Whats Behind The New Recommendation
This change has been coming for some time. It is driven by data from a dozen-plus studies that include more than 300,000 people whose cholesterol and other lipids were measured when they hadnt fasted. Their levels predicted cardiovascular risk, as well as, or possibly better than, fasting lipid levels.
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 Once the needle is positioned, a small amount of blood is withdrawn and collected in a vial or a syringe.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.
Ensuring Good Results For Your Next Test
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Why Are Cholesterol Tests Used
A person can have too much cholesterol in their body. Often, people with high cholesterol have no symptoms.
Cholesterol can combine with other substances in the blood and make a substance called plaque that clogs the arteries.
The higher a persons cholesterol levels, the more likely they are to have health problems related to high cholesterol, including:
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.
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When Should I Call My Doctor
If you develop new risk factors for cardiovascular disease, contact your healthcare provider. They may have you undergo a lipid panel or more frequent lipid panel screening.
A note from Cleveland Clinic
Seeing an abnormal test result can be stressful. Know that having an abnormal lipid panel result doesnt necessarily mean you need treatment. While cholesterol and triglyceride levels can play a significant role in your overall health, many other factors contribute to your risk for cardiovascular disease. Your healthcare provider will take many factors about your health and history into consideration when determining the next steps. Together you will decide on a plan that works best for you.
Last reviewed by a Cleveland Clinic medical professional on 11/09/2021.
How To Test Your Cholesterol Levels
To test your cholesterol levels, you need to collect a blood sample. The two main ways to do this are to do:
- a venous blood test a trained professional will use a needle to puncture a vein, usually in your arm, to collect a blood sample.
- a finger-prick blood test using a lancet, you can prick your own finger and collect a small blood sample.
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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
How Is Cholesterol Tested
Cholesterol is measured using a blood test. A healthcare provider will draw your blood using a needle and collect it in a vial. This typically takes place at your doctors office or at a lab where the blood is then analyzed.
The test only takes a couple of minutes and is relatively painless. However, you might have some soreness or bruising on your arm around the injection site.
Your results will likely be available in a few days or within a couple of weeks.
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How Should I Prepare For My Cholesterol Test
If you arent already taking cholesterol medications, it may not be necessary to fast.
Depending on your situation, your doctor might recommend drinking only water and avoiding food, other drinks, and certain medications in order to make sure your results are accurate.
What else should you avoid? Alcohol. Drinking within 24 hours before your test can affect your triglyceride levels.
What Can I Eat Before A Cholesterol Test
Then, are cholesterol tests affected by food eaten the day before?
Fasting for 10 to 12 hours before a cholesterol test ensures that a single food or meal does not affect the outcome of the test. However, if you ate a cheeseburger every day, that probably would affect your numbers. Cholesterol levels are affected by what you eat over time.
Also Know, can I drink coffee before a cholesterol test? Drinking a cup of black coffee before a cholesterol test might not significantly affect the test results. However, it is best to follow a doctor’s orders. If the doctor suggests fasting before a cholesterol test, then the person should fast.
In respect to this, hOW DOES NOT fasting affect your cholesterol test?
The truth is, your cholesterol can be tested without fasting. This is because your low-density lipoproteins also known as badcholesterol may be affected by what you’ve recently eaten. Your levels of triglycerides may also be affected by a recent meal.
How can I lower my cholesterol before a blood test?
How To Reduce Cholesterol Quickly
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When To Get Tested
Screening when no risk factors present: for adults, every four to six years for children, teens and young adults, once between the ages of 9 and 11 and again between ages 17 and 21
Monitoring: at regular intervals when you have risk factors, when prior results showed high risk levels, and/or to monitor effectiveness of treatment
Can You Take Medication Before A Blood Test
Again, whether you take medication or not before a blood test depends on the exact test youre having. Certain medications can affect the outcome of a test. But that might be less important than the medications continued effects. Your doctor will balance these two concerns and tell you what to do, either way.
Steroids are an excellent example. They can increase the level of cholesterol in your bloodstream. But if its important that you keep taking them, your doctor will bear that in mind. All theyll do is make a note of it when they interpret your results.
One particular gray area is if youre taking herbal remedies. Vitamins and supplements can also have unintended effects on your test, so its best that you stop taking them. If you do take supplements or medication, take it with you to your blood test. You can show it to your phlebotomist . Theyll make a note of what you take for the doctor to see.
Above all, remember the rule: dont stop taking prescribed medication unless your physician tells you. Your doctor has access to all your medical records. Plus, if theyre your family doctor, theyll be entirely familiar with any medication youre taking. If they knew that the medication was contraindicated against your blood test, they would have told you. If youre unsure, just ask.
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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.
Is There Anything Else I Should Know
Cholesterol should be measured when a person is not ill. Blood cholesterol is temporarily low during acute illness, immediately following a heart attack, or during stress . Wait at least six weeks after any illness to have cholesterol measured.
There is some debate about whether very low cholesterol is bad. Low cholesterol ) is often seen when there is an existing problem like malnutrition, liver disease, or cancer. However there is no evidence that low cholesterol causes any of these problems.
Cholesterol is typically high during pregnancy. Women should wait at least six weeks after having a baby to have cholesterol measured.
Some drugs that are known to increase cholesterol levels include anabolic steroids, beta blockers, epinephrine, oral contraceptives, and vitamin D.
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Other Risks And Follow
Your cholesterol numbers don’t determine your destiny. Remember, other things besides cholesterol can also lead to heart disease. Diabetes, smoking, high blood pressure, obesity, exercise, and genetics are important as well.
People with normal cholesterol can have heart disease people with high cholesterol can have healthy hearts. Overall, though, more people whose cholesterol levels are off will get heart disease.
Experts recommend follow-up cholesterol testing every 5 years for most people. If your lipid results aren’t what you and your doctor had hoped for, or if you have other reasons to be concerned about heart disease, you’ll need cholesterol tests more often.
American Heart Association: “How to Get Your Cholesterol Tested,” “Triglycerides,” “Triglycerides: Frequently Asked Questions,” “About Metabolic Syndrome,” âWhat Are High Blood Cholesterol and Triglycerides?â “LDL and HDL Cholesterol: Whatâs Bad and Whatâs Good?”
Kontush, A. Arteriosclerosis, Thrombosis, and Vascular Biology, 2003.
Tabas, I. Journal of Clinical Investigation, 2002.
National Heart, Lung, and Blood Institute: “High Blood Cholesterol: What You Need to Know.”
Jenkins, D. JAMA, 2003.
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.
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Getting Your Cholesterol Checked
Many people have never had their cholesterol checked, so they dont know whether they are at risk.
High cholesterol usually has no signs or symptoms.
The only way to know whether you have high cholesterol is to get your cholesterol checked. Your health care team can do a simple blood test, called a lipid profile, to measure your cholesterol levels.
Should You Fast Before A Cholesterol Test
Several years ago it was announced that there is no benefit in fasting before a cholesterol test. What ever happened as a result of that study, if anything?
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Current cholesterol testing guidelines in the United States stipulate that fasting before a cholesterol test is preferred. But repeated studies have found no clinically significant differences between results from cholesterol tests done on a full stomach and those done after fasting.
Fasting may provide a more accurate assessment of triglyceride levels, another measure of heart risk. But it doesnt matter if you eat before a cholesterol test if the main goal is to evaluate LDL and HDL cholesterol levels, said Dr. Mary Norine Walsh, the president-elect of the American College of Cardiology.
One of the barriers to getting cholesterol testing done is that patients arrive at the doctors office not fasting, and then it doesnt get done, Dr. Walsh said. She runs the test even if patients have eaten before an appointment and encourages other doctors to do the same.
Fasting is just one of those things that gets started and just carries on and on, said Dr. Borge G. Nordestgaard, the first author of the consensus document, which was . He noted that nonfasting triglycerides might be higher after someone eats fat, though not by much, and that the nonfasting sample would be more realistic, providing a better picture of what the average lipid levels in the patient are.
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What You Can Do About Abnormal Lipid Levels
Lifestyle changes are the first thing to tackle to reduce your chance of heart disease. Your doctor may also recommend that you start taking prescription drugs to help your cholesterol level.
Lifestyle habits to lower cholesterol
A cholesterol-lowering diet can bring down bad cholesterol by up to 30%. A diet low in saturated fat and simple carbohydrates and that has no more than 200 miliigrams of cholesterol daily can lower LDL cholesterol. Fiber and plant sterols help, too.
Keep these dietary tips in mind:
- Cut saturated fat to less than 7% of your total calories.
- Avoid trans fat completely. Check the ingredients label for âpartially hydrogenatedâ oils. Those are trans fats. Even if a product says “0 grams trans fat,” it can have a small amount of trans fat , and that adds up.
- Read food labels. Products that say âlow cholesterolâ or âno cholesterolâ could be too high in saturated fats or sugar.
Regular aerobic exercise can lower bad cholesterol and raise good cholesterol . If you smoke, quit.
Lifestyle changes such as diet, exercise, and weight loss are also effective ways to improve your triglyceride levels. Ask your doctor for a sensible diet that will help. If you smoke, get suggestions on ways to help you quit.
Medications and procedures
Your doctor may prescribe:
Statins available in the U.S. are:
New Guidelines Simplify Cholesterol Tests: No Fasting Needed
Im supposed to have my cholesterol checked soon. Its a simple test, but Im not looking forward to it since it requires fasting overnight. And that means making a special early-morning trip to my doctors office.
But new international guidelines say its OK even preferred to skip the overnight fast.
To learn more about this small but oh-so-useful shift, I talked with cardiologist Dr. Samia Mora. She helped write the new guidelines, which were published this week in the European Heart Journal and summarized in JAMA Internal Medicine. Mora is director of the Center for Lipid Metabolomics at Brigham and Womens Hospital and associate professor of medicine at Harvard Medical School.
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