Do I need to fast before having my cholesterol blood test?

Most labs ask for a 9‑12‑hour fast because food, especially fatty meals, can temporarily raise triglycerides and affect calculated LDL values. Water is allowed, and some newer non‑fasting protocols focus on total cholesterol and HDL only, but ask your provider which method they use.

When are triglyceride levels a red flag, and what lifestyle changes can lower them?

Triglycerides above 200 mg/dL are considered high; above 500 mg/dL raise the risk of pancreatitis. To lower them, limit added sugars and refined carbs, reduce alcohol intake, lose excess weight (5‑10 % of body weight can help), increase omega‑3 fatty acids (fatty fish or supplements), and engage in regular aerobic exercise (150 minutes/week).

How often should I have my cholesterol checked if I have a strong family history of heart disease?

If a first‑degree relative had a heart attack before age 55 (men) or 65 (women), guidelines recommend a baseline lipid panel at age 20‑25, then every 3‑5 years if results are normal. If any abnormality (elevated LDL ≥ 130 mg/dL, low HDL, high triglycerides) appears, repeat testing annually or as directed by your clinician.

My LDL is high but my HDL is also high—does that still increase my heart‑disease risk?

Yes. LDL (“bad”) cholesterol drives plaque formation, while HDL (“good”) helps remove cholesterol. A high HDL can blunt risk somewhat, but an elevated LDL (≥ 130 mg/dL) still signals increased atherosclerotic risk. Your overall risk is best assessed with a full lipid profile, a calculated 10‑year ASCVD risk score, and consideration of blood pressure, smoking, and diabetes status.

Cholesterol Levels

A cholesterol test is a blood test that measures the amount of cholesterol and triglycerides in your blood to help assess your risk of developing heart disease.

What is a cholesterol test?

A cholesterol test is a blood test that measures the amount of cholesterol and triglycerides (a type of fat) in your blood. Cholesterol is a waxy, fat-like substance found in your blood and every cell of your body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods.

Your liver makes all the cholesterol your body needs and removes excess amounts. Cholesterol is also found in foods from animal sources, such as meat, egg yolks, poultry, and dairy products. Foods high in dietary fat can increase the cholesterol in your blood. If there's too much cholesterol in your blood, your liver can't remove it all.

There are two main types of cholesterol: LDL (low-density lipoprotein), or "bad" cholesterol, and HDL (high-density lipoprotein), or "good" cholesterol.

Too much LDL cholesterol in your blood increases your risk for coronary artery disease and other heart diseases. High LDL levels can cause the buildup of a sticky substance called plaque in your arteries. This buildup of plaque is known as atherosclerosis. Over time, plaque can narrow your arteries or fully block them. When this happens, parts of your body may not get enough blood:

If the blood flow to your heart is blocked, it can cause a heart attack.
If the blood flow to your brain is blocked, it can cause a stroke.
If the blood flow to your arms or legs is blocked, it can cause peripheral artery disease.

Other names for a cholesterol test include Lipid profile and Lipid panel.

What is it used for?

A cholesterol test gives you and your health care provider important information about your risk of developing heart disease. If your test shows you have high cholesterol, you can take steps to lower it. This may decrease your risk of developing heart problems in the future.

A cholesterol test measures your:

LDL level:LDL ("bad") cholesterol is the main source of blockages in the arteries.
HDL level:HDL ("good") cholesterol helps get rid of "bad" LDL cholesterol. A higher HDL level may help reduce your risk of heart attack or stroke.
Total cholesterol: This is a measure of the total amount of cholesterol in your blood, including HDL and LDL.
Triglyceride level: Triglycerides are a type of fat found in your blood. High levels may increase the risk of heart disease, especially in women.

There is another type of cholesterol called VLDL (very low-density lipoprotein). Some people also call VLDL a "bad" cholesterol because it contributes to the buildup of plaque in your arteries. VLDL isn't usually included in routine cholesterol tests because it's difficult to measure, but a lab can use your triglyceride level to estimate your VLDL level.

Why do I need a cholesterol test?

Your provider may order a cholesterol test as part of a routine exam. Recommendations for testing frequency include:

For people who are age 19 or younger:

The first test should be between ages 9 to 11.
Children should have the test again every 5 years.
Some children may have this test starting at age 2 if there is a family history of high cholesterol, heart attack, or stroke.

For people who are ages 20 to 65:

Younger adults should have the test every 5 years.
Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years.

For people older than 65:

They should be tested every year.

You may also have a cholesterol test more often if you are at high risk of heart problems due to family history, high blood pressure, type 2 diabetes, smoking, excess weight, lack of physical activity, or a diet high in saturated fat.

What happens during a cholesterol test?

A health care professional will take a blood sample from a vein in your arm using a small needle. You may also be able to use an at-home kit, which involves pricking your finger to collect a drop of blood. If using an at-home kit, tell your provider if your total cholesterol level is higher than 200 mg/dL.

Will I need to do anything to prepare for the test?

You may need to fast (not eat or drink) for 9 to 12 hours before your blood cholesterol test. Your provider will let you know if you need to fast and if there are any other special instructions.

What do the results mean?

Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. In general, low LDL levels and high HDL cholesterol levels are good for heart health.

Healthy Levels for Anyone Age 19 or Younger:

Total Cholesterol: Less than 170 mg/dL
Non-HDL: Less than 120 mg/dL
LDL: Less than 110 mg/dL
HDL: More than 45 mg/dL

Healthy Levels for Men Age 20 or Older:

Total Cholesterol: Less than 200 mg/dL
Non-HDL: Less than 130 mg/dL
LDL: Less than 100 mg/dL
HDL: Greater than or equal to 60 mg/dL is best; levels less than 40 mg/dL are considered low.

Healthy Levels for Women Age 20 or Older:

Total Cholesterol: Less than 200 mg/dL
Non-HDL: Less than 130 mg/dL
LDL: Less than 100 mg/dL

Is there anything else I need to know about my cholesterol levels?

You can take actions to lower your LDL levels and reduce your risk of heart disease, including:

Eat a healthy diet: Reduce or avoid foods high in saturated fat and cholesterol.
Manage your weight: Being overweight can increase your cholesterol and risk for heart disease.
Stay active: Regular physical activity may help lower LDL and raise HDL cholesterol.
Quit smoking: Smoking lowers HDL and raises LDL cholesterol.
Reduce stress: Stress may raise levels of hormones that cause your body to make more cholesterol.
Avoid drinking too much alcohol: Alcohol can raise your total cholesterol level.