Cholesterol levels – LDL, HDL, Triglyceride, Total Cholesterol, VLDL, Ratio

Keeping your cholesterol levels healthy is a great way to keep your heart healthy – and lower your chances of getting heart disease or having a stroke. Cholesterol can be tricky to understand, though, because not all is bad for you. Some is actually good for you. The most important thing you can do as a first step is to know your cholesterol numbers by getting your cholesterol tested.

Here are some easy ways for you to understand what the testing involves, how it can help you and ways to improve your health by improving your cholesterol.

All adults age 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides — once every five years.   This test is done after a nine- to 12-hour fast without food, liquids or pills. It gives information about total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides.

1. Total Cholesterol:

Total Cholesterol LevelCategory
Less than 200 mg/dLDesirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dLBorderline high
240 mg/dL and aboveHigh blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.


2. HDL

HDL Cholesterol LevelCategory
Less than 40 mg/dL
(for men)
Less than 50 mg/dL
(for women)
Low HDL cholesterol. A major risk factor for heart disease.
60 mg/dL and aboveHigh HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease.

With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol (less than 40 mg/dL for men, less than 50 mg/dL for women) puts you at higher risk for heart disease. In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease. The mean level of HDL cholesterol for American adults age 20 and older is 54.3 mg/dL.

Smoking, being overweight and being sedentary can all result in lower HDL cholesterol. To raise your HDL level, avoid tobacco smoke, maintain a healthy weight and get at least 30-60 minutes of physical activity more days than not.

People with high blood triglycerides usually also have lower HDL cholesterol and a higher risk of heart attack and stroke. Progesterone, anabolic steroids and male sex hormones (testosterone) also lower HDL cholesterol levels. Female sex hormones raise HDL cholesterol levels.

3. LDL

LDL Cholesterol LevelCategory
Less than 100 mg/dLOptimal
100 to 129 mg/dLNear or above optimal
130 to 159 mg/dLBorderline high
160 to 189 mg/dLHigh
190 mg/dL and aboveVery high

Your other risk factors for heart disease and stroke help determine what your LDL level should be, as well as the appropriate treatment for you. A healthy level for you may not be healthy for your friend or neighbor. Discuss your levels and your treatment options with your doctor to get the plan that works for you. The mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.

4. Triglyceride

Triglyceride is the most common type of fat in the body. Many people who have heart disease or diabetes have high triglyceride levels. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls). Atherosclerosis increases the risk for heart attack and stroke.

Triglyceride LevelCategory
Less than 100 mg/dLOptimal
Less than 150 mg/dLNormal
150–199 mg/dLBorderline high
200–499 mg/dLHigh
500 mg/dL and aboveVery high

Many people have high triglyceride levels due to being overweight/obese, physical inactivity, cigarette smoking, excess alcohol consumption and/or a diet very high in carbohydrates (60 percent or more of calories). High triglycerides are a lifestyle-related risk factor; however, underlying diseases or genetic disorders can be the cause. The mean level of triglycerides for American adults age 20 and older is 144.2 mg/dl. People with high triglycerides should substitute monounsaturated and polyunsaturated fats —such as those found in canola oil, olive oil or liquid margarine —for saturated fats, limit added sugars, eat complex carbohydates and reduce fructose intake.

The main therapy to reduce triglyceride levels is to change your lifestyle. This means control your weight, eat a heart-healthy diet, get regular physical activity, avoid tobacco smoke, limit alcohol to one drink per day for women or two drinks per day for men and limit beverages and foods with added sugars. Visit your healthcare provider to create an action plan that will incorporate all these lifestyle changes. Sometimes, medication is needed in addition to a healthy diet and lifestyle.

A triglyceride level of 150 mg/dL or higher is one of the risk factors of metabolic syndrome. Metabolic syndrome increases the risk for heart disease and other disorders, including diabetes.


VLDL (very low density lipoprotein) transports cholesterol and triglycerides within the body. It is made in the liver in response to a high-carbohydrate meal. Conditions known to increase levels include diabetes, obesity, and acute hepatitis. It is thought to play a role in atherosclerosis as well. Lifestyle changes and medications are often successful in reducing levels in the blood.

An elevated level of VLDL cholesterol (>30 mg/dL or >0.77 mmol/L), like elevated LDL cholesterol, is considered a risk factor for heart disease and stroke. The presence of high VLDL in addition to high LDL may affect the choice of therapy used to lower cholesterol.

Since high triglycerides and high VLDL cholesterol are often associated with such conditions as diabetes, alcohol consumption, overweight and obesity, these may be lowered by lifestyle changes as well as drug treatment aimed at lowering triglyceride and cholesterol levels.

Low levels of VLDL cholesterol are not generally a concern.

6. Direct LDL Cholesterol

Direct LDL-C is ordered whenever calculation of LDL cholesterol will not be accurate because the person’s triglycerides are significantly elevated. It may be ordered by a doctor when prior test results have indicated high triglycerides. In some laboratories, this direct LDL test will automatically be performed when the triglyceride levels are too high to calculate LDL-C. This saves the doctor time by not needing to order another test, saves the patient time by not needing to have a second blood sample drawn, and speeds up the time to provide the test result.

