Holistic Approach to Wellness

Cholesterol Numbers Explained

It’s important to keep your cholesterol levels within healthy limits. If you have other risk factors for developing heart disease, you need to be even more careful — especially with your low-density lipoprotein (LDL), or “bad,” cholesterol level.

Who should get a cholesterol test?

All adults age 20 or older should have a cholesterol test once every five years. Ideally, you should begin having your cholesterol checked during your early 20s. You should have your cholesterol measured when you’re relatively healthy. An acute illness, a heart attack or severe stress can affect cholesterol levels.

Cholesterol testing is especially important if you:

  • Have a family history of high cholesterol or heart disease
  • Are overweight
  • Are physically inactive
  • Have diabetes
  • Eat a high-fat diet
  • Are a man older than 45 or a woman older than 55

These factors put you at increased risk of developing high cholesterol and heart disease.

If you have high cholesterol levels, your doctor may want you to get tested more often. Discuss with your doctor how often you should have a cholesterol test if your cholesterol levels are abnormal.

Also, if you have a strong family history of early heart disease, your doctor may want to test other risk factors, such as lipoproteins, that aren’t part of the standard cholesterol profile.

Cholesterol is often high during pregnancy, so pregnant women should wait at least six weeks after giving birth to have their cholesterol measured. The same is true for people who’ve been ill or had a heart attack, surgery or an accident.

Some drugs are known to increase cholesterol levels, including anabolic steroids, beta blockers, epinephrine, oral contraceptives and vitamin D. Be sure the doctor who orders your tests is aware of all the drugs and supplements you’re taking.

Children and cholesterol testing

Children as young as age 2 can have high cholesterol, but not all children need to be screened for high cholesterol. The American Academy of Pediatrics recommends a cholesterol test only for children between the ages of 2 and 10 who have a known family history of high cholesterol or premature coronary artery disease. Your child’s doctor may recommend retesting if your child’s first test shows he or she has abnormal cholesterol levels. If you have a family history of coronary artery disease that develops at a young age, your doctor may recommend more frequent cholesterol tests beyond the recommended screenings.

The American Academy of Pediatrics also recommends testing if the child’s family history for high cholesterol is unknown, but the child has risk factors for high cholesterol, such as obesity, high blood pressure or diabetes.

Interpreting your cholesterol numbers

Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood in the United States and some other countries. Canada and most European countries measure cholesterol in millimoles (mmol) per liter (L) of blood. Consider these general guidelines when you get your cholesterol test (lipid panel or lipid profile) results to see if your cholesterol falls in an ideal range.

Total cholesterol
(U.S. and some other countries)
Total cholesterol*
(Canada and most of Europe)
 
Below 200 mg/dL Below 5.2 mmol/L Desirable
200-239 mg/dL 5.2-6.2 mmol/L Borderline high
240 mg/dL and above Above 6.2 mmol/L High

 

LDL cholesterol
(U.S. and some other countries)
LDL cholesterol*
(Canada and most of Europe)
 
Below 70 mg/dL Below 1.8 mmol/L Ideal for people at very high risk of heart disease
Below 100 mg/dL Below 2.6 mmol/L Ideal for people at risk of heart disease
100-129 mg/dL 2.6-3.3 mmol/L Near ideal
130-159 mg/dL 3.4-4.1 mmol/L Borderline high
160-189 mg/dL 4.1-4.9 mmol/L High
190 mg/dL and above Above 4.9 mmol/L Very high

 

HDL cholesterol
(U.S. and some other countries)
HDL cholesterol*
(Canada and most of Europe)
 
Below 40 mg/dL (men)
Below 50 mg/dL (women)
Below 1 mmol/L (men)
Below 1.3 mmol/L (women)
Poor
40-49 mg/dL (men)
50-59 mg/dL (women)
1-1.3 mmol/L (men)
1.3-1.5 mmol/L (women)
Better
60 mg/dL and above 1.6 mmol/L and above Best

 

Triglycerides
(U.S. and some other countries)
Triglycerides*
(Canada and most of Europe)
 
Below 150 mg/dL Below 1.7 mmol/L Desirable
150-199 mg/dL 1.7-2.2 mmol/L Borderline high
200-499 mg/dL 2.3-5.6 mmol/L High
500 mg/dL and above Above 5.6 mmol/L and above Very high

*Canadian and European guidelines differ slightly from U.S. guidelines. These conversions are based on U.S. guidelines.

