Heart Health
Cholesterol, Total
What This Marker Tells Us
Total cholesterol measures all cholesterol in your blood, including HDL (protective), LDL (potentially harmful), and VLDL, therefore providing a broad overview of cholesterol status but missing critical details about cardiovascular risk.
Why It Matters
Total cholesterol is the sum of all cholesterol particles: HDL + LDL + VLDL (roughly triglycerides/5). While historically used for cardiovascular risk assessment, total cholesterol alone is a poor predictor because it lumps protective HDL with potentially harmful LDL. Someone with very high HDL and low LDL might have "high" total cholesterol but low cardiovascular risk, while someone with low HDL and moderate LDL might have "normal" total cholesterol but high risk. Total cholesterol screening remains useful for identifying extremes requiring lipid panel evaluation, but HDL, LDL, triglycerides, and especially particle numbers (apoB, LDL-P) provide much better risk assessment. Very high total cholesterol (above 300 mg/dL) warrants investigation for familial hypercholesterolemia or other lipid disorders.
How to Interpret Your Trends
Total cholesterol below 200 mg/dL is traditionally considered "desirable," though this cutoff is overly simplistic. Levels of 200-239 mg/dL are "borderline high," and above 240 mg/dL are "high." However, these ranges don't account for HDL; high total cholesterol with very high HDL may be protective. Very low total cholesterol (below 160 mg/dL) may indicate malnutrition, liver disease, hyperthyroidism, or rarely genetic conditions. Optimal total cholesterol depends on the composition.
What Influences This Marker
Total cholesterol increases with dietary saturated fat, dietary cholesterol (modest effect), obesity, sedentary lifestyle, hypothyroidism, diabetes, kidney disease, familial hypercholesterolemia, and aging. It decreases with statin medications, plant-based diets, high fiber intake, weight loss, exercise, hyperthyroidism, liver disease, and malnutrition. Total cholesterol is less responsive to diet than triglycerides, with genetic factors playing larger roles in LDL levels.
How Your Team Uses It
Your coach uses total cholesterol as a general screening marker but focuses intervention on HDL optimization, triglyceride reduction, and LDL particle management.
Related Signals We Also Review
HDL, LDL, triglycerides, total cholesterol/HDL ratio, non-HDL cholesterol, apoB or LDL particle number when available, hs-CRP, and metabolic health markers for comprehensive cardiovascular risk assessment.