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.

Citations

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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11 Comments

  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?

    Reply

    1. Virta Health

      Fasting is typically required for triglyceride levels.

      Reply

    2. Avatar

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

      Reply

  2. Avatar

    Yes, fasting does make a difference. In addition, cholesterol may elevate briefly at the beginning of a ketogenic diet, until the body becomes keto-adapted and begins burning fat as its primary source of fuel (can take up to, and for some longer, 6 weeks). Being in ketosis and being keto-adapted are 2 separate processes.

    Reply

  3. Avatar

    hi
    my TRIGLYCERIDES was 2.96mmol/L after 3 weeks of Keto become 17.66mmol/L
    is this normal ?

    Reply

    1. Virta Health

      Hi, We are unable to provide specific medical advice via this forum. We would encourage you to reach out to work with your healthcare provider to address your concerns.

      Reply

    2. Avatar

      Mine also did this. My dr had me do labs in office unannounced unfasted. Results were terrible.
      Now I’m on a triglyceride lowering drug. I believe in keto, I obviously did something wrong.

      Reply

  4. Avatar

    Hello. I’ve been basic keto for a few years. Super clean keto.
    My cholesterol has gone up and up since starting.
    My hdl is very low 0.9 and my trigs are way up high 6.6
    Should I be alarmed ?
    Any advice please I need help

    Reply

    1. Virta Health

      We are unable to provide medical advice in this forum, so we would recommend that you speak with your physician.

      Reply

  5. Avatar

    Been on Keto for a couple month my triglycerides went from 300 ish to 469, while my A1C went from 8.3 to 5.4, my ketones always stay between 1.0-3.0, I don’t drink, and I maintain a diet well under 50 carbs most the time closer to 25 carbs a day.
    my labs all looked great, except hdl was low, ldl “not valid” due to high triglycerides.

    Reply

  6. Avatar

    This is something I’m concerned about also. Starting out with 50 or less carbs, and only eating healthy fats. I’m not going to consume butter or high-fat meats. I feel a little bit better about this diet with taking this approach having high triglycerides. The high fats are okay but I’m making mine healthy fats

    Reply

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