Cholesterol is a fat-like substance without which cell membranes, hormones and vitamin D would be impossible. It is not an "enemy" in itself — the question is its amount and the balance of fractions.
Total cholesterol is made up of LDL ("bad") and HDL ("good"). So looking at total cholesterol alone is not enough — the breakdown is what matters.
Reference ranges
Reference points for total cholesterol:
| Optimal | < 5.2 mmol/L |
| Borderline | 5.2 – 6.2 mmol/L |
| High | > 6.2 mmol/L |
What an elevated level means
High cholesterol (especially from LDL) is a key factor in atherosclerosis: the excess is deposited in the artery walls, narrowing them and raising the risk of heart attack and stroke.
Causes: a diet high in saturated and trans fats, excess weight, inactivity, heredity (familial hypercholesterolemia), hypothyroidism, diabetes.
What to do: diet, movement, weight loss; with high risk — statins as prescribed.
What a low level means
A low total cholesterol is usually not dangerous and is more often favorable. Very low values are occasionally seen with liver disease, hyperthyroidism or undernutrition — then the cause matters, not the number itself.
How the test is done
Venous blood. Classically fasting (9–12 hours), though current guidelines also allow it without strict fasting.
Test the full lipid profile: total cholesterol, LDL, HDL and triglycerides — only together do they give the risk picture.
What affects the value
- Saturated and trans fats — raise LDL and total cholesterol.
- Excess weight and inactivity — worsen the profile.
- Heredity — familial hypercholesterolemia gives high cholesterol from a young age.
- Thyroid gland — hypothyroidism raises cholesterol.
- Movement — raises the "good" HDL.
Calculate using this marker
Calculators where Cholesterol (total) is used directly:
Frequently asked questions
What cholesterol is considered normal?
Total — optimally below 5.2 mmol/L. But the fractions matter more: "bad" LDL should be low, "good" HDL adequate. With high cardiovascular risk the LDL goals are stricter. The whole lipid profile is assessed.
Cholesterol is high — take statins right away?
Not necessarily. The decision depends on overall cardiovascular risk, not just the number. With low risk, treatment often starts with diet, movement and weight loss. With high risk, statins do reduce heart-attack risk — but that is the doctor's call.
What matters more — total cholesterol or LDL?
LDL ("bad") is the main culprit in atherosclerosis and is the primary target. Total cholesterol is a summary figure; it can be "high" because of good HDL, which is not bad. So the whole profile is examined.