terrible way. And then in our world where like, if you’ve got hormone problems, then you therefore need hormones. So everyone has this beautiful idea of, “let’s just give exogenous, bioidentical hormones”—and you’re actually just adding insult to injury. Because most of us actually have difficulty in processing our hormones—metabolizing our hormones—such as certain epigenetic hiccups around column T catecholamine issues, or CYP1B1, or ESR2 snips, that basically take any exogenous or overly-processed hormones in your body, and stores it up in your adipose tissue and in places where it doesn’t belong—where it turns on a million different growth factors. So we’re kind of in a “hormone soup” today. And we’re seeing like—I mean, in the past six months, I’ve seen a handful of children under the age of five—little girls under the age of five—with ovarian cancer. I mean, come on. It was weird when I was 19 and 20 with ovarian cancer!
And that was in 1991! It’s even weirder in 2019 to see 5-year-olds with stage 4 ovarian cancer.
Ari Whitten: Yeah.
Dr. Nasha Winters: It’s crazy! And then the last two—huge: circadian rhythm and stress response. I mean, my gosh, we’re winning Nobel prizes—for crying out loud—in circadian rhythm biology. I don’t think your listeners are strangers to the fact that we’ve really done a number on our circadian rhythm patterns. [inaudible] You and I talking to each other right now, thanks to my crazy blue blockers and things on my screens, I can mitigate it—
Ari Whitten: I have a computer screen with low blue-light setting built into it.
Dr. Nasha Winters: Right? And like we—you gotta like take those little steps today. And even that, when you do your best, it’s still wonking up your inner-works! And then stress. We live in a stressful time, and we can’t change that, but we certainly need to start to work hard and changing the way we respond to it or express it. And then probably the most challenging one is: the mental emotional piece. No one wants to deal with their baggage, but you have to unpack it eventually.
I think that’s sums up the things that have dropped into our “bucket”, and I think that also shows you—what you alluded to in the first two we talked about—why our rates in the industrialized Western worlds far exceed those of our tribal folks, even those who eat a high-carbohydrate diet, because we have these other things that are kicking off all kinds of growth factors and processes in the body. And even in the last couple of weeks, Westernized-affluent countries now have cancer as the number one cause of mortality. It’s always been cardiovascular disease, but cancer just came in for the win.
Ari Whitten: Yeah. Okay, so we’ve got all these 10 factors that you’ve just mentioned. These are ultimately sort of coalescing in forming toxic goop in and around the cells…
Dr. Nasha Winters: You got it.
Ari Whitten: …And then ultimately, this is converging at the mitochondrial level, where it’s doing something to the mitochondria that is initiating cancer development.
What happens at the mitochondrial level that initiates tumor development
Ari Whitten: I know this is a huge topic and we only have about 20 more minutes here—but can you just kind of succinctly explain what is actually happening at the mitochondrial level that’s initiating tumor development?
Dr. Nasha Winters: Sure. So we’ve always thought of mitochondria just as our ATP energy building blocks, but it actually is much more about the communication that it has with our epigenome and our microbiome. It’s sort of like, maybe the operator between those two, so it’s really taking in information and directing information to how those things express. That’s one of the things we’re learning now that we did not know was a role for the mitochondria. The other role we’ve been learning about the mitochondria, which is really critical, specifically to cancer, is that it is the control center for apoptosis—basically, programmed cell death.
So in our healthy, functioning metabolic processes, we should get to the point where cells get worn out, they get tired, they get damaged, they should die and be removed from the building. That’s what happens in our normal physiology. We take about 60,000 hits a day to our DNA, and silently behind the scenes, we’re cleaning it up. But when you have assault after assault after assault, and the burden in the “bucket” is becoming so much, we don’t repair as well as we did, and we accumulate more, and we basically overwhelm the system, and sort of like throwing monkey wrenches into the cycle that creates our energy. So we end up producing less ATP, we up actually sort of suffocating and killing off more of our mitochondria, and we end up in a point where all of that its ability to communicate, “Hey guys, it’s time to die. You’re broken. Get on out of here. Thank you for your service and move on!”—those cells don’t get that message. They go into ongoing immortality and that is when you’re in trouble.
