Hi all,
I’ve been on Keto for the better part of 4 years and have great success with it. Dropped 60 lbs.
I had normal cholesterol numbers before i started keto. lost a ton of weight, but on a regular blood test, my numbers all shot up. i went to see a cardiologist (about a different matter - extra heart beats) and when he saw the number he wanted to put me on Statins right away. I was able to talk him down and he agreed to let me get a CAC for my arteries. When the score came back at 0, i was able to hold him off for a few months until i got a CCTA done (soft build up of Plaque). Unfortunately the test came back at 25% blockage. Now he wants me to be on statins and consider changing my diet to something less fatty.
ANY ADVICE??
I do keto in a high protein low carb kind of way - concentrating my carbs in minimal higher soluble fiber and polyphenol rich organic berries, cruciferous vegetables, asparagus, and occassional peas, etc.(except when I have my Bday and cheat). I have changed a few additional supplements since a year ago, but my total cholesterol increased a tad. My triglycerides fell markedly from 198 H in Dec 2024 to 104 in Feb 2026. However, my guess is I was burning less fat, because my ketones went from 1 to trace this year. My non HDL cholesterol actually went down from 117 in Dec 2024 to 108 in Feb 2026. My HDL cholesterol went from 44 in Dec 2024 to 57 in Feb 2026 putting me in the very low risk category ratio of 1.5 LDL/HDL RATIO. My HbA1c dropped from 5.6 to 5.4 with a fasted blood sugar of 88. My insulin was 3.2. My oxLDL dropped markedly from the low of 59 to the very low 34, which pleased me greatly. My omega 6-omega 3 ratio was a low 3.3 in Feb 2026 - mostly because my DHA was quite high at 9. I attribute that to the calamari supplement I take in the evening, and a weekly diet of wild sockeye salmon for 2 evenings.
I found I do carry a risk of heart disease even with my very good numbers because my LIPOPROTEIN (a) is 78 (nmol/L), which is high. I have never tested this before, so I need to watch my diet. I believe I reversed the start of heart disease from about 5 years ago as I have dropped my blood pressure around 50 pts, and improved my varicose veins in my R leg. Recent sonogram testing found no plaque in my carotid arteries nor abdominal aorta. I believe the soluble fiber I do eat has contributed greatly to the improvement of my cardiovascular status, and if you would like you can question me about specifics.
I’ve never been on any prescription cardiovascular drugs - changed everything with supplements and diet. I think one important thing we lack in the Western diet is vitamin K2. That’s what I started with to get any excess calcium out. Then quickly added vitamin D in the winter when I found it went too low. The next year I started keto, the way I’ve described, and everything started getting better yet. I’ve gotten my blood pressure as low as 98/62. I don’t do keto year round. From April to October I’m simply low carb. I’m 44 lbs below my peak 8 years ago and 21 pounds down from when I first started keto at 195. If you have severe blockage, statins may help the healing process, but I personally vowed not to go on them or any heart drugs. My plan is to optimize the design God gave me. I do spend quite a bit on supplements, but $0 on prescription drugs.
At work now so won’t half enough time to track it down, but check Ben Greenfields podcast and search for reducing plaque. A handful of cardiologists have developed protocols for getting it back out, statins are part of it, but along with other stuff that actually gets it done vs constantly upping statins alone and pretending it fixes anything.
I may have the list of things they used bookmarked at home, I’ll check, but when I listened to that I remember saying “better keep this for when my scan sucks” lol.
The reason for soft plaque build up may not be dietary, if that is properly dialled in.
Stress hormones and inflammation can result from stress (e.g. high stress job or workplace), or poor sleep quality. They would be two areas to look into.
The other thing to consider is that blood vessel endothelial plaque build up is secondary to inflammation in and around the arteries. Persistent high blood insulin and high blood glucose are the usual culprit sorted out with a low-carb way of eating, but it is worth monitoring fasting insulin and HBA1C blood tests, serially, over time to identify and concerning trends.
The other inflammatory cause may be toxic visceral fat surrounding the heart. If you have had a CT for a CAC score, then you might be able to get a look at the actual image slices to see the amount of visceral fat around the coronary vessels, and whether something needs to be done.
