Total Cholesterol
Total Cholesterol
Total cholesterol is a measure of all cholesterol types in your blood.
Total cholesterol is a measure of all cholesterol types in your blood.
Total Cholesterol
Normal range
Normal range
<5 mmol/L
<5 mmol/L
Normal range
<5 mmol/L
<5 mmol/L
Normal range
Total Cholesterol
Total Cholesterol
Total cholesterol is a measure of all cholesterol types in your blood.
Total Cholesterol
Normal range
<5 mmol/L
Normal range
<5 mmol/L
<5 mmol/L
Normal range
Total Cholesterol
Total Cholesterol
Total cholesterol is a measure of all cholesterol types in your blood.
Total Cholesterol
Normal range
<5 mmol/L
Normal range
<5 mmol/L
<5 mmol/L
Normal range
Total Cholesterol
Dr. Yiannis Balanos
MBBS MRCGP
The Heart Health Indicator
The Heart Health Indicator
Total cholesterol is calculated from all the cholesterol fats circulating in your bloodstream—the "good" HDL cholesterol that protects your arteries, the "bad" LDL cholesterol that can clog them, and triglycerides, the circulating fat used for energy. Whilst cholesterol is essential for hormone production, cell membrane function, and vitamin D synthesis, elevated levels in your blood increase your risk of heart disease and stroke.
Total cholesterol is calculated from all the cholesterol fats circulating in your bloodstream—the "good" HDL cholesterol that protects your arteries, the "bad" LDL cholesterol that can clog them, and triglycerides, the circulating fat used for energy. Whilst cholesterol is essential for hormone production, cell membrane function, and vitamin D synthesis, elevated levels in your blood increase your risk of heart disease and stroke.
When Cholesterol Levels Become Dangerous
When Cholesterol Levels Become Dangerous
When Cholesterol Levels Become Dangerous
Discover why high cholesterol is called a "silent" risk factor and how it quietly threatens your cardiovascular health.
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What Influences Your Cholesterol Levels
What Influences Your Cholesterol Levels
What Influences Your Cholesterol Levels
From genetics to lifestyle choices, learn the surprising factors that can dramatically affect your cholesterol balance.
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Managing Your Cholesterol Levels
Managing Your Cholesterol Levels
Managing Your Cholesterol Levels
Evidence-based strategies and treatments that can protect your heart and reduce your cardiovascular risk.
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Understanding Your Results
Understanding Your Results
Understanding Your Results
Decode your lipid profile numbers and know exactly what your cholesterol levels mean for your health.
Read more
When Cholesterol Levels Become Dangerous
Normal total cholesterol levels indicate a healthy balance that supports your body's functions without overwhelming your cardiovascular system. Your liver produces about 75% of your cholesterol naturally, whilst the remaining 25% comes from your diet.
At healthy levels, cholesterol helps build strong cell membranes, produces important hormones like testosterone and oestrogen, and aids in digestion through bile acid production.
When Cholesterol Becomes Too High
High total cholesterol means there's too much cholesterol circulating in your bloodstream. Over time, excess cholesterol can build up in your artery walls, forming plaques that narrow blood vessels and restrict blood flow to your heart and brain.
High cholesterol rarely causes noticeable symptoms, which is why it's often called a "silent" risk factor. You might feel completely normal whilst cholesterol quietly increases your risk of heart attack, stroke, and peripheral artery disease. The concern lies in the gradual process: as cholesterol deposits accumulate in arteries, they can eventually cause blockages, resulting in clots that block blood flow entirely. This is how most heart attacks and strokes occur.
When Cholesterol Levels Become Dangerous
Normal total cholesterol levels indicate a healthy balance that supports your body's functions without overwhelming your cardiovascular system. Your liver produces about 75% of your cholesterol naturally, whilst the remaining 25% comes from your diet.
At healthy levels, cholesterol helps build strong cell membranes, produces important hormones like testosterone and oestrogen, and aids in digestion through bile acid production.
When Cholesterol Becomes Too High
High total cholesterol means there's too much cholesterol circulating in your bloodstream. Over time, excess cholesterol can build up in your artery walls, forming plaques that narrow blood vessels and restrict blood flow to your heart and brain.
High cholesterol rarely causes noticeable symptoms, which is why it's often called a "silent" risk factor. You might feel completely normal whilst cholesterol quietly increases your risk of heart attack, stroke, and peripheral artery disease. The concern lies in the gradual process: as cholesterol deposits accumulate in arteries, they can eventually cause blockages, resulting in clots that block blood flow entirely. This is how most heart attacks and strokes occur.
