Profound Elevation in LDL Cholesterol Level Following a Ketogenic Diet: A Case Series

The ketogenic diet (KD) is currently popular for the achievement of weight loss and improvement in glycemic variables. The diet allows consumption of foods high in fat and protein, with strict limitation of carbohydrates. We present a case series of substantial increases in total cholesterol and low-density lipoprotein cholesterol following the initiation of a KD, with improvements in cholesterol levels once the KD was stopped. Novel teaching points include the need for lipid monitoring in patients who choose to follow a KD and for raising awareness of the extreme lipid response that can occur in some patients, particularly lean individuals.