DoctorAIA lipid panel, often called a cholesterol test, is a blood test that measures total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. Doctors use it, together with age, blood pressure, smoking status and other factors, to estimate the risk of heart disease and stroke and to see whether treatment is working.
What the lipid panel measures
Conventional US units (mg/dL) come first, with mmol/L in brackets. The categories below are the standard adult cut-offs. Your report will print its own flags.
| Marker | What it is | Typical adult range | If higher | If lower |
|---|---|---|---|---|
| Total cholesterol | All the cholesterol carried in your blood | Desirable: under 200 mg/dL (5.2 mmol/L). Borderline high: 200 to 239 (5.2 to 6.2). High: 240 or above (6.2 or above) | Linked with higher long-term risk of heart disease. Diet, weight, inherited factors, an underactive thyroid and some medicines can contribute. | Usually not a concern on its own. Your doctor may look further if it is very low. |
| LDL cholesterol | Often called the "bad" cholesterol because it can build up in artery walls | Optimal: under 100 mg/dL (2.6 mmol/L). Near optimal: 100 to 129 (2.6 to 3.3). Borderline high: 130 to 159 (3.4 to 4.1). High: 160 to 189 (4.1 to 4.9). Very high: 190 or above (4.9 or above) | The main target for lowering heart disease risk. Values of 190 mg/dL or above may prompt a check for an inherited cause. | Generally considered favorable. Very low values are uncommon, and your doctor may look for a cause. |
| HDL cholesterol | Often called the "good" cholesterol because it helps carry cholesterol back to the liver | Low: under 40 mg/dL (1.0 mmol/L) in men, under 50 mg/dL (1.3 mmol/L) in women. 60 mg/dL (1.6 mmol/L) or above is considered protective | Generally considered favorable. | Linked with higher heart risk. Smoking, inactivity, excess weight, type 2 diabetes and some medicines can lower it. |
| Triglycerides | The main form of fat stored in the body | Normal: under 150 mg/dL (1.7 mmol/L). Borderline high: 150 to 199 (1.7 to 2.2). High: 200 to 499 (2.3 to 5.6). Very high: 500 or above (5.6 or above) | Can follow a recent meal, alcohol, excess weight, type 2 diabetes, an underactive thyroid or some medicines. Very high levels can raise the risk of pancreatitis. | Usually not a concern. |
| Non-HDL cholesterol | Total cholesterol minus HDL, which covers all the artery-clogging types | Generally desirable: under 130 mg/dL (3.4 mmol/L) | Tracks with LDL and triglycerides, and is useful when triglycerides are high. | Generally considered favorable. |
Most labs calculate LDL from the other three results rather than measuring it. That calculation becomes unreliable when triglycerides are very high (above about 400 mg/dL, or 4.5 mmol/L), so the lab may measure LDL directly instead.
Why your lab's range may differ
The cut-offs above are population-wide categories that many labs and guidelines use. Your doctor sets a personal target from your overall risk, including age, blood pressure, smoking, diabetes and family history. People who already have heart disease or diabetes are often given stricter targets, so a number that is acceptable for one person can be too high for another.
What can affect your results
- Fasting: triglycerides rise after a meal. Many labs now accept a non-fasting sample, but some still ask for a fast of 9 to 12 hours, so follow your instructions.
- Alcohol: drinking in the day or two before can raise triglycerides.
- Recent illness or surgery: cholesterol can read lower than usual for several weeks after a serious illness, heart attack or surgery.
- Pregnancy: cholesterol and triglycerides normally rise.
- Medicines: steroids, some blood pressure medicines, hormone treatments and some HIV medicines can change lipid levels.
- Other conditions: an underactive thyroid, diabetes, kidney disease and liver disease can all affect results.
How the results fit together
- High LDL on its own and high LDL alongside other risk factors are treated differently. Your doctor looks at the whole picture, often with a risk calculator.
- High triglycerides with low HDL is a common pattern in people with excess weight, insulin resistance or type 2 diabetes. A HbA1c or glucose test may be added.
- A new rise in LDL can be a reason to check thyroid function. See thyroid tests.
- A very high LDL, especially with early heart disease in the family, may lead your doctor to consider an inherited condition called familial hypercholesterolemia.
When to contact a doctor
Raised cholesterol usually causes no symptoms, which is why the test matters. Contact your doctor if:
- your LDL is 190 mg/dL (4.9 mmol/L) or above, or your triglycerides are 500 mg/dL (5.6 mmol/L) or above
- your results are flagged and you have diabetes, high blood pressure, or a parent or sibling who had heart disease at a young age
- you have severe abdominal pain, particularly with very high triglycerides
Seek emergency care for chest pain or pressure, shortness of breath, sudden weakness on one side of the body, drooping of the face or trouble speaking. In an emergency, call your local emergency number.
Frequently asked questions
What is a good cholesterol level?
For adults, total cholesterol under 200 mg/dL (5.2 mmol/L), LDL under 100 mg/dL (2.6 mmol/L), HDL of 60 mg/dL (1.6 mmol/L) or above, and triglycerides under 150 mg/dL (1.7 mmol/L) are the usual desirable categories. Your own target depends on your overall heart disease risk, so ask your doctor.
Do I need to fast for a cholesterol test?
Not always. Many labs and doctors now accept a non-fasting sample, because total cholesterol and HDL change little after eating. Triglycerides do rise after a meal, and some labs or situations still call for fasting for 9 to 12 hours. Follow the instructions you were given.
What is the difference between LDL and HDL?
LDL carries cholesterol to the tissues and can build up in artery walls, so lower values are generally better. HDL helps carry cholesterol back to the liver, so higher values are generally better. Doctors usually focus on lowering LDL, while lifestyle changes can also raise HDL.
What is a normal triglyceride level?
A normal triglyceride level for adults is under 150 mg/dL (1.7 mmol/L). Levels of 150 to 199 are borderline high, 200 to 499 are high, and 500 mg/dL (5.6 mmol/L) or above is very high. A recent meal, alcohol and excess weight can all raise the number.