When Cholesterol Levels Become Dangerous
Normal total cholesterol levels indicate a healthy balance that supports your body's functions without overwhelming your cardiovascular system. Your liver produces about 75% of your cholesterol naturally, whilst the remaining 25% comes from your diet.
At healthy levels, cholesterol helps build strong cell membranes, produces important hormones like testosterone and oestrogen, and aids in digestion through bile acid production.
When Cholesterol Becomes Too High
High total cholesterol means there's too much cholesterol circulating in your bloodstream. Over time, excess cholesterol can build up in your artery walls, forming plaques that narrow blood vessels and restrict blood flow to your heart and brain.
High cholesterol rarely causes noticeable symptoms, which is why it's often called a "silent" risk factor. You might feel completely normal whilst cholesterol quietly increases your risk of heart attack, stroke, and peripheral artery disease. The concern lies in the gradual process: as cholesterol deposits accumulate in arteries, they can eventually cause blockages, resulting in clots that block blood flow entirely. This is how most heart attacks and strokes occur.
What Influences Your Cholesterol Levels
Common Causes of High Cholesterol: High cholesterol commonly results from diets high in saturated and trans fats, excess body weight, lack of physical activity, smoking, genetics, diabetes, hypothyroidism, or certain medications. Specific dietary contributions include meat products, full-fat dairy products, processed foods, and foods containing partially hydrogenated oils.
The Genetic Factor: Genetic factors play a significant role in cholesterol levels. Familial hypercholesterolaemia (FH) is an inherited condition affecting about 1 in 250 people, where the body builds up more LDL cholesterol (the ‘bad’ cholesterol) than ideal. People with FH often have very high cholesterol levels from birth, regardless of diet or lifestyle. This condition significantly increases the risk of early heart disease, sometimes affecting people in their 30s and 40s.
Other genetic variations can also influence how your body produces, processes, and clears cholesterol. This is why some people can eat a healthy diet and exercise regularly but still have high cholesterol, whilst others with poor lifestyle habits maintain normal levels. A strong family history of high cholesterol or early heart disease often indicates a genetic component that may require more intensive monitoring and treatment.
Factors That Help Lower Cholesterol: Protective factors include diets rich in soluble fibre (oats, beans, fruits, vegetables), regular physical activity, maintaining healthy weight, omega-3 fatty acids, plant sterols and stanols, limiting saturated fats, and moderating alcohol consumption if you drink.
What Influences Your Cholesterol Levels
Common Causes of High Cholesterol: High cholesterol commonly results from diets high in saturated and trans fats, excess body weight, lack of physical activity, smoking, genetics, diabetes, hypothyroidism, or certain medications. Specific dietary contributions include meat products, full-fat dairy products, processed foods, and foods containing partially hydrogenated oils.
The Genetic Factor: Genetic factors play a significant role in cholesterol levels. Familial hypercholesterolaemia (FH) is an inherited condition affecting about 1 in 250 people, where the body builds up more LDL cholesterol (the ‘bad’ cholesterol) than ideal. People with FH often have very high cholesterol levels from birth, regardless of diet or lifestyle. This condition significantly increases the risk of early heart disease, sometimes affecting people in their 30s and 40s.
Other genetic variations can also influence how your body produces, processes, and clears cholesterol. This is why some people can eat a healthy diet and exercise regularly but still have high cholesterol, whilst others with poor lifestyle habits maintain normal levels. A strong family history of high cholesterol or early heart disease often indicates a genetic component that may require more intensive monitoring and treatment.
Factors That Help Lower Cholesterol: Protective factors include diets rich in soluble fibre (oats, beans, fruits, vegetables), regular physical activity, maintaining healthy weight, omega-3 fatty acids, plant sterols and stanols, limiting saturated fats, and moderating alcohol consumption if you drink.
What Influences Your Cholesterol Levels
Common Causes of High Cholesterol: High cholesterol commonly results from diets high in saturated and trans fats, excess body weight, lack of physical activity, smoking, genetics, diabetes, hypothyroidism, or certain medications. Specific dietary contributions include meat products, full-fat dairy products, processed foods, and foods containing partially hydrogenated oils.
