Summary

Total cholesterol is the total amount of cholesterol in the blood. Cholesterol is a waxy, fat-like substance found in every cell in the body. It is used to make hormones, vitamin D, and substances that help us with food digestion.

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Overview

Total cholesterol includes several types of cholesterol, e.g. low-density lipoprotein (LDL, or “bad”) cholesterol and high-density lipoprotein (HDL, or “good”) cholesterol.
LDL cholesterol can build up in your arteries and form plaque, which can narrow and harden them. This condition is known as atherosclerosis and can lead to a heart attack or a stroke.
HDL cholesterol helps remove LDL cholesterol from the arteries and carries it back to the liver, where it is broken down and removed from the body. However, it is important to mention that the human body needs both LDL and HDL cholesterol for its proper function.

Total cholesterol can predict the risk of developing atherosclerosis. Higher LDL and lower HDL concentrations indicate a higher probability of plaque development. Atherosclerosis can lead to coronary artery disease, angina, heart attack, stroke, peripheral artery disease, and carotid artery disease.^[1,2]

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What should you know about this biomarker?

There are many resources and ways that describe the optimal levels. However, each laboratory uses different machines and protocols so the results might differ in the reference ranges or used units of measurement. 

In Macromo blood tests we use mmol/l (millimole per liter), but you may also find values in mg/dl (milligram per deciliter) on the internet.

A level of total cholesterol less than 5.0 mmol/l is optimal. Although the ratio of LDL to HDL cholesterol is important, the assessment should also include other risk factors that may be present. The elevated level is between 5.0 mmol/l and 5.75 mmol/l, and the high level is 5.75 mmol/l and above. Your total cholesterol level reflects your risk for heart disease. In general, the higher the level, the higher your risk.^[2,3]

Your blood test outcome can be classified into one of the potential categories: 

• If your total cholesterol is lower, it is usually nothing to be concerned about. However, if you don't feel well or you have any doubts, consult your doctor for any necessary follow-up.
• If your total cholesterol is within the reference range, that is a good sign.
• If your total cholesterol level is higher than the optimum, it's important to find the underlying cause. Consulting your doctor or a dietitian could be beneficial for personalized advice and potential medication.

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Genetics

In most of the population, there is no single gene that would be responsible for high cholesterol as we know it. But still, genetics is important, it influences the conditions causing the increase of cholesterol levels, such as obesity, overeating, or diabetes. 

In a smaller number of cases, high cholesterol can actually be a result of familial hypercholesterolemia (FH). It is the world’s most common autosomal dominant genetic disease leading to an extreme increase in LDL values, causing the development of heart disease at a very young age. FH is caused by genetic changes in the LDL receptor gene (LDLR), which encodes a protein that removes LDL cholesterol from the bloodstream.^[4]

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Recommendations

If your total cholesterol result is outside the optimal range, it is important to consider some steps to protect your health^[5]:

• Choose foods that are good for your overall health, such as fruits, vegetables, whole grains, lean protein, and healthy fats. Eat a balanced diet that is low in fat, sugar, and salt, and high in fiber, vitamins, and antioxidants. 
• Increase your physical activity, which has a great impact on your overall health status. Exercise can help you lose weight, improve your metabolism, and reduce inflammation in the body.
• Take medication if prescribed by your doctor and don't skip regular checkups, as they're a great tool to keep your health monitored.
• Try to take steps to manage your stress levels, as stress can worsen the defense mechanisms of the body.
• Quit smoking if you are a smoker. It can raise the levels of HDL cholesterol, which helps to remove LDL cholesterol from your arteries.

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The information and tests provided on our website are for educational purposes only and are not a substitute for professional medical advice. Always consult with your healthcare provider before making health decisions. Our tests do not diagnose or treat diseases. Individual results may vary and should be discussed with a healthcare provider.