Introduction
Dr. Eric Westman: I review and debunk nutritional misinformation online. Sometimes, I will interview movers and shakers in the nutritional world that I feel like you should know about. I have Judy Cho to talk to today. Thanks for being on my podcast.
Judy Cho: Thank you. Thank you so much for having me.
Dr. Eric Westman: How did you get into this world? How did you get into the carnivore diet?
Judy Cho: I am a board-certified holistic nutritionist. I have a private functional medicine practice. We do all things carnivore, getting people to root cause healing. But I actually started as a management consultant. I was plant-based for about 12 years, and I could attribute that to UC Berkeley. I became plant-based. I thought it was the best thing to do for my health. I used to eat big bowl salads. Beyond Meats weren’t out. Boca burgers were out, so I would eat that occasionally, but it was really like big bowl salads, low fat, and I started noticing that I was getting sick. There were two things. I was struggling with mood imbalances, but I also went off to college, so I thought maybe I struggle with depression because I’m in college, or I’m struggling because I’m away from my family. Secondly, I started having this desire to binge. I didn’t even know what that was, but I would be really “good,” and all day I’m eating plant-based vegetables – all the things you could think of – and then at night I had this incredible urge that I needed to go and binge.
Some days, when I’m really strong and really disciplined, I wouldn’t do that, and I would just have like a gallon of green tea or hot tea. But the remaining times I would go to the store, and I would binge all of the most processed, high-fat, but plant-based foods you could think of. All the junk food was on the table as long as there was no meat on it. I lived that life for probably about 12 years. I never thought once that it was a diet. I thought something was broken in me. I went to a therapist. They told me I had an eating disorder, and then even in therapy they were just telling me, “Oh, I think you suffer from depression, anxiety,” et cetera, and so then I even got on medications, and the thing is that I wasn’t getting much better.
Fast forward in time. I get married, and I have my first child, and I suffer from really severe postpartum depression – or that’s at least what they defined it as – and I end up going into the hospital because I had this mental break. To this day, they don’t know what it was. And so then I go in there, and they say, “We think she’s actually suffering from a severe eating disorder and postpartum depression, so we think she should go into an eating disorder facility to get more in-depth care.” I sort of lost my memory during that time because I had a psychotic break, I think. In there I learned great tools of mindful eating, intuitive eating, but I was still plant-based the whole time.
They were teaching me how to eat correctly, and yet I would still end up falling, binging, purging, and all those things. In that interim, I had to go on disability because I literally lost my memory. My brother happened to just find a keto diet, and I was out to actually prove him wrong – that he would die from adding sticks of butter to his coffee in the morning. Crazy enough, I ran into your book, Keto Clarity, and realized that everything I knew was misinformed information.
I started a keto diet with a plant-based diet. I started adding the olive oils, avocado oils, but still eating strictly plant-based. Occasionally I would have some fish, so I guess technically it’s pescatarian, but for the most part I was eating big bowl salads with tons of olive oil, maybe having some eggs, but generally speaking it was just plants, like the quinoa, garbanzo beans, the hummus, and again, I learned the tools in that therapy, but I wasn’t healing enough. I would end up binging and purging and then eating all the bad things.
Finally, a friend told me, “Hey, there’s this crazy diet online called ‘carnivore’. Why don’t you try it? I’ve heard some miraculous stories with depression, with all of these other chronic illnesses.” I said, “That is crazy. I would never do that. That is so bad for you.” And so I stuck to my keto plant-based diet for a while longer until I was one day in the bathroom – where that’s where you do your purging – and I said, “It’s enough.” Like, I’m at a point of desperation, at a point of “I just would prefer to sleep forever” type thing, and so I said, “I’m going to try it.”
For the first time in 12 years, I had a first bite of ground beef. I ended up throwing up but I think it was more psychosomatic. I think it was just in my head. The second time I had meat, it was great and I continued. I thought I would just do it for a little while, just to see. Within, I would say, two weeks to maybe a month, the physical desire of wanting to go out and binge – the “I’m so sorry, my husband, I have to still go out and do the things I promised you I wouldn’t do, like I can’t control myself” – actually went away. The emotional – “I’m still turning to food for X reason” – was something that I think maybe people need therapy for, but if you can strengthen the body and nourish the body properly, that battle becomes somewhat easier. I knew that there was something to this, and then I started digging deeply into nutrition.
Dr. Eric Westman: So like a lot of people, it was your own personal experience that led you to write books and get the deeper dive. That is extremely powerful. Now we know from other people like at Metabolic Mind and the Baszucki Foundation, that the keto diet, whether it be carnivore or whatever variation of it, has mental health benefits. We don’t know for how many people, but certainly for some, so that makes sense looking back at the binge eating.