Elevated levels of LDL, as measured with the direct LDL-C test, indicate a greater risk of developing heart disease. Decreasing levels show a response to lipid-lowering lifestyle changes and/or drug therapies and indicate a decreased risk of heart disease.

Low levels of LDL are not generally a concern and are not monitored. They may be seen in people with an inherited lipoprotein deficiency and in those with hyperthyroidism, infection, and inflammation.

7. Cholesterol Ratios

Some lipid panel results will include ratios, such as the total cholesterol to HDL cholesterol ratio (total/HDL) and the low density lipoprotein/high density lipoprotein (LDL/HDL) ratio. These ratios may provide useful information on gauging a person’s health. However, researchers and doctors are divided on the effectiveness of using these ratios for predicting the chances of developing heart disease.

a. Total/HDL ratio

b. LDL/HDL ratio

c. HDL/LDL ratio

a. Total Cholesterol/HDL Cholesterol

Total cholesterol to HDL ratios (or total/HDL ratios) are determined by dividing the HDL cholesterol into the total cholesterol. If a person has a total cholesterol of 200 mg/dL and an HDL cholesterol of 40 mg/dL, his or her total/HDL ratio would be 5:1. The goal is to keep these ratios of cholesterol below 5:1, with the ideal being below 3.5:1.

Scientists and doctors are divided on the effectiveness of these ratios for predicting the chances of developing heart disease. At this point, the American Heart Association recommends using the absolute numbers for total blood cholesterol and HDL cholesterol instead of the total/HDL cholesterol ratio. They believe that the absolute cholesterol numbers are more useful to plan treatment than this cholesterol ratio.

b. LDL/HDL Cholesterol

Another ratio that certain labs determine is the LDL to HDL ratio. These cholesterol ratios are sometimes used to help predict the chances of developing heart disease. Such ratios compare levels of bad cholesterol (LDL) to good cholesterol (HDL). For LDL/HDL ratios, the goal is to keep it below 3.5:1, with the ideal being under 2.5:1.

However, similar to the total/HDL ratio, the medical community is divided on whether the LDL/HDL ratio is better than absolute total cholesterol or LDL cholesterol levels in predicting a person’s risk for heart disease. For treatment of high cholesterol, using the absolute numbers for LDL and HDL is recommended.

c. HDL/LDL Cholesterol

HDL/LDL ratios compare the level of good cholesterol (HDL) to bad cholesterol (LDL). In the case of HDL/LDL ratios, the goal is to keep this ratio above .3:1, with the ideal being above .4:1.


If you have not got your lipid profile done in past 5 years, be ready to get your cholesterol levels soon by lipid panel.

Dr. Anil Singhal, MD (Homeo)

Cholesterol levels – LDL, HDL, Triglyceride, Total Cholesterol, VLDL, Ratio
by ( Author at Dr. Anil Singhal MD (Homeo) )
Posted on at 6:36 am.
Find more from Dr. Anil Singhal's Blog on: Health

28 comments on “Cholesterol levels – LDL, HDL, Triglyceride, Total Cholesterol, VLDL, Ratio”

  1. Fasting prior to blood lipid tests appears to have limited association with lipid subclass levels, suggesting that fasting for routine lipid level determinations may be unnecessary, according to a report published Online First by Archives of Internal Medicine, a JAMA Network publication.

    “Although current guidelines recommend measuring lipid levels in a fasting state, recent studies suggest that nonfasting lipid profiles change minimally in response to food intake and may be superior to fasting levels in predicting adverse cardiovascular outcomes,” write Davinder Sidhu, M.D., L.L.B, and Christopher Naugler, M.Sc., M.D., C.C.F.P., F.C.F.P., F.R.C.P.C., with the University of Calgary, Alberta, Canada.

  2. Additional prospective studies that directly compare the association of fasting and nonfasting lipid levels with cardiovascular outcomes in the same individuals would be informative. Further validation studies are needed before a nonfasting lipid testing strategy is universally endorsed.

  3. MY AGE 48 YRS, MALE
    lipid frofile AS UNDER :

    CHOLESTROL : 157

    HDL : 28
    VLDL : 83.4
    LDL: 45.6
    LDL/HDL RATIO : 1.63



  4. my age is 41, weight – 70kg, height-168cm.
    My total cholestrol- 285
    Triglyceride- 167
    hdl- 40
    Am having now homeomedicine chionanthus ,chelon gl 5 drops 2 times and aliumsat .let me know this will reduce soon my cholestrol level down?suggest a medicine and diet for me. Expecting your valuable reply..


