The Great Cholesterol Debate

Oh cholesterol, you dirty little bastard, why do you wreak such havoc on health?? Medical professionals are obsessed with cholesterol levels, and it seems like every other commercial I see is for a damned cholesterol medication. But what exactly is cholesterol?

What is Cholesterol?

Cholesterol is not the bad guy here contrary to what your doctor might be telling you. Now, it’s not your doc’s fault. They only know what was ground into their heads in medical school, (and what they continue to be bombarded with from the parade of drug reps pouring into their offices, showering them with freebies and literature). Cholesterol is a vital part of our existence. We need it to maintain proper cell function.

Cholesterol is a type of lipid, like oil or fat. More specifically, it is a sterol, or modified steroid.  We get it both from the foods we eat, and from our bodies manufacturing it. All animals produce and use cholesterol. When our body breaks it down, it is used to produce things like estrogen and testosterone, as well as vitamin D. Cholesterol is vital to the stability of our cell membranes, while also keeping them flexible so they may perform their jobs effectively. Cholesterol helps with the formation of memories and is essential for neurological function.  Sounds like good stuff, right? So what’s the deal with the maniacal pursuit to beat it into submission?

Here is a great video, explaining much more clearly than I would, about how and why cholesterol became so demonized. It’s about 17 minutes long, but well worth the watch if you have the time. A brief summary of the video is posted below in case you don’t have time to watch it at the moment.


In short, a guy named Ancel Keys conducted a study on the correlation of saturated fats and cholesterol, and their effects on heart disease. Finding nothing conclusive, he fudged the numbers to make it seem like fat raised cholesterol which in turn caused heart disease. This was total bs. Then, in the late 1980’s, the surgeon general’s office set out to prove the Lipid Hypothesis. They failed miserably. So they simply scraped the project, but still continued to perpetuate the lie. And despite having a myriad of eminent scientists state over and over that there was just no actual medical data backing up the hypothesis, a room full of politicians decided to recommend a low-fat diet to the general public. Finally, the USDA jumped on the cuckoo train, wanting to set official low-fat dietary guidelines for everyone to follow. But they had trouble finding any actual scientists to support them, so they shopped around until they finally found one.

And that was that, legitimate research data was tossed out in favor of the opinions of a handful of influential government folks with zero scientific background. Why you ask? Money, that’s why. Congress was pretty much telling the scientific community that if you want to continue to get funding, you need to get on board with our agenda. These geniuses went as far to say that even though there was absolutely no evidence linking cholesterol and heart disease, scientists should drop the whole thing, and instead focus on breeding hens that lay low cholesterol eggs. You can’t make this shit up folks.

Luckily, A steady stream of doctors have since found absolutely zero impact on heart health including, eventually, Keys himself. They found the same occurrence of heart disease in those with “high” cholesterol as in those with “normal” cholesterol. So what is behind all the rampant heart disease? Wait for it…INFLAMMATION. If only we knew of a way of eating that was anti-inflammatory…

When arteries become damaged or inflamed, cholesterol goes to work trying to repair them. If the smaller LDL particles become damaged by oxidation as a result of the arterial damage, they can penetrate the artery wall and begin to build up causing inflammation which can lead to heart disease. What’s the primary source of small LDL particles? Carbohydrates. And what are the factors that lead to the artery damage to begin with? Things like smoking, stress, and elevated blood sugar are the main culprits. If only we knew of a diet that regulated blood sugar levels…

Cholesterol 101.

Cholesterol is basically a fatty substance that cannot travel through the bloodstream on its own because it’s not water-soluble. This is where the lipoproteins come in. They are essentially the boats that carry cholesterol where it needs to go so it can carry out its job. Without getting all sciency, let’s look at how the results of cholesterol blood work are generally interpreted. It’s broken down predominantly into 4 main categories.

