A complete cholesterol test measures levels of cholesterol and other fats in your blood. The CDC recommends testing every 4 to 6 years for healthy adults. People with a family history of high cholesterol or other risk factors may need to be tested more often.

Cholesterol is a waxy substance your body needs to produce certain hormones and to build the outer membrane of every cell. Although a certain level of cholesterol is essential, too much of it can build up in your blood vessels and raise your risk of:

  • heart disease
  • stroke
  • atherosclerosis, a clogging or hardening of your arteries

The Centers for Disease Control and Prevention (CDC) recommends beginning cholesterol testing in childhood or adolescence and getting retested at least every 5 years after the age of 20.

A complete cholesterol test, also called a lipid panel or lipid profile, measures the levels of lipids, or fats, in your blood. It primarily measures your:

  • High-density lipoprotein (HDL) cholesterol. HDL cholesterol is referred to as “good” cholesterol because it helps remove LDL cholesterol from your blood.
  • Low-density lipoprotein (LDL) cholesterol. LDL cholesterol is referred to as “bad” cholesterol. Too much of it can cause cholesterol to build up on the walls of your arteries. This raises your risk of heart attack, stroke, and atherosclerosis.
  • Triglycerides. When you eat, your body breaks down fats in your food into smaller molecules called triglycerides. High levels of triglycerides in your blood increase your risk of developing cardiovascular disease. Having obesity or unmanaged diabetes, drinking too much alcohol, and eating a high calorie diet can all contribute to high triglyceride levels.
  • Very low-density lipoprotein (VLDL). Your blood also contains another type of cholesterol linked to an increased risk of cardiovascular disease called VLDL. VLDL is often not mentioned on cholesterol tests because it’s not directly measured. Instead, VLDL levels are calculated by assuming VLDL levels are 20 percent of your triglyceride levels. Your VLDL levels are not used to determine treatment for elevated cholesterol.
  • Total cholesterol. This is the total amount of cholesterol in your blood. It’s the sum of your LDL, HDL, and VLDL cholesterol. Total cholesterol and HDL cholesterol are the the only levels that are directly measured. LDL and VLDL are both calculated values based on the the measurement of your total cholesterol, HDL, and triglycerides.

In the United States, cholesterol and triglyceride levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

Cholesterol test results

Ideal results for most adults are as follows:

  • LDL: less than 100 mg/dL
  • HDL: 40 to 60 mg/dL (a higher number is better)
  • Total cholesterol: less than 200 mg/dL
  • Triglycerides: less than 150 mg/dL
  • VLDL levels: under 30 mg/dL
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If your cholesterol numbers are outside of the normal range, you may be at a higher risk of heart disease, stroke, and atherosclerosis.

Your doctor will consider other factors, such as your family history, weight, and exercise levels, to determine your risk.

If your test results are abnormal, your doctor may order a blood glucose test to check for diabetes. They might also order a thyroid function test to determine if your thyroid is underactive.

Can test results be wrong?

In some cases, cholesterol test results can be wrong. For example, a recent study found that the assumption that VLDL levels are 20 percent of triglyceride levels is less accurate when triglyceride levels exceed 400 mg/dL

Improper fasting, medications, human error, and a variety of other factors can cause your test to produce false negative or false positive results.

Testing both your HDL and LDL levels typically produces more accurate results than checking your LDL alone.

Cholesterol testing is very important if you:

The CDC recommends regular testing every 4 to 6 years for most healthy adults. People with a family history of high cholesterol or other risk factors may need to get tested more often.

The CDC also recommends that children, adolescents, and young adults have their cholesterol levels checked once between the ages of 9 and 11, and again between 17 and 21.

In some cases, your doctor may ask you to fast before having your cholesterol levels tested.

However, according to 2018 guidelines published in the Journal of the American College of Cardiology, a nonfasting test can accurately detect high cholesterol or lipids in adults over age 20 who aren’t taking medications to lower their lipid levels.

If you do need to fast, you should avoid eating or drinking anything other than water for 9 to 12 hours before your test.

Before your test, you should also tell your doctor about:

  • any symptoms or health problems you’re experiencing
  • your family heart health history
  • all medications and supplements that you’re currently taking

If you’re taking medications that could increase your cholesterol levels, such as birth control pills, your doctor may ask you to stop taking them a few days before your test.