  5. My lipid profile are as follows:
    chloesterol total- 157
    triglycerides- 390
    hdl chlossterol- 33
    ldl chloesterol, calculated- 46
    vldl cholesterol calcultes- 78
    glucose fasting- 85
    uric acid serium- 5.80
    Sgpt serum- 35
    creatinine serum- 0.86
    total protein- 6.80
    albumin- 4.27
    A:G ratio- 1.69
    HbA1c- 6.10

    using following medicine-
    For uric Acid
    1.Urtica Urenus-Q- dose- 10 drops thice in hot water
    2. Lithium carb- 200- dose- 05drops thrice
    3. ledum pal- 200- dose- 05 drops twice.
    Every 15 days Thuja 01M- dose- 05 drops- stop all medicine when taking this one.

    For Cholesterol
    1. Avena Sativa-Q – Dose- 15drops in water thrice
    2, Cactus-G- Q- dose- 10drops thrice in water
    3. Crataegus oxy-Q- 10drops thrice in water.
    mix all these three medicine.

    Pl. advice if I am taking correct medicine or not.
    Dr. Hamid

  6. My age is 45 years & Iam overweight & hypertensive as well. I am taking hypertyensive medicine as well.
    Dr. Hamid

  7. hello sir My age is 59 I am facing problem lipids my cholesterol 217 Tri Glycerides 273 LDL 130 VLDL 55 HDL 32 and uric acid 7.4. Please suggest medicines. Thanks

  8. My age is lipid profile is as follows.

  9. R/Dr.I’m 59yrs.My lipid profile is as under,
    VLDL Cholesterol:51.2
    Other Parameters of Haematology,Biochem.&Urine analyses are keeping well within the range.Kindly advise homoeo med.&remedialmeasures to bring down the afore stated levels to keep heal & healthy.

  10. Dear Dr. Singhai,
    I am a 65 year old male who eats a paleo-type diet. I exercise considerably also. I just received my fasting blood works and my new doctor appeared alarmed and wanted to put me on high dose statin… atorva 40mg. There does appear to be a dichotomy as concerns my blood works because both my HDL (73) AND MY TRIGLYCERIDES (53) are very good yet my total cholesterol (286) and my LDL (202) are not very good.

    Currently I am 5’9″ and weigh 160 with 32″ waist. Years ago when I drank alcohol and ate what I wanted and weighed just under 200 pounds with 38″ waist my total cholesterol was 240 and my LDL was 145 or so. My HDL was 64.

    Can you make any sense of this apparent dichotomy?

    Carl Davis

  11. Dear sir
    My age is 45 yr.
    Pl suggest medicine.

  12. Hi Doctor,

    My cholesterol total: 224, my HDL is 43, LDL is 165, triglyceride: 79. Do I have to worry about this?

    I am 40 years old female.


  13. Dear colostral level is. Uric acid 7.2
    Total colostral. 241
    Triglycerides. 22o
    Hdl. 53
    LDL. 152
    VLDL. 44

  14. Hi there ,my name is Gary
    Ive just done a fasting cholestrol bllod test and the results are as follows
    Total cholestrol-5,9 mmo1/1
    Trig. -1,3 mmo1/1
    Hdl chol. -1,5 mmo1/1
    Ldl chol. -3,6 mmo1/1
    Non hdl chol. -4,4mmo1/1
    Im 48 years of age and 5,9 height and 110 kg in weight
    Do you think i need bring it down and to what
    Many thanks

  15. Dear doctor sir my age is 32 years and my investigation reports are as follows-

    Total Cholesterol 163 mg/dl
    Triglyceride 268 mg/dl
    VLDL 53 mg/dl
    HDL 39 mg/dl
    LDL 71 mg/dl

  16. My husband is a 46yr old male with:
    Cholesterol – 225
    Trigylcerides – 388
    HDL – 37
    LDL – 110
    VLDL – 78
    Cholesterol/HDL Ratio Risk – 6.1
    Are these numbers dangerous?

  17. Concern for the first time ever my total cholesterol 230 hdl 73 ldl 147. Trig.48. All other factors great. Should I immediately take lipitor. Is there another plan of action . I will be 64 years old and overweight 168 height 5’7 thanks

  18. I am 46yr old male with:
    Cholesterol – 225
    Trigylcerides – 210
    HDL – 41
    LDL – 141
    VLDL – 42
    Cholesterol/HDL Ratio Risk – 5.47
    Is homepath having medicin to cure lipid profile disorder

  19. I am 60 years old

    Total chol 184
    Ldl 77
    Hdl 80
    Triglycerides 135

    I will appreciate your kind respond for advising whether to take lowering tablets or not such as atrovastatine

    Thank you again and remain at your disposal

    With regards

    • Dear Mori,

      Your reports about values related to lipid profile of your blood samples seem to be with in normal limits.

      If you are not taking any cholesterol lowering medicines then you can avoid it, but meet your physician also.

      Best regards.

  20. Dear sir,
    My dad report is as below.
    Hdl 43
    Ldl 127
    Total cholesterol 204
    Triglycerides 167

    They had high bp but now in control.
    They are on medication of stamp 5/12.5 morning
    And omlezest am 40 with altocorin (lipid tablet) at night daily.
    I want to know their health is good?
    And please tell me the nigh tablet are need for everyday from now on.


Leave a Reply

Your email address will not be published. Required fields are marked *