Dr. Shabani Sethi at Stanford is actually doing clinical trials using the exact opposite of what dieticians are taught. The dietitian is taught not to do what you’re doing, which is to restrict binging or eating disorders.
Unlearning How to Treat Eating Disorders
Dr. Eric Westman: As you got into this, tell me the process of learning. Did you learn, again, that there shouldn’t be a restrictive diet for eating disorders, and did you have to go against that?
Judy Cho: At the eating disorder facility I went to, I was there for about 10 to 12 hours a day. We didn’t stay overnight. There’s higher care where they do that. I didn’t get covered by insurance to do that, so that’s why I did the 10 to 12 hours. In there, you worked with a dietitian, you worked with a therapist, and you worked with a psychiatrist.
The psychiatrist gives you meds, which I was on, and the biggest question I started having was, “Well, that’s weird, I went on the highest dose of antidepressants and I didn’t see a huge change.” And then they’re like, “Well, maybe you also need to get on antipsychotics.” So then I got on Zyprexa and all of these other medications, which again weren’t making me fully better.
That’s when I started thinking maybe there’s something beyond this. But in the facility it was so interesting because they were super against you being low-carb. If you were like, “I don’t eat carbs. I don’t eat sugar,” they were like, “That is an eating disorder.” But if you said, “I don’t eat any meat,” they were like, “Oh, you’re plant-based? Totally cool. We will absolutely not require you to eat.”
Dr. Eric Westman: So that’s an acceptable restrictive diet?
Judy Cho: Yeah. Totally, totally! In there, they had you eat three full meals – breakfast, lunch, and dinner – and then you had two snacks. After every meal, you would have to write down what you were feeling and what you were going through. The meals were very, very, very processed. At lunch for example, they would have these microwavable pizzas in plastic cases that you would have to eat. If you didn’t eat everything, you were still sick.
Then, they would have a “challenge food,” and the challenge food was always something very processed – a cupcake, a cookie, some dessert. If you didn’t eat that and you didn’t feel well sitting there after – mind you, there’s a ton of sugar and processed foods and seed oils – then they would say, “Oh, you’re still sick. You’re still sick because you’re having these thoughts of eating disorders, anxiety, and all of that.”
If you didn’t eat your meals, you would get dinged for it. After a certain number of meals that you didn’t eat, you were forced into a private room and maybe sometimes they would get a therapist or a helper. You would have to drink a full glass of Ensure, which supposedly has all the nutrients, but it’s filled with seed oils and high fructose corn syrup.
If you didn’t eat that, eventually you would get enforced into higher care, where you had to sleep through the night. You could eat any food as long as it fits the carbohydrate, fat, and protein macros that they had.
Dr. Eric Westman: And if you’re not tugged by the food, they would adjust the medication?
Judy Cho: Yeah, everyone was on medications. Everyone would meet with the psychiatrist. That psychiatrist in there told me, “After hearing your entire story, you were always slightly, mildly depressed.” I didn’t know if I really wanted to get on medications. They said, “If somebody breaks their arm and they need to get on a little bit of Tylenol every day until they’re better, there’s nothing wrong with getting on antidepressants and taking a little bit every day, because if you have a broken arm, you would take it.”
That logic made sense to me so I was like, “Okay, if this will help me get back to my family and have a ‘normal’ life, then I’m willing to do that.” But it just didn’t work. And so most people on there were at least on three medications: an antidepressant, an anti-anxiety, and then some people were on an antipsychotic.
The Pivotal Moment
Dr. Eric Westman: How long did this go on, and when did you have an ‘aha’ moment?
Judy Cho: I was in there for about a few weeks until insurance kicked me out. I was still in care, but it was a lot less. Around that time, I found out my brother was doing the keto diet. Once I learned and then went through and started eating carnivore, I got really mad. I genuinely believed that I was broken, that I was mildly depressed my whole life, and that I needed the medications to be better. Then, once I got on carnivore – I think faith played a part in my healing too, the therapy really helped – understanding what my needs, my wants, and the needs I need to share with my loved ones are really helped. But I think what really happened is I started getting really mad that I didn’t actually feel depressed anymore.
I weaned myself off the medications slowly. Thank goodness I didn’t have an adverse reaction; I think it’s because I used it for less than a year. I started eating carnivore. I wasn’t having those cravings at night anymore and that made me dig deep into all the books that were written when Keto Clarity came out.
I had young children by then, and I decided I wanted to go back to nutrition and understand the anatomy and the biology of the body so that I could at least feed my children well. Because something happened in me where now I’m healing by eating meat. I didn’t understand why, but I wanted to understand. I went back to nutritional therapy school during disability, and I learned so much in that time.
