Why Do I Need A Cholesterol Test
Cholesterol is a waxy, fat-like substance. Your liver makes all the cholesterol your body needs. But you take in more cholesterol from certain foods, such as those from animals. If you have too much cholesterol in your body, it can build up in the walls of your arteries and eventually harden. This process, called atherosclerosis, actually narrows the arteries, making it harder for blood to travel through the vessels.
Unfortunately, high cholesterol doesn’t cause symptoms. In later stages of atherosclerosis, though, you may suffer angina — severe chest pain from lack of blood flow to the heart. If an artery gets totally blocked, a heart attack results. A routine blood cholesterol test is a far better way of finding out what your cholesterol level is.
What Age Should I Get Screened For High Blood Cholesterol
About 1 in 5 adolescents have an unhealthy cholesterol reading,1 and nearly 93 million U.S. adults age 20 or older have high cholesterol.2 But since high cholesterol doesnt have symptoms, many people dont know their levels are high.
Cholesterol should be checked starting early in lifeeven children and adolescents should have their cholesterol checked.
Cholesterol testing should be done
- Every 5 years for people age 20 or older who are at low risk for cardiovascular disease.3
- More frequently than every 5 years for people with cardiovascular disease risk factors.3
The 2018 ACC/AHA Guidelines recommend that cholesterol management be based on a persons lifetime cardiovascular risk.1
If your family has a history of early heart attacks or heart disease, or if a child has obesity or diabetes, doctors may recommend screening for high cholesterol more often.
What Is This Test
This group of tests measures the amount of cholesterol and other fats in your blood.
Cholesterol and triglycerides are lipids, or fats. These fats are important for cell health, but they can be harmful when they build up in the blood. Sometimes they can lead to clogged, inflamed arteries, a condition call atherosclerosis. This may keep your heart from working normally if the arteries of your heart muscle are affected.
This panel of tests helps predict your risk for heart disease and stroke.
A lipid panel measures these fats:
- Total cholesterol
- High total cholesterol
If you are already being treated for heart disease, you may have this test to see whether treatment is working.
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Cholesterol Chart For Adults
According to the 2018 guidelines on the management of blood cholesterol published in the Journal of the American College of Cardiology , these are the acceptable, borderline, and high measurements for adults.
All values are in mg/dL and are based on fasting measurements.
Your doctor may recommend a plan of treatment for high cholesterol that includes lifestyle modifications and potentially medication. This will vary based on factors like other medications you may be taking, your age, sex, and general health.
Here are some medications more commonly prescribed for high cholesterol:
Medications can also be used to treat contributing factors to cholesterol like triglycerides. These may be used in addition to some of the medications above.
What If Your Results Are Different Than The Reference Range
It is possible to have a result that is different than the reference range even though nothing is wrong with you. Sometimes certain factors can affect your test results, such as pregnancy, a medicine you are taking, eating right before a test, smoking, or being under stress.
When your lab numbers are lower or higher than the numbers in the reference range, further testing may be needed. Your doctor may want to repeat the test or order another test to confirm the results.
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Cholesterol: The Good And The Bad Of It
HDL High-density lipoprotein
- Makes up 20%30% of total cholesterol
- The “good” cholesterol
- Moves cholesterol from arteries to the liver.
LDL Low-density lipoprotein
- Makes up 60%70% of total cholesterol
- Main form of “bad” cholesterol
- Causes build-up of plaque inside arteries.
VLDL Very-low-density lipoprotein
- Makes up 10%15% of total cholesterol
- With LDL, the main form of “bad” cholesterol
- A precursor of LDL.
LDL cholesterol.;The LDL measurement is usually considered the most important for assessing risk and deciding on treatment. The definition of a healthy level keeps on getting lower. For people at low risk of heart disease, an LDL of less than 100 is desirable, However, people at higher risk of heart disease, an LDL of less than 70 or perhaps even lower is considered “optimal.” Some experts say that an LDL of less than 70 would be a healthy LDL goal for all of us.
Your LDL is computed by plugging the measurements for total cholesterol, HDL, and triglycerides into a: LDL = Total cholesterol HDL . LDL can also be measured directly in a non-fasting blood sample.
You have to fast for about 10 hours before the test because triglyceride levels can shoot up 20%30% after a meal, which would throw off the equation. Alcohol also causes a triglyceride surge, so you shouldn’t drink alcohol for 24 hours before a fasting cholesterol test.
The numbers to know
Another Type Of Fat Found In The Blood Mainly From The Food We Eat
Whats healthy? Less than 1.7 mmol/L ideally on a fasting sample, or less than 2.3 mmol/L on a non-fasting sample.
What should I do? Very high triglyceride levels can cause a painful condition called pancreatitis. People can have raised levels for many reasons, but the most common reasons are lifestyle-related:
- Being apple-shaped .
