← All Tests
Heart Health

Cholesterol Test (Lipid Profile)

Your cholesterol test, also called a lipid panel, measures four key fats in your blood. Together they reveal your heart disease risk. Here's what each number means.

Written and clinically reviewed by Suman Konda, PharmD, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last reviewed and updated: · How we check our content

The four numbers in your cholesterol report

TestDesirableBorderlineHigh Risk
Total Cholesterol<200 mg/dL200–239≥240 mg/dL
LDL ("Bad" cholesterol)<100 mg/dL100–159≥160 mg/dL
HDL ("Good" cholesterol): Men>40 mg/dL40–59<40 (low is bad)
HDL: Women>50 mg/dL50–59<50 (low is bad)
Triglycerides<150 mg/dL150–199≥200 mg/dL
Non-HDL Cholesterol<130 mg/dL130–189≥190 mg/dL

What does HIGH LDL mean?

HIGH LDL above 160 mg/dL

LDL is the "bad" cholesterol that deposits in artery walls, causing plaques that narrow arteries (atherosclerosis) and raise the risk of heart attack and stroke. High LDL is caused by: saturated fat and trans fat diet (red meat, fried food, butter, ghee in excess), genetics (familial hypercholesterolaemia), hypothyroidism, diabetes, kidney disease, and obesity. Target LDL depends on your overall risk, people with diabetes or previous heart attack need LDL below 70 mg/dL.

What does LOW HDL mean?

LOW HDL below 40 mg/dL (men) / 50 mg/dL (women)

HDL is the "good" cholesterol that removes excess cholesterol from artery walls and carries it back to the liver. Low HDL is an independent risk factor for heart disease, even if total cholesterol is normal. Causes: smoking, physical inactivity, obesity, Type 2 diabetes, very high carbohydrate diet. Best ways to raise HDL: regular aerobic exercise, quitting smoking, losing weight, replacing refined carbs with healthy fats (nuts, olive oil, avocado).

What do HIGH triglycerides mean?

HIGH Triglycerides above 200 mg/dL

Triglycerides are fats stored from excess calories, especially from sugar, refined carbs and alcohol. High triglycerides raise heart disease risk and, when very high (above 500 mg/dL), risk causing acute pancreatitis: a medical emergency. Common causes: a diet high in refined carbohydrates and sugar, alcohol, uncontrolled diabetes, hypothyroidism, kidney disease. Reducing refined carbs and sugar is more effective than reducing fat for lowering triglycerides.

You Probably Do Not Need to Fast for This

Fasting for nine to twelve hours before a cholesterol test was the universal rule, and until around 2009 essentially every guideline required it. The evidence has moved, and many countries have moved with it.2

The rule existed because triglycerides rise after eating. But the rise measured after a deliberate fat-loading test is not what happens after an ordinary meal. Across four large prospective studies, the maximum average change after normal eating was about +26 mg/dL for triglycerides, and roughly −8 mg/dL for total cholesterol, −8 mg/dL for LDL and −4 mg/dL for HDL.2 Those shifts are small next to the differences that change what a doctor does.

More importantly, the non-fasting numbers predict outcomes at least as well. In 108,602 people from the Copenhagen General Population Study, non-fasting measurements of triglycerides, total cholesterol, LDL, non-HDL cholesterol, lipoprotein(a) and apolipoprotein B all showed the expected relationship with heart disease and heart attack. Trials that lowered non-fasting lipid levels reduced cardiovascular events.2 Non-fasting triglycerides have in fact been shown to predict risk better than fasting ones.

Why this is a practical improvement, not just a technicalityIt removes the early-morning appointment, and the day spent hungry. For someone with diabetes taking insulin or a sulfonylurea, it removes a real risk of hypoglycaemia caused purely by fasting for a blood test.2 There are still situations where a fasting sample is asked for — very high triglycerides being the usual one — so follow the instruction you were given rather than assuming.3

The Number Under-Reported on Most Lab Slips

Most attention goes to LDL, but LDL is not the whole of the cholesterol that damages arteries. Non-HDL cholesterol — simply total cholesterol minus HDL — captures every particle that contributes, including the remnant cholesterol carried in triglyceride-rich particles that an LDL measurement leaves out.

