Cholesterol Test – Everything You Need to Know

What is cholesterol?

Cholesterol is a group of essential fats. This is why cholesterol blood tests are also called a lipid profile. Lipid is the scientific term for fat. Lipids are used to make almost every cell in your body1. Cholesterol is also used to make hormones and bile – the acid in your stomach that breaks down food1.

In this post, we will understand everything about the cholesterol test and focus on the need to track it for an optimum physical health.

Different types of cholesterol

There are three types of fats under the Cholesterol group:

  • High-Density Lipoproteins (HDL)
  • Low-Density Lipoproteins (LDL)
  • Triglycerides.1

HDL and LDL are very similar fats, but they have very different roles in the body. HDL is commonly known as “good” cholesterol, whereas LDL is commonly known as “bad” cholesterol1.

Triglycerides are fats made in the liver from calories that aren’t required right away. These are available for use when the body requires extra energy.

The difference between HDL and LDL

  • LDL is the fat that sticks to blood vessel walls. That’s why too much of it is bad for you.
  • HDL is the fat that catches LDL in the bloodstream before it sticks to the blood vessels1.
    • Additionally, HDL transports LDL to the liver where both types of cholesterol convert into bile – the food dissolving acid1. For this reason, HDL is known as the “good” cholesterol.

When should you get a cholesterol test?

Strangely, our bodies do not show any side effects of abnormal cholesterol levels. It just causes emergency events like heart attacks and strokes. Hence, it is commonly known as one of the silent killers. The only way to find out cholesterol levels is with a blood test.

Cholesterol tests are carried out to monitor the risk of your body developing further problems, particularly in your heart. The general advice is to have a regular cholesterol test between the ages of 40-742.

You should also take the tests regularly if you fall into an increased risk category or already have or have had a heart condition2. The increased risk categories are groups of people include:

  • Overweight individuals
  • Smokers
  • Inactive individuals
  • Individuals with a family history of heart disease
  • Individuals with high blood pressure
  • Diabetics
  • Individuals with an unbalanced diet1,2,3

If you are concerned about the health of your heart, there is a quick way to check. Here’s a nifty heart health calculator for people above the age of 30 years created by the NHS. It checks your heart’s age against what’s normal for your health. If your heart age is higher than your actual age, then you are more at risk of developing heart disease.

The ElevateMe health test measures cholesterol levels as part of its 21 blood test insights. Take our free health quiz to get your health score and check if you need a health test.

What does high cholesterol mean?

If the body has too much cholesterol, then where does the cholesterol go? Our bodies only have a way of storing triglycerides (stored in fat cells). This means that the other two types, LDL & HDL, are left trapped in the bloodstream.

The extra cholesterol flows with the bloodstream, collects, and starts sticking to the blood vessels. This collection of cholesterol, therefore, causes the blood vessels to effectively become thinner.

This phenomenon of the thinning of blood vessels owing to the build-up of plaque is known as Atherosclerosis. Plaque is primarily composed of fat, cholesterol, and calcium. Having atherosclerosis quite obviously increases your risk of having a heart condition1.

Note: There are some groups of drugs that can increase the amount of cholesterol you have in your blood just by the way that they work. These include beta-blockers, corticosteroids, oral contraceptives, and some diuretics1. It is especially important to keep an eye on your cholesterol levels if you take some of these medications.

What does low cholesterol mean?

Having a low cholesterol level is not very common or dangerous for the body. This can only be caused by liver disease, malnutrition problems, or cancer1. Although these are serious conditions, the low levels of cholesterol do not harm your body further.

Cholesterol levels can also dip if you are unwell. It is unknown exactly why your cholesterol is lowered when responding to an illness, but it may be linked to reduced food intake or the way your body uses energy to tackle illnesses4. Thus, for an accurate assessment, a cholesterol test should be taken when you are feeling well1.

HDL Cholesterol Test

How does HDL cholesterol affect you?

