Total Cholesterol
The total amount of cholesterol carried in all lipoprotein particles in your blood.
| Typical reference range | below 199 mg/dL |
| Commonly cited optimal range | below 180 mg/dL |
Ranges vary by laboratory, method, age and sex: always use the range printed on your own report. Why labs differ.
What it measures
Cholesterol is a waxy lipid used to build cell membranes, steroid hormones, vitamin D and bile acids. About three-quarters is made by the liver; the rest comes from food. Because it does not dissolve in blood, it travels inside lipoproteins (LDL, HDL, VLDL and others), and total cholesterol is the sum of cholesterol in all of them.
Why it matters
Total cholesterol is a coarse screening number: it mixes potentially harmful (LDL, VLDL, remnants) and protective (HDL) fractions. It is most useful in combination with HDL, LDL, non-HDL cholesterol and ApoB, which are better predictors of atherosclerotic cardiovascular risk.
What a high result can mean
Elevated values usually reflect high LDL or remnant cholesterol from genetics (e.g. familial hypercholesterolemia), diets high in saturated fat, excess weight, or insulin resistance. Hypothyroidism, nephrotic syndrome, cholestatic liver disease, pregnancy and some medications (corticosteroids, some diuretics, isotretinoin) can also raise it. A high value driven mainly by high HDL carries different meaning than one driven by LDL.
What a low result can mean
Very low values (below ~120 mg/dL) can occur with statin therapy, hyperthyroidism, malnutrition, malabsorption, chronic liver disease, active infection or cancer, and rare genetic disorders.
What affects the result
Fasting is not required for total cholesterol. Values can shift 5-10% between draws; acute illness, surgery or recent weight loss can temporarily lower it. Diet (saturated and trans fat, fiber), weight, exercise, thyroid status and lipid-lowering drugs are the main levers; interpret alongside HDL, LDL, non-HDL and ApoB.
Units and conversion
Usually reported in mg/dL.
- From mmol/L: multiply by 38.67 to get mg/dL
Also called on lab reports
Cholesterol, Cholesterol, Total, Cholesterol Total, Chol, Cholesterol, Serum
Related tests: Lipids & Cardiovascular Risk
This page is educational and does not replace advice from a healthcare professional.