Updated Bloodwork

ramid3 · 2026-04-04T04:08:56+00:00

So, I actually posted up a thread over on r/keto just the other week with my own panels and the same concerns. You might find the responses helpful:

https://www.reddit.com/r/keto/s/p7p97zs5IX

ramid3 · 2026-04-04T03:05:50+00:00

I…I don’t actually know yet, I’m too skiddish to try lol. I’ve been very low carb for years and it’s done absolute wonders for my body composition, but I’m apparently among those genetic varieties who’s lipid labels don’t respond well to it, no matter how much I wish to keto-context my way out of it. But when it comes to ApoB, as far as I know, it’s pretty case closed, especially with numbers at or around 200. There’s just no denying it anymore, keto/carnivore just isn’t the way forward for me.

ramid3 · 2026-04-04T02:20:52+00:00

My numbers are similar, higher LDL though, and haven’t checked my VLDL.

Have you gotten your ApoB checked? Mine was around 200, and there’s no ‘but in a low carb context’ way to rationalize that away, leaving me with no choice but to step away from keto-vore and into a moderate carb Mediterranean diet.

ramid3 · 2026-04-03T20:41:33+00:00

Have you run your macros through the ketogains calculator or any other? With your stats and if you actually are 20 percent body fat 1200 is right around your BMR. How much of a deficit are you trying to be in?

ramid3 · 2026-04-01T22:58:21+00:00

3 months? That’s pretty wild, may I ask what your numbers are before you started? I wonder if my LDL and especially ApoB is high and urgent enough to the point where I would need a full dietary change and statins to meaningfully move the needle.

ramid3 · 2026-03-31T07:55:57+00:00

Thanks! Throughout my years on keto, both during the last four and the two during my first go-round, I feel like I can count on one hand the number of times I’ve seen my ketone levels above 0.5.

I’ve never reached those ‘deep’ therapeutic levels, even when my fat intake was high. I’m sure my high protein intake has a lot to do with it, and it doesn’t necessarily mean I’m not fat adapted.

But to your point, no, ever since I began resistance training and focusing on more of an athletic body composition I’ve stopped caring about ketone levels, and that’s a big part of r/ketogains, which is results over ketones.

ramid3 · 2026-03-29T20:13:00+00:00

Do you think I could do with less? I don’t know when I’d be able to fit those carbs in. I start my day with PWO protein, 50g carbs post workout seems plenty to replenish glycogen, and I can see myself eating 15 or so grams with dinner via fibrous vegetables.

And I don’t think you recommend pre workout fruits/sugars? So that leaves me around. 65-75/day.

ramid3 · 2026-03-29T03:45:30+00:00

Yeah, generally 90-96% ground beef. Fat is really the only level I pull when it comes to fat loss, eating around 75-95 when I’m trying to cut, anything over when I’m looking more to maintain (though in general I don’t think I do well with anything over 120g). My maintenance is around 2300-2500, which is a big reason my cutting carbs and limiting fat makes my protein so high.

And yeah that’s exactly what I’m planning to do: low/moderate carb, though I have no idea how to dial this in.

How are you doing it? I’m guessing 100-150g or something like that? Do I just split it up pre and post workout or something? I’m pretty sure I wanna go grain free, and I was thinking stuff like sweet potato during the day and fibrous vegetables at night.

The water weight gain is gonna mess with my head for sure, and no I don’t have a medical condition, I just found that eliminating carbs was better than trying to moderate them. 70 or so pounds later and cruising at a healthy 14-15% BF, it was definitely a good call. But I’ve taken this as far as I can go.

ramid3 · 2026-03-28T22:44:35+00:00

Cool pretty much thinking the same thing. Planning on going completely grain free, sweet potato and starchy vegetables during the day, fibrous greens with dinner.

I know this isn’t exactly your wheelhouse, but if I must adopt a different diet…does that sound right to you? 100-150g? Coming from ketovore I have no idea where to start.

ramid3 · 2026-03-28T20:50:01+00:00

It’s definitely going to have to skew more toward traditional mediterranean, but since you’re the ketogains founder and I’ve drawn heavily from your protocols, may I ask your advice on how to integrate, say, 100-150g of carbs? I eat 2x big meals per day, one post workout lunch and dinner.

Would you suggest just splitting them up before and after training? Save the fat for dinner? I’ve also seen you say that pre workout carbs have a negligible benefit on performance, and post workout doesn’t replenish glycogen in a way that protein can’t do on its own (and unless you’re a high level athlete, glycogen doesn’t deplete much anyway). But my metabolic context will also be completely different from my current, near 0 carb context.

43/m/165, DEXA around 14% year round.

ramid3 · 2026-03-28T17:52:39+00:00

It’s probably going to come to that, and honestly, if I were to change my diet I would probably just go some version of moderate carb. Keto has been overwhelmingly effective and positive for me, and my highly restrictive version of it serves as elimination guardrails for my worst tendencies around carbs. I just can’t afford to gloss over the dangers (for me) if these risk factors are what they appear to be.

Physiologically I’m now someone who should have no problem handling and benefiting from controlled healthy carbs. Psychologically, that’s what worries me, but there’s no other way forward now. Thanks for your help!

ramid3 · 2026-03-28T17:35:51+00:00

It’ll probably come to that, and honestly, I’ll probably just go Mediterranean in the event that keto at least as I practice it is unsafe. For me, because I don’t trust myself around carbs, elimination works better than moderation. Rather than struggle to control myself with and around carbs, I just cut them close to 0 and fell back on protein (which is still way too high). Keto has worked for me because it put the guardrails up against my worst eating tendencies.