- Developing or having type 2 diabetes.
Excessive alcohol consumption.
You can keep your triglyceride levels low by losing weight, being more active and eating sensibly, especially by cutting back on alcohol, sugary foods and saturated fats, and eating more fruits, vegetables, pulses and wholegrains.
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Facts You Should Know About Cholesterol Tests
- Cholesterol is a naturally occurring substance in the body that is an important part of normal body function.
- Cholesterol has two main types: HDL, or good cholesterol, that protects against heart disease, stroke and peripheral vascular disease; and LD, or bad, cholesterol, which increases the risk of these conditions.
- Cholesterol tests measure total cholesterol as well as HDL and LDL levels in the blood. Triglycerides, another type of fat present in the bloodstream, may also be measured.
- Cholesterol tests are usually ordered and blood drawn in a doctor’s office. There are also home test kits available. It is important to be fasting for the tests to be accurate. Typically, a fasting test is performed first thing in the morning before the individual has eaten anything for the day. Fasting typically requires 12 hours without food. Water, plain tea or coffee are permitted, and hydration is required. No other liquids are acceptable during the fasting period. Patients cannot add sugar, artificial sweeteners, cream, or milk to drinks.
- If you take OTC, prescription, or herbal supplements discuss these with your doctor prior to the test.
- Cholesterol test results should be discussed with the health-care professional to determine if treatment of high cholesterol is necessary to decrease the risk of heart disease and stroke.
Who Should Get One How Often
Everyone should get their cholesterol checked regularly. How often depends on age and certain health risk factors.
An adult with average risk of heart disease should get their cholesterol checked every 4 to 6 years starting at age 20.
Some adults need to test their cholesterol more regularly. Those adults include the following individuals:
- those with a family history of heart disease or high cholesterol
- anyone with a previously high cholesterol test
recommend testing a childs cholesterol levels once between the ages of 9 and 11 and again between the ages of 17 and 21.
Cholesterol testing is generally avoided during puberty because hormones can alter the results of the tests.
Most of the time, cholesterol tests require fasting, which means no food or drink other than water for up to 12 hours prior to the test.
Because of this requirement, most people choose to have their cholesterol test done in the morning.
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Red Cell Distribution Width
With this test, we get an idea of the shape and size of red blood cells. In this case, width refers to a measurement of distribution, not the size of the cells. Liver disease, anemia, nutritional deficiencies, and a number of health conditions could cause high or low RDW results.
Normal range: 11% to 15%
Where Is The Cholesterol In Food From The Transformation Of Fats
But why does beef liver contain more than ten times the cholesterol that low fat milk contains?
Where is all this cholesterol in food coming from?
The thing that causes cholesterol to be present in your food is fat, the greasy, delicious thing that makes bacon, beef steak, and sausage so tempting and so terrible for your cholesterol levels.
Fat is harder for the body to process, and the body usually turns it into cholesterol to keep the bodys mechanisms greased. Just enough fat helps to oil the gears smoothly, but too much fat makes it impossible for the body to digest everything.
When the body cant digest all the unhealthy fats, it turns it into LDL cholesterol that causes the heart problems.
The unhealthy fats like trans fats and saturated fats go straight to your arteries, and you will create a lot of cholesterol by consuming these fats. Sugar can also cause cholesterol in food, as the sugar is converted by the body to fat before anything else is.
Those that eat lots of foods that are high in fat are guaranteed to be the ones that have the highest cholesterol levels, as those foods are being converted directly into cholesterol. The lipids in the fats combine with protein particles to produce lipoproteins , and thus they are turned into cholesterol by the body.
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What Are Risk Factors For High Blood Cholesterol
Lifestyle, some health conditions, and family history can raise your risk for high cholesterol. Your doctor may suggest you have your cholesterol checked more often if you have risk factors, such as the following:
- A family history of heart disease or high blood cholesterol. You are more at risk of having high cholesterol if other people in your family have it. This may be due to genetics, but it may also be that families share the same unhealthy lifestyle habits. Some people also have a genetic condition called familial hypercholesterolemia, which can cause high levels of low-density lipoprotein , or bad, cholesterol from a young age.
- Diabetes.;Type 2 diabetes raises bad cholesterol and lowers high-density lipoprotein , or good, cholesterol, raising the risk for heart disease and stroke.
- Older age.;As you age, your body cant clear cholesterol as well as it used to.
- Being male.;Men tend to have higher LDL and lower HDL cholesterol levels than women do. But after menopause , LDL cholesterol levels in women increase.4,5
- Having overweight or obesity.;Excess weight, unhealthy eating habits, and lack of physical activity can lead to high cholesterol.
- Previously having had high cholesterol.;If you have a history of high cholesterol, your doctor may want you to keep a closer watch on your cholesterol.
