High LDL Question on keto for about 7 months


(David ) #1

Hi all,

I have been on keto for about 6 months and have now lost about 18kgs, I’m pretty speechless and impressed but my bloodwork had my doc telling me that she wanted to put me on statins to lower my LDL - this is my same doc that told me I needed to go on diabex to lower my HbA1c which used to be 6.1…anyhow my results are now…

HbA1c - 5.3 (really happy about this)
Total Cholesterol- 7.0 mmol/L
Triglycerides 0.6 mmol/L
HDL. 1.16 mmol/L
LDL. 5.75 mmol/L (this seemed to really bother her)

I watched a couple of online videos about this and it seems LDL does rise on keto - I’m not keen on taking meds if I can change stuff with lifestyle changes - should I be concerned about any of this? And what diet changes should I implement to lower my LDL (if this is even necessary?).

Comments / Advice appreciated - :slight_smile:


Ya, Total is a little high, LDL sucks, but trigs are good. Are you watching your fat sources or tracking what you eat by any chance? Do you have a limit on the amount of fat you eat?

You may want to poke around at http://cholesterolcode.com/

Also, may want to paste in these to help others, I (think) most of us are more familiar with cholesterol measured in mg/dL

Total 270
Trigs 53
HDL 44
LDL 220

(Michael - When reality fails to meet expectations, the problem is not reality.) #3


(David ) #4

Hi - thanks for the replies.

No, I have never really “watched” what fats I ate - I just went all out on eating lots of fat and never tracked or did macros - so 4-5 servings of bacon / salmon / goats cheese etc etc.

I may try and download a macro app like carbmanager and monitor things better - I also have been eating a lot of natural peanut butter (I luv the stuff…) and prolly finish a 500g container every week…will try and half this and see whether total comes down after 3 months.

If anyone has any suggestions on how to lower total cholesterol a bit quicker please feel free to chime in - cheers

(Alec) #5

There’s lots of discussion on high LDL cholesterol on these forums. Quite a few differing views on whether it is important or not.

My view is that this is good. There’s lot of evidence that higher LDL leads to lower All Cause Mortality. Yep, LDL is protective, not the big nasty that it is portrayed by the CW, the Health authorities and the media.

One day, this whole high cholesterol being bad for you thing will get unwound and forgotten about. The timing on this is approximately the time when the major statin drugs end their copyright period ie there’s no money to be made from statins any more.

(Give me bacon, or give me death.) #6

@David1 The diet-heart hypothesis (that eating fat causes coronary heart disease) is backed up by almost no data whatsoever. The key study underlying this hypothesis has been shown to be fraudulent. Various large government-funded studies to determine the link between LDL-cholesterol and cardiovascular disease have either failed to show a correlation, or shown a negative correlation (i.e., higher LDL correlates with lower cardiovascular disease), or shown that higher LDL lowers all-cause mortality. These are important studies, among them the Minnesota Coronary Study, the Framingham Study (still ongoing), the Nurses’ Study, the Women’s Health Initiative, and MRFIT.

Furthermore, it has been shown that the best indicators for cardiovascular risk are HbA1C and the ratio of triglycerides to HDL. Your ratio is 0.52, which is superb, anything under 0.9 being considered an indicator of low or no risk for cardiovascular disease. If your physician had ordered an NMR test of your LDL, I am confident it would have shown that your LDL falls into the healthy Type A pattern.

If you want a real assessment of your cardiovascular damage and risk for the future, ask for a CAC (coronary arterial calcium) scan. A score under 100 indicates no risk of cardiovascular disease. Higher scores indicate some arterial damage, but the absolute value of your score is not as important as the trend, as it has been shown that a stable or decreasing CAC score is an indicator of very low cardiovascular risk.

For more information on the CAC score and its meaning, check out www.thefatemperor.com, which is a site run by Ivor Cummins, a software engineer who specialises in medical trouble-shooting. He aggregates information about cholesterol and cardiovascular disease. For more information about lipidology in general and cholesterol in particular, check out www.cholesterolcode.com, a site run by another software engineer, Dave Feldman, who is a citizen-scientist doing some fascinating research.

(David ) #7

Cheers man - yup I think a CAC is the next thing I should do for good measure - thats where all my research is leading me also :+1:

Must say I luv youtube and the way we can skill up on our health and not take everything a doctor says as gospel

(David ) #8

Oh I did have another question - I read somewhere that ppl on keto (especially those who are type 2 diabetes need to be careful about reintroducing carbs into our diet b/c carbs have an increased detrimental effect on type 2 diabetes ppl on keto?

Carbs needed to be gradually re-introduced if not there was high risk for increased damage?

Is that correct?

It had something to do with the carbs / sugars being in an environment that had been primed for fat metabolism…not sure where I read this…


I’d say that would be the start then. Can’t figure out your cholesterol when your blindly shoving every fat you want down the hatch without paying attention.

I’d recommend Cronometer, I have the paid versions of Cronometer, Carb Manager and My Fitness Pal, for overall tracking and watching trends Crono destroys the others, plus the free version of Cronometer is more feature rich than the others. On the PB… that’s a LOT of peanut butter man! Peanuts as a whole screw a lot of people up but PB is fat heavy and you’re downing it at a crazy rate! Gotta back down. The fairy tale of fat being a free for all for keto’rs is just that! We’re all different but on the fat loss front, I can’t have my fat over 80-100g/day. If you’re downing a 500g jar of PB a week you’re probably eating that just in PB everyday… plus your real food! I got a feeling once you see it all in front of you your cholesterol will be fixed in no time.


Not sure if I should start my own thread, but this was so close to what I was about to post I thought I’d start here. I am also 6 months in, and my numbers went from:
TC: 244 to 379
Tri: 102 to 72
HDL: 63 to 74
LDL 161 to 287
HB A1C: 5.6 to 5.1%
My doc left me a stern message that I need to stop keto. I’ve read the reasons I should not be concerned, and I tend to believe them, but really, who knows? I am now trying to cut down on the cheese and limit fat more than I was doing before. I haven’t lost a lot of weight (didn’t have too much to lose to start), but still want to take off another 5-10 pounds. I’ve been at a plateau for most of the time on keto, and since being super careful about limiting calories (starting 3 days ago), I finally dropped another pound. Btw, my main reason for starting was to control fibromyalgia pain. I am better but by no means “cured”. Still, I want to keep trying!

I do not mean to hijack David’s post! If I should start a new thread, please let me know.
P.S. I do not think I am “lean” body mass, so not sure I should be considered a "lean body mass hyper-responder.


And I forgot to ask – any suggestions on how to speak with my doc who is calling me back today?? I know arguing with them doesn’t work. I might try “negotiating”. I will tell him I’m going to limit saturated fat and replace with more veggies, maybe go up to 50 g net carbs, or just limit calories. I’d like to get retested after that. How long should I wait? I’ve read that for hyperresponders like me, a few days might be enough.

(Give me bacon, or give me death.) #12

@Wendy198 Your numbers look great! Whatever is your doctor concerned about? Your triglyceride/HDL ratio is excellent, being just under 1.0, when anything under 2.0 (in those measurements) is a sign of extremely low risk for cardiovascular disease. Your doctor should know that. Your HbA1C has gone from pre-diabetic to normal. You are fine.

If you go on YouTube and look up presentations by Prof. David Diamond on cholesterol and statins, you will learn a lot. Prof. Diamond is a neurophysiologist who got interested in lipidology because of personal circumstances. His critiques of the “science” behind our current fear of fat and cholesterol, and especially of the way statin manufactures manipulate their test data, are spot-on. He also has an entertaining lecture style, that makes the data easy to absorb. He is a member of the group of scientists known as the International Network of Cholesterol Sceptics (THINCS), who are all respected researchers and clinicians trying to present an alternative understanding of cholesterol and its role in the body.

Dr. Ken Berry is another YouTuber who speaks at keto conferences. He has a very down-home style, but don’t let that fool you—he is as sharp as a tack. His videos aren’t as data-rich as Prof. Diamond’s, but he has more practical information about how to talk to your doctor. He has a couple of podcasts that are highly relevant to your situation.

Well, yes. The excessive carbohydrate you ate that gave you Type II diabetes is still a problem. Eating a low-carbohydrate ketogenic diet will put your diabetes into remission, but it takes quite a while for insulin-resistance to resolve, if it ever does in your case (it’s hard to predict how an individual’s metabolism is going to recover). If you return to eating carbohydrate at the level that caused your problem in the first place, of course the problem is going to return. Think of it like this: You were showing signs of arsenic poisoning. You stopped eating arsenic, and your symptoms went away. Do you really want to go back to eating arsenic? Or think of it like this: A ketogenic diet is like showering; if you stop doing it, you stop getting the benefits from it. It’s not fair, but life is like that.


Thank you for this reassurance. Btw, never in my life was a I told I have diabetes of any kind. Why do you think I have this? The past few years I’ve had HbA1c measured, it was never anywhere near 6. I don’t have any other metabolic issues either (never had high trig, or low HDL, never obese or even very overweight).

Waiting for my doc to call and I will ask his concerns, but my guess is it’s the high LDL. Interestingly, I did the Atkins diet when I was 19 (in 1979) and still have my bloodwork! My total cholesterol at that time was also 340. After I went off it, my bloods in my 30’s and even 40’s (pre-menopause) were all in the usual “normal” (<200) range.


Sorry! That was for David. (Probably should have started a new thread…)

(Michael - When reality fails to meet expectations, the problem is not reality.) #15

@Wendy198 See my links above.

(Tracy) #16

Wendy, the question of cholesterol has plagued me from the beginning. Your numbers look exactly like mine. I have taken 4 lipid panels in the last 7 months and my total cholesterol has jumped wildly. The numbers that are important have remained low, which doctors don’t seem to care much about. Your Trig:HDL ratio is .9 which is the same as mine. That can’t get any better. The longer I Keto and more I learn about cholesterol, the more I believe the demonization of cholesterol is BS. Please watch this video and it will set your mind at ease:


Thanks all. I will watch the videos and read the links. I guess I just wish the number was at least in the plausible range provided by quest (which stops at 320…)! :wink:


There’s no evidence that high cholesterol increases heart risk IF your HDL is at least half your triglycerides.

If you can make your HDL higher than your triglycerides, that’s even better.

Approximately 50% of those who have heart attacks have normal cholesterol levels.

Some people on Keto see their Triglycerides levels rise. Maybe eliminating all dairy can bring this number down. If your T number is going higher on Keto then examine the potential causes.

I also look at my CRP number.

(David ) #19

Cheers & Thanks - yea I prolly do need to cut down on the PB - but its been my new go to “cheat” since I gave up the pastas, breads, chocolates etc - I don’t find keto hard but the portion control takes a bit of self control and I come from a bodybuilding background where eating heaps 6-7 times a day has become a habit. On keto I’m not “hungry” but i still find my self reaching for food out of habit I guess…

Wish I knew the stuff I know now when I was in my 20s…

(Bob M) #20

It’s typically coffee. It can also be fasting too much before getting the test (that is, if you do a lot of fasting, eat more regularly a few days before the test).

I doubt it’s “dairy”. If so, under what plausible mechanism?

In fact, I did a test of Dave Feldman’s cholesterol drop protocol and lowered my trigs, while drinking cups of cream.

Three days with a lot of dairy dropped my trigs.

And here’s going the other way, starting with a 12 hour fast, then taking another test 4 days later:

People are different, and it MIGHT be dairy, but I doubt it.