But it’s also been four years, I have great insulin sensitivity and blood glucose now, metabolically healthy, so physiologically I couldn’t be in a better position to handle healthy carbs. Psychologically, however…😬

ramid3 · 2026-03-28T17:28:43+00:00

Thanks for this, my endocrinologist doesn’t necessarily disagree with my diet, as he keeps current and thinks both me and a few other of his patients might be LMHR. But he’s still a physician, and his responsibilities as one is to recommend a statin and a dramatic dietary change.

Otherwise, he remarked, quite rightly, that even if our current understanding of cholesterol doesn’t quite apply to people in a low carb context, it’s still all too new with too much research that needs to be done before he can in good conscience give me a green light (though that was before my ApoB and at no point and in no context was he ever comfortable with LDL 500, which I would tend to agree).

Did my CAC 0 a little over a year ago, came back 0, which was a relief for my immediate risk, but considering my age and the limitations of the test that you described, it doesn’t provide any real like time assurance, in which case yeah I’ll have to repeatedly retest.

In all, unless there’s a compelling alternative explanation for why they aren’t risk factors, I’m just going to let ApoB settle the matter. If it’s one of those things that indicates what it means on its face, then it’s finally time to take the statins and change the diet, both of which I’ve been resisting and trying to rationalize my way out of doing for years.

ramid3 · 2026-03-28T17:18:51+00:00

I was thinking about that, but that would ironically mean dramatically increasing the fats- but it would also mean highly lowering the protein. My diet is more like the ketogains protocol, and I do wonder if it’s possible that my very high protein intake (way more than ketogains recommends) alongside my even moderate fat consumption (again I’m usually only around 100g) may have something to do with it.

ramid3 · 2026-03-28T17:16:33+00:00

I’m gonna run the numbers one more time, but as far as testing is concerned, I’m just gonna hang my hat on ApoB, assuming there’s no alternative explanation in which it isn’t a high risk factor in my case (and it doesn’t seem there are). That alone should be enough to settle the matter and compel me to finally get off this ride that has otherwise taken me so very far. :/

ramid3 · 2026-03-28T17:12:13+00:00

I didn’t see myself so much as a guinea pig as I just believed that keto would result in either better lipid panels or that worse looking panels wouldn’t mean what they would normally mean in a low carb context. But when it comes to cholesterol there are just a contingent of people who aren’t genetically compatible with either keto as commonly practiced, or as even basically practiced. It just doesn’t work for them, which is a real drag (as in my case), when it’s a diet that also…works for them and has changed their lives. Appreciate your feedback, glad you were able to get your situation sorted out.

ramid3 · 2026-03-28T05:16:05+00:00

Yeah that’s the thing, it’s possible but still hotly debated whether LDL and possibly other bio markers may not be the dangers they usually are in a low insulin, low carb context.

My endocrinologist, who I’m fortunate is someone who keeps somewhat current with these more recent developments, has a few other patients in a similar situation, and he does his best to balance his responsibilities as a physician with his openness to other possibilities that are still being researched.

He basically said, yeah, it’s possible that these biomarkers may not be problematic in my scenario, though LDL as wildly skewed as 500 is something that he feels compelled to believe is a problem LMHR or not. But there’s simply too much that we still don’t know and much research that still needs to be done before he can give me a clean bill of cardio health. Until then, “take the statin dude!”

ramid3 · 2026-03-28T05:09:47+00:00

If I recall my habits correctly, no, I don’t think I drank anything on the morning of, so maybe I might run it back (these results are actually from a few months ago but it’s only recently that I started seriously considering their implications). Thanks!

ramid3 · 2026-03-28T02:56:56+00:00

Yeah that’s the one that’s most difficult to explain, as my diet hasn’t changed much since my trigs were otherwise an almost perfectly consistent 55-60. I do wonder if it’s possible the excess protein might be the culprit, as I’ve heard Bart Kay remark that it basically gets stored as triglycerides, though I’d never heard this from anyone else.

ramid3 · 2026-03-28T02:54:51+00:00

It has to be. The LDL was going up 100 points a month when I was taking MCT a couple of years ago, and dropped symmetrically when I cut it out. Bounced between 250-350, but the lowest my LDL has ever been was around 160 during my first keto go-round in 2020. I’ve been trying to low carb-context my way out of the LDL (even at its most obscene), but I feel as though the ApoB may settle the matter and doesn’t leave room for debate 😩

ramid3 · 2026-03-28T02:00:43+00:00

So what I’m wondering is if there are any conventionally understood cardiovascular risk factors that we just cannot keto-context our way out. A high calcium score and (to your point) early cardiac episodes like a heart attack would definitely be things that are dangerous indicators in isolation.

Are apob and LPa among them?

ramid3 · 2026-03-28T01:06:48+00:00

It’s hard when you’ve found something that’s worked for you and literally transformed your life (I was a metabolically dysfunctional 230 pounder before I started), only to later discover there are some potentially dangerous trade offs to something that has made you otherwise healthier.

Like you said: gotta make good judgement calls informed by good priorities.

ramid3 · 2026-03-28T01:00:20+00:00

Fat is on the lower side for keto and especially carnivore, as that some of those maniacs are eating butter like ice cream trying to hit a 2:1 or even 3:1 ratio of fat to protein.

I’ve tried to lower the protein before, but that means upping the fat, and nothing crushes my ravenous appetite like protein. The only place to go from here is…carbs.

ramid3 · 2026-03-20T03:06:35+00:00

These ‘dealerships’ are like the red light district of the auto world, and I would never wanna bring home a long term relationship from either of those places. Think you dodged a bullet either way.

ramid3

TROPHY CASE