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Cholesterol Level Guide: Keto and Low Carb Diets
Cholesterol Level Guide: Keto and Low Carb Diets
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Written by Base Medical Team
Updated over a week ago


  1. What is cholesterol?

  2. What is cholesterol’s role in the body, and how does it affect you?

  3. What are the different types of cholesterol?

  4. What are ideal cholesterol ranges for most people?

  5. What happens if your cholesterol gets too high?

  6. Can you reduce cholesterol levels naturally?

  7. How do low-carb or ketogenic diets affect cholesterol levels?

  8. How can you measure your own cholesterol levels?

Cholesterol Level Guide: Keto and Low Carb Diets

In Brief:

  • Cholesterol may be something that you’ve been taught to avoid, but a certain level of cholesterol is necessary for optimum health

  • Too much cholesterol can seriously mess with your health - and you may not even realize that you’re in trouble until it’s too late

  • On the other hand, you don’t want too little cholesterol either, since your body needs it to manufacture key hormones, protect nerve fibers, and much more

  • Even though your body makes most of its own cholesterol, it’s still possible to manage your cholesterol levels through external factors, such as dietary and lifestyle changes

What is cholesterol?

Cholesterol is a fat-like substance that we get from our own livers, and from high-cholesterol foods. Some people compare cholesterol in your bloodstream to bacon grease being poured down the kitchen sink, but that’s definitely an exaggeration. Instead, think of it as the oil that’s used to lubricate an intricate machine. Too much oil, and the gunk starts to build up; too little, and the machine starts to get dry and creaky. Once you find a happy medium, though, it’s fairly easy to keep the machine running smoothly.

Of course, cholesterol is a little different since your body can make as much as it needs; however, you probably get some of your cholesterol from food as well. That epic pizza you had last weekend? There was definitely cholesterol in there. The scrambled eggs you had for breakfast? Also a source of cholesterol. If you eat meat and dairy products or anything with trans-fats, you’re getting cholesterol from your diet.


What are the different types of cholesterol?

If you want to understand how to balance your cholesterol, this is one of the first things to figure out. Lucky for you, it’s actually pretty simple! There are three main kinds of cholesterol:

  • First, there’s high-density lipoprotein (HDL) cholesterol. Of the three types of cholesterol, this is the only one that actually helps protect you against strokes and heart attacks. Yes, you read that right - this type of cholesterol is one of the good guys, provided it’s present in the right amounts.

  • Second, you have the low-density lipoprotein (LDL) cholesterol - this is the stuff that blocks your arteries. You don’t want too much of this stuff circulating in your bloodstream, because it has a nasty habit of accumulating around your heart or brain when levels stay elevated for too long.

  • Third, there are the triglycerides. They’re a way for your body to store extra energy in the form of fat stores, but too many triglycerides will increase your risk of heart disease (especially when they’re combined with high LDL cholesterol).

Now that you’ve got the basics down, here’s an extra little tidbit about HDL cholesterol - it actually regulates LDL cholesterol. HDL cholesterol is able to escort LDL cholesterol to the liver, where it’s metabolized. If LDL cholesterol is getting processed by the liver, that means it isn’t forming arterial plaque, and you have a much smaller chance of ending up with a blocked artery.

What is cholesterol’s role in the body, and how does it affect you?

You probably already know about sex hormones like estrogen, progesterone, and testosterone. In the right amounts, these hormones are instrumental in maintaining a healthy sex drive, helping you age gracefully, and even keeping your mood generally cheery. What’s the connection to cholesterol? As it happens, cholesterol is necessary to make all of these hormones, and others as well.

What about your nerves - those are pretty important, right? Well, nerve fibers are encased in a cholesterol-rich sheath, called the “myelin sheath”. If this starts to deteriorate due to low cholesterol, your nerves will not be happy campers. Your nerve impulses could start to slow down, possibly resulting in brain fog or decreased physical coordination. Keep your HDL cholesterol levels in the healthy range, though, and your brain will have a much better chance of firing on all cylinders.

What are ideal cholesterol ranges for most people?

Here’s the breakdown for adults’ recommended cholesterol levels:

  • Total cholesterol should be less than 200 mg/dl. 200 to 239 mg/dl is a bit outside the safe zone, and 240 mg/dl or above is when it’s definitely time to get those levels down.

  • HDL cholesterol should be over 60 mg/dl. For men, a measurement under 40 mg/dl is considered too low; for women, the number is 50 mg/dl.

  • LDL cholesterol should be under 100 mg/dl. If your levels are 100 to 129 mg/dl, you’re still doing alright. If your levels are above 130 mg/dl, it’s time to take it easy on the fast food. Some people can register levels of 190 mg/dl or more - at this point, they’re at increased risk of a stroke or heart attack.

  • Triglycerides should stay under 150 mg/dl. If your levels are between 150 and 199 mg/dl, that’s considered borderline high. Once you pass the 200 mg/dl mark, that’s blocked artery territory.

