Peter Attia

Yeah.

So let's talk about that.

So a standard drink is about 15 grams of ethanol, maybe more, right?

Yeah.

Yeah.

Call it 20.

We round up 20.

So now I'm asking you to have five alcoholic beverages a day.

And by the way, you could space that out over the course of the day and not even get a buzz.

Say five alcoholic beverages a day for two weeks, you are metabolizing ethanol with alcohol dehydrogenase and...

You're going to create all of the various metabolites.

And the reason your transaminases are elevating is those enzymes are leaking out of hepatocytes because the hepatocytes are injured due to the inflammation that results from that metabolic pathway.

Is that at all analogous to what's happening with a comparable dose of 1,3-butanediol?

Do you generate the same amount of aldehyde?

And why can't that patient make enough insulin in response to the beta-hydroxybutyrate to bring the acidosis under control?

Oh, you're saying the liver doesn't respond to the insulin signal to make less BHB in that situation?

It does?

So why does it in the rest of us?

Like when you and I used to do our ridiculous 10-day fast, do you still do those, by the way?

Yeah, yeah, yeah.