HDL cholesterol is the good type of cholesterol. HDL moves freely around the bloodstream, looking for LDL cholesterol. Once found, HDL will carry LDL cholesterol to the liver to remove it1. This mechanism helps prevent LDL cholesterol from building up in the blood vessels. HDL, therefore, helps prevent heart disease from developing.

How to increase your HDL cholesterol?

There are a few ways to increase your HDL cholesterol levels.

  • If you are a smoker, reducing the amount you smoke will help1. In fact, stopping smoking has been seen to double HDL levels after one year5.
  • Increasing exercise will encourage the body to produce more HDL6.
  • Moderate alcohol consumption can increase HDL levels too. However, make sure you do not go over 14 units a week and have drink-free days. Otherwise, it will cause more issues (like Alcohol-Related Liver Disease) and not help your cholesterol levels7.

LDL Cholesterol Test

How does LDL cholesterol affect you?

LDL cholesterol is known as the “bad” cholesterol. This is because when LDLs are not needed, they become stuck in the bloodstream causing Atherosclerosis 1,8. Basically, LDLs will attach to the blood vessels, and as a result, cause a fatty build-up.

These fatty build-ups, called fatty plaques, narrow down the blood vessels. They can cause severe heart problems if they break off. When a fatty plaque gets stuck whilst passing through the heart, it can cause a heart attack3. Fatty plaques can also break off and get stuck in the brain, leading to a stroke3.

How to reduce LDL Cholesterol?

LDL cholesterol can be reduced by reducing your triglyceride levels. Scroll down to the “How to reduce your triglyceride levels?” section further down this article.

What is Total Cholesterol:HDL ratio?

This is a test that compares the total amount of cholesterol in the blood to the amount of HDL cholesterol10. It is part of the lipid profile test (LPT). The results are then presented as a number in the form of a ratio. In short, it’s just a simple way of expressing the level of good cholesterol in the body in comparison to the other types that are less helpful to your health10.

What does the Total Cholesterol:HDL ratio mean for your health?

The aim of this test is to score as low as possible10. Low Total Cholesterol:HDL ratio corresponds to low fat in the bloodstream. Of these fats in your bloodstream, you want the highest percentage to be HDL cholesterol, the “good” cholesterol. Having a low ratio indicates that you are at a lower risk of developing heart disease10.


What are triglycerides?

Triglycerides are common fats that include both saturated and unsaturated fats11. Triglycerides come from the excess food that we eat and are made in the liver11. When we consume excess calories that we do not need, they convert into triglycerides. These are stored in our fat cells. These fats are the source of energy for the body to burn through in between meals11.

How do triglycerides affect you?

Triglycerides are fats that provide the body with energy11. There are 3 types of fats in this group: saturated fats, unsaturated fats, and polyunsaturated11.

Unsaturated fats are good for you. Polyunsaturated fats are even better. Saturated fats, however, are trickier to classify as good or bad. As long as your saturated fats are originating from dairy and vegetable sources, they can be healthy. However, if your saturated fats are the result of carb-heavy junk food, then they are bad.12

Triglycerides are absorbed from your diet in the intestines and carried to cells to be used as energy. If they are not needed right away, they are stored in your fat cells until needed3.

Additionally, the liver will produce its own triglycerides. These are known as Very Low-Density Lipoproteins (VLDL). VLDLs are counted separately in the lipid profile blood test11. Interestingly, if you are asked to fast before the blood test, this will only show VLDL levels11.

What does having elevated triglycerides mean?

There are two causes of having a high triglyceride level: Primary and Secondary11. Primary causes are due to rare genetic reasons11. Whereas secondary causes are due to lifestyle and other medical reasons11. Medical conditions that can increase triglyceride levels include:

  • Kidney disease
  • Non-alcoholic fatty liver disease
  • Gout
  • Pregnancy
  • Type 2 diabetes
  • Underactive thyroid.11

How to reduce triglyceride levels?

