Introducing Dr. Anthony Chaffee
Dr. Eric Westman: It’s my pleasure to meet, for the first time, and talk to Dr. Anthony Chaffee.
Dr. Anthony Chaffee: It’s a pleasure to meet you as well. I’ve been looking forward to this.
Dr. Eric Westman: Tell me a little about yourself. Imagine we’re talking to my patients.
They come to me for diabetes reversal, obesity reversal, and all sorts of disease reversals that I couldn’t have predicted 25 years ago when two of my patients used the Atkins diet to lose weight. I thought this would be easy. We’ll publish a few papers, and there will be no more obesity left. That was 25 years ago.
I’m very curious, where are you from? The training you got, and how did you come to where you are now?
Where he came from, his training, and where he is at now
Dr. Anthony Chaffee: I grew up in Southern California and Seattle. I went to high school and then university in Seattle. I did my undergraduate degree at the University of Washington and then transferred for my last year, actually finishing up in Arizona at the University of Arizona.
I played professional rugby at the highest levels I could and then professionally after college. I played at all the highest levels in the U.S., Super League in America, and Premiership in Canada, and I also represented the side. I was an All-American, and I went overseas to play professionally in England.
I really liked it over there. I enjoyed living abroad. My grandfather had been a Rhodes Scholar at Oxford, did his PhD there, and had all these great stories of doing grad school overseas. I thought it would be fun to do the same thing, so I ended up going to medical school at the Royal College of Surgeons in Ireland.
I was there for four years of medical school and then two years as a doctor after that. My parents were having some health issues, and I had been focusing on neurosurgery. I was going to continue in neurosurgery. I had very close ties to the neurosurgical department there and really liked the department, but my parents became unwell, and I wanted to come back and help them.
So, I was back in Seattle helping my folks. When that settled down, I heard about a humanitarian crisis in Bangladesh with the Rohingya refugees, who were escaping an actual genocide in Burma in 2017. I went over there in 2017, stayed until early 2018, and helped out in the refugee camps. When I came back, I started looking into where I wanted to go and finish up my residency. Should I go back to Europe, or should I come back to America? I did my sub-internship in plastic reconstructive surgery at Duke, and I absolutely loved it there. I thought maybe I should look around here.
I ended up deciding to come to Australia, probably because of the rugby connection. I had been all over the world with rugby, to New Zealand, South Africa, and Europe, but I’d never quite made it to Australia. I had some friends that I’d played rugby with professionally in England who were now living down here, and they really liked it. Some doctors that I knew from medical school were down here as well. So, all else being equal, I just decided to come and check it out. I got back into neurosurgery here, working as a neurosurgical registrar, which would be equivalent to a resident in America, and did that for about four years. I have subsequently transitioned into private practice in the metabolic health space, applying diet, lifestyle, and nutrition interventions, as well as allopathic medicine, to help my patients.
Dr. Eric Westman: For those who don’t know about medical training and neurosurgery, it’s got to be the most difficult, arduous, and longest path, even among surgical specialties. Neurosurgery is very much a pyramid; not everyone gets to the top.
The joke was, ‘You mean you’re always on call”. When I started hearing, you’re a neurosurgery resident and you’re doing this, I thought, come on. Although I have to say, the neurosurgeons I’ve met are superhuman types. Those are the ones who can stay up all night for a week and still go in and do a craniotomy. It kind of fits that, of course, you’d be playing rugby and being at the top of the game, and so that makes a lot of sense.
You kind of transitioned to a metabolic practice. I wondered about a couple of things. Did your rugby and fitness experience, your athletic experience, get you into this metabolic health, or was that a distraction?
How he got into metabolic health
Dr. Anthony Chaffee: I think that it certainly was complementary because I was studying biology and all the different prerequisites. I was interested in biology, chemistry, and human physiology just because, since I was a kid, I’d wanted to be a doctor. That always fascinated me. My parents instilled in us the importance of nutrition for health, so that was always something in the back of my head.
I studied nutrition because I thought, how do we make people as healthy as possible? Nutrition is obviously going to be a major component of that. Then, you learn medicine to treat all the things that nutrition, lifestyle, and those sorts of interventions can’t help with, when things go really wrong and you actually need help. That’s what medicine is in its raw form.
So, I was always interested in nutrition. I would take nutrition classes, but what really sparked this for me is sort of a funny story and the progenitor of some of the videos that I’ve named with shocking titles.
I studied botany and biology. I understood that plants have toxins and defend themselves in this chemical nature. We’ve identified, cataloged, quantified, and named about a million different defensive chemicals that plants use to stop predation. Animals and plants are in that evolutionary arms race, plants becoming more and more toxic so fewer animals can eat them, and animals becoming more and more adapted to specific poisons in specific plants so they can survive and thrive. That’s their evolutionary niche.
I understood that, but then you go home and eat your vegetables. There’s this sort of separation – nature and humanity as two separate things – when, of course, they’re one.
Toxins in plants, fruits and vegetables
I had a professor of cancer biology when I was at the University of Washington who really impressed this upon us. He explained how these toxins weren’t just in the plants in the woods, the ones you couldn’t eat. They were in all plants, even the fruits and vegetables we ate.
This was specifically a cancer biology class about carcinogens. He said there were 136 known carcinogens identified in brussels sprouts back in 2000 when I took this class. There were over 100 in mushrooms, and 60 or 80 in broccoli, cabbage, celery, cucumber, and other produce items we would normally eat.
