Losing weight but cholesterol climbing?

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SaulMichaels

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I began taking low-dose Reta at the end of August, and alongside that I cut back on how much I eat, cleaned up my diet, and started dropping pounds. When I had bloodwork drawn at the end of September, I was roughly 10lbs lighter and figured my labs would come back looking great. For reference, I'm 6'3" and my starting weight was about 235lbs, with body fat in the low 20's. On top of that I train 3-5 times a week at a CrossFit gym, so I wasn't in awful shape and didn't have a huge amount of weight to shed.

So it caught me off guard when the results came back and every marker except my triglycerides (which actually got better, at 120) moved in the wrong direction... my LDL being the biggest offender. My HDL has basically always run low while my LDL runs high… genetics 🫤… but this round was worse than before. Is there any sensible reason for that? It feels like I'm doing everything right and yet my cholesterol keeps getting worse. Has anyone else dealt with this?

Total= 202

LDL = 148 (up from 126)

HDL = 30

ApoB= 131

Triglycerides= 120
 
Honestly, I can't offer anything useful here beyond 'same here'. These days cholesterol is the single yellow flag showing up in my bloodwork. My plan is to start going to the gym and to prioritize fiber over protein if I want any shot at moving the needle, but apart from that there's nothing interesting to report.
 
When carbs are reduced or cut back, cholesterol tends to climb. That isn't necessarily a negative — it has a job to do (repairs).

I'd also assume that fat we lose doesn't simply vanish.

Are you eating fats?
 
I get that the pep world treats routine bloodwork as a given, but my view runs the other way: if you're in the middle of a serious weight loss cycle, blood tests shouldn't be something you stress over. Time and again I've read stories of folks getting labs done partway through, and then both they and their doctor freak out about a result that — had either of them looked a little closer — is actually completely expected to be out of range BECAUSE of the weight coming off. Rapid loss knocks all sorts of markers out of balance, and personally, I have zero interest in having medication or other "solutions" pushed on me for something that will fix itself once I stop dropping pounds every single week!

I'm aware this isn't a popular opinion.
 
Slaine said:

When carbs are reduced or cut back, cholesterol tends to climb. That isn't necessarily a negative — it has a job to do (repairs).

I'd also assume that fat we lose doesn't simply vanish.

Are you eating fats?
Click to expand...
Right now I aim for a specific calorie and macro goal every day. Of the 65g of fat I take in daily, I try to get the largest share from healthy sources like nuts and fish. That being said, I only made this much stricter once I had seen how my previous lab results came back. Before that point, my saturated fat consumption was higher, though not dramatically so, and it would have matched the level of saturated fat I had been eating for years.
 
Hold off another 3 months. Reduce your carbs. Stay away from seed oils. Skip alcohol, and take some omega3.

That said, as mentioned earlier, when you are shedding weight — especially during the first few months — blood tests can come back all over the place.

So do not be shocked if your LDL comes back even higher next time.

As for me, my numbers are :

LDL 180

HDL 70

Triglycerides = 70

The last 2 are the ones I care about more, and in my case they look pretty good.
 
SaulMichaels said:


I started low doses of Reta at the end of August and began eating less, eating cleaner and losing weight. At the time I had my bloodwork done at the end of September, I was down around 10lbs and felt like my lab work was going to look really good. I am 6’3” and started at around 235lbs with body fat % in the low 20’s. I also workout 3-5 times a week at a CrossFit gym so I wasn’t in terrible shape and didn’t have a tremendous amount of weight to lose.

To my surprise, I got my bloodwork back and everything but my triglycerides (which actually improved to 120) went the wrong direction... most notably my LDL. My HDL has almost always been low and my LDL high… genetics 🫤… but these results were worse. Any logical explanation for that? Seems like I’m doing the right things and still slipping on the cholesterol front. Anyone ever had this experience?

Total= 202

LDL = 148 (up from 126)

HDL = 30

ApoB= 131

Triglycerides= 120

Click to expand...
Click to expand...
When fat is burned off, it enters the bloodstream and causes a short-term rise in cholesterol.

Google info:

On blood labs, extreme or rapid weight loss can cause cholesterol and triglyceride levels to rise temporarily. [1, 2]

Why This Happens

    • Fat Cell Shrinkage: When weight comes off quickly, your fat cells break down (lipolysis) and release stored energy. [1, 2]
    • Release of Stored Cholesterol: Dissolved cholesterol sits inside fat droplets. As fat cells shrink, that stored cholesterol plus extra triglycerides pour into your bloodstream. [1, 2]
    • Liver Processing: For a while the liver takes on a heavy load of mobilized lipids and requires time to process them, turn them into bile, and clear them out. [1, 2]

What to Expect on Labs

    • LDL ("Bad") Cholesterol: Frequently spikes transiently while weight loss is active and aggressive (for example with very-low-calorie or keto diets), then falls afterward.
    • Triglycerides: Can rise or swing around while the body leans hard on fat burning for fuel.
    • Timeline: The elevation is only temporary. Numbers usually return to normal 8 to 12 weeks once your weight has stabilized
 
Skidude said:

When fat is burned off, it enters the bloodstream and causes a short-term rise in cholesterol.

