What happens to triglyceride levels on a ketogenic diet?

By Dr. Stephen Phinney and the Virta Team

Triglycerides are among one of the most predictable changes when one adapts to and maintains a well-formulated ketogenic diet. For people starting out with elevated triglycerides, they almost always show a sharp and sustained reduction. On average, people with metabolic syndrome will see their serum triglycerides reduced by half when on a ketogenic diet (Volek, 2009).

Yes, there are people who may not respond this way, but the exceptions tend to be people whose serum triglycerides were already within the normal range. Increases in triglycerides during a well formulated ketogenic diet may occur, but this is rare. In those cases, it may be due to carbohydrate consumption that is greater than one’s tolerance or due to alcohol consumption in the day or two prior to the blood test.


Volek JS, Phinney SD, Forsythe CE, Quann EE, Wood RJ, Puglisi MJ, Kraemer WJ, Bibus DM, Fernandez ML, Feinman RD. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids. 2009; 44:297-309. doi: 10.1007/s11745-008-3274-2.

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  1. Avatar

    My friend who had been on keto for 3 weeks went from 45-70 triglyceride levels between her 2 medicals and her total cholesterol had increased . She didn’t do the test fasted as nobody informed her of it, would this make a difference?


    1. Virta Health

      Fasting is typically required for triglyceride levels.


    2. Avatar

      Absolutely that would impact the test. You always fast for a lipid panel bloodtest


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