We were very shocked by this. He went into further research about how harmful this stuff was and explained that it was, many times, hundreds of times more likely to cause cancer in lab studies than various pesticides used on them.
We thought he must be joking. We were looking around wildly for a TA in the back to be snickering or something, but there wasn’t one. At a certain point, we realized, this guy was serious.
We all settled down. I remember thinking, “But vegetables are still good for you though, right? I mean, overall?” He gave us a bit of a funny look and just said, “I don’t eat salad. I don’t eat vegetables. I don’t let my kids eat vegetables. Plants are trying to kill you.”
That sold me.
I went to the grocery store after that and looked for anything that didn’t have a plant. I realized that almost everything had plant ingredients or was predominantly or solely made from plants and grains, etc. I finally came across eggs and meat, and I just said that’s what I’m going to eat.
My entire litmus test for what I was going to eat for the next five years was: does it have a plant? No? Fine. Yes? Then no.
I felt absolutely amazing. I was playing better than I ever had in my entire life. I was already an All-American, and this launched me to new heights. I felt incredible, I was on a different level than the people around me.
Then, I was in England playing professionally, and I slipped off because some of the meat I was buying had crumbs on it. I thought the dose made the poison. Maybe it’s not that big of a deal, the same argument that people throw at me now: “Plants have toxins, but dose makes the poison.” Sure, the dose does make the poison, but it’s actually a lot smaller than we think.
I absolutely noticed a huge drop-off in my performance and how I felt. I started getting soreness, aches, and little niggling injuries that were never there before. I didn’t understand what was going on. I thought I needed surgery or something because I had a groin pull, and I was like, “What is going on?”
That opened the door to let other foods in. I ate a very clean diet. I never ate processed food. The argument is that people on a carnivore diet improve because they’re getting away from junk food. But I never ate junk food. I ate a very clean omnivorous diet with lean meats, fruits, and vegetables, and really no sugar.
I was never a big bread or sugar person, so I naturally swung to a more ketogenic diet simply out of preference, I didn’t eat many carbs out of habit. But then, adding in a bit more vegetables, I would basically still eat lean meats and salads because you’re supposed to eat salads. I did not feel the same.
I chalked it up to age, but that doesn’t make sense because when I was 25, I felt like a superhero. When I was 25 and a half, I did not. I couldn’t figure out what was going on, but there was a clear line in how I felt. After a few weeks, I was like, “Wait, what’s going on? What’s happening?”
Humans are biologically carnivores
It took me a long time to figure that out. It took another 12 or 13 years. Right when I got back from Bangladesh in 2018, I came across information that really convinced me that humans are biologically carnivores.
We’ve been apex predators for millions of years. Apex predators, by definition, are carnivores. We have very strong evidence that people were thriving in the Arctic Circle during the Ice Ages. We had people traveling by foot across the land bridge from Asia to North America in the last Ice Age.
This was a time when the middle of America and Seattle were under a mile-high block of ice. What exactly is there to eat in those conditions besides meat? That sort of clicked for me: okay, that’s what I was doing. Biologically, humans are carnivores.
We’re most adapted to meat. There’s this biological law of adaptation, what you’ve been exposed to the longest is what your species is better equipped to eat. That’s what I was doing. I was eating as a carnivore. I was eating to our biological design, and I felt better than I ever had. I said, “Right. I knew it. I knew plants were trying to kill me. Get rid of these stupid things.” I stopped eating them.
I was already ketogenic at that time. I had gravitated away from carbohydrates because I felt the inflammation. My back hurt whenever I ate carbs. It was very simple: whenever I had a spring roll or sourdough bites, my back would hurt for several days. I didn’t like that, so I naturally gravitated away.
I was just eating vegetables and lean meat, not much meat, and a lot of vegetables because that’s what you’re supposed to do. I was trying to lean up and get healthy so I could get back to playing rugby.
As soon as I dropped the vegetables and started eating a lot more meat, especially fatty meat because I came across data showing it’s not actually harmful and is an essential nutrient, I felt massively better. I lost a significant amount of weight in the first few weeks, which I think was largely due to reduced inflammation, but there was some fat loss there, too.
I started honing my body composition, shedding a lot of fat, and putting on a lot of muscle because I was working out heavily. After about two weeks, I felt so good I said, “It’s time to go back and play rugby.” At 38 years old, I went back and started playing professional rugby.
I felt so good, I was back. I felt like I was 22 again.
Dr. Eric Westman: Was the rugby world involved in this? Gater Brookner, a coach in Australia, and Prof. Timothy Noakes in South Africa, they go to those meetings and all they talk about is rugby.
I’m a typical American. I call football “football,” so to me, soccer is “soccer.” I don’t know the rugby rules. Did this penetrate the rugby players that you played with?
How did this penetrate to the rugby players?
Dr. Anthony Chaffee: In Seattle, they saw how well I was doing, my performance and my fitness, and how my fitness just took off. Two weeks after I did this, I went to practice and felt amazing. Even though I was very much out of shape and hadn’t played a full season in three years, I was able to be at a dead sprint and perform at the level that everybody else was at, even though it was midseason and they were all in pretty good shape.
