Online mini-symposium

Online mini-symposium

December 4, 2021

16:00 Budapest/CET time

Online nutritional course, mini symposium

 

December 4, 2021

16:00 Budapest/CET time

Online

Duration: 3 x 50 min + 30 minutes for questions

Speaker: Dr. Zsófia Clemens, neurobiologist, clinical researcher curriculum, publications

Language: English

 

Price: 140 EUR

Through PayPal to paleomedicina@gmail.com

If you have transferred the amount, please, also send an email to paleomedicina@gmail.com

Upon cancellation 50% of the payment is refundable

The presentation will cover the following topics:

 

Presentation #1: Ketosis

  • Ketosis – basics
  • Glucose and ketones
  • Ketosis vs. ketoacidosis
  • Ketogenesis at the physiological level
  • Glucose and ketone metabolism
  • Dow e need carbohydrates?
  • The practice of ketosis
  • History of the ketogenic diet
  • The PKD
  • The classical ketogenic diet
  • The carnivore diet
  • Physiological differences between glucose- and fat-based metabolism

 

Presentation #2: Nutrients

  • Dietary supplements
  • Evolutionary logic
  • Clinical experience
  • Glucose-ascorbate antagonism (GAA) theory
  • Antinutrients
  • Organs and vitamins
  • Nutrient interactions
  • Intervention studies with vitamin C
  • Intervention studies with vitamin D
  • Vitamin D and the brain
  • Vitamin D level on the PKD (161 patients)
  • Vitamin D and seasons in patients on the PKD
  • Vitamin D according to countries in patients on the PKD
  • Magnesium and glucose
  • Plant vs. animal sources of vitamins
  • What can cause low vitamin levels on the PKD?

 

Presentation #3: Clinical cases

  • Crohn’s disease
  • High blood pressure
  • Type 1 diabetes
  • Chronic fatigue
  • Glioblastoma
  • Autism

The 2-week follow-up program

The 2-week follow-up program

The 2-week follow-up program

Zsófia Clemens, Csaba Tóth
2021.09.11

Description of the Initial consultation + 2-week follow-up program

 

What is the aim of the 2WFU?

The aim of the program is to make sure you understand and apply the PKD protocol properly and to provide you with the needed support during the transition period. PKD rules are simple but details and individual suggestions are crucial and should not be underestimated. Even small deviations may hinder your recovery. Often, small deviations from the rules are hard to notice and preexisting habits are in the way of recovery. We are here with the 2WFU program to help you identify and rectify whatever is hindering your recovery for you to reach your health goals.

 

Why do we only provide medical consultation with the 2WFU?

Your success is our success. Experience tells us that patients who take part in the 2WFU program are much more successful in reaching the expected health goals as compared to those who only had an initial medical consultation. It is our goal to help you reach your health goals effectively, without frustration, as quickly as possible.

 

What do we offer during the 2WFU?

During the 2WFU we offer dietary guidance along with medical follow-up. The follow-up takes place on an online platform. On this platform, you will be able to access comprehensive educational material. The 2WFU includes tracking of your daily home measurements, two dietary consultations with our dietary assistant via skype, and message exchange.

 

Dietary guidance

As part of the dietary education, we provide you with comprehensive educational material to read, daily recipe tips for the two weeks, meal pictures explaining the basics of the diet, and more than 100 questions and answers. During the dietary consultations, our dietary consultant answers questions about recipes, kitchen techniques and is ready to assess your diet diary or food pictures. You can change messages with our colleagues on a daily basis. You will be able to upload pictures of your meals to get feedback. Whenever possible, we do our best to share information about reliable meat sources in your own country.

 

Medical guidance

During the 2WFU we provide continued medical guidance. This means that a medical doctor will track your progress and evaluate your daily feedback. You will receive medical suggestions, and/or advice on additional medical tests if applicable. We are ready to evaluate the medical test results that you send us anytime within the 2WFU. We also provide short medical explanations if needed. Please, note that we cannot provide medical guidance once the dietary suggestions are not followed, or the other way around. Taking only dietary or medical advice, or cherry-picking among our suggestions may have undesired consequences. We will only provide continued medical guidance if you comply with suggestions and we receive the necessary continued feedback from you.

 

How do I keep in contact with you during the 2WFU?

All correspondence will take place on this online patient follow-up platform. Shortly after the initial consultation, you will receive an email with a user name and password that will allow you to enter the follow-up platform. The two consultations with our dietary assistant will take place on skype.

 

What do we not provide during the 2WFU?

Our program is primarily a medical and not an educational service. It is also not a discussion forum. Our goal is to provide you with the necessary medical and dietary advice that is needed to reverse your health condition. We provide short nutritional or medical explanations regarding the advice given to you. At the same time, we cannot get into the discussion of specific scientific and medical topics.