Out of pure boredom I started sharing graphics online because I was a consultant who created PowerPoints and presentations for C-suite people. I used that creative knowledge to then use it for carnivore because there were no carnivore pyramids, only keto. I shared it under a fake name because I just wanted to put a creative outlet out there while I was on disability. It took off.
I never once thought I would change my career because I really was doing this for my own healing and then to feed my kids. But I started sharing, and I noticed a lot of people are sick. I just felt like if I could just create one book, just like Keto Clarity did for me, and I could just share all the things I learned and why I’m so upset about it, if I could just give back to the community that helped me heal in an indirect way, then that’s how I fell into everything.
Food is Medicine
Dr. Eric Westman: The idea that the eating disorder is treating the food reminded me of Rob Lustig’s statement that good food is medicine, bad food requires medicine. We’re treating the food’s effect on you. Most doctors don’t understand the benefit of food or how powerful it can be in helping or in harming. Then, you bring out the pretty stark reality that a plant-based approach takes away all animal products, and a carnivore-based approach takes all plant-based – they’re very similar in their restrictiveness, yet one has almost brainwashed people.
Judy Cho: When I look back to how I was suffering, one, I was eating low fat, and I don’t think that was the only reason because I also did keto, a plant-based version of keto, but it did help a lot. There was a level of satiation. Your hormones – your sex hormones, your cortisol – all need a sufficient amount of cholesterol. I think the big thing is that the brain-gut axis is very connected. Your gut feels something; it sends messengers up to your brain and then vice versa. When I was eating just processed foods my gut was in disarray. I also used laxatives. That was another way that I was purging. Most of your serotonin, or your happy endorphins and hormones, are made in your gut. While it doesn’t go to your brain per se, all of it communicates with each other.
As I started eating carnivore, I did use some gut supports like hydrochloric acid or digestive enzymes. But as my gut healed and I wasn’t using any of those laxatives that I used for years and I was abusing those, my brain fog, my depression, all of that was also going away. There is absolutely a connection. Not only is it that processed foods wreck your gut and your body, but it’s also not giving enough nutrition for you to have the adequate hormones, the vitamins and minerals, to get all the things in your body to work properly.
As I started feeding my body the right foods, my depression went away. I wasn’t having gut issues. My immune system started healing. I used to suffer from allergies and eczema, and I don’t suffer from those things anymore. I was getting all of these other benefits.
If you talk to my husband – before carnivore, one day I would be angry and temperamental. Other days, I would be more subdued. Now, I am so consistent in my mood and energy. Sure, I have days where I might be cranky, but overall, the healing that I’ve had through a carnivore diet — and only because I tried a carnivore diet — and as I’ve healed, I don’t ever suffer from a day of depression. That just shows you how important what we feed is to our bodies. We know that because when we go to the vet, they say, “Well, if your dog’s sick, what are you feeding your dog?” Yet we never ask that for humans.
Is It Necessary To Go Fully Carnivore?
Dr. Eric Westman: I am always optimistic that there’ll be more practitioners doing this. I’ve been teaching 20 total gram carbs per day for over 25 years now. I’ve learned a lot from my patient care, for sure. Do you really need to go to carnivore? Or is carnivore-ish, with two cups of leafy greens, one cup of a non-starchy vegetable, low enough on the carbs?
In my clinical experience, there are some people who eat some veg – even though it’s very little veg – and then go to no veggies and they do get a change. Some get off a plateau, some have the arthritis symptoms going away. Do you have to go carnivore?
Judy Cho: Our practice works with the people for whom carnivore doesn’t work enough or diet doesn’t work enough. We get the most complex, chronically ill cases so we get to learn a lot from that. With that said, if it was just my journey, I would say not everyone needs to go super strict carnivore. I’m not super strict carnivore. I make it a point to share that because I don’t want people to think perfection is the only way to heal. I know that in End Your Carb Confusion you share that consistency is more important than perfection because if you’re perfect one day and then you fail for five days, what’s the point of perfection?
I think it’s really nuanced. It depends on the person. If we are trying to remove diet as a factor for your chronic illness, then maybe going strict for a period is really good for you. Then it’s figuring out, as you heal and you are healing with the diet, maybe sometimes it’s the environment. It could be mold, or Lyme, or MCAS, or something else, or even the mind-body – viewing the world in such a negative way that it’s causing you to release more cortisol in the morning. Assuming that the diet is fundamental, which I believe, then it’s figuring out, okay, so if you’ve healed enough with carnivore or strict carnivore, where will you be your best at being consistent?
