Journey Into Ketosis Part III

Warning: This  post contains shirtless pictures of me.

TL;DR Ketosis has treated me well. I share expected and unexpected results.

Six Months of Ketosis

In Part I I talked about what ketosis is and how to achieve it. In Part II I talked about my first month of complications. This post is about long term adaptation.

When I last measured, my liver was still metabolizing fat and producing a healthy amount of ketones.

Picture of a Precision Xtra ketone measurement device showing the measurement 1.4 mmol/dl

Reminder that nutritional ketosis is defined as a minimum of 0.5 mg/dL of beta-hydroxybuterate in the serum.

Health Markers


My "total" cholesterol went up significantly. I regularly donate blood, and they measure total cholesterol from each sample.

The current American standard labels 200-239 mg/dL as "borderline high," which is the range I'm in now.

Bar chart showing 4 of my my total cholesterol measurements over a few months: 155, 170, 244, then 201 in ketosis.

Should I be worried? No. If you've studied cholesterol, you know that the "total" number is meaningless [1][2]. To quote from "Whose Line Is it Anyway": "everything's made up and the points don't matter."

I actually hoped my cholesterol would go up! If raised cholesterol worries you, please read The Great Cholesterol Myth. If you're not worried, you should read it anyway.

Unfortunately, particle breakdown isn't provided. If I had to guess, I'd say my HDL to LDL ratio improved, and my circulating triglycerides went down. I plan to get a full lipid profile soon.

Workout Intensity

Intensity has remained unchanged, if not slightly improved.

I've made significant progress in rock climbing. My weightlifting progression has always been slow, but I've seen steady results in terms of strength and body mass. As mentioned in Part II, I almost died during my initial ketotic exercise, but now I have no problems. I don't currently do any cardio except a recent two mile barefoot run, and commuter bicycling.

Body Composition

Warning: Shirtless pictures below.

Front, Side and Flexing Body Picture

Who says fat makes you fat? I included a flexing picture to show muscle composition. This is the best body composition I've had in my life.

Anecdotal Changes

Some changes were expected, some not.

My waist circumference has gone down, but I've gained weight. I was about 150 pounds (68 kg), and recently I weigh 155 (70kg). I haven't measured BMI, but I'm guessing I've lost fat and gained muscle.

My culinary world has exploded. I'm trying all sorts of things I never thought I would. Animal organs are loaded with nutrients and offer a surprising array of tastes. I've cooked with heart, liver, kidney, brain, tongue, throat, stomach, and head cheese to name a few. I've made my own bone broth, mixed homemade bone marrow honey butter, and rendered my own lard.

I am much more sensitive to sweet, and much less sensitive to salty. Even blueberries can taste sickeningly sweet to me now. Interestingly, I'm more sensitive to spicy food. Hot sauce is no longer a staple for me.

I rarely have energy crashes. On paleo, there would be days where I needed coffee to survive, or I'd need to zone out on a couch for half an hour to rest. Now my energy levels are more consistent. "Energy" is very hard to measure, so take this point with a grain of salt.

I completely stopped coffee and any caffeinated beverages. I no longer need them for sustained energy. For the first three months I did zero caffeine. Now I will have at most two cups of tea a day because I like the taste. I mix in coconut milk, a good source of saturated fat.

I never have strong hunger pains. I didn't realize it until I went on a family vacation. Brief story: I was early in my ketosis journey. As it was a vacation, I indulged in homemade deserts and deep fried country cooking. On the plane ride back, my stomach was gurgling, and I felt intense hunger pains. I realized I hadn't felt those since starting ketosis. When I returned and measured my blood BOHB, I was nearly out of ketosis. My body may have been expecting more sugar to fuel my ketone-impaired brain. Since then I have been able to skip meals without having any hunger problems.

I discovered I'm probably lactose intolerant. I'm in the middle of a separate dairy experiment right now, which I'll write about in a later post.

Random Tidbits

Ketosis has been great without supplements. At the recommendation of Voleck and Phinney I'll have a spoonful of cod liver oil when I remember, and if my muscles feel tense after a workout I'll take a magnesium pill.

I found healthy vices. I'll occasionally indulge in a glass or two of red wine, and I eat 100% dark chocolate regularly. Not baking chocolate; there are bars made from pure cacao solids. When I want something cool and refreshing, I'll indulge in some blueberries or strawberries from the farmers' market. Anything ending in -berry is safe for ketogenics. If I'm feeling wicked, I'll have a little wild farmed honey. Despite its sugar content, honey is not as insulinogenic as other carbohydrate sources [1].

A typical day of meals might look like this:

  • Breakfast: 3 or 4 egg omelette stuffed with cooked vegetables, prepared in copious amounts of lard. Tea with coconut milk.
  • Lunch: Intermittent snacking on raw vegetables or dark leafies, and leftover meat from the night before. Drink bone broth if available.
  • Dinner: A significant piece of animal, such as a lamb shank or salmon filet, from  a local butcher or farmer's market. Ideally include some animal organs, like heart or liver paté. Cooked veggies like broccoli or asparagus as a side. Some dark chocolate or berries for desert.
  • Snacks: Nuts or seeds (walnuts, pistachios and Macadamia most recently). Random animal organs (tongue pastrami, head cheese).

I've found the quality of my sleep dictates my energy levels more than anything I eat. No amount of bacon will reverse the effects of a restless night.

The Future of My Health

Will I stay in ketosis for the long term? Absolutely. A lifestyle where I can eat as much bacon as I want, lose weight, gain muscle, and feel energetic? What's not to like?

There are some supporters of cycling ketosis (think our ancestors harvesting fruit in the summer), which is a likely research alley for me.

There are some other experiments and measurements I still want to perform, like a full blood lipid profile, and a full body scan or accurate BMI measurement. On the reading list is Nutrition and Physical Degeneration and Keto Clarity.

If this information on ketosis helped your own nutritional journey, consider following me on Twitter.