Total Cholesterol Test

Know Your Cholesterol, Protect Your Heart

Simple at-home cholesterol blood test to assess heart disease risk. NHS laboratory analysis with clear, easy-to-understand results.

The cholesterol (lipid) profile has four component parts.

The lipid profiles includes:

• Cholesterol
• Triglycerides
• High density lipoprotein cholesterol
• Non-high density lipoprotein cholesterol

What is cholesterol and why is it important?

Cholesterol is a fatty substance known as a lipid, and is important for the normal function of cells and organs in the body. It is also used to make hormones which are essential for reproduction, development and growth including Vitamin D.

Cholesterol is mainly produced by the liver and the cells of the intestinal wall, but intake can also be obtained from the diet. Having elevated cholesterol can increase the risk of developing vascular disease which may lead to serious health conditions such as atherosclerosis (clotted arteries), a blood clot, angina (arm or chest pain during physical activity), heart attack or stroke.

Lifestyle factors such as a poor diet with a high saturated fat intake, smoking, obesity and drinking large amounts of alcohol can increase the risk of developing serious health conditions including heart disease. Other health disorders such as diabetes mellitus (HbA1c test), high blood pressure, liver or kidney disease, hypothyroidism or a family history of heart disease or stroke can also contribute towards increasing the risk of developing cardiovascular disease (CVD).

There is an inherited condition which runs in families, which can cause high cholesterol even in patients who have a healthy lifestyle and diet. This is called familial hypercholesterolaemia (FH).

Some factors which cause high cholesterol cannot be changed; these are called 'non-modifiable' risk factors. These include:

• A family history of cholesterol-related conditions such as FH
• Age: increasing age increases the risk of atherosclerosis
• Ethnicity: Sri Lankan, Indian, Bangladeshi or Pakistani descendants have an increased risk of a heart attack
• Sex: men have a higher heart attack risk than women

Signs & symptoms of a lipid disorder

Having a high cholesterol or triglyceride result, or having an abnormal lipoprotein fraction more often than not will not have any outwards signs or symptoms.

Risk factors to consider are:

• having a mother, father, siblings or children who have high cholesterol levels
• mother, father or siblings who have had angina, a heart attack or stroke before the age of 50 years
• having type 2 diabetes
• having a diet which is high in animal fat and/or saturated fats
• being overweight or obese
• having a sedentary lifestyle or a health condition which may impair your activity

Preparation

This is a non-fasting lipid test, so you do not need to fast. However, for the most consistent results, we recommend taking the test in the morning, before eating and before taking supplements on the day of testing. Recent meals can temporarily affect triglyceride levels.

Drinking water is encouraged before your test. Being well hydrated can make it easier to collect your blood sample and does not affect your results.

Important: these tests are available for people aged over 18 only. Please collect and post your sample to us Monday-Thursday, to avoid delays over the weekend. In a small number of cases, it may not always be possible to provide a result, please see our terms and conditions for details.

ROYAL MAIL TRACKED 24 SAMPLE RETURN INCLUDED

What are triglycerides and why are they important?

Triglycerides are fats made by the liver and are also a type of fat found in the diet. These foods include dairy products, meat and cooking oils.

Triglycerides increase in the blood after eating a meal, and slowly reduce over a few hours after eating.

The role of triglycerides in the body are as a source of energy for cells, tissues and organs, or as fat storage.

Triglyceride concentrations are important as they can be used as an independent risk factor for the diagnosis and treatment of cardiovascular disease. Very high triglyceride levels may also confer a risk for the development of acute pancreatitis.

What is HDL-Cholesterol and why is it important?

High-density lipoproteins are also known as 'good cholesterol' as they protect against heart disease, so the higher the HDL-cholesterol levels, the better. Low HDL-cholesterol concentrations, especially paired with high levels of triglycerides increase the risk of heart disease.

What is non-HDL-C and why is it important?

Non-HDL cholesterol is a calculated result using total cholesterol minus HDL-cholesterol which is 'good cholesterol'. This final number represents all the 'bad cholesterol' together and should be less than 4 mmol/L and is the best individual risk factor.

Do you measure LDL Cholesterol?

Non-HDL cholesterol is not the same as LDL cholesterol. Non-HDL cholesterol is a measure of all types of "bad" cholesterol which includes LDL cholesterol. We do not measure or calculate LDL cholesterol as part of the total cholesterol test. Accurate measurement of LDL cholesterol requires that the sample is taken whilst fasting which we do not recommend for our testing service.

It is possible to calculate LDL cholesterol from Cholesterol, HDL and Triglycerides. There are some online calculators available e.g. www.mdcalc.com/ldl-calculated. However, the LDL calculation will only be accurate if the sample was taken whilst fasting and if the triglycerides were less than 4.5 mmol/L.

Should I fast when completing this test?

We do not recommend that you fast before taking our total cholesterol test. Fasting will have very little effect on total cholesterol, HDL Cholesterol or non-HDL cholesterol. Fasting may lead to a small reduction in triglyceride levels, usually no more than 0.3 mmol/L.

How can I improve my Cholesterol levels?

If your results show Intermediate risk:

We recommend making lifestyle and diet changes which may help lower bad cholesterol and increase good cholesterol. Heart UK has an ultimate cholesterol lowering plan which is based on scientific evidence and includes some changes even for those who feel they already have a healthy diet and lifestyle. Please see: https://www.heartuk.org.uk/ultimate-cholesterol-lowering-plan/uclp-introduction

If you results show High risk:

We recommend that you make an appointment to see your doctor to discuss your results as soon as possible.

What are your reference ranges?

Total Cholesterol:

5.0 or below = Target level

5.1-8.9 = Intermediate risk

9.0 or above = High risk

Non-HDL Cholesterol:

4.0 or below = Target level

4.1-7.5 = Intermediate risk

7.6 or above = High risk

High Density Lipoprotein (HDL) cholesterol (Female):

Below 1.2 = High risk

1.2 or above = Target level

High Density Lipoprotein (HDL) cholesterol (Male):

Below 1.0 = High Risk

1.0 or above = Target level

Triglycerides:

2.2 or below = Target level

2.3-4.4 = Low-Intermediate risk

4.5-9.9 = Intermediate risk

10.0 or above = High risk

Do you offer other cholesterol tests?

We do not currently offer testing for lipoprotein(a), advanced particle subtypes, ApoB or ApoA1.

How can I calculate my my Cardiovascular risk?

Total cholesterol is made up of HDL cholesterol and non-HDL cholesterol. HDL is considered "good" cholesterol and non-HDL is considered "bad" cholesterol. It is important to bear in mind that cholesterol levels are only one part of your cardiovascular risk. You can calculate your overall cardiovascular risk using the QRISK3 tool: https://qrisk.org/three/

This includes other important aspects such as blood pressure and lifestyle factors. If you are at all concerned then we would recommend discussing the results with your doctor.

Description provided by Monitor My Health.