So I completed my annual health screening required by my company...1st time while on low carb.

The good news is BP 116/67, down from 130/75 2 years ago.

Glucose is in high normal, at 94. It was slightly lower the last 2 years (92, 87)...not sure why it is higher when I have been below 30 grams carbs for over 2 months now. Not worried just wondering.

BMI at 25.8, lower than it has been in a while, but it is kinda a useless measure. Shows me above normal range....I see guys in their 50's every day and I am no longer above the normal range...maybe for a 20 year old but not for a 55 year old.

Cholesterol HDL at bottom of normal range - 54 mg/dl

Here is where the problem comes in. Cholesterol LDL has spiked up to 150 mg/dL (82, 93 last 2 years), and therefore total cholesterol has moved above normal range to 218 mg/dL.

Has anyone seem similar results? Should I be worried, or change my eating habits...maybe lay off eggs and bacon? Thoughts? Thanks!

i freaked. kept getting messages from my pcm's nurse to retest / call. i did neither. did some research and found out...

your ratio is a better indicator.

Cholesterol HDL, LDL, Triglycerides Ratio Calculator

Has Your Cholesterol Skyrocketed on a Ketogenic Diet? Read This! 6-13-2018

How to Lower Your Cholesterol Fast in Time for Blood Tests < feldman... didn't do it, but it looks like a neat experiment. lots of fat = lower your results.

my total cholesteral was high, ldl was very high, but all of my ratios were good to excellent as my hdl was 98 and triglyceride 60. here's my ratios using the first linke above:

Your Total Cholesterol/HDL ratio is: 4.80 - (preferably under 5.0, ideally under 3.5) GOOD
Your HDL/LDL ratio is: 0.272 - (preferably over 0.3, ideally over 0.4) AT RISK
Your triglycerides/HDL ratio is: 0.612 - (preferably under 4, ideally under 2) IDEAL

yearly checkup is coming up in 3-4 months. i may skip it.

First, on the surface, your numbers and ratios look good. Do you know if they used an NMR Lipid Panel to conduct these measurements or if they used a simple Cholesterol blood lipid tests that uses estimates and doesn't distinguish between LDL types? I assume this was the case, as the NMR Lipid Panel is more costly. Also, it's very likely the medical care people that are conducting these tests for your company will not be aware of the lack of information a simple blood lipid test provides. They interpret test results based on the standard accepted ranges and numbers.

One thing you could consider if your company sees a red flag is to follow the Feldman Protocol to change the results of the next test into the healthy range. He provides detailed instructions on his website:

https://cholesterolcode.com/

Given the lack of knowledge and new findings refuting that LDL is the "bad" cholesterol and that eating carbs contributes more to blood lipids than eating healthy fats, I believe the Feldman "hack" is a reasonable option. Good luck.

Two of my recent Lipid Panels...

April Results vs Last September
TC: ... 349 ... 198
HDL: ... 78 .... 80
LDL: .. 259 ... 111
TG: .... 60 .... 35
VLDL: ...12 ..... 7

The only difference in diet prior to both of these tests was the volume of carbs and fiber that I was eating. January to April 2019 I was doing a VLC "plant free" diet tweak with virtually no fiber. Last September I was chasing better cholesterol numbers for my doctor -- eating more carbs (50 to 60 net) and plenty if fiber (25+ grams daily). I am active and metabolically healthy. When I eat VLC my TC/LDL goes way up. When I eat carbs right at or above my keto limit my TC/LDL goes down. My numbers are not unusual. Dave Feldman has coined the term "Lean Mass Hyper Responder" for those of us Keto people who have doctor freaking cholesterol numbers. The question is... Is it unhealthy. I can't say for sure, but my CAC score dropped by 54% in 28 months - and most of that time I had doctor freaking cholesterol numbers. I'm over being concerned about it. The problem is my Doctor and perhaps someday my health insurance company.

I’m apparently a hyper responder. My numbers were in the amazingly excellent range two years ago, at 260 pounds. I was eating low carb, but not keto levels. After that test, I went on to slowly lose 60 pounds and felt great. I started IF and keto and weight training and haven’t felt better in my whole life. Two months ago, my doctor wanted to check again and my LDL was 20 points higher than their reference range considers healthy. So, it wasn’t horrible, but I went from being in the totally amazing category to being barely in the “danger zone”. The change, not the actual numbers shocked my doctor. But my triglycerides were 39, so my doctor told me to eat more fat. 😆 She’s not worried and her husband is a cardiologist. So...I’m not going to worry about it either. It’s just a number.

I have a similar response as Ken in favoring VLC for remaining in or close to fat burning mode, which makes me much healthier. I may be just outside of the LMHR profile described by Feldman, and with a few adjustments, I'm able to make insurance companies and doctors happy if I have to. I've proven that in the past.

I think the main issue here with your tests is whether you'll be penalized in any way by your company by being considered a health risk for insurance or whether there is a prescription suggested in your future for lowering your numbers. That's something we all may be faced with in the future if current standards get adopted by insurers, and that includes people like me who are on medicare. If that should happen, I can follow Feldman's protocol to demonstrate that I'm healthy.

Until that time comes, I like where my numbers are, particularly my TG-HDL ratio which is usually 1 or below with anything from 2-4 being a warning to take corrective action. The crazy thing is that increased TC and LDL may in fact be healthier for those on low carb. It's important to get your triglyceride (TG) number to compare with your HDL. Also, as mentioned, with a simple blood lipid test, the LDL is calculated from other scores, not measured directly and only provides a partial picture. However, all this is moot if the analysis of your results must comply with the standard levels that are currently considered healthy.

Suggest you go through Feldman's website to learn more, as he's got a raft of information about this. We are not doctors on this forum, so an informed patient is the best to make their own decisions. However, I know that a doctor of mine with best intentions doesn't understand the recent research and details on blood lipids, so I've had to close that gap by educating myself. This topic has been discussed frequently on this forum, and people like Ken and a few others have provided solid information. Here's one link and an advanced search will provide additional information:

https://forum.lowcarber.org/showthread.php?t=471974

One final point: those of us who have adopted and follow a VLC keto approach tend to respond differently to lipid tests. It's very common, and I believe that category requires a different lipid profile assessment, as the metrics for those following a SAD indicate something very different. Apples to oranges.

Or maybe Apples to avocados

Thank you . . . .