And at this point in time, in Western medicine, we don’t know how to deal with that. So we feel like if we napalm the system with chemotherapy, radiation, targeted therapy, surgery—we’ll at least get ahead of the game enough to kill off as much as we can, hoping to keep some healthy guys behind. But if you don’t have the ability to apoptose, then that means that a lot of those therapies are also less effective, because they depend on decent mitochondria functioning to do their job. And the irony of those therapies alone is that they further damage the mitochondria. So it’s no wonder that we have a 70% recurrence rate after a first time diagnosis. Everyone gets excited and rings the bell after they’re done with chemo or radiation, and I’m like, “You’re just getting started. Now is the time to go into your mitochondrial resuscitation program,” which we don’t talk about.
In our book, we actually ask folks to ask their oncologists, “What are you doing for my mitochondria?” And basically the way they respond to that should tell you whether you stay or go from that.
Ari Whitten: Yeah, most conventional oncologists probably just cock their head to the sideways and go, “What the hell are you talking about?”
Dr. Nasha Winters: Exactly. So what’s really cool is a lot of the things you’re questioning. We’re actually finally starting to do some good research around. So, for instance, we know that people, say, fast around the time that they are doing their chemotherapy, they will sort of protect those healthy mitochondria, and then act like a Trojan horse so that the toxicant coming in after the cancer cell gets more to its target and does not take out the innocent bystanders along the way.
And these patients tend to have better recovery from the treatment. They tend to have better, more sustainable, robust maintenance of remission, or at least stabilization of the disease. They will all tell you their quality of life is better. They tend to need less pharmaceuticals—like the side drugs—to help these things. So where I think the research is really going into the realm of using something like a metabolic therapy, be it the diet or even an exogenous ketones or fasting strategies—are that they’re enhancing the effect of our standard of chemotherapies. So if we can look at them as more of a team player versus an “either/or”, that’s where we have the biggest success. Yes, you can push that cancer with just the diet. Yes, you can push that cancer with just the chemo. But when you put them together, you can have a pretty profound experience.
The use of chemo in treating cancer
Ari Whitten: Gotcha. So I almost hesitate to do this because I know this requires a long nuanced answer, and there’s so many other topics I want to cover—but it sounds like you are not necessarily opposed to chemo, but maybe there’s like, certain cancers where you’d recommend it and others that you wouldn’t?
Dr. Nasha Winters: Sure. So for me, where we are meaning to leave—what we’re [going] to leave in the dust and leave behind, is the way we approach cancer today, is called “maximum tolerated dose”. And that’s that concept I talked about earlier: if we’re going to napalm the hell out of you, and we hope that a few good cells are left behind to keep you surviving—that’s how we’ve been doing it for several years. That is a failed experiment. I think that’s really easily stated. Where cancer is moving is to something called adaptive theory: it’s this idea where you can do a little cytotoxic reduction—a little tumor burden reduction—by pushing it back a certain percentage, whether it’s 20-80%, and then you help the rest of the body kind of wake up around it, be it an immune therapy such as standard of care Keytruda, be it mistletoe, be at IV vitamin C, be it with all these other adjutant therapies—we’re having better outcomes. And people like Dr. Rosenberg over at Moffitt Center and others are doing—there’s a lot of emerging research in this field that what happens when we over-harvest the cancer, below like 20% of those daughter cells—those rapid-dividing daughter cells—you wake up the stem cells. You wake up the mama bears and they’re pissed. They’re not responsive and they’re a whole ‘nother animal. They’re a whole ‘nother mutation that are not responsive typically to standard of care. So if we push it back just enough, and then we support the rest of the cytoplasmic jelly—the “bucket”, the immune system, the metabolism—all of those pieces…
Ari Whitten: I’ll help you out here—if we detoxify the goo—
Dr. Nasha Winters: You nailed it. And that’s where I think that we can do standard of care far smarter, less toxic, and in far less dosages than we’ve been doing to get the win across the board.
The keto diet in preventing and treating cancer
Ari Whitten: Awesome. Nice. Well done on answering a hard question in, I think, two minutes. So we’ve talked about this whole kind of big picture paradigm, all these different environmental causes converging at the mitochondrial level, resulting in failed apoptosis, cancer generation—where does the keto diet fit into this specifically? What is it doing at that level that is… And are you talking about it more in a preventive context or in a treatment context? Where do you see this fitting in?
