Last year I went to the doctor for a wellness check up, and to make a separate appointment for blood work. When I got there the nurse and doctor wanted to take blood. I said I just ate 2 1/2 hours prior. I wanted to make a separate appointment for that so I could fast. The doctor said he would take the number into consideration. I balked at the idea but went ahead with the blood work. The lipid panel returned as follows: HDL 64, Total Cholesterol 228, LDL-C 138, and triglycerides at 160! Oh, and my fast glucose was 78. I know not fasting played a big role in my elevated lipids. My Triglyrides are always around 50 give or take. Needless to say, the doctor wanted to put me on statins, so much for consideration. I refused. and I won't be going back to him again.
This shows how variable these numbers are. What we need is an A1C-type measure for triglycerides and LDL (i.e., a 3 month average or similar). Otherwise we're basing medical decisions and risk assessments on an erratic measurement that can be affected by a few extra hours of fasting or eating the wrong type of food the night before the test.
I’m so happy that I found your channel. I had “non fasting” blood panel taken by a D.O. that I had visited for a possible hip bursitis issue. After the visit a medical assistant called and to let me know that my triglycerides were 255, HDL 60, and LDL 101. This was, as I see it, an incidental result and not accurate because it was non fasting. She wanted to start me on meds for high cholesterol, and I said NO, I will have a fasting lipid panel done, and then go from there. I’ve never had my cholesterol levels out of the normal range. I’ve been worried sick for several days thinking about heart attacks, strokes, you name it. So again, I’m very relieved to hear that your results were high after the fat shake, and that a 12+ hour fast is important for accurate diagnosis. Thank you.😊
I'm on my 3rd year of KETO ,OMAD and IF I'm now up to a 22 hour fast / 2 hour feeding daily regiment My Cholesterol has been going up and my doctor insisted I go on meds .No Way ..so I declined will tell him to watch your videos Dave Feldman ... Thanks to you and all the others on You-Tube that are showing KETO and IF is a healthy way of life
I am exactly where you are. I am on OMAD generally and have done a 72 hour fast. I wonder when in the fast cycle might be the best place to take the cholesterol test to keep my doctor from having a heart attack.
My doc asked me to add back healthy carbs and it was noted on my visit notes. Anyway I did and it really did not ruin anything when I did follow up after 3, 6 months except LDL and HDL both went down. Rest were all fine. I think after controlling your my metabolic issues with keto, it's safe to get back to healthy non keto diet as long as you are not gaining body fat
@@sunnyBLR unfortunately having a reasonable bodyweight and low amount of fat does not equal safe from heart attack. It just lulls you into a false sense of security. The damage from carbs and sugar is still happening. Guess how I know that one 😞
I’m am so glad I watched this video. I started my LCHF adventure 43 days ago to include bulletin proof coffee in the morning. I had my annual blood test done three days ago and my cholesterol test came back with a total cholesterol score of 247 LDL, 47 HDL and triglycerides of 116. I was a little concerned, but not too much, hoping my body needed to adjust for the new eating lifestyle. My doc wanted to put me on Statens, but I elected have another draw done 3 months later. Next time no butter in my coffee before the blood test. Thank you for the information.
I was actually curious about this very thing watching youtube videos these past few days on "the Feldman Protocol." Thank you for this follow-up. Y'all keep up the awesome work!!
Hey Dave, great information as always. 👍 Your total TC and HDL didn’t change much. I usually rely more on Non HDL Cholesterol (calculated by TC - HDL) to give me an idea of LDL Cholesterol vs. the calculated number. I think the big bump in Trigs (and the small bump in Cholesterol) is most definitely from the chylomicrons. Always thought these were very short lived but would have to agree that its always better to fast 10 to 12 hours to get a accurate reading for the panel.
I thought that as well. I'd always hear how they would be absorbed in "minutes" -- but like so many other things I've read/heard, I find straight up N=1 testing can often extend or even disprove the original literature. It's really too bad in this case as this will especially effect everyone on a low carb high fat diet who doesn't fast.
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
Came here for this! I fast for 18 or 20 hours before my blood draws. I have been intermittent fasting 20/4 sometimes 18/6 for three years in which time all of my cholesterol tests are 50pts higher for me than before I started long fasting daily. I’m on a statin but I want to test with just a 12 hour fast before my next cholesterol draw to see if my ldl comes down. I really think this is what it is.
It’s a complete nightmare trying to understand this and impossible to have a conversation with your doctor about it. I have been referred to a lipid clinic due to high LDL and total cholesterol, I told them I had been on keto for three years and the doctor basically shouted at me to stop keto immediately and take a re-test of the cholesterol in three months... every time I have taken a blood test I have been fasting for probably 20 hours before. I kept trying to tell them I lost 20 kg and never felt better in my life these three years, but again basically shouted at to stop keto immediately...
Who cares what they are shouting about! You should be shouting about your great state of health!⚕😁 Find a doc in your area who understands keto. Dr. Ken Berry has a website that you can find on his RUclips channel where there are lists of keto friendly providers within your zip code.👍
I am also having very good results from keto, but doctor having issues with LDL, but not to the degree you are. I found a LOT of info on this showing why most doctors are simply wrong. RUclips searches on lab work on the following channels have been most helpful to me Dr Rob Cywes Dr Paul Mason Low Carb Down Under Dr Nadir Ali Dr Ken Berry Can cite specific episodes, and other sources, if it would be helpful Good luck and God Bless
I messed up bigtime. I am on keto and I ate 2 hours before having my blood drawn and my triglycerdies were outrageously high. They couldn't even calculate my LDL. I have to go back fasted to get the real results.
John Matrixx I did the same... but my LDL is also very high, according to the conventional limits... will have to adopt an unhealthy diet to get my levels into accepted ranges
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
I think this happened to me. I can’t be certain but I think I ate about 120g clotted cream about 90 minutes before my blood draw. Usually I log everything on Cronometer but not this time. Glad I’m not the only one having a similar issue. I take comfort in HbA1c being really low, as is C-RP, so something doesn’t add up.
I did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee in both cases
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
This is why non-HDL (total cholesterol minus HDL) is perhaps better parameter than calculated LDL. Non-HDL targets are 30 mg/l higher than LDLC targets within the specific risk groups. In Dave's case, the non-HDL didn't change significantly after the fat shake (10 mg/dl = 0.26 mmol/l change). Directly measured LDLC would be ideal, but its cost is around $30.00 (same as of the whole standard lipid panel with TC, TG, HDL and calculated LDLC and ratios), so adding direct LDLC measurement doubles the cost.
Hi Dave. Is that fasting applies to ApoB as well? I just had my blood drawn and I was fasted for only 4.5 hours. I wasn’t happy with my result, 1.13 g/L. Thanks for making this video.
Thanks for sharing this Dave. My recent blood test came out pretty scary with almost 300 total cholesterol. Next time I will fast at least 8 hrs and see what will the results shows.
I have found a lot of helpful info that completely refutes accepted practice regarding cholesterol tests, and showing me that the items to watch are: ratio of triglycerides to HDL, remnant cholesterol, HOMA-IR (calculated from insulin and glucose) Searching RUclips on lab work or bloodwork and looking for the following (among others) completely changed my understanding Dr Rob Cywes Dr Paul Mason Dr Ken Berry Dr Nadir Ali Can cite others if desired Keto, intermittent fasting, and other info from these sources revealed insulin resistance as a significant underlying issue for me, and have had a most beneficial impact on my health Good luck and Gob Bless
Hoping this is ok to ask here. Have been watching a few of your videos and am learning a LOT...Thank You! At the end of July I'm going for labs and more importantly so is the fellow I care for who has a brain injury, very low mobility, but who has responded with positive (necessary) weight loss on the Keto diet! He is already on low blood pressure and cholesterol meds and of course his Dr. doesn't want to change those. I'm wondering besides the 12 hr fast, what is the best way to eat in the days prior to the appointment. Thank you so much and I'm subscribing!
If you're looking for accuracy of your baseline, then just eat your typical diet for three days before the test. If you're asking about the protocol, read this: cholesterolcode.com/extreme-cholesterol-drop-experiment/
Dave Feldman. Dave I was going to ask identical ques...but should I try and Eat very similar to what I ate. 6 months earlier (in My fitness pal log) for accuracy ...following your Works ..I realize the 72 hrs ...I just want it as Similar as possible...what say you...and thanks ...great Works
Do according to the Friewald equation, because LDL is calculated by subtracting the triglycerides, the higher your triglycerides are, the lower your LDL will be.