It costs nothing to calculate, needs no extra test, and requires no fasting. If your report gives total cholesterol and HDL, you can work it out yourself: subtract one from the other. In the Copenhagen data, non-HDL cholesterol and apolipoprotein B both tracked risk in non-fasting samples alongside the conventional measures.2

This matters most when triglycerides are high, which is exactly when LDL alone becomes least informative. If your LDL looks acceptable but your triglycerides are raised, non-HDL cholesterol is the number worth asking about.

Questions to ask your doctor

  • What is my 10-year heart disease risk (Framingham or PCE score)?
  • Do I need a statin, or can lifestyle changes bring my LDL down enough?
  • My HDL is low. What exercise and diet changes will raise it most?
  • Should I get a coronary calcium score (CT scan) to assess actual plaque?

Why cholesterol matters for your heart

Cholesterol is a fatty substance your body needs to build cells and make hormones, but too much of the wrong type raises the risk of heart attack and stroke. The danger comes when excess LDL ('bad') cholesterol is deposited in artery walls, forming plaques that narrow the vessels and can rupture to trigger a clot.

This is why a cholesterol test is not just a number to normalise but part of an overall assessment of your cardiovascular risk, alongside blood pressure, smoking status, age, diabetes and family history.

How to improve your cholesterol

Diet and lifestyle can meaningfully shift cholesterol: reducing saturated fat, eating more soluble fibre (oats, beans, fruit), losing excess weight, exercising regularly and stopping smoking all help, and can lower LDL by 10–20%.

When lifestyle alone is not enough, or when cardiovascular risk is high, statins and other medicines are highly effective. Diet and medication work together rather than being alternatives.

Frequently Asked Questions

Do I need to fast before a cholesterol test?
Modern guidance increasingly allows non-fasting cholesterol testing, but a fasting sample (9–12 hours) is still often requested, especially when triglycerides are being measured. Follow your clinic's instructions.
Is high cholesterol always caused by diet?
No. While diet contributes, genetics play a large role. Familial hypercholesterolaemia is an inherited condition causing very high cholesterol from birth, and it needs specific treatment regardless of diet.
Can cholesterol be too low?
Extremely low cholesterol is uncommon and usually only occurs with certain illnesses or malnutrition. For most people on treatment, lower LDL is beneficial within recommended ranges.
How often should cholesterol be checked?
This depends on your risk and whether you are on treatment: every few years for low-risk adults, and more frequently when monitoring statin therapy or managing high risk.

References

The clinical information on this page is based on peer-reviewed sources indexed in PubMed, the biomedical literature database of the US National Library of Medicine.

  1. Ward NC, Watts GF, Eckel RH. Statin toxicity. Circ Res. 2019;124(2):328-350. doi:10.1161/CIRCRESAHA.118.312782 · PMID 30653440
  2. Kalra S, Raizada N. Dyslipidemia in diabetes. Indian Heart J. 2023;76(Suppl 1):S80-S82. doi:10.1016/j.ihj.2023.11.002 · PMID 37956957
  3. Langsted A, Nordestgaard BG. Nonfasting versus fasting lipid profile for cardiovascular risk prediction. Pathology. 2019;51(2):131–41. PMID 30522787 · doi:10.1016/j.pathol.2018.09.062
  4. Dyce E. Non-fasting versus fasting cholesterol measurement. Nurse Pract. 2018;43(2):16–20. PMID 29341990 · doi:10.1097/01.NPR.0000529668.54564.b9

Related reading

Medical Disclaimer: This page is for general educational purposes only. It does not constitute medical advice. Always consult a qualified doctor before making any health decisions.