I have just had the same very high total cholesterol test result. Never been so high. Doing lchf diet and IF, but not strictly, for 6 months and lost 10 kilo. Feeling healthy and fitter than l have been for many years. I don't have any other markers for coronary disease risk. Result was a shock but l have been Google searching and learning more around the subject lchf + cholesterol and there's a lot of questions and uncertainty about these test results for lchf dieters. Particularly interesting reports and thoughts from Low Carbs Down Under forum. Hopefully you will find some useful insights to discuss with your doctor