This is the mistake I made the first time I got my bloods done! I will be fasting the next time I get them done that is for sure. My Cholesterol (LDL) was 8 and the recomended was 5, so it will be intersting what the readings are at the end of this month.
What I don't understand is why we are taking blood tests for LDL anyhow, since it is not something to worry about. Is there something that I missed about the cholesterol test that makes it important?
Would a longer fast be better? I've been on keto for 2 years. My doc keeps trying to get me to take statins. I am on OMAD generally and have done a 72 hour fast. I wonder when in the fast cycle might be the best place to take the cholesterol test to keep my doctor from having a heart attack. If I fast for 72 hours before the test will it be lower?
This happened to me as well. I had blood test first time in five years WITHOUT fasting (I was not aware I was going to have it that day). I had my morning coffee with about 1/4 cup of whipping cream, 11% yogurt with some berries and blood test followed about 2 hours later. In 5 years my triglycerides were 0.5 mmol/L at their highest. Well this time they shot up to 1.44 mmol/L. Also my plasma calcium was elevated but only 0.01 above normal. I guess it was all that cream circulating in my veins :).
@@realDaveFeldman Did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee.
I was told to fast 8 hrs and got there and they said 12. Difference was 50 points on my cholesterol level. Always do 12 hours and do 4 days of green veggies. No sugar.
Hi Dave, one point I didn't either understand or hear you mention. - You reduce the LDLs and Triglycerides by using the higher fat and higher calorie method for the 3 days before the test. What then happens to the HDLs by using this method? Do they reduce, stay the same or rise? Also how would this method affect any other blood tests analysed with the same sample? ( Glucose, HbA1c, Proteins, Insulin Resistance...)
@davefeldman. Hello I hope you are well. Thanks for all your research. I’ve had a question for a long time. I’ve been on keto and mostly carnivore for a year and a half. My doctor wanted to put me on a statin, I told him I wasn’t interested as my remnant cholesterol was 19, under 24 that I’ve seen you talk about. (I also paid for a ct calcium scan to put the statin question to bed, it was zero). But I’ve wondered what does one do if remnant cholesterol goes over 24? I’ve never seen that addressed. It would appear your fasted remnant is at 29. Total -hdl - ldl = remnant is the method I used. Can you shed some light?
Thanks Cindi, that is what I've recently learned and explains my higher LDL readings with IF of 16-18 hours before the test. Good news is that HDL = 72, Trig = 64, Glucose = 74, blood pressure is now normal and I've lost 30 lbs reaching my goal of BMI Normal weight level.
It happened the same to me! 18hrs fasting and I had TC 410, LDL 319 but HDL 73 and TRG 89 ... but doctors arent ready to see those high levels of TC 🤷🏼♀️
Most Pathology providers recommend, however, don't insist on fasting for lipids. It's always been known that fasting has minimal effect on Total Chol, and significant effect on Trigs. Not all patients are able to be compliant (for fasting), so it's quite practical to accept non-fasting patients for lipid testing. The report always should signify whether the patient is fasting or not. Practicality of fasting is a pre-analytical testing issue that's been beaten to death. Iron studies, B12, Folate and many other tests should ideally be performed after a 12 hour fast. Setting more conditions on testing can be problematic in itself. Best to keep it simple for most patients. If patients want to optimise their personal health and data from testing, probably a fair amount of DYOR (do your own research) is required. Many GPs will probably not understand nuances in testing.
Doctors called my brother told him his triglycerides were high after his blood test he was a little worried but he had ate at McDonald's 2 hours prior to the blood they did not tell him to fast before the here was his results HDL-38 triglycerides 248.
What would happen if, instead of fatty meal, you (on low-carb diet) had a carb-loading meal a couple of hours before the test? Would the fat transport system go to rest and effectively lower the LDL and triglycerides, or is it not enough time for this to happen?
you will need to make sure that there is no leftover fat in the digestive system or it will activate the randle cycle - still its better to have carb/protein or even just a normal carb meal with 0 fat
@@user-uo7ch2lf3z LDL-C means the amount of cholesterol carried by the LDL particles. LDL-P means the count of the LDL particles. Unfortunatelly, most labs in most countries do measure only LDL-C (which doesn't say much about the risk). Sometimes, if you are lucky, they measure ApoB, which is more similar to measuring LDL-P and correlates quite a bit better with the actual risk. (But even here, Dave Feldman would probably disagree, haha)
I recently had my 1st blood test since starting keto 8 mons ago. Dr. Insisted non-fasted was OK. My numbers compared to when i started keto (also fasted) did EXACTLY like you show in the video. I FREAKED out!! I now know the numbers are basically invalid and wish i had followed my instinct to be fasted for the test. Now im stuck with these numbers for another 6 mons before dr. Will order another test. 🙄. Can i pay for my own test???
Was on high sugar carb fruit diet with low red meat for decades Insulin resistant fast glucose upper 90's 10 months ago started IF 16/8 to 19/5 and still on same diet with relatively lower table sugar intake After 7 mo. (3 mo. ago) started low carb diet (50-70g /day) w/ IF. 2 months after that I did my first triglyceride blood test ever Fasting glucose 84 Total chol 202 HDL 55 LDL 16O TG 302 Freaked out and stopped eating red meat and meat fat After 10 days repeat bloodwork but I was 45 hours into a 48 hour fast (coincidence) Fasting glucose 64 Total chol 184 HDL 63 LDL 102 TG 95 1. Is the low carb diet for 2 mo. Caused TG 302 or it must hv been 400 or 500 and low carb/keto brought down to 302? 2. What brought TG down from 302 TO 96 in 10 days is it from obstaining from red/fat meat or caused by prolonged fast towards the end of which they draw the blood sample. Is 302 to 95 good sign or just the product of not eating for 45 hours. Please provide your opinion thoughts about this.
Very interested in this topic and before I start my question I’d like to say thank you for having an extremely informative channel on this subject. Ok I’ve been on a strict carnivore diet for 3 months I do eat eggs and fat bomb coffees with butter and Mct oil, my whole life I’ve have high cholesterol average 225 hdl 40 ldl 170 triglycerides 85ish and I’ve been put in statins but have been off them now for 4 months even a small does of 5mg daily I get joint pains and lethargy Brian fog etc. my daily average of macros is 70% fAt, 3% carbs and 27% protein very consistent the last 3 months. Ok I’m getting blood work and a full yearly physical in 7 days and I usually don’t eat 10 to 12 hours before always have but the way my eating schedule is now it’s gonna be more like 16 to 17 hours fasting before the blood work is going to be helpful or harmful to an honest representation of my blood work which we all k ow can change hour by hour? Thank you ahead of time.
CivilianSheepdog631 Sorry I didn’t catch this question earlier. In general, it’s best to ping us at CholesterolCode.com in a comment as that’s where we are the most responsive. But to your question: I suspect 16-17 hours probably won’t be too bad. It might increase your LDL and TG somewhat as more of a fasted state will activate more lipolysis - but I don’t have a lot of direct data of my own on that just yet.
@@realDaveFeldman Hi Dave, what if I fast for more than 12 hours. I recently had a NMR Lipid Profile done. I had been water fasting for 6 days. My Total Cholesterol was very very high and my Triglycerides in the mid 50s.
Was on high sugar carb diet for decades 20 2 fasting reduced carb 6 months Pk up 10 4 16 6( 2 months on low carb) 26 6 (10 days stopped red meat) Was on high sugar carb fruit diet with low red meat for decades Insulin resistant fast glucose upper 90's 10 months ago started IF 16/8 to 19/5 and still on same diet with relatively lower table sugar intake After 7 mo. (3 mo. ago) started low carb diet (50-70g /day) w/ IF. 2 months after that I did my first triglyceride blood test ever Fasting glucose 84 Total chol 202 HDL 55 LDL 16O TG 302 Freaked out and stopped eating red meat and meat fat After 10 days repeat bloodwork but I was 45 hours into a 48 hour fast (coincidence) Fasting glucose 64 Total chol 184 HDL 63 LDL 102 TG 95 1. Is the low carb diet for 2 mo. Caused TG 302 or it must hv been 400 or 500 and low carb/keto brought down to 302? 2. What brought TG down from 302 TO 96 in 10 days is it from obstaining from red/fat meat or caused by prolonged fast towards the end of which they draw the blood sample. Is 302 to 95 good sign or just the product of not eating for 45 hours. Please provide your opinion thoughts about this.
