Good advice form all the posters on this thread so far. I'd add only that some of us have noticed that our blood lipid numbers tend to be higher during and just after a weight loss, particularly those of us on a ketogenic approach where we burn fat as a primary energy source. Like Ken, I had lipid numbers very high when I had a blood draw on the last day of a 4-day fast (it was my own form of experiment just to see what my numbers would be). My triglycerides were still very low, around 46, and my IR score (insulin resistance) was so low, it indicated zero insulin resistance, all good, but the high LDL-C made sense for those who are fat burners. We've often said that a blood lipid interpretation must be changed to allow for those who are following a ketogenic protocol. This settles once one achieves a reasonable weight and is not in weight losing mode. My follow-up NMR Lipid panel when I didn't play games with fasting after the one in question was one that made the doctor say, "Whatever you're doing, keep doing it."

After reading Dave Feldman's findings, reading Marty Kendall and other experts, and discussing our experiences with colleagues on this forum, it all makes sense. There is still a lot to learn about blood lipids and heart health that we don't know today. However, as Ken states, one can achieve a result that is in the window considered healthy simply by dietary protocol. Feldman is a great resource for this.

The questions still remain until further research is done: Are total cholesterol and LDL-C valid health markers? Do their numbers indicate a healthy or unhealthy state for an individual? How can interpretations be adjusted to allow for those following very low carb? Today, most doctors still take them seriously to the point where they'll prescribe statins at the drop of a hat. I believe cholesterol and LDL-C are not valid health markers and higher numbers are healthier as we age. Good luck with your follow-up visit.