I got my bloodwork back today from my annual physical I did yesterday. Everything looks good, but my cholesterol is high for the first time.
Values:
Cholesterol: 250
Triglyceride: 59
HDL: 97
LDL: 143
How do these look? I’m concerned the LDL is up (it was 94 when last tested) and the total cholesterol is also up. I’m 52, healthy weight range. My diet does include a lot of eggs and meat, and not much processed foods.
@T3hPwnisher : You may have some insight. Don’t know who else to tag.
I have a LOT to say on the subject but am short on time at the moment. Bottom line is I would be happy with those numbers.
You may like checking out Dave Feldman and the cholesterol code along with the idea of “lean mass hyper responders” to go down a rabbit hole here
1- When was the last time you tested?
2- Has your diet/body composition changed?
The jump in numbers may not mean anything serious but it’s something I would look at. I would get an ApoB test.
If you want more detail a test that gives LDL particle number and particle size like the “Cardio IQ Lipoprotein Fractionation Test” from Ulta.
I tested in 2025 and I test every year. Last year:
Total cholesterol: 183
Triglycerides: 70
HDL: 69
LDL: 92
I’m about 15% BF, based on dexa. But, yes, I have made some changes over the last ~8 months.
Training: I pivoted from CF, which I had done as my main type of training for 2.5 years, and MetCon training to the opposite of HIIT: explosive KB work with long rests. Specifically to avoid the glycolitic state during normal training and only go all out every week or two. Using Dan John and Pavel approaches.
Diet/weight: I am about 172/3 lbs, which is where I’ve been at for years. I do think I’m leaner now with the shift in training. I have also stopped taking whey protein, and focused more on meats, eggs, fruits, veggies. As an example, for years I would take a pre-workout carb drink (like Surge), then for breakfast have a protein slurry of whey, yogurt, oats, and blueberries. Now, I train fasted and eat eggs and berries as a typical breakfast. Sometimes adding sausage or beef to the eggs.
I just googled that a read a bit. Interesting. The LDL levels he discusses are even higher (above 200), but the rest seems to track with where I’m at. I don’t eat ultra low carbs, but as I said above have changed some aspects of my diet and training.
The standard HDL, LDL, Tri cholesterol test usually leaves more questions than answers. At 3 years old I had pre op bloodwork with high cholesterol. What I noticed personally, the more carbs and processed food I have in my diet, the higher my cholesterol numbers. Low carb, high protein and fat lowers my cholesterol numbers. Dietary cholesterol had almost 0 effect. I think the “best” bloodwork I’ve ever had I was eating 6 eggs a day, trained boxing at the time.
I would consider what you’re seeing compared to these numbers to be a significant improvement. HDL soared up and Trigs dropped.
I find that LDL gets a bad rap. LDL in and of itself isn’t a bad thing: the issue is when the body is producing it in response to chronic systemic inflammation as a means to heal it. That’s because the use of a it to heal inflammation in the heart is what results in blockages. But if you don’t have the inflammation, the LDL isn’t doing any harm.
If I was truly concerned about my cardiac health, I’d get a CAC scan done.
In a similar way, the “best” bloodwork I ever had, as defined by current medical science, was at the time where my test was in the low double digits. Labs are just A snapshot, and not necessarily a good one.
Thanks for sharing your thoughts and experience. I haven’t heard from my doctor - but the results are just coming in - so I don’t really have any concerns about my cardiac health, unless I hear otherwise. Of course, a test wouldn’t hurt.
I know that tests and interpreting the results are also geared towards the average American that eats processed foods and rarely exerts themselves. Given the high HDL and low triglycerides and your experience, I’m inclined to feel pretty good where I’m at.
LDL isn’t produced to “heal” inflammation in the heart. LDL particles circulate, some enter the artery wall, get stuck, and that triggers inflammation.
Feldman’s study was only 1 yr long, it takes decades for issues to develop. More particles = more exposure and more chances of them getting stuck and forming plaque. Even if you’re not showing high inflammation markers today, it doesn’t mean it isn’t building up. It’s cumulative LDL particle exposure that raises risk.
A lot of people saying LDL isn’t an issue are people who jumped on keto/carnivore in adulthood, their high LDL is recent. However, studies on Familial Hypercholesterolemia show that even metabolically healthy, insulin-sensitive people still develop issues from years of high LDL exposure. Are there any long term studies on people with high LDL to support Feldman’s views?
Also, a CAC scan only shows existing calcified plaque. It does not measure early risk. ApoB and LDL-P are better for measuring early exposure and risk.