A cholesterol test result usually arrives as four or five numbers with little explanation. This guide walks through each one, shows the ranges labs and doctors use, and explains what a change between two tests actually tells you.
This guide is general information, not medical advice
The ranges below are general guidelines for adults. Your own target depends on your age, other conditions, family history and overall heart risk, so always go through your results with your doctor.
What's on a standard lipid panel
A standard cholesterol test (also called a lipid panel or lipid profile) measures the fats in your blood. Most reports include:
- Total cholesterol: all the cholesterol carried in your blood.
- LDL cholesterol ("bad" cholesterol): the main driver of plaque build-up in artery walls, and the number most treatment decisions are based on.
- HDL cholesterol ("good" cholesterol): helps carry cholesterol away from your arteries to your liver.
- Triglycerides: the most common type of fat in your blood, strongly affected by sugar, refined carbs and alcohol.
- Non-HDL cholesterol: total cholesterol minus HDL. It captures every cholesterol-carrying particle that can contribute to plaque.
Some reports also show a total cholesterol to HDL ratio, VLDL cholesterol, or extra markers like ApoB and Lp(a), covered further down. For a short definition of any of these terms, see our cholesterol glossary.
Updated for the 2026 US guideline
In March 2026 the American College of Cardiology and American Heart Association replaced their 2018 cholesterol guideline. The new one brings back LDL goals based on your risk, uses a new risk calculator called PREVENT, and recommends an Lp(a) test for every adult. This guide reflects those changes. For a plain-English summary of everything that changed, read the new cholesterol guidelines for 2026.
Cholesterol levels chart for adults
These are the general categories used in the US by the National Heart, Lung, and Blood Institute and MedlinePlus. mmol/L values (used in the UK, Canada, Australia and most of Europe) are converted and rounded.
| Test | mg/dL | mmol/L | What it means |
|---|---|---|---|
| Total cholesterol | Under 200 | Under 5.2 | Desirable |
| 200–239 | 5.2–6.2 | Borderline high | |
| 240 and above | 6.2 and above | High | |
| LDL cholesterol | Under 100 | Under 2.6 | Optimal for most people |
| 100–129 | 2.6–3.3 | Near optimal | |
| 130–159 | 3.4–4.1 | Borderline high | |
| 160–189 | 4.1–4.9 | High | |
| 190 and above | 4.9 and above | Very high (ask about inherited high cholesterol) | |
| HDL cholesterol | Under 40 (men), under 50 (women) | Under 1.0 (men), under 1.3 (women) | Low, linked to higher heart risk |
| 60 and above | 1.5 and above | Generally considered protective | |
| Triglycerides | Under 150 | Under 1.7 | Normal |
| 150–199 | 1.7–2.2 | Borderline high | |
| 200–499 | 2.3–5.6 | High | |
| 500 and above | 5.6 and above | Very high | |
| Non-HDL cholesterol | Under 130 | Under 3.4 | Desirable for most adults |
"Normal" isn't the same as your target
The chart above shows where you stand compared with the general adult population. If you already have heart disease, diabetes, or a high 10-year risk score, your doctor will usually aim for an LDL well below 100 mg/dL (2.6 mmol/L). If your risk is low, a result in the borderline range may simply mean lifestyle changes and a re-test. The chart tells you where you stand; your doctor sets where you're heading.
LDL and non-HDL goals by risk (2026 ACC/AHA guideline)
The 2018 US guideline dropped fixed LDL targets and focused on how much medication lowered LDL in percentage terms. The 2026 guideline keeps the percentage drops and brings back numeric goals for people on treatment. The higher your risk, the lower the goal:
| Who it applies to | LDL goal | Non-HDL goal |
|---|---|---|
| Heart or artery disease at very high risk (for example, more than one heart attack or stroke, or one plus several high-risk features) | Under 55 mg/dL (1.4 mmol/L) | Under 85 mg/dL (2.2 mmol/L) |
| Heart or artery disease, not very high risk | Under 70 mg/dL (1.8 mmol/L) | Under 100 mg/dL (2.6 mmol/L) |
| No heart disease, but a high 10-year risk (PREVENT score of 10% or more), or diabetes with several other risk factors | Under 70 mg/dL (1.8 mmol/L) | Under 100 mg/dL (2.6 mmol/L) |
| No heart disease, borderline or intermediate risk (PREVENT 3% to under 10%) and taking a statin, or diabetes aged 40 to 75 | Under 100 mg/dL (2.6 mmol/L) | Under 130 mg/dL (3.4 mmol/L) |
A few things to know about this table:
- These are treatment goals, not diagnoses. They're for deciding how far to lower LDL once you and your doctor have agreed on treatment. Which row you're in depends on your history and your risk score, and only your doctor can place you.
