ADVICE Please! 1 Year Keto-High Cholesterol



So I started Keto in September of 2021, mainly to lose just a few pounds/maintain weight and also hormones.

I enjoyed the eating style, and especially liked the energy and not needing to eat as often. I loved burning fat as my fuel.

Then last month, after my first cholesterol test after 2 years, it was very high(near 300-though levels were elevated across the board). So I went researching those in the ‘hyper responder’ category, and found Ken D Berry MD’s video about the subject. He and his panel in the video suggested to increase carbs and the level would drop.

I did this, going from about 20 to 35(max), and now, as much as 80 (total) carbs per day-which of course kicked me out of ketosis(which I anticipated). I also cut out red meat, and only have whole eggs and dairy about once a week.

I made the agreement with my GP(whom I do not agree with regarding the alarm at my levels) to try this style of eating (essentially LCHF) until December, then get my levels checked again. This is also a sort of ‘guinea pig’ situation, where I am seeing if what Dr. Berry & his panel suggested may really make a difference.

I like being able to eat a greater variety of vegetables and more berries right now. But! I miss eating all my whole eggs, regular butter, bacon/pork/beef/sausage/mayo and my overall Keto lifestyle.

I am considering doing Vegetarian Keto as a transition once December hits, but regardless of my cholesterol levels, I really, really want to go back to eating all fats and proteins. However, I don’t know how to keep my levels in what is considered by current regular medicine as ‘balanced’. I don’t want to go through a regular push-pull/argument with my GP over my levels, you know?

Any advice from those who have experienced this, and their journey after finding high levels, is greatly appreciated!

Thank you so much!

(Bacon is a many-splendoured thing) #2

I edited the post to be more legible. Please do not indent your paragraphs. Use an extra line space, instead.


There’s no reason you can’t eat fats, and there’s absolutely no reason to cut out the protein, that doesn’t even make sense.

What were you eating on average macro wise while you were rising? Were you losing fat during this time, or doing things like fasting? What are your current stats and activity level?

(Bacon is a many-splendoured thing) #4

This works for lean-mass hyper-responders, as Dave Feldman calls them. I don’t know how well it works for other people.

The problem with cholesterol is not that it causes cardiovascular disease, but that it is an easy target for expensive drugs. There is plenty of evidence to show that cholesterol does not cause cardiovascular disease. It might serve as a marker for the problem (though even that is pretty much in doubt), but it is definitely not the cause of the problem. So any effort to solve the problem by lowering cholesterol is equivalent to trying to reduce fires in your city by selling off fire engines and eliminating firefighters from the payroll.

The main lipid number to worry about is your ratio of triglycerides to HDL. If it is under 2.0 (U.S.) or 0.9 (everywhere else), then your cardiovascular risk is minimal. The easiest way to lower triglycerides is to avoid eating carbohydrates, and the easiest way to increase HDL is to eat saturated fat.

A low-carbohydrate, high-fat diet of real food will most likely be the path to better health for you, as it is for most people. Vegan keto is possible, but it is difficult and requires certain supplements, since there are vitamins that are found only in meat. Protein and fat are essential in our diet; carbohydrate is not.


Thank you PaulL for the both the formatting and reply(I am not sure why it appeared as it did on other devices, as my PC presented everything normally).

Regarding weight: I found that unless I dropped my calories to around 1200(which I did not like or prefer), I would not lose weight (and I really only wanted to lose about 5 lbs, based on my height and other factors). However, it has appeared in the last year, due to reasons unknown, it would take dropping my calories down that low, or my egg fast week, to see any substantial difference.
As a side, I had tried both counting ‘net carbs’ at first,Here are my (non-fasting)stats as of 10/1/20:
Cholesterol: 254 HDL: 59 LDL: 176 Triglycerides: 53

I began keto on 9/21 and have been on it for a little over a year. I was due a new cholesterol test, which was done 8/8/22. I only did one fast in the entire year, lasting for 1 week, which was an egg fast. I am 5’4, about 137 lbs, 46 years old, and currently being treated by a specialist for hormone balance and heavy metal toxicity(taking natural supplements to cleanse heavy metals from the body. I have counted net carbs at first, and then later ‘total carbs’, going as low as 20 a day, in an effort to feel my best and maintain my weight. When counting ‘total’, I felt I ate to more satiety. When I went to 20 total carbs, I had to eat a large amount of fat and protein in order to feel satiated. (I was following Dr. Westman’s 20-carb list of Keto foods)

