Cholesterol blood tests (often called the lipid panel) measure the amounts of cholesterol carried by three main lipoproteins—low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL)—all of which play a role in cell metabolism. The lipid panel will also measure triglycerides, the most common type of fat in the blood.
The amounts of LDL cholesterol, HDL cholesterol, VLDL cholesterol, and triglycerides in your blood will help your doctor assess your overall risk of heart disease, stroke, and other cardiovascular conditions.
The cholesterol test, then, is a critical part of the medical toolkit, which is why it’s important to understand how it works and what results mean.
What Does a Lipid Panel Measure?
As stated, when you have a lipid panel, there are several notable measurements. The results of your lipid panel are an important component in allowing your doctor to assess your cardiovascular health and risk. Other factors that are taken into account when determining your risk include your blood pressure, weight, exercise levels, and the presence of medical conditions such as diabetes.
Each component of the results provides different pieces of information. Important measures are:
Total cholesterol: The total cholesterol represents the total of all the cholesterol being carried by all the major lipoproteins in your blood. This measurement is generally not as useful in assessing your cardiovascular risk as the other cholesterol measurements made in the lipid panel. LDL: LDL cholesterol is often called “bad” cholesterol because it’s the source of buildup and blockages in the arteries. Typically, there’s an elevation of health risks when these are too high. HDL: In contrast to LDL, you generally want higher levels of HDL, or “good” cholesterol. The HDL lipoprotein helps clear cholesterol from the bloodstream and takes it to the liver. VLDL: Another type is VLDL cholesterol, a precursor to LDL that comes directly from food you eat. This type contributes to plaque buildup in the arteries and is considered “very bad. ”Non-HDL: The HDL score is subtracted from the total cholesterol measure to assess levels of the bad cholesterols, LDL and VLDL. Triglyceride: Triglycerides are fats in the bloodstream that come from food. High triglyceride levels may be associated with metabolic syndrome and type 2 diabetes and can increase your cardiovascular risk independent of cholesterol levels. High levels here raise heart disease and type 2 diabetes risk and are of particular concern in women. Cholesterol ratio: Also important is the ratio of total cholesterol to HDL. The lower the ratio, the lower your risk for heart or circulation problems, with 5:1 being targeted, and 3. 5:1 considered ideal.
When you have a cholesterol test, doctors are most concerned with total cholesterol, HDL, LDL, and triglyceride levels.
How to Prepare for the Test
There’s not too much that goes into preparing for a cholesterol test. Whenever you go in for medical visit, it’s a good idea to come early and bring a list of any medications or supplements you’re taking. Wear comfortable and loose-fitting clothing so that you don’t put pressure on the site of collection when leaving. In addition, you may be asked to steer clear of any food or drink (aside from water) for 9–12 hours before the test.
Cholesterol tests provide a broader glimpse of your health status. You can’t really affect results without making significant, long-term dietary or lifestyle changes (or by taking medications). As such, behaviors like steering clear of foods high in cholesterol or saturated fat within a couple of days of your lipid profile won’t really affect results.
That said, food before a test can elevate triglyceride levels, so accuracy there does require fasting. Prior to your test, double-check with your doctor about how best to prepare.
How the Test Is Performed
Cholesterol tests are performed on blood samples taken in a clinic, hospital, or outpatient center. This sample blood is usually collected from a vein in the forearm. You’ll feel a pinch when it’s being taken, and, from start to finish, the procedure typically only takes about five minutes.
A rapid test, which relies on blood collected from a finger prick, can also be given in the clinic or taken at home. These are typically not as accurate or detailed as their standard counterparts.
After the Test
Generally, the turnaround time for your results is relatively quick, only taking one to two days. Rapid test results from finger pricks are ready faster than that.
