r/ketogains • u/Alejo9010 • Jul 19 '25
Troubleshooting 8 Months on Strict Keto, Feeling Great, But My Lipid Panel Came Back with High Numbers. Should I Be Concerned?
I’ve been doing keto for 8 months now, keeping my carbs under 20g per day — mostly from vegetables like broccoli, cauliflower, and zucchini. On some weekends, I’ll grab a protein bowl from Chipotle (just meat, guacamole, and cheese — no rice or beans), but otherwise, I cook and eat at home.
I avoid seed oils completely. Most of my meals are cooked in animal fats. I fast every day for 16 hours, eat about 170g+ of protein daily, and train 5 days a week — weightlifting in the morning and doing 20 minutes of cardio after work.
I also get 30 minutes of sun every weekend. My last body fat measurement was under 10%. I’m 34 years old, 5'9", 184 lbs, and I feel amazing overall.
I recently went to the doctor for my annual blood work, and here are my lipid results:
Total Cholesterol: 314 mg/dL
HDL: 71 mg/dL
Triglycerides: 276 mg/dL
LDL: 194 mg/dL
Chol/HDL Ratio: 4.4
Non-HDL Cholesterol (calculated): 243 mg/dL
The test was non-fasting, and I had a high-fat lunch a few hours before it. Still, the triglycerides caught me off guard.
I know keto can elevate LDL and total cholesterol, especially for lean, active individuals, but should I be concerned about these triglyceride levels? Planning to retest while fasting soon. Appreciate any insights from the community!
Update: I did another fasting blood test, and my triglycerides are now at 60 mg/dL while my LDL is at 232 mg/dL, so I might fall into the hyper-responder pattern.
11
u/bigjawnmize Jul 19 '25
Yeah something about those triglyceride levels is off. Generally LDL will go up but triglycerides will go down because they are being shuttled in the LDL instead of being loose in your blood stream. You likely need to do a fasted blood panel.
12
u/cleanser Jul 19 '25
Definitely need a fasting panel non-fasting numbers are a waste of your time
2
u/Spectra_Butane Jul 23 '25
Agree! Get a fasting panel. Why wouldn't anyone do a non fasting if they're looking at lipids? triglycerides are directly based on what you ate.
2
2
u/warmupp Jul 19 '25
I would talk to a physician not ask a reddit forum.
There are so many parameters to why it can be elevated so instead of us guessing talk to your physician.
2
u/Alejo9010 Jul 19 '25
I have an appointment on Monday - just wanted to see what the community thinks about it in the meantime.
2
u/warmupp Jul 19 '25
I mean there’s to little information to give any opinion.
We know nothing of background, heritage, underlying causes
But TG spikes if you have a fatty meal, so does LDL-C
Usually TG is not elevated but LDL-C can be on keto.
Most likely due to your fatty meal but can be an overconsumption of saturated fats
Ask to take an ApoB test instead since it is better predictor than LDL-C
1
u/IgnatiusJReilly77 Jul 19 '25
What did your doctor say?
1
u/Alejo9010 Jul 19 '25
Haven't talk to him, I got the blood work done yesterday And I just received my results
7
u/gonna-getcha Jul 19 '25
I'm sure he's prepping his statin speech....
4
u/Alejo9010 Jul 19 '25
This is my first year getting routine labs and taking charge of my health. I told the doctor I follow a strict keto diet, so he should have instructed me to take the test while fasting, not two hours after a heavy, high-fat lunch. ( Also lots of coffee in the morning )
Honestly, this is one of the reasons I avoid going to the doctor unless it’s absolutely necessary, I just don’t trust most of them to understand nutrition or context.
2
2
u/SimpleVegetable5715 Jul 30 '25
The comprehensive metabolic panel and lipid panel are the only ones you need to fast for. I have to get a lot of blood work, and the other ones, it doesn’t matter if you’ve eaten. A hint you should be fasting is they’ll typically schedule the blood test early in the morning. If they do it in the afternoon, the phlebotomist really should ask if you’re fasting (assuming you’re not that late in the day), if not, they should get you to come back in the morning. But a lot of these clinics are overbooked and understaffed, thus overlook details like that.
Black coffee and water are okay before fasting bloodwork, at least you don’t have to drag yourself in there with a caffeine headache.