The best way to reduce triglyceride levels is through improving your diet and exercise11. This is because excess triglycerides are stored in fat cells. So losing weight and reducing fat percentage will burn through the extra triglycerides.

Changing your diet by swapping saturated fats for unsaturated fats will also help lower triglyceride levels11. Check out the section “How can you improve your cholesterol levels?” further down below.

What are the normal ranges for the different types of Cholesterol?

Overall all your cholesterol levels should be as low as possible. So there are no recognised ideal results. Normal ranges advised by the NHS for the majority of the population can be seen below.

Type of TestNormal Reference Range Optimal Range
Total Cholesterol5 mmol and below2.59 – 5.18 mmol
LDL Cholesterol3 mmol and below2.59 mmol and below
HDL Cholesterol1 mmol and above1.55 – 2.33 mmol
Total Triglycerides 2.3 mmol or below 1 mmol or below
Total Cholesterol: HDL6 mmol and below4 mmol or below
Table of NHS guide to cholesterol blood test results10,13

The table above shows a guide of the levels you should not exceed to avoid developing heart disease. These are the reference ranges. Reference ranges differ from optimal ranges.

At ElevateMe, we identify optimal ranges that compare your results with values obtained from healthy individuals. These optimal ranges allow you to do more than just be healthy. In fact, optimal ranges are the ranges at which you will thrive and not just survive. By design, our health program tracks your optimal ranges across a range of blood test biomarkers for holistic health management. You can learn more about the differences between optimal ranges and reference ranges in blood tests here.

How can you improve your cholesterol levels?

Cholesterol levels can be improved by two broad lifestyle changes.

  • Changing your diet

The easiest and most effective way to control your cholesterol is by changing your diet. This is because 80% of the cholesterol comes from your diet2.

Fat is present in nearly all types of foods so it is impossible to completely cut out fat. However, reducing the amount of fat you eat will result in lowering your cholesterol levels. Eating the right types of fats can help too7.

Here’s a table of foods that show examples of the unsaturated fats you should try to increase and the saturated fats to reduce7.

Saturated Fats to CUT DOWNUnsaturated fats to INCREASE
Meat pies Oily fish
Sausages and fatty cuts of meatNuts
Butter, ghee & lardSeeds
Hard cheese Vegetable oils and spreads
Cakes and biscuits
Foods containing coconut or palm oil
Table showing NHS fat substitution to aid in reducing cholesterol levels7

  • Exercising

Alongside reducing fat intake, you can reduce cholesterol by exercising. When your body is exercising, your HDL picks up more amounts of LDL from the bloodstream6. This results in a reduction in the amount of free cholesterol flowing through your body.

Increasing exercise levels also leads to the body requiring more energy. To meet the higher energy requirements, the body starts accessing your fat storage14. This is where the excess triglycerides are stored. Exercising helps you lose fat and simultaneously reduces your cholesterol.

Common myths about the Cholesterol test

Q. Will alcohol affect cholesterol test?

A. Yes. Alcohol is broken down by the body into triglycerides. Alcohol also increases the number of triglycerides formed from any food that’s eaten at the same time. If alcohol is still in your system whilst going for the test, triglycerides will be at a higher level than normal in your bloodstream15.

Q.Will coffee/tea affect cholesterol test?

A. No. In fact, studies that have focused on drinking black tea or coffee show that there is no impact on the cholesterol test results16,17.

Q.Will a cholesterol test show diabetes?

A. No. Diabetes develops when the body cannot break down sugar correctly. Although diabetes type 2 can have high levels of triglycerides, there are several other reasons this can occur11. The HbA1c glucose test is an option to check for diabetes.

Q.Will a cholesterol test show cancer?

A. No. There are over 100 types of cancer and all provide various symptoms and effects on the body. Although some of these cancers do cause cholesterol disturbances. But these cancers cannot be diagnosed through a cholesterol blood test alone18.

Q.Can we take a cholesterol test on keto diet?

