The whole Karma system is way off in NV.
No reason to worry other than if you like me, like to have the right title and picture for the role you're playing.
In FO3 it used to have a larger effect, it would improve / hinder speech checks.
Most companions were unrecruitable unless you were a specific karma.
In NV I think two events are kama based that I remember off the top of my head.
You do have an easy way to balance them out not matter the trouble however.
Evil > netural / good kill fiends and ghouls amongst others.
Good > netural / evil steal every item in every location then dump them, if you open a container take the items one at a time and exit after taking one.
Or an easier way just keep click on a owned computer that's been hacked and exiting as this will give you constant negative karma.
All said though I can't say I miss it being so central to the game tbh.
As the game is way to good for a minor detail to disrupt my enjoyment.