Cholesterol, Explained Without the Jargon
Cholesterol: what it is, why it matters, and what published guidance actually asks of you.
Total cholesterol alone says little; the split between LDL and HDL, and your overall risk, is what a decision rests on.
Key takeaways
- Total cholesterol, commonly quoted desirable level: below 200 mg/dL
- LDL, commonly quoted optimal level: below 100 mg/dL
- Most useful single change: Ask for your LDL figure and your ten-year risk estimate, not just the total.
- Commonest mistake: Judging your result on total cholesterol alone.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
The short answer
Fat-like substances carried in the blood by lipoproteins, reported as several fractions.
Where it fits
This is part of Heart Health. The figures come first, because the advice only makes sense against them.
The numbers, in one place
| Measure | Figure |
|---|---|
| Total cholesterol, commonly quoted desirable level | below 200 mg/dL |
| LDL, commonly quoted optimal level | below 100 mg/dL |
| HDL, commonly quoted healthy level | 40 mg/dL or higher for men, 50 mg/dL or higher for women |
| Fasting required | usually not |
| Familial hypercholesterolemia | affects roughly 1 in 250 people |
What that means in practice
The practical version:
- Ask for your LDL figure and your ten-year risk estimate, not just the total
- Replace saturated fat with unsaturated fat rather than refined carbohydrate
- Increase soluble fiber from oats, beans and fruit
- Mention any family history of early heart disease: a father or brother before 55, or a mother or sister before 65
What gets people into trouble
Where people most often come unstuck:
- Judging your result on total cholesterol alone
- Stopping a statin without discussing it with your doctor
- Assuming diet alone can bring very high inherited levels down to normal
Related topics
- Saturated Fat: Sorting the Evidence From the Noise (Nutrition)
- Knowing Your Numbers: Sorting the Evidence From the Noise (Preventive Care)
- What the Guidance Really Says About Circulation and the Feet (Foot Health)
- The Evidence on Brain and Diet, Without the Hype (Brain Health)
Where to go next
- New to Cholesterol? Start Here
- Your Questions About Cholesterol, Answered
- Cholesterol — the reference entry
- Heart Health: The Complete Guide
- What the Guidance Really Says About Cardiovascular Risk
- Smoking and the Heart: What Published Guidance Supports
When to speak to a doctor
See your doctor if you have a family history of early heart attack or stroke, or fatty deposits around the eyes or in tendons. Call 911 for chest pain or pressure lasting more than a few minutes, pain spreading to the arm, neck or jaw, or sudden shortness of breath with sweating.
Where this comes from
- National Heart, Lung, and Blood Institute — Blood Cholesterol
- American Heart Association — What Your Cholesterol Levels Mean
- CDC — Familial Hypercholesterolemia
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
Spotted something wrong? Report an error on this page. We correct on the page and say what changed.
