37: MCT-Based Keto, Purpose Of Fasting, Calorie Surplus To Build Muscle, Carbs For A Pounding Heart

37: MCT-Based Keto, Purpose Of Fasting, Calorie Surplus To Build Muscle, Carbs For A Pounding Heart


If you are interested in the low-carb, moderate protein, high-fat, ketogenic diet, then this is the podcast for you. We zero in exclusively on all the questions people have about how being in a state of nutritional ketosis and the effects it has on your health. There are a lot of myths about keto floating around out there and our two amazing cohosts are shooting them down one at a time. Keto Talk is cohosted by 10-year veteran health podcaster and international bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” and Arizona osteopath and certified bariatric physician Dr. Adam Nally from “Doc Muscles” who thoroughly share from their wealth of experience on the ketogenic lifestyle each and every Thursday. We love hearing from our fabulous Ketonian listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes and listened to the past episodes, then you can do that and leave a review HERE. Listen in today as Jimmy and Adam share more great answers to your best keto questions today in Episode 37.



KEY QUOTE: “In general, people in ketosis sleep better, not worse. If there’s something that being in ketosis is amplifying, which is can do, that may affect your sleep. The contractility of the pulse is enhanced in ketosis which explains why some people think they have a pounding heart.” — Dr. Adam Nally

Here’s what Jimmy and Adam talked about in Episode 37:

Hi Jimmy and Doc Nally!

I’m loving this new podcast and as a fellow Southerner, I also love love love your way with words. I have a few questions about an MCT oil-based ketogenic diet as advocated by people like Dr. Terry Wahls and Paul Jaminet that has added a layer of confusion to my understanding of a ketogenic diet.

It seems unbalanced to me to rely mainly on MCT oil and coconut oil as my primary sources of fat just so I can consume upwards of 80g carbohydrates in my diet as Dr. Wahls and Jaminet suggest. Do we really need to add in so many more vegetables and supplements so that we’re not in danger of scurvy and other health calamities while eating keto? And they both push resistant starch which I know you’ve covered on your podcast previously, but can’t you just eat green leafy vegetables and kimchi to cover gut health?

Neither Dr. Wahls nor Jaminet seems to believe it’s ideal to remain on a ketogenic diet over the long-term, and yet both of you seem to be thriving on it after many years of experience. Can you help clear up this major confusion I’m having about what to believe? Thanks so much for your great contributions and wonderful spirit.

All the best,


Anti-Tumor Effects of Ketogenic Diets in Mice: A Meta-Analysis

1. What’s the purpose of fasting on a ketogenic diet?

Hey Jimmy and Adam,

I’m learning that on a standard American diet, cutting calories just doesn’t work. I think the reasons are because the metabolism slows accordingly, cravings kick in, and that leads to binge eating junk food or just more food when the willpower disappears. Why doesn’t this same logic apply to fasting on a keto diet? If cutting calories doesn’t work on the standard American diet, then why is fasting on a ketogenic diet beneficial?

Thank you for everything,


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2. Do you need to eat a calorie surplus while in ketosis to build muscle?

Hey guys,

I love your show and I listen in every week. I’ve often read that a calorie is not necessarily a calorie while researching keto and I believe I’ve heard you say the same thing on your show. My question is in regards to strength training, specifically powerlifting. I often see most of the fitness experts say you need to be in a caloric surplus to build muscle. Oftentimes these calculations work out to well over 3,000 calories. Eating a ketogenic diet, I don’t know if I could ingest that much food without feeling stuffed all the time.

Is it possible that the old equation that says you need to be in a calorie surplus is not necessarily true in ketosis because you use a portion of your body fat to supply those calories? In the high-carb world your body would break down protein to supply the extra energy from glucose. But because we burn fat fuel, it makes me think perhaps it works differently for us Ketonians. I’ve been struggling to find a good answer to that question and I hope you and The Doc can help.

Thank you again for your show!

Jason from Canada

3. Should I add in a few more carbs to my keto diet, especially at night, to help with a pounding heart?

Hi Jimmy & The Doc,

I love your show. It is chock full of great info and you two are both entertaining and fun to listen to!

