My sister, without getting doxxy-specific, "makes her living in the field of nutrition and preventive medicine" and I bounced my results off her:
Total Cholesterol - most health professionals don't take too much stock in this value. More relevant to see the breakdown of cholesterol types than just the total amount present, especially for people whose total is mostly made up of HDL (the "good" type)
Triglycerides - on a Ketogenic diet, I'd expect yours to be pretty low. Things that keep this elevated are high refined carb intake and alcohol. Your metabolic flexibility is such that triglycerides are constantly needed by cells in the body for fuel so they don't end up just hanging around in the blood
HDL - arguably the most important value on here and one more doctors are focusing on since it's the one that cleans up any deposited cholesterol in the arteries. Bigger numbers are better. >40 is within normal limits for males, >60 is what we call a "negative risk factor". When looking at all your risk factors for heart disease, having an HDL >60 serves to "cancel" out a factor that might not be in your favor (i.e. high blood pressure, family hx)
LDL - while <100 is considered OPTIMAL and a value to shoot for if you have other heart disease factors, <130 is generally considered to be good. Also, this is modulated by intake of dietary fat from animal sources (think butter, cheese, red meat). Given a keto eating pattern, not surprising for you
Yes, cholesterol has flexibility and can be obtained from the diet or made by the body. Either way, your body will make whatever you don't intake. It's a component of the cell membrane of every cell in our body. Where people get confused is conflating DIETARY cholesterol (the number listed on the facts panel for a food) and BLOOD cholesterol (the values you just had drawn). Used to be a time in history where we thought that increasing our consumption of DIETARY cholesterol (e.g. eggs) increased BLOOD cholesterol, which we now know is a very weak link.
Also right in that most useful data is the breakdown of cholesterol particle size. But you can get a good idea of health status with the numbers above.
What blew my mind is that she had a lipid panel done a month ago, unbeknownst to me, and her HDL, Total Cholesterol were all within 2 mg/dL of mine and LDL was within 10... she eats generally a healthy omnivorous organic-y diet and exercises a lot.
I am also in this field. A low LDL-C per se, independent of all dietary and lifestyle factors, reduces risk of coronary heart disease. https://www.ncbi.nlm.nih.gov/pubmed/16554528
"<130 is generally considered to be good." No. Once LDL-C passes 75 mg/dl there is a linear relationship for the acceleration of atherosclerosis. https://www.docdroid.net/phVPODB/01cir00001036644740649.pdf
"Used to be a time in history where we thought that increasing our consumption of DIETARY cholesterol (e.g. eggs) increased BLOOD cholesterol, which we now know is a very weak link." Very false. The relationship isn't linear. If someone is already eating dietary cholesterol, then adds more, little change is seen in the serum. If someone isn't consuming cholesterol, THEN adds cholesterol to the diet, dramatic change is seen in the serum. https://www.docdroid.net/8wHNh57/cholesterol-curve.pdf
Researchers have known since the 1970s that the only “appropriate design for demonstrating or refuting diet and coronary heart disease incidence is a dietary experiment.” https://www.ncbi.nlm.nih.gov/pubmed/313701 https://www.docdroid.net/9zeKYqE/confusion-about-dietary-fatty-acids-recommendations-for-chd-prevention.pdf
So when the appropriate study design is done, dietary cholesterol does impact serum cholesterol https://www.ncbi.nlm.nih.gov/pubmed/9006469
But, we see recent papers like this one: https://academic.oup.com/ajcn/article/107/6/921/4992612 that uses an inappropriate study design to conclude that eggs are healthy. The inappropriate study design is epidemiological studies, which don't control for enough factors (e.g. baseline cholesterol)
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