Ben’s Health Log

Last updated: March 12, 2026

Profile

• 6’2”, ~227 lbs (goal: 200), ~25% BF
• Family history of diabetes
• Orthodox Christian (fasting calendar shapes protocol)

Diagnosis (Dec 2025)

Metabolic syndrome / prediabetes:

• Fasting insulin 29.6 (severely elevated, ref ≤18.4)
• Triglycerides 361 (severe, ref <150)
• A1c 6.0% (prediabetic, ref <5.7)
• Fasting glucose 101 (borderline)
• ALT 47 (fatty liver)
• eGFR 68 creatinine-based (later resolved — see Kidney below)
• HDL 38 (low)
• LDL 214, Total chol 313

Bloodwork History

Glucose note: Fasting glucose paradoxically higher (101→110) while A1c improved. Classic OMAD pattern — hepatic glucose output increases during long fasting windows (dawn phenomenon), but average glucose is lower as confirmed by A1c and CGM data.

Kidney — CLOSED: eGFR decline (94→68) was entirely due to ~10g/day creatine supplementation confounding creatinine-based eGFR. Cystatin C eGFR = 84 (normal). Creatine discontinued. No kidney concern.

Current Protocol (Lent 2026: Feb 18 – Apr 5)

Daily: OMAD

• Black coffee AM, nicnac, tea PM, one meal at dinner
• Been consistent since Feb 18

Extended Fasts (3-day water fasts)

• Fast #1: Feb 16-19 (Clean Week). No ketone data.
• Fast #2: Mar 3-6. ~70 hours. Ketone trajectory: 0.4(24h) → 0.5(36) → 0.6(44.5) → 0.9(49) → 1.5(60) → 1.6(66). Hockey stick inflection at ~hour 45 — insulin brake lifting. Broke with bone broth + eggs.
• Fast #3: Planned for week of Mar 16 (after URI clears)
• Holy Week fast: Planned Mar 30 - Apr 2

Exercise

• Alternating Z2 Zwift cycling (35-40 min) and kettlebell complexes (30 min)
• All fasted, 6am on non-fasting days
• Goal: liver fat reduction + insulin clearance, NOT fitness gains
• TTGNG (time to gluconeogenesis) tracked via CGM: ~8:15am after Z2

Tracking

• CGM (Libre) during Lent
• Keto-Mojo BHB meter
• Monthly bloodwork via OwnYourLabs/Quest (insulin + trigs primary)
• Quarterly cystatin C for kidney
• Weight: Eufy scale → Apple Health (227.4 on Mar 5)
• Intervals.icu for exercise

What Worked

1. 3-day fasts are the primary lever. Per-fast modeling: trigs drop ~37% multiplicatively, insulin drops ~7.4%. Trigs went from 361→143 with 2 fasts + 3 weeks OMAD.
2. OMAD is effective maintenance between fasts. Sustains the metabolic pressure.
3. Exercise stacking (Z2 AM + KB PM) produces clean glycogen depletion curves on CGM. March 9 was best day: glucose 110→89 through stacked exercise, dinner peaked at 146.
4. Fasted Z2 cycling depletes glycogen efficiently. TTGNG around 8am confirms liver glycogen clearing by mid-morning.
5. Weight loss: 239→227 (~12 lbs) in first 2 weeks.

What Didn’t Work

1. Dietary keto (eating keto, not fasting): 4+ days of keto eating produced only 0.1 mmol/L BHB. Insulin too high for dietary keto to produce meaningful ketones. Abandoned.
2. Big carb OMAD: Feb 25 baptism anniversary dinner (noodles, dumplings, corn) caused massive glucose spike, poor sleep, felt hungover. High-glycemic OMAD is counterproductive.
3. Creatine supplementation: 10g/day confounded eGFR readings for months, creating false kidney alarm. Discontinued.

Failed Experiments

• Dietary keto experiment (Feb 25 – Mar 2): Hypothesis: eating strict keto would produce therapeutic ketosis. Result: After carb-loading, took 2-3 days to even enter mild ketosis (0.5 mmol/L), and never reached >0.5 via diet alone. Conclusion: at insulin 29.6, dietary keto doesn’t overcome the insulin brake. Extended fasting is the only reliable path to >1.0 mmol/L ketones.

Modeling & Projections

Per-fast decay model (from 2 data points, heavy caveats):

• Trigs: each fast ≈ –37%. Predict 90 → 57 → 36 over next 3 fasts. Floor ~50-80 (normal).
• Insulin: each fast ≈ –7.4%. Much slower.
  • Fast 5: ~20 | Fast 8: ~16 | Fast 12: ~12 | Fast 16: ~8.5
  • <15 target: ~8 fasts (October-ish biweekly)
  • <10 target: ~14 fasts (Feb 2027-ish)

Diminishing returns expected:

Early fasts clear easy liver fat. As metabolic health improves, per-fast yield shrinks. Sub-5 insulin is a 2027 goal if it happens.

Phased Strategy

Phase 1 — NOW → ~Oct 2026: Break insulin resistance

• Extended fasts (3-day, biweekly)
• OMAD between fasts
• Z2 + KB exercise
• Target: insulin <15, trigs <100, A1c <5.7

Phase 2 — ~Oct 2026 → Spring 2027: Rebuild metabolic flexibility

• Transition to Bersens-style frequent small meals (requires working insulin machinery)
• Add strength training (3-4x/wk, 4-6 reps × 3-4 sets)
• Low PUFA, choline supplementation (500mg-2g/day)
• Grazing protocol for glycogen cycling
• This phase only works AFTER insulin sensitivity is restored

Strength training can start now

• GLUT4 translocation is insulin-independent
• Compounds with fasting rather than conflicting

North Star Metric

Morning fasting BHB (blood ketones). Inverse proxy for insulin. Target: >0.5 mmol/L consistently on non-fast days. Currently 0.2 on normal OMAD days.

Research Knowledge Base

• ~/notes/wiki/metabolic-flexibility/ — Tim Bersens (Amplified Vitality) video series
  • 5 videos transcribed with claims analysis
  • claims.md — 30+ claims rated by evidence tier with citations
  • prediabetes-reversal.md — literature review
  • papers/ — saved PDFs

Data Files

• Bloodwork CSV: ~/ava/ben/health/bloodwork/results.csv
• Bloodwork PDFs: ~/ava/ben/health/bloodwork/pdfs/
• CGM data: Libre app (not exported yet)
• Weight: Apple Health / Eufy scale
• Exercise: intervals.icu

Open Questions

1. Will per-fast insulin drops accelerate or decelerate as liver fat clears?
2. Is fasting glucose rise (101→110) concerning, or just dawn phenomenon from OMAD?
3. When to add GGT to bloodwork panel? (proxy for liver fat)
4. Should strength training start now or wait for Phase 2?
5. What does C-Peptide 2.93 tell us about beta cell function?