- Most people with heart disease fall in the top row. The guideline says the majority of people who've had a heart attack or stroke will likely qualify for the under 55 mg/dL goal.
- The percentage drop still matters. The guideline also expects LDL to fall by 30–49% at borderline or intermediate risk, and by 50% or more at high risk or with heart disease.
- PREVENT is the new risk score. It replaces the older Pooled Cohort Equations for adults aged 30 to 79 and estimates your chance of a heart attack or stroke over 10 years (and over 30 years if you're 30 to 59). If you haven't been told your score, ask.
If you're in the UK
NHS doctors follow NICE guidance rather than the US guideline. NICE uses the QRISK3 calculator, aims for a fall of more than 40% in non-HDL cholesterol for people taking a statin to prevent a first heart attack or stroke, and aims for LDL of 2.0 mmol/L or less (or non-HDL of 2.6 mmol/L or less) for people who already have heart or artery disease. The NHS healthy ranges further down still apply.
Converting between mg/dL and mmol/L
If your lab uses different units from an article or app you're reading, convert with these factors:
- Cholesterol (total, LDL, HDL, non-HDL): mg/dL ÷ 38.67 = mmol/L. For example, LDL of 130 mg/dL ≈ 3.4 mmol/L.
- Triglycerides: mg/dL ÷ 88.57 = mmol/L. For example, 150 mg/dL ≈ 1.7 mmol/L.
Reading your results in mmol/L (UK, Canada, Australia)
If your report is in mmol/L, the UK's NHS uses a simpler guide for healthy adults than the US categories above:
- Total cholesterol: below 5 mmol/L
- HDL: above 1.0 mmol/L for men, above 1.2 mmol/L for women
- Non-HDL: below 4 mmol/L
Here's how some common total cholesterol readings compare:
| Total cholesterol (mmol/L) | Same in mg/dL | What it usually means |
|---|---|---|
| 4.0 | 155 | Healthy by both NHS and US guides |
| 5.0 | 193 | Right at the NHS limit; still "desirable" by US categories |
| 5.5 | 213 | Above the NHS guide; borderline high by US categories |
| 6.0 | 232 | Above the NHS guide; borderline high by US categories |
| 6.5 | 251 | High |
| 7.5 or more | 290 or more | Very high. With a family history of early heart disease, ask about inherited high cholesterol |
Total cholesterol on its own doesn't tell you much, because it includes your HDL. Two people with a total of 6.0 mmol/L can be in very different places: with an HDL of 2.0 the non-HDL is 4.0 (on target), but with an HDL of 1.0 it's 5.0 (high). Always look at the breakdown, not just the headline number.
Cholesterol levels by age and sex
The healthy ranges are the same for all adults, with one difference: women's HDL threshold is higher. Children and teenagers have lower targets. These are the general guidelines from MedlinePlus (US National Library of Medicine):
| Age 19 or younger | Men 20 and over | Women 20 and over | |
|---|---|---|---|
| Total cholesterol | Under 170 mg/dL (4.4 mmol/L) | Under 200 mg/dL (5.2 mmol/L) | Under 200 mg/dL (5.2 mmol/L) |
| LDL | Under 110 mg/dL (2.8 mmol/L) | Under 100 mg/dL (2.6 mmol/L) | Under 100 mg/dL (2.6 mmol/L) |
| Non-HDL | Under 120 mg/dL (3.1 mmol/L) | Under 130 mg/dL (3.4 mmol/L) | Under 130 mg/dL (3.4 mmol/L) |
| HDL | Over 45 mg/dL (1.2 mmol/L) | 40 mg/dL (1.0 mmol/L) or higher; 60+ is best | 50 mg/dL (1.3 mmol/L) or higher; 60+ is best |
Cholesterol tends to creep up with age in both sexes. For women, LDL often rises noticeably around menopause as oestrogen falls, so a result that was fine at 40 can look different at 55. That's a good reason to re-test at the intervals your doctor suggests rather than relying on an old result.
Reading each number
LDL: the number to watch most closely
LDL is the main target of both diet changes and medication. Many labs don't measure it directly. They calculate it from your total cholesterol, HDL and triglycerides. The classic formula (Friedewald) is LDL = total cholesterol − HDL − triglycerides ÷ 5 in mg/dL. It becomes unreliable when triglycerides are high (around 400 mg/dL / 4.5 mmol/L or more) or LDL is very low. The 2026 US guideline now prefers the newer Martin/Hopkins or Sampson/NIH equations over Friedewald, and many labs already use one of them. If your report says "calculated" and your triglycerides are high, ask whether an ApoB test would help.
HDL: higher is usually better, up to a point
Low HDL is linked to higher heart risk, and regular exercise, not smoking and losing excess weight tend to raise it. But raising HDL with medication hasn't been shown to prevent heart attacks, and extremely high HDL isn't necessarily extra-protective. Treat a good HDL as a positive sign, not a licence to ignore a high LDL.
