LDL on Keto: What Happens When Ezetimibe Enters the Picture? | Dr. Josh Wageman, Dr. Laura Buchanan, and Dr. Matt Calkins - E460

A ketogenic diet can dramatically improve metabolic health while sending LDL-C through the roof. So what's actually happening? Dr. Josh Wageman and Dr. Laura Buchanan break down their new study, "Increased LDL-C reduction with ezetimibe in ketogenic diet-induced hypercholesterolemia."

The results raise some fascinating questions. In 14 patients who developed very high LDL-C while following a ketogenic diet, ezetimibe cut median LDL-C from 254 to 127 mg/dL—a remarkable 53% reduction. Why was the response so much greater than what's typically seen with ezetimibe? Could altered cholesterol absorption help explain why some people experience dramatic LDL increases on keto?

Josh Wageman, Matt Calkins, and Laura Buchanan take us inside the study, explore the biology behind the findings, discuss what the results can—and cannot—tell us about cardiovascular risk, and explain why much more research is needed.

If you've ever wondered why LDL can rise so dramatically on a ketogenic diet—and what might be driving it—this is a conversation you won't want to miss.

In this episode, Dr. Tro, Dr. Buchanan, Dr. Calkins, and Dr. Wageman talk about…

• (00:00) Intro

• (05:07) Statins, lipids, and ezetimibe

• (08:44) Insulin resistance, the liver, and the ketogenic diet

• (15:01) The results from Drs. Josh, Laura, Tro, and Matt's cohort study (see links below)

• (24:24) Some side effects and other downsides of statins

• (25:47) Statins and lipid lowering

• (32:26) Plaque reduction

• (41:45) Recent studies on statin use and effectiveness in reduction of all-cause mortality

• (43:50) Why it is such a massive task to begin changing long-held medical paradigms

• (54:43) Rapping about lipids

• (57:38) Outro

For more information, please see the links below. Thank you for listening!

Links:

Please consider supporting us on Patreon: https://www.lowcarbmd.com/

Resources Mentioned in this Episode:

Increased LDL-C reduction with ezetimibe in ketogenic diet-induced hypercholesterolemia (STUDY): https://www.researchgate.net/publication/413581066_Increased_LDL-C_reduction_with_ezetimibe_in_ketogenic_diet-induced_hypercholesterolemia

Josh Wageman:

• IG: https://www.instagram.com/wagemanjosh/

• Book: https://www.amazon.com/dp/B0DTJ1HJ4Y?lv=shuf&channelId=500&plpRedirect=mhFallback

• Website: https://lifelovelipids.com

Dr. Laura Buchanan:

• X: https://x.com/LauraBuchananMD

• The Society of Metabolic Health Practitioners: https://thesmhp.org

Dr. Matt Calkins:

• X: https://x.com/MattCalkinsMD

Dr. Brian Lenzkes:

• Website: https://arizonametabolichealth.com/

• Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author

Dr. Tro Kalayjian:

• Website: https://toward.health

• Twitter: https://twitter.com/DoctorTro

• IG: https://www.instagram.com/doctortro/

Toward Health App

Join a growing community of individuals who are improving their metabolic health; together.

Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more.

Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888

Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US

Learn more: https://toward.health/community/