The Genetic Factor: Genetic factors play a significant role in cholesterol levels. Familial hypercholesterolaemia (FH) is an inherited condition affecting about 1 in 250 people, where the body builds up more LDL cholesterol (the ‘bad’ cholesterol) than ideal. People with FH often have very high cholesterol levels from birth, regardless of diet or lifestyle. This condition significantly increases the risk of early heart disease, sometimes affecting people in their 30s and 40s.
Other genetic variations can also influence how your body produces, processes, and clears cholesterol. This is why some people can eat a healthy diet and exercise regularly but still have high cholesterol, whilst others with poor lifestyle habits maintain normal levels. A strong family history of high cholesterol or early heart disease often indicates a genetic component that may require more intensive monitoring and treatment.
Factors That Help Lower Cholesterol: Protective factors include diets rich in soluble fibre (oats, beans, fruits, vegetables), regular physical activity, maintaining healthy weight, omega-3 fatty acids, plant sterols and stanols, limiting saturated fats, and moderating alcohol consumption if you drink.
Managing Your Total Cholesterol
Lifestyle Modifications: The most effective approach starts with a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Focus on soluble fibre from oats, beans, apples, and barley to help lower cholesterol naturally. Choose healthy unsaturated fats from olive oil, nuts, and avocados, and aim for fatty fish like salmon, mackerel, or sardines twice weekly.
Limit saturated fats to less than 7% of your daily calories and eliminate trans fats completely. Maintain a healthy weight through balanced nutrition and regular exercise—aim for at least 150 minutes of moderate activity weekly. If you smoke, quitting will significantly improve your cholesterol profile, and limiting alcohol consumption also helps.
Medical Treatment: Your doctor may recommend cholesterol-lowering medications like statins if lifestyle changes aren't sufficient, particularly if you have a genetic predisposition or very high levels. These medications work alongside lifestyle modifications to achieve target cholesterol levels and reduce cardiovascular risk.
Managing Your Total Cholesterol
Lifestyle Modifications: The most effective approach starts with a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Focus on soluble fibre from oats, beans, apples, and barley to help lower cholesterol naturally. Choose healthy unsaturated fats from olive oil, nuts, and avocados, and aim for fatty fish like salmon, mackerel, or sardines twice weekly.
Limit saturated fats to less than 7% of your daily calories and eliminate trans fats completely. Maintain a healthy weight through balanced nutrition and regular exercise—aim for at least 150 minutes of moderate activity weekly. If you smoke, quitting will significantly improve your cholesterol profile, and limiting alcohol consumption also helps.
Medical Treatment: Your doctor may recommend cholesterol-lowering medications like statins if lifestyle changes aren't sufficient, particularly if you have a genetic predisposition or very high levels. These medications work alongside lifestyle modifications to achieve target cholesterol levels and reduce cardiovascular risk.
Managing Your Total Cholesterol
Lifestyle Modifications: The most effective approach starts with a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Focus on soluble fibre from oats, beans, apples, and barley to help lower cholesterol naturally. Choose healthy unsaturated fats from olive oil, nuts, and avocados, and aim for fatty fish like salmon, mackerel, or sardines twice weekly.
Limit saturated fats to less than 7% of your daily calories and eliminate trans fats completely. Maintain a healthy weight through balanced nutrition and regular exercise—aim for at least 150 minutes of moderate activity weekly. If you smoke, quitting will significantly improve your cholesterol profile, and limiting alcohol consumption also helps.
Medical Treatment: Your doctor may recommend cholesterol-lowering medications like statins if lifestyle changes aren't sufficient, particularly if you have a genetic predisposition or very high levels. These medications work alongside lifestyle modifications to achieve target cholesterol levels and reduce cardiovascular risk.
Understanding Your Results
Total cholesterol levels are measured in millimoles per litre (mmol/L):
Normal: <5.0 mmol/L
High: 5.0-7.5 mmol/L
Very high: Above 7.5 mmol/L
Total cholesterol should be evaluated alongside HDL cholesterol, LDL cholesterol, and triglycerides for a complete cardiovascular risk assessment. The ratio between different cholesterol types is often more important than total cholesterol alone.
People who already have a great diet, exercise regularly, and have a healthy weight can still have a high baseline cholesterol level - but likely still lower from what they would be if they weren’t having good lifestyle habits. Genetic factors usually play a role in these cases, and it is helpful to track changes over time to appreciate the impact of lifestyle changes on cholesterol levels.
