What is a Cholesterol Test?‍

A cholesterol test or the lipid panel/profile measures the amount of cholesterol and other types of fats you have in your body. Cholesterol is one of the important substances in the body that help its function and ensure that the body is working at its optimal level. It is a waxy, fat-like substance that is produced by the liver. The primary function of cholesterol in the body would be to produce other specific hormones and to help build the outer membranes of the cells in the body. The production of cholesterol, therefore, is necessary. However, too much cholesterol can be harmful. To measure the amount of cholesterol, and its types, in the body, doctors might order to get these levels tested.

Higher cholesterol levels can cause a build-up in the blood vessels, increasing the risk of:

•  Heart disease
• Atherosclerosis (hardening of arteries)
• Stroke

The Centres for Disease Control and Prevention (CDC) recommend that testing for cholesterol can begin in childhood or adolescence. Its retesting should be done every 5 years after the age of 20. Since the shift towards eating junk food, processed and fried food has increased, there is a reportedly high amount of cholesterol that is obtained in the body due to these foods. Eating meat, eggs, poultry, dairy, etc can catalyze the liver to produce more cholesterol.

The major types of cholesterol in the blood are HDL (good) and LDL (bad). Too much LDL cholesterol can lead to coronary heart disease and other heart conditions due to plaque build-up in the arteries. This is what the test would aim to measure.

What are the types of cholesterol test

There is one single test, called the lipid profile, that you will need to take to measure the cholesterol levels in your body. This profile is extensive and will provide you with a reading of the 4 different forms of cholesterol in your body and the types of fats present in the blood. The ideal and normal levels will depend on the age of the person, the sex assigned at birth, family history, previous history of cholesterol, and any other medical conditions. It may also vary in certain racial and ethnic groups.

Here is what your test will tell you:

1. Total cholesterol – The overall level of cholesterol in the blood will be provided here. A certain range will be given to depict whether your levels are in the average category or not.
2. LDL cholesterol – Low-density lipoprotein is also known as bad cholesterol. The test will give you an LDL cholesterol range and indicate whether your reading is at a harmful level. You need to be wary of this number and make sure that in case this is on the higher side, you take enough precautions to lower it as soon as you can.
3. HDL cholesterol – High-density lipoprotein is good cholesterol as it reduces the levels of LDL in the blood and keeps the arteries open for proper blood flow. The higher this number, the better it would be for you.
4. Triglycerides – The comprehensive panel will reveal the level of triglycerides in the body. This is a fat that is created when the calorie intake is higher than what your body requires. These are carried into the bloodstream by VLDL (very low-density lipoprotein) molecules. High triglycerides can cause obesity and might be linked to higher consumption of alcohol and a sedentary lifestyle.
5. Others – The test will also give you an indicator of other parameters like levels of non-HDL cholesterol and the ratio between cholesterol and HDL.
6. Advanced tests – In case your test results show higher LDL levels than normal, doctors may ask you to get more testing done. These tests will be more specific and will measure the LDL particle numbers. They will also break down the size and shape of cells that contain LDL cholesterol. These tests are not conducted often.

Who should get their cholesterol checked?

 A cholesterol blood test can be advised for people based on their history and age. It will be different for different people and no universal rule is set for how often you need to get these tests done. However, you can begin testing once every 5 years, even early in life. Even children and adolescents should get their blood tests done to avoid any complications.

A basic guideline that people can follow would be:

• For healthy adults – Cholesterol levels can be checked every 5 years
• For people with comorbidities like heart disease, diabetes, family history of cholesterol – The test can be taken once in 2 years.
• For children and adolescents – They can get one test between the age of 9 and 11 and once more between the ages of 17 and 21.
• For children who are overweight or with diabetes – The screening would have to be more often, at least once a year.

Other factors that would prompt your doctors to ask you to get these tests done would be:

• Health conditions
• High blood pressure or if you are on treatment for hypertension
• Smoking and alcohol consumption
• Other risk factors for cardiovascular disease

What happens during a cholesterol test?

When you are getting a cholesterol test done, it will be with a sample of your blood drawn from your vein in the arm like any other blood test. For proper and accurate test results, you will have to fast for 9-10 hours before the test is conducted. Most often than not, this will be a fasting blood test and your blood will be taken for testing in the morning before you have had your breakfast or morning beverage. You will only be allowed water in the 9-10 hours that you fast before the test. This is a simple procedure and is relatively painless. It will not take more than 10-15 minutes for this process. You might have to visit a diagnostic lab or call a lab tech home to collect the sample of your blood.

