Cholesterol - When to Get Tested and How to Read a Test

In order to transport cholesterol through the blood vessels, the body uses special proteins called lipoproteins. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are the two main ones, and they impact our health differently:

• LDL (also known as “bad” cholesterol) carries cholesterol from the liver to the cells. LDL is often called “bad” because high levels of it build up in the blood vessels and raise the risk of cardiovascular disease.
• HDL (also known as “good” cholesterol) takes the cholesterol back to the liver. The liver helps remove cholesterol from the body, so it reduces one’s risk of cardiovascular issues.

Overall, cholesterol isn’t harmful, but a sedentary lifestyle and overeating made it so that it is. It’s really a “too much of a good thing” scenario exemplified. When cholesterol levels are high, this raises your risk of atherosclerosis, stroke, heart attack, and other cardiovascular issues.

As Dr. Robert Greenfield explained in an article for Medical News Today, “Our bodies weren’t designed to live in an environment where food was in excess, and so when cholesterol is in excess, it will be deposited in our body. And that deposit center can often be our blood vessels, and that’s when it’s bad for us.”

The CDC also recommends that children and adolescents have their cholesterol levels checked once in the age range of 9-11 years, and once again between 17-21 years old.

Your family physician will help you estimate when and how often you need to get the cholesterol test done. The test itself is simple: you go to your physician and ask them to order a lipid panel (also known as a complete cholesterol test or lipid profile). 

This is a blood test that measures the amount of cholesterol and triglycerides in your blood according to Mayo Clinic. The physician will refer you to get the blood test done, and once you complete it, all you have to do is wait for the results.

Cholesterol levels are measured in milligrams per deciliter (mg/dL). Depending on your age, the normal range changes. For different ages, healthy cholesterol levels are as follows:

• Everyone 19 years or younger: total cholesterol below 170 mg/dL, LDL - below 100 mg/dL, HDL - above 45 mg/dL.
• Men 20 or older: total cholesterol - 125-200 mg/dL, LDL - below 100 mg/dL, HDL - 40 mg/dL or higher.
• Women 20 or older: total cholesterol - 125-200 mg/dL, LDL - below 100 mg/dL, HDL - 50 mg/dL or higher.

Furthermore, the American Heart Association and the American College of Cardiology also suggest that LDL levels of 100 mg/dL or less are optimal. People whose cholesterol levels are in this range have lower rates of heart disease and stroke.

Some tests will also show you the levels of Very Low-Density Lipoprotein (VLDL) - one of the most dangerous types of blood lipids. Not all tests contain VLDL levels, as this measure is merely calculated by assuming that VLDL levels make up 20% of triglyceride levels. Another reason why it may be omitted is that this measurement is NOT taken into account in the treatment of elevated cholesterol.

We already discussed the repercussions of high cholesterol, but is having low levels of this waxy substance good or bad? To answer briefly, one’s total cholesterol level can never be too low. But once you distinguish between LDL and HDL cholesterol, the picture becomes more nuanced.

Low HDL Cholesterol Levels

When the HDL levels drop below 40 mg/dL in men and 50 mg/dL in women, the risk of atherosclerosis (hardening of the arteries), heart attack, and stroke climb astronomically. That’s because HDL cholesterol is an antioxidant responsible for clearing the other, bad kind of cholesterol from the body and preventing clogged arteries.

A diet high in carbohydrates can also lower one’s HDL levels while raising LDL and triglycerides by 30-40% according to previous studies. Certain medications, health conditions (kidney disease, metabolic syndrome, liver disease, diabetes), as well as smoking, and undereating can also lead to a reduction in HDL levels.

Low HDL Cholesterol Levels

Counterintuitively, critically low LDL levels may not be the best outcome either. We need LDL cholesterol to build cells, make hormones (including estrogen, progesterone, and testosterone), and keep the brain healthy. So, eliminating it from the body completely isn’t a good idea.

In most cases, low LDL levels are a sign of either mismatched cholesterol-lowering medication or serious underlying health conditions, such as cancer, liver disease, and severe malnutrition.

That being said, having LDL levels so low that this becomes a problem - below 25 mg/dL - is incredibly rare. Such negative outcomes have mainly been observed in pregnancy, causing hormonal imbalances that could harm the baby.

How to Deal with High Cholesterol

Unless you suffer from an underlying genetic or acquired condition that specifically causes elevated cholesterol levels, this blood measurement is within your control. You can lower your cholesterol levels by tweaking your lifestyle. The CDC recommends the following lifestyle changes to manage your cholesterol:

• Eliminate foods high in trans fats, and lower your intake of saturated fats, salt, and sugar. Instead, switch your focus to foods high in fiber, healthy fats, and fresh fruit and vegetables. 
• Moderate exercise for at least 150 minutes. This can include cycling, swimming, or even brisk walking.
• Consider quitting smoking if you do. Smoking damages blood vessels.

Related Article: Reduce Your Cholesterol Quickly with These 11 Tips

You may also consider vitamin supplementation to help normalize your LDL and HDL levels. Some people take vitamin E and vitamin A for their cholesterol. It’s best to discuss with your physician if this approach is right for you. Your doctor will also help you get that cholesterol down with medication if the lifestyle changes aren’t helping.