Two weeks later, we did a fitness test called the modified bleep test. I had only four practices under my belt, but because of my diet and how good I felt, I was able to come in the top five out of about 90 players. All my friends, who I grew up playing with, along with the coaches and managers, and some still playing, came to me and said, “You’ve really been staying on it and staying in shape, haven’t you?” I said, “Absolutely not. I’m completely out of shape. This is one hundred percent diet.”
They started getting interested in that. A lot of the players there got interested in it, they hadn’t known about it before, but a lot of the guys started doing it, feeling much better and much stronger. We ended up winning the Major League Rugby that year. It was actually the first year that competition was enacted. Not everybody did that, but there were a few people who had significant improvements to their performance.
Australia
Here in Australia, absolutely, there are a lot of rugby players that will do this at the local, semi-pro, and professional levels. In fact, Peter Bruckner, I know, works with several sports teams around here. Our mutual friend, Dr. Paul Mason, another sports medicine doctor down here, works with quite a lot of top athletes and even entire teams. He gets them on a more ketogenic or carnivore diet, not just ketogenic but oftentimes full carnivore, and they’re having massive improvements.
Some of these stories have been in the national newspapers, talking about their transformations on a ketogenic or carnivore diet. We’re seeing massive improvements in people’s health.
My reawakening to this, and my ability to go back and play at a high level and feel so good at it, made me start thinking about this from a medical perspective. I started thinking that if the type of animal we are is carnivorous, and we’re not living as such, then we could be getting sick as a result of that.
That’s why zoos have signs saying, “Don’t feed the animals.” They get very sick if they eat something outside of their normal diet. We’re animals. If we have an evolved diet, why wouldn’t we? We didn’t come here from space. The same biological laws that apply to other forms of life on Earth should apply to us.
If we eat outside of our biological design, we should see similar patterns. It’s interesting because the types of diseases that zoo animals and domesticated pets get when they’re fed the wrong thing are diabetes, obesity, cancers, autoimmunity, and feline lupus. These sorts of things.
So why is it that we recognize, from a veterinary perspective, that feeding an inappropriate diet causes animals to get so-called “human diseases,” but when humans get those diseases, we just say, “Oh, that’s genetic, you can’t help that?”
Dr. Eric Westman: I have to say, I’m a clinical trialist. I got into this by doing, first, uncontrolled but prospective studies, and then clinical trials. The argument of what we ate over time, to me, is a bit academic. It’s definitely not appreciated by my colleagues in academia or other doctors. They say, “Give me the study. Give me the randomized trial.”
But it occurred to me, like you, that it wasn’t the teeth or the other arguments vegetarians make, which, by the way, it would be great to have a side-by-side debunking of those arguments. It was the internal anatomy of a human that got me. As an internist, I know a little bit about every organ, when it fails. Later, I became an obesity medicine doctor, so most people come to me for diabetes reversal, obesity reversal, and metabolic issues.
Our internal intestines are more related to dogs and other carnivores than a gorilla’s
I was intrigued, or persuaded, by two things. One was the internal anatomy of a human. There was a book called Eat Bacon, Don’t Jog. There was this little thing in there, it just said, “Match the human intestines to the animal.” It wasn’t the gorilla. We see doctors and other vegetarian folks saying the gorilla is closest to us, ancestrally. Steve Phinney, one of my teachers, said, “But there were a couple of million years between the ancestors.”
Things can change in a million years. The internal intestines of a human are basically like those of a dog or other carnivore. The appendix we have is the vestigial cecum that the gorilla has to help digest plants. It irritates me when someone who should know better talks about us being gorillas and says, “Just eat plants.”
The internal anatomy persuaded me. Then I had to say, the face validity of plants, they can’t run away. How do they defend themselves? It was that science and the reasoning where I said, “I’m the guy who looks out the window to see if it’s going to rain, even if I’ve seen the weather prediction.” I don’t just rely on predictions. I think that’s what clinical practice forces you to do. You learn things, but then you see the practical reality.
The other thing that was in this book, which we all learned is not really yours, was included in one of your lectures. It mentioned Barry Groves’ idea. He did a video called Homo Carnivorous, and I pulled it up. Great video. Basically, all mammals can absorb a high-fat diet, and it’s just a brilliant, quick rundown, not just on internal anatomy, but also on the physiology of what happens.
I’m not an animal husbandry or botany kind of guy. When I learned that it’s the bacteria inside ruminant animals that eat grass, actually turning it into fat, and that the bacteria becomes a major protein source. It blew my mind. We didn’t get any of this comparative physiology in school. I still kind of liked this as a summary.
Tell me about this book, Why we are Carnivores and how plants try to poison you. I got it on Amazon. Did you really write it?
The book Why we are Carnivores and how plants try to poison you
Dr. Anthony Chaffee: Unfortunately, that was taken from some transcripts of my videos. The information there is collected from things I’ve put together. Unfortunately, it was taken without my permission and used without my knowledge.
They say that 25% of the proceeds or whatever goes to charity for Professor Thomas Seyfried’s cancer research. I’ve spoken to Professor Seyfried, and unfortunately, he hasn’t received anything from these people. So it’s a bit of a scam.
The information is mine, so hopefully, it’s still helpful to people.
Dr. Eric Westman: I wondered who your editor was because it’s reassuring to me that someone with your credentials and background didn’t come up with this. I think it’s important to know that there are scams. There are people who’ve done that with my books as well. The telltale sign is there’s no frontispiece of a publisher. It has tarnished your reputation a little bit. Yet the information still is really good.
