Concerned call from PCP's nurse


I have a physical coming up with my PCP in a week and had to get some blood tests done. I have been Keto since February. Here’s how the conversation went:
Nurse: Hi, is this Mr ____?
Me: Yes it is.
Nurse: Hi, This is Beth from Dr. ____'s office. We have your blood work back and need to discuss the results (very concerned voice).
Me: OK? What’s going on?
Nurse: Well there’s two things that Doctor is concerned about: First is your LDL, that’s the “BAD cholesterol”. That number is 147. The norm is less than 100.
Me: OK, What is the other concern?
Nurse: Well your fasting glucose is 111. This should be below 100.
Me: What was my fasting insulin?
Nurse: Let me see… Yes, that was 8.3… Very good, the norm is 2-25.
Me: I can explain. I started a ketogenic diet in February. My body is eating it’s own fat. Within about two years I’ll be at my ideal weight and my LDL will come down. There actual is no science that links high LDL’s to heart disease, in fact the opposite has been found… My sugars are a bit high because my muscles are now burning ketones. Given my reasonable insulin I’m not diabetic and therefore not concerned. This is normal.
Me: A better indicator of heart disease is the relationship between triglycerides and heart disease.
What are my HDL’s?
Nurse: Hmm… Let me see… Excited voice: They went from 36 to 45! The norm is 39!
Me: Awesome! What are my triglycerides?
Long pause…
Nurse: (really excited voice): They went from 187 last year to 93! Norm is less than 150!!!
Me: One sec (pulling calculator app off my phone)- If you divide you’re total triglycerides by your HDL you get a much better indicator of Coronary Artery disease. Less than 2 is great. 2-4 ok and above 4 is a concern. So last year this number was about 5.2 (not good). This year the number is around 2 (excellent).
Nurse: How did you do this???
Me: I went on a ketogenic diet a few months ago.
Nurse: Did you lose any weight?
Me: Yes, about 40 pounds
Nurse: WHAT??? At that point we spent the next few minutes with her quizzing me about this ketogenic diet.
I’d like to acknowledge @carl and @richard at this point. Had it not been for what I learned from the 2ketodudes podcast I likely would have went on statins and off keto… Which likely would have killed me… Thanks guys, what you do truly is a vocation!

Cholesterol bloodtest help LDL
(TJ Borden) #2


well done sir :+1:t2:

(Eric - The patient needs to be patient!) #3

Awesome**2. Good job on the conversation and even better job with your stats.:clap:


Thank you… I’ll update this thread after I see the Primary on Monday:)

(EMILY) #5

This is fantastic - thank you so much for sharing. I literally just wrote your description on the back of my lab results to take with me to my Primary next visit.

One question I have is I noticed my HDL is higher than the “normal is 39” at 57. When I divided HDL by my Triglycerides, I got 2 so I’m not concerned. I am wondering if there was a reason for a slightly elevated HDL. These results are from May and I began Keto at the end of February.

(Rocky B) #6

Excellent post and I thank you. I’m headed to my doc’s for the same conversation following a blood draw Monday. I feel much better prepared now.

(carl) #7

Well done!


The norm for HDL is Greater than 39. So the higher the better. Optimal levels are 60 or higher.

(Casey Crisler) #9

Did you actually get to speak with a nurse? I only ever get the office assistants. :frowning:

(Beth) #10

Awesome! You have inspired me! It’s been a year since I had my last bloodwork, I was keto then and the labs were great. I’m getting my blood drawn tomorrow morning and I always get nervous about the results… I’ll think about this post when I go in for the labs tomorrow.

I considered doing the Feldman protocol but decided the best thing would be to see where I stand now. It represents my baseline.


Hmm. She said it was Dr. ____ Nurse…


My body is still healing all the damage I’ve done to it for all these years… I can’t wait to see where I’m at in a year or two! KCKO:)

(David Speckleback) #13

Very encouraging and am looking forward to my next doctor visit. I’ve very much a newbie in that I’m on my 4th day.

I assume I should wait about 3 months before getting updated blood work?

(Bacon enough and time) #14

Basically, when you want to get tested depends on what effect the results will have on your life. If you have an employer’s health program or an insurance company to worry about, it might be better to wait until six months in, when most people’s numbers have stabilized. Unless you want to get tested right now, in addition to later, for a benchmark. You could tell your doctor you’ve just started a new diet, and ask if he wants to see how the numbers change. Or if you’re in the U.S., there are labs that will test you without a prescription if you give them money (this is legal in many, but not all, states, I understand).

(David Speckleback) #15

Thanks! There is no rush in getting tested but it’s something I need to do for work within the 4 months.


This is legendary, so much for me to learn from so I can be hot on these numbers if required.

(Mark Wolinsky) #17

Hi. Very interesting. Curious. I am a newby to Keto. What is a fasting insulin reading? Is a measure of the level of insulin in the blood at that moment? Thanks.

(bulkbiker) #18

Exactly… usually taken in the morning after 12 hours of not eating.


If youre fasting insulin is high it is an indicator of insulin resistance.

(Jeanne Wagner) #20

I love it!! (Except my doctor would totally expect this, he’s a natural doctor. hahah) It’s so important to have this information though, because you can explain to anyone this way. Well done!!!