If my last meal is at 6:pm it will be 15-16 hours before blood is drawn. Is there any downside to more than 14 hours? IOW: will more triglycerides be released due to the longer fast?
I had a lipid test 2 days ago. I drank coffee with stevia one hour before test, and later in the evening one night before, I had some supplements that had 30 calories. Anyway, my total cholesterol was 271, LDL was 194, HDL was 45, and triglycerides were 145. I was shocked. I think it was from the coffee I had one hour before the test.
@@rafaazar3137 I will do the test again, but my doctor ordered it to be done after one month. I am sure my cholesterol is fine. I think supplements and coffee affected it. The problem is that it is hard to get my doctor to order the test soon, and the cost is an issue for me.
Thank you very much for the response. I had almost the same situation on 15.07.2024: test / total cholesterol 291 / LDL 215 / HDL 56 / triglycerides 98 / of course, immediately statins were suggested.. but I declined. I am happy to take another test in a month with a different approach and I will send you the results - we will check them.
@@rafaazar3137 I did again test after one month and I my total cholesterol was 242, LDL was 173, HDL was 48, and triglycerides were 104. I was eating the same but I took Omega 3 and I was taking BPC-157 for my gastritis.
I'm confused, DR. Eric Berg says fasting increases cholesterol levels so he says NOT to fast before cholesterol panel because it shows higher numbers so it's not accurate... did I misunderstand something?
Did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee
Okey so the numbers get better when fasting before test, but what about real life effects? Because you normaly have higher triglyserides, because you are in fact eating, not fasting in normal everyday life. So you can manipulate the test, but who are you then cheating?
I read you should not fast before cholesterol tests because we are in fed state 12+ hours a day on a consistent basis and non fasted is a better reflection of reality.. why disguise daily reality by fasting just to see lower number? Makes no sense! Can someone help me understand?
one could say that LDL is the insulin of the LCHF person and triglycerides are the glucose. If you fast for a insulin/glucose test, why not fast for a LDL/triglyceride test?
I am assuming One can drink black coffee and water morning of the fast. Fasting for 16 hours prior to testing is not an issue as well. Correct Dave? And Thank you
Hi Dave. Looking to plug in my lipid panel from last Oct and today (when I get them). 2 Q's: 1) I had 1 cup of black coffee about 3 hours before blood drawn but otherwise water fasted for 15 hours, should I input 3 hours or 15? 2) Quest uses the Martin-Hopkins calculation for LDL-C not Friedewald, any issue there wrt your calculator? Thanks!
Hi Terry- 1. Alas, coffee *does* count against the fasting. In fact, we’ve been having a lot of issues with coffee for some individuals suggesting unexpected results with lipolysis, etc. 2. I’m not that familiar with that calculator. But you could always calculate Friedewald yourself and plug it into the calculator.
Doctors won't always tell you to. I recently went to one who told me NOT to fast, then did a lipid panel when I had eaten within 3 hours, and he then prescribed a statin based on that test.
Doctors won't always tell you to, but the automated e-mail telling you your appointment details usually says to fast. I thought this was common, at least it is for me?
Oliver Magoo Exactly! With the guidelines changing, we expect a lot more people getting calls from their doctor about “surprisingly high triglycerides” - especially if one is on a high fat diet.
Well, I think I just blew my recent blood test, as I was in a 18 hour IF. My doctor won't understand why my numbers are going to be up from last time. I will just tell him, it was because I fasted too long, but he will not buy that, oh well.
Mr.Feldman, don’t you think that smoking also is a huge variable that might impact the lipid profile readings? It is very interesting to find out the difference in readings if there is any between smokers and non smokers on a ketogenic diet with regular lipid profile readings, cheers.
I'm in diet for 2 years and my LDL increased from 3 to 4.1 😭.Idon't eat any fat I just eat fruits and veg and nuts , avocado !what shall I do to reduce it because it make me crazy
My cholesterol was 225 dropped to 185 in a month And lost 5 pounds Eating giant baked potatoes/peanutbutter Whatever except I Cut all meat/dairy out. Works great kinda weird to till body Adjust just take b12 and maybe iron tablet to cure meat cravings first month. Now I gross out thinking about meat it’s so strange when body adjusts kinda Neat 2. Always get blood checked making any drastic changes to eating. Keto works losing weight but so many people die from heart prob. Not Veagans.
Same, I also fasted daily for 16-18 hours, and lost a bit of weight (body fat) in a week prior to the test. Then after my weight stabilized and I've loosened the fasting regimen to 12-14 hours for a week before the test, triglycerides were lower. Although as Dave mentioned in other talks, the TR numbers can fluctuate quite a lot, 20% deviation is normal, and I would assume that any intervention/change (such as weight loss, more exercise, etc.) can affect the numbers even more.
Dave, I assume you fast 12 hours before testing with the CardioChek as well? Also, how to you feel about an alternative to the Friedewald Equation for calculating LDL, one that doesn’t involve Triglyceride numbers in the equation: LDL = 3/4 (Total Chol - HDL)?
I didn't fast as gp said didn't need to . She didn't even test tryglicerides and my cholesterol was over 9 in uk which is over 300 in USA. My ldl is very high but hdl and ldl ok . I'm slim , 58 , exercise , have normal blood pressure do I need to worry about the high ldl .?
Is it okay to fast more than 12 hours before? My Dr. said if you fast for too long your sugar will go up. That's what happened to me when I had all my blood work done. My sugar was 111 and he said it was probably because I had fasted for about 14 hours. Mind you this is before I started the keto lifestyle, which I've been doing the past 15 days. My cholesterol was 270. All these bad numbers and needing to lose some weight led me on the path I'm now on.
Sure -- it's okay to fast for more than 12 hours -- just know if it gets much longer, it is likely your cholesterol will go up. Myself and now many who follow me have demonstrated multi-day fasting in the short term will spike our numbers. Not so sure about the fasting glucose spiking. I find the longer period of fasting following a meal, the lower my glucose tends to be when fat-adapted.
Hi Dave! Thank you so much for all of your work and willingness to share your findings. You are amazing! I started keto back in August after having my dr. want to put me on statins for elevated cholesterol and high triglycerides a few months earlier in the year. I denied the statins and instead started my research which lead me to keto. Well, I will be taking a blood test this coming Tue. Been eating roughly 80/15/5 fat/prot/carb. What do I need to do, if anything, to be sure that my numbers are as low as possible? I've seen you mention upping calories, and I'm still trying to find the video again where you mentioned something about a threshold of upping your carbs that dropped your TGs dramatically. Do you have any tips for me? I've stopped working out and will definitely fast 12 hrs before blood draw (I've been an IFer for 5yrs now). Is there anything else for me to do? Up my calories? Add/swap some carbs? Thanks in advance and thanks again for all you share. I'm happy to share my test results with you.
Hi Lz V -- I have a write up on the protocol here: cholesterolcode.com/extreme-cholesterol-drop-experiment/ Note that it is about an 85% success rate thus far, but that also means it is about a 15% failure rate, of course. Cheers!
Thank you!!! That's what I was looking for....Fast before Cholesterol test should be done!! Stopped eating at 7:00pm..blood test set for 11:30am. Sleeping most of fasting time so should not be a problem. Also..have cardio workout class an hour and a half before test. On Keto since September hoping for good numbers... nervous though.
What is this non HDL cholesterol I’m now seeing? Why are they posting it and what’s the affect of it? What’s the concern level of this marker? Or is it another excuse for statin conversation???
So would an even longer than 12-hour-fast be even better? I tend to be an "if some is good, more is better" kind of person. Because my doctor continues to freak out over my cholesterol numbers, I would love to get it a little lower just for the test because I don't really worry about my cholesterol.
