High cholesterol can lead to heart disease, but since it doesn’t have any symptoms, you can’t know your cholesterol level without a blood test. A cholesterol test, or lipid panel, measures how much cholesterol is in your blood, but the result of a lipid test isn’t just a single number. A variety of components make up your test results, so understanding your cholesterol levels requires knowing a little about each of these components. 

Table of Content

  1. What is cholesterol?
  2. What is LDL cholesterol?
  3. What is HDL cholesterol?
  4. What are Triglycerides?
  5. What is VLDL cholesterol?
  6. What is total cholesterol?
  7. How often do you need to get your cholesterol level checked?
  8. Can you check your cholesterol at home?
  9. High cholesterol levels FAQs

What is cholesterol?

Cholesterol is a waxy type of fat, or lipid, that travels throughout your body in your bloodstream. Every cell in your body needs cholesterol, which helps form the layers of membranes that protect the contents of the cells. Cholesterol is also a key component in the production of vitamin D, some hormones, and the bile that helps your body digest food.

Your liver makes all of the cholesterol your body needs for these functions, but cholesterol also enters your bloodstream through the foods you eat that come from animals—meat, eggs, and dairy. Cholesterol particles are carried through your bloodstream by lipoproteins, which are made up of a combination of various types of fats and proteins. 

The two types of lipoproteins that carry cholesterol are low-density lipoproteins (LDL), also known as “bad” cholesterol, and high-density lipoproteins (HDL), also known as “good” cholesterol. Another lipoprotein, the lesser-known very-low-density lipoprotein (VLDL), mainly carries triglycerides, rather than cholesterol, through your blood. After VLDL deposits the triglycerides in your muscles, its remnants are metabolized into LDL cholesterol.

Clear as mud? Let’s take a closer look at each of these components of a cholesterol test and what’s generally considered “normal” levels for them—keeping in mind that a variety of factors will determine what’s normal for you.

What is LDL cholesterol?

LDL cholesterol is the bad guy—let the “L” stand for Loser. That’s because as LDL transports particles of cholesterol through your veins, those particles can build up and harden on the walls of your arteries—the vessels that carry oxygen-rich blood away from your heart and to the organs. 

This buildup is called plaque, and it makes the arteries narrower and may cause blockages. Narrowing arteries due to plaque buildup is a condition known as atherosclerosis, and it increases your risk for heart attack, stroke, and peripheral artery disease (PAD).

What is a normal LDL cholesterol level?

The optimal LDL cholesterol level is less than 100 mg/dL. It’s considered high if it’s above 160 mg/dL.

What is HDL cholesterol?

HDL cholesterol is the good guy—let the “H” stand for Hero. HDL travels through the blood and picks up excess LDL cholesterol from the arteries and delivers it to the liver, where it’s broken down and expelled from the body. While higher levels of HDL cholesterol are believed to lower the risk for heart disease, this “good” cholesterol can only manage to remove around one-third to one-fourth of the LDL cholesterol in your arteries. If your LDL gets too high, the HDL can’t keep up, so the LDL will continue to build up and narrow your arteries.

What is a normal HDL cholesterol level?

A normal HDL cholesterol level for men is above 40 mg/dL, and for women, it’s above 50 mg/dL. An HDL cholesterol level of 60 mg/dL or higher is considered a protective factor for heart disease. If your HDL cholesterol is under 40 mg/dL, you may have a major risk for heart disease.

What are Triglycerides?

Like cholesterol, triglycerides are a type of fat produced in the liver and found in some of the foods we eat. But while cholesterol is used by the body to build hormones and cells, triglycerides are used to store fuel. 

Whenever you consume calories, your body burns them as energy. Any extra calories that your body doesn’t need at the moment are converted immediately into triglycerides, which are stored in your fat cells. Later, when your body needs more fuel, hormones trigger the release of the triglycerides.

If you eat far more calories than your body needs, or if you eat large amounts of carbs, your triglyceride levels may be higher than normal. Like high cholesterol, a high level of triglycerides, known as hypertriglyceridemia, increases the risk for heart disease—especially in women.

What is a normal triglyceride level?

A triglyceride level above 150 mg/dL may increase your risk for heart disease.

What is VLDL cholesterol?

