Cholesterol Package
- Total cholesterol
- Triglycerides
- HDL
- LDL
What Is Cholesterol?
Cholesterol is a fat-like substance used to produce cell membranes, certain hormones and bile acids in our bodies. It is produced by the liver and is also obtained from food. Although it is essential for normal bodily function, high blood levels of certain types of cholesterol can adversely affect cardiovascular health.
In particular, high LDL cholesterol can cause cholesterol to accumulate in artery walls and plaques to form over time. This process, called atherosclerosis, increases the risk of heart attack, stroke and peripheral arterial disease in the legs.
High cholesterol usually causes no symptoms. Measuring blood lipids is therefore important for identifying risk early and planning the necessary preventive measures. Results should be assessed not only on the basis of laboratory values, but also alongside age, family history, blood pressure, diabetes, kidney disease and smoking.
Which Tests Are Included in the Cholesterol Package?
1. Total Cholesterol
This measures the total amount of cholesterol carried by different lipoproteins in the blood. It provides initial information for assessing cardiovascular risk. However, total cholesterol alone is not sufficient; it should be interpreted alongside LDL, HDL and triglyceride results.
2. LDL Cholesterol — Bad Cholesterol
LDL is one of the lipoproteins that carry cholesterol from the liver to the tissues. High blood LDL levels contribute to plaque buildup in artery walls.
LDL is the primary target of cholesterol treatment. The appropriate LDL level varies from person to person. Lower LDL levels are targeted in people with cardiovascular disease or a high risk of developing it than in people at low risk.
3. HDL Cholesterol — Good Cholesterol
HDL helps transport excess cholesterol from the tissues to the liver. Low HDL levels may be associated with increased cardiovascular risk.
However, high HDL does not eliminate the risk posed by high LDL. Very high HDL levels do not necessarily mean greater protection either. All blood lipid levels and the person's other risk factors are considered together in the assessment.
4. Triglycerides
Triglycerides are one of the main types of fat the body uses to store energy. Excess calorie intake, excess weight, alcohol consumption, uncontrolled diabetes, certain diseases and medications can raise triglyceride levels.
High triglyceride levels are important in assessing cardiovascular risk. Very high levels can also increase the risk of pancreatitis, which is inflammation of the pancreas.
How Are Cholesterol and Triglyceride Levels Interpreted?
The tables below show the general classification for adults. Values are expressed in mg/dL. These thresholds are not the same as individual treatment targets.
Total Cholesterol Levels
| Total cholesterol | General assessment |
|---|---|
| Below 200 mg/dL | Desirable level |
| 200–239 mg/dL | Borderline high |
| 240 mg/dL and above | High |
There is no single threshold for “low” total cholesterol that applies to everyone. Unexpectedly low results are assessed alongside the medications being taken and the person's health status.
LDL Cholesterol Levels
| LDL cholesterol | General classification |
|---|---|
| Below 100 mg/dL | Optimal level |
| 100–129 mg/dL | Near optimal / above optimal |
| 130–159 mg/dL | Borderline high |
| 160–189 mg/dL | High |
| 190 mg/dL and above | Very high |
This table alone is not used to make treatment decisions. For example, although an LDL level of 90 mg/dL appears optimal in the general classification, it may be above target for someone who has had a heart attack. An LDL level of 190 mg/dL or above may also require assessment for inherited high cholesterol.
LDL Targets Based on Cardiovascular Risk
In the approach used by the European Society of Cardiology and the European Atherosclerosis Society, LDL targets are determined according to overall cardiovascular risk:
| Cardiovascular risk level | LDL target |
|---|---|
| Low risk | Below 116 mg/dL |
| Moderate risk | Below 100 mg/dL |
| High risk | Below 70 mg/dL and a reduction of at least 50% from baseline |
| Very high risk | Below 55 mg/dL and a reduction of at least 50% from baseline |
Your risk category is determined by your doctor. Low LDL levels achieved through treatment should not, on their own, be considered harmful or a reason to stop medication.
HDL Cholesterol Levels
| HDL cholesterol | General assessment |
|---|---|
| Below 40 mg/dL in men | Low |
| Below 50 mg/dL in women | Low |
| 40 mg/dL or above in men, 50 mg/dL or above in women | Above the low HDL threshold; assessed together with other results |
| Above 90 mg/dL | Very high; should not be assumed to provide greater protection |
The main approach to HDL is not to use medication to reach a specific number, but to reduce overall cardiovascular risk through measures such as regular physical activity, a balanced diet and stopping smoking.
Triglyceride Levels
| Fasting triglyceride level | General assessment |
|---|---|
| Below 150 mg/dL | Desirable level |
| 150–199 mg/dL | Borderline high |
| 200–499 mg/dL | High |
| 500 mg/dL or above | Very high |
This classification applies to fasting samples. Non-fasting triglyceride measurements may be assessed differently.