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
@@Hiker_Mike did lots of reading on this. Found that many mention this pattern of higher LDL the longer we fast. Mason mentions lower insulin means less LDL receptors thus higher LDL in blood. From my results I see this too. Feldman menstions if he eats bread and crap for a week his LDL plummets. Not a good marker of health is LDL. I trust the 'new science ' on this topic
@@contrarian717 , Yes, agree. If I ate more carbs I know my LDL would drop but my HDL would also drop and my TG would substantially rise. I'll keep doing what I'm doing with < 20g total carbs per day but I've added calorie counting for a while because I was way over eating. I was unknowingly eating 4,000 kcal's/day. I dropped to a 20% cal deficit of 2,100 kcals/day and my weight has dropped 3 lbs in 3 days! I was stalled for 6 months and I couldn't figure out why, now I know why, way too many cal's. That likely caused my LDL numbers to skyrocket beyond the normal "hyper-responder" levels. Take care.
But haven’t people shown that fasting will raise the total cholesterol? Since the body needs to send energy but isn’t being fed? I’m trying to lower my cholesterol just for a life insurance exam. I Don’t have diabetes. Just been doing keto/carnivore so my total cholesterol was 475. I need to get it lower than 300. Doing the 3 day high calorie protocol right now. But wondering if I should have a little bit of cream before the test to lower total cholesterol.
Just had non-fasting blood drawn this a.m in Dr's office for cholesterol levels despite my objections to it not being a 12 hr. fast.....being Keto for six months, had bulletproof coffee just two hours prior.....awaiting results which I will have NO faith in. My family doc has no interest in LCHF/Keto as being legit.....am an otherwise healthy 65 yr.old female...well, do have long-term stable hyothyroidism: corrected with replacement therapy, which I understand may skew results as well?
They did my cholesterol non fasting and it jad gone from 8.05 to 9.25 . The first one was fasting but I didn't even know they were testing it second time. I'm also on thyroxine and always had high cholesterol andni know thyroid problems can raise cholesterol. My tryglicerides are OK as is my hdl but doctor didn't even test tryglicerides ! The first one was a private test They only bang on about total cholesterol and I have to always ask about hdl but don't know why they didn't do tryglicerides. My ldl is very high . I'm not bothered as done my research over the years and back in 2000 bought a book called the Great cholesterol myth . In uk its expensive to do the ldl particle test or CAC tests and only do it in London.
I'm actually going to have a very solid answer to that soon as I'm compiling a lot of side-by-sides of lab draws with the cardiochek data taken at the same time. Check CholesterolCode.com in the coming weeks.
I'm getting my blood work done in a couple of weeks via Boston Heart. I'd like to get my LDL levels on the test down. I understand 4 days before to increase fat intake? Anything in keto I should avoid during that time? Is there a cheat sheet for getting LDL down on a test?
Thanks Dave! Just lowering my LDL to keep the doc and the Ins company happy. But also trying to reduce CAC. What about D/K2, Niacin, Magnesium and Omega 3's during the 4 days? Should I stop taking them?
I have fasted almost 65 days this year alone and was amazed how shitty my lipids test was yesterday after fasting almost 22 hours prior to the test. WTF?
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
@@contrarian717 Yes, I did get another test and fasted for only 14 hours. My LDL was a little lower but still very high. I also reduced the amount of fat I'm consuming on the Ketovore diet. But, even with the lower fat consumption, my total cholesterol is 414 and my LDL is 321. I'm not worried about it, my HDL is 84 and Trig. 44 and VLDL 9. I've had 2 CAC tests in the past 5 years, scored 0. High sensitivity Crp is 0.11. I have no family history of heart disease/stroke. I'm way more concerned about cancer... it seems we can potentially reduce the risk with diet/exercise but its still relatively high risk.
@@Hiker_Mike thanks. Interesting. Can't help to think however, if 10hours would even be better. My LDL dropped 60%, but not sure if it was less fasting before the test, or oats I added, or less eggs. Busy testing for the next reound of bloodwork
@@contrarian717 Replacing the eggs with oats drops cholesterol for me but I can't eat oats due to pre-diabeties. That's why I'm on a Ketovore diet. I eat 4 eggs a day and live with the super high cholesterol levels from eggs. Interesting that they say dietary fat doesn't raise LDL but for me it does... consuming eggs results in a large increase in my LDL.
Cas Casca I don’t give medical advice, of course. I simply try to arm you with as much knowledge and research as I have given what I know to this point. You may want to check into many of the great lectures from Dr. David Diamond on this subject.
Last year I went to the doctor for a wellness check up, and to make a separate appointment for blood work. When I got there the nurse and doctor wanted to take blood. I said I just ate 2 1/2 hours prior. I wanted to make a separate appointment for that so I could fast. The doctor said he would take the number into consideration. I balked at the idea but went ahead with the blood work. The lipid panel returned as follows: HDL 64, Total Cholesterol 228, LDL-C 138, and triglycerides at 160! Oh, and my fast glucose was 78. I know not fasting played a big role in my elevated lipids. My Triglyrides are always around 50 give or take. Needless to say, the doctor wanted to put me on statins, so much for consideration. I refused. and I won't be going back to him again.
Surely the massive and rapid variability in TG and LDL numbers points to how useless they are in deciding whether you need to medicate or not?
This shows how variable these numbers are. What we need is an A1C-type measure for triglycerides and LDL (i.e., a 3 month average or similar). Otherwise we're basing medical decisions and risk assessments on an erratic measurement that can be affected by a few extra hours of fasting or eating the wrong type of food the night before the test.
I’m so happy that I found your channel. I had “non fasting” blood panel taken by a D.O. that I had visited for a possible hip bursitis issue. After the visit a medical assistant called and to let me know that my triglycerides were 255, HDL 60, and LDL 101. This was, as I see it, an incidental result and not accurate because it was non fasting. She wanted to start me on meds for high cholesterol, and I said NO, I will have a fasting lipid panel done, and then go from there. I’ve never had my cholesterol levels out of the normal range. I’ve been worried sick for several days thinking about heart attacks, strokes, you name it. So again, I’m very relieved to hear that your results were high after the fat shake, and that a 12+ hour fast is important for accurate diagnosis. Thank you.😊
Right on. I had the same experience: triglycerides doubled after a bullet-proof coffee. Thanks for corroborating that.
I'm on my 3rd year of KETO ,OMAD and IF I'm now up to a 22 hour fast / 2 hour feeding daily regiment My Cholesterol has been going up and my doctor insisted I go on meds .No Way ..so I declined will tell him to watch your videos Dave Feldman ... Thanks to you and all the others on You-Tube that are showing KETO and IF is a healthy way of life
I am exactly where you are. I am on OMAD generally and have done a 72 hour fast. I wonder when in the fast cycle might be the best place to take the cholesterol test to keep my doctor from having a heart attack.
My doc asked me to add back healthy carbs and it was noted on my visit notes. Anyway I did and it really did not ruin anything when I did follow up after 3, 6 months except LDL and HDL both went down. Rest were all fine. I think after controlling your my metabolic issues with keto, it's safe to get back to healthy non keto diet as long as you are not gaining body fat
@@sunnyBLR unfortunately having a reasonable bodyweight and low amount of fat does not equal safe from heart attack. It just lulls you into a false sense of security. The damage from carbs and sugar is still happening. Guess how I know that one 😞
I’m am so glad I watched this video. I started my LCHF adventure 43 days ago to include bulletin proof coffee in the morning. I had my annual blood test done three days ago and my cholesterol test came back with a total cholesterol score of 247 LDL, 47 HDL and triglycerides of 116. I was a little concerned, but not too much, hoping my body needed to adjust for the new eating lifestyle. My doc wanted to put me on Statens, but I elected have another draw done 3 months later. Next time no butter in my coffee before the blood test. Thank you for the information.
How about asking doc for a CAC Score? $150 totally worth it
And the results were?
And results?
@@gregl2249 they 💀
Thanks Dave, for this video. Will try the 14 hrs fast before my nest lipid test in 5 months to see if the numbers will be lower.
I was actually curious about this very thing watching youtube videos these past few days on "the Feldman Protocol." Thank you for this follow-up. Y'all keep up the awesome work!!
Kerry Wilson Thanks, Kerry!
Hey Dave, great information as always. 👍
Your total TC and HDL didn’t change much. I usually rely more on Non HDL Cholesterol (calculated by TC - HDL) to give me an idea of LDL Cholesterol vs. the calculated number.