For me, when I was eating beef, salt, and water, it lasted maybe four months, and I noticed that I wanted the chicken but people said the stricter you are, the better you’ll be. I was struggling even though I didn’t have a food sensitivity. My thing was mood imbalances, my depression. And so I’m like, I can’t eat the chicken though, I’m not allowed to. Finally, I got to a point where I’m like, I need to make this more practical. As I ate everything in the animal kingdom, I was healing even further and it wasn’t as difficult. I think what really matters is people finding the balance that they can be more consistent. If they’re consistently eating carnivore-ish – so the 20 grams – but they’re not healing enough, then maybe at that point, now you’re already adjusted to carnivore plus 20 grams. Why not remove the 20 grams just for a short bit to see if the extra healing can happen? It’s very nuanced. I wish I could just say for everybody, we should do this, but it doesn’t work that way. If you are eating 20 grams carnivore and still not fully better, you can always try zero-carb carnivore and then see how you do.
Dr. Eric Westman: And the individual preferences are really important. Some people are happy as a clam to just eat meat. Others want the variety. Those who don’t know anything about this world say, “How could anyone ever do this?” Well, if you reverse your diabetes or fix some other severe medical issue just by changing the food, and now you’re off all the medicines, of course it’s relatively easy to do this, right?
Judy Cho: They say it’s either divine inspiration or it’s just being at rock bottom. Those are the two ways most people change. For me, I would have never done a carnivore diet had I not been rock bottom. When I was in the hospital, I stopped nursing my child. I don’t even remember how I stopped nursing my first child because I lost my memory. The number one fear of any mom, as a first-time mom, is, “I will be a bad mom” and I completely failed. When I had to go to my eating disorder facility, my mom took care of my son 1,800 miles from me. That is a big enough reason. And then to learn that my diet was a fundamental reason I got sick, that I wasn’t even able to spend New Year’s with my child, that I was forced to stop breastfeeding – all of those things could have been circumvented by eating the right diet. That is enough of a passion and a reason to start saying, I’m going to help other people and share what I’ve learned because no one should go through the angst, the pain, that I went through.
I don’t even suffer from an eating disorder anymore. I still say I’m in remission because anybody could always fall back into their addictions but I am healing for years now and I will never go back to eating a lot of carbs. I might have an occasional small garden salad if I want to, but I can handle that and I can test my boundaries of my eating disorder by doing that. But I would never ever go back to the way I used to eat. Meat-based carnivore will always be my preference because it has given me my life back. It has allowed me to live my life with my children, be present without being in my mind with an eating disorder, and now I can serve others. What a great way to live.
Traditional Thinking Versus Carnivore
Dr. Eric Westman: When dietitians or even the general public are first given the idea that there is such a thing as carnivore, there are all sorts of concerns about nutritional deficiencies and vitamins and where are you going to get the fiber and all this. How have you reconciled traditional teaching with a carnivore diet?
Judy Cho: One of the first things we hear is obviously vitamin C. When I did the research for that book right there, for Carnivore Cure, the dosage for vitamin C, I think in the 1970s, was 45 milligrams for men and in the 2000s they upped it to 90. So we have to wonder, what happened where now they’re saying in order for a person to have a decent amount of vitamin C, it has doubled in less than 30 years? I think it was Amber O’Hearn that found this data where the glucose receptor also competes with vitamin C. Could it be that we are eating so much more sugar than we used to, and instead of saying, maybe we reduce the glucose or the sugar coming in that’s competing with vitamin C, instead let’s just up the vitamin C amounts. I like to also put on my logical hat of, well, my second child, which I got a do-over with for breastfeeding, he, for one full year, did not eat anything for the most part other than breast milk. Breast milk has almost zero vitamin C. How did he thrive from being a seven-pound baby to being, I don’t know, 15 pounds later?
It’s just that we are fed these things, again, which I fully believed and became plant-based. I was even part of the PETA community, and I believed in all of it until I lost my health and nearly my life. Then you realize a lot of what we are fed is misinformation and incorrect. If we think about just even 200 years ago, how many of the people that were eating meat were also getting a plethora of vegetables and fruits and all of these things? They didn’t have those opportunities. I just think that we were fed a message that is probably incorrect and it is absolutely harmful to our health. For vitamin C, I don’t think we need as much, and we see the data. I almost never eat fruit. I would probably say never and I’ve never had a vitamin C deficiency. I’ve been eating carnivore for over seven years and I feel great. I don’t think it’s a vitamin C deficiency.
We do a lot of functional testing in our practice, which I love that we do. We get to see all the short-chain fatty acids. The recommendation is for us to eat fiber or plants that are fibrous because then those fibers in our colon are then converted to short-chain fatty acids, and it is the short-chain fatty acids that we need for utmost colon health. We see in our carnivore practice, it doesn’t matter how long they’ve been on carnivore, the short-chain fatty acid ranges are all over the map. So some people may have some, like you said, blueberries or some leafy greens – they could still be really low in short-chain fatty acids. And then we see carnivores where they’re not eating any plants and their short-chain fatty acids are within range. So there is something more than just fiber. Also, the beta-hydroxybutyrate of ketones – there is a form that your colon will use. Butyrate – butter is actually derived from “butyrum”, and butyrum is a version of butter, and so it actually has some of the most amounts of short-chain fatty acids. Lastly, a lot of your colon uses the end mammalian cells to produce the nourishment that it needs. There’s just a lot of misinformation in terms of the need for fiber. And in fact, we see that people that reduce their fiber actually feel better gut health overall.
