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Comment by misja111 | Hacker News Reader

> The size of the brain and lung lesion remained stable after nine years of KD therapy. However, dyslipidemia developed after this time which led to the discontinuation of the diet.

This is new to me, I didn't know that a keto diet can lead to dyslipidemia? If I search for secondary causes of dyslipidemia (primary cause is genetic), the only lifestyle factor I can find is excessive alcohol use.

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I was doing the keto diet several years ago. I went from 240lbs to 175. I had to stop though because my bad cholesterol went through the roof. Came to find that I am APOE4/4, basically I have a genetic mutation that among other things means my body has trouble dealing with saturated fats.

I stopped doing keto and ended up getting back up to 220lbs, but my blood levels went back to normal.

I really want to do keto again because it's the only thing that's ever worked for me and I keep hearing about studies like this, but I also don't want to mess up my levels again.

There's evidence that having super high LDL cholesterol on keto may be fine (do your own research, obviously). Check out https://cholesterolcode.com/ and look up Dave Feldman. Some really interesting research will be coming out soon.

Feldman was on Peter Attia's podcast [0] and I was not impressed. LDL seems causal in the process of ASCVD. [1] I can't think of a stronger statement in science than one invoking causality. (In particular, it seems necessary, but not sufficient. Interestingly, it seems you can't go too low with LDL [2].)

I wonder if OP could continue keto, but go on a statin/pcsk9 inhibitor/bempedoic acid/ezetimibe. Of course, these are prescriptions, so he'll need to find a willing doctor. And have money to shell out. It sucks that he's APOE4/4, since that makes him so much more susceptible to other types of metabolic/cardiovascular disease [3]

0: https://peterattiamd.com/davefeldman/

1: https://pubmed.ncbi.nlm.nih.gov/28444290/

2: https://www.health.harvard.edu/blog/ldl-cholesterol-how-low-...

3: https://peterattiamd.com/johnkastelein/

If your body cannot find blood glucose for metabolism then it will respond by efficiently digesting dietary fats and maintaining high lipid levels in the blood.

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