I think the big bump in Trigs (and the small bump in Cholesterol) is most definitely from the chylomicrons. Always thought these were very short lived but would have to agree that its always better to fast 10 to 12 hours to get a accurate reading for the panel.
I thought that as well. I'd always hear how they would be absorbed in "minutes" -- but like so many other things I've read/heard, I find straight up N=1 testing can often extend or even disprove the original literature. It's really too bad in this case as this will especially effect everyone on a low carb high fat diet who doesn't fast.
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
Came here for this! I fast for 18 or 20 hours before my blood draws. I have been intermittent fasting 20/4 sometimes 18/6 for three years in which time all of my cholesterol tests are 50pts higher for me than before I started long fasting daily.
I’m on a statin but I want to test with just a 12 hour fast before my next cholesterol draw to see if my ldl comes down. I really think this is what it is.
It’s a complete nightmare trying to understand this and impossible to have a conversation with your doctor about it. I have been referred to a lipid clinic due to high LDL and total cholesterol, I told them I had been on keto for three years and the doctor basically shouted at me to stop keto immediately and take a re-test of the cholesterol in three months... every time I have taken a blood test I have been fasting for probably 20 hours before. I kept trying to tell them I lost 20 kg and never felt better in my life these three years, but again basically shouted at to stop keto immediately...
Who cares what they are shouting about! You should be shouting about your great state of health!⚕😁 Find a doc in your area who understands keto. Dr. Ken Berry has a website that you can find on his RUclips channel where there are lists of keto friendly providers within your zip code.👍
If he's shouting it must be true 😉
I am also having very good results from keto, but doctor having issues with LDL, but not to the degree you are.
I found a LOT of info on this showing why most doctors are simply wrong.
RUclips searches on lab work on the following channels have been most helpful to me
Dr Rob Cywes
Dr Paul Mason
Low Carb Down Under
Dr Nadir Ali
Dr Ken Berry
Can cite specific episodes, and other sources, if it would be helpful
Good luck and God Bless
I messed up bigtime. I am on keto and I ate 2 hours before having my blood drawn and my triglycerdies were outrageously high. They couldn't even calculate my LDL. I have to go back fasted to get the real results.
John Matrixx I did the same... but my LDL is also very high, according to the conventional limits... will have to adopt an unhealthy diet to get my levels into accepted ranges
That's exactly
what happened to me.
LOL. Me too. Scared the crap out of me.
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
I think this happened to me. I can’t be certain but I think I ate about 120g clotted cream about 90 minutes before my blood draw. Usually I log everything on Cronometer but not this time. Glad I’m not the only one having a similar issue. I take comfort in HbA1c being really low, as is C-RP, so something doesn’t add up.
I did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee in both cases
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
That’s good to know, about the fasting, I didn’t fast, but on my next test I will be fasted 12 hours. 👍👍 I’m looking forward to the results.
This is why non-HDL (total cholesterol minus HDL) is perhaps better parameter than calculated LDL. Non-HDL targets are 30 mg/l higher than LDLC targets within the specific risk groups. In Dave's case, the non-HDL didn't change significantly after the fat shake (10 mg/dl = 0.26 mmol/l change). Directly measured LDLC would be ideal, but its cost is around $30.00 (same as of the whole standard lipid panel with TC, TG, HDL and calculated LDLC and ratios), so adding direct LDLC measurement doubles the cost.
Hi Dave. Is that fasting applies to ApoB as well? I just had my blood drawn and I was fasted for only 4.5 hours. I wasn’t happy with my result, 1.13 g/L.
Thanks for making this video.
Thanks for sharing this Dave.
My recent blood test came out pretty scary with almost 300 total cholesterol.
Next time I will fast at least 8 hrs and see what will the results shows.
I have found a lot of helpful info that completely refutes accepted practice regarding cholesterol tests, and showing me that the items to watch are: ratio of triglycerides to HDL, remnant cholesterol, HOMA-IR (calculated from insulin and glucose)
Searching RUclips on lab work or bloodwork and looking for the following (among others) completely changed my understanding
Dr Rob Cywes
Dr Paul Mason
Dr Ken Berry
Dr Nadir Ali
Can cite others if desired
Keto, intermittent fasting, and other info from these sources revealed insulin resistance as a significant underlying issue for me, and have had a most beneficial impact on my health
Good luck and Gob Bless
Hoping this is ok to ask here. Have been watching a few of your videos and am learning a LOT...Thank You! At the end of July I'm going for labs and more importantly so is the fellow I care for who has a brain injury, very low mobility, but who has responded with positive (necessary) weight loss on the Keto diet! He is already on low blood pressure and cholesterol meds and of course his Dr. doesn't want to change those. I'm wondering besides the 12 hr fast, what is the best way to eat in the days prior to the appointment. Thank you so much and I'm subscribing!
If you're looking for accuracy of your baseline, then just eat your typical diet for three days before the test. If you're asking about the protocol, read this: cholesterolcode.com/extreme-cholesterol-drop-experiment/
Dave Feldman. Dave I was going to ask identical ques...but should I try and Eat very similar to what I ate. 6 months earlier (in My fitness pal log) for accuracy ...following your Works ..I realize the 72 hrs ...I just want it as Similar as possible...what say you...and thanks ...great Works
Do according to the Friewald equation, because LDL is calculated by subtracting the triglycerides, the higher your triglycerides are, the lower your LDL will be.
This is the mistake I made the first time I got my bloods done!
I will be fasting the next time I get them done that is for sure. My Cholesterol (LDL) was 8 and the recomended was 5, so it will be intersting what the readings are at the end of this month.
What I don't understand is why we are taking blood tests for LDL anyhow, since it is not something to worry about. Is there something that I missed about the cholesterol test that makes it important?
Would a longer fast be better? I've been on keto for 2 years. My doc keeps trying to get me to take statins. I am on OMAD generally and have done a 72 hour fast. I wonder when in the fast cycle might be the best place to take the cholesterol test to keep my doctor from having a heart attack. If I fast for 72 hours before the test will it be lower?
Triglycerides 173 after 15 hours fasting and 320 after 3 hours low diet meal? Why this is significant change? Please suggest
I intermittent fast every day, so this will be really easy.
This happened to me as well. I had blood test first time in five years WITHOUT fasting (I was not aware I was going to have it that day). I had my morning coffee with about 1/4 cup of whipping cream, 11% yogurt with some berries and blood test followed about 2 hours later. In 5 years my triglycerides were 0.5 mmol/L at their highest. Well this time they shot up to 1.44 mmol/L. Also my plasma calcium was elevated but only 0.01 above normal. I guess it was all that cream circulating in my veins :).
Excellent comment, Andrea. This is especially important for the LCHF community to be aware of especially.
@@realDaveFeldman Did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee.
I was told to fast 8 hrs and got there and they said 12.
Difference was 50 points on my cholesterol level.
Always do 12 hours and do 4 days of green veggies. No sugar.
probably best way
Hi Dave, one point I didn't either understand or hear you mention.
- You reduce the LDLs and Triglycerides by using the higher fat and higher calorie method for the 3 days before the test. What then happens to the HDLs by using this method? Do they reduce, stay the same or rise?
Also how would this method affect any other blood tests analysed with the same sample? ( Glucose, HbA1c, Proteins, Insulin Resistance...)
@davefeldman. Hello I hope you are well. Thanks for all your research. I’ve had a question for a long time. I’ve been on keto and mostly carnivore for a year and a half. My doctor wanted to put me on a statin, I told him I wasn’t interested as my remnant cholesterol was 19, under 24 that I’ve seen you talk about. (I also paid for a ct calcium scan to put the statin question to bed, it was zero). But I’ve wondered what does one do if remnant cholesterol goes over 24? I’ve never seen that addressed. It would appear your fasted remnant is at 29. Total -hdl - ldl = remnant is the method I used. Can you shed some light?
Fasting too long raises LDL too. So is 14 hours generally the upper limit?
Thanks Cindi, that is what I've recently learned and explains my higher LDL readings with IF of 16-18 hours before the test. Good news is that HDL = 72, Trig = 64, Glucose = 74, blood pressure is now normal and I've lost 30 lbs reaching my goal of BMI Normal weight level.