Dr. Anthony Chaffee: It does tarnish my reputation because it’s being portrayed as my book. But it’s just a transcript that’s been put out there. It doesn’t read like a book. It’s a very poorly written book. It has good information in there, but it’s very poorly written. I see people in the reviews saying, “I was disappointed with this, it looks like he just phoned this one in.” Unfortunately, the guy did phone it in, and it doesn’t look that good.
Dr. Eric Westman: Do you have intentions to write a book or any other? Before we get to what you’re doing, I wanted to close the history of what we’ve eaten. I think it’s interesting, but it’s not what we should dwell on. What can we do going forward? We might be able to come up with food and a lifestyle that’s even better than what we’ve had before. I grew up in the age of technology and science, and I would never have dreamed that I could take a picture with my phone or that the internet would be this amazing thing.
I want the health of a carnivore. Like you said, they don’t get cancer or diabetes out there. I don’t want the health of herbivores or many omnivores because of the diseases they cause. At the same time, I’m not totally convinced that everyone needs a carnivore diet.
Switching gears, carnivores have some unbelievable stories of transformation and resolution of medical problems that the medical world couldn’t fix. I see that in my practice now. I kind of passively allow it – “Well, if you don’t want those greens, especially if they hurt,” or if someone once told me they finally figured out it was the plants that made their stomach hurt but they never could figure it out with all the different food.
Tell me about what you’ve learned about carnivore, and what it can do, and then I have some tough questions we need to wrestle with before it can be a policy, I think. What have you seen? What do you teach? What are you doing now?
What Dr. Anthony Chaffee has learned about carnivore and what it can do
Dr. Anthony Chaffee: I certainly have seen quite a lot of benefits. I think there’s a gradient, you can get so much benefit from ketogenic diets in general. I try to instill that in my patients. When I really had this “aha” moment that this could have a huge impact and be a big part of why everybody is so sick and experiencing this rise in chronic diseases, because we’re eating the wrong things, I started digging into the research.
Thankfully, I still had some time off before I went down to Australia. I spent probably 8 to 10 hours a day just reading studies and trying to understand. I found this entire world of literature and knowledge that was not spoon-fed to me in medical school or beyond. It was amazing, absolutely incredible.
I even tried to say, “Okay, everything’s coming up aces for eating meat. What am I missing?” There are all these vegan doctors and people saying that meat is bad. What are they saying that I’m not getting here?
I went to their resources. I went to their websites. I asked questions to see what was going on. Everything they presented was based on old, outdated information, like “Cholesterol causes heart disease” or “Meat causes cancer.” Or it was outlandish lies, like “Humans have always been herbivores.” I thought, “No, we have not.”
It just didn’t show any real merit to me. I didn’t want to be a victim of confirmation bias, so I went to the most compelling people arguing for a vegan diet. I did not find their arguments very convincing.
When I started applying this knowledge to my patient population, I saw things reverse that even now, 99% of humanity would think are irreversible. People believe you just can’t reverse these things, but I see it every day, and I love that.
Amazingly, ketogenic diets and carnivore diets are becoming more accepted for treating things like diabetes. If you have diabetes, you likely have multiple other issues as well. Doctors are starting to see, “This can reverse diabetes, that’s amazing.” Then they’re seeing, “This person’s Crohn’s went into remission at the same time.” Now, they’re on less blood pressure medication, and all these other things are improving.
Dr. Eric Westman: What about joint pains?
Joint pains and chronic pains
Dr. Anthony Chaffee: Absolutely. Joint pain is an amazing one. I know several orthopedic surgeons who have come to this specifically because, by putting their patients on this diet, they no longer need joint replacements. Even though they have severe arthritis, they don’t have the pain anymore and can function. It’s amazing.
I’ve also spoken to chronic pain doctors who use ketogenic and carnivore approaches because it radically improves pain syndromes like fibromyalgia or even radiculopathies.
In neurosurgery, we’ve had so many patients with neurological dysfunction due to disc impingement or some sort of canal stenosis. You could surgically repair this or reverse the impingement, but sometimes the nerve was permanently damaged, and surgery wouldn’t help their pain. Unfortunately, these patients would be absolutely racked with pain, and it wouldn’t get better. Then I would suggest these sorts of dietary approaches, specifically being ketogenic.
As you know, there are thousands of very high-quality studies showing the medical benefits of ketogenic diets in human health. I relay this to people, discussing inflammation and how ketogenic diets, and carnivore diets in particular, which are, of course, ketogenic, can help reduce inflammation and improve pain. I’ve seen massive improvements in pain. People who have been on opiates for 10 years, in very short order, within a couple of months, people come off their very serious medications.
Dr. Eric Westman: An example in my career is that I’ve only been asked to speak at other medical health conferences, like those of other sub-specialties, a couple of times. One of those was at the American Society of Interventional Pain Practitioners. They came up to me and said, “We’re using keto for pain.” That’s where I learned about it. There were about 10 doctors who came up, it was a national meeting, and I was the keynote speaker.
The pain relief signal isn’t just something observed by a few doctors. There are a lot of people who also see that. That’s kind of the grassroots dilemma, right? We see all of these changes, but can we really say it’s going to work 100% of the time? 50%? What’s your gestalt about using an approach like mine, but with fewer vegetables? If someone does it, is it 100% effective?
