Total Cholesterol Test
Also known as: TC, Serum Cholesterol, Blood Cholesterol
What is Total Cholesterol?
Total cholesterol is the overall amount of cholesterol in your blood, including LDL (bad), HDL (good), and other lipid components. It is a key indicator of cardiovascular health.[MedlinePlus (NIH)]
What This Test Measures
This test measures the combined amount of LDL cholesterol, HDL cholesterol, and 20% of your triglycerides in your blood.[American Heart Association]
Why It's Important
Total cholesterol is used to assess your risk of heart disease and stroke.[CDC]
High total cholesterol increases plaque buildup in arteries, which can lead to heart attack and stroke.[American Heart Association]
Who Should Get This Test?
Cholesterol screening is an important part of cardiovascular health assessment.
Risk Factors
- Adults 20 years and older (routine screening every 4-6 years)
- Family history of high cholesterol or heart disease
- Personal history of heart disease, stroke, or diabetes
- Obesity or overweight
- High blood pressure
- Smokers
- Sedentary lifestyle
- Diet high in saturated and trans fats
- Men 45+ and women 55+ (more frequent screening)
- Taking cholesterol-lowering medications
Screening Schedule
Adults should have cholesterol checked every 4-6 years starting at age 20. More frequent testing is recommended for those with risk factors or those on treatment.
What Happens During the Test
A blood sample is drawn from a vein, usually in the arm. The test is typically part of a lipid panel that also measures LDL, HDL, and triglycerides.
Duration
5 minutes for the blood draw; results usually available within 24 hours
Discomfort Level
Minimal - brief pinch from needle insertion
Risks & Side Effects
Cholesterol testing through blood draw carries very few risks.
- •Minor pain or bruising at the needle site
- •Slight bleeding
- •Rarely, lightheadedness
- •Very rare risk of infection
Normal Range
Desirable: Less than 200 mg/dL. Borderline high: 200-239 mg/dL. High: 240 mg/dL and above.
Note: Total cholesterol alone does not give the full picture; LDL, HDL, and triglycerides should also be evaluated.
Source: MedlinePlus (NIH)Unit Conversion
Convert between mg/dL and mmol/L
| mg/dL | mmol/L |
|---|---|
| 150 | 3.9 |
| 175 | 4.5 |
| 200 | 5.2 |
| 220 | 5.7 |
| 240 | 6.2 |
| 260 | 6.7 |
| 280 | 7.3 |
| 300 | 7.8 |
High Values
High total cholesterol increases cardiovascular risk. It can be caused by diet high in saturated fat, obesity, lack of exercise, smoking, genetics, or conditions like hypothyroidism and diabetes.[Mayo Clinic]
Low Values
Very low total cholesterol (below 120 mg/dL) is rare and may be associated with malnutrition, hyperthyroidism, liver disease, or certain genetic conditions.[Cleveland Clinic]
Test Limitations & Accuracy
While useful as a screening tool, total cholesterol has important limitations.
- ⚠Does not distinguish between LDL and HDL - someone with high HDL may have elevated total cholesterol but low cardiovascular risk
- ⚠May fluctuate day-to-day by 5-10%
- ⚠Recent illness or surgery can temporarily affect levels
- ⚠Non-fasting samples may be slightly higher
- ⚠Pregnancy increases cholesterol levels
- ⚠Certain medications can affect results
- ⚠Does not measure particle size or number, which may be more predictive of risk
Alternative & Complementary Tests
A complete lipid panel provides more comprehensive cardiovascular risk assessment.
For specific assessment of "bad" cholesterol
For assessment of "good" cholesterol
Part of complete lipid assessment
Calculated from total minus HDL; may be better predictor than LDL
For more accurate assessment of atherogenic particles
For genetic cardiovascular risk assessment
Test Preparation
You may need to fast for 9-12 hours before a cholesterol test for accurate results.[MedlinePlus (NIH)]
Frequently Asked Questions
What is a good total cholesterol level?
A total cholesterol level below 200 mg/dL is considered desirable. However, the ratio of LDL to HDL is more important than total cholesterol alone.
Source: American Heart AssociationHow can I lower my total cholesterol?
Lower cholesterol by eating a heart-healthy diet (less saturated fat, more fiber), exercising regularly, maintaining a healthy weight, quitting smoking, and taking medication if prescribed.
Source: CDCReferences
Related Condition Guides
Medical Disclaimer
This information is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for interpretation of test results and medical decisions.
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