The technician will clean your arm with an alcohol swab to clear the site from any infections. They will tie a band around your upper arm tightly to spot the vein and increase blood flow to it. Ensure that a clean and sterilized needle is being used to draw the blood. They will then prick the vein and draw the required amount of blood for this or any other test that you would like to do. They will remove the band and take the needle out. They might place a small band-aid on the puncture site to avoid bleeding.‍

How to get prepared for a cholesterol test?

 If you are recommended a non-fasting test, the lab may only take into account the total cholesterol and your HDL numbers. All you will have to do for this test would be get the blood drawn at a diagnostic lab. However, for a test that requires fasting, the comprehensive lipid profile, will be the LDL cholesterol test that your doctors will focus on. Here, the LDL, HDL, triglyceride, and total cholesterol levels will be measured and you will be asked to fast the previous night.

Your doctor may ask you to get a non-fasting test done first. Depending on those numbers, they may ask for a lipid profile test. In case you are required to fast before the test, do not eat or drink anything except water 9-10 hours before the test

Before your test, inform your doctor about:

• Any symptoms or health problems that you have been dealing with
• A complete family history of cholesterol or heart issues
• All the medications that are currently prescribed to you

This is important because if you are on any medications that might increase your cholesterol levels, such as birth control pills, you might be asked to not take them a few days before the test is conducted.

Are there any risks of Cholesterol tests?

There is little to no risk of getting a blood test done. You will have to make sure that the injection site is clean before the prick and that the technician is using a clean and fresh needle to draw your blood. These will reduce the risk factors to almost zero. In some cases, there might be slight bruising or soreness on the spot. But these symptoms go away quickly. In case you have any other issue or the blood is not stopping, you can apply pressure on the injection site.

Understand Cholesterol levels

If you are conducting a complete lipid profile, it will be important to look at all the numbers in the cholesterol test, not just the total cholesterol value. The LDL and HDL levels are the two primary values that you can see that may indicate potential heart-related conditions. This is why a comprehensive profile is recommended.

Levels of total blood cholesterol:

· High risk: 240 mg/dL and above

· Borderline high risk: 200-239 mg/dL

· Optimal: Less than 200 mg/dL

LDL cholesterol levels:

Regarding the LDL blood test, this is the value that will represent the high-risk symptoms for heart disease and if the values are high (above 190mg/dl), it may be an indicator of the need for special treatment that includes lifestyle changes, diet, medication, etc. LDL levels that are less than 190mg/dl, the guidelines would recommend the lowering of this level by 30% to 50% based on other risk factors that may affect your health.

 HDL cholesterol levels:

• High risk: Less than 40 mg/dL for men and less than 50 mg/dL for women

Triglycerides:

• Very high risk: 500 mg/dL and above
• High risk: 200-499 mg/dL
• Borderline high risk: 150-199 mg/dL
• Normal: Less than 150 mg/dL

Can Cholesterol test results be wrong?

In some cases, the cholesterol values can be wrong. Several factors can affect the values of these tests, faulty equipment used for testing, improper fasting, human errors, etc. These can result in false negative or positive reports. The complete panel should be tested to mitigate and minimize these errors as far as possible. Testing for both HDL and LDL levels can produce more accurate results than checking only one of them

Are home cholesterol tests reliable?

The at-home cholesterol test cost and reliability may vary between brands. The reliability might also depend on how you use the test materials and how well you follow instructions.