If you are interested in specific scientific topics, we can suggest you articles to read. At the same time, be aware of the fact that as regards PKD and diseases there is no relevant literature other than the one written by Paleomedicina-ICMNI. The reason behind this is that PKD was created by Paleomedicina-ICMNI, and currently no one else uses it in a clinical practice or publishes about it. Yet, we have not published articles on each and every subject we have experience in and you may be interested in.

Please, also note that we do not manage emergency situations. If you experience a sudden deterioration of your condition or a serious new-onset symptom, you have to be seen by your local emergency health care service.

The 2WFU does not include evaluation of the 3-week control blood work or the control consultation. Evaluation of the 3-week blood work is part of the control consultation.

 

What do we need from you during the 2WFU?

We provide our time, expertise, and knowledge in dietary therapy and in standard medical therapies. We require your cooperation in following our suggestions and providing us with the necessary feedback. Once the 2WFU starts, we need daily feedback from you regarding your home-measured blood glucose, blood ketones, body weight, daily food amount, and symptoms. You will be able to enter these data on the online platform. During the first dietary consultation with the dietary assistant, you will receive instructions on how to provide the follow-up data to us.

Please, keep your questions short and concise. The dietary assistant may not be able to send more than one reply a day. Questions that are not urgent and require a more extensive elaboration will be discussed during the dietary consultation call.

 

How long after my initial consultation should I start the 2WFU?

You have to start the 2WFU within a week after your initial consultation.

 

When do I have my first dietary consultation?

The first dietary consultation should be done during the first three working days of the 2WFU.

 

When do I have my second dietary consultation?

The second dietary consultation typically takes place 7 days after the first consultation, but the exact timing may depend on our dietary assistant’s and your schedule.

 

How long does the 2WFU last?

The program lasts for 14 days. We are available during the 14 days and not beyond.

 

What is happening after the 2WFU?

Once the 2WFU ends, you will not be able to upload data or send messages. Upon finalizing the 2WFU you will receive a closing report summarizing our clinical impression, suggestions on how to improve your diet, medical conclusions, and the next medical steps so that you exactly know how to go on.

Please, note that we cannot reply messages after finishing the 2WFU. For administrative issues please use the paleomedicina@gmail.com email address.

If you feel that you need of a continued support after the 2WFU finishes, you may consider booking an additional 2WFU

Although you will not be able to reach us through the follow-up platform, your measurements, uploaded documents and messages will remain available to you. Thus at a later point, you will be able to come back and check all the information that you received from us during the 2WFU.

As regards the next steps after the 2WFU, please, see the next section (What to do after the 2WFU is over?)

 

What to do after the 2WFU is over?

Once the 2WFU ends, in most cases, we suggest a 3-week blood test as a next step. The blood work list will be individualized for you based on your disease and specific diet and medical questions to answer. This blood work list will be available for on the follow-up platform. Once you have the blood test result you are suggested to book a control consultation. You can book a control consultation at this link (You have to purchase the service called “Control consultation”. Please, also upload your blood work or any other new medical test or home measurement log that you have.

The original blood work result document is absolutely necessary to apply for a control consultation. Please, make sure that the whole list of laboratory parameters is done otherwise we can only give you a partial feedback.

During the control consultation, we will discuss your blood work or any new medical test, compare it to the previous ones, draw conclusions and help to fine-tune the diet if needed.

 

Can you give me examples of how other patients benefited from your program?

You will be able to find short medical reports of previous patients taking part in the initial consultation + 2-week program here.

 

Do you have published case studies?

Yes, we do. We are involved in nutritional and medical research. You can find our published scientific studies at this link.

 

Before booking a consultation: FAQ

Before booking a consultation: FAQ

Before booking a consultation: FAQ

Zsófia Clemens, Csaba Tóth
2021.08.29

Below are the questions that we typically receive from new patients. Please, check if you have the same/similar question.

 

Below are the questions that we typically receive from new patients. Please, check if you have the same/similar question.

 

In which diseases is the paleolithic ketogenic diet effective?

Below you will find a list of diseases in which the paleolithic ketogenic diet proves to be effective. We have encountered almost every medical condition. Yet, infectious and traumatic disorders, as well as surgical cases, fall into a separate category. In addition, there are always exceptions, rare diseases, or rare medical situations. Therefore, when it comes to individual cases, we will only be able to respond in light of the full knowledge of the medical records and during the consultation. However, we can safely say that if you have a non-genetic chronic medical condition, we can either cure it or improve it significantly if you follow our recommendations. Below you can read an extensive but not complete list of the diseases we most often come across and treat with success:

 

  • Metabolic syndrome conditions

Type 2 diabetes

Insulin resistance
Obesity
Hypertension

 

