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How to Lower Your Cholesterol on Ketogenic Diet

author avatar Dr. Eric Berg 04/11/2024

Whether the keto diet is effective often leads to concerns about its impact on cholesterol levels. There's a common misconception that a high-fat diet like keto might raise cholesterol levels and that all cholesterol is automatically bad.

Learn about how keto affects cholesterol, what good cholesterol is, and how to avoid bad cholesterol.

What is Cholesterol?

Cholesterol, contrary to popular belief, isn't evil. It's an essential fat in your cells, making up 25-50% of each cell. Your body uses it for crucial functions such as hormone production and digestion.

LDL (low-density lipoprotein) cholesterol is harmful to the body and should be avoided. HDL (high-density lipoprotein) is beneficial for the body, aids in digestive functions, and is the type of cholesterol that is encouraged by the keto diet.

The Role of Keto in Regulating Cholesterol

Keto can help regulate cholesterol over time. When you cut carbs drastically (the hallmark of a ketogenic diet), your body starts burning fats instead - including those stored in the liver that may be clogging things up.

A study showed improved liver function after adapting to keto, resulting from reduced triglyceride accumulation, which could lead to increased bad LDL cholesterol.

Cholesterol form

The Importance of Bile in Cholesterol Regulation

Our bodies are incredibly efficient machines, especially when managing cholesterol levels.

How Bile Helps Eliminate Excess Cholesterol

Bile, an essential fluid produced by the liver and stored in the gallbladder, helps eliminate excess cholesterol. Think of bile as your body's recycling service for excess cholesterol. Studies show that one of its primary jobs is eliminating surplus cholesterol from our systems.

Factors Affecting Bile Production and Flow

Certain conditions can affect our body’s ability to produce or flow enough bile. These include cirrhosis, hepatitis C, endotoxin exposure, or even the absence of a gallbladder.

Research indicates these factors could lead to impaired elimination of excess cholesterol, making us more prone to higher levels than we'd like.

Awareness about these conditions can aid us all in taking better care of our health while following diets like keto that require good management of fats.

The Role of Dietary Choices in Lowering Cholesterol

Your plate can be a powerful tool for managing cholesterol. You can influence your body's cholesterol levels by filling up on certain foods and limiting others.

Importance of Fiber-Rich Foods

Fiber helps block bad LDL cholesterol from being absorbed into your bloodstream. So, where do we get fiber? The answer is vegetables.

At least seven cups daily are recommended for optimal health benefits, including lowering cholesterol due to their high fiber content.

Various vegetables, from leafy greens to crunchy bell peppers, will help you meet the recommended seven cups daily.

Eating more vegetables fills you with fewer calories and provides essential nutrients that support overall health while helping lower our bad LDL (low-density lipoprotein) numbers.

Supplementation for Cholesterol Regulation

Navigating cholesterol management can be winding, but certain supplements may help straighten the path. Let's explore some key players in this game: bile salts, choline, and niacin.

The Benefits of Bile Salts and Choline Supplements

Bile salts play an important role in removing excess cholesterol from our bodies. By boosting your body’s production with bile salt supplements, you're giving your body extra power to regulate its cholesterol levels.

Next is choline - another superstar supplement that helps keep things moving smoothly by supporting liver function. It's like a traffic cop directing fat cells away from potential pile-ups in the bloodstream.

Understanding the Role of Niacin

Niacin, also known as vitamin B-3, has been proven effective at breaking down fats and managing overall lipid profiles. At the same time, niacin increases HDLs and reduces triglycerides by attacking LDLs.

  • Taking bile salts or choline supplements can aid in regulating cholesterol levels.

  • Niacin intake has been indicated to potentially reduce LDL, boost HDL, and lower triglyceride levels.

Human liver illustration

Impact of Liver Health on Cholesterol Levels

The liver plays a vital role in cholesterol management. Specifically, the connection becomes more pronounced when we talk about fatty livers.

How a Fatty Liver Influences Cholesterol Regulation

As its name suggests, a fatty liver is filled with excess fat. This overload can interfere with how well your body processes and regulates cholesterol. Too much fat hampers the liver's ability to break down cholesterol effectively.

Unprocessed cholesterol can cause serious health issues such as heart disease and stroke.

Improving Liver Function for Better Cholesterol Management

To manage this situation better, we need strategies that help improve overall liver function.

Losing some pounds if you are overweight or obese may be a good tactic. Even losing a small amount of weight could significantly affect your liver's well-being.

Another strategy could involve limiting alcohol intake since excessive drinking may harm the liver over time. Yet another approach could be regular exercise, which not only aids in maintaining an ideal body weight but also improves overall organ functionality, including that of the liver.

Improved liver health comes with better processing and regulation of fats, including cholesterol, making these steps worth considering seriously.


Understanding how the keto diet affects cholesterol levels is crucial for overall health. While cholesterol is often vilified, it plays essential roles in the body. The keto diet, with its low carb and high-fat approach, can help regulate cholesterol by boosting beneficial HDL while reducing harmful LDL over time.

Factors like bile production and dietary choices also influence cholesterol. Including fiber-rich foods, like vegetables, can lower LDL absorption.

Supplements like bile salts, choline, and niacin may support cholesterol regulation, while lifestyle changes such as weight loss and exercise can improve liver function.

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