Cholesterol Levels Measurement Units
Cholesterol is typically measured in milligrams per deciliter .Millimoles per liter is the standard medical unit for measuring concentrations of substances in blood. It’s used in Canada and some European countries.Various publications use either one or the other unit and it can be confusing to understand the guidelines. Our cholesterol calculator is here to help you.
Bile Acid Sequestrating Agents
These impede the reabsorption of bile acids from the terminal ileum thereby increasing the hepatic requirement for cholesterol as a precursor for the synthesis of bile acids to replenish the enterohepatic pool . The increased hepatic cholesterol requirement is partially met by increased LDL receptor expression thereby lowering circulating LDL. Even at doses insufficient to lower LDL to the extent that can be achieved by statin therapy, they are poorly tolerated, but they can decrease CVD risk . Unfortunately, they are not available in most European countries.
Recommended Normal Cholesterol Levels In The Uk
The average cholesterol level for people in the UK varies according to gender, age, and other factors out of your control. But, if youre interested in lowering cholesterol and keeping it at healthy levels, what are the figures you should be aiming for?
The NHS as a general guide recommends that total cholesterol levels should be 5mmol/L or less for healthy adults, and 4mmol/L or less for those at high risk of heart and circulatory diseases. As a guide, levels of good HDL cholesterol should be at least 1mmol/L and levels of bad LDL cholesterol should be below 3mmol/L for healthy adults, and 2mmol/L or less for those at high risk.
Your doctor may talk to you about your level of non-HDL cholesterol. This is now sometimes used as a measurement instead of LDL, and includes your LDL cholesterol and other forms of bad cholesterol.
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What Factors Affect The Blood Level Of Cholesterol
To an extent your blood cholesterol level can vary depending on your diet. However, different people who eat the same diet can have different blood cholesterol levels. In general, however, if you eat less fatty food in your diet your cholesterol level is likely to go down.
In some people a high cholesterol level is due to another condition. For example, an underactive thyroid gland, obesity, drinking a lot of alcohol and some rare kidney and liver disorders can raise the cholesterol level. Hyperlipidaemia means too much lipid in your bloodstream. See the separate leaflet called Hyperlipidaemia.
In some people a very high level of cholesterol runs in the family, due to a genetic problem with the way cholesterol is made by the cells in the body. One example is called familial hypercholesterolaemia. See the separate leaflet called Familial Hypercholesterolaemia.
High Cholesterol
Fixed risk factors – ones that you cannot change
However, if you have a fixed risk factor, you may want to make extra effort to tackle any lifestyle risk factors that can be changed. See the separate leaflet called Cardiovascular Disease .
Ways To Reduce Cholesterol Through Healthier Eating
- Replace butter on bread with sunflower or olive oil spreads.
- Reduce cooking with high level fats such as butter, lard, ghee, and goose fat. Use minimal amount of vegetable oils and spreads when cooking instead.
- Replace fatty meats, such as sausages and burgers, with lean meats, such as chicken and all kinds of fish .
- Avoid snacks such as cakes, biscuits, chocolate and;pastries, and replace with nuts , dried and fresh fruit, or hummus.
- Cut out full fat milk or cream in yoghurt, tea and coffee, soups and sauces. Replace with a lower fat option, such as skimmed milk.
- Try;to cut out cheese altogether. If you must eat cheese, ensure it’s low fat or stick to much smaller portion sizes, less often.
- Eat soups that are low in salt and made with vegetable stock and choose tomato-based sauces over creamy ones. However, also be aware of the sugar in some tomato-based sauces. High sugar content food is not good for someone with raised cholesterol.
- Avoid frying foods. Use alternative cooking methods such as grilling, slow cooking and poaching. If roasting something, ensure you use a small amount of vegetable oil, such as;olive, sunflower or rapeseed oil.
Take a look at our article on the best cholesterol-lowering foods for more information, or visit our;diet and nutrition centre for lots of dietary tips, inspiration and healthy and delicious recipesto help get you started.
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Box 2 Simon Broome Familial Hypercholesterolemia Register Diagnostic Criteria For Heterozygous Familial Hypercholesterolaemia
| Criteria | Description |
|---|---|
| A | Total cholesterol concentration > 7.5 mmol/l in adults or > 6.7 mmol/l in children aged < 16 years, or |
| Low density lipoprotein cholesterol concentration > 4.9 mmol/l in adults or > 4.0 mmol/l in children | |
| B | Tendinous xanthomata in patient or first-degree relative |
| C | DNA-based evidence of mutation in LDLR |
| D | Family history of myocardial infarction < 50 years in second-degree relative or < 60 years in first-degree relative |
| E | Family history of raised total cholesterol concentration 7.5 mmol/l in first- or second-degree relative |
| Diagnosis | |
| A + B or C constitutes a definite diagnosis of HeFH | |
| A + D or A + E constitute probable HeFH |
provides a clinically relevant classification of primary dyslipidaemias .
What If My Cholesterol Level Is Above The Recommended Level
Theres a lot that you can do with the information you receive when it comes to your cholesterol test results. In the first instance you should consult your GP or healthcare professional for advice. But to help give you more information that you might find of interest, weve put together a guide to the causes of elevated cholesterol here.
Many of these are beyond our control, but there are some steps you can take to help lower cholesterol through small changes to your diet and lifestyle. Why not try Flora ProActiv? The plant sterols in Flora ProActiv can help lower cholesterol within 2-3 weeks. There are other useful tips in Flora ProActivs 21 day cholesterol-lowering plan! *
If, as a result of finding out about your cholesterol levels, friends and family start to ask you What is normal, cholesterol-wise? or What are normal cholesterol levels? please dont keep the information to yourself! Encourage close family members to speak to their doctor about taking a cholesterol test, and help to spread awareness amongst your friends. If you want to start lowering your cholesterol today, check out and download our Cholesterol Starter Kit.;
BNF suggested references:
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Who Should Have A Cholesterol Test
Anyone can have their blood cholesterol level tested, but its particularly important for people that are over 40 years old, have high blood pressure, are overweight, or have a family history of coronary heart disease.
Adults aged between 4074 years, living in England are eligible for a free NHS Health Check which includes a blood cholesterol check. If you have a history of heart disease in the family or youre concerned you have high cholesterol, speak with your doctor who will be able to offer some advice.
Reducing Ldl Cholesterol Levels
The liver produces enough cholesterol to meet all of the bodys needs. Any cholesterol consumed in foods and drinks, known as dietary cholesterol, is excess. This extra, unnecessary cholesterol is more likely to build up in the bloodstream.
Changing the diet is the most effective way to reduce levels of unhealthy cholesterol and increase levels of healthy cholesterol.
Saturated and trans fats should account for no more than between 5 and 6 percent of a persons daily intake of calories.
If a person consumes 2,000 calories per day, they should only take in between 11 and 13 grams of saturated fat each day.
A person can also achieve and maintain healthy cholesterol levels by making changes to their lifestyle.
The following tips can help a person to reduce their levels of LDL cholesterol:
- eating fewer full-fat dairy products, such as whole milk, butter, cream, and cheeses
- eat fewer red meats, pork, lamb, and poultry with skin
- avoiding packaged, fast, and fried foods
- limiting the consumption of oils high in trans fats
- avoiding some tropical oils and butters, especially those derived from cocoa, coconuts, palm, and palm kernel
- eat fewer refined carbohydrates, such as those found in pastries, breads, crackers, and chips
- avoiding sugary foods and drinks, such as candies, chocolate bars, juices, prepared smoothies, sodas, and energy drinks
- losing weight or maintaining a healthy weight
The following activities can boost a persons levels of HDL cholesterol:
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Box 1 Familial Hypercholesterolaemia
Heterozygous familial hypercholesterolaemia :
Homozygous Familial Hypercholesterolemia :
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HoFH is rare; 1 in 500 000 to 1 in 300 000 .
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Both LDL receptor genes are mutated. LDL cholesterol is greatly increased.
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Tendon and planar xanthomata develop in young children and CVD may occur even before adolescence.
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Survival into adulthood is generally only possible if treatment with extracorporeal removal of LDL is available.
Autosomal recessive hypercholesterolemia :
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Rare, generally occurs only in people of Sardinian descent.
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Due to dysfunction of an adaptor protein required for receptor-mediated hepatic uptake of LDL.
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Finds little expression in heterozygotes, but in homozygotes is almost as severe as HoFH.
How Often Should Cholesterol Levels Be Checked
Healthy adults should have a lipid profile test every four to six years, but anyone who has a preexisting medical condition such as diabetes or heart disease, or a family history of high cholesterol, should be tested more frequently. Children and younger adults should have a lipid profile baseline established between ages 9 and 11 and again between ages 17 and 21.
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Can I Test My Own Cholesterol At Home
Its better to have your cholesterol tested by a professional because taking blood and measuring cholesterol levels is a skilled job and your results will be affected by the way you do the test. Going to a health professional means you will get an accurate reading.
We dont recommend home sampling, but if you do decide to test your cholesterol at home, follow these simple steps to take your sample safely and get a more accurate result.;;
Is There An Ldl
The European Society of Cardiology and United States National Lipid Association guidelines propose aiming for an LDL-C of 1.8 mmol/l . Findings from meta-analyses suggest that the relationship between LDL-C and CVD is likely to be curvilinear leading to the assumption that with lower LDL-C levels there should be a further reduction in CVD events .
Association between cardiovascular risk reduction and absolute reduction in low density lipoprotein cholesterol in major randomised control trials . Adapted from Soran et al. . There is a consistent reduction in cardiovascular risk of about one-fifth for every 1 mmol/l reduction in LDL-C
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Gut Health: Dr Chris George On How To Improve Microbiome
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Having high levels of cholesterol can cause several health problems. Too much cholesterol can cause blocking in blood vessels, which may cause someone to have a stroke or experience heart problems. By keeping a healthy diet and taking regular exercise, many people can lower their cholesterol if it is too high, while some may need to take medicine for the condition.
Health Impacts Of Serum Cholesterol Levels
Overall, a person with higher levels of HDL cholesterol and lower levels of LDL cholesterol will have a healthier serum cholesterol measurement.
This is because HDL cholesterol helps to reduce the presence of LDL cholesterol in the blood. It can also prevent LDL cholesterol from collecting and forming hard deposits called plaques, which stick to artery walls and reduce blood flow.
Plaques can become so large that they cause the arteries to narrow and stiffen, which can contribute to heart disease.
A significant amount of LDL cholesterol in arteries can prevent enough blood and oxygen from reaching organs and tissues, causing severe health complications.
A chunk of a plaque, known as a thrombus or blood clot, can also break off and become stuck in a narrower or restricted artery. This will make the blockage of blood more severe.
Complications associated with high serum cholesterol levels include:
- heart attack
- organ or tissue damage
Less is known about how triglycerides impact health. However, people with high levels of triglycerides tend to be at risk for similar conditions, including diabetes, high blood pressure, and heart disease.
Below is a 3-D model of high cholesterol, which is fully interactive.
Explore the model, using your mouse pad or touchscreen, to understand more about the impact of high cholesterol levels.
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Are Test Results Accurate
Cholesterol testing is widely regarded as reliable. Although no test is perfect, laboratories follow strict protocols that help standardize cholesterol tests and make their results dependable. When these procedures and pre-test instructions are followed, inaccurate results are unlikely.
Point-of-care and at-home cholesterol tests are relatively accurate but are subject to more variation than laboratory testing. If abnormal results are found on one of these tests, follow-up testing by a laboratory is commonly recommended.
Why You Should Measure Your Cholesterol
While cholesterol is essential for your health, if it gets too high it might increase your risk of heart disease putting you at risk of things like a heart attack or stroke.
There are a number of things that can raise your cholesterol to an unhealthy level:
- eating foods high in cholesterol, saturated fats, and trans fats can increase your levels
- lack of exercise
- drinking too much alcohol
- a genetic condition called familial hypercholesterolaemia
There arent any signs of high cholesterol until something goes wrong, like a heart attack. So measuring your cholesterol levels regularly is recommended.
Regular cholesterol tests are particularly important if you:
- are overweight or obese
- have a family history of high cholesterol or heart disease
- have high blood pressure, coronary artery disease, or diabetes
- are on medication for high cholesterol and need to track your levels
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What Should My Cholesterol Levels Be
Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L.
As a general guide, total cholesterol levels should be:
- 5mmol/L or less for healthy adults
- 4mmol/L or less for those at high risk
As a general guide, LDL levels should be:
- 3mmol/L or less for healthy adults
- 2mmol/L or less for those at high risk
An ideal level of HDL is above 1mmol/L. A lower level of HDL can increase your risk of heart disease.
Your ratio of total cholesterol to HDL may also be calculated. This is your total cholesterol level divided by your HDL level. Generally, this ratio should be below four, as a higher ratio increases your risk of heart disease.
Cholesterol is only one risk factor. The level at which specific treatment is required will depend on whether other risk factors, such as smoking and high blood pressure, are also present.
The Bottom Line On Cvd Risk Assessment Using Multiple Risk Factors
An article of this length does not permit full discussion of the merits or otherwise of the risk engines available, but only to correct certain misapprehensions about existing ones in a rapidly developing field. A method should be used which will have the greatest population impact . This is not solely dependent on accuracy, although it would be better if that was achieved. It is of paramount importance that a method identifies people who stand to gain most from giving up smoking and receiving statin and/or antihypertensive treatment, which is a reason for not using QRISK2. In our view, the best methods for use with British guidelines remain the modified Framingham method in the British National Formulary and the Scottish ASSIGN method . An ASSIGN score of 20 is equivalent to a CVD risk of 20% over the next 10 years and, as is the case for a similar risk estimated by the JBS modified Framingham method, is an indication for a statin if the LDL cholesterol is 2 mmol/l . There is, however, no reason in the UK not to adopt the European SCORE method. With SCORE a 5% 10-year risk of fatal CVD is an indication for statin therapy if LDL cholesterol is 2.5 mmol/l and a 10% 10-year risk of fatal CVD is an indication if LDL cholesterol is 1.8 mmol/l .
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Box 5 Severe Hypertriglyceridaemia
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Severe hypertriglyceridaemia .
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The capacity of lipoprotein lipase to clear triglyceride from the circulation is exceeded.
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Both chylomicrons and VLDL are dependent on lipoprotein lipase for removal of their triglycerides. Thus both contribute to the hypertriglyceridaemia even in the fasting state.
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Associated with acute pancreatitis, hepatosplenomegaly, lipaemia retinalis, eruptive xanthomata and a milky appearance to serum and plasma.
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It can be monogenic or polygenic.
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Rarely it is due to Familial Lipoprotein Lipase Deficiency in which mutations of both lipoprotein lipase genes severely impair triglyceride clearance. It may present in childhood.
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More commonly it occurs in adults who have genetic variants diminishing lipoprotein lipase activity less severely than in FLLD, but in combination with factors which increase triglyceride entry into the circulation or compromise lipoprotein lipase function .
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Lipodystrophy syndromes are associated with severe insulin resistance and hypertriglyceridaemia.