Did your doctor also tell you to take a blood test and check your cholesterol? When you got that report, did you get confused by the numbers in front of each one? LDL, HDL, triglycerides... You may be wondering what these are, what these numbers really mean. Don't be afraid, today we will talk about this simply, as if we were telling a friend. Understanding this will be a great help for you in making decisions about your health.
First, let's see, what is this lipid profile?
The blood test you take to check your cholesterol is what we medically call a `Lipid Profile`. Lipid simply means fat. This test gives us information about several types of fats in your blood. Knowing these values is very important, because it can give you an idea of your risk of diseases such as heart disease and stroke in the future.
| Lipid Type | Simply put... |
|---|---|
| Total Cholesterol | The sum of all the types of cholesterol in your blood. |
| LDL (Low-Density Lipoprotein) | "Bad" cholesterol. This is what deposits in blood vessels and clogs them. |
| HDL (High-Density Lipoprotein) | "Good" cholesterol. This is what cleans the blood vessels by removing bad cholesterol. |
| Triglycerides | Another type of fat that is formed from the food we eat, especially sugar and extra calories. |
The important thing is that you can't make a complete decision about your risk based on the numbers in this report alone. Your doctor will explain your risk to you by taking into account many factors, such as your age, blood pressure, whether you smoke, and whether you take medication for your blood pressure, along with these numbers.
Let's learn about LDL, the "bad" cholesterol.
We often hear about this `LDL` cholesterol. Actually, our body needs a certain amount of `LDL` to build cells, produce hormones and vitamins. It is produced by our liver.
The problem starts when there is too much LDL. Then this extra LDL starts to build up on the walls of your blood vessels. Like dirt building up in a water pipe. Over time, this build-up (plaque) can cause your blood vessels to become narrow and blocked, leading to serious conditions like heart attacks and strokes. That's why LDL is called "bad" cholesterol. So the lower your LDL level, the lower your risk.
- If your LDL level is very high (over 190 mg/dL): This is a very high level. In this case, your doctor will often recommend starting you on a statin drug along with lifestyle changes (diet, exercise).
- Even if your LDL level is below 190 mg/dL: Your doctor may decide to lower your LDL level further, taking into account your other risk factors (such as diabetes and high blood pressure).
- Very low LDL levels (more than 40 mg/dL): This is very rare. But abnormally low LDL levels are not good either. It can lead to depression, anxiety, and sometimes a risk of hemorrhagic stroke.
The importance of HDL, the "good" cholesterol
`HDL` (High-Density Lipoprotein) is like our friend. The higher the `HDL` value, the lower the risk of heart disease. The reason is that `HDL` captures the `bad` `LDL` cholesterol that is about to be deposited in the blood vessels and takes it back to the liver. It's like sweeping a street and cleaning it.
Exercise and some types of statins can slightly increase HDL levels.
- What is a good HDL level?: A level above 40 mg/dL for men and above 50 mg/dL for women is considered a healthy level.
- Very high HDL levels (over 100 mg/dL): While it's generally considered good to have high HDL levels, recent research has found that in rare cases, abnormally high HDL levels can be associated with an increased risk of heart disease. So it's important to keep everything in balance.
What are triglycerides?
Triglycerides are not a type of cholesterol, but they are another type of fat in our blood. The extra calories in the food we eat, especially those from sugar, flour, and alcohol, are converted into triglycerides by the body and stored in fat cells.
Elevated triglyceride levels are directly linked to an increased risk of heart disease. Often, people with high triglycerides have low "good" HDL and high "bad" LDL. This combination is very dangerous.
Causes of high triglyceride levels:
- A lazy lifestyle without physical exercise.
- Eating a diet high in sugar, refined carbohydrates (such as bread, rice, noodles), and saturated fats.
- Excessive alcohol consumption.
- Uncontrolled diabetes, kidney disease, thyroid problems.
- Obesity.
- Certain medications (e.g., medications for breast cancer, HIV).
- Some people may also be affected by genetic factors that come from their families.
If your triglyceride level is higher than 150 mg/dL, your doctor will likely recommend lifestyle changes, such as regular exercise, a healthy diet, weight loss, and limiting alcohol intake. They may also prescribe medication.
What are healthy cholesterol levels?
This table will help you compare the numbers on your report with normal healthy levels. In Sri Lankan reports, these values are measured in mg/dL (milligrams per deciliter), just like in the United States.
| Category | Target healthy level (mg/dL) |
|---|---|
| Children and young people (19 years and under) | |
| Total Cholesterol | Under 170 |
| LDL ("bad") | Under 110 |
| HDL ("good") | Over 45 |
| Adults (20 years and older) | |
| Total Cholesterol | Between 125 - 200 |
| LDL ("bad") | Less than 100 (less than 70 for those with risk factors) |
| HDL ("good") | Male: Over 40 Women: Over 50 |
| Triglycerides | |
| To everyone | Under 150 |
Remember, these are just general target values. If you already have a condition like heart disease or diabetes, your doctor may give you a lower target. So always talk to your doctor about this.
Important questions to ask your doctor
When you find out that your cholesterol levels are high, don't forget to ask your doctor these questions.
1. What are the dangers of high cholesterol? Can it cause other diseases?
2. What could be causing my high cholesterol? Is this hereditary?
3. What can I do in my lifestyle and at home to lower cholesterol?
4. Do I really need to take medication? Are there no alternative treatments?
5. If you have to take medication, how does it work?
6. How long will I have to take this medicine? What are the side effects?
7. How can I lower my cholesterol through exercise?
8. How should I change my diet? What is good to eat and what is bad to eat?
9. When should I get my cholesterol checked next?
Take-Home Message
- Cholesterol is something our body needs, but too much of it can be dangerous. That's why it's important for you, as a healthy adult, to have your cholesterol levels checked at regular intervals .
- Understand the LDL ("bad"), HDL ("good"), and triglyceride values in your Lipid Profile report.
- These numbers are only a rough indication of your risk of heart disease and stroke. Always see your doctor for a complete assessment.
- Based on the results of your report, work with your doctor to develop the best plan for lifestyle changes and, if necessary, medication.
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