Researchers found that lipid profile testing can vary depending on different brands. A much better and more standardized method of home testing kits for cholesterol needs to be developed for testing at home. For diagnosis and more accurate results, the lab would always be the more suitable option. Lab results include regulated procedures with little margin for error

Lifestyle changes and treatment to Manage Cholesterol 

After a cholesterol measurement, if the values are high, they can be treated with a combination of lifestyle changes and medication. The primary goal would be to lower the LDL values so that it can help reduce the risk of heart conditions and other issues that may arise as a result of high cholesterol

To lower these levels:

1. Quit smoking – come up with a plan to stop smoking to see significant results in the reduction of cholesterol levels in the body
2. Balanced diet – Diet is everything when it comes to health management. Focus on a balanced diet with unprocessed foods. Try to include a variety of vegetables, fruits, whole grains, low-fat products, etc. in the diet chart. Increase the intake of soluble fibers and limit foods that are high in saturated fats like butter, meat, cream, etc.
3. Avoid trans fats – The most hazardous food for cholesterol health would be trans fats. Food that has labels should be checked thoroughly for trans fats. Avoid foods that have partially hydrogenated items on the list
4. Exercise – Be as regular as possible in your exercise regime. At least 30-40 minutes of exercise should be done per day. Moderate aerobic activities will work best
5. Lose weight – Loose excess weight and maintain a moderate weight range. Too much weight can be a risk factor for high cholesterol levels.
6. Limit the consumption of alcohol – Higher alcohol consumption can be a risk factor for many diseases like heart problems, diabetes, high cholesterol, cancer, etc

 A type of diet where only 5-6% of the total calories come from trans fats and saturated fats will be best. Consume not more than 200-300mg of cholesterol from foods in a day

Some foods may help your digestive tract to absorb less cholesterol from them. For example, you may be asked to eat more:

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

At times, doctors may also recommend you include medications in the plan to lower cholesterol levels. If lifestyle changes are not enough, medications might be added on to help lower the overall LDL levels in the body‍

Bottomline

Cholesterol testing is one of the most important tests that each person may have to get done to be able to lead an overall healthy life. In case of risk factors, the testing might need to be more frequent as recommended by doctors. Additionally, tests may reveal the values of different variants of cholesterol in the body, each variant may mean something and the values can be interpreted by trained healthcare professionals. Based on these values, the treatment method going forward will be suggested. Get these tests done regularly for a better quality of life.‍

FAQs‍

1. How Often Should I Have A Cholesterol Test?

Most healthy adults will be asked to get their cholesterol test levels every 2-3 years. However, if you are a person with diabetes or have any other chronic illness like kidney disease, liver dysfunction, heart disease, etc, you may be asked to get these levels checked once in 6-12 months. If you have high cholesterol levels and are on a treatment plan, you will have to check these levels more often.

2. Why Do I Need a Cholesterol Test?

High cholesterol usually comes without any signs or symptoms. Therefore, doctors recommend getting these levels tested as frequently as needed to stay one step ahead of the problem, in case it arises. Since high cholesterol is directly linked to an increased rate of heart attacks or strokes, testing is the best way to detect early signs and prevent the onset of any issue.

3. What is a normal cholesterol level in a blood test?

The normal level of cholesterol will differ according to your age and sex assigned at birth. It may also vary if you have any underlying conditions. The average normal range for these levels is – less than 200mg/dl for adults. Borderline high levels would be around 200-239mg/dl. Any level above 240mg/dl is considered high.

4. What are LDL and HDL in blood tests?

HDL and LDL are the two main types of cholesterol present in the blood. High-density lipoprotein is the good cholesterol that is responsible for transporting the bad cholesterol to the liver so that it can be disposed of. The higher the HDL quantity, the better. LDL or low-density lipoproteins are responsible for plaque build-up in the arterial walls and can result in further complications. This level should be low ideally in a blood test.

5. How can you check your cholesterol at home?

A standard at-home cholesterol test can be a finger prick test. This will contain a lancet and testing strips. You can use a cholesterol home testing kit. Prick your finger with the lancet and place the drop of blood on the strip with the enzyme. This enzyme will cause a chemical reaction and the strip will change colors. These colors will depict the level of cholesterol in the blood.

6. What are the warning signs of cholesterol?

High cholesterol may not be preceded by any warning signs. However, it can lead to complications like – chest pain, heart attack, stroke, etc. Some warning signs may be present in and around the eyes as cholesterol deposits can create issues in the vision.

7. What are the Cholesterol symptoms on the skin?

Some yellowish-orange waxy growth on the skin including the corner of the eyes, near the nose, lines on the palms, backs of the lower legs, etc could mean high cholesterol. Other signs could be ­– swelling of the feet, the bluish-purple color of the skin, a blue-purple net-like pattern on the skin, waxy bumps that might look like a rash, nail curvature, etc might indicate higher levels of cholesterol.