What Carnivore Can Fix
Dr. Eric Westman: In my experience with my patients, having fiber is just creating gas, bloating, and more stool.
Using this diet, what kinds of things have you seen fixed? Have you seen any nutritional concerns in your practice?
Judy Cho: One thing I want to say is I think that with modern medicine – we tend to look a lot at labs. I think they’re important because it shows data, but I really think the biggest thing for everyone that’s listening and watching is your symptoms. Back in the day when they didn’t have testing, they went by symptoms. If you can track your symptoms – so if you start carnivore with brain fog and fatigue, rate it from 1 to 10, and then every week you check in on where it is now. If you see healing, does it really matter that you might be eating lower than the vitamin C amounts that the recommended daily allowance recommends? Until you’re at a point where things are breaking or not working, then you can look at, okay, well maybe let’s do some nutrient status testing. Maybe we do further testing to get us more answers. But if you’re moving in the right direction with your sleep, stool, hormones, energy, and then all the symptoms reducing, then I call that a win. And so, from my practice, that’s what I generally recommend.
With all that said, we don’t see nutrient deficiencies. Some people will have some, and it might be very little, but generally speaking, the biggest thing we recommend is gut healing from the beginning. Some people may be eating a lot of protein, but they’re not digesting, breaking it down, absorbing, and assimilating it. If you start with some gut supports, that could be a big thing. But generally speaking, it’s not like, oh, because of carnivore you’re deficient in this. We rarely see that. We might see folate low, but it’s because maybe they have the MTHFR gene, so they need methylfolate instead of regular folate.
I will say also, I’m not a big fan of organ meats. It’s okay if people want to consume it, but the reason is liver in itself has a lot of vitamin A and a lot of copper, and it just causes an imbalance. Occasionally eating it I think is totally fine, but too much of it in excess is not ideal.
Dr. Eric Westman: You’re in a clinical practice. You mentioned brain fog, fatigue, and gut health. Have you seen any other diseases or syndromes improve?
Judy Cho: We see pretty much everything. If you think of modern disease as chronic inflammation, and every food we eat is either a friend or foe to our immune system, and our immune system is mostly lined in the gut – 70 to 80% of our immune health is in our gut – and it’s because it’s the one place we’re allowing foreign stuff to come in. Every time you have a bite, you are creating some level of inflammation in the body, especially if the food is a foe instead of a friend. If you eat a carnivore diet, that overall systemic inflammation is reduced. We are actually doing blood markers on a part of the immune system that shows that level of reduction. In that reduction of inflammation, you start seeing people healing everything. We have a patient that had MS, hypothyroid or Hashimoto’s, super sensitive to all foods, couldn’t even eat dairy without a mast cell or histamine response, and now eats keto and is perfectly fine with it. If they ever start showing symptoms, they’ll just go stricter for a period until they start healing again.
There is no person to whom we say, “Oh, for you a carnivore diet is not going to help you.” One thing we see is for people that are super, super lean, that are almost underweight, those people get an appetite by adding carbohydrates. That’s one thing we’ve seen. But other than that, there is no one that couldn’t go strict carnivore if they balance things, whether it’s digestive support or the macros or the meal timings. In fact, every illness we see, we see benefits by eating a meat-based or carnivore diet.
Mast Cell Activation Syndrome (MCAS)
Dr. Eric Westman: I do see more and more people who have the mast cell problem. Can you tell me a little more about that?
Judy Cho: The simplest way to share it is mast cells are the first defense of our immune system. They are white blood cells. When the body has an invader – it could be a food, it could be a toxin in the air, it could be mold in the home, it could literally be anything – your mast cells send out chemical mediators. They’re basically messages to the rest of the body, sharing, “Hey, there’s a foreign invader, we need to go on the attack.” One of those chemical mediators –and there’s thousands of them – is histamine. I know people say histamines, but it’s actually a mast cell response. Your mast cells then are having this war with whatever the invader is, whether, again, it’s allergies or a food you’re eating. That war, depending on how severe that war is, causes the symptoms you will be feeling. That’s why people will get hives after they eat something, or they’ll get brain fog. It really depends on the person on how they react.
Once that bucket is full – your immune system is reacting – you will go out and maybe the allergies that never used to bother you now are bothering you. Tree pollen is actually affecting you when before it wasn’t. It’s because you’re adding to the mast cell war.
