Cholesterol

What is Cholesterol?

Cholesterol is a waxy substance. It’s not inherently “bad.” In fact, your body needs it to build cells. But too much cholesterol can pose a problem.

Your cholesterol numbers show how much cholesterol is circulating in your blood. Your HDL (“good” cholesterol) is the one number you want to be high (ideally above 60). Your LDL (“bad” cholesterol) should be below 100. Your total should be below 200. Talk with your provider about what your results mean for you and how to manage your cholesterol.

Why are my cholesterol numbers important?

Your cholesterol numbers are important because they help you know your risk for heart disease. Cholesterol is a type of lipid (fat) that helps your body perform many important functions. But too much cholesterol in your blood is bad for you. It can enter your artery wall, damage its integrity and lead to the formation of atherosclerotic plaque (hardened deposits).

This process of plaque buildup is called atherosclerosis. It can lead to serious problems like:

  • Coronary artery disease: Blocked blood flow to your heart.
  • Peripheral artery disease: Blocked blood flow to your legs and arms.
  • Carotid artery disease: Blocked blood flow to your brain.

Cholesterol travels through your blood silently. And it turns into plaque silently. Plaque buildup is like someone tip-toeing on carpet. You might not see or notice its presence for a long time. You may have no symptoms until you have a heart attack or stroke. At that point, the plaque is like high heels on a hardwood floor. And it’s already caused serious damage to your body.

You can live for many years with high cholesterol and not even know it. That’s why it’s essential to get your cholesterol numbers checked on a regular basis. If your cholesterol numbers are too high (hyperlipidemia), that’s a red flag for you and your healthcare provider. High cholesterol is a major risk factor for heart disease. But catching it early gives you a chance to make changes and get your cholesterol to a healthy level.

What kind of test measures cholesterol?

Your provider checks your cholesterol levels through a blood test called a lipid panel (or lipid profile). Your provider will draw blood from a vein in your arm and send the blood to a lab for analysis. Be sure to closely follow your provider’s instructions on how to prepare for the test. You’ll likely need to fast for 12 hours beforehand. This means avoiding all foods and drinks except water.

When your results come in, your provider will let you know. You may also be able to access your results through your electronic medical record.

Your lipid panel gives you the following numbers:

  • Total cholesterol: This is the total amount of cholesterol that’s circulating in your blood. Here’s the formula for calculating it: HDL + LDL + 20% triglycerides = total cholesterol.
  • HDL level: HDL is high-density lipoprotein. This is the “good” cholesterol that moves extra cholesterol from your bloodstream to your liver. Your liver then gets rid of it from your body. When you see HDL, think of “h” for helpful. HDLs help your arteries clear out the cholesterol your body doesn’t need. It’s the one number in your lipid panel that you want to be high.
  • LDL level: LDL is low-density lipoprotein. This is the “bad” cholesterol that contributes to plaque buildup in your arteries. You need some LDLs because they carry cholesterol to your body’s cells. But having too many can cause problems.
  • VLDL level: VLDL is very low-density lipoprotein. It’s another “bad” form that contributes to plaque buildup. VLDLs carry a type of fat (triglycerides) in your blood. If you have too many VLDLs, the extra fat can build up in your arteries.
  • Triglycerides: This is a type of fat. You need some triglycerides. But high levels (hypertriglyceridemia) can put you at risk for atherosclerosis and other diseases.
  • Non-HDL cholesterol: This is all the cholesterol in your blood that isn’t HDL. The formula for calculating this number is simple: Total cholesterol – HDL = Non-HDL cholesterol
  • Ratio between total cholesterol and HDL: This is your total cholesterol divided by your HDL. In general, you want your number to be below five. Your results may show a chart with more details and desirable levels.

What is the unit of measurement for cholesterol?

Healthcare providers measure cholesterol levels as milligrams of cholesterol per deciliter of blood. The abbreviation is mg/dL. Providers use these same units to measure your triglycerides.

What are normal cholesterol levels?

Normal cholesterol levels vary based on your age and sex assigned at birth.

Normal cholesterol levels by age chart

The chart below shows normal cholesterol levels. Healthcare providers consider these numbers healthy for most people. If you have heart disease or many risk factors, your LDL target may be different. Your healthcare provider may want your LDL level to be below 70 mg/dL. So, it’s important to talk with your provider about your test results and what they mean for you.

All units in the chart below are mg/dL.

AGETOTAL CHOLESTROLNON HDL CHOLESTROLLDL CHOLESTROLHDL CHOLESTROL
19 and youngerBelow 170Below 120Below 110Above 45
20 and older125 to 200Below 130Below 100People assigned male at birth: 40 or higher
People assigned female at birth: 50 or higher

As you review your results, remember that you want your LDL to be low and your HDL to be high. Ideally, your HDL should be above 60. It’s the helpful cholesterol. An HDL above 60 offers you protection against heart disease.

How can I lower my cholesterol?

You can lower your cholesterol through heart-healthy lifestyle changes. They include a heart-healthy eating plan, weight management, and regular physical activity.

If the lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. If you take medicines to lower your cholesterol, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

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