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Cholesterol is often viewed negatively due to its historical association with heart disease. However, its role in heart health is controversial. Read on to learn what cholesterol is, how your body uses it, why low-carb and keto diets may lead to a change in blood cholesterol levels, and whether you should be concerned if your cholesterol increases with a keto or low-carb lifestyle.

Your body makes most of the cholesterol that is found in your bloodstream. It’s primarily produced in the liver. Dietary cholesterol – found in animal foods like eggs, shellfish, cheese and organ meat – makes up a smaller portion of your blood cholesterol pool.

The basics: What is cholesterol?

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Cholesterol is absorbed from your digestive tract and circulated throughout your bloodstream, where it can be used by cells as needed. It then returns to the liver to be converted into bile acids or used for other purposes.

Importantly, cholesterol doesn’t travel around your bloodstream on its own. As a hydrophobic (water-repelling) substance. So that means when we talk about blood cholesterol levels, we’re referring to the amount of cholesterol contained in different lipoprotein particles. In addition to cholesterol, triglycerides and other compounds.

Many factors can affect your blood cholesterol, including genetics, hormonal changes, injury, and certain health conditions. For instance, people with untreated hypothyroidism often have elevated cholesterol.

A rise in cholesterol during keto or low-carb eating may be related to losing weight. It’s been known for decades that major weight loss often leads to a temporary rise in LDL cholesterol. Lipidologist Dr. Thomas Dayspring has found that around a third of his patients experience increased LDL as a result of weight loss. For this reason, it could make sense to wait until your weight has been stable for a few months before assessing your cholesterol levels.

How does keto or low-carb eating affect your cholesterol?

Dr. Dayspring, however, urges caution. In his paper “Lipidaholics Anonymous Case 291: Can losing weight worsen lipids?”

provides detailed information about your LDL and HDL particle sizes and counts, along with an insulin resistance score that reflects your risk of developing diabetes.

As mentioned above, sometimes a rise in LDL cholesterol is temporary, especially during weight loss.

Vitamin K exists in two forms: K1 and K2. Vitamin K1 is found in plants and is involved in blood clotting. By contrast, vitamin K2 is found mainly in animal products – and might help protect heart health by keeping calcium in your bones and out of your arteries. The best sources of vitamin K2 include liver, eggs, grass-fed dairy products and chicken.

What are “normal” cholesterol levels?

Some would argue, however, that these cut-off points are arbitrary and do not apply to all individuals depending on their baseline metabolic health and overall health. For instance, far too many examples exist of people with low LDL levels having heart attacks and those with high LDL having improved longevity. So while these numbers make sense for whole populations, tremendous individual variation exists.

In most people who follow keto or low-carb diets, blood cholesterol goes up very little, if at all. Some even experience a drop in LDL cholesterol after starting low carb. However, others experience an increase in both LDL and HDL cholesterol levels.

  • Total cholesterol: < 200 mg/dL (5.2 mmol/L)
  • LDL cholesterol: < 100 mg/dL (3.4 mmol/L)
  • HDL cholesterol: > 40 mg/dL (1.04 mmol/L) for men, > 50 mg/dL (1.3 mmol/L) for women
  • Triglycerides: < 150 mg/dL (1.7 mmol/L)

LDL levels >160 mg/dL (4.1 mmol/L) are considered high, and levels 190 mg/dL (4.9 mmol/L) and above are considered very high.

Many factors can affect your blood cholesterol, including genetics, hormonal changes, injury, and certain health conditions. For instance, people with untreated hypothyroidism often have elevated cholesterol.

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