Therapeutic
After resolving bipolar 2, I tapered medications over three years with a psychiatrist's oversight, though they didn't support keto or tapering. Horowitz's work on hyperbolic tapering and the Maudsley Deprescribing Guidelines were invaluable.
Integration
No medications or supplements. Regular bloodwork for deficiencies. LDL more than doubled but LDL sub-fraction testing and coronary calcium CT scan show lowest heart attack risk. Lean mass hyper responder - comfortable with this.
Nutritional
Always under 20g carbs daily, 90-130g protein, 70-80% fat. I eat full meals when hungry, no snacking. No need to measure macros anymore. I just eat delicious low-carb food with enough fat. Twice a year I do a 3-5 day fast.
Ketosis
First year: tested daily with urine strips to learn what kept me in ketosis. Now use a blood monitor but test only out of curiosity - I can feel whether I'm in ketosis. Feel best at 1.5-3 mmol; above 4 I get edgy, below 1 I feel off. Rarely test glucose.