  • Autoimmune diseases

Autoimmune thyroiditis (Hashimoto’s thyroiditis)
Crohn’s disease
Ulcerative colitis
Eczema
Psoriasis
Rheumatoid arthritis
Idiopathic thrombocytopenic purpura (ITP)
Polycystic ovary syndrome (PCOS)
Immune hepatitis
Lupus
Sarcoidosis
Scleroderma
Multiple sclerosis
Wegener’s granulomatosis and other granulomatous
Myasthenia gravis
Pernicious anemia
New-onset type 1 diabetes mellitus (T1DM)
LADA diabetes
Autoimmune encephalitis
Anemia pernicious
Antiphospholipid syndrome (APS)
Aplastic anemia
Temporal arteritis
Celiac disease
Guillain-Barré syndrome (GBS)
Graves’ disease
Myasthenia gravis
Pemphigus vulgaris
Primary biliary cirrhosis (PBC)
Sjögren’s syndrome
Multiple sclerosis (MS)
Ankylosing spondylitis (Bechterew’s disease)
Systemic Lupus Erythematosus (SLE)
Wegener’s granulomatosis
Lichen plans
Alopecia universalis
Behcet’s disease
Neuromyotonia

 

  • Cancers

Rectal cancer
Colon cancer
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
Chronic lymphocytic leukemia
Acute lymphoblastic leukemia
Renal cancer
Liver cancer
Brain cancer
Melanoma
Breast cancer
Cervical intraepithelial neoplasia (CIN)
Thyroid cancer
Lung cancer
Bronchial cancer
Larynx cancer
Soft palate cancer
Pancreatic tumor
Biliary tumors
Esophagus cancer
Prostate cancer
Metastatic cancer

 

  • Other Conditions

Sleep apnea
Other sleep issues: snoring, restless legs syndrome (RLS)
PCOS syndrome
Female infertility
Male infertility
Transient global amnesia
Pickwick syndrome
Toxicosis of pregnancy
Gestational diabetes
Coronary artery bypass surgery
Paranoid schizophrenia
Panic disorder
Gingivitis
Hyperactivity, ADHD
Autism
Gilbert’s syndrome
Chronic fatigue syndrome (CFS)
Migraine
Allergy
Reflux
Breast and ovary cysts
Epilepsy (generalized epilepsy, localization-related epilepsy, other forms of epilepsy)
Depression
Anxiety
Learning difficulties
Dry eye syndrome
Myopathy
Prostate hypertrophy
Renal failure
All forms of anemia
Upper respiratory tract infections
Leg ulcers
Uncertain abdominal complaints
Cystic diseases
Overmedicated conditions

 

 

I am a vegetarian. Can you help me?

If you are ready to change your diet, then yes, we can help you. But we will not be able to help you if you are not willing to change your diet.

 

My mother/father/friend is suffering from a disease. Can you help me persuading them to consult with you and to start following the PKD?

We cannot help with this. It is their own and free decision what to eat and what therapy to follow. We can only help those who have already made their own decision and are open to our suggestions.

 

I want to stop taking my medications / I do not want to stop taking my medications. Please, advise!

Whether you need or do not need your medicines is an individual medical decision. We can give medicine-related advice only to those patients who take part in the 2-weeks follow-up program and adhere to the diet. We cannot provide such advice in advance because it would not be safe.

 

You are currently following up my wife/husband/daughter/son/mother/father. I am worried. I would like to inquire about his/her condition.

Please, be informed that we are in contact only with the patient himself/herself. We understand that you are concerned, but we can not give any information without their consent. If you would like to receive information about your loved one, they need to provide us with his/her consent to answer your question.

 

Are you able to help me? I cannot purchase your program without having a prior answer to this question.

Most patients with chronic diseases are helped by our method. But your cooperation, perseverance are also needed. You also need to follow our recommendations to see results. What we can say to you is that we are doing our best and using most of our experience in order to help you.

 

I was diagnosed with histamine intolerance, familiar hypercholesterinaemia, adrenal fatigue etc… I was said that your diet and method might worsen my condition.

When it comes to the PKD and its use in different diseases, we suggest not relying on others who do not have a medical background or have no experience with the PKD specifically. In our program, we will also check the correctness of your diagnosis and revise it if needed. We will discuss whether any of the given diagnoses is a bogus, fake diagnosis and, if so, what may be the root of your problem in your case.

 

I am a cancer patient. Are you able to treat me with the press-pulse method, hyperbaric oxygen therapy, 2-deoxy-glucose, or the (Buteyko) breathing technique?

Please, be aware that we do not support these practices. We only support scientific methods that we have seen to be working in reality. We are not supporting practices that are currently popular but not helping or even harming patients.

 

Please, contact my doctor and persuade him/her that I should eat this way.

It is only your decision, not your doctor’s, what diet and therapy you follow. You do not need consent from your doctor to eat in a specific way.

 

I want to use your method together with what my physician is suggesting to me. My ask is that you team up with my physician.