The American Heart Association (AHA) recommends that a triglyceride level of 100 mg/dL (1.3 mmol/L) or lower is considered optimal. The AHA says this optimal level would improve your heart health. However, the AHA doesn’t recommend drug treatment to reach this level. Instead, for those trying to lower their triglycerides to this level, lifestyle changes such as diet, weight loss and physical activity are encouraged. Elevated triglycerides usually respond well to dietary and lifestyle changes.

LDL targets differ

Because LDL cholesterol is a major risk factor for heart disease, it’s the main focus of cholesterol-lowering treatment. Your target LDL number can vary, depending on your underlying risk of heart disease.

Most people should aim for an LDL level below 130 mg/dL (3.4 mmol/L). If you have other risk factors for heart disease, your target LDL may be below 100 mg/dL (2.6 mmol/L). If you’re at very high risk of heart disease, you may need to aim for an LDL level below 70 mg/dL (1.8 mmol/L). In general, the lower your LDL cholesterol level is, the better. There is no evidence that really low LDL cholesterol levels are harmful.

You’re considered to be at a high risk of heart disease if you have or have had any of the following:

  • A previous heart attack or stroke
  • Artery blockages in your neck (carotid artery disease)
  • Artery blockages in your arms or legs (peripheral artery disease)
  • Diabetes

In addition, two or more of the following risk factors also might place you in the very high risk group:

  • Smoking
  • High blood pressure
  • Low HDL cholesterol
  • Family history of early heart disease
  • Age older than 45 if you’re a man, or older than 55 if you’re a woman
  • Elevated lipoprotein (a), another type of fat (lipid) in your blood

Types of cholesterol

LDL cholesterol can build up on the inside of artery walls, contributing to artery blockages that can lead to heart attacks. Higher LDL cholesterol levels mean higher risk. High-density lipoprotein (HDL) cholesterol is known as “good” cholesterol because it helps prevent arteries from becoming clogged. Higher HDL cholesterol levels generally mean lower risk.

A blood test to check cholesterol levels — called a lipid panel or lipid profile — typically reports:

  • Total cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides, a type of fat often increased by sweets and alcohol

For the most accurate measurements, don’t eat or drink anything (other than water) for nine to 12 hours before the blood sample is taken.

Lifestyle changes

If your LDL cholesterol is too high, the first thing your doctor will probably suggest is lifestyle changes. These changes include:

  • Quitting smoking
  • Eating more soluble fiber, found in oatmeal, beans, fruits and vegetables
  • Eating less fat and cholesterol from meat and dairy products
  • Losing weight
  • Exercising at least 30 minutes a day on most days of the week

Being overweight and inactive tends to increase your LDL cholesterol and lower your HDL cholesterol, exactly the opposite of what you want. Exercise and weight loss can help reverse this trend. This is especially important for people who have large waist measurements — more than 40 inches (101.6 centimeters) for men and more than 35 inches (88.9 centimeters) for women — because people with this body shape are more likely to develop heart disease.

Consider Nutraceuticals before taking Statins 

When lifestyle changes aren’t enough to reach your cholesterol targets, your doctor may prescribe medications to help lower your cholesterol levels. These drugs, such as statins, aren’t a replacement for lifestyle changes and have serious side effects. Consider natural remedies such as Red Yeast Extract with CoQ10 along with Omega’s and a diet that helps lower cholesterol. It’s strongly recommended you work with a holistic professional to find the best remedy for you. 

A hidden risk factor — family history

High cholesterol has no symptoms, but your genetic makeup — reflected in a family history of high cholesterol — might make you more prone to high cholesterol, even if you eat right and exercise.

That’s why it’s so important to have a baseline cholesterol test at age 20 and have follow-up tests at least once every five years. Finding the problem early allows you to take action before it’s too late. Your doctor may recommend more frequent cholesterol tests if your total cholesterol level or LDL cholesterol level is high, or if you have a family history of heart disease or high cholesterol.

The particle test for high cholesterol is an advanced cholesterol test for LDL, or “bad,” cholesterol and gaining more popularity

The particle test breaks down LDL cholesterol into its types of particles. LDL cholesterol particles can be broken down into small, dense particles and large, less dense particles. If you have the small, dense particle type of LDL, it increases your risk for forming the plagues in your arteries that lead to strokes and heart attacks.

The smaller LDL particles seem to be able to slip through the tiny openings between the cells that line the inside of your arteries. That means it’s a lot easier for them to build up into the plaques, or blockages, that can cause heart attack or stroke. They may also escape detection during routine cholesterol screening — you could have the dangerous type of LDL particles yet have a normal LDL result on a standard test which is why it’s a good idea to check particle size along with a standard panel.