The goal is, how do you reduce the noise of the mast cells? Obviously, supporting your gut. There are certain meats that have more histamines than others. Aged and canned meats will have more. Seafood tends to have more histamines. Same with organ meat and caviar. But beyond that, you can also reduce a lot of the plants because plants can have histamines. If you’re eating strict carnivore and it’s still not fully going away – it’s better but not enough – then I would highly recommend looking at the environment. The environment is what you breathe in – we all know that from COVID. That can also cause your mast cells to be slightly reacting and you don’t realize it. And then add the food, add the stress, add whatever else, and now you’re reacting to everything.
Moving Away From Medication
Dr. Eric Westman: I’d really like to see an expert in the mast cell area start shifting from just the drugs. I have a patient who was on every antihistamine known, even with prednisone, to try to calm that mast cell defense mechanism and then on her own cut out all the foods creating that effect and is off the medicine. If you do it in a simple way, it actually can be simple. If you can figure out that you’re not going to have hives because you’re not eating peppers, it’s an important thing to know rather than just medicating the green pepper response that caused your hives.
It’s fascinating because I didn’t get much training in medical school, nor did most doctors who have gone through American medical schools at DO schools. One of my patients taught me, as she was in the eating disorders unit at a local university hospital for anorexia, that she wasn’t in the right place. She was trying to tell them that her stomach was hurting and they were giving her medicine for her brain. She found a carnivore diet, an elimination diet. She basically fixed her own anorexia. Now, when someone comes in and says, “When I eat such and such, it hurts,or I have hives,” I pay attention.
Judy Cho: I think that in our society, we want everything yesterday. It’s the quicker fix. I think that’s why people get on medications. To say, “You have to eat this way forever,” sounds almost daunting. But I love using the thought of, well, if you are sick and tired of being sick and tired, you’ve been to so many doctors, why don’t you just try eating low-carb or reducing a lot of the processed foods and then having meat as the center of your plate? Whatever meat you want to eat, I’m totally fine with that, and then see how much you heal in a few weeks. Give it two weeks to a month (obviously, a hundred days would be ideal). You can always go back to whatever you want to do.
A lot of times when people taste healing and they feel how good it feels to feel good, they remember that. Then that’s the motivation they need to want that change. Because before that, it does sound crazy – all meat, carnivore – that sounds insane. But if you get some of your health back, it doesn’t matter what people are saying. I think it’s just try it, track your symptoms, and if it doesn’t work for you, then maybe you add some other stuff back.
The truth about medications is, yeah, it might work initially. It’s blunting some of the immune function, but your body is the number one way to know if you have health. If you have symptoms, that’s your body telling you, “Hey, something’s wrong. Go investigate it because things are breaking down.” When you start taking medications to mute that, in the beginning it may give you your life back, but long term your immune system is smart. It is trying to fight you by blunting that. There’s also a root cause. If you don’t figure that out, those are the things that then lead to Parkinson’s, Alzheimer’s, cancers, and all of these other things that we could have fixed initially by eating the diet that was meant for us to eat as humans.
Alpha-Gal Syndrome (AGS)
Dr. Eric Westman: There is a condition where people can’t eat mammalian meat called alpha-gal syndrome. It is a reaction to a tick bite and that is often hard to figure out. People will be in the urgent care or emergency room, sometimes with anaphylactic shock, meaning they’re flat out and the doctors scratch their head, don’t know how to figure it out. So if someone does try carnivore or you’re switching to eating meat, that initial “Oh, I’m not used to it” should go away quickly. If you have a reaction, it’s not common by any means, but there is a situation where the alpha-gal reaction means you just want to stay away from the mammalian meat. How common that is in your practice. Have you seen that?
Judy Cho: We do work with people with chronic Lyme. We have tested a few people with alpha-gal. We test the immunoglobulins or the IgMs. We haven’t seen it positive yet, but there are people who have had alpha-gal. My understanding with alpha-gal is that if you have alpha-gal and then you eat red meat, all of the immune stuff will affect you and then it could, like you said, cause anaphylactic shock. If you stay away from the red meat for a period, it could actually go through your system, and then if you support it, you might be able to eat meat again. You could temporarily not eat red meat and treat the alpha-gal, then you’re probably able to eat it again. Ideally, you try not to get those tick bites again, because my understanding from the Lyme world is if you get a second alpha-gal exposure, there is a chance that it could be a forever thing. In that period you should eat chicken and all the other meats that are not beef and pork. (Note: people with alpha-gal syndrome can safely consume poultry, eggs, seafood, and other non-mammalian proteins.)
The best thing is to be preventative. Oftentimes people don’t know where they got the tick bite but if there’s a place you always go hiking, you may just want to be extra cautious in being outdoors so that you don’t get the same exposure.