Recommended cholesterol levels will vary by age, but if someone is talking about recommended levels without specifying the age group, they’re probably talking about adults age 20 and up. Children (ages 10 to 19) have their own set of recommendations, but it isn’t that common to check kids’ cholesterol levels.

What happens if your cholesterol gets too high?

Sadly, the benefits of HDL cholesterol don’t mean that double-bacon cheeseburgers are now a health food - too many of those are still bad for you. Why can’t you just hold off on watching your cholesterol levels until you start experiencing symptoms, though? That’s the catch: the first symptom of high cholesterol is usually a serious health event, and by then your treatment options could be pretty limited.

Excess cholesterol works slowly, usually by building up plaque in your arteries over several years. In most cases, the problem is caused by LDL cholesterol. When high LDL cholesterol is accompanied by low HDL cholesterol, that’s when the stroke or heart attack risk really goes through the roof. A blockage near the heart restricts blood flow, resulting in a heart attack; if the buildup is in an artery that supplies blood to the brain, that would result in a stroke. In either case, the common denominator is plaque buildup due to high cholesterol.

Can you reduce cholesterol levels naturally?

You sure can! Here are some of the things that could have the biggest impact in lowering your cholesterol:

  • Avoid foods that cause high cholesterol. You probably knew this was coming, didn’t you? Don’t panic! You don’t have to go cold-turkey on cholesterol - you just have to know which high-cholesterol foods to avoid.

Trans-fats should be reduced as much as possible, since they’re some of the worst culprits for raising LDL cholesterol. Foods that are high in trans-fats include margarine and vegetable shortening, fried foods, some non-dairy creamers, many pre-packaged baked goods…you get the picture.

Saturated fats should be limited, but you don’t have to avoid them entirely. Foods like eggs, cheese, butter, and red meat are all high in saturated fat; if any of these make a regular appearance on the menu, it might be time to make a few adjustments.

  • Focus on foods that will maintain healthy cholesterol levels. Reducing LDL cholesterol isn’t just about getting rid of certain foods - you can add stuff into your diet too. Fish, avocados, olive oil, and nuts contain loads of omega-3 fatty acids, which will lower your total cholesterol by reducing triglycerides. Eggs are a great source of HDL cholesterol, while being low in LDL cholesterol - perfect (in moderation!) for someone who’s working on improving their cholesterol levels.

Foods that are high in soluble fiber, like most fruits and veggies, have also been proven to lower cholesterol. Just one per day is enough to make a difference! If apples and carrots aren’t your thing, try adding some leafy greens, oats, or legumes to your diet.

  • Give acupuncture a try. Some people have had success in lowering their cholesterol levels with acupuncture - and guess how it works? Mainly by targeting the liver, which not only makes cholesterol, but metabolizes it when there’s too much in the bloodstream.

How do low-carb or ketogenic diets affect cholesterol levels?

Until now most of the focus has been on HDL and LDL cholesterol - it’s time to give the triglycerides some attention. Most people have no problem getting enough carbohydrates, so their metabolisms are adapted to running on the energy supplied by those carbs. If you’re eating a low-carb diet, though, what does the body burn instead? Fat - also known as triglycerides. If you consistently limit carbohydrates, you’re likely to see your triglyceride levels decrease slowly but surely.

You can even get similar results on a ketogenic diet, as long as you put sensible limits on saturated fats. Your body is still being fueled by fats instead of carbs, so you’ll probably see a reduction in your triglyceride levels after just a few weeks. This is assuming, by the way, that you’re starting out with elevated triglyceride levels - if you’re already in the normal range, you shouldn’t see any major reductions.

How can you measure your own cholesterol levels?

While the most accurate way to measure cholesterol levels is to have it done by a professional, there are a couple of at-home options too. A bathroom scale can’t measure the amount of fat circulating through your bloodstream (duh), but the really smart ones can tell you how much visceral fat you have - which is linked to your cholesterol levels. If you have more visceral fat than is optimal, that’s your clue that it’s time to check your cholesterol.

There are also at-home cholesterol tests that promise accurate results without the wait time of a typical cholesterol test, but the reality is that you’ll probably just get a ballpark figure. They aren’t really accurate enough to help you decide on a firm action plan, and they can’t give you personalized advice on your recommended next steps.

For most people, a visit to the doctor’s office is the obvious choice. The results will be accurate, all the numbers will be explained to them, and they’ll get advice on what to do next. However, getting a doctor’s appointment could involve a long wait time - and let’s be honest, nobody likes going to the doctor.

If you liked the sound of those at-home tests, but want the accuracy of lab-processed tests, you might want to have your cholesterol levels checked with Base. Their at-home lab tests are easy to use, and just as accurate as what you’d get from a doctor. You could opt for the lipids panel, for example, and figure out your HDL, LDL, triglyceride, and total cholesterol levels - all without leaving the house. You simply complete the test kits that Base sends you, mail them to the lab, and wait a few days for the results to appear in your Base app. In addition to your results, you’ll get personalized recommendations on what to do next. The hardest part of optimizing your health is figuring out how to do it - and that’s exactly what Base can do for you.

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