Hi there! My name is Justin,

I’ve noticed a lot of discussions around high cholesterol levels, but I’m still a bit unsure whether my latest blood work results are something to be concerned about.

I’m 34 years old and have been following a low-carb/keto diet for about 10 years. My blood work has generally been fine, with cholesterol a little on the higher side, which I’ve assumed is normal given my diet. In January, I switched to a carnivore diet to help break a weight-loss plateau. I’m also quite active, weightlifting 2-3 times a week and aiming for 10-15k steps a day. My weightless journey is finally going well! around 10 kilo in 3 months and I'm almost at my ideal body weight. 

My most recent blood work (from around 2023) while on keto was generally okay. I’ll share those results here, but I’m more concerned about my new blood work after three months on carnivore:

(mmo per liter)

Glucose 5.3

Cholesterol 5.5

LDL 3.5

HDL 1.4

Triglyceride 1.2

recent result:

Glucose 4.6

Cholesterol 10.9

LDL 8,2

HDL 1.3

Triglyceride 1.8

 

The LDL  even felt outside the chart they provided with the test results (goes to 8)
 

I primarily eat eggs, grass-fed butter, -beef, -steaks, and bacon. I’m starting to feel concerned about these results, especially since I’ve come across conflicting information on the subject. If anyone has any insights and would be willing to take a look at my results, I would really appreciate it!

also my BSE went from 2 (mm/u) to 38
And if it adds anything of importance:  I weigh 74 kilo with length of 186 cm

Edited April 8, 2025Apr 8 by justin-nl

Since other posts mainly talk about mg/dl. 

Older scan

• Glucose: 5.3 mmol/L × 18 = 95.4 mg/dL

• Cholesterol: 5.5 mmol/L × 38.67 = 213.7 mg/dL

• LDL: 3.5 mmol/L × 38.67 = 135.3 mg/dL

• HDL: 1.4 mmol/L × 38.67 = 54.1 mg/dL

• Triglyceride: 1.2 mmol/L × 88.57 = 106.3 mg/dL

Recent scan with carnivore

1. Glucose: 4.6 mmol/L × 18 = 82.8 mg/dL

2. Cholesterol: 10.9 mmol/L × 38.67 = 421.1 mg/dL

3. LDL: 8.2 mmol/L × 38.67 = 317.1 mg/dL

4. HDL: 1.3 mmol/L × 38.67 = 50.3 mg/dL

5. Triglyceride: 1.8 mmol/L × 88.57 = 159.4 mg/dL

163.1 pounds and approximately 6 feet 1 inch

Nick Norwitz just posted about a paper that was published showing that people on a ketogenic diet did not have more calcification than others. Just check out his most recent YouTube channel. You most likely are a lean mass hyper responder. Nick norwitz has a PHD in metabolism and is finishing Harvard medical school on a couple of months. He also follows a ketogenic diet and has high numbers. 

I’m not concerned with the LDL as it’s normal to see higher LDL as a carnivore because we are getting our energy from fat so it only stands to reason that if that is our only source of energy then there should be plenty of it running around. 
The thing I don’t like seeing is the high triglycerides. 

Triglycerides going up after starting carnivore while rare could be caused by several things. 

Loss of triglyceride clearance pathways when carbs are restricted

Low fiber intake failing to lower triglyceride absorption

Too high of intake of saturated fat

Weight loss releasing triglycerides from fat cells

Underlying conditions like genetics, hypothyroidism, or fatty liver

A triglyceride level below 150 mg/dL is considered ideal. Levels between 150-199 mg/dL are borderline high. Having levels between 200-499 mg/dL is considered elevated and higher than 500 mg/dL is very concerning.

Some things that you might consider trying is increasing your omega 3 intake  Eating more high omega-3 foods like fatty fish, fish roe, oysters, and beef liver can help combat high triglycerides. Omega-3 fats help improve triglycerides, 

Reducing your intake of saturated fats. Limiting intake of high saturated fat animal foods like pork, lamb, beef ribeye, cheese, and butter may help lower triglyceride levels. I know you’ve already tried this but maybe look at what kind of fats you are eating. Mostly ruminant fat or pork?

Try more monounsaturated fats.
Focusing on fattier cuts of meat that are high in monounsaturated fat like beef tenderloin, chicken thighs, and salmon can help improve  triglycerides.

As much as it pains me to say this, maybe add some fiber back in.
 Although fiber is limited on carnivore, options like chia seeds and avocado can help bind to triglycerides and reduce their absorption.

Exercise regularly.                                  Engaging in aerobic exercise and strength training most days of the week can help lower triglyceride levels over time.

Losing weight if overweight.
Excess weight is tied to high triglycerides. Losing weight through the carnivore diet can lower triglyceride levels.

Manage any underlying conditions you may have.
Getting conditions like hypothyroidism, diabetes, and fatty liver under control can all help lower excessive triglycerides. If you don’t have any of those you might aught to get checked out to make sure.

Lowering your protein intake.
Overeating protein can raise triglycerides in some people. Try reducing protein portions if levels remain very elevated.

Consider taking a supplement.
Like fish oil, berberine, curcumin, and vitamin E may help support healthy triglyceride levels.

Triglycerides are energy, so in general we can look at it as an energy surplus. The question then is where is the surplus coming from? If it's from dissolving body fat, well this isn't a bad thing. As you thin out and become weight stable, the trig levels should return to baseline. If it's from your liver manufacturing them, then it's from carbohydrates, high protein, or possibly even overeating.

And then in super rare circumstances, there is an underlying medical condition.

I hope some of this helps. 

On 4/8/2025 at 6:42 AM, justin-nl said:

My weightless journey is finally going well! around 10 kilo in 3 months and I'm almost at my ideal body weight.

LDL is stored in adipose tissue. As you lose weight and dissolve fat, it gets released into the blood stream. Most people will see a rise in LDL while actively losing weight, especially if the weight loss is rapid. I wouldn't put too much stock into a lipid panel until about 6 months after weight has stabilized.

Cholesterol and LDL aren't inherently bad by themselves. There are people who are LMHR's (lean mass hyper responders), that is, they eat a zero to low carb diet and are very lean individuals whose LDL skyrockets, but this is because energy needs around the body are being served by lipids/fats.

You will want to check out Dave Feldman and Nick Norwitz work on "the lipid energy model" for a more detailed understanding of why you likely have nothing to worry about.

 

Thank you so much for your thorough and thoughtful responses! I really appreciate the time you took to explain everything in such detail. The higher LDL levels don’t concern me as much anymore, especially after reading your insights, but I do agree that focusing on improving triglycerides is a good next step.

Regarding the triglycerides, I don’t think I’ve been overeating. My diet has been pretty strict and consistent: I usually stick to a simple menu of 4 eggs, 60 grams of bacon, and about 300 grams of ground beef with some cheese most days, with measured butter to hit around 1700 to 1800 kcal. So, I think the idea that the higher triglycerides might be related to weight loss makes a lot of sense to me as well + missing the other healthy foods.

I’ve tried various organ meats, but unfortunately, I really dislike the taste, so that's been a bit of a challenge. I also don't particularly care for fish, so that’s not ideal either for a carnivore diet. That being said, I’ve bought omega supplements for the omega oils and looking for the others, and I'll start incorporating a bit more fiber and mix up my meat choices — less beef every day (against inflammation) and more fatty chicken, as you suggested and more fish. I’ll get my blood work done in 1 or 2 months to see where things stand.

Thanks again for all your advice, it’s been really helpful!