Single-subject case study of a healthy, active 88-year-old man eating ~25 eggs/day (~5,300 mg cholesterol/d for years) with normal plasma cholesterol (~200 mg/dL) and no clinical evidence of significant atherosclerosis. Measured mechanisms: only ~18% cholesterol fractional absorption (vs. a typical ~40-60%), reduced hepatic cholesterol synthesis, and increased diversion of cholesterol into bile acids — extremely efficient compensatory mechanisms.
relevance_note: The most extreme documented hypo-responder phenotype — an existence proof that the absorption/synthesis compensation McNamara 1987 described statistically can fully neutralize even very high habitual intake in some individuals; the anecdotal anchor most reviews reach for on the hypo-responder side.