Is Carnivore 100% effective?
Dr. Anthony Chaffee: It depends on the condition. Like you said, does everybody need diabetes reversal or obesity reversal? I have yet to see somebody not be able to reverse their diabetes. Let’s put it that way.
Dr. Eric Westman: You can say, yes, it’s 100%.
Dr. Anthony Chaffee: in fact, from what I’ve seen, anyway. When people do it 100%, I’ve seen 100% of them reverse their diabetes. And probably near 100% for autoimmunity as well. Autoimmunity is an amazing one for the carnivore diet because you’re eliminating everything that could possibly cause a problem.
Maybe you can add certain things back in without causing a flare-up, but it’s hard to figure out which ones those are. Some people can’t have anything besides just meat and water, or even just ruminant meat and water. Some people, very few, but some, can’t even have anything except grass-fed, grass-finished ruminant meat and water because their autoimmunity is so sensitive.
I’ve seen everybody improve. Maybe not 100%, unless they go very, very strict with grass-fed, grass-finished meat, and so on, but I’ve seen significant improvements. People are able to come off medications in very short order.
I’ve had MS (multiple sclerosis) patients who had very severe degenerative conditions. They not only reversed their symptoms but, on MRI, reduced their lesion burden by over 50%. That’s not something well described in the literature as being possible. We’re actually putting together a case series of MS patients who have reversed their condition.
Congestive heart failure is another one. I’ve had patients with under 15% ejection fraction who, in a matter of months, came back to completely normal. I’ve even seen patients with congestive heart failure after previous myocardial infarctions (MIs), where scarring on the heart really shouldn’t improve. Yet the rest of the heart must have picked up the slack.
I spoke to another physician who had a patient in this category, someone with a 22% ejection fraction post-MI, years after the event. The patient went on a ketogenic carnivore diet and, after just a couple of months, improved to 33%. That’s not completely back to normal, but it’s significantly better.
So, yes, I do see dramatic improvements. I do think that some of these diseases, like diabetes and most autoimmune conditions, are caused by eating the wrong things. If you remove those things and start eating the right ones, it’s a combination that works. This is the premise of my book. I argue that the majority of the so-called “chronic diseases” we’re treating nowadays are not diseases per se, but rather toxicities and malnutrition.
Dr. Eric Westman: Exactly – oral exposures and malnutrition.
Dr. Anthony Chaffee: Yes, or some sort of nutrient deficiency. You’re not getting the right nutrients in a certain way, and that’s causing problems. I make that argument in my book.
Dr. Eric Westman: I wonder if, through the years, you’ve met Tom Tednon in Seattle. He’s a keto doctor there, in family medicine, and works with Diet Doctor. We were on a podcast once, and I said, “People come to me in wheelchairs and lose weight.” He said, “Oh, yeah.” The competitive guy that he is, he added, “I treated someone who came to me on a gurney. He was paraplegic and lost weight.”
So, that’s amazing. I’ve had people come to me, reverse their diabetes, obesity, and other conditions. I basically said, “Here’s your food prescription.” There are some plants on it, but I tell them, “If you follow this, have no doubt it will work.”
So I’m in that space where just a lot of people don’t want to do it, or they’re carb-addicted. There’s potential strength in just sticking to carnivore: it’s simple. Doing one thing might work better.
I’d like to see a head-to-head comparison. I teach a keto diet with two cups of leafy greens and one cup of non-starchy vegetables. You could take the worst-case scenario, patients like that are a good space to be in, where other doctors don’t want to deal with these people because they’re just so complicated. They say, “They don’t follow my life; we’ll just have them meet you,” you know? Amazing things can happen.
Carnivore – a subtype of a low-carb keto diet
I see carnivore scientifically, as you said, as a subtype of a low-carb, keto kind of diet. Although there are some people in ketosis, others aren’t. I think most people are, or they’re shifting to keto-burning. They don’t have elevated ketones, and, of course, heart failure gets better if you take a drug that increases the ketones. That’s the SGLT2 inhibitor story.
The medical mainstream is learning about keto diets through a drug side effect. It almost reminds me of how erectile dysfunction medicines were discovered, it was a side effect of a drug used for something else. Locally, though, the cardiology researchers don’t know anything about a keto diet. They’re giving exogenous ketones to help with heart failure, which raises some eyebrows. They might be talking about a drug benefit, but the side effect of the drug is that it can give you Fournier’s gangrene and ketoacidosis. Carnivore shouldn’t give you ketoacidosis unless you have diabetes.
As for autoimmunity, I think this is a space where I’ve seen people do keto for a while and not totally fix their autoimmune issues. Then, they go to a carnivore diet, drop off that last cup of vegetables, and they improve. That kind of leads to your thesis, or the way you’re summarizing it, that just a little bit of poison can still affect you.
On the other hand, some people argue that if you stay away from it, you get more sensitive to it. Let’s get into the thorny aspects of carnivore, which is that the stricter you are, the more sensitive you get to those things. Some people come back and say, “Well, I’m doing great, but if I have just a little bit of something, I don’t feel right.” It could be something they used to have before, but either they were numb to it, or it didn’t affect them in the same way. Can you adapt? How can people eat carbs and vegetables and still be healthy? What are your thoughts about that?
