What Is A Cholesterol Test
A cholesterol blood test, also called a lipid panel or lipid profile,measures the amount of cholesterol and certain types of fats in your blood. The test is used to assess your risk of heart disease. A cholesterol test is often part of a routine annual physical. Its typically a test offered to adults, but children and teens can also have high cholesterol, says , the chief medical officer and cofounder of Redirect Health in Phoenix, Arizona.
A cholesterol test measures the following types of cholesterol:
- High density lipoprotein levels: This good cholesterol can lower your risk of heart attack.
- Low density lipoprotein levels: This bad cholesterol can cause plaque buildup in your arteries and blood vessels, and lead to cardiovascular disease including coronary artery disease , cerebrovascular disease, and peripheral artery disease the leading causes of heart attacks, stroke, and lower limb amputations.
- Total blood cholesterol level: This measures the total amount of cholesterol in your blood, including high-density lipoprotein and low-density lipoprotein .
- Triglyceride levels: This is another form of fat in your blood that can raise your risk of heart disease, especially in women.
Youve probably heard that high blood cholesterol is not good for your health, but its important to keep in mind that not all cholesterol is created equal.
When Should I Get A Cholesterol Test
Cholesterol testing has different uses depending on your overall health situation and can be used for screening, monitoring, or diagnosis. In general, tests to measure cholesterol typically begin as an adult, usually around 35 years old.
Screening
Health screening is a way of proactively looking for potential problems before symptoms become apparent. Cholesterol tests are often used in this way to identify people who may have an above-average risk of cardiovascular problems.
There are no consensus guidelines for when to do cholesterol screening. Based on different views of the benefits and downsides of screening, expert groups have varying recommendations for when to start screening and how frequently to do repeat tests.
In general, screening occurs less often in people who do not have risk factors for cardiovascular problems. In low-risk patients, screening with a lipid panel test may begin in their 20s, 30s, or 40s and be repeated about every five years. If results are normal, screening may continue with only measurements of total cholesterol and HDL.
People with risk factors tend to start screening at a younger age and have screening tests more frequently. Some risk factors for cardiovascular disease include:
- Being over 45 years old for men and over 50-55 for women
- High cholesterol on a previous test
- Prior cardiovascular problems
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Monitoring
Diagnosis
What Affects The Test
Many conditions can affect cholesterol and triglyceride levels, including:
- Medicines, such as diuretics, corticosteroids, male sex hormones , tranquillizers, estrogen, birth control pills, antibiotics, and niacin .
- Physical stress, such as infection, heart attack, surgery.
- Other conditions, such as hypothyroidism, diabetes, or kidney or liver disease.
- Alcohol use disorder.
- Liver disease , malnutrition, or hyperthyroidism.
- Pregnancy. Values are the highest during the third trimester and usually return to the pre-pregnancy levels after delivery of the baby.
Your doctor will talk with you about any abnormal results that may be related to your other health problems.
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When Is It Ordered
This testing may be ordered as part of an overall evaluation of cardiac risk when you have a personal or family history of early cardiovascular disease , especially when you dont have typical cardiac risk factors, such as high cholesterol, high LDL cholesterol, high triglyceride, low HDL cholesterol, smoking, obesity, inactivity, diabetes, and/or hypertension.
Your health care practitioner may order LDL-P testing, along with other lipid tests, after you have made lifestyle changes and/or been treated with lipid-lowering medications to determine whether treatment is working.
Although it is not generally recommended as a screening test, a few healthcare providers are ordering LDL-P along with a battery of other cardiac risk tests when they are attempting to determine someones overall risk of developing CVD.
How Does Cholesterol Get Distributed In The Body
Cholesterol is carried through your bloodstream by carriers made of fat and proteins called lipoproteins.
There are two types of lipoproteins:
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Who Needs A Cholesterol Test
Cholesterol tests are recommended for everyone over the age of 20, at least once every five years if normal. Screening for high cholesterol in children can also be considered. High cholesterol doesnt cause any symptoms, so it can be easy to ignore, Dr. Johnston says. Its important to get regular cholesterol screenings in order to understand your risk of heart disease and to take measures to protect your health. A blood test is the only way to determine your cholesterol levels.
Many doctors and patients prefer to have annual lab tests for cholesterol, that way if there are problems, we can address them early, Dr. Brocato says. Those at a high-risk of heart disease, or who already have heart disease may be tested more often.
There are now at-home cholesterol test kits if you cant make it to a lab. If you use an at-home cholesterol test kit, ensure that its labeled CDC Certified, which means its been approved by the Cholesterol Reference Method Laboratory Network, a group that works with the Centers for Disease Control and Prevention to ensure tests are accurate.
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Fasting And Cholesterol Tests
For many years, fasting prior to cholesterol tests was recommended in every case. However, increasingly, doctors are reconsidering this recommendation. Research suggests that food intake doesnt affect the accuracy of measurements for total cholesterol, HDL, and LDL.
That said, food before a test can elevate triglyceride levels, so accuracy there does require fasting. Prior to your test, double-check with your doctor about how best to prepare.
Cholesterol tests provide a broader glimpse of your health status. You cant really affect results without making significant, long-term dietary or lifestyle changes . As such, behaviors like steering clear of foods high in cholesterol or saturated fat within a couple of days of your lipid profile wont really affect results.
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How Is The Test Used
Low-density lipoprotein particle testing evaluates LDL particles according to their concentration in the blood. It may provide useful information for assessing your cardiac risk if you have a personal or family history of heart disease at a young age, especially if your total cholesterol and LDL cholesterol values are not significantly elevated.
While for many people, the standard LDL-C test is a good indicator of risk of cardiovascular disease , research has found that some people with healthy levels of LDL-C still have increased risk of CVD. Similarly, individuals with some chronic conditions such as diabetes may have increased risk even though their LDL-C is at a healthy level. For these populations, it has been suggested that the number of LDL particles might be an additional factor to consider when determining their CVD risk. In these cases, LDL-P testing may be used to further evaluate an individuals CVD risk.
LDL-P may also be occasionally ordered to monitor the effectiveness of treatment.
The National Lipid Association has specifically called out the terms large and fluffy LDL as potentially misleading as it should be emphasized that all LDL is able to form arterial plaques. Importantly, patients with Familial Hypercholesterolemia, who develop heart attacks at an extremely young age, have large and fluffy LDL.
How It Is Done
The health professional taking a sample of your blood will:
- Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
- Clean the needle site with alcohol.
- Put the needle into the vein. More than one needle stick may be needed.
- Attach a tube to the needle to fill it with blood.
- Remove the band from your arm when enough blood is collected.
- Put a gauze pad or cotton ball over the needle site as the needle is removed.
- Put pressure on the site and then put on a bandage.
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What Are Normal Cholesterol Levels
Cholesterol is a fat-like substance found in the cells in your body. Cholesterol is found in some foods, like meat and dairy products. Your liver is responsible for making cholesterol. Your body needs it to function properly. There are two types of cholesterol high-density lipoprotein , or good cholesterol, and low-density lipoprotein , or bad cholesterol. Too much LDL cholesterol can increase your risk of heart disease.
The total cholesterol in your body is the amount of cholesterol in your blood. It consists of both LDL and HDL cholesterol. The good cholesterol, HDL, helps remove cholesterol from your arteries. The bad cholesterol, LDL, is the main source of cholesterol buildup and blockage in your arteries. Too much LDL can put you at risk for a stroke, heart attack, or other heart problems.
Cholesterol levels vary by age, weight, and gender. As you age, your body will produce more cholesterol. As an adult, you should check your cholesterol levels every four to six years to make sure youre in a healthy range.
Can You Check Cholesterol Without A Blood Test
During a cholesterol test procedure, a blood sample will have to be taken from a vein in your arm.
To do so, a tourniquet is tied around your arm just above the elbow. A needle is then inserted into a vein in your arm near the inside of your elbow. Once the needle is positioned, a small amount of blood is withdrawn and collected in a vial or a syringe.
After the blood is collected, the needle is removed from the vein, and the tourniquet is removed from your arm. A small cotton ball is pressed over the puncture site to stop any bleeding. A Band-Aid may be placed to protect clothing should a small amount of blood leak out of the puncture site.
How long does a cholesterol take?
Having blood tests drawn takes only a few minutes.
Does a cholesterol test hurt?
Blood tests cause a minimal amount of discomfort. Some people do have anxiety about having blood drawn and it may be worse than the pain of the procedure.
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How Is A Total Cholesterol Test Different From A Lipid Panel
A total cholesterol test measures only the sum of all kinds of cholesterol. A lipid panel includes the total cholesterol measurement but also determines the levels of HDL, LDL, and triglycerides. For this reason, a lipid panel offers more detail and is more commonly used as a test for initial cholesterol screening.
What Do Cholesterol Test Numbers Mean
If you have a lipoprotein profile, it’s important to look at all the numbers from the cholesterol test, not just the total cholesterol number. That’s because LDL and HDL levels are two primary indicators of potential heart disease. Use the information below to interpret your results . This will help you get a better idea about your risk for heart disease.
Total blood cholesterol level:
- High risk: 240 mg/dL and above
- Borderline high risk: 200-239 mg/dL
- Desirable: Less than 200 mg/dL
- Borderline high risk: 150-199 mg/dL
- Normal: Less than 150 mg/dL
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Why Do I Need A Lipid Panel Blood Test
There are several reasons why you may need a lipid panel blood test. Healthcare providers use lipid panels often for screen and monitoring purposes.
If you have one or more risk factors for cardiovascular disease, your provider may suggest frequent screening through the use of a lipid panel to try to catch elevated cholesterol levels before you have symptoms. Risk factors for cardiovascular disease include:
- Being over age 45 if youre a man or you were assigned male at birth and over 50 if youre a women or you were assigned female at birth.
- Having a high cholesterol result on a previous test.
- Having diabetes or prediabetes.
- Having a first-degree relative, such as a parent or sibling, who developed heart disease at an early age .
Children can also have high cholesterol, so your child may need a lipid panel blood test. Cholesterol levels in children are linked to three factors: heredity, diet and obesity. In most cases, kids with high cholesterol have a parent who also has elevated cholesterol.
While providers mostly use lipid panels for screening or monitoring cholesterol levels, providers sometimes use them as part of the diagnostic process for certain health conditions that can affect your lipid levels, including:
If youre experiencing symptoms of any of these conditions, your provider may have you undergo a lipid panel blood test.
Do I Need To Fast For A Lipid Panel
In most cases, you need to fast for 10 to12 hours before your lipid panel blood test. Fasting means not eating or drinking anything except water. In some cases, getting a lipid panel test without fasting is possible.
In any case, its important to ask your healthcare provider in advance about whether you need to fast before the test. Always follow the instructions that your provider gives you. If your provider has instructed you to fast and you accidentally break the fast , please let your provider know because the test is not as useful without fasting.
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Preparing For A Cholesterol Test
There are a couple of things you can do before a blood test so the process is as smooth as possible:
- drink a lot of water being hydrated makes it easier to collect your blood sample and evidence shows that dehydration can affect your results
- keep warm having a hot shower or jumping on the spot for a minute makes it easier to collect a finger-prick blood sample
You might also need to fast before doing a cholesterol test.
Where To Get A Cholesterol Test
NHS cholesterol testThe NHS offers blood tests that can be done at your GPs or a local hospital. A trained nurse or doctor will take your blood, usually a venous sample.
Home cholesterol test Its possible to order a home blood test online and do it yourself. For this test, youll use a lancet to collect a finger-prick blood sample. Your results will be reviewed by a GP and are available for you to view online.
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Cholesterol Test Results Explained
Your cholesterol results will provide you with a range of figures. Its important to look at each one and not just your total cholesterol. In the UK, cholesterol and triglyceride levels are measured in millimoles per litre of blood.
The ideal ranges are:
- LDL cholesterol ideally this should be below 3 mmol/L
- HDL cholesterol ideally this should be above 0.9 mmol/L
- triglycerides ideally this should be below 1.7 mmol/L
- total cholesterol ideally this should be below 5 mmol/L
- cholesterol ratio ideally this should be below 4 mmol/L
The reference ranges for LDL particle size is are:
- less than 0.87 is ideal
- above 1.74 is high risk
- above 2.62 is very high risk
Interpreting Cholesterol Test Results
Your cholesterol results will typically be ready within a day or two. At-home cholesterol tests either offer immediate results via a monitor or come with a mailer that you use to send a blood sample to a lab in order to receive your results. Your test results will show your cholesterol levels in milligrams per deciliter of blood .
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What Are The Five Tests In A Lipid Panel
A lipid panel measures five different types of lipids from a blood sample, including:
- Total cholesterol: This is your overall cholesterol level the combination of LDL-C, VLDL-C and HDL-C.
- Low-density lipoprotein cholesterol: This is the type of cholesterol thats known as bad cholesterol. It can collect in your blood vessels and increase your risk of cardiovascular disease.
- Very low-density lipoprotein cholesterol: This is a type of cholesterol thats usually present in very low amounts when the blood sample is a fasting samples since its mostly comes from food youve recently eaten. An increase in this type of cholesterol in a fasting sample may be a sign of abnormal lipid metabolism.
- High-density lipoprotein cholesterol: This is the type of cholesterol thats known as good cholesterol. It helps decrease the buildup of LDL in your blood vessels.
- Triglycerides: This is a type of fat from the food we eat. Excess amounts of triglycerides in your blood are associated with cardiovascular disease and pancreatic inflammation.
While these are the main measurements in a standard lipid panel, some versions of the test may include other measurements.
When Should I Have A Cholesterol Check
We believe all adults should know their cholesterol numbers, no matter what your age. Even if you havent been invited for a cholesterol check its a good idea to get one anyway because its the only way to know your cholesterol numbers.
You should also be offered a free cholesterol test by the NHS if any of the following apply to you:
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You are aged 40-74
Your GP should invite you for an NHS health check once every five years from the age of 40 to 74. The NHS health check is designed to spot the early signs of heart disease, stroke, kidney disease, diabetes and dementia. Youll be weighed and measured, have a cholesterol check and a blood pressure check, and youll be asked some simple questions about your health.
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You are at high risk of heart disease
Your GP or practice nurse might also offer you a cholesterol test if you are more likely to develop heart disease. For example, if other people in your family have had it, you smoke, youre overweight, or you have high blood pressure, diabetes or certain other health problems.
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