When I have increased my carbs(done paleo or as in more recently, gone up to 80 total carbs a day) my body has responded with retaining water, a feeling of bloating, sore joints(I also take collagen and/or gelatin daily both then and now) and noticeable acid reflux. (I am not eating grains, and extremely small amount of dairy at this time. Coconut oil/olive oil/avocado/some mayo/cream/nuts/seeds have been my substantial fats for the last 3 weeks. My proteins have been white meat chicken, egg whites and of course, nuts/seeds, and plenty of vegetables. The main reason for these modifications, was an effort to bring down the cholesterol levels, and get my GP(and worried husband) off my back. Regardless of what happens when I have my next follow up lipid panel in December of this year, I have no intention to take any cholesterol lowering drug.

Here is my latest (non-fasting) lipid test from 8/8/22(with slightly more details):

Cholesterol:393 High Density Lipoprotein:6.8 Cholesterol/Non LDL:335 HDL:58 LDL:295 Triglycerides:194

My activity level went from occasional walking, to daily walks, from 15-30 mins long. I do not drink coffee or caffeinated drinks, or sugar.

The reason for considering ‘a modified-vegetarian keto’, was that I was finding myself not wanting red meat or processed meats(bacon, sausage, lunchmeat, etc) as much. But now, I find I am desiring them again.

Hopefully, that will fill in any gaps from the questions from my post. I mainly want to hear about anyone else having elevated cholesterol levels, and how they either lowered their numbers naturally, or, if they ever lowered at all. (Or, if it’s even possible to do so on Keto?? All the doctors I have covered under my insurance follow the same standard of cholesterol/fats teaching that is so outdated. So, I am unable to get a brand new GP under that insurance who believes anything different.)


I was in a similar situation as you regarding the cholesterol. Made a deal with the doc that I would get my ldl down and for four months I upped carbs ldl came down enough to make my doctor happy and now I am returning to my keto diet since it is easier for me to keep fit and leaner on it. And I also like it.

In April my numbers were

Total 7.36 mmol/L (285 mg/dL)
Triglyceride0.73 mmol/L (65 mg/dL)
LDL; 5.07 mmol/L** (196 mg/dL)
HDL*1.96 mmol/L** (76 mg/dL)
5.40 mmol/L**

In August after 4 months on standard

Total 5.27 mmol/L (204 mg/dL)
Triglyceride0.59 mmol/L (52 mg/dL)
LDL;.3.08 mmol/L* (119 mg/dL)
HDL*1.92 mmol/L (74 mg/dL)
Non HDL 3.08

(Ethan) #7

But why do you care about what the cholesterol is?

(Bacon is a many-splendoured thing) #8

That is an excellent question. I was just watching a new lecture by Eric Westman, who was saying that he can’t find anything to worry about where cholesterol is concerned. He also speculates that higher LDL may simply be the keto normal.

After all the things I’ve learned about human nutrition since going keto, the more I value my cholesterol.
The only thing I worry about cholesterol these days is how pharmaceutical industry executives are going to be able to afford to pay themselves such big bonuses, once we all stop worrying about cholesterol and refuse to buy their drugs.

(Robert) #9

I am going thru the same thing, namely doctor pressure and loads of gaslighting from them too. In brief, you may ask yourself whether your GP is one of those who services a predominantly insulin resistant population? The standard suburban GP do not have much exposure to those who are not somewhere on the IR spectrum, because a lot of what they treat is geared towards IR related pathologies. For myself, I have decided that lowering LDL levels is not a meaningful goal because I’m not convinced that a high LDL level is a bona-fide pathology. My focus is on results, represented by direct measures of cardiac health. Everything, and I mean every single marker, from pulse, ECG, BP, the small “a” lipoprotein, TGL / HDL, functional tests, CAC scores, other bloodwork etc show no evidence of coronary disease. In that sense, I am thinking that just because the GP has a problem with my cholesterol levels that this does not override the absence of any direct evidence of CVD. I have been keto since 2017, have had double-digit LDL over that time and enjoy no measurable or functional markers of heart disease. Feeling and doing great… Interested in real world results, not theory…

I thank everyone for your replies and comments. It's much appreciated.