Definition
A total cholesterol test is a rough measure of all the cholesterol and triglycerides in your blood.
Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart disease.
Some cholesterol is considered "good" and some is considered "bad." Different blood tests are needed to individually measure each type of cholesterol.
See also:
How to prepare for the test
To get accurate results, you should not eat or drink anything for 9 to 12 hours before the test. You may drink water, but other beverages such as coffee, tea, or soda should be avoided.
Your health care provider may tell you to stop taking drugs that can affect the test. Never stop taking any medicine without first talking to your doctor.
Drugs that may increase total cholesterol measurements include:
- ACTH
- Anabolic steroids
- Beta-adrenergic blocking agents
- Corticosteroids
- Epinephrine
- Birth control pills
- Phenytoin
- Sulfonamides
- Thiazide diuretics
- Vitamin D
Drugs that may decrease total cholesterol measurements include:
- Allopurinol
- Androgens
- Captopril
- Chlorpropamide
- Colchicine
- Colestipol
- Erythromycin
- Fibrates
- Isoniazid
- MAO inhibitors
- Neomycin
- Niacin
- Nitrates
- Statins
How the test will feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
This test is often done to determine your risk for coronary artery disease. High blood cholesterol and triglycerides have been linked to heart attack and stroke.
Experts recommend that you have a complete cholesterol and triglycerides analysis every 5 years starting at age 20.
The total cholesterol test is usually done as part of a lipid profile, which also checks for LDL, HDL, and triglycerides.
Additional conditions under which the test may be performed:
Normal Values
Total cholesterol is an important measure of both bad and good cholesterol. Other lab tests are done to measure specific amounts of good (HDL) and bad (LDL) cholesterol. A cholesterol breakdown including LDL and HDL is preferred.
The total cholesterol values listed below are used to target therapy:
- Desirable: Under 200 milligrams per deciliter (mg/dL)
- Borderline high: 200 to 239 mg/dL
- High risk: 240 mg/dL and higher
What abnormal results mean
In general, a total cholesterol value over 200 mg/dL may mean you have a greater risk for heart disease. However, LDL levels are a better predictor of heart disease, and they determine how your high cholesterol should be treated.
High total cholesterol levels may be caused by:
Low cholesterol levels may be caused by:
What the risks are
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks, although rare, may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Special considerations
Any acute illness can raise or lower your total cholesterol number. If you have had an acute illness in the 3 months before having this test, you should have it repeated in 2 or 3 months. Even a flare-up of arthritis can affect your cholesterol level.
Other conditions associated with high cholesterol include:
- Pregnancy
- Removal of the ovaries
References
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.
