Total cholesterol is the sum of HDL, LDL, and VLDL cholesterol fractions. It is considered high when levels are above 190 mg/dL, as determined by a blood test.
High total cholesterol is usually caused by unhealthy lifestyle habits, such as drinking too much alcohol or eating fatty foods and sweets. However, it can also develop as a result of conditions like diabetes or hypothyroidism, genetic factors, or the use of certain medications such as corticosteroids and antiretrovirals.
If your cholesterol levels are elevated, it’s important to see your primary care provider or a cardiologist for an evaluation. A healthcare provider can determine whether medication is necessary, in addition to recommending lifestyle changes to help bring total cholesterol levels back to normal.
Types of cholesterol
The main types, or fractions, of cholesterol include:
-
HDL (high-density lipoprotein): Often called “good” cholesterol, HDL cholesterol helps remove excess fat from the body;
-
LDL (low-density lipoprotein): Known as “bad” cholesterol, it can build up in the arteries and increase the risk of cardiovascular disease;
-
VLDL (very-low-density lipoprotein): Another form of “bad” cholesterol that contributes to plaque buildup in blood vessels.
Maintaining healthy levels of HDL, LDL, and VLDL is important for cell and hormone production and for preventing diseases like atherosclerosis.
Symptoms of high total cholesterol
High total cholesterol usually doesn’t cause noticeable symptoms.
However, excess fat can accumulate in the body, which may lead to small fatty bumps on the skin, abdominal bloating, or a grayish ring around the eyes.
Read more about high cholesterol symptoms and what to look out for.
Total cholesterol test
A total cholesterol test measures the overall amount of cholesterol in your blood. It typically includes the different cholesterol fractions, which is why it’s also called a “total and fractionated cholesterol test.”
The test involves collecting a blood sample at a lab, and fasting for 8 to 12 hours before the test is generally recommended.
The reference range for total cholesterol is 190 mg/dL or lower. Levels above this value are considered high.
Is total cholesterol above 200 mg/dL dangerous?
Having total cholesterol above 200 mg/dL can be serious, especially for men, smokers, or people with high blood pressure, low HDL, or elevated LDL levels.
In these situations, the risk of cardiovascular conditions such as atherosclerosis, heart attack, and stroke increases.
Possible causes
The main causes of high total cholesterol include:
-
A diet high in fats and sugars;
-
Lack of physical activity;
-
Excessive alcohol consumption;
-
Uncontrolled diabetes;
-
Genetic factors.
Certain medications, such as corticosteroids, thiazide diuretics, hormonal contraceptives, and antiretrovirals, can also raise total cholesterol levels.
How to lower high total cholesterol
To lower high total cholesterol, it is recommended to:
- Lose weight if overweight or obese;
- Limit alