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Understanding Cholesterol: Diagnosis and Treatment

If you're older than 20, you should get your cholesterol checked at least every 5 years. It's a simple blood test.

Your doctor may ask you to not eat or drink overnight before the test, so they can check your total cholesterol, your HDL (“good”) cholesterol, and your LDL ("bad”) cholesterol.

Understanding Cholesterol

Find out more about cholesterol:

Basics

Symptoms

Diagnosis and Treatment

Prevention

What the Numbers Mean

What levels to expect can vary, depending on whether you smoke, have diabetes or high blood pressure, are overweight, or are at risk for heart disease for other reasons. But here are the general guidelines:

 

Total Cholesterol Levels

Normal: Below 200

Borderline high: Between 200 and 239

High: 240 or more

 

HDL (‘Good’) Cholesterol Levels

Excellent: Above 60

Normal: Above 40

Too low: Below 40

 

LDL (‘Bad’) Cholesterol Levels

Normal: Below 130. However, if you have diabetes or a history of heart disease, normal LDL is below 70.

Borderline high: Between 130 and 159 for most people

High: Above 160

Very high: Above 190

Getting High Cholesterol Under Control

If you have high cholesterol or want to prevent it, most doctors and dietitians agree that changing your habits is your first line of defense.

That means eating a diet low in saturated fat and simple carbohydrates, avoiding trans fats, getting more fiber, keeping your weight healthy, exercising regularly, and not smoking.

Keep these tips in mind:

  • Cut saturated fat to less than 7% of your total calories.
  • Avoid trans fat completely. Check the ingredients label for "partially hydrogenated" oils. Those are trans fats. Even if a product says "0 grams trans fat," it can have a small amount of trans fat (less than half a gram per serving), and that adds up.
  • Read food labels. Products that say "low cholesterol" or "no cholesterol" could be too high in saturated fats or sugar.

Your doctor may also recommend that you start taking prescription drugs to help your cholesterol level. They include:

Statins. These are among the most widely used drugs to lower total and LDL cholesterol. Statins available in the U.S. are Altocor, Crestor, Lescol, Lipitor, Livalo, Mevacor, Pravachol, and Zocor. These drugs block the liver's ability to make cholesterol. Though they usually don't cause problems, in rare instances, they can damage the liver and muscle. Because of this, your doctor will do blood tests to check your liver function while you're taking it. There have also been reports of memory loss and a small increase in the risk of getting type 2 diabetes. The benefits may outweigh the risks, so talk with your doctor about that.

Niacin. Doctors prescribe this to help raise HDL ("good") cholesterol. To be effective, it must be taken in large doses. Unfortunately, in these amounts it often causes skin flushing and upset stomach. Newer versions of niacin made to minimize these side effects may be easier to take. Despite its effects on cholesterol levels, an important scientific study recently found that adding niacin to statin therapy did not lower the risk of future heart problems.  

Is This Normal? Get the Facts Fast!

Is Your Cholesterol Level Heart Healthy?
What is your LDL (low-density lipoprotein) level?

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or
Answer:
Desirable
0-199
Borderline
200-239
High
240+

Your level is currently

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is optimal.

Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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