Dr. Eric Westman: You can follow this with the blood test. Like you said, you follow the antibody level in the blood, and in most cases it does fade over time. Yet, the individual is pretty reluctant to test it, I have to say, if they’ve had a severe reaction. But yes, you can eat eggs and other low-carb things – fish, for example. It’s the mammalian protein you’d want to avoid. Hopefully if you’re watching this, you will never have to come across this. I just wanted to think of one instance where you wouldn’t want to do a carnivore diet, at least temporarily.
The Efficacy of a Carnivore Diet
Dr. Eric Westman: How many people do you think have been doing a carnivore diet and for how long? How confident are you that it is safe in the long run?
Judy Cho: I’ve been carnivore for over seven years. Granted, in the last four years, I’ve added occasional, probably less than 10 grams of carbs. My main meals are steak, eggs, butter, and then I try to get in omega, so I try to eat sardines or salmon. I eat chicken wings, I eat pork, I eat the rainbow of meats. Sometimes I might have celery, but not often. I still try to share and demonstrate that I’m not a perfect carnivore and I could still have health even without being perfectly strict. With all that said, I think the last time I was in Shawn Baker’s Facebook group, I think he had almost 100,000 people. I don’t really know what the number is, but in our practice we’ve already worked with 2,500. These are people that are super, super sick, yet carnivore still helps them. They’re just working on other stuff in addition to the diet. In our practice, there has never been a “Oh, we need to get off this diet, it’s not working,” or “somebody needs to be plant-based because of this.” There has been none of that. In fact, we’ve had a few plant-based people that have changed their lives from working with us and going carnivore.
I’m a firm believer in the diet. I think it is the way we’re supposed to eat. Whether you argue it in nutrition, gut health, your mood imbalances, autoimmune, chronic illness – everything – the answer of carnivore or a low-carb diet or keto diet just answers a lot of the issues that we have today for modern illness.
Is Carnivore Dangerous?
Dr. Eric Westman: Have you, in your experience, never seen anyone harmed by the diet?
Judy Cho: Not harmed. What I would say is, one thing I love about carnivore is that it’s the ultimate elimination diet. For some people – we know in our practice, in working with the chronically ill – there’s just a subset for whom diet won’t fix everything. If they’re living in a moldy home, for example, the inflammation from the mold spores and the mycotoxins will cause them to have inflammation, but they will still find benefits eating carnivore. If you’re already having inflammation from the moldy home, and it’s already at a certain level, the mast cells are higher, and then you’re eating cup of noodles for your dinner – you could imagine the inflammation that’s added to that versus, even if your full inflammation doesn’t go down because you’re living in a home that has bad air quality, but then you add carnivore, the reduction of noise on the diet side is gone. That’s where carnivore is still good. To answer – yes, there has been no harm, but sometimes people need more help than just diet alone. But the fundamental diet we will always recommend that we have seen the most efficacy is keto/carnivore.
Can Carnivore Cause Hair Loss?
Dr. Eric Westman: If someone’s doing it for diabetes reversal or weight loss, weight loss can make things happen. I have a subset of folks who have telogen effluvium – they have hair loss because they’re losing weight. It’s not the particular method that they’re using. Do some people lose weight and lose hair on the carnivore diet?
Judy Cho: The number one thing we see is, especially women, undereat. I think all the people that have a little bit of weight on them are the ones that diet the most. Their whole lives they’re trying to get off this diet cycle, and they want to eat cleaner but they just don’t have the right tools or the right diet. As soon as they go on keto or carnivore, they’re not as hungry because their insulin’s going down, their blood sugar is regulating and so then they tend to undereat. There’s still this stigma around eating fat. People think fat makes me fat, there’s that myth. What we see in our practice is there will be women that maybe undereat on a carnivore diet. They’re undereating protein and then undereating fat, so their calories are super low, and then in three months’ time, their hair may be coming out.
It could be several things. It could be the diet change itself – going from a standard American diet to a keto diet will absolutely change things. Your body is now using ketones more than glucose, so that shift may cause a stress on your body temporarily, which will cause your hair to shed. If your hair is still shedding a year in or six months in, it oftentimes is because people are undereating and undereating fat. We need to get our energy a lot of times from the ketones or fat. We have noticed that for people under eating, that impacts their thyroid. So when we hear, “Carnivore ruined my thyroid,” or “Keto ruined my thyroid,” no, it’s oftentimes that the tool was not used properly. I would just make sure that people are eating sufficiently.
Constipation and Muscle Cramps
Dr. Eric Westman: How do you handle constipation and muscle cramps?