Triglyceride results of 500 mg/dL or above require prompt medical assessment. The risk of pancreatitis increases substantially, particularly at levels of 1.000 mg/dL or above. There is no universally applicable disease threshold for low triglycerides.
Who Should Have Cholesterol Tests?
Cholesterol measurement is part of cardiovascular risk assessment. It is particularly important for people with a family history of cardiovascular disease at an early age or high cholesterol, those who smoke, and those who are overweight or have hypertension, diabetes or chronic kidney disease.
People with known cardiovascular disease or those receiving cholesterol-lowering treatment are also monitored to assess the effectiveness of treatment. How often tests should be repeated depends on the individual's risk factors and previous results.
Do I Need to Fast Before a Cholesterol Test?
Routine cholesterol assessment can be performed without fasting in most people. However, fasting may be requested because of high triglycerides, a suspected inherited lipid metabolism disorder or other tests to be performed at the same time.
If fasting is requested, you generally need to avoid consuming calories for 8–12 hours; you may drink water during this time. If non-fasting triglycerides are 400 mg/dL or above, a repeat fasting measurement is recommended. Follow our laboratory's preparation instructions before the test and do not stop taking your medication without medical advice.
Where Can I Have Cholesterol Tests in Northern Cyprus?
You can have your cholesterol tests at Wellcare Laboratories' branches at Wellcare Health Clinic and Miracle Hospital in Nicosia and Medicalport Tunççevik Hospital in Kyrenia.
By reviewing your results with your doctor, you can learn about your personal cardiovascular risk and develop a follow-up and prevention plan suited to your needs.
About Cholesterol Tests
Frequently Asked Questions
Does high cholesterol cause symptoms?
High cholesterol usually causes no symptoms. LDL or triglyceride levels may be high even if you feel well. A blood test is therefore needed for assessment.
What should my total cholesterol level be?
In adults, a total cholesterol level below 200 mg/dL is desirable. Levels of 200–239 mg/dL are classified as borderline high, and 240 mg/dL or above as high. However, LDL, HDL, triglycerides and other risk factors should also be assessed to determine cardiovascular risk.
What should my LDL cholesterol level be?
The LDL target varies according to an individual's cardiovascular risk. European guidelines recommend targets below 116 mg/dL for low risk, 100 mg/dL for moderate risk, 70 mg/dL for high risk and 55 mg/dL for very high risk. For high and very high risk, a reduction of at least 50 percent from the baseline level is also recommended.
Am I protected against heart disease if my HDL is high?
No. High HDL does not cancel out the effects of high LDL or risk factors such as smoking, diabetes and hypertension. Very high HDL does not necessarily provide greater protection either. The results need to be assessed together.
At what level are triglycerides dangerous?
A fasting triglyceride level below 150 mg/dL is desirable. Levels of 500 mg/dL or above should be assessed promptly because of the risk of pancreatitis. The risk increases substantially, particularly at levels of 1.000 mg/dL or above.
Do I have to fast for a cholesterol test?
In most people, a routine lipid panel can be performed without fasting. However, fasting may be requested because of high triglycerides or additional tests. When fasting is required, avoiding food for 8–12 hours is generally sufficient; you may drink water. Follow the preparation instructions you are given.
Will I definitely need medication if my cholesterol is high?
The decision to prescribe medication is not based on a single cholesterol value alone. LDL level, age, existing medical conditions and overall cardiovascular risk are taken into account. Healthy lifestyle habits are important for everyone; some people also need medication.
Can I stop my medication once my cholesterol returns to normal?
Results returning to normal may indicate that treatment is effective. Stopping medication may cause cholesterol to rise again. The decision to continue or change treatment should be made together with your doctor.
Should I also have ApoB and Lipoprotein(a) tests?
Current guidelines recommend measuring Lipoprotein(a) at least once in adults to help assess inherited cardiovascular risk. ApoB may provide additional information, particularly in people with high triglycerides, diabetes or a risk level that is not adequately explained by standard lipid results. These tests are separate from the standard cholesterol package.
How often should I repeat my cholesterol test?
How often you need testing depends on your previous results, risk factors and whether you are receiving treatment. Earlier follow-up testing may be needed after starting medication or changing the dose. People with normal results and a low risk may be assessed at longer intervals.
Where can I get a cholesterol test in Northern Cyprus?
You can have your cholesterol tests at the Wellcare Laboratories branches at Wellcare Health Clinic and Miracle Hospital in Nicosia, and Medicalport Tunççevik Hospital in Kyrenia. Our branches can provide information on test preparation and an assessment tailored to your needs.