A sensitization process
Dr. Anthony Chaffee: As far as sensitivity goes, this is something you do see. I think it’s twofold. First, you’re seeing the contrast in how you feel. You feel a lot better, and then you add in something else that may be deleterious to your health. You notice the contrast and think, “I don’t like that.” It becomes noticeable.
Second, I think there’s a sensitization process. Just like you’d be more sensitive to alcohol if you abstained from it for a long period of time, you lose tolerance over time. We build up tolerances to drugs, toxins, or anything else we’re regularly exposed to.
We do know that these plant chemicals are toxins because our body tries to detoxify them. It tries to clear them from the body. We don’t use them for any biological purposes. In fact, our body ramps up its biological machinery to get rid of them, break them down, and flush them out. Over time, we build a tolerance to these substances and become better at processing them.
When you stop subjecting yourself to these things, your body becomes more efficient and doesn’t need to maintain these defenses. As a result, you lose your tolerance, just like if you didn’t drink alcohol for six months and then drank the same amount, it would hit you much harder.
I think it’s twofold: you notice the contrast more, and the substances hit you harder because you’ve lost your tolerance. I think that’s one of the reasons so many people are fixated on doing this long-term. We talk about whether there’s a need to do it, but it depends on your definition of “need.”
For some people, if they want to stay off medications and be healthy, they probably do need to stick with it, especially for very sensitive autoimmune patients.
I don’t “need” to from a medical perspective. I wasn’t sick before. But I still feel a lot better now. My body performs so much better, and my brain works so much better. I can work 130 hours a week in the neurosurgical department and do interviews at 1:00 in the morning – which is what I was doing when I first started my channel – because of my diet. It’s because of how well my body works based on what I’m eating.
Going back and eating something else, I feel so much worse. Not that I get sick; I don’t get a rash or anything, but I feel strongly worse. I don’t go to a hospital, but I feel worse, and my body doesn’t work the way I know it can. So, I have no interest in going back to that. You do have a sensitivity to it because you lose that tolerance, and I think that’s a good thing. I don’t think we need to drink alcohol every day just to maintain that tolerance, just in case we decide to binge one weekend.
The same thing applies here. I don’t think we necessarily need to subject ourselves to different toxins of other descriptions in order to maintain that, just in case we go and have a big salad.
Dr. Eric Westman: You’re making me think, which is great. There’s so much hullabaloo about ultra-processed food and all the toxins in it, but there are just as many in vegetables.
Dr. Anthony Chaffee: Absolutely.
Dr. Eric Westman: When I came to this, I didn’t have much nutrition training, but you had more than I did, and I had to learn on my own. It occurred to me that the absence of certain foods is how this works in many cases, the absence of toxins. The gluten is eliminated. I had someone who had, I think, gluten neuropathy for seven years that was undiagnosed. We even had scopes up and down, but they never looked at the jejunum and the villi. Some of these diseases are hard to diagnose. Yet, within a week of going carnivore, she was feeling better and absorbing iron. Nobody ever figured it out.
So, I came to this thinking, “It’s because they’re not eating junk food. It’s because they’re not eating gluten. It’s because they’re not having the simple sugars.” But now, we have to ask: Is there an extra benefit of ketosis? Ketones themselves can actually have positive benefits. Now you’re expanding my mind by saying, “Maybe even a little bit of vegetable matter is a toxin and should be eliminated as well.”
So, carnivore would be the ultimate elimination diet, wouldn’t it?
Carnivore would be the ultimate elimination diet
Dr. Anthony Chaffee: Yes, absolutely. I’m not the first person to argue this. I don’t know if you’ve come across Dr. J.H. Salisbury, for whom the Salisbury steak was named. A great book. Dr. J.H. Salisbury was a New York doctor in the 1800s during the Civil War era. He did a 30-year research project into optimal nutrition for human beings. He tested all sorts of different ways of eating. He lived with the Native Americans in the Great Plains before the bison were wiped out. He found that these people were extremely long-lived and didn’t have any of these so-called “Western diseases.” They predominantly just ate meat.
This was long before processed food companies started making a name for themselves, or even existing. Before seed oils, before Crisco, and before sugar became a rampant commodity. He found that people eating more grains and plants and less meat were getting diseases others simply weren’t. They were getting autoimmunity, they were more susceptible to tuberculosis, and they were getting gout. He found that he could cure them by putting them on a pure beef and water diet.
The Salisbury steak involved grinding the meat in such a way that it filtered out the gristle and made it much more easily digestible. You’d just get the soft muscle body and the soft fat, or even add butter back to that because a lot of fat would get pulled off with the gristle. That was a Salisbury steak, and it was specifically for his patients who had extremely poor digestion. Think of people with Crohn’s or ulcerative colitis, a hundred years before any sort of treatment for this existed.
He said that it was very important to get that gristle out for these patients because they had such horrible digestion. You had to completely rest the bowel, and by removing the gristle, they could absorb essentially 100% of the meat they were eating. This completely rested the bowel, and they could reverse Crohn’s, ulcerative colitis, and even rheumatoid arthritis. He wrote a book called The Relation of Alimentation and Disease.
Alimentation refers to digestion, the relationship between what we eat and the diseases we get. That’s the exact premise of the book I’m writing, which is essentially the 2024 version of his work. This has already been discussed. Then, you have people like Vilhjalmur Stefansson, who wrote The Fat of the Land. He lived with the Inuit for 15 years and discovered their meat-based diet.