Because I’ve also heard some people—for example, I’ve interviewed Dr. Chris Masterjohn on the program recently, and he was saying that… I’m not going to get the exact words, but basically the kind of diet that I would eat to prevent cancer is different than the one I’d eat to treat cancer. So I’m curious what your take on keto is, as far as prevention and treatment.
Dr. Nasha Winters: Well, first we’ll start with how does it play in? So people like Dr. Adrienne Scheck out of—[now, she was embarrassed at] the time of this research, now, at Children’s in Arizona—but basically she was able to take the 10 hallmarks of cancer—which anybody can google and get those specifics because we don’t have the time to go into each of them—and shows that being in a state of ketosis literally enters into the doorway of every one of those hallmarks. That’s pretty cool. We thought it was just a diet that was going to lower our sugar and start the cancer that way.
It’s so much more than that. It’s literally about epigenetic expression. It’s literally about turning on and off certain signaling pathways—proliferation pathways, angiogenic pathways—it literally impacts every one of those. So it definitely has a place at the table, in my mind, at some point along the way in both treatment and prevention.
Number two, specifically, I never guess with the diet. And I don’t really feel comfortable when a colleague says, “This diet for this condition, this diet for this condition” or, “Before, after”. Because what I do, is I’m an insane data point collector. I want the data to determine. So if I have a patient that is chronically in a metabolic mass state—they can’t fast for 13 hours, their hemoglobin A1c is above 5, their insulin is above 5, they are constantly shaky here with the [hangrays]—I know they’re a metabolic nightmare, and that’s just a matter of time before they have pretty bad diseases: diabetes, osteoporosis, Alzheimer’s, cancer. So I am absolutely looking at getting them into some metabolic flexibility. That might be in some intermittent fasting strategies; that might be in some high-fat/low-carb strategies. However, to get them back to being that dual-hybrid engine they were meant to be, then depending on the cancer type or the sort of sugars like a sugar pusher that it is, and a lot of our highly metabolic cancers—especially in the brain cancer world—you bet your butt I’m going to have them in a very therapeutic level of ketones above 3 or 4 on the [blood] ketone level to actually act like a treatment. At that point, it’s a therapeutic diet. It’s not just, “Hey, this is how you eat for vitality.” And I think a lot of the longevity researchers out there, like—people are out there promoting things like the Mediterranean diet, and yet when you actually pull back and look at the literature, what’s actually more compelling is not what they ate, it’s the fact that the population in which they studied were very privy to fasting almost 200 days a year. In the Orthodox Christian environment—
Ari Whitten: You mean the like the centenarians that they’ve studied specifically, not like, modern-day Mediterranean peoples eating their Mediterranean diet.
Dr. Nasha Winters: Nailed it. Like the blue zones and the moderate, more centenarian areas—that’s where we saw this. And so I think that fasting probably has more room at the table for prevention versus hitting hardcore ketosis. So that’s probably where Dr. Masterjohn and I would probably agree? I don’t know, I haven’t heard your interview, I’d love to go back and listen—
But that seems to show all over survival and longevity, positive outcomes with more fasting than what it is you’re actually eating.
Ari Whitten: Gotcha. Okay. So there are some cancer researchers I know—I’m acquaintances with a guy named Chad Macias who is very critical of the metabolic theory of cancer approach. One thing that I saw him citing is—this is a little bit academic and jargony—but basically it’s a quote that says, “In the work of the la Santé group,”—which is a referring to specific researchers—“Grabacka et al.,”—who’s the name of these researchers noted—quote, “that cancer cells actively contributed to the stromal fibroblast metabolic reprogramming and took advantage of the subsequent ketone body consumption for energy generation. This is a special property of epithelia-derived tumors.” And then they said, “This observation is pivotal as about 90% of all human cancers are derived from epithelium.”
So basically what they’re saying is, the vast majority—about 90% of human cancers—can use ketones for fuel, too. And they’re kind of skeptical of the keto diet approach as starving the cancer tumors—the cancer cells—for that reason. What would you say in response to that?
