Reversal of severe hypertriglyceridemia with intermittent fasting and a very-low-carbohydrate ketogenic diet: a case series

Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):308-311. doi: 10.1097/MED.0000000000000566.


Purpose of review: To illustrate successful reversal of hypertriglyceridemia using a very-low-carbohydrate ketogenic diet in conjunction with intermittent fasting in two patients.

Recent findings: Hypertriglyceridemia remains an important component of residual risk for atherosclerotic cardiovascular disease. Current guidelines from the AHA/ACC recommend the initiation of a very-low-fat diet to treat persistently elevated triglycerides, whereas the National Lipid Association argues that a very-low-carbohydrate, high-fat diet is contraindicated in severe hypertriglyceridemia. In contrast, we report resolution of two cases of severe hypertriglyceridemia with implementation of very-low-carbohydrate ketogenic diets and intermittent fasting.

Summary: Here, we describe two patients who have demonstrated substantial reductions in serum triglycerides, effectively reversing severe hypertriglyceridemia using unconventional dietary methods. Although anecdotal, these cases point to a critical lack of flexibility in current dietary guidelines that hinder their application in clinical practice.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diet, Ketogenic*
  • Fasting / physiology*
  • Female
  • Humans
  • Hypertriglyceridemia / blood
  • Hypertriglyceridemia / diet therapy*
  • Hypertriglyceridemia / pathology
  • Lipids / blood
  • Male
  • Middle Aged
  • Remission Induction
  • Retrospective Studies
  • Severity of Illness Index


  • Lipids