When you leave your appointment, you’ll have gauze or a bandage at the site of the blood draw. Some care needs to be taken to prevent bruising or hematoma, swelling, and pooling of the blood in the affected area. Here’s a quick breakdown:
Leave the bandage on for at least eight hours, but take it off within a day of your appointment. Don’t take aspirin, ibuprofen (Motrin, Advil), or other nonsteroidal anti-inflammatory drugs (NSAIDs) for at least 72 hours. Avoid lifting heavy objects or carrying bags or purses with the affected arm for several hours after the sample’s been taken. Apply a cold pack or ice wrapped in cloth (if a hematoma has formed) for sessions of 20 minutes for 24 hours. Apply warm compresses to the area if you’ve developed a hematoma and after the initial 24 hours of applying cold.
Though rare, some needlestick injuries and blood draw sites can become infected and problematic.
Interpreting the Results
Typically, you’ll have a consultation with your doctor about the results of your lipid panel. While each individual measure has its oen importance and place, a true assessment of health involves comparing them to each other, as well as assessing other health factors, such as disease status, lifestyle, genetics, gender, and age.
Your hand changes color. The swelling worsens. Pain, throbbing, or numbness are evident in the affected arm.
What sorts of measures raise red flags? There are several, including:
High total cholesterol: Because total cholesterol factors in both levels of unhealthy LDL and healthy HDL, this measure, on its own, may not be enough to determine cardiovascular risk. However, high levels here, along with high LDL, low HDL, and other risk factors for heart disease, prompt concern. High LDL: If your score is above 100 milligrams per deciliter (mg/dL), you’re at a higher risk of developing heart diseases or blood vessel diseases like peripheral artery disease (PAD). Doctors may want those with other risk factors for these issues to have scores of 70 mg/dL or less. Low HDL: Insufficient “good cholesterol,” at 40 mg/dL or lower, is considered a risk factor for heart disease. In women, doctors want to see scores of 50 mg/dL or higher. LDL scores above 60 mg/dL reduce the risk of heart disease. High triglycerides: When levels of this fatty acid are above 200 mg/dL, you’re at a higher risk for cardiovascular issues, such as heart attack and stroke. In addition, elevated triglycerides in the blood can be a sign of obesity or type 2 diabetes.
While individual health factors can influence what’s considered healthy, typically doctors want to see:
Total: For people 19 and younger, less than 170 mg/dL is healthy. This number becomes a range of 125-200 mg/dL in men and women 20 and older. Non-HDL: Nineteen-year-olds and younger should have less than 120 mg/dL of this type, and this figure jumps to 130 mg/dL for adults. LDL: In men and women 20 and up—as well as those younger—levels smaller than 100 mg/dL are considered within a healthy range. HDL: Those 19 and younger should have an HDL of greater than 45 mg/dL. In adult men, this figure should be at least 40 mg/dL, with the healthy range climbing to 50 mg/dL or higher for women.
A Word From Verywell
Clearly, your cholesterol levels are closely tied to your health, and understanding your numbers as well as where you should be, is an important step in taking care of yourself. If you don’t know your cholesterol levels, ask your doctor when you should get tested. And if your scores aren’t where they should be, know that, while it may take effort, your measurements can definitely be managed. Whatever challenges you face, the benefits—a longer, healthier life—are worth it.
However, food before a test can cause triglyceride levels to spike significantly. If testing without fasting reveals these to be too high, another lipid panel will be ordered.
Uncontrolled conditions: In the clinic, doctors, medical staff, and clinicians employ specific methods to ensure they collect a good, usable sample. If too much blood is collected, or if it’s collected improperly, results of at-home testing kits can be thrown off. Missing panels: Most at-home kits are only able to provide measures of total cholesterol, which by itself is not enough to give you a total picture of cardiovascular health and risk. Lacking analysis: Even if kits are able to test for other types of cholesterol, they may report results in terms of general, national guidelines. While that can be helpful, it doesn’t take into account factors that your doctor can, such as your other health conditions and factors.
However, those with certain health conditions, such as heart disease or a family history of high cholesterol, may require more frequent assessments.
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