There’s also Weston A. Price, who looked at early, primitive Pre-agricultural populations transitioned to a post-agricultural way of eating, and the decline in their dental arches, teeth, and jaw development became evident. Even more recently, there was Dr. Walter Voegtlin, I think he was a gastroenterologist, who in the 1970s, around 1975, wrote something called The Stone Age Diet.
Again, he said, “We’re carnivores. Here’s the evidence for this,” and pointed out that the diseases we’re treating now are largely due to eating outside of this way of life. It’s being rediscovered now, but I certainly didn’t figure this out myself.
I sort of came to this independently, but when I started looking, I found that this is a tried-and-true, tested hypothesis. When put into practice, people see quite a lot of results.
I think there is enough evidence, when you look at the totality of biological and physiological evidence, to support this theory. You can say, “Maybe this will help people.” It’s not going to hurt you. There’s nothing unsafe about eating meat. We know we can get all our nutrients from it because people have lived in the Arctic Circle during the Ice Ages, or even now in the Arctic Circle, predominantly eating meat. We know we can survive and thrive because if you can’t thrive in the Arctic Circle during an Ice Age, you’re not living. You have to be very successful to survive.
Dr. Eric Westman: I look forward to a book, or any kind of work, that puts all that history together.
Let’s now go to the present day, where the old and the new clash. People get their blood work done, and, oh my goodness! I learned this 25 years ago, the ketones go up in the blood on a keto diet, and it’s marked as abnormal because people who eat carbs don’t have ketones. The lab work is based on people who eat carbs.
Okay, ketones, that’s fine. But then, Shawn Baker has an elevated hemoglobin A1c, and some people don’t have perfectly pristine glucose levels. And now, a prominent influencer did a ferritin level test, and it was really high. They got concerned and stopped doing the diet. What about the long-term implications? The clash of the blood work doesn’t always look good, does it?
Long-term implications and blood work
Dr. Anthony Chaffee: You have to take individual cases as just that: individual cases. I’m sure, in your practice, you’ve seen the totality move in the right direction, haven’t you? I have.
At least hundreds of patients I’ve put on a carnivore diet over the years, and my predecessor, who I took over from, the reason I transitioned from neurosurgery into the metabolic health space is because my friend who had this metabolic health practice had been doing this for 34 years. He was sort of forced into retirement and would have had to shut down the practice entirely. These patients wouldn’t have had anyone to see unless I stepped in and took it over. I decided to do that because I didn’t want to leave the patients hanging.
He’s been applying carnivore diets, largely due to our relationship and me talking to him, for about five years now. Over the past five years, he’s worked with hundreds and hundreds of people.
I’ve been involved here and there, a day or two now and then, and then full-time for the last year and a half to two years. Probably two years at this point. We meticulously track blood work. I’ll see patients, do a full set of blood work, metabolic, hormonal, and various other relevant panels, and then talk to them about how their diet and lifestyle affect these markers.
For example, I explain how carbohydrates raise their insulin to certain levels, causing specific problems elsewhere. Then, we put a diet and lifestyle plan in place, and I say, “Let’s check your blood work again in a few months, two or three months, and we should see this marker go up, that marker go down, and so on.” Almost invariably, this is exactly what happens. You see these changes in the expected directions.
I’ve had patients who didn’t have genetic hemochromatosis but still had to donate blood every two months because their ferritin would skyrocket. They went on a carnivore diet, and suddenly their ferritin came down to an ideal level. Is that going to happen for everybody? I can’t say that it will, but it did for these patients.
Dr. Eric Westman: Ferritin levels to me don’t really matter. It’s, are they really accumulating in the liver? That would be a great case study, by the way. The Journal of Metabolic Health takes case studies. I’m on the editorial board, and the editors are in New Zealand.
Ferritin was one thing; hemoglobin A1C is another. Vitamin C – now, I ask these questions with the knowledge that I’ve been using this in practice for 20 years, and I’m not worried about it. It’s just other people’s concerns. How do you handle the vitamin C issue? We can’t go back to the Masai and the Inuit, that only goes so far. My colleagues, your medical colleagues, aren’t going to take that. There’s a case, one case, of scurvy from someone who was up in Appalachia. No one really knew what he was doing, but every time he came down from the mountains, he had scurvy. He said he was doing a carnivore diet. So, that’s not really a credible case.
Steve Phinney, one of my teachers, says, “We handle vitamin C differently with different ways of eating, and we need less.” So, there’s conditional essentiality, even. How do you respond to the claim, “Well, you’re going to get scurvy?”
Vitamin C
Dr. Anthony Chaffee: You absorb different amounts of vitamin C depending on what you’re eating. If you’re eating carbohydrates, you compete for uptake in the gut with vitamin C and the GLUT4 receptor. If you have an abundance of carbohydrates in your gut, you are going to crowd out the vitamin C.
You only need about 10 milligrams of vitamin C if you’re eating carbohydrates to stave off scurvy. That’s what the recommendations say. If you’re not eating carbohydrates, you need far less than that.
Let’s think about what scurvy is. Scurvy is a misfolding of the collagen molecule because if you don’t hydrolyze proline and lysine, they won’t bind together properly. You’ll get loose connective tissue, and you’ll get damaged vessels. You start bleeding, and you can die. It’s very serious.