Understanding Your Results
Total cholesterol levels are measured in millimoles per litre (mmol/L):
Normal: <5.0 mmol/L
High: 5.0-7.5 mmol/L
Very high: Above 7.5 mmol/L
Total cholesterol should be evaluated alongside HDL cholesterol, LDL cholesterol, and triglycerides for a complete cardiovascular risk assessment. The ratio between different cholesterol types is often more important than total cholesterol alone.
People who already have a great diet, exercise regularly, and have a healthy weight can still have a high baseline cholesterol level - but likely still lower from what they would be if they weren’t having good lifestyle habits. Genetic factors usually play a role in these cases, and it is helpful to track changes over time to appreciate the impact of lifestyle changes on cholesterol levels.
Understanding Your Results
Total cholesterol levels are measured in millimoles per litre (mmol/L):
Normal: <5.0 mmol/L
High: 5.0-7.5 mmol/L
Very high: Above 7.5 mmol/L
Total cholesterol should be evaluated alongside HDL cholesterol, LDL cholesterol, and triglycerides for a complete cardiovascular risk assessment. The ratio between different cholesterol types is often more important than total cholesterol alone.
People who already have a great diet, exercise regularly, and have a healthy weight can still have a high baseline cholesterol level - but likely still lower from what they would be if they weren’t having good lifestyle habits. Genetic factors usually play a role in these cases, and it is helpful to track changes over time to appreciate the impact of lifestyle changes on cholesterol levels.
The Takeaway
Total cholesterol is a key indicator of cardiovascular health. High levels can increase your risk of heart disease and stroke over time, particularly in older adults and those with additional risk factors such as family history, diabetes, or high blood pressure.
Most people can improve their cholesterol through lifestyle changes—healthy eating, regular exercise, weight management, and not smoking. Some individuals with genetic predisposition or very high levels may need medication alongside lifestyle modifications. Regular monitoring through blood tests helps track your cholesterol levels, helps you match your lifestyle changes and their corresponding impact on cholesterol profile, and better understand your ‘unique cholesterol biology’.
The Takeaway
Total cholesterol is a key indicator of cardiovascular health. High levels can increase your risk of heart disease and stroke over time, particularly in older adults and those with additional risk factors such as family history, diabetes, or high blood pressure.
Most people can improve their cholesterol through lifestyle changes—healthy eating, regular exercise, weight management, and not smoking. Some individuals with genetic predisposition or very high levels may need medication alongside lifestyle modifications. Regular monitoring through blood tests helps track your cholesterol levels, helps you match your lifestyle changes and their corresponding impact on cholesterol profile, and better understand your ‘unique cholesterol biology’.
The Takeaway
Total cholesterol is a key indicator of cardiovascular health. High levels can increase your risk of heart disease and stroke over time, particularly in older adults and those with additional risk factors such as family history, diabetes, or high blood pressure.
Most people can improve their cholesterol through lifestyle changes—healthy eating, regular exercise, weight management, and not smoking. Some individuals with genetic predisposition or very high levels may need medication alongside lifestyle modifications. Regular monitoring through blood tests helps track your cholesterol levels, helps you match your lifestyle changes and their corresponding impact on cholesterol profile, and better understand your ‘unique cholesterol biology’.
References
British Heart Foundation. (2023). Cholesterol and heart disease: Understanding the risk factors and management strategies.
National Institute for Health and Care Excellence. (2023). Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline [CG181].
Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 Guideline on the Management of Blood Cholesterol. Circulation, 139(25), e1082-e1143.
Nordestgaard, B. G., Chapman, M. J., Humphries, S. E., et al. (2013). Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population. European Heart Journal, 34(45), 3478-3490.
References
British Heart Foundation. (2023). Cholesterol and heart disease: Understanding the risk factors and management strategies.
National Institute for Health and Care Excellence. (2023). Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline [CG181].
Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 Guideline on the Management of Blood Cholesterol. Circulation, 139(25), e1082-e1143.
Nordestgaard, B. G., Chapman, M. J., Humphries, S. E., et al. (2013). Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population. European Heart Journal, 34(45), 3478-3490.
References
British Heart Foundation. (2023). Cholesterol and heart disease: Understanding the risk factors and management strategies.
National Institute for Health and Care Excellence. (2023). Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline [CG181].
Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 Guideline on the Management of Blood Cholesterol. Circulation, 139(25), e1082-e1143.
Nordestgaard, B. G., Chapman, M. J., Humphries, S. E., et al. (2013). Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population. European Heart Journal, 34(45), 3478-3490.
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