It happened the same to me! 18hrs fasting and I had TC 410, LDL 319 but HDL 73 and TRG 89 ... but doctors arent ready to see those high levels of TC 🤷🏼♀️
I'm having a blood draw this Monday and IF daily about 18-20 hours. I think Sat and Sun I will only fast 12 hours
So what is the best
I mean how many hours should fast befor the test?
Most Pathology providers recommend, however, don't insist on fasting for lipids. It's always been known that fasting has minimal effect on Total Chol, and significant effect on Trigs. Not all patients are able to be compliant (for fasting), so it's quite practical to accept non-fasting patients for lipid testing. The report always should signify whether the patient is fasting or not. Practicality of fasting is a pre-analytical testing issue that's been beaten to death. Iron studies, B12, Folate and many other tests should ideally be performed after a 12 hour fast. Setting more conditions on testing can be problematic in itself. Best to keep it simple for most patients. If patients want to optimise their personal health and data from testing, probably a fair amount of DYOR (do your own research) is required. Many GPs will probably not understand nuances in testing.
Thanks for sharing. I did not know to take this approach.
The real question is: Why you should not take cholesterol test at all? Because its stupid to test if water is wet.
Doctors called my brother told him his triglycerides were high after his blood test he was a little worried but he had ate at McDonald's 2 hours prior to the blood they did not tell him to fast before the here was his results HDL-38 triglycerides 248.
What would happen if, instead of fatty meal, you (on low-carb diet) had a carb-loading meal a couple of hours before the test? Would the fat transport system go to rest and effectively lower the LDL and triglycerides, or is it not enough time for this to happen?
you will need to make sure that there is no leftover fat in the digestive system or it will activate the randle cycle - still its better to have carb/protein or even just a normal carb meal with 0 fat
Here in the Europe, LDL-C is actually meassured not computed...
Then what does -C mean?
Thanks in advance.
@@user-uo7ch2lf3z LDL-C means the amount of cholesterol carried by the LDL particles. LDL-P means the count of the LDL particles.
Unfortunatelly, most labs in most countries do measure only LDL-C (which doesn't say much about the risk).
Sometimes, if you are lucky, they measure ApoB, which is more similar to measuring LDL-P and correlates quite a bit better with the actual risk.
(But even here, Dave Feldman would probably disagree, haha)
@@btudrus Thank you very much for your detailed reply!
I recently had my 1st blood test since starting keto 8 mons ago. Dr. Insisted non-fasted was OK. My numbers compared to when i started keto (also fasted) did EXACTLY like you show in the video. I FREAKED out!! I now know the numbers are basically invalid and wish i had followed my instinct to be fasted for the test. Now im stuck with these numbers for another 6 mons before dr. Will order another test. 🙄. Can i pay for my own test???
Going through exacthe same situation--pay 100.00 at local hospital
Was on high sugar carb fruit diet with low red meat for decades
Insulin resistant fast glucose upper 90's
10 months ago started IF 16/8 to 19/5 and still on same diet with relatively lower table sugar intake
After 7 mo. (3 mo. ago) started low carb diet (50-70g /day) w/ IF.
2 months after that I did my first triglyceride blood test ever
Fasting glucose 84
Total chol 202
HDL 55
LDL 16O
TG 302
Freaked out and stopped eating red meat and meat fat
After 10 days repeat bloodwork but I was 45 hours into a 48 hour fast (coincidence)
Fasting glucose 64
Total chol 184
HDL 63
LDL 102
TG 95
1. Is the low carb diet for 2 mo. Caused TG 302 or it must hv been 400 or 500 and low carb/keto brought down to 302?
2. What brought TG down from 302 TO 96 in 10 days is it from obstaining from red/fat meat or caused by prolonged fast towards the end of which they draw the blood sample.
Is 302 to 95 good sign or just the product of not eating for 45 hours.
Please provide your opinion thoughts about this.
funny but obvious
Not cutting out red meat but lowering your sugar brought your Triglycerides down.
@@kaweka260thx. Exactly. knowledge is gold. I eat meat often. Here u go. U got it
Very interested in this topic and before I start my question I’d like to say thank you for having an extremely informative channel on this subject. Ok I’ve been on a strict carnivore diet for 3 months I do eat eggs and fat bomb coffees with butter and Mct oil, my whole life I’ve have high cholesterol average 225 hdl 40 ldl 170 triglycerides 85ish and I’ve been put in statins but have been off them now for 4 months even a small does of 5mg daily I get joint pains and lethargy Brian fog etc. my daily average of macros is 70% fAt, 3% carbs and 27% protein very consistent the last 3 months. Ok I’m getting blood work and a full yearly physical in 7 days and I usually don’t eat 10 to 12 hours before always have but the way my eating schedule is now it’s gonna be more like 16 to 17 hours fasting before the blood work is going to be helpful or harmful to an honest representation of my blood work which we all k ow can change hour by hour? Thank you ahead of time.
CivilianSheepdog631 Sorry I didn’t catch this question earlier. In general, it’s best to ping us at CholesterolCode.com in a comment as that’s where we are the most responsive. But to your question: I suspect 16-17 hours probably won’t be too bad. It might increase your LDL and TG somewhat as more of a fasted state will activate more lipolysis - but I don’t have a lot of direct data of my own on that just yet.
@@realDaveFeldman Hi Dave, what if I fast for more than 12 hours. I recently had a NMR Lipid Profile done. I had been water fasting for 6 days. My Total Cholesterol was very very high and my Triglycerides in the mid 50s.
Was on high sugar carb diet for decades
20 2 fasting reduced carb 6 months
Pk up 10 4
16 6( 2 months on low carb)
26 6 (10 days stopped red meat)
Was on high sugar carb fruit diet with low red meat for decades
Insulin resistant fast glucose upper 90's
10 months ago started IF 16/8 to 19/5 and still on same diet with relatively lower table sugar intake
After 7 mo. (3 mo. ago) started low carb diet (50-70g /day) w/ IF.
2 months after that I did my first triglyceride blood test ever
Fasting glucose 84
Total chol 202
HDL 55
LDL 16O
TG 302
Freaked out and stopped eating red meat and meat fat
After 10 days repeat bloodwork but I was 45 hours into a 48 hour fast (coincidence)
Fasting glucose 64
Total chol 184
HDL 63
LDL 102
TG 95
1. Is the low carb diet for 2 mo. Caused TG 302 or it must hv been 400 or 500 and low carb/keto brought down to 302?
2. What brought TG down from 302 TO 96 in 10 days is it from obstaining from red/fat meat or caused by prolonged fast towards the end of which they draw the blood sample.
Is 302 to 95 good sign or just the product of not eating for 45 hours.
Please provide your opinion thoughts about this.
If my last meal is at 6:pm it will be 15-16 hours before blood is drawn. Is there any downside to more than 14 hours? IOW: will more triglycerides be released due to the longer fast?
This was super interesting....thanks. And how well presented! Awesome, thanks.
I had a lipid test 2 days ago. I drank coffee with stevia one hour before test, and later in the evening one night before, I had some supplements that had 30 calories. Anyway, my total cholesterol was 271, LDL was 194, HDL was 45, and triglycerides were 145. I was shocked. I think it was from the coffee I had one hour before the test.
Hi, how are the later test results? What are your current results? I’d be happy to exchange information. Best regards.
@@rafaazar3137 I will do the test again, but my doctor ordered it to be done after one month. I am sure my cholesterol is fine. I think supplements and coffee affected it. The problem is that it is hard to get my doctor to order the test soon, and the cost is an issue for me.
@@rafaazar3137 Sure, I will let you know when I do another blood test. The doctor said I need to check again after one month.
Thank you very much for the response. I had almost the same situation on 15.07.2024: test / total cholesterol 291 / LDL 215 / HDL 56 / triglycerides 98 / of course, immediately statins were suggested.. but I declined. I am happy to take another test in a month with a different approach and I will send you the results - we will check them.
@@rafaazar3137 I did again test after one month and I my total cholesterol was 242, LDL was 173, HDL was 48, and triglycerides were 104. I was eating the same but I took Omega 3 and I was taking BPC-157 for my gastritis.
I'm confused, DR. Eric Berg says fasting increases cholesterol levels so he says NOT to fast before cholesterol panel because it shows higher numbers so it's not accurate... did I misunderstand something?