Please, be informed that the approach and method we use and the current standard of care for most diseases may be mutually contradictory at several points. Therefore, an attempt to combine the two approaches will likely predispose you to disappointment. We suggest that you opt for one direction or another, one physician or another, and stick to it. Otherwise, you will not be able to see things clearly and draw the correct conclusions.

 

Can you suggest me a physician with your approach in my country?

No, it is not possible, as only our medical group uses PKD to treat chronic diseases. Even if it may seem that others are undertaking patients with low carb/keto/carnivore diets, these diets are not the best choices when it comes to autoimmune diseases and cancer. Also, the treatment of such conditions requires a lot of experience.

 

I have Lyme disease.

I have SIBO.

I have chronic fatigue.

I have histamine intolerance.

I have a C. difficile infection.

I have adrenal fatigue.

I have gut dysbiosis.

I am a lean mass hyperresponder

Please, note that many of the above diagnoses are overdiagnoses, false diagnoses, irrelevant diagnoses, or even bogus diagnoses. Regardless of these” diagnoses,” we will be doing our best to find out the real cause of your symptoms and will let you know how to fix them.

 

I do not want a consultation. I only have one question.

Even if this seems to be only one question, it is impossible to answer responsibly without knowing more about you and your medical and nutritional background.

 

I am a previous patient of yours. Can I eat vegetables? Why do I have a symptom? Why do I lose weight? Why do I gain weight?

We are not able to answer these questions for those patients whose follow-up program is not active. Not because we do not want to. But because it is impossible to answer if we do not have all the up-to-date information and specifically if we do not see a recent blood work. In this case, we suggest that you do a control consultation.

 

Why is it not possible to have a single consultation?

Because, in our experience, the single consultation is simply not efficient for most of the patients. We do not want you setting up for disappointment.

 

 

What do I need to apply to your program of initial consultation+2 weeks follow-up?

Our automatic system will walk you through the consenting and booking stages. You will need to provide your baseline data, answer a few questions regarding your history of disease and current condition, and upload your medical documents.

 

What kind of medical document do you need?

We need the medical documents from the last 12 months. Specifically, we need your latest blood work. If you have cancer or autoimmune disease, then the blood works and your imaging data (MRI, CT or ultrasound report), and your discharge documents from your last doctor’s visits are needed. If further documents are needed to be seen, we will contact you before our scheduled appointment.

IMPORTANT: We need to have your original medical documents with the original title with your identifying data. We cannot accept and review medical records where the patient name or other identifying data are edited out.

 

Do you need the CD of my MRI, CT or PET?

Yes, it is helpful to review the original imaging data. You will be able to send the content of the CD through a megafile sending program. First, prepare a single compressed/zipped file from everything that you have on the CD and upload this single file.

 

What do you offer during the 2-weeks follow-up?

During the 2-weeks follow-up, we offer dietary guidance along with medical follow-up. It includes tracking your daily home measurements, two dietary consultations with our dietary assistant, a messages exchange, access to our knowledge base containing recipes, meal pictures, questions and answers, detailed written information about the PKD.

 

What is happening after the 2-weeks follow-up?

Upon finalizing the 2-weeks follow-up, we will provide a closing report summarizing our clinical impression, suggestions on how to improve your diet, medical conclusions, and the following medical steps so that you exactly know how to go on.

If you feel that you need continued support after the 2-weeks follow-up finishes, you may consider booking an additional 2-weeks follow-up. Also, there are cases, where there is a medical reason to do a second 2-weeks follow-up.

Typically, the next step is to do a control blood work (according to the list that we provide to you). Once you have the blood test result, you are suggested to book a control consultation. You can book a control consultation at this link: https://c.nutriintervention.com/order. You have to purchase the service called “Control consultation”.

 

I have already finished my 2-weeks follow-up. What can I do if I have a quick question?

If you need quick message exchange or advice outside the control consultation (which cannot be a substitute for emergency medical care), you may book this consultation type “Extraordinary, Short Medical Advice” for a written communication within a short time https://c.nutriintervention.com/order

 

Can you provide me with a medical certificate / medical opinion / referral.

For existing patients, yes, we can. To do so, please go to book this service at https://c.nutriintervention.com/order and choose” Medical certificates”

 

What do your services cost?

You can see the prices here https://c.nutriintervention.com/order after subscribing.

 

Can you put me in contact with a patient who has a similar disease to mine?

No, unfortunately, we cannot. We are not entitled to give out anybody else’s contacts.

 

I am lost. I can only see conflicting ideas and suggestions. I do not know what to do. Please, help! Please, suggest a podcast that I can listen to!

If you have a disease or you are taking medicines, you need expert advice, not theoretical discussions, podcasts, or papers to read. First, decide who do you want help from, and then stick to that expert. We suggest choosing an expert whose recommendations have been consistent over time.