Triglycerides: the most changeable number
Triglycerides swing more than the other numbers. They rise after meals, with alcohol, and with diets heavy in sugar and refined carbohydrates, and they often fall quickly when those change. Very high triglycerides (500 mg/dL / 5.6 mmol/L or more) need prompt attention because they raise the risk of pancreatitis. For food changes that bring them down, see what to eat for high triglycerides.
Non-HDL cholesterol and the cholesterol ratio
Non-HDL cholesterol is simply total cholesterol minus HDL, and many guidelines now treat it as just as useful as LDL, especially when triglycerides are high. The total cholesterol to HDL ratio (total ÷ HDL) is another way some labs summarise risk. Lower is better, and many reports flag a ratio above 5.
Fasting vs non-fasting tests
For most people, a non-fasting test is fine for routine checks, and the 2026 US guideline accepts either. Eating mainly affects triglycerides (and a calculated LDL), so if a non-fasting result shows triglycerides of 400 mg/dL (4.5 mmol/L) or more, or you have a family history of lipid problems, your doctor may repeat the test after an overnight fast. Follow whatever instructions your doctor or lab gave you, and try to test the same way each time so your results are comparable.
Lp(a), ApoB and other markers you might see
Lp(a): now recommended once for every adult
Lp(a), or lipoprotein(a), is a cholesterol-carrying particle whose level is mostly set by your genes. Diet and exercise barely change it, and it stays fairly stable through life, so one test is usually enough. The 2026 ACC/AHA guideline says Lp(a) should be measured at least once in every adult. It isn't part of a standard lipid panel, so you may need to ask for it. Our Lp(a) test guide explains the thresholds and how to ask, in the US and on the NHS.
| Lp(a) result | What the 2026 guideline says |
|---|---|
| Under 125 nmol/L (under 50 mg/dL) | Not considered elevated |
| 125 nmol/L (50 mg/dL) or more | Elevated. Counts as a "risk-enhancing factor", linked to roughly 1.4 times the risk of heart attack and stroke |
| 250 nmol/L (100 mg/dL) or more | Linked to about twice the risk or more |
Labs report Lp(a) in either nmol/L or mg/dL, and the two can't be converted with a simple factor, so compare your result with the threshold in the same unit. A high Lp(a) doesn't mean something is wrong today. It means your doctor may want your LDL and other risk factors lower than they otherwise would, and that close relatives may want to be tested too.
ApoB: a particle count, used selectively
ApoB (apolipoprotein B) counts the number of potentially plaque-forming particles rather than the cholesterol inside them. It can flag risk that LDL alone misses, especially with high triglycerides, type 2 diabetes or metabolic syndrome. The 2026 guideline doesn't make it a routine test for everyone. It says ApoB is reasonable for people already on treatment, particularly with heart disease, diabetes or high triglycerides, to decide whether to step treatment up once LDL and non-HDL goals are met, and may be useful for some people not yet on treatment.
Other markers
- hs-CRP: a marker of inflammation that's sometimes used alongside a lipid panel to refine risk.
- Coronary artery calcium (CAC) score: a CT scan rather than a blood test. The 2026 guideline suggests it for men from 40 and women from 45 when the decision about starting treatment is uncertain.
Why one result can be misleading
Cholesterol numbers naturally vary from test to test, and so do labs. Recent illness, a big weekend, a change in weight, or simply biological variation can move a result by several percent. That's why a single borderline number is usually re-checked rather than acted on alone, and why the trend across several tests tells you far more than any one report.
What it means if your cholesterol stays high on repeat testing
If your LDL stays high even after a few months of genuine diet and lifestyle changes, it doesn't mean you failed. Genetics play a large role in how much cholesterol your liver makes. An LDL of 190 mg/dL (4.9 mmol/L) or more, especially with a family history of early heart disease, can point to familial hypercholesterolemia (inherited high cholesterol), which usually needs medication. Read more in our article on genetics and cholesterol hyper-responders.
How to tell whether your treatment is working
After starting a statin (see what to eat on statins) or making a significant lifestyle change, doctors commonly re-check a lipid panel within about 4 to 12 weeks to see the response. Signs it's working:
- LDL is falling by a meaningful percentage. Under US guidelines, moderate-intensity statins aim to cut LDL by roughly 30–49% and high-intensity statins by 50% or more. Diet changes alone typically produce smaller, but still worthwhile, drops.
- Non-HDL cholesterol is falling alongside LDL.
- Triglycerides are coming down if they were high, often the fastest number to respond to cutting alcohol, sugar and refined carbs.
- The direction holds across more than one test, not just a single good result.