Dr. Nasha Winters: I’ve heard this response a million times and my first comment to this is that, you put anything into a Petri dish and you push one mechanism all the way, you’re going to see problems. Period. But we are not a single-cell line in a Petri dish being fed just acetate, which are what a lot of these studies where done with. In a complex body that has a liver that’s been dealing with the gluconeogenesis and all the other processes going on, as well as the cytoplasmic goo that’s wrapped around all of this, there is a hell of a lot more going on in this myopic viewpoint. So you can make the data show you whenever you want. But I’m here to tell you that after 28 years of working with 90% of my patients with epithelial-based cancers—probably—that they’ve had some form of a diet that reestablished metabolic flexibility, and approached it from a metabolic concept that did not necessarily have to be treated with ketones.
We are treating all of the things that go into that “bucket”. So when I think of epithelium dysfunction, that’s gonna take us back to the angiogenesis cardiovascular. I’m checking [inaudible], I’m checking [inaudible], and I’m looking at copper and ferritin—iron overload—I’m looking at [CO] 181 synthesis and issues around collagen and matrix; and I’m working with high-dose IV vitamin C, I’m looking at their hormonal status and whether that’s taking off cortisol on blood sugar—I mean, dude, there is not a single “one target, one treatment”! It doesn’t exist! And if we keep going down that path then we’ll get nowhere. And the trenches that I live in, I don’t have patients that can wait for that. So I’m the “bench to the bedside and the bedside to the bench” kind of gal. So I definitely appreciate the studies. I read them, I take them in, I filter them through everything I’m seeing, but I’m never myopic with my observations. I test, assess, address, and never guess.
Ari Whitten: Yeah. I’m noticing the language that you’re using around the keto diet and how it’s affecting cancer development is very nuanced. It’s not just as simple as, “Hey, ketones are these magical things that are killing cancer cells,” or, “We’re starving the cancer tumors.” You have more nuance to your view than that. And even what you just said, there was something to the effect that we’re reprogramming that goo by establishing more metabolic flexibility. And I’m wondering—and I think you even said something to the effect of suggesting and may not even necessarily need to be a keto diet, but other types of diets that re-establish metabolic flexibility or detoxify that environment. So I’m going to read into what you said a little bit by saying like, what if we work on doing some fasting protocols, and at least the nightly fasting window and time restricted feeding to build metabolic flexibility and getting rid of processed foods and more whole foods; and some days that are higher-fat/lower-carb, and other days where you maybe can eat carbs but still whole food carbs; decreasing overall calorie intake so you’re not constantly overloading the cell with an over-abundance of calories—things like that, I would imagine, would also improve that goo such that it’s going to decrease the likelihood of oncogenesis of cancer development?
Dr. Nasha Winters: Ari, I can hug you. I think you nailed it! That’s the key—I think in this world… I’ve been at this this for 28 years, and I never called it “keto” until I could [inaudible] at the type of diet. But still, I’ve then got labels like “the keto person”, but I’ve never ever once said, “The keto diet will kill—will take care of your cancer.” There are moments where you can use ketones to be a tool in the treatment of cancer, but it’s never by itself. It drives me crazy when you get put in those places, but you just do. That’s human nature and I’m totally okay with that. But I think you summed it up beautifully that it is nuanced, but it is also very, very individual: that your needs change as you change, as your cells change, as the goo changes—and down to even like you said, that the season of when to eat certain things, getting back into the rhythm of the nature around us and the climate in which you’re living. Our entire survival has been based on adaptability and flexibility to the changes in the environment around us. The world today around us, we gotta move with it.
Ari Whitten: Yeah. There are a lot of—especially I’ve noticed like, vegan diet health gurus, who are really demonizing the keto diet. I just saw Dr. Michael Greger is publishing a series of videos right now on his site, NutritionFacts, and the one he published this morning was talking about how keto diets basically caused the buildup of methylglyoxal, this sort of toxic byproducts that promotes advanced glycation end products, and making the case that this is actually promoting disease development—and for various diseases, so: stroke, cardiovascular disease, kidney disease, cataracts, Alzheimer’s, things like that. So there’s obviously that, and then everything from that to the “Perlmutter”’s of the world and people who are promoting the keto diet as this magical panacea.
