What Do Your Cholesterol Numbers Actually Mean?

Understanding Your Cholesterol Numbers

Cholesterol testing is one of the simplest and most powerful ways to check your heart health. Yet when you receive your results, the numbers and abbreviations can be confusing — especially since the US and Europe use different units.

In the US, cholesterol is measured in mg/dL (milligrams per decilitre). In the UK and Europe, it’s measured in mmol/L (millimoles per litre). Knowing what the different cholesterol measures mean, and what’s considered healthy, can help you take control of your wellbeing and reduce your risk of heart disease.

What the Numbers Mean

A typical cholesterol test, called a lipid panel, measures four main things:

1. Total Cholesterol

This is the overall amount of cholesterol in your blood. Yes – everything. The good, the bad and the ugly. It includes LDL, HDL, and a range of other lipids.

Why it matters.

Total cholesterol is a crude measurement. But high total cholesterol can be a sign of increased heart risk, but it doesn’t tell us the full story without looking at LDL and HDL separately.

2. LDL Cholesterol (bad cholesterol)

LDL stands for low-density lipoprotein – which is really a cholesterol transport molecule. It carries cholesterol TO your arteries where it’s needed (yes we do need some cholesterol). The problem is when levels are too high, it can build up as fatty deposits (plaque). This narrows arteries and increases the risk of heart attack and stroke.

Therefore high LDL is strongly linked to cardiovascular disease.

3. HDL Cholesterol (good cholesterol)

HDL stands for high-density lipoprotein. It is also a cholesterol transport molecule. Only, it does the opposite of LDL. HDL helps to clear excess cholesterol from the blood and carries it BACK to the liver for processing and disposal.

Higher HDL levels are therefore protective against heart disease, because they help balance out LDL cholesterol.

Remember: HDL = H for Healthy

4. Triglycerides

Triglycerides are a type of fat that stores unused calories in the body. While they provide energy, high levels can be harmful.

High triglycerides often go hand in hand with low HDL and are linked to obesity, type 2 diabetes, and heart disease.

Putting the Numbers Together

Looking at one number alone doesn’t give the full picture.

For example, someone may have slightly high total cholesterol but very high HDL, which can reduce risk. Others may have normal total cholesterol but high LDL, which is more concerning. It is for these reasons that sometimes other cholesterol numbers are also used.

Cholesterol ratio is usually calculated as total cholesterol ÷ HDL cholesterol. Remember that HDL (good cholesterol) helps to clear excess cholesterol from the bloodstream, while total cholesterol includes both ‘good’ and ‘bad’ forms. Therefore a lower ratio is better, because it means you have more of the ‘protective’ or good HDL compared to harmful cholesterol. In general, a ratio below 4 is desirable, while 5 or above may suggest higher cardiovascular risk.
Non-HDL cholesterol is another important marker. It’s worked out by subtracting HDL cholesterol from total cholesterol, leaving behind all the “bad” types, such as LDL, VLDL, and remnants that contribute to artery plaque. Non-HDL is often seen as more accurate than LDL alone because it captures all harmful particles.

Clinicians like non-HDL because it doesn’t require fasting, it’s simple to calculate, and target levels are easy to interpret. Ideally, non-HDL should be less than 130 mg/dL (USA) or 3.4 mmol/L (UK/Europe), though lower is better for those at higher risk.

Together, cholesterol ratio and non-HDL give a fuller picture of heart risk than total cholesterol alone.

Improving Your Cholesterol Numbers

The good news is that cholesterol is often highly responsive to lifestyle changes.

Understanding your cholesterol numbers is about more than memorising targets — it’s about seeing how the different measures work together to reflect your heart health. So check your numbers against the table below to see how where your numbers fit in.

So with this in mind, our aims when it comes to maintaining a healthy lipid panel are as follows:

low LDL
low triglycerides
low cholesterol ratio
low non-HDL cholesterol
High HDL

Easy to remember because HDL (the only one beginning with H) should be High, the rest should be low.

By combining healthy eating, regular activity, and medical guidance where needed, you can manage your cholesterol numbers and reduce your risk of heart disease for the long term. Normal and abnormal ranges can be seen in the table below:

Cholesterol Measure	US Units (mg/dL)	Europe/UK Units (mmol/L)
Total Cholesterol – Desirable	Less than 200	Less than 5.0
Total Cholesterol – High	More than 240	More than 6.2
LDL – Optimal	Less than 100	Less than 2.6
LDL – High	160–189	4.1–4.9
HDL – Low (Men)	Less than 40	Less than 1.0
HDL – Low (Women)	Less than 50	Less than 1.3
HDL – Protective	More than 60	More than 1.6
Triglycerides – Normal	Less than 150	Less than 1.7
Triglycerides – High	200–499	2.3–5.6

If you’re looking for an easy-to-follow blueprint (along with a whole host of other useful materials) to build heart-healthy habits and strategies to take control of your cholesterol once and for all then take a look at our Cholesterol Protocol.

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