Cholesterol and heart health
Total cholesterol blood test: what a high or low result means
What a total cholesterol result means, what the parts of a lipid profile show, and what to ask your doctor.
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Explain my results → Available on web, iOS & Android.What is total cholesterol?
Cholesterol is a fatty substance your body needs to build cells and make hormones. It travels in the blood attached to proteins called lipoproteins. A cholesterol test, called a lipid profile in the UK or lipid panel in the US, usually reports total cholesterol, LDL ('bad') cholesterol, HDL ('good') cholesterol, triglycerides and often non-HDL cholesterol. Doctors use these results, together with other factors such as age, blood pressure and smoking, to estimate your risk of heart attack and stroke.
Why is this test done?
- As part of an NHS Health Check or cardiovascular review, where it is plugged into a risk calculator (such as QRISK) alongside blood pressure and lifestyle factors to estimate cardiovascular risk.
- To assess your risk of heart disease and stroke
- To monitor treatment with statins or other cholesterol medicines
- If you have diabetes, kidney disease or a family history of high cholesterol
What does a high total cholesterol mean?
High cholesterol usually causes no symptoms, but over time it can build up in artery walls and raise the risk of heart attack and stroke. What matters most is your overall risk, not one number on its own.
Possible reasons include:
- Diet high in saturated fat
- Being inactive or overweight
- Inherited high cholesterol, such as familial hypercholesterolaemia
- An underactive thyroid
- Diabetes, kidney or liver conditions
- Some medicines
What does a low total cholesterol mean?
Low total cholesterol is usually not a concern. If you are not on treatment, an unexpectedly low result can occasionally reflect another condition.
Possible reasons include:
- Cholesterol-lowering medicines
- Diet and lifestyle
- Less commonly, an overactive thyroid, liver disease or malnutrition
Why we don't list a "normal range". Reference ranges differ between laboratories and can depend on your age, sex and whether you are pregnant. The range printed next to your result on your own report is the one that applies to you, so use that, and talk to your doctor about what your result means for you.
What can affect your total cholesterol result?
- Whether you fasted, which mainly affects triglycerides
- Recent illness, surgery or a heart attack
- Pregnancy
- Medicines such as statins, steroids and some contraceptives
Make sense of the whole report, not just one line
Results are easier to understand together. Patiently AI explains your report as a whole and writes personalised questions for your next appointment.
Try it with your own results → Paste, upload or photograph your results.Questions to ask your doctor
- What is my overall risk of heart disease or stroke over the next ten years?
- Which part of my cholesterol is most important to improve?
- Would lifestyle changes be enough, or should I consider a statin?
- Should my family be tested for inherited high cholesterol?
Frequently asked questions
Do I need to fast for a cholesterol test?
Often not. Many cholesterol tests are now done without fasting. Your doctor may ask you to fast if your triglycerides need to be measured accurately.
What is non-HDL cholesterol?
It is your total cholesterol minus your HDL cholesterol, so it includes all the 'bad' types. It is increasingly used to judge heart risk and treatment.
Why does my doctor talk about risk instead of my cholesterol number?
Cholesterol is one of several factors that affect heart and stroke risk. Doctors combine it with age, sex, blood pressure, smoking, diabetes and family history to decide whether treatment would help.
Can Patiently AI explain my total cholesterol result?
Yes. Paste your results, or upload a photo, PDF or Word file, and Patiently AI explains them in plain English, sticking to the numbers and ranges on your own report rather than adding its own, and suggests questions to ask your doctor. It is free, needs no account, and removes identifying details on your device first.