 

I have a disease. I am not following and not willing to follow PKD. Can I have a discussion with you about my condition?

No, we cannot devote time to such discussions. We want to focus on those who already decided to work with us. If you are not yet there, we suggest you read our webpage for more information. We also suggest that you read the detailed description of the PKD. https://www.paleomedicina.com/paleolithic-ketogenic-diet/

 

Do you have a case study of disease …?

We do have case studies about many diseases, though far less than the ones we have experience with. There are two reasons for this: publishers in mainstream media pushing back approaches and results with low carb/ketogenic diets, and the more so with the PKD. Second, what’s important is to have the knowledge and experience, independent of whether there is a publication. Just remember, whenever you visit your GP or another specialist, you also do not ask for his or her publications.

Nevertheless, you will be able to read short case studiesof ours here: https://nutriintervention.com/case-studies_hypothyreosis-prostate-enlargement-t2dm-overmedication/ and https://www.paleomedicina.com/en/?page=tartalom&tipus=cikk

 

 

Case studies: hypothyreosis, prostate enlargement, T2DM, overmedication, metastatic cancer and more…

Case studies: hypothyreosis, prostate enlargement, T2DM, overmedication, metastatic cancer and more…

Case studies: hypothyreosis, prostate enlargement, T2DM, overmedication, metastatic cancer and more…

Zsófia Clemens, Csaba Tóth
2021.08.28

We are often asked the question of whether we have a case report on a specific disease. We cannot write a case report on every single case we cured. Not to mention case reports published in peer-reviewed journals, which is a big task and usually a very long process to wait out. Usually more than the time required to recover and sometimes even longer than you have if you are diagnosed with a severe condition. In the below article we are giving you outlines or at least a glimpse of the histories of patients with different diseases. The descriptions are far from being full, but we concentrate on the main aspects of the diseases.

 

 

CASE 1: HYPOTHYREOSIS

 

 

 

CASE 2: PROSTATE ENLARGEMENT

PSA (prostate specific antigen) is only one marker, and there are many more to keep an eye on in prostate enlargement and prostate cancer. But the below figure shows what is expected if one switches to the PKD. The classical ketogenic diet (KD) is not ok if you have this condition. During the classical ketogenic diet, PSA increased, despite the patient followed a low-carb diet. Ketosis alone is not enough. The composition of your diet is crucial if you have prostate enlargement.

 

 

 

CASE 3: OBESITY, T2DM, HYPERTENSION, JOINT PAIN, OVERMEDICATION

 

 

 

CASE 4: RECURRENT METASTATIC CANCER (METASTASES OF BREAST CANCER IN NEW LOCATION: LIVER AND HIP BONE)

 

 

CASE 5: FATIGUE, SLEEP AND MOOD ISSUES

This patient had extreme fatigue, bad sleep, bruises on the arms, and mood swings. She was already “trying” to follow PKD with mixed results. She took part in our consultation + two-week follow-up program. Day-by-day, we rectified her diet, adjusted the meat:fat ratio to her actual needs, and caught other small mistakes that preventing her from improving previously.

 

 

CASE 6: HASHIMOTO THYROIDITIS

Initially, the patient had brain fog, body pain, swollen extremities, diarrhea and other symptoms. She was overweight. She has been taking desiccated thyroid. She was already following “partial” PKD (meat+vegetables) without major results. She took part in our program, and during the two weeks she perfected her diet, she solidified her knowledge about the application of the PKD, and gained confidence. As can be seen in the below figure, all her symptoms improved during the two weeks. She lost a significant amount of weight. Her thyroid supplementation could have been tapered down. In one month, her TSH went back to normal, and her vitamin levels (vitamin B12, folate, vitamin D) improved.

 

 

CASE 7: G6PD (GLUCOSE-6-PHOSPHATE DEHYDROGENASE) DEFICIENCY

The patient had G6PD deficiency, multiple chemical sensitivity, muscle weakness, depression, and anxiety. He had a history of multiple hemolyses requiring hospitalization.

 

CASE 8: LONG_STANDING TYPE 1 DIABETES

In long-standing type 1 diabetes, it is not possible to stop using external insulin. However, there are at least 3 benefits: lowering insulin dose, avoiding hypoglycemia episodes, and preventing long-term diabetic complications

 

 

 

 

CASE 9: GESTATIONAL DIABETES

 

CASE 10: OBESITY, HYPERTENSION

49-years-old male patient taking part in the two-weeks follow-up program. In 18 days blood pressure normalized, and he could discontinue the antihypertensive medication. He lost 4 kilograms.