Did a 3hour and a 15 hours fast. My Trigs lowered a LOT with the longer fast, but my LDL increased a LOT. All other factors equal. I am HFLC. Had high fat breakfast with black coffee
Dr Berg says to always do a 12 hour fast before cholesterol test: ruclips.net/video/zCpthHQVcC8/видео.html
A revisit as a refresher. Thank you.
Okey so the numbers get better when fasting before test, but what about real life effects? Because you normaly have higher triglyserides, because you are in fact eating, not fasting in normal everyday life. So you can manipulate the test, but who are you then cheating?
I read you should not fast before cholesterol tests because we are in fed state 12+ hours a day on a consistent basis and non fasted is a better reflection of reality.. why disguise daily reality by fasting just to see lower number? Makes no sense! Can someone help me understand?
one could say that LDL is the insulin of the LCHF person and triglycerides are the glucose. If you fast for a insulin/glucose test, why not fast for a LDL/triglyceride test?
I am assuming One can drink black coffee and water morning of the fast. Fasting for 16 hours prior to testing is not an issue as well. Correct Dave? And Thank you
Hi Dave. Looking to plug in my lipid panel from last Oct and today (when I get them). 2 Q's: 1) I had 1 cup of black coffee about 3 hours before blood drawn but otherwise water fasted for 15 hours, should I input 3 hours or 15? 2) Quest uses the Martin-Hopkins calculation for LDL-C not Friedewald, any issue there wrt your calculator? Thanks!
Hi Terry-
1. Alas, coffee *does* count against the fasting. In fact, we’ve been having a lot of issues with coffee for some individuals suggesting unexpected results with lipolysis, etc.
2. I’m not that familiar with that calculator. But you could always calculate Friedewald yourself and plug it into the calculator.
Which calculation method is preferable? I also use Quest labs and noticed recently that it uses the Martin-Hopkins equation. Thank you!
How often does a person fast? Wouldn't real time labs be more meaningful?
Shouldn't you always fast for any blood test anyway?
Doctors won't always tell you to. I recently went to one who told me NOT to fast, then did a lipid panel when I had eaten within 3 hours, and he then prescribed a statin based on that test.
Doctors won't always tell you to, but the automated e-mail telling you your appointment details usually says to fast. I thought this was common, at least it is for me?
The reason for the video is because they changed the guidelines. Fasting is no longer required for lipid panels.
Oliver Magoo Exactly! With the guidelines changing, we expect a lot more people getting calls from their doctor about “surprisingly high triglycerides” - especially if one is on a high fat diet.
Oliver Magoo -- Ahh. When did the guidelines change, and where can the guidelines be seen?
try fasting for 3 days then refeed another 3 days low carb high fat or carnivore diet then fast for another 12-14hrs right before your blood test..
sounds like a way to get super high cholesterol reading lol
Very informative 👍
Your equation appears great. .a good understanding on numbers. .thank you dear
Well, I think I just blew my recent blood test, as I was in a 18 hour IF. My doctor won't understand why my numbers are going to be up from last time. I will just tell him, it was because I fasted too long, but he will not buy that, oh well.
I understood Dr. Paul Mason say don’t go move than 8 hours as it increases the results.
Where did you see this? I got tested after a 22 hour fast and my LDL was above 450, HDL 39 and trigs 129. Docs wants me off the diet
My Dr is wanting my LDL under 70, have you ever heard a Dr wanting it that low? I'll definitely do a 12 hr fast.
@Rodney Booth
Get a new doctor!
Can't always know how long one will wait to get blood drawn. I've sometimes waited hours after arriving in the early morning hours.
What if I fast more than 16 hours more prior to my blood test can it lower the reading of ldl?
Fasting increases LDL
Mr.Feldman, don’t you think that smoking also is a huge variable that might impact the lipid profile readings? It is very interesting to find out the difference in readings if there is any between smokers and non smokers on a ketogenic diet with regular lipid profile readings, cheers.
What is a good dinner meal before the 12hr fast?
I'm the 9000th subscriber!!! Yayy
(Now you're in for over 9000 subscribers)
Waht about prolonged fasting before blood test? Will it increase or decrease LDL reading?
I'm in diet for 2 years and my LDL increased from 3 to 4.1 😭.Idon't eat any fat I just eat fruits and veg and nuts , avocado !what shall I do to reduce it because it make me crazy
Fructose is converted directly into fat by the liver. That's how it's metabolized.
Stop eating fruit. It’s “tree candy”.
My cholesterol was 225 dropped to 185 in a month
And lost 5 pounds Eating giant baked potatoes/peanutbutter
Whatever except I
Cut all meat/dairy out. Works great kinda weird to till body
Adjust just take b12 and maybe iron tablet to cure meat cravings first month.
Now I gross out thinking about meat it’s so strange when body adjusts kinda
Neat 2. Always get blood checked making any drastic changes to eating.
Keto works losing weight but so many people die from heart prob. Not Veagans.
Shannon Allums This is all disputed now. Check Drs Ivor Cummins and Dr Nadir Ali. Lack of fats kills and disables people.
I fasted for 16 hours and my triglyceride were high.
Same, I also fasted daily for 16-18 hours, and lost a bit of weight (body fat) in a week prior to the test. Then after my weight stabilized and I've loosened the fasting regimen to 12-14 hours for a week before the test, triglycerides were lower.
Although as Dave mentioned in other talks, the TR numbers can fluctuate quite a lot, 20% deviation is normal, and I would assume that any intervention/change (such as weight loss, more exercise, etc.) can affect the numbers even more.
This whole cholesterol/triglyceride issue is such a nightmare!
great vid, have you ever tasted after 24hr fast?
Interesting. My last doctors visit they told me I only needed to fast for 2 hours.
Can you overdo this? I do a lot of fasting. Would 48 hours of fasting be OK?
Hubby has one tomorrow, can he drink water b4? Office didn’t tell him anything🤷♀️
So would you have lower numbers if you fast for 16 hours compared to 12?
They tell you you can have black coffee in your fast. Coffee has lipids. What do you think that does to the bloodwork?
coffee doesnt have lipids genius.. it releases fatty acids though
Dave, I assume you fast 12 hours before testing with the CardioChek as well? Also, how to you feel about an alternative to the Friedewald Equation for calculating LDL, one that doesn’t involve Triglyceride numbers in the equation: LDL = 3/4 (Total Chol - HDL)?
Yes, I always fast around 12-14 hours.
Hadn’t seen that equation before, actually.
What if we do the cholesterol test after 15 hours of fasting will it be a very potent block work.
I didn't fast as gp said didn't need to . She didn't even test tryglicerides and my cholesterol was over 9 in uk which is over 300 in USA. My ldl is very high but hdl and ldl ok . I'm slim , 58 , exercise , have normal blood pressure do I need to worry about the high ldl .?
Is it okay to fast more than 12 hours before? My Dr. said if you fast for too long your sugar will go up. That's what happened to me when I had all my blood work done. My sugar was 111 and he said it was probably because I had fasted for about 14 hours. Mind you this is before I started the keto lifestyle, which I've been doing the past 15 days. My cholesterol was 270. All these bad numbers and needing to lose some weight led me on the path I'm now on.
Sure -- it's okay to fast for more than 12 hours -- just know if it gets much longer, it is likely your cholesterol will go up. Myself and now many who follow me have demonstrated multi-day fasting in the short term will spike our numbers.
Not so sure about the fasting glucose spiking. I find the longer period of fasting following a meal, the lower my glucose tends to be when fat-adapted.
I did my test and it was total 270 but had a full meal with soda before it . Will that raise it ?
For carnivores you definitely want to wait at least 12 hours. I suspect much longer absorption rate
Hi Dave! Thank you so much for all of your work and willingness to share your findings. You are amazing!
I started keto back in August after having my dr. want to put me on statins for elevated cholesterol and high triglycerides a few months earlier in the year. I denied the statins and instead started my research which lead me to keto.
Well, I will be taking a blood test this coming Tue. Been eating roughly 80/15/5 fat/prot/carb. What do I need to do, if anything, to be sure that my numbers are as low as possible? I've seen you mention upping calories, and I'm still trying to find the video again where you mentioned something about a threshold of upping your carbs that dropped your TGs dramatically.
Do you have any tips for me? I've stopped working out and will definitely fast 12 hrs before blood draw (I've been an IFer for 5yrs now). Is there anything else for me to do? Up my calories? Add/swap some carbs?
