Key takeaways
- A cholesterol test gives you five figures, so "normal" depends on which one you are looking at.
- NHS guidance gives a general target for each figure, and a doctor reads yours against your overall heart risk.
- Non-HDL cholesterol adds up all the higher-risk types in one number, which is why many doctors now watch it closely.
- Most people can eat as normal before a standard lipid profile.
A health check, a work medical or a home kit has given you a cholesterol number, and you are not sure whether to worry. Or you have just turned 40 and want to know where you stand.
NHS guidance describes a healthy total cholesterol as 5 mmol/L or under. HDL, the "good" cholesterol, should be 1 mmol/L or above for men and 1.2 or above for women. LDL should be 3 mmol/L or under, and non-HDL 4 mmol/L or under. These are general targets, and your doctor weighs your result against your overall heart disease risk. A lipid profile checks all of them from one sample.
If you just want the numbers, book a lipid profile at 117a Harley Street. It costs £72.50 plus the £50 blood draw Results are back in 1 day.
What do the different cholesterol numbers mean?
A cholesterol test, usually called a lipid profile, reports five separate figures. Total cholesterol is all the cholesterol carried in your blood. LDL is often called "bad" cholesterol because it can build up in artery walls. HDL is called "good" cholesterol because it helps carry excess cholesterol away.
Non-HDL cholesterol is everything except HDL added together. Many doctors use it as one overall marker, because it captures all the higher-risk particles in a single figure. Triglycerides are a separate type of fat, affected by diet, alcohol, weight and blood sugar control.
| Marker | What it is | NHS guidance figure |
|---|---|---|
| Total cholesterol | All cholesterol types combined | 5 mmol/L or under |
| HDL cholesterol | The protective, "good" type | 1 mmol/L or above (men), 1.2 or above (women) |
| LDL cholesterol | The "bad" type linked to artery build-up | 3 mmol/L or under |
| Non-HDL cholesterol | Total minus HDL; all higher-risk types combined | 4 mmol/L or under |
| Triglycerides (fasting) | A separate blood fat | Under 1.7 mmol/L |
These are NHS general guidance figures. Your doctor judges your result against your overall cardiovascular risk as well as this table.
Do I need to fast before a cholesterol test?
Most people can eat normally before a standard lipid profile. A recent meal mainly affects the triglyceride result, so if a doctor has asked you to fast, that is usually why. Water is fine either way, and just tell the person taking your sample whether you have eaten.
Why does my cholesterol result matter more as part of a risk score than as a single number?
Cholesterol is one of several things that affect heart disease risk, alongside blood pressure, smoking, weight, diabetes and family history. Doctors generally put your result into a wider risk score, such as QRISK3.
Two people with the same LDL cholesterol can have quite different overall risk, depending on the rest of their picture. That is why the same total cholesterol can be handled differently in different people. Your cholesterol ratio adds useful context to the individual numbers too.
What raises cholesterol?
Diet, particularly saturated fat, is one factor, alongside body weight, how much you move, smoking and alcohol. Some of it is genetic: a strong family history of high cholesterol or early heart disease can raise your levels whatever your lifestyle.
Certain health conditions can also affect your result, including an underactive thyroid, type 2 diabetes, kidney disease and liver disease. That is one reason a doctor reads the numbers alongside the rest of your health. A very high result can point to an inherited condition called familial hypercholesterolaemia, which a doctor should assess. So can high cholesterol with a family history of early heart disease.
What if my cholesterol result is high?
A raised LDL, total or non-HDL cholesterol, or a low HDL, is a risk factor to act on with your doctor. Your laboratory report shows the reference range beside each result. If a marker sits outside it, book a follow-up with a doctor to talk about what it means for you. The right next step depends on your wider risk picture. You can add a doctor review of your report to your test for £75.
Chest pain, especially if it spreads to your arm, jaw or back or comes with breathlessness or sweating, is an emergency: call 999.
Are there tests that look at cholesterol in more detail than a standard lipid profile?
Yes, for people who want more detail than the standard five markers.
- HDL cholesterol can be tested on its own where only that figure is needed: £58.13, results in 1 day.
- The ApoB blood test measures apolipoprotein B, the particles that carry cholesterol into artery walls. Some doctors consider it a more precise marker than LDL: £98.75, results in 3 days.
- Lipoprotein(a) is a separate, largely inherited type of cholesterol particle. Because the level changes little through life, it is often tested only once: £79.38, results in 1 day.
Each price is for the test itself, plus the £50 blood draw. For a fuller cardiovascular picture in one visit, see the range of heart health blood tests.
How cholesterol testing works at our Harley Street clinic
The lipid profile is one of our most requested private blood tests in London. You can walk in or book online at 117a Harley Street, seven days a week, with no GP referral needed. Results are sent by email, usually within 1 day.
Would you like these markers alongside a doctor's examination and a wider health assessment? The Full Body MOT health check covers cholesterol as part of a broader review. Otherwise, start your booking for the lipid profile.
Frequently asked questions
What is a good cholesterol level for my age?
NHS guidance gives the same general targets for all adults. Your doctor takes your age into account as part of your overall risk score.
Can I lower my cholesterol without medication?
Diet, activity, weight and stopping smoking can all improve your numbers, and many people are advised to try lifestyle changes first. Whether that's enough, or whether treatment is also needed, is a decision for your doctor based on your full risk picture.
Does high cholesterol have symptoms?
Usually not, because high cholesterol is picked up through testing, which is why routine checks matter even when you feel well.
How often should I check my cholesterol?
That depends on your risk factors and history. The NHS Health Check, which includes a cholesterol test, is offered every 5 years to adults aged 40 to 74. People on treatment or with a strong family history are usually tested more often, as their doctor advises.
Is a private lipid profile the same test as the NHS uses?
It reports the same standard markers: total, HDL, LDL and non-HDL cholesterol and triglycerides. Going private mainly changes the speed and convenience.
What's the difference between LDL and non-HDL cholesterol?
LDL is one specific cholesterol type. Non-HDL is everything except HDL added together, so it includes LDL and the other higher-risk particles. That is why some doctors treat it as the more complete figure.
References
- Cardiovascular disease: risk assessment and reduction, including lipid modification (NICE)
- High cholesterol (NHS)
- High cholesterol: cholesterol levels (NHS)
- Familial hypercholesterolaemia (NICE)