My question for you is this: Does the liver require adrenaline to make ketones? I ask this question because my heart is sensitive to adrenalin and it has been keeping me awake at night with noticeable pounding at night. I’ve tried adding in more electrolytes before bedtime which hasn’t helped. I’ve just begun my sixth week of keto and I had my heart checked out earlier this year via echocardiogram-it is normal.

Could I still be in ketosis if I raised my carbs to say 40g daily as a means for dealing with this? If I do that would my fat intake remain the same, or should I decrease it? Maybe if I just eat a few more carbs before bedtime it would help? What do you suggest?

It’s frustrating because I want to remain keto, but I want to sleep at night too.

Thank you both so much,


KEY QUOTE: “When you eat a ketogenic diet, it’s very easy to not eat. This seems kinda foreign to people who are literally constantly eating every few hours. Fasting is a very natural and normal thing to give your pancreas a rest every now and then.” — Jimmy Moore


Dear Jimmy and Dr. Adam,

I am a 41-year old woman with 2 children and have been very active all of my life, playing NCAA women’s basketball for 4 years in college, and have since run two full marathons and at least 15 half marathons.  I still have at least 2-3 workouts a week as I chase after my kids, averaging about 14K – 20K steps a day on my Fitbit.

But I have been struggling with one major problem—a consistently elevated blood sugar. I have Hashimoto’s and while pregnant with my second child, I was diagnosed with gestational diabetes.  During that pregnancy I was extremely disciplined watching my carbs as directed by my doctor. And yet I still couldn’t control my blood sugar and was required to take both slow acting insulin shots at night, and fast acting shots of insulin during the day.  I thought that this would improve after having my son, but it didn’t.

Since the birth of my son in 2013, I have not been able to get my blood glucose under 100 mg/dL. I was on Metformin, but it didn’t seem to help. In 2016 I went off of Metformin with my doctor’s permission to see what would happen. Nothing has changed, so I was excited when I learned about the ketogenic diet. I started eating keto in mid-April 2016 and have been doing it ever since. I have lost 22 pounds (with 18 more to reach my goal) and I feel AWESOME with inches lost, increased energy, and improved focus. I’ve even done some extended fasts of 48-60 hours, but my blood sugar hasn’t budged. My average morning fasting blood sugar level is around 105-115. I test my ketones with the Ketonix breath meter and it shows I’m on the low end of nutritional ketosis.

I intend to stick with the keto lifestyle as it is extremely easy for me and I love how I feel. I forgot to mention that my A1c has been around 5.2 for the last few years (which is encouraging), my cholesterol under 200, and my triglycerides around 130.  I guess that overall my numbers are good but I’m obsessed with that fasting glucose reading.  It seems to be my nemesis. 

I also forgot to mention that I have a Ph.D. in cell and molecular biology and every single word of science that you have described on your podcasts is spot on, and aligns with everything that I have been taught about cellular metabolism. Any words of wisdom on the timeline for lowering my fasting blood sugar level? Or, am I overly focused on this number? Is it worth going back on a low dose of Metformin again?

Thanks for all that you do.  I love your podcast!


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Anti-Tumor Effects of Ketogenic Diets in Mice: A Meta-Analysis
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3 responses to “37: MCT-Based Keto, Purpose Of Fasting, Calorie Surplus To Build Muscle, Carbs For A Pounding Heart”

  1. judybarnesbaker says:

    Great info. BTW, coconut is a nut. Coco–NUT, right?

    • This Old Housewife says:

      Paleoites will say that coconut is a “pseudo” nut, but my body says it can tolerate coconut OIL and coconut FLOUR, but not the meat, the sugar, the sap, or any other coconut product.

  2. This Old Housewife says:

    I just listened to Chris Masterjohn over at the Keto summit and he says there are 2 pathways to high ketones:

    1. the standard keto diet (caloric restriction)
    2. calolric abundance + MCT oil

    This explains why I, after consuming a serving of potato salad (via the Carb Nite Solution), along with the rest of my meal being keto, had SOARING ketone levels (for me–3.5) at the 2 hr. mark, and even higher before bed (4.9–the highest I ever had). I’m sure I lost no weight or burned no fat during that time–had I been epileptic, or doing this diet for neuro reasons, the MCT oil + abundance foods across the food spectrum sounds like the ideal way to go.