Hi doctors, I hope you’re well!
I’m trying to more proactive with my health as I get older, so had a fairly comprehensive blood work up recently. Primarily just to see how I’m doing, not because of any particular symptoms. Most things were in the normal range fortunately, but I wanted to ask your opinion on the cholesterol results please? I’ll discuss these with my GP too, but I’d appreciate your input.
For reference, I’m 45yrs, 178lbs, 5’10, currently strength train x2/week and cardio x2/week. I’m in the UK and I think we use different units with our tests, so I’ll try to convert them!
- Total cholesterol = 6.28 mmol/L or 113 mg/dL
- HDL = 1.97 mmol/L or 35.5 mg/dL
- LDL = 3.85 mmol/L or 69.4 mg/dL
- Non-HDL = 4.31 mmol/L or 77 mg/dL
- Triglycerides = 0.8 mmol/L or 14.4 mg/dL
- Total/HDL ratio = 3.18 mmol/L or 57.3 mg/dL
The only other things flagged by the test were slightly low neutrophils and a slightly raised T4 of 22.7 pmol/L (my T3 and TSH were both within normal range). And testosterone of 10.82 nmol/L which I think is the lower end of normal.
I used your helpful Cholesterol Action Plan and I think my results were not too bad (I don’t have ApoB unfortunately). But I’m a bit concerned about my Total Cholesterol and HDL being quite high, so any input would be great, thanks!
Hi,
These conversions to mg/dL are incorrect, FYI:
Total: 243 mg/dL
HDL-c 76 mg/dL
LDL-c 149 mg/dL
TG 71 mg/dL
Non-HDL-c 167 mg/dL
As discussed in the CAP and our cholesterol article, the primary metric to attend to here is the non-HDL-cholesterol of 167 mg/dL, which is moderately elevated. Your triglycerides are in an excellent range.
We would need much more history here (personal medical history, family medical history, etc.) to provide specific individualized guidance, which is something that we do regularly with folks through BBM Consultations.
In the meantime, I’d suggest the same lifestyle interventions described in our cholesterol article Cholesterol - Causes, Prevention & Treatment - specifically focusing on dietary fiber and fat substitutions. Depending on your overall risk assessment, you may be a good candidate for the use of medicines to further lower your lifetime risk.
Hi Austin, thanks for your reply.
Apologies about the conversions - I asked google but didn’t realise the conversion factor it gave of 18.018 was for glucose not cholesterol! 
Thanks for helping me to understand the metrics a little better. Most friends and family I speak with just focus on the total cholesterol figure when casually discussing their test results, but I see that can be misleading as it includes the “good’” HDL. I guess in my case, my HDL is slightly on the higher end of the range, which would contribute to a higher “total”. So I’m understanding now why using the non-HDL metric is more useful.
I see that my results are a little mixed - some good (triglycerides) and some not ideal (non-HDL), so definitely something to discuss with my GP and I’ll look into the BBM consultations as it would be good to discuss my wider history. I’ve been trying to increase my fibre and reduce saturated fat over the last year, so it’s disappointing that my non-HDL is moderately high (although I don’t have any personal or family history of heart disease).
Would you recommend getting an additional ApoB test, or do you think the metrics I have so far are sufficient to determine a plan of action? Thanks again
I think you have enough information to act based on the non-HDL-c; an ApoB, while a fine test, is unlikely to dramatically change recommended management for you.
If you were to get any other lipid-related blood testing done, it should probably be a Lipoprotein(a) level, if this has never been checked in your life before.