As you may already know, the LDL cholesterol that is usually reported when a lipid panel is ordered is not measured but calculated. When the triglycerides are high, LDL cannot be accurately calculated because triglycerides are part of the equation. Show
How is LDL-C Calculated?LDL-C is most often calculated using a formula based on other components of the lipid panel. Many lab companies use different equations to calculate LDL-C. A common equation used is the Friedewald equation that has been around since the 1970s. It incorporates the total cholesterol, HDL-cholesterol (HDL-C), and triglyceride concentrations: LDL-C (mg/dL) = total cholesterol – HDL-C – (triglycerides/5), where “triglycerides/5” is used to represent very low-density lipoprotein-C (VLDL-C). Total cholesterol (TC) = LDL + HDL + VLDL.Where VLDL ≅ TG/5. The formula valid if TG <400 mg/dL. If TG > 400 mg/dL, you have to measure the LDL directly, rather than calculating it. There are several other newer equations that are slight modifications of the Friedewald equation. TLDL-C concentration can also be measured directly. If a patient’s LDL cholesterol concentration could not be calculated because the triglycerides were too high (>4.35 mmol/L; >400 mg/dL). What options do you have for getting an LDL cholesterol concentration?If the LDL concentration could not be calculated because the triglyceride level was too high, direct LDL-C testing may be useful. At Quest Diagnostics, for example, direct LDL measurement provides a reliable result even when triglyceride levels are up to 1,000 mg/dL. “It can be ordered as a stand-alone test, as a reflex if the patient’s triglyceride level is likely to exceed 400 mg/dL, or as part of one of several panels. low-density lipoprotein-cholesterol (LDL-C) Reference Total cholesterol represents the combined amount of "bad" cholesterol (low-density, or LDL) and "good" cholesterol (high-density lipoprotein, or HDL) in your blood. The measurement is then compared to your individual HDL result to gauge your risk for heart disease and stroke. This comparison is telling because it reveals whether LDL, which is the one that can build up in your arteries and cause blockages, is or is not the predominant cholesterol type in your body.  What Are Lipoproteins?The HDL and LDL lipoproteins are tiny “packages” in your blood, with fat (lipid) on the inside and proteins on the outside, that carry cholesterol throughout your body. You will often see them called the good cholesterol and the bad cholesterol. High-Density Lipoprotein (HDL)HDL is called the good cholesterol because it helps usher cholesterol out of your arteries. You hear a lot about keeping
your cholesterol low. But in the case of the HDL component of total cholesterol, the higher your level, the better. The problem is, it can be hard to keep your HDL levels high. That’s because it’s often hard to control lifestyle factors that can lower it, including type 2 diabetes, being overweight, not getting enough exercise, and smoking. Genetic factors can also play a role. Low-Density Lipoprotein (LDL)This “bad boy” of the cholesterol family needs to be kept at the lowest level you and your healthcare provider can achieve. Although statin medications can help, your diet matters. LDL cholesterol goes up if your diet is high in saturated and “trans” fat, also called trans-fatty acid. (This is the manufactured fat used to increase food products’ shelf life and flavor stability.) TriglyceridesTriglyceride is the most common type of fat in your body. It’s not cholesterol. But it’s measured because elevated triglyceride levels increase your risk of developing atherosclerosis—a buildup of fatty plaques on artery walls—and increased risk of heart disease and stroke. How Total Cholesterol Is MeasuredThis is done using a blood test called a lipoprotein panel, which also measures your triglycerides. Your total cholesterol score is calculated using the equation: HDL level + LDL level + 20% of your triglyceride level. Why You Should Be TestedKeeping total cholesterol levels within a healthy range is important for people of all ages, whether they have heart disease or not. If like many people, you have high blood cholesterol and don’t know it, the only way you can find out is by having your blood tested. By itself, high blood cholesterol doesn’t cause symptoms. That’s why, if you’re age 20 years or older, you should have your cholesterol tested at least every five years. Understanding ResultsTest results for total cholesterol are expressed in milligrams per deciliter (mg/dL) of blood and raked desirable, borderline high, or high. Total Cholesterol RangesTotal cholesterol is ranked as follows:
Your total cholesterol level reflects your risk for heart disease. In general, the higher the level, the higher your risk. Why does the test also measure the lipoproteins in your total cholesterol as well as your triglycerides?
If your total cholesterol is too high, your healthcare provider may recommend lifestyle changes and/or medications to lower it. Cholesterol Doctor Discussion GuideGet our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Thank you, {{form.email}}, for signing up. There was an error. Please try again. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. By
Jennifer Moll, PharmD Thanks for your feedback! What is the formula for calculating HDL?To obtain their total cholesterol HDL ratio, a person can divide their total cholesterol level by their HDL level. A higher ratio means a higher risk of heart disease. For example: 240 (total cholesterol) ÷ 60 (HDL) = 4 (total cholesterol HDL ratio).
How do you calculate total cholesterol to HDL cholesterol?To calculate your cholesterol ratio, divide your total cholesterol number by your HDL cholesterol number. So if your total cholesterol is 200 mg/dL (5.2 mmol/L) and your HDL is 50 mg/dL (1.3 mmol/L), your ratio would be 4-to-1. Higher ratios mean a higher risk of heart disease. Francisco Lopez-Jimenez, M.D.
How do you calculate HDL LDL and total cholesterol and triglycerides?The traditional Friedewald equation estimates LDL cholesterol this way: total cholesterol minus HDL cholesterol minus triglycerides divided by five.
What is HDL calculated in blood test?What is an HDL test? A high-density lipoprotein (HDL) test measures the level of good cholesterol in your blood. Cholesterol is a waxy substance that's found in all of the cells in your body. It has several different functions, including helping to build your body's cells.
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How to calculate hdl from total cholesterol and triglycerides
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