Low Carb MD Podcast

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/

Anthony G. Jay, Ph.D., is a biochemist, researcher, bestselling author, and founder of AJ Consulting Company. His research background spans fats, hormones, cholesterol, genetics, epigenetics, stem cells, and infrared light, including work with the U.S. Department of Veterans Affairs and Mayo Clinic. Today, Dr. Jay combines his scientific expertise with public speaking and writing, exploring topics at the intersection of biology, health, and human performance. He and his wife homeschool their five children.
In this episode, Dr. Brian and Dr. Jay talk about…
(00:00) Intro

(00:54) Biology and theology

(03:54) The highest risk factor for heart disease

(05:43) Plaque reversal

(08:34) Statins and diabetes risk

(14:45) LDL and heart disease

(22:35) Connecting insulin resistance and heart disease

(25:44) How corruption is keeping harmful medical narratives afloat

(34:41) Covid coverups

(37:28) How to avoid bias information in the heart disease space

(51:40) LPA

(55:07) ApoB

(01:01:34) Plaque stabilization and reversal

(01:06:35) Outro

For more information, please see the links below. Thank you for listening!
Links:
Please consider supporting us on Patreon: https://www.lowcarbmd.com/
Dr. Anthony Jay:
X: https://x.com/anthonygjay

Website: https://www.ajconsultingcompany.com

Sugar Beat (new book!): https://www.amazon.com/Sugar-Beat-CHOLESTEROL-Destroys-REVERSING-ebook/dp/B0H9QN2BL9?ref_=ast_author_mpb

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/

Dr. Annette Bosworth, known as Dr. Boz, is a physician, educator, and bestselling author who has become a leading voice in metabolic health and therapeutic nutrition. After witnessing firsthand the limitations of conventional approaches to chronic disease, she began exploring the powerful role of nutrition, fasting, and ketosis in improving health. Through her clinical work and popular educational platform, Dr. Boz helps people understand the science behind metabolic health and turn it into practical, sustainable strategies for everyday life.
In this episode, Dr. Brian, Dr. Tro, and Dr. Annette talk about…
(00:00) Intro
(02:42) A little bit about Dr. Annette and an overview of the research she is working on
(11:56) Dr. Annette's research on ketogenic patients and Tirzepatide
(21:09) GLP1 non-responders
(38:01) Sardine fasting
(42:25) Food noise and behavioral change
(49:35) Outro
For more information, please see the links below. Thank you for listening!
 
Links:
 
Please consider supporting us on Patreon: https://www.lowcarbmd.com/
 
Dr. Annette Bosworth:
X: https://x.com/AnnetteBosworth
Website: https://bozmd.com/
IG: https://www.instagram.com/drboz_annettebosworthmd/
 
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/

Brian Ruby is the founder of Medifoodz, a company focused on making therapeutic ketogenic nutrition more practical, accessible, and sustainable. Through Medifoodz's Glyvance program, Ruby is combining chef-prepared ketogenic meals with continuous glucose monitoring, digital support, and clinician oversight to help patients translate metabolic health science into everyday life. His work centers on one of the biggest challenges in nutrition-based care: not simply knowing what to eat, but making it easier to consistently eat that way.
Dr. Adrian Soto-Mota, MD, PhD, FACP is an internist, metabolic researcher, and professor whose work focuses on human metabolism, ketone biology, and evidence-based approaches to metabolic disease. He earned his PhD in Physiology and Metabolism from the University of Oxford and has conducted research on exogenous ketones, glucose metabolism, and cardiovascular health.
Zetia Study: https://link.springer.com/article/10.1186/s12944-026-03034-w
In this episode, Dr. Brian, Dr. Tro, Dr. Adrian, and Brian Ruby talk about…
(00:00) Intro
(02:20) Why Brian Ruby founded Medifoodz
(09:49) Dr. Soto Mota's recent study pitting the ADA's recommended diet and a ketogenic diet
(22:28) The hardest barrier to entry most people struggle to overcome when starting a keto diet
(26:15) Why CGMs are so incredibly valuable sustainability
(32:16) Babies, dogs, and real food
(39:24) Big Food and subsidies
(45:58) Real food and dietary motivation
(51:38) The AHA recommended diet diabetes reversal
(59:15) Accepting and embracing criticism
(01:05:51) Dr. Soto Mota's recent Zetia Study (link below)
(01:18:24) Outro
 
For more information, please see the links below. Thank you for listening!
 
Links:
 
Please consider supporting us on Patreon: https://www.lowcarbmd.com/
 
Brian Ruby:
Glyvance: https://medifoodz.com/
X: https://x.com/Medifoodz
 
Dr. Adrian Soto Mota:
X: https://x.com/AdrianSotoMota
 
 
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/

Catherine Seo, PhD is the founder of Lipedema Simplified and director of The Lipedema Project. A psychologist, educator, and lipedema advocate, Catherine's work grew from her own experience with lipedema and lymphedema. She produced and directed the documentary The Disease They Call FAT and has dedicated her career to raising awareness, advancing research, and empowering women living with lipedema.
Siobhan Huggins is a researcher, metabolic health advocate, and Research Specialist with Lipedema Simplified and The Lipedema Project. Diagnosed with lipedema in 2021, she focuses on ketogenic nutrition, cholesterol metabolism, inflammation, and metabolic health. Siobhan is also a co-founder of Own Your Labs and an international speaker on lipedema and the potential role of low-carb nutrition in managing the condition.
In this episode, Dr. Brian, Dr. Tro, Catherine, and Siobhan talk about…
(00:00) Intro

(03:58) Catherine Seo's personal and professional history with lipedema

(11:20) The gaslighting and prejudice experienced by people suffering from lipedema

(20:31) How lipedema can impact peoples' relationships

(28:07) How the microbiome effects everything

(39:32) How lipedema is hormonally effected

(53:06) How different types of fat are released

(01:00:02) Outro

For more information, please see the links below. Thank you for listening!
Links:
Please consider supporting us on Patreon: https://www.lowcarbmd.com/
Catherine Seo, PhD:
Lipedema Simplified: https://lipedema-simplified.org/

X: https://x.com/catherineseo

Lipedema: Principles and Practice of Diagnosis and Treatment: https://www.amazon.com/Lipedema-Principles-Practice-Diagnosis-Treatment/dp/1781612641

Siobhan Huggins:
Own Your Labs: https://ownyourlabs.com/

X: https://x.com/siobhan_huggins?lang=en

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/