Thanks in advance and thanks again for all you share. I'm happy to share my test results with you.
Hi Lz V -- I have a write up on the protocol here: cholesterolcode.com/extreme-cholesterol-drop-experiment/
Note that it is about an 85% success rate thus far, but that also means it is about a 15% failure rate, of course. Cheers!
I was wondering what your results would be if you fasted for 60 hours and then didnthe test?
What happens if fasting longer than 12-14-16 or longer? 7:01
Thank you!!! That's what I was looking for....Fast before Cholesterol test should be done!!
Stopped eating at 7:00pm..blood test set for 11:30am.
Sleeping most of fasting time so should not be a problem.
Also..have cardio workout class an hour and a half before test.
On Keto since September hoping for good numbers... nervous though.
@@catea2551 I get my blood work done in 2 weeks...thank you for the reminder. Finger crossed 🤞
Shouldn’t you do the fasted after the fat bomb? What did you eat the day before the fasted test?
But all labs in my country only accept water fast up to 11 hours. They reject giving a test if over 11 hours. Don't know why?
because they are trying to get a screenshot of what your blood looks like regularly day to day
What is this non HDL cholesterol I’m now seeing? Why are they posting it and what’s the affect of it? What’s the concern level of this marker? Or is it another excuse for statin conversation???
Doctors want u on meds their kids need to go to college
The risk ratio of ldl/hdl should be below 5.0. His is 3.55.
So would an even longer than 12-hour-fast be even better? I tend to be an "if some is good, more is better" kind of person. Because my doctor continues to freak out over my cholesterol numbers, I would love to get it a little lower just for the test because I don't really worry about my cholesterol.
this is the same reason why I'm here! I have my test on Friday and wondering if I could help it improve by some "trick"
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
@@Hiker_Mike did lots of reading on this. Found that many mention this pattern of higher LDL the longer we fast.
Mason mentions lower insulin means less LDL receptors thus higher LDL in blood. From my results I see this too.
Feldman menstions if he eats bread and crap for a week his LDL plummets.
Not a good marker of health is LDL. I trust the 'new science ' on this topic
@@contrarian717 , Yes, agree. If I ate more carbs I know my LDL would drop but my HDL would also drop and my TG would substantially rise. I'll keep doing what I'm doing with < 20g total carbs per day but I've added calorie counting for a while because I was way over eating. I was unknowingly eating 4,000 kcal's/day. I dropped to a 20% cal deficit of 2,100 kcals/day and my weight has dropped 3 lbs in 3 days! I was stalled for 6 months and I couldn't figure out why, now I know why, way too many cal's. That likely caused my LDL numbers to skyrocket beyond the normal "hyper-responder" levels. Take care.
But haven’t people shown that fasting will raise the total cholesterol? Since the body needs to send energy but isn’t being fed? I’m trying to lower my cholesterol just for a life insurance exam. I Don’t have diabetes. Just been doing keto/carnivore so my total cholesterol was 475. I need to get it lower than 300. Doing the 3 day high calorie protocol right now. But wondering if I should have a little bit of cream before the test to lower total cholesterol.
Its times like this that I love living in Canada.
Thank you for your service.
Can you over fast? I did a 22 hour fast before my test and my LDL was 11.9 1.4 TG and 0.9 HDL
Hi, how are the later test results? What are your current results? I’d be happy to exchange information. Best regards.
Have you tried a post fasted aerobic (or strength training) exercise blood draw? What would you predict from that?
High LDL
I would guess low trigs if you are exercising in a fasted state. The body burns trigs as fuel but the ldl boats will be high.
Just had non-fasting blood drawn this a.m in Dr's office for cholesterol levels despite my objections to it not being a 12 hr. fast.....being Keto for six months, had bulletproof coffee just two hours prior.....awaiting results which I will have NO faith in. My family doc has no interest in LCHF/Keto as being legit.....am an otherwise healthy 65 yr.old female...well, do have long-term stable hyothyroidism: corrected with replacement therapy, which I understand may skew results as well?
Change your doctor!👍
They did my cholesterol non fasting and it jad gone from 8.05 to 9.25 . The first one was fasting but I didn't even know they were testing it second time. I'm also on thyroxine and always had high cholesterol andni know thyroid problems can raise cholesterol.
My tryglicerides are OK as is my hdl but doctor didn't even test tryglicerides ! The first one was a private test
They only bang on about total cholesterol and I have to always ask about hdl but don't know why they didn't do tryglicerides. My ldl is very high . I'm not bothered as done my research over the years and back in 2000 bought a book called the Great cholesterol myth .
In uk its expensive to do the ldl particle test or CAC tests and only do it in London.
How do I share my test results with you for you study?
Comment at CholesterolCode.com -- preferably at this post: cholesterolcode.com/blood-pool/
How accurate are cardio check finger prick tests for lipids ?
I'm actually going to have a very solid answer to that soon as I'm compiling a lot of side-by-sides of lab draws with the cardiochek data taken at the same time. Check CholesterolCode.com in the coming weeks.
I'm getting my blood work done in a couple of weeks via Boston Heart. I'd like to get my LDL levels on the test down. I understand 4 days before to increase fat intake? Anything in keto I should avoid during that time? Is there a cheat sheet for getting LDL down on a test?
Found your protocol. Going to do the 4 day one before the test. Thanks for the research!
Yes, if you haven't already, read this page first: cholesterolcode.com/extreme-cholesterol-drop-experiment/
Thanks Dave! Just lowering my LDL to keep the doc and the Ins company happy. But also trying to reduce CAC. What about D/K2, Niacin, Magnesium and Omega 3's during the 4 days? Should I stop taking them?
I'm generally a fan of keeping all variables the same where it doesn't likely impact the result (removing things changes the variables too).
Who in the world drinks a fat shake? For your testing you should have had a cheeseburger, fries, chips, or meat pizza or something before your test.
Exactly..all these are useless if not using real world patterns
I have fasted almost 65 days this year alone and was amazed how shitty my lipids test was yesterday after fasting almost 22 hours prior to the test. WTF?
I fasted 18 hours before testing and got record high values for LDL & total cholesterol, Keto for 2 years... off the chart high value for LDL-P... but, LDL size was 21.6 (type-A) so I'm not too concerned at this point. I'm going back to a 12 hr MAX fast for the next test.
@@Hiker_Mike did you do another test since this one, (with less fasting before the test) and was your LDL better?
@@contrarian717 Yes, I did get another test and fasted for only 14 hours. My LDL was a little lower but still very high. I also reduced the amount of fat I'm consuming on the Ketovore diet. But, even with the lower fat consumption, my total cholesterol is 414 and my LDL is 321. I'm not worried about it, my HDL is 84 and Trig. 44 and VLDL 9. I've had 2 CAC tests in the past 5 years, scored 0. High sensitivity Crp is 0.11. I have no family history of heart disease/stroke. I'm way more concerned about cancer... it seems we can potentially reduce the risk with diet/exercise but its still relatively high risk.
@@Hiker_Mike thanks. Interesting. Can't help to think however, if 10hours would even be better.
My LDL dropped 60%, but not sure if it was less fasting before the test, or oats I added, or less eggs. Busy testing for the next reound of bloodwork
@@contrarian717 Replacing the eggs with oats drops cholesterol for me but I can't eat oats due to pre-diabeties. That's why I'm on a Ketovore diet. I eat 4 eggs a day and live with the super high cholesterol levels from eggs. Interesting that they say dietary fat doesn't raise LDL but for me it does... consuming eggs results in a large increase in my LDL.
Hi Dave, I'm sadly on statins, is there any way to get off them ?
Cas Casca I don’t give medical advice, of course. I simply try to arm you with as much knowledge and research as I have given what I know to this point. You may want to check into many of the great lectures from Dr. David Diamond on this subject.
Thank you, I'll do that.
ruclips.net/video/b7zWNabebxs/видео.html ruclips.net/video/oydeTasQD0c/видео.html good stuff!
Would a longer fast drop your triglycerides even lower? So say doing a 48 hour fast prior to the blood draw?
you might enter increased fat burn and they can rise
Mr Feldman....thank you for your invaluable info,stats and data......please improve your HDL....that's a little low, but not extremely low.....