Your doctor may tell you not to eat or drink anything except water for 9 to 12 hours before the test.
How Can I Lower My Cholesterol
There are two main ways to lower your cholesterol:
- Heart-healthy lifestyle changes, which include:
- Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples include the Therapeutic Lifestyle Changes diet and the DASH Eating Plan.
- Weight Management. If you are overweight, losing weight can help lower your LDL cholesterol.
- Physical Activity. Everyone should get regular physical activity .
- Managing stress. Research has shown that chronic stress can sometimes raise your LDL cholesterol and lower your HDL cholesterol.
- Quitting smoking.Quitting smoking can raise your HDL cholesterol. Since HDL helps to remove LDL cholesterol from your arteries, having more HDL can help to lower your LDL cholesterol.
- Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol medicines available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you should continue with the lifestyle changes.
NIH: National Heart, Lung, and Blood Institute
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Getting The Most From Your Blood Test Results
There are quite a few more tests available, but the ones included here are among the most common.;
To get accurate readings, be sure to follow your doctors instructions in preparing for tests. You may, for example, be asked not to eat and to drink only water for anywhere from a few hours to 12 hours beforehand.
Please follow these instructions, or your results may be skewed, requiring additional tests or even unnecessary medications.
If you dont understand something in your results, remember its okay to ask questions. Doctors are busy people, but you are entitled to the information. If your doctor cant provide it, ask the nurse or physicians assistant for help.
Knowing where you stand with these important parameters is essential for being proactive and owning your own health.We hope you find this guide handy and helpful the next time your doctor orders a blood panel.
Take good care.;
Disclaimer: Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
;Feb 23, 2021Originally Published: August 20, 2012
How Is An Hdl Cholesterol Test Different From A Lipid Panel
A lipid panel always includes a measurement of HDL cholesterol, but HDL cholesterol levels can be tested without doing a full lipid panel.
A standard lipid panel measures total cholesterol, HDL cholesterol, and triglycerides. It then uses those measurements to calculate the amount of LDL cholesterol.
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How To Read Your Lipid Panel Results
Most people dont think about their cholesterol levels until a doctor orders a lipid panel for them. There are;no symptoms of having high cholesterol. Thats how you can go from living your life normally one day and having your whole world turned upside down the next. If your lipid panel results come back high, what do you do? Heck, what does these numbers even mean? And while were at it, whats a lipid anyway?
Lets take that last one first. Lipids are fat-like substances found in your blood and body tissues. You need them in order for your body to function at all. There are several types of lipids in our bodies. While they are usually used as a substitution for the word fats, the strict definition is a substance that can dissolve in alcohol, but not in water. Cholesterol and triglycerides are considered lipids, but so are fatty acids and steroids.
For a long time, cholesterol was considered just one thing. Then, it was broken down into good cholesterol, which is really HDL, which stands for High Density Lipoprotein and bad cholesterol, which is really LDL, which stands for Low Density Lipoprotein. Cholesterol as a whole is not bad. Part of why there are diets that recommend avoiding cholesterol in your foods is because our livers actually make all the cholesterol we need to build cells. So, whatever cholesterol our bodies get from food is above and beyond what we need.
What Is My Risk Of A Heart Attack If I Have High Cholesterol
High cholesterol increases your risk of a heart attack. The higher the cholesterol, the higher the risk. However, many other factors also affect your risk of a heart attack, such as smoking, diabetes, age, and high blood pressure. For more information on related risk factors, read the American Heart Association’s article Understand Your Risk for High Cholesterol.
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A More Accurate Measurement Tool
The traditional Friedewald equation estimates LDL cholesterol this way: total cholesterol minus HDL cholesterol minus triglycerides divided by five. For simplicitys sake, the formula applies a one-size-fits-all factor of five to everyone. But Johns Hopkins researchers found that this often makes LDL cholesterol appear lower than it really is for some high-risk patients. The researchers sought a more accurate formula that would take into account specific details about a persons cholesterol and triglyceride levels.
Using a database of blood lipid samples from more than 1.3 million Americansalmost 3,000 times larger than the one used to develop the Friedewald equation Johns Hopkins researchers developed a more accurate system for calculating LDL cholesterol. It can be used to make more precise decisions about treatment to prevent heart attack and stroke.
This newer LDL cholesterol formula is being adopted by U.S. laboratories as well as others around the world. The best implementation is direct coding the LDL cholesterol estimation in the lab IT system, which automates the process and saves clinicians time. The formula is also available as a mobile device app called the LDL Cholesterol Calculator. It is available on the iTunes App Store and on Google Play, for those whose lab hasnt adopted it.
Researchers hope the new formula will one day be adopted by all labs that process lipid panels, as it can improve patient care.