So I’m just curious—I personally think that keto diets have value, but I see them more as a hormetic stimulus—as something that is, in some kind of small doses, whether that’s like a few days here and there incorporated into your monthly routine, or whether it’s like a few months, a seasonal thing, or something like that—I see it as definitely having potential benefits. But I am personally deeply concerned about long-term keto—potential side effects—and this seems to be a big unknown, given that there’s no real natural populations in the world doing this long-term, so we don’t know what the long-term effects are. I’m just curious if you have any thoughts on keto diets: should they be transient things and then go back to a more moderate diet? Or do you think keto diets—somebody should just stay on it for years and decades?
Dr. Nasha Winters: So here’s what’s interesting is, I personally use it as another therapeutic tool. So that means—you don’t get on chemo and stay on it forever. You shouldn’t. It’s just like those moments where we try and take anything and make it the “end-all, be-all” is dangerous. But here’s what I do find is interesting, because again, I test everybody, myself included, and thanks to getting cheaper ketone monitors out there and cheaper ketone strips, I can test people a lot more often. So what happens when someone becomes metabolically flexible in the population I’ve worked with—this is all anecdotal, I’m not even going to pretend otherwise, and someday I would like to have clinical trials around it but to find funding is ridiculous—but what happens, so example for myself included, is people who did do a therapeutic ketogenic diet for a period of time to kind of reset and use it as a tool and use it like a [sword] to get in there and get after it, when they kind of go back to more of a flexible, flexitarian-based diet, it would raise their carbohydrate up a little bit, when they become more nuanced within themselves, even a 13-hour fast at night, when they get up in the morning, if they’re actually showing trace ketones—even on blood, not just in a urine—and so I’m finding people showing like 0.3-0.8 in their blood ketones, just from simple nightly fasting. So my premise is that we actually are meant to be, in some degree of it, when we’re metabolically flexible, but we don’t have to force it. It becomes a natural place and that our body then has a choice like, “Hey, I need this fast energy right now and I’m going to use this source,” or, “Hey, I need this fast energy source right now.” I think that’s how what we came from, evolutionarily.
So if you don’t need to use a certain amount of energies, your body then can process it and move it on off the building, however it needs to. But ultimately when people do become metabolically flexible, they can push their ketones way up without very much push, just by even going to a 16-18 hour fast, or a 3-day fast, my God, really! 7-8 on their blood ketones! So I want people to kind of get a sense that, when we have these conversations, I would like to look at peoples that have—the [“Rob Will”’s] out there, the other guys who’ve been out there in decades of being on a keto diet—I want to look at their metrics. I want to look at the people’s metrics who have been on it short-term for therapeutic status, and follow them for a while.
But even for myself today, it’s very hard to actually get me out of ketosis. And I’m not trying to be in it, but I had to use it for a tool for many years off and on, more assertively and less. Now I actually do better or more fasting than I do by eating a high-fat diet. My body doesn’t need or want to go into that high-fat place. I think this is going to be biochemically individual, and I see that a lot. I’m interpreting people’s epigenetic [epps] or snips—single nucleotide polymorphisms—so I can kind of tell from the get-go who’s going to have more of a problem long-term or short-term with this diet, and how to help them find the diet that matches—that has these molecular mimicry, or the best genetic match to where they came from to help them play the best deck of cards they can.
The use of mistletoe (viscum album extract) in treating cancer
Ari Whitten: Excellent. I have two quick questions for you to wrap up; they could be long questions—
Dr. Nasha Winters: I’ll do my best!
Ari Whitten: —but we only a couple minutes here. Mistletoe: I’m just curious if you could summarize that super quickly, like, where do you see the value of that? And then the final question is: if you could do one thing to help lower your risk of cancer, what would that be?
Dr. Nasha Winters: Cool. So mistletoe is a semi-parasitic plant that’s been used consecutively for a hundred years as an injection of these little lectins—these polysaccharides, these viscotoxins—that were extracted from the mistletoe that grows in trees. There are 3000 species worldwide, but there’s the main anticancer species grows in the Black Forest area of Switzerland, Austria, France, and Germany. It has over 2500 clinical trials, and it is the most-studied and the most-used integrative cancer therapy in the world.
