Correcting High Cholesterol and LDL on Keto

author avatar Dr. Eric Berg 05/13/2024

You've been rocking the keto life, watching those pounds melt away. But then, a bombshell at your last check-up: your cholesterol levels are through the roof! What gives? I thought keto was supposed to be healthy!

Hey, don't freak out about your high cholesterol on keto! It's actually pretty common, and the reasons behind it might catch you off guard.

But here's the awesome part: you can get your cholesterol under control with just a couple of adjustments, all while still enjoying the incredible perks of living the keto life.

Uncovering the roots of high cholesterol might seem daunting at first, but fear not! Together, we'll identify the sneaky factors contributing to those numbers and develop a plan to get you feeling your best.

Understanding Cholesterol Production and Regulation on Keto

The ketogenic diet, with its high-fat, low-carb approach, can have a significant impact on cholesterol production and regulation in the body.

To fully understand how this happens, we need to take a closer look at the roles of the liver, intestines, and bile salts in managing cholesterol levels.

The Role of Liver and Intestines

Did you know that cholesterol is produced by two main organs in the body? That's right, the liver and intestines are responsible for creating this essential substance.

The liver is the primary site of cholesterol synthesis, accounting for about 70% of the body's total production.

It uses acetyl-CoA, which is derived from the breakdown of fats, proteins, and carbohydrates, to create cholesterol through a complex series of enzymatic reactions.

The intestines, on the other hand, contribute to about 30% of the body's cholesterol production. They absorb cholesterol from the diet and also synthesize it locally.

When following a high-fat diet like keto, the increased intake of dietary fats can stimulate the intestines to produce more cholesterol.

Bile Salts and Cholesterol Regulation

Bile salts, produced by the liver, play a crucial role in regulating cholesterol levels in the body. These salts are stored in the gallbladder and released into the small intestine when needed to help digest fats.

They act as emulsifiers, breaking down large fat globules into smaller droplets that can be more easily digested and absorbed.

But bile salts have another important function - they help remove excess cholesterol from the body. When bile salts are released into the intestine, they bind to cholesterol and form micelles, which are then excreted in the feces.

This process helps maintain a balance between cholesterol production and removal, preventing excessive accumulation in the body.

On a ketogenic diet, the high intake of fats can lead to an increased production of bile salts to aid in digestion. This, in turn, may enhance the removal of cholesterol from the body, potentially helping to regulate cholesterol levels.

However, individual responses to the keto diet can vary, and some people may experience an increase in cholesterol levels despite the increased bile salt production.

Factors Contributing to High Cholesterol on Keto

The keto diet can help you shed pounds and keep your blood sugar in check but watch out for your cholesterol levels. What you eat on this low-carb plan and any health issues you're dealing with can sometimes lead to higher cholesterol readings.

Impact of High-Fat Diets

The type of fats consumed on a ketogenic diet can significantly influence cholesterol levels. Saturated fats, found in animal products like meat, dairy, and eggs, have been shown to raise LDL (bad) cholesterol levels.

On the other hand, unsaturated fats, such as those found in avocados, nuts, and olive oil, can help improve cholesterol profiles by increasing HDL (good) cholesterol and reducing LDL cholesterol.

When following a keto diet, it's crucial to choose healthy sources of fats and limit the intake of saturated fats. Opting for monounsaturated and polyunsaturated fats can help maintain healthy cholesterol levels while still adhering to the high-fat nature of the diet.

Man suffering from kidney failure

Hypothyroidism and Kidney Damage

Certain underlying health conditions can also contribute to high cholesterol levels on a ketogenic diet. Hypothyroidism, a condition in which the thyroid gland doesn't produce enough hormones, can slow down metabolism and lead to increased cholesterol levels.

Similarly, kidney damage can impair the body's ability to remove excess cholesterol, resulting in elevated blood cholesterol levels.

Already have a health problem? Don't dive into keto without your healthcare provider's okay. They'll watch those cholesterol levels like a hawk and fine-tune your diet and meds to keep you feeling your best.

The Role of Bile Production

Bile is crucial for keeping cholesterol levels in check, but sometimes our bodies can't make enough.

Liver damage, intestinal issues, or having your gallbladder removed can all lead to low bile production, which makes it harder for your body to get rid of extra cholesterol on a ketogenic diet.

If you have a history of liver, intestinal, or gallbladder issues, it's crucial to work closely with your healthcare provider when following a ketogenic diet.