 

More case studies are coming…

The case of the best performing glioblastoma patient in the world and Frontiers in Nutrition

The case of the best performing glioblastoma patient in the world and Frontiers in Nutrition

The case of the best performing glioblastoma patient in the world and Frontiers in Nutrition

Dr. Csaba Tóth,  Dr. Zsófia Clemens

 

The case of the best performing glioblastoma patient in the world and Frontiers in Nutrition

It seems that “prestigious” medical journals are notoriously hindering reliable scientific medical information. This is, of course, nothing new and also applies to less prestigeous journals. Yet, still shocking when it comes to a cure of a deadly disease, namely glioblastoma. Here we tell the story in the form of questions and answers.

 

What kind of disease is glioblastoma?

Glioblastoma is one of, if not, the deadliest cancer type. Glioblastoma results in epileptic seizures, nausea, vomiting, trouble with walking, paralysis of the muscles, personality changes, problems with speaking and memory. In more advanced stages of the disease, it causes an inability to swallow, incontinence, somnolence, unstoppable epileptic seizures, coma, and ultimately death. This is the disease that took the life of John McKain, Edward Kennedy, and Beau Biden, son of the current American president. As shown by the so-called Kaplan-Meier curves, glioblastoma survival after 4 years is less than 3%. The below figure also shows the ”on the diet” survival and overall survival of our glioblastoma patient.

Figure: Our glioblastoma case vs. the Kaplan-Meier curve for survival

To what extent is glioblastoma affecting people?

There are 250,000 new cases in the world annually, and the numbers are increasing.

 

Why do you use an unconventional approach to treat glioblastoma when you are supposed to use the standard one?

Because we know from experience that the standard therapy (chemotherapy and radiotherapy) only worsens the outcome. We also know that the PKD (paleolithic ketogenic diet) gives the best chances to live as long as possible. As a physician, you took an oath (aka Hippocratic Oath) to strive for your patients’ recovery and life. The Hippocratic Oath is about the patient’s interest and not about following certain guidelines and standards.

 

What does recurrent glioblastoma mean?

“Reccurent” means that cancer has already been treated by standard modalities (surgery, chemotherapy, and radiotherapy), but despite all these “efforts” the disease recurred. 

 

What are the prospects with recurrent glioblastoma?

Somebody with a new glioblastoma diagnosis has six months to live on average. When we first met this patient it was already 8 months after his initial diagnosis. You can do the math about the prospects of this patient. 

 

What are the results you had with this patient?

The patient had remained progression-free, completely seizure-free, completely medication-free, and completely symptom-free. Currently, already for 4 and a half years.

Figure: MRI and CT scans performed during the course of the disease. 

 

What was the reaction from your colleagues when they learned about the unusual survival time of your patient?

  • You are going to kill this patient!
  • You are irresponsible! 
  • Don’t be too happy. The patient will die “in the end”.
  • This is a miracle from God
  • It is ok that the patient is still alive, but he cannot live without his antiepileptic medication
  • The initial diagnosis was wrong
  • The patient has a rare genetic feature that predisposed him to live that long despite glioblastoma

 

What reactions did you get from laypeople?

Mixed ones. More negative than positive ones. A lot of people were outraged and reacted in a highly offensive way. When we started the diet therapy with this patient back in 2016, we were the only ones saying that stopping eating plants is the way to go if you want to stay alive with glioblastoma or any other advanced cancer. Today’s carnivore influencers were nowhere at that time, so we were quite alone with our opinion. Some of these carnivore influencers were still following a vegetarian diet at this point. We were also the only ones telling the patients that chemotherapy and radiotherapy would shorten their lives. As a result, we received an immense amount of emotionally charged attacks.

 

Why did you want to publish in a scientific journal? Why is it not enough that you know you saved this patient?

Because we aim to help as many patients as possible. Publishing in a scientific journal is normally the way to introduce new scientific results in the field. This is how you disseminate your scientific result if you are a scientist. It is also the Health Law that tells you that publishing at scientific forums is the preferred way to make your results visible. Of course, nobody will pay you for the unique contribution that you want to share with others. On the contrary, you have to pay a large amount of money to get your article published. If you are not particularly wealthy, you may not be able to cover the publishing fee yourself. 

 

Where did you try to publish your results? 

We tried Frontiers in Nutrition.

 

Why did you pick Frontiers in Nutrition?

As the journal’s name implies, we thought that this journal is interested in publishing cutting-edge research. Also, because it is known as a low-carb friendly journal, we thought they would not immediately decline our manuscript with a knee-jerk reaction. An additional reason for picking Frontiers in Nutrition is because this journal was suggested by the author of the “other” case report that we will speak about later.

 

Did you publish your paper as a preprint beforehand?

Yes, we published the manuscript preprint at preprints.org in 2019. To tell you the whole story, preprints.org first also rejected publishing the manuscript, we guess, as a knee-jerk reaction. Since there was no formal reason to reject it, after some correspondence, they did post it.

https://www.preprints.org/manuscript/201912.0264/v2

Figure: Preprint

 

Why is it important to publish a paper as a preprint?