It’s never been meant to be a stand-alone cancer treatment. Though we’ve seen anecdotally and in clinical trials, that it has been positive outcomes on reducing cytotoxic burden, and definitely known for longevity—increasing survival rates with cancer. But it’s always been used as an adjuvant, because it helps act like kind of like a natural Neupogen or Neulasta—keeps the blood counts up, it’s a natural bed JAK inhibitor, lowers Interleukin-6, C-reactive protein, NF-kappa beta; it definitely helps with T-cell/dendritic cell formation; it’s definitely an immunomodulator. And then people always talk about the main symptoms or side effects is a quality of life. So we had studies showing that it’s enhancing endorphin and endocannabinoid function, so it’s definitely kind of a good, like, cushy little friend to bring into your cancer treatments. And so, again, another tool that can enhance your outcomes and keep you thriving through your cancer treatment.
And then we use it post-treatment to help maintain your remission and clean up your—it’s also really good for DNA repair. In fact, in Chernobyl, they’re still injecting, right into the thyroid gland, mistletoe to heal ill effects of radiation poisoning. So things like that. It’s really powerful. There’s a clinical trial that I helped write the IRB for going on at Hopkins, it’s going into its third year now for a standalone treatment for stage 4 cancers that stopped responding to standard of care. And it finally got full-on FDA approval for all three phases well beyond just its safety phase that it’s in right now. As a cancer treatment, which is totally above and beyond what we expected, but that shows you that the outcomes are very hopeful. And again, if you live in Europe—you have anywhere from 60-85% chance anywhere you live in Europe of having this as a therapy somewhere along the way. And it’s getting ready to celebrate its 100th year in use this coming fall, 2020.
Ari Whitten: Very interesting.
Dr. Nasha Winters: Big time! There’s a lot of cool stuff. Google it: mistletoe—in the thing it’s known as Viscum album extract. If you’re going to do the research, if you Google “mistletoe”, you might won’t find much about it.
How to lower your risk of cancer
Ari Whitten: Okay, very cool. And then the final thing is: if you were going to do one thing to lower your risk of cancer, what would that be?
Dr. Nasha Winters: Honestly, find your purpose. And that sounds really crazy, but there are so many studies showing that people without purpose have a poor survival rate compared to those with purpose. I don’t know any studies that have been done on finding purpose, but I have met so many people along this journey that were lost, and cancer gave them back their mojo, if that makes sense. And then it seems like kind of the “bulletproof” people are those where their purpose is really intact; they seem a little more resilient to this. And that’s usually an answer. People are a little bit like, “That’s a little ‘Wu’ and ‘Esoteric’,” but I’d like to see some more trials around it. We know it definitely helps with longevity and survival, but I’ve seen some pretty interesting things that make me wonder if it has impact on prevention as well.
Ari Whitten: Yeah. Very cool. Well, Dr. Winters, I’ve really, really enjoyed this conversation. Thank you so much for coming on the show. If people want to work with you, or—obviously they can get your book on Amazon, The Metabolic Approach to Cancer—but if they want to work with you or follow your work, where would you like to send them?
Dr. Nasha Winters: Send them over to drnasha.com (D-R-N-A-S-H-A dot com), and then all the typical social media handles—either Dr. Nasha, Inc., or The Metabolic Approach to Cancer—have a couple of little zones there. And then I now just consult directly with your physician to help you because the bottleneck or the physicians, they need training in this terrain-centric approach. So I help doctors, who now help their patients.
Ari Whitten: Excellent! Awesome. Well thank you again, Dr. Winters. Really, really enjoyed it, and I hope to talk to you again in the near future.
Dr. Nasha Winters: Thanks, Ari. All the best!
Ari Whitten: Thank you.
The Metabolic Approach to Treating Cancer, with Dr. Nasha Winters – Show Notes
The metabolic approach to cancer (3:29)
Genetically vs. Environmentally-induced cancer (10:04)
Environmental lifestyle causes that promote the development of cancer (14:07)
What happens at the mitochondrial level that initiates tumor development (28:10)
The use of chemo in treating cancer (32:45)
The keto diet in preventing and treating cancer (34:56)
The use of mistletoe (viscum album extract) in treating cancer (44:49)
How to lower your risk of cancer (52:52)