They can help monitor your cholesterol levels and provide guidance on dietary modifications and supplements that may be necessary to support healthy bile production and cholesterol regulation.

Strategies for Managing Cholesterol on Keto

Worried about your cholesterol levels on a ketogenic diet? Don't stress. You can take control and improve your numbers with a few simple strategies.

Tackle genetic factors, boost your gut health, and make smart food choices to keep your cholesterol in check while still enjoying the perks of a keto lifestyle.

Addressing Essential Hypercholesterolemia

Essential hypercholesterolemia, including familial hypercholesterolemia, is a genetic condition that can lead to high cholesterol levels regardless of diet.

If you have a family history of high cholesterol or have been diagnosed with essential hypercholesterolemia, it's crucial to work with your healthcare provider to manage your condition.

In addition to following a healthy ketogenic diet, your doctor may recommend medications like statins to help lower your LDL cholesterol levels.

They may also suggest regular monitoring of your cholesterol levels and adjustments to your diet and medication regimen as needed.

Optimizing Gut Health

Maintaining a healthy gut microbiome is essential for effective bile production and cholesterol regulation.

Factors like antibiotics, celiac disease, Crohn's disease, diverticulitis, and imbalances in the microbiome can all impact bile production and, consequently, cholesterol levels.

Fermented foods like sauerkraut, kimchi, and kefir are your gut's best friends on a ketogenic diet. These probiotic powerhouses will keep your digestive system happy and healthy.

And don't forget about prebiotic foods like garlic, onions, and leeks – they'll feed the good bacteria in your gut, helping them thrive. Just remember to steer clear of processed foods and artificial sweeteners, which can throw your gut microbiome out of whack.

Dietary Adjustments for Better Cholesterol Management

Strategic dietary changes can significantly influence cholesterol levels for those adhering to a ketogenic diet. Prioritizing the consumption of healthy fat sources is paramount.

Substituting saturated fats with monounsaturated and polyunsaturated fats can favorably alter one's cholesterol profile, promoting overall cardiovascular well-being.

Some excellent sources of heart-healthy fats include avocados, nuts (especially almonds and walnuts), seeds (like chia and flax), fatty fish (such as salmon and sardines), and olive oil.

Incorporating these foods into your ketogenic diet can help you maintain a healthy balance of fats while still staying within the macronutrient guidelines of the diet.

In addition to choosing healthy fats, increasing your intake of fiber-rich, low-carb vegetables can also support cholesterol management.

Vegetables like leafy greens, broccoli, cauliflower, and Brussels sprouts contain fiber that can help reduce LDL cholesterol levels and promote overall gut health.

By understanding the factors that contribute to high cholesterol on keto and implementing these strategies for managing cholesterol levels, you can enjoy the benefits of a ketogenic lifestyle while still maintaining optimal heart health.

Remember to work closely with your healthcare provider, monitor your cholesterol levels regularly, and make adjustments to your diet and lifestyle as needed to ensure long-term success and well-being.

Tuna patties

Cholesterol Chronicles

Delve into the complex relationship between the ketogenic diet and cholesterol levels, shedding light on the potential causes of elevated cholesterol.

This exploration navigates the nuances of cholesterol management while highlighting the role of Keto Tuna Patties, a savory dish that epitomizes the delicious possibilities of keto-friendly meals.

By examining the impact of dietary choices on cholesterol levels and incorporating the satisfying flavors of Keto Tuna Patties, individuals can gain insights into optimizing their cardiovascular health while savoring wholesome and nutritious meals.

Through this journey, readers embark on a quest for cholesterol clarity, armed with knowledge and empowered to make informed dietary decisions that support their overall well-being.


So, there you have it - the surprising causes of high cholesterol on keto. From genetics to hidden carbs, and even a sluggish thyroid, it's not always just about the fat.

Don't let this news throw you off your keto game! With a few clever adjustments, such as opting for heart-healthy fats, upping your fiber intake, and keeping tabs on those sneaky carbs, you can maintain healthy cholesterol levels while still enjoying the benefits of the keto lifestyle.

Remember, knowledge is power. Now that you know what to watch out for, you're armed and ready to tackle any cholesterol curveballs that come your way. So keep calm, keto on, and show that cholesterol who's boss!

Supporting Data

Healthy Keto Guide for Beginner

FREE Keto Diet Plan