  1. LDL or low-density lipoproteins are also called “the bad cholesterol”. These come in small and large particle size. They are the supposed bad boys of the bloodstream, blamed for clogging arteries and causing heart disease havoc. These guys are just trying to do their job though, getting cholesterol to where it needs to be.
  2. HDL or high-density lipoproteins are known as “the good cholesterol”. These are the janitors of the blood, sweeping through and picking up all the unused cholesterol and bringing it back to the liver where it gets reprocessed.
  3. Triglycerides just a fancy word for fat particles. These are the end products of digesting and breaking down fats in food. Triglycerides are like little energy stores. They are tapped into when the body needs fuel.
  4. Total cholesterol-pretty sure this one is self-explanatory.

Here we can see the traditional “normal” ranges that your doctor would like to see on your blood work. Mine was done a couple of months after I started Keto and the results were alarming, to say the least. Especially since at the time I thought like everyone else, that high cholesterol was bad and required medication to control. My doctor wanted to put me on a statin immediately. These were my numbers on 9/20/2017:

  • Total=289
  • LDL=193
  • HDL=66
  • Triglycerides=148

Holy crap on a cracker, no wonder my doc was freaking out! I am not, however, a fan of taking regular medications unless It is absolutely necessary. Take birth control for example, I take that shit every day because I absolutely don’t want any more ankle biters. But a statin? Definitely wasn’t ready for that road.

I also remembered reading about keto’s lowering effects on cholesterol from a Facebook group I am a member of, and after talking my doctor off the ledge, we agreed to retest in three months. Fortunately, I have an amazing doctor who is open and willing to listen to me about an area in which he is not completely familiar, keto. Unfortunately, most doctors have very little nutrition classes during medical school, which is why they rely so heavily on the same old information that has been taught for decades.

So I walk into my doctor’s office three months later like a boss, because I’m totally expecting my numbers to be perfectly within range. But once again, he looked at me and said, “your cholesterol is disgusting” and told me I needed to take a statin. What. The. Actual. Fuck. I was deflated, but not defeated. Again, I said no. I asked for three more months but this time, I was going to seriously dive into the facts about cholesterol. There was no way in hell that keto was lowering everyone else’s cholesterol, but raising mine.  He said that it may be just my genetics and no amount of dietary changes would help, be he reluctantly agreed to retest.

I went home and decided I was going to take a look at my numbers to see if I could make sense of them. These were my results on 12/27/2017:

  • Total=296
  • LDL=165
  • HDL=110
  • Triglycerides=104

Whoa, whoa, whoa…wait just a freakin minute…look at the differences in those numbers! Sure my total was up but my LDL, which is the “bad cholesterol” was down 28 points. My HDL or “good cholesterol” was up 44 points. My triglycerides were down 44 points. I’m sorry but I call that a win. As much as I wanted to call my doc and ask why he didn’t think these changes were a good sign, I figured I’d wait until the retest. Instead, I’ll spend my time arming myself with as much information as I can about cholesterol and why it’s not a bad thing to have high numbers.

The Bigger Picture. 

We maintain in the keto world that it’s completely normal to have elevated lipid levels in the bloodstream. After all, it’s what we run on. It only makes sense that fat molecules are floating around in there in plentiful fashion. I have high hopes that my next set of blood tests will come back with even better results than the previous two, and I will be posting them in an update as soon as I get them back.

In the beginning of keto, it’s very common for your cholesterol readings to be off the charts, your body is still trying to sort out what the hell it’s supposed to be doing. The numbers will start to levelize, usually after about 6-9 months, and most people find they end up settling somewhere in the normal range. Many even find they are able to stop taking cholesterol medications, under supervision of their doctor of course. Never stop taking your meds on your own, that can be dangerous.

Hopefully you made it to the end, apologies for the lengthy post, there was a lot to cover. And this is really only the tip of the iceberg. I encourage you to read some of the sources below if you get the time, and also to check out more of Jimmy Langkop’s work. He’s the author of the Lipid Hypothesis video above. Thanks for reading, and I welcome any questions or concerns in the comments below.




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