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Cholesterol levels: what they mean

by Josephine Andrews
Published: Last Updated on 384 views

Cholesterol levels provide information about the amount of cholesterol in the blood. Contrary to its bad reputation, cholesterol is an essential substance for the body. However, if a person has high cholesterol levels, this can have health consequences. Find out here what cholesterol levels tell you about your health.

What is cholesterol?

Cholesterol is an alcohol from the group of fats (lipids) that is required as a building block for cell membranes. It is also used by the body to make bile acids, vitamin D and steroid hormones (such as the sex hormones estrogen and testosterone).

The body produces most of the cholesterol it needs itself, about two-thirds. The remaining third is ingested through food. If we eat too much cholesterol, the body tries to ensure that cholesterol levels remain normal or do not rise by reducing its own production.

Only 30 percent of cholesterol is free in the human body. The remaining 70 percent is associated with fatty acids (cholesterol esters).

Fats and fat-like substances are water-insoluble (hydrophobic). Therefore, they have to combine with water-soluble proteins to form so-called lipoproteins in order to be able to be transported in the watery blood . Depending on the fat or protein content, a distinction is made between different lipoproteins, which also fulfill different tasks. These include, among others:

  • VLDL (very low density lipoprotein): lipoprotein with very low density; precursor of LDL; VLDL transport large amounts of triglycerides and also cholesterol from the liver to other body cells.
  • LDL (low density lipoprotein): low density lipoprotein; mainly brings cholesterol from the liver to other cell tissue, where it is further processed.
  • HDL (high density lipoprotein): high density lipoprotein; transports excess cholesterol back to the liver, where it can be broken down.

It is problematic if the LDL cholesterol levels are too high because the excess cholesterol is built into the muscle layer of the vessel walls and can cause “hardening of the arteries”. This arteriosclerosis promotes circulatory disorders in various tissues and organs and can ultimately lead to strokes, heart attacks and the like.

LDL cholesterol

You can read more about the “bad” cholesterol in the article LDL cholesterol .

HDL cholesterol

You can find out everything you need to know about “good” cholesterol in the article HDL cholesterol .

When is the cholesterol level determined?

Cholesterol values ​​are determined, among other things, if lipid metabolism disorders are suspected. They also help to assess the success of a fat-lowering therapy (e.g. through diet or medication).

Measuring cholesterol levels is particularly important if the doctor wants to assess the patient’s risk of arteriosclerosis.

Cholesterol: table with limit values

The doctor takes a blood sample to measure cholesterol levels. Total cholesterol, HDL and LDL, among other things, are then determined in the laboratory.

Since fat enters the blood through the intake of food, the blood should be taken on an empty stomach. Due to newer laboratory procedures, this is no longer absolutely necessary; However, high-fat binges and excessive alcohol consumption in the days before are not advisable, as they falsify the readings.

For healthy adults without risk factors for vascular calcification, the following total cholesterol limits apply:

Total Cholesterol Table
1st-3rd age < 140 mg/dl
4th-7th age < 150 mg/dl
5th-8th age < 160 mg/dl
under 19 years of age < 170 mg/dl
20 to 29 years of age < 200 mg/dl
30 to 40 years of age < 220 mg/dL
over 40 years of age < 240 mg/dL

To simplify things for children, it can be noted that the total cholesterol values ​​are ideally less than 170 mg/dl, but at least less than 200 mg/dl.

LDL cholesterol is typically 70 percent of total cholesterol . The relationship between the “bad” LDL cholesterol and the “good” HDL cholesterol , i.e. the LDL/HDL quotient, is known as the arteriosclerosis risk index. The more LDL cholesterol and the less HDL cholesterol someone has, the higher the ratio, and vice versa.

In people who do not have other risk factors for atherosclerosis (such as high blood pressure ), the LDL/HDL ratio should be less than four. On the other hand, a quotient below three is recommended for people with such other risk factors and a quotient below two for people who already have arteriosclerosis, for example.

The LDL/HDL quotient has lost some of its importance when it comes to estimating the cardiovascular risk. Apparently there is an increased risk of arteriosclerosis with extremely high values ​​of “good” HDL cholesterol (above approx. 90 mg/dl). The following does not apply to HDL cholesterol: the more, the better.

In the current guidelines, too, experts recommend taking total cholesterol values ​​and systolic blood pressure values ​​into account in order to assess the risk of cardiovascular disease. In addition, nicotine consumption also plays a role here, which further increases the risk.

If your blood cholesterol levels are too high, your doctor will take a second blood sample to check the cholesterol levels again to be on the safe side. Sometimes the cholesterol level is normal at the second measurement and then there is usually no need for action.

When is cholesterol too low?

The total cholesterol is reduced only in rare cases. If so, it could be due to malnutrition . However, this is very rare in industrialized countries.

Other possible causes of reduced (total) cholesterol levels are:

  • Overactive thyroid (hyperthyroidism)
  • Inflammation of the liver (hepatitis)
  • Chronic inflammatory bowel disease (Crohn’s disease, ulcerative colitis , etc.)
  • Overdose of cholesterol-lowering drugs

When is cholesterol too high?

Large amounts of LDL lead to an increase in total cholesterol. This is then referred to as hypercholesterolemia. It is usually the result of an unhealthy lifestyle or another illness. These include

Also, various medications, such as corticosteroids, can raise cholesterol levels.

What to do if cholesterol levels change?

Low cholesterol levels are only in very rare cases pathological. Nevertheless, as a precaution, the patient should be examined for possible underlying diseases. If dangerous causes and an incorrect dosage of medication can be ruled out, the doctor will check the cholesterol levels regularly.

Elevated cholesterol levels pose a serious health risk. If excess cholesterol builds up in the vessel walls, this can result in arteriosclerosis. This is considered an important risk factor for the development of a heart attack, stroke and other circulatory disorders, for example in the legs (peripheral arterial occlusive disease) or in the abdomen. Cholesterol levels should be strictly controlled, especially in patients with pre-existing conditions such as diabetes mellitus, congenital hypercholesterolaemia or obesity.

A healthy diet with little saturated fat and sufficient exercise can lower and normalize the values. If you are overweight , weight loss is advisable. Affected patients should also avoid alcohol and nicotine. If these basic measures do not work, the doctor prescribes medication such as statins or cholesterol absorption inhibitors to lower cholesterol levels that are too high .

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