Judy Cho: The number one reason we see constipation is also undereating, or if people are eating too lean of meats without enough fat. You’re not having the peristalsis or your colon moving. Under-drinking water is also a problem. When you’re not eating sugar, salt, and fat together, you’re not as thirsty, so people tend to under-drink water. I’m not going to say how much to drink, but if you could ideally drink the ideal weight that you’re supposed to be, and then half of your ounces in that – so if I’m supposed to ideally be 100 pounds, I would ideally try to hit 50 ounces of water. It’s going to be nuanced, though, but if you are constipated, I would try hydration. You could even try a little bit of sole water in the morning to see if the minerals will help the peristalsis.
Ensure that you’re eating sufficiently. Make sure you’re eating enough protein and fat. I think most people that see the way I eat, even though I’m on the leaner side, will often, “Wow, you eat a lot of meat.” That’s the first thing that people say to me. I just think that it’s a little bit more meat than we’re used to. I think that as an example, if you weigh about 130 lbs, you should be eating at least 20 ounces of meat a day. I know that’s so general, but just making sure you’re eating sufficiently. Usually we will see constipation improve with that.
In terms of electrolytes, it depends. If patients are doing carnivore and they’re eating sufficient salt and their blood sugar is balanced and they’re not super stressed, we will start testing for aldosterone or ADH, or antidiuretic hormone. Sometimes that can be imbalanced because of environmental illness and it has nothing to do with the diet. What I love about carnivore is you remove all the noise, so everything starts quieting down. I take zero electrolytes and I’m seven years into this diet. If I ever feel leg cramps coming in, headache, I’ll take some of the sole water, or I’ll take electrolyte powder, but I rarely ever take it because I don’t need it. My body has assimilated. For people that can’t balance even five years out or a few years out, it could be something with the environment, because the antidiuretic hormone or the aldosterone is what tells the kidneys to retain water or not. When you’re eating low-carb, you retain less water. When you’re eating carbs, since you have more water, it mutes the imbalance that aldosterone or ADH is causing but when you reduce the carbs, that imbalance that was there is now being pronounced. When people are like, “Oh, the low-carb diet makes me feel electrolyte imbalances,” you’re maybe just aware of an imbalance that was always there.
I challenge the salt sensitivity. If people are balanced at a certain point and they’re still sensitive to salt, saying “I only feel better on carnivore if I eat zero salt,” I think there’s something imbalanced in their system. The average person can eat salt and their body is able to regulate the salt and potassium and all of that. We have levers in our system that say, okay, more water, release, kidneys release. 95% of the people could do carnivore with salt. Why can’t you? I believe there’s a bigger root cause that they haven’t investigated. But still, you could do what’s working for you.
Judy Cho’s Book – Carnivore Cure
Dr. Eric Westman: Can you tell me a little about your books, please?
Judy Cho: Carnivore Cure is a lot more of the science of why carnivore is ideal. It touches on a lot of the hot topics that are actually coming out lately – food dyes, aluminum, fluoride, even some of the adjuvants and vaccines. It’s all touched on there, and then why a carnivore elimination diet actually has enough nutrition. Then, it has the elimination protocol. I’ll give you a link. We have a cheat sheet to our elimination protocol, even if you don’t want to buy the book. Then, I have a beginner’s guide, which still shares some of the science, but it’s a lot more simplified because some people don’t care about all the science. They’re just like, “Tell me what to do.” And so it shares a little bit about if you eat processed foods and why it’s not necessarily ideal, and then still getting to the elimination diet.
Watch the full video here.
Speaker Bios
Eric Westman, MD, MHS, is an Associate Professor of Medicine at Duke University, the Medical Director of Adapt Your Life Academy and the founder of the Duke Keto Medicine Clinic in Durham, North Carolina. He is board-certified in Internal Medicine and Obesity Medicine and has a master’s degree in clinical research. As a past President of the Obesity Medicine Association and a Fellow of the Obesity Society. Dr. Westman was named “Bariatrician of the Year” for his work in advancing the field of obesity medicine. He is a best-selling author of several books relating to ketogenic diets as well as co-author on over 100 peer-reviewed publications related to ketogenic diets, type 2 diabetes, obesity, smoking cessation, and more. He is an internationally recognized expert on the therapeutic use of dietary carbohydrate restriction and has helped thousands of people in his clinic and far beyond, by way of his famous “Page 4” food list.
Judy Cho is a functional medicine practitioner, board certified in holistic nutrition, and holds multiple degrees from the University of California, Berkeley. Judy is host of the health podcast Nutrition with Judy, author of the best-selling books, Carnivore Cure and The Complete Carnivore Diet for Beginners, and founder of Nutriment, the most comprehensive elimination and reintroduction resource tool. Judy shares her very raw and personal journey, here. While she hid the details of her shameful history for so long, she now shares publicly to shed light on this debilitating disease. Animal-based foods gave Judy a second chance at life and she is passionate to give back, healing the world one steak at a time.
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