Understanding the Results of Your Lipid Panel

By: 
Chaitanya Mamillapalli, MD, MRCP, FAPCR
doctor holding lipid panel results

What is a lipid panel?

A lipid panel measures the level of cholesterol in the blood.

Cholesterol is an essential component of the cell and helps the cell maintain normal function. But when cholesterol is present at high levels, it can cause a buildup in blood vessels, resulting in heart disease, stroke and circulation problems in the legs.

A typical lipid panel test measures:

  1. Total cholesterol (TC)
  2. Good cholesterol called high-density lipoprotein (HDL) (20%–30% of the total cholesterol)
  3. Main form of bad cholesterol called low-density lipoprotein (LDL) (60%–70% of the total cholesterol)
  4. A form of bad cholesterol called very-low-density lipoprotein (VLDL) (10%–15% of the total cholesterol)
  5. Fatty component called triglyceride

Should I have a lipid panel test?

You should have an initial lipid panel test at the age of 20 and every 5 years thereafter. Based on your risk factors, your doctor may recommend a lipid panel test at an earlier age and more frequently monitor your levels.

How should I prepare for my lipid panel test?

When a total lipid profile is performed, usually no food or drink other than water should be consumed for 10 hours before the lab draw (fasting lipid panel). Alcohol consumption can spike triglyceride levels and should be avoided 24 hours before the lab draw. Total cholesterol testing can be done in a non-fasting state.

How do I read my cholesterol levels?

Total cholesterol

Total cholesterol includes both bad cholesterol (LDL) and good cholesterol (HDL) levels and provides a preview of the lipid panel. As it measures both bad and good cholesterol, total cholesterol by itself can be misleading and usually is not used for making treatment decisions.

Normal ranges:

  • Normal: Less than 200 mg/dl
  • Borderline High: 201–239 mg/dl
  • High: Above 240 mg/dl; levels in this range double the risk of heart disease

HDL

HDL is considered good cholesterol, and higher values protect against heart disease.

Normal ranges:

  • Acceptable: 40–59 mg/dl
  • Low: <40 mg/dl increases the risk of heart disease. A level less than 25 mg/dl doubles the risk of heart disease.

Recommended HDL levels for men are >40 mg/dl, and for women are >50 mg/dl.

Regular physical activity can increase HDL levels.

LDL

LDL is considered bad cholesterol, and a higher level can clog blood vessels and increase your risk of heart disease and stroke. Desired LDL targets are personalized based on your medical condition. Your doctor will estimate your risk of heart disease based on your risk factors and determine the target LDL goal for you.

If you are healthy with no heart disease or blood-vessel disorder or do not have conditions that predispose you to heart disease, the following normal ranges apply to you.

Normal ranges:

  • Normal: <100 mg/dl
  • Near normal: 100–129 mg/dl
  • Borderline high: 130–159 mg/dl
  • High: 160–189 mg/dl
  • Very high: above 190 mg/dl

If you have a condition that increases the risk of heart disease, the desired goal of LDL is less than 100 mg/dl. If you have a history of heart attack, stroke or blood-vessel problems, the recommended LDL is less than 70 mg/dl. Moving away from saturated fats, including unsaturated fats (such as nuts, avocados, olive oil) and increasing fiber intake in your diet can lower LDL levels.

Triglycerides

Triglycerides are the main components of natural fats and oils found in the blood and stored in fat cells.

Normal ranges:

  • Normal: Less than 150 mg/dl
  • Slightly high: 150–199 mg/dl
  • High: 200–499 mg/dl
  • Very High: Above 500 mg/dl

Moderate elevations in triglycerides can increase the risk of heart disease and very high triglyceride elevation >500 mg/dl can increase the risk of pancreatitis.

Foods with high amounts of trans and saturated fats, simple carbohydrates, concentrated sweets, excessive calorie consumption and alcohol use can increase triglyceride levels and avoiding them can lower the triglyceride values.

Total cholesterol: HDL ratio

Total cholesterol: HDL ratio is obtained by dividing total cholesterol by HDL level. This measure provides additional information regarding risk of heart disease. A high ratio indicates a greater risk. A ratio less than 4:1 is desired.

Non-HDL cholesterol

Non-HDL cholesterol is a measure of the total amount of bad cholesterol (both LDL and VLDL) in the body and is obtained by subtracting HDL cholesterol from total cholesterol. Non-HDL cholesterol less than 130 mg/dl is desired to lower the risk of heart disease.

Your doctor will personalize your lipid target goals based on your overall risk for cardiovascular disease and will determine the need for medications like statins. Get acquainted with your lipid panel results and stay engaged in the treatment of lipid problems.