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Understanding Cholesterol: Diagnosis and Treatment

How Are Cholesterol Problems Diagnosed?

A blood test to determine your blood cholesterol (also called 'total cholesterol') level is now a routine part of most annual doctor’s visits.

In fact, it is now recommended that all people older than age 20 have their cholesterol checked at least every five years. In addition to checking your total cholesterol, your doctor will probably check your HDL cholesterol.

Understanding Cholesterol

Find out more about cholesterol:

Basics

Symptoms

Diagnosis and Treatment

Prevention

In most instances, your doctor will also check your LDL cholesterol, which is a better predictor of heart disease than total cholesterol.

You may need to fast overnight before getting an LDL cholesterol test. Your triglycerides are measured whenever your LDL cholesterol is checked.

Inside Your Cholesterol Numbers:

  • Total cholesterol below 200 is considered "desirable."
  • Total cholesterol levels between 200 and 239 are considered borderline-high.
  • A total level of 240 or more is high.
  • HDL levels should ideally be above 40. The American College of Cardiology recommends that women have an HDL level above 45.
  • LDL ("bad") cholesterol should ideally be below 100, but less than 130 is considered adequate for many people. However, if you have other risk factors, like diabetes or a history of heart disease, then your LDL should be below 70.
  • LDL levels between 130 and 159 are considered borderline-high risk.
  • An LDL above 160 is high and puts you at an increased risk for developing heart disease.
  • LDL greater than 190 is considered very high.
  • Your fasting triglyceride level should be below 150.
  • Optimum cholesterol levels are different for everyone, depending on how many risk factors they have for heart disease (such as smoking, diabetes, obesity, and high blood pressure). For that reason, if you need to lower your cholesterol, your doctor won’t set a specific number to use as a target level. Instead, your doctor will discuss with you lowering your LDL by a certain percentage as part of an overall approach for reducing your risk of heart disease.

 

What Are the Treatments for Cholesterol Problems?

Most doctors, nutritionists, and dieticians agree: Adopt a diet low in saturated fat, simple carbohydrates, and trans fats, increase your fiber intake, maintain a healthy weight, exercise regularly, and if you smoke -- quit.

Diet. It is recommended that people with abnormal cholesterol should reduce saturated fat intake to less than 7% of total calories, though this is difficult to achieve.

People also should be wary of trans fat found in processed foods such as chips, cookies, and some margarines. Diets high in trans fats are associated with increased risk of heart disease. Look for labels that list partially hydrogenated vegetable oil or hydrogenated vegetable oil (other names for trans fats) and avoid them.

Note that products that say "low cholesterol" or "no cholesterol" may not be that healthy because they could be loaded with saturated fats or sugar, which also impact your lipids.

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WebMD Medical Reference

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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