For practical first steps after a high result, see what to do when your doctor says your cholesterol is high, how to lower cholesterol naturally and our list of 100 food swaps that lower cholesterol.
Questions to ask your doctor about your results
- What LDL (or non-HDL) goal is right for me, given my overall risk?
- What is my estimated 10-year heart risk (PREVENT score in the US, QRISK3 in the UK)?
- Have I ever had my Lp(a) measured? If not, should I?
- Was my LDL calculated or measured directly? Would an ApoB test be useful for me?
- Should my next test be fasting?
- How soon should I re-test after changing my diet or starting medication?
- Does my family history suggest inherited high cholesterol?
Make your next appointment easier
Bring your previous results with you, or keep them in one app. Seeing three or four tests side by side, with dates, makes it much easier for you and your doctor to tell a real trend from normal variation.
Sources
- MedlinePlus: Cholesterol levels, what you need to know
- National Heart, Lung, and Blood Institute: Blood cholesterol
- American Heart Association: Cholesterol
- CDC: Cholesterol
- NHS: Cholesterol levels
- Blumenthal RS, Morris PB, et al. 2026 ACC/
AHA/ . J Am Coll Cardiol. 2026;87(19). Also published in Circulation.AACVPR/ ABC/ ACPM/ ADA/ AGS/ APhA/ ASPC/ NLA/ PCNA Guideline on the Management of Dyslipidemia - American Heart Association: Top things to know, 2026 Guideline on the Management of Dyslipidemia
- NICE NG238: Cardiovascular disease risk assessment and reduction, including lipid modification
Frequently asked questions
What is a normal cholesterol level?
For most adults, desirable levels are total cholesterol under 200 mg/dL (5.2 mmol/L), LDL under 100 mg/dL (2.6 mmol/L), HDL of 60 mg/dL (1.5 mmol/L) or higher, and triglycerides under 150 mg/dL (1.7 mmol/L). Your personal goal may be lower: under the 2026 ACC/AHA guideline, people with heart disease or a high 10-year risk have LDL goals of under 70 mg/dL (1.8 mmol/L) or under 55 mg/dL (1.4 mmol/L).
What LDL level should I aim for under the 2026 guidelines?
The 2026 ACC/AHA guideline brought back LDL goals for people on treatment, set by risk: under 55 mg/dL (1.4 mmol/L) for people with heart disease at very high risk; under 70 mg/dL (1.8 mmol/L) for other people with heart disease or a 10-year PREVENT risk of 10% or more; and under 100 mg/dL (2.6 mmol/L) for people at borderline or intermediate risk who take a statin. Your doctor decides which group you're in.
Should I get my Lp(a) tested?
The 2026 ACC/AHA guideline recommends that every adult has Lp(a) measured at least once. A level of 125 nmol/L (50 mg/dL) or more is considered a risk-enhancing factor, and 250 nmol/L (100 mg/dL) or more is linked to roughly double the risk. Lp(a) is mostly inherited, so one test is usually enough. Ask your doctor if it's never been checked.
Is it OK if my HDL is high but my LDL is also high?
A good HDL is a positive sign, but it doesn't cancel out a high LDL. Treatment decisions are mainly based on LDL (or non-HDL cholesterol) and your overall heart risk, so a high LDL is still worth discussing with your doctor.
Do I need to fast before a cholesterol test?
Usually not for a routine check. The 2026 ACC/AHA guideline accepts a fasting or non-fasting test. Eating mainly raises triglycerides, so your doctor may ask for a fasting test if a non-fasting result showed triglycerides of 400 mg/dL (4.5 mmol/L) or more. Follow the instructions you were given.
Is a cholesterol level of 6 high?
A total cholesterol of 6 mmol/L (about 232 mg/dL) is above the NHS guide of 5 mmol/L and borderline high by US categories. What matters more is how it splits: check your non-HDL (ideally below 4 mmol/L) and HDL, and talk to your doctor about your overall heart risk. Our guide to getting from 6 to 5 mmol/L sets out a practical plan.
What is a normal LDL level for women?
The same as for men: under 100 mg/dL (2.6 mmol/L) for most adults, and lower for women with heart disease or a high 10-year risk. The difference is HDL, where women should aim for 50 mg/dL (1.3 mmol/L) or higher. LDL often rises around menopause, so regular re-testing matters.
How often should I get my cholesterol checked?
The 2026 ACC/AHA guideline recommends a lipid panel from age 19 and at least every 5 years after that, more often if you have other risk factors. People with high cholesterol, heart disease, diabetes, or who have just started treatment are checked more often, commonly within 4 to 12 weeks of a change and then every 3 to 12 months.
Keep every result in one place
Heart Tracker charts your total cholesterol, LDL, HDL and triglycerides against these ranges, and lines them up with what you were eating between tests.
Download Heart Tracker Free