To check your cholesterol levels, your doctor will need to get a sample of your blood. You will probably have your blood drawn in the morning, sometimes after fasting since the night before.

A blood test is an outpatient procedure. It takes only a few minutes and is relatively painless. It’s usually performed at a diagnostic lab. In some cases, it can also be performed during a regular doctor visit, at a local pharmacy, or even at home.

Walk-in clinic rates usually cost anywhere from $50 to $100. Cholesterol testing at a local pharmacy can cost $5 to $25. An at-home test can cost anywhere from $15 to $25, while tests that need to be shipped to a lab can average from $75 to $200.

If you have health insurance, cholesterol tests that are ordered by your doctor will likely be fully or partially covered by your health insurance plan.

There are very few risks associated with having your blood drawn for a cholesterol test. You may feel slightly faint or have some soreness or pain at the site where your blood was drawn. There’s also a very slight risk of infection at the puncture site.

The reliability of home cholesterol tests can vary between brands. The reliability can also be affected by how well you follow the test instructions.

In a 2017 study, researchers found that two point-of-care lipid testing devices were relatively accurate and operated within the industry standards. This means that:

  • HDL levels were within 12 percent of the result of lab testing.
  • Total cholesterol was within 10 percent.
  • Triglyceride levels were within 15 percent.

In a 2021 study, researchers analyzed the performance of five types of commercially available home cholesterol tests. The researchers found that the Roche Accutrend Plus test had an excellent performance, but that several of the other products had poor accuracy and diagnostic ability.

The researchers concluded that better regulation and standardization are needed for at-home cholesterol tests.

For the most reliable results, laboratory testing may still be the best option, especially if you have risk factors for high cholesterol.

High cholesterol can be treated with lifestyle changes and medication. Lowering your LDL may help reduce your risk of heart conditions and other related issues.

To help lower your bad cholesterol levels:

  • If you smoke, consider quitting. Talk with your doctor about how to create a smoking cessation plan that will work for you.
  • Eat a balanced diet. Focus on eating a balanced diet that consists mostly of unprocessed foods. Try to eat a wide variety of vegetables, fruits, whole-grain products, low-fat dairy products, and lean sources of protein. Try to increase your intake of soluble fiber and limit your intake of foods that are high in saturated fats, such as butter, cream, meat, and palm oil.
  • Avoid trans fats. Artificial trans fats are hazardous to your heart and health. Read food labels and avoid foods that list partially hydrogenated items on the ingredients list.
  • Exercise regularly. Aim for at least 150 minutes of moderate intensity aerobic activity per week. This works out to about 22 minutes of exercise per day.
  • Maintain a moderate weight. Carrying too much weight is one of the main risk factors for high cholesterol. Talk with your doctor about what a healthy weight range is for you.
  • Limit your alcohol consumption. Heavy alcohol consumption is one of the leading risk factors for many types of diseases, including heart disease, high cholesterol, liver disease, and certain cancers.

Your doctor may put you on a “therapeutic lifestyle changes” or TLC diet. With this meal plan, only 7 percent of your daily calories should come from saturated fat. It also requires you to get less than 200 mg of cholesterol from your food each day.

Some foods may help your digestive tract absorb less cholesterol. For example, your doctor may encourage you to eat more:

  • oats, barley, and other whole grains
  • fruits, such as apples, pears, bananas, and oranges
  • vegetables, such as eggplant and okra
  • beans and legumes, such as kidney beans, chickpeas, and lentils

If changing your lifestyle habits alone isn’t enough to lower your cholesterol, your doctor may recommend taking medications, such as statins. These medications help lower your LDL levels.

Learn more about lowering your cholesterol here.

A cholesterol test can measure levels of cholesterol and fats in your blood to assess your risk of cardiovascular disease.

Most healthy adults should get their cholesterol levels tested at least every 5 years. People with a family history or at an increased risk of high cholesterol should get tested more often.

If you do have high cholesterol, your doctor can work with you to create a treatment plan to get your cholesterol levels into a healthy range.

Treatment for high cholesterol usually consists of some combination of dietary changes, increased exercise, smoking cessation, and medication.