If you’re eating meat, you actually get an abundance of hydrolyzed proline and lysine. You don’t need vitamin C to catalyze a reaction to hydrolyze those molecules. I remember thinking this when I just stopped eating plants. Initially, every few months I thought, “Do I need to take a multivitamin? Do I need to eat a banana or something?” I remember thinking to myself, “I feel good. My gums aren’t bleeding. Let’s ride this out and see what happens.”
Now I know the biochemistry behind it and why I didn’t get sick. But at the end of the day, we can have different sorts of theories on what should or would happen, but what happens, what does happen when people do this on a day-to-day basis? No one gets scurvy. This isn’t something that happens, and we can understand why, mechanistically, we shouldn’t get scurvy if we’re eating enough meat.
I looked into the history of it as well. You know the British “limey,” when they started having lime juice to stave off scurvy? It was just the sailors in front of the mast, so, not the officers who were getting scurvy. They ate a very different diet. The officers weren’t getting scurvy – they had a ration of meat.
The reason they’re called “limeys” is because that was a pejorative from the other European powers who thought that the British were crazy to eat limes and lime juice. They thought, “Oh, you get scurvy. You get sick!” But none of them were getting sick. So, they called them “limeys” as an insult, thinking they were being silly. This catches on, and I think it’s similar to the “carrots” myth because it’s good for your night vision. That was propaganda from World War II fighter pilots. We had radar technology, and we didn’t want Hitler to know about it. We put out a press release that our fighter pilots were the best because they ate a bunch of carrots and could see super far, spotting planes before they were seen. These things get stuck in our minds, and we don’t really know where they come from. When you look into it a bit more, it’s interesting.
That’s the mechanism behind it, and conditionally, that’s your point. Vegans will say, “You get all your proteins from meat or from plants and things like that, which is not true, conditionally. Because we say that carnitine is a non-essential amino acid, but that’s only true for about 70% of the population. About 30% of the population doesn’t make a sufficient amount of carnitine, and some don’t make any at all. So, for them, it is conditionally required. They absolutely can’t just subsist only on a vegetarian or vegan diet.
That’s a third of the population of Earth. That’s a serious thing to think about. Taurine, we make that in our liver. It’s expelled in our bile, and fiber binds the bile. When you eliminate your bile, you can also pull the taurine out with it. Even though we make taurine, you may be deficient in taurine depending on what you eat, or if you’re on one of these medications that draws out your bile as well.
I think we need to think of this, not just of, “Are you getting anything from a carnivore diet?” Which historically, we always have. But what about this other way of eating? What about the anti-nutrients in plants that actually block the absorption of different vitamins and minerals as well? I think everything is fair game to look at.
Dr. Eric Westman: Thank you so much for talking. I’m going to be respectful of time, and I’m very, very impressed. Coming from the background that you have, knowing the things you’ve done, you’re kind of superhuman in doing the sports, and then the neurosurgery, the endurance, the deep dives, and literature reviews. You’re like checking off all the boxes of me, as a critic, saying, “You’re spot on.” I look forward to a book or other things that come, even a case series of a practice, which would advance the science in this regard.
Great to meet you. Where do people find you? How can we promote what you’re doing now?
Where to find Dr. Anthony Chaffee
Dr. Anthony Chaffee: Thank you very much. It was a pleasure to come on. I’ve enjoyed your videos, and my fiancée loves your videos too. She liked your presentation style and just how knowledgeable you are. She’s coming from a layman’s perspective, doesn’t know the jargon and she likes how you present that. Thank you for everything that you do.
I have a YouTube channel myself. It’s just my name. You can find me by my name, Anthony Chaffee. I also have a podcast with a silly name, but it catches attention. It’s called “The Plant-Free MD,” and that’s available wherever people go for podcasts. I think I’m most active on things like Instagram. Again, that’s just my name: Anthony Chaffee MD. And Twitter’s also Anthony Chaffee.
That’s where I’m most active, and I try to involve myself in the community, interact with people in the comments, and answer messages as much as I can. I just try to help people. All my material is available for free. I don’t do anything behind a paywall because that’s not why I’m doing this. I have a job, I like my job, and I enjoy that. This is really just to try to get this information out there because I see how much it helps people. I think that this is everybody’s birthright of good health, and I just want to get that out to as many people as possible. Hopefully, I’ll have a book forthcoming sometime this year.
Dr. Eric Westman: This year? Fantastic. Dr. Anthony Chaffee, thank you again. Take care.
You can watch the full video here.
Speaker bios:
Dr. Eric Westman is an Associate Professor of Medicine at Duke University Health System and the Director of the Duke Keto Medicine Clinic in Durham, North Carolina. He is a past president of the Obesity Medicine Association and a fellow of The Obesity Society. Dr. Westman has over 25 years of experience researching low-carbohydrate ketogenic diets and has authored more than 90 peer-reviewed publications. He co-founded the Adapt Your Life® Academy to provide accessible, research-backed education on the low-carb lifestyle.
Dr. Anthony Chaffee is a neurosurgeon with over 20 years of research into optimal human nutrition. He began his academic journey at age 16, studying molecular & cellular biology with a minor in chemistry at the University of Washington, and later earned his MD from the Royal College of Surgeons.