Because if you publish your manuscript as a preprint, then it becomes citable to other researchers.

 

Have you presented the case of this patient elsewhere?

Yes, we did present this case at several international conferences, including Italy, Germany, and the US.

 

What was the reaction at these conferences?

We tell you one typical story. In 2019, the Low Carb Denver Conference committee first declined the abstract of our poster, saying that it is highly “controversial” that the patient received no chemotherapy and radiotherapy. Later on, they did accept it.

 

What did you expect from Frontiers in Nutrition?

We expected that the publication process would be complicated, but we thought it would be fair.

 

Did you receive positive reviews from Frontiers in Nutrition reviewers?

The first reviewer said “everything is a limitation” then answered 13 times “no” to the 13 review questions. That was the whole review in this prestigious journal. The other review was correct. After this first round, the Editor decided to decline the manuscript based on the review’s suggestions. We decided to appeal the Editor’s decision and replied to the journal that that review may have included certain flaws and maliciousness, and we would appreciate another reviewer who can be fair. After this, a new Editor was appointed, and new reviewers were invited, altogether 4 more reviewers. Some of them were quite positive.

 

How long was the publication process at Frontiers in Nutrition?

It was 18 months long. It included two editors, six reviewers, and four rounds of resubmission. We were in the midst of preparing the 5th revision of the manuscript. We have to do so as one of the reviewers raised concerns about the diagnosis (at 14 months after initial submission!) and asked for additional histopathological exams from a sample that was more than 5 years old at this time. The reviewer specifically asked for checking for IDH mutation and MGMT methylation status. Considering all the associated legal aspects, this is a huge task because this necessitated obtaining a bunch of approvals from many parties. With all this amid the corona pandemic, we needed more time and asked for an extension of the deadline. Interesting things started to happen at this point.

 

What kind of interesting things happened?

Frontiers in Nutrition wrote that they are unwilling to extend the deadline because the review process has already been “too long”. After a few days, another interesting thing happened. Frontiers in Nutrition published a case study with a very long glioblastoma survival due to a ketogenic diet therapy. It was not our case report.

 

Was there anything else interesting with this paper?

Honestly, this alone was quite a shock. Moreover, there was no reference to our glioblastoma manuscript in this paper, even though our manuscript is formally citable as a preprint. 

 

Not that that’s not enough, but has there been anything else interesting?

Yes. We sent the case of our glioblastoma patient to one of the authors of this group in January 2018 (that is 3 and half years ago!). In an absolutely selfless way, we provided very specific information to this other group. Upon the request of this group, we sent original, yet unpublished data too. We genuinely thought that we should not withhold any crucial information from like-minded colleagues. Very soon after this, the first version of our glioblastoma manuscript was also sent to this group. The “other” case report not only did not reference our glioblastoma manuscript, but there was no reference to any of our previous case reports in the context of cancer. We also have a paper where we discussed the standard therapy vs. no standard therapy.

approach in cancer, which was a first of its kind that points to the likely adverse effects on cancer, based on direct clinical experience. Although the “other” case study also attributed long-term survival to not having chemo- and radiotherapy, the authors did not cite this paper either.

 

Has there been anything else as an “interesting” circumstance?

Yes, it was quite interesting to see that the last reviewer of our manuscript asked for checking for IDH status in our patient while the “other” case report was about a glioblastoma patient with IDH 1-mutant glioblastoma. This is an interesting coincidence that may raise the possibility of a conflict of interest. Of course, reviewers are anonymous, and we cannot be entirely sure about this. Anyway, the IDH status, in our opinion, is not at all a central issue, or we should rather say, is entirely irrelevant. Also, it is not too frequently discussed elsewhere as an attribute of glioblastoma.

 

Why do you think IDH status is irrelevant?

In our opinion, the IDH status and the other two molecular markers the reviewer asked for are irrelevant. In our experience, no matter what mutation the glioblastoma patient has, this will not affect the outcome of the diet therapy. It is only diet adherence and the presence/absence of other standard treatments that matter. Despite all these, we opted to do this additional histopathological exam to accommodate the reviewer, even if we knew this would significantly delay publication.

 

 

Why did the reviewer ask about the IDH status?

This was also about the correctness of the diagnosis. This reviewer also asked whether the histopathologist was independent from us. We assured the reviewer that the histopathologist who did the report was completely independent from us, as it was 8 months before we met the patient himself. We also replied that the diagnosis of glioblastoma, as stated in the histopathological report, was presented at the specialists’ consultation where all the attendant specialists of the hospital agreed with the diagnosis of glioblastoma (WHO grade IV). Apart from this, the review was very positive.

 

Why do you think Frontiers in Nutrition favored this glioblastoma manuscript over yours?

We don’t know. Our case report is superior over the “other” case as regards all relevant medical aspects. Our overwhelming experience is that journals massively sabotage researchers from Eastern-Europe and Russia.