Google info:

On blood labs, extreme or rapid weight loss can cause cholesterol and triglyceride levels to rise temporarily. [1, 2]

Why This Happens

    • Fat Cell Shrinkage: When weight comes off quickly, your fat cells break down (lipolysis) and release stored energy. [1, 2]
    • Release of Stored Cholesterol: Dissolved cholesterol sits inside fat droplets. As fat cells shrink, that stored cholesterol plus extra triglycerides pour into your bloodstream. [1, 2]
    • Liver Processing: For a while the liver takes on a heavy load of mobilized lipids and requires time to process them, turn them into bile, and clear them out. [1, 2]

What to Expect on Labs

    • LDL ("Bad") Cholesterol: Frequently spikes transiently while weight loss is active and aggressive (for example with very-low-calorie or keto diets), then falls afterward.
    • Triglycerides: Can rise or swing around while the body leans hard on fat burning for fuel.
    • Timeline: The elevation is only temporary. Numbers usually return to normal 8 to 12 weeks once your weight has stabilized
Click to expand...
Funny enough, ChatGPT and I were just talking about this 😆 The reasoning behind it does click for me, even though I doubt I’d qualify as someone experiencing “extreme/rapid weight loss.”
 
SaulMichaels said:

Funny enough, ChatGPT and I were just talking about this 😆 The reasoning behind it does click for me, even though I doubt I’d qualify as someone experiencing “extreme/rapid weight loss.”
Click to expand...
My interpretation is this: fat loss itself means cholesterol is being added along the way.

After things level off and you're maintaining, those lab values should get better.

There's no fixed equation or set figure for pounds of fat lost each week that determines a short-term cholesterol increase. [1, 2]

How Weight Loss Affects Cholesterol

    • Temporary Mobilization: As fat is burned off during weight loss, the body pushes stored cholesterol and fatty acids into circulation. Lipid panel results can therefore show a short-lived rise or elevation while you are actively shedding pounds. [1, 2, 3]
    • Long-Term Improvement: Eventually, after your weight holds steady (typically about 8 to 12 weeks past reaching a stable weight), losing weight usually brings down total cholesterol, LDL ("bad") cholesterol, and triglycerides, while HDL ("good") cholesterol is often improved or held stable. [1, 2, 3]
    • Dietary Factors: The foods you consume during weight loss (for example, a lot of saturated fat or a very strict low-carb approach) can shift LDL on their own, independent of how quickly fat is lost. [1, 2]
    • Recommended Rate: A sound, maintainable pace of fat/weight loss is 1 to 2 pounds per week, reached via a moderate calorie deficit. Fast or extreme weight loss has no direct mathematical conversion rate for cholesterol spikes, and doctors generally suggest waiting for your weight to stabilize before judging long-term lipid results. [1, 2]
 
Reta brought my cholesterol down right away, and my doctor told me he had never witnessed such a fast improvement. Of course, my diet was perfect and I was training 2 hours daily, but even so. On top of that, I take a fair number of supplements very consistently, omega 3's included. Eating 4 eggs at breakfast each day helps as well.

If yours is getting worse, then something is off somewhere, most likely connected to diet.
 
Skidude said:

When fat is burned off, it enters the bloodstream and causes a short-term rise in cholesterol.

Google info:

On blood labs, extreme or rapid weight loss can cause cholesterol and triglyceride levels to rise temporarily. [1, 2]

Why This Happens

    • Fat Cell Shrinkage: When weight comes off quickly, your fat cells break down (lipolysis) and release stored energy. [1, 2]
    • Release of Stored Cholesterol: Dissolved cholesterol sits inside fat droplets. As fat cells shrink, that stored cholesterol plus extra triglycerides pour into your bloodstream. [1, 2]
    • Liver Processing: For a while the liver takes on a heavy load of mobilized lipids and requires time to process them, turn them into bile, and clear them out. [1, 2]

What to Expect on Labs

    • LDL ("Bad") Cholesterol: Frequently spikes transiently while weight loss is active and aggressive (for example with very-low-calorie or keto diets), then falls afterward.
    • Triglycerides: Can rise or swing around while the body leans hard on fat burning for fuel.
    • Timeline: The elevation is only temporary. Numbers usually return to normal 8 to 12 weeks once your weight has stabilized
Click to expand...

There's something else worth mentioning here: since some people on glp1s end up with higher serum cholesterol, my understanding is that this is the reason a certain amount of regular, mostly 'healthy' fats still belongs in the diet (paired with enough dietary fibre) whenever someone is on a prolonged significant calorie restriction — it keeps the gallbladder moving, which means the bile doesn't turn sludgy or stagnant and doesn't become saturated with cholesterol.
 
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