A. Yes. No matter what your dietary requirements are, a blood test for cholesterol can be taken.

In Summary

Cholesterol is one of the most essential biomarkers that you should ideally be tracking. Especially if you are in the risk category.

Choose from one of our health plans. We’ll then ship out your 21 blood insights kit and get your lifestyle details. As soon as your blood test results are in, we will start tracking your most essential blood markers. You will also get a personalised health program to help you improve your health and performance toward optimal levels, in the areas that matter to you most.

You can also take our free health quiz to check your overall health score, and also get free personalised health advice.

How’s your heart? 

Did you know 39% of adults have high levels of cholesterol, putting them at risk for heart attacks or strokes

Take an ElevateMe blood test today to capture 21 blood test insights and track your sleep, fitness, energy, metabolism, cognition, mood, and immunity.

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1 Lab Tests Online, (2020). Cholesterol Test. Last accessed 04/04/2021.

2 Heart UK, (N.D.) Getting a cholesterol test. Last accessed 04/04/2021.

3 Mayo Clinic. (2019). Cholesterol test. Last accessed 04/04/2021.

4 Jacobs, D., Herbert, B., Schreiner, P., Sidney, S., Iribarren, C. & Hulley, S. (1997). Reduced Cholesterol is Associated with Recent Minor IllnessAmerican Journal of Epidemiology. 146 (7), 558-564.

5 Gepner, A., Piper, M., Johnson, H., Fiore, M., Baker, T. & Stein, J. (2011). Effects of Smoking and Smoking Cessation on Lipids and Lipoproteins: Outcomes from a Randomized Clinical TrialAmerican Heart Journal. 161 (1), 145-151.

6 Mann, S., Beedie, C. & Jimenez, A.. (2014). Differential Effects of Aerobic Exercise, Resistance Training and Combined Exercise Modalities on Cholesterol and the Lipid Profile: Review, Synthesis and Recommendations. Sports Medicine. 44, 211-221.

7 NHS. (2018) Lower your cholesterol. Last accessed 04/04/2021.

8 Heart UK high, (N.D.). What is high cholesterol?. Last accessed 04/04/2021

9 Mauricio, C. & Cordova, M. (2012). A new accurate, simple formula for LDL-cholesterol estimation based on directly measured blood lipids from a large cohortInternational Journal of Laboratory Medicine. 50 (1), 13-19.

10 NHS (2020). Your NHS Health Check results and action plan. Last accessed 04/04/2021

11 Heart UK. (N.D.) Triglycerides. Last accessed 04/04/2021.

12 NHS (2019). Cholesterol levels. Last accessed 04/04/2021.

13 Moini, J. (2019). Anatomy and Physiology for Health Professionals. 3rd ed. Burlington, USA: Jones & Barlett. 402-508; 626-688.

14 Van de Wiel, A. (2012). The effect of Alcohol on Postprandial and Fasting TriglyceridesInternational Journal of Vascular Medicine. .. (article ID 862504), 1-4.

15 Cheung, R., Gupta, E. & Ito, M.. (2055). Acute Coffee ingestion does not affect LDL cholesterol LevelThe annals of pharmacotherapy. 39 (7-8), 1209-1213.

16 Troup, R., Hayes, J., Raatz, S., et al . (2014). Effect of Black Tea Intake on Blood Cholesterol Concentrations in Individuals with Milk Hypercholesterolemia: A Diet-Controlled Randomised Trialjournal of the academy of nutrition and dietetics. 115 (2), 264-271.

17 Ding, X., Zhang, W., Li, S. & Yang, H.. (2019). The role of Cholesterol Metabolism in CancerAmerican Journal of Cancer Research. 9 (2), 219-227.

18 Healthy Fats vs. Unhealthy Fats: What You Need to Know. Last Accessed 25/04/2021

cholesterol blood test elevateme

Written by Louise Taylor

After completing Clinical Technology at the University of Bradford, I am venturing into the NHS as a General Medical Engineer.


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