 

Why do you think your glioblastoma case is superior to the “other” one?

First of all, our patient remained completely progression-free now already for 4 and a half years. At the same time, the “other” case, even if slowly, continuously progressed over the years.

 

In what other aspects is your case superior to the “other” case?

Our patient did not receive any other treatment after starting the diet therapy. The other patient underwent surgery because of tumor progression. Our patient did not have a single epileptic seizure in the last 4 and half years. The other patient did have seizures. Our patient did not receive antiepileptic or any other medicines. The other patient has been receiving antiepileptic and other medicines. Our patient is indeed “our” patient, meaning that we advised and followed him very closely and continuously, including several hundreds of email exchanges, phone and personal consultations during the 4 and half years. The “other” patient self-applied the diet without any professional guidance but relied on internet-based information of variable reliability, some of them not even qualifying as being scientific. The thing is that our patient is currently the best performing glioblastoma patient that ever received a dietary therapy in the world (but likely also the best performing one considered all other glioblastoma patients).

 

Your case report was reviewed for 18 months without a result. How long was the other case report reviewed?

The other paper took only 2 and half months to be published from submission.

 

Aren’t you happy about the result from the other case?

We are not happy with Frontiers in Nutrition very trickily delaying the publication of our manuscript for 1 and half years. This is 3 times the rest of your life if you are a glioblastoma patient. Given the annual number of new cases worldwide, this information theoretically could have affected 375,000 glioblastoma patients. What if it is your mother, wife or daughter the one who could have benefited out of these 375,000 patients? Of course, we are glad that there are other research groups on the same side, even if these groups are, as it turned out, “rival” research groups. It is ok if results, ideas, and methodologies compete with each other. But this should be done in an ethical and correct way. We think it is entirely unacceptable from a publisher or a journal to deceive and silence a research group and favor another.

 

Do you have any other glioblastoma patient who is that successful?

Yes, we do have many who are progression-free for a long time, not taking medications, and experience a high quality of life. Only in the last 12 months, we had more than 10 new glioblastoma patients. And many more with brain cancers of other types. Most of them are progression-free, medicine-free, and symptom-free. As you can imagine, with a dietary and non-standard therapy, the “human factor” is enormous. Therefore not all patients are adherent enough to the diet or the medical suggestions given to them, and not all patients are as successful as the patient from the case report.

 

Why did you go public about this issue?

The “other” case study was published “publicly”. Why shouldn’t we react publicly?

 

Are you going to publish about your other glioblastoma cases after all?

What would be your suggestion? 

 

 

  Journal Decision What did we do?
07.12.2019 Preprints   Submitted
09.12.2019   Declined without explanation Asked for explanation
10.12.2019   Answered that we did not upload one of the documents  
10.12.2019     We answered that we did upload the requested document
17.12.2019   Accepted the preprint  
26.12.2021 Frontiers in Nutrition   1st submission
      2 reviewers involved
05.02.2020   Rejected by the Editor  
14.03.2021     We raised concerns about serious “flaws” in the review process: one reviewer answered “no” 13 times, that was the review!
24.04.2020   New Editor was assigned and review started again with 2 new reviewers  
    Asked for revision We did the revision
17.09.2020     2nd submission
    Asked for revision Did the revisions
15.10.2020     3rd submission
    Asked for revision Did the revisions
11.02.2020     4th submission
    Asked for revision, reviewer questioned the diagnosis of the patient, and asked for additional histopathology. Started working on the revision including doing the new histopathology
      We asked for deadline extension because the scale of the requested extra work was impossible to finish in time
20.05.2020   Frontiers declined deadline extension because of the “delayed” state of the manuscript  
20.05.2020     We asked for considering deadline extension after all, because of the scale of the modifications asked by the reviewer
31.05.2021   Case study got accepted by Frontiers in Nutrition!!! The only “problem” that it was not ours, it was another glioblastoma case study but with a strikingly similar methodology. This case study took only 2.5 months to review! This case study included no reference to our study, even though the online preprint is citable.  
02.06.2021   Frontier in Nutrition wrote that we may complete the revision and submit the new version of the manuscript ???

Table: Overview of the 18-months review process at Frontiers in Nutrition

 

Dr. Zsófia Clemens and Dr. Csaba Tóth

 

How to cite:

Tóth, C.; Dabóczi, A.; Chanrai, M.; Schimmer, M.; Horváth, K.; Clemens, Z. 4-Year Long Progression-Free and Symptom-Free Survival of a Patient with Recurrent Glioblastoma Multiforme: A Case Report of the Paleolithic Ketogenic Diet (PKD) Used as a Stand-Alone Treatment After Failed Standard Oncotherapy. Preprints 2019, 2019120264 (doi: 10.20944/preprints201912.0264.v2).