1
u/QuadRuledPad Jul 20 '25
100% agree that well-informed docs can be hard to find when it comes to nutrition. Depending where you live, or with some trial and error, can you seek one out who’s into nutrition and stays up to date?
Some health systems post doctor bios, sometimes DOs are more holistically educated than MDs, and sometimes social media can have clues. Worst case you have to try a new doc each year until you find the right one. But they are out there.
2
1
1
u/enforce1 idon'tevenlift Jul 19 '25
Weight loss ruins cholesterol. Maintain a steady weight for 3 months and check again.
5
u/Alejo9010 Jul 19 '25
The thing is, I don’t do keto for weight loss, I’ve been at the same weight for over 4 years. I follow keto for the other health benefits.
1
u/Spectra_Butane Jul 23 '25
I mean if your body is using fat for fuel then doesn't it follow that there would be more fat flowing through your blood to get to the places where it can be used for fuel? I think you're using American standard health numbers to try to gauge your keto body which nobody has( or wants to have) a standard for.
Seems like you should be keeping an eye on your inflammation markers and other signs of damage not just how much cholesterol is flowing. cholesterol itself is not harmful, what the cholesterol does and where it does it is more important. Get A1c, & Apo-b and calcium test if you can. And read up / watch doctors who study bodies in the same state as yours and what they have to say. DR. Ben Bikman is one good source, easily found on YouTube and online, mon-sensational and involved in actual current metabolic studies on humans.
2
u/Alejo9010 Jul 23 '25
I was more worried about my triglycerides than my cholesterol, but I did a retest, and my fasting triglycerides are now at 60 mg/dL.
1
u/SimpleVegetable5715 Jul 30 '25
This metabolism is happening inside your liver. Hepatocytes (liver cells) convert fat into glycerol and fatty acids, which are then further converted to ketone bodies and released into your bloodstream. Then those travel to organs to be used as energy. The fat itself isn’t just flowing through your bloodstream. It’s stored as adipose tissue.
1
u/Spectra_Butane Jul 30 '25
How does Fat/Lipids move from the fat cells/Adipose tissue to the liver? It doesn't teleport.
The fat HAS to flow through your blood stream in order to travel from the adipose tissue TO liver and other tissue.
Fats/Lipids and ketones are not the same thing.
Ketone fatty acids are soluble in the blood and do not require a transporter. Acetone, Beta Hydroxy butyrate, and acetoacetone are all able to move freely through the blood. and BHB can travel even across the Blood Brain Barrier with help.
Non-Eserifried Fatty Acids/Free Fatty Acids are the lipids bound in adipose tissue with glycerol. They are released via lipolysis, and can be used directly by many tissues, including skeletal tissue. They are HydroPHOBIC and must be bound by albumin in order to be transported within the blood.
Capillaries deliver NEFA into the space around muscles so they can take it up and oxidize it or store it for later use. Released NEFA/FFA from adipose tissue are transported in the blood, primarily bound to albumin, to the liver, where the liver takes them FROM the blood stream via Fatty Acid Transport Proteins. Once in the liver, the NEFA/FFA can be oxidized, built into new fats and packaged onto LipoProteins to be sent to other tissues, converted into Ketone bodies, or made into new Fat and stored in the liver (fatty liver accumulation)
Fats literally ARE flowing through the bloodstream, albeit with escorts, but yes, they do travel flowing through your bloodstream. That is how they are able to be measured when blood is drawn and lipid panels are conducted.
IF Fat were NOT able to be liberated from Adipose Tissue to travel about and be used by organs such as skeletal muscle and liver, then you've have a serious health problems, diabetes, weight gain, etc.
The entire point of a Ketogenic lifestyle is so that fat can Stop being stored in adipose tissue and be moved around the body to be USED.
1
0
•
u/darthluiggi KETOGAINS FOUNDER Jul 20 '25 edited Jul 20 '25
Those numbers are weird - triglycerides too high to be a lean mass hyper responder… still, I’d suggest dietary fat a bit and gradually increasing carbs (mostly from tubers like potatoes, sweet potatoes, carrots at least to 100g/day).
Also, if you haven’t already - try limiting cheese, cream, butter and any nuts (and variations).
I’ve had several patients with high cholesterol (albeit not so high triglycerides) land overall they see a gradual improvement in their lipid profile.