VLDL stands for very-low-density lipoprotein, which is another type of “bad” cholesterol produced by the liver. VLDL cholesterol is similar to LDL cholesterol, except that VLDL particles mainly carry triglycerides, rather than cholesterol, to your tissues. High triglyceride and VLDL levels in your blood contribute to the buildup of plaque in your arteries. Since there’s no test that directly measures VLDL cholesterol, labs use your triglyceride level to estimate your VLDL. Typically, your VLDL level is about one-fifth of your triglyceride level.

What is a normal VLDL cholesterol level?

Your VLDL cholesterol should be lower than 30 mg/dL. A level of 30 mg/dL or higher increases your risk for heart disease and stroke.

What is total cholesterol?

Traditionally, total cholesterol level is calculated by adding together your LDL and HDL cholesterol, plus 20 percent of your triglyceride level. 

What is a normal total cholesterol level?

Your total cholesterol level should be lower than 200 mg/dL. A level above 240 mg/dL is considered high cholesterol. However, it’s important to focus on more than just the number. Total cholesterol may be high because of a high HDL and a low LDL level, or it could be because of a low HDL and a high LDL level.

To determine what your total cholesterol level means, you need to calculate the ratio of total cholesterol to good cholesterol by dividing total cholesterol by your HDL cholesterol. This ratio is often used by healthcare professionals to help them create a personalized treatment plan and help their patients better understand their health risks. In general, the higher the ratio, the higher the risk. Doctors generally like to see a ratio below 5:1, but a ratio below 3.5:1 is ideal.

How often do you need to get your cholesterol level checked?

A cholesterol test is also known as a lipid profile or a lipid panel. It’s a blood test that measures HDL, LDL, triglyceride, VLDL, and total cholesterol levels.

The National Heart, Lung, and Blood Institute recommends a baseline cholesterol screening between the ages of nine and 11, and then every five years after that. Once men reach the age of 45 and women turn 55, a screening should be done every one to two years, depending on various factors. Anyone over 65 should get a cholesterol screening every year. 

Your doctor may recommend more frequent tests at any age if your levels aren’t in the desirable range, or if you have specific risk factors for high cholesterol, such as a high blood pressure or a family history of high cholesterol or heart disease.

Can you check your cholesterol at home?

Home cholesterol tests let you check your own cholesterol levels. Home tests are about as accurate as the test your doctor performs—if you follow the directions carefully. 

To use a home test, you’ll prick your finger to draw blood, then deposit the blood on a piece of paper containing special chemicals. The paper will change color based on the amount of cholesterol in your blood.

To find the best home test for cholesterol, read the information about the test’s accuracy on the packaging. Tests that say they are “traceable” to a Centers for Disease Control (CDC) program may be more accurate than others.

FAQs: High cholesterol levels

What happens if you ignore high cholesterol?

High cholesterol is a major risk factor for heart disease. If you ignore high cholesterol, the chances are good that it’ll continue to build up, narrowing your arteries, and could lead to a heart attack or stroke. Read more about how high cholesterol affects your heart health.

Can high cholesterol be cured without medication?

With certain lifestyle changes, chances are, you can lower your cholesterol without medication. Some people can lower their cholesterol quickly, but for others, it may take three months or longer. 

When does high cholesterol require medication?

If you make essential lifestyle changes and your cholesterol level doesn’t improve after three months, you may need to take one of a variety of medications to lower your cholesterol. Your physician will weigh a range of factors to determine whether medication is right for you, and if so, what type. One of these factors is your ASCVD score, which is a calculation of both the 10-year and lifetime risk of heart attack and stroke in people over 40. It’s used to help your physician determine whether a statin drug might benefit you. 

Do age and gender affect cholesterol levels?

Yes, indeed. High cholesterol affects women differently than it affects men, and recommended cholesterol levels for both sexes change with age. Risk factors also vary by sex and age. 

What does high cholesterol feel like?

High cholesterol has no symptoms, which is why following screening guidelines is important. If you’re experiencing symptoms like chest pain while exercising, lightheadedness, fainting, or shortness of breath, talk to your doctor right away. 

High cholesterol increases your risk for heart disease, and keeping your cholesterol level low—or lowering it if it’s elevated—can help you improve your heart health. Forward’s Healthy Heart Program is included in your Forward membership. Led by doctors and personalized based on your unique risk factors, this 12-week program includes cholesterol testing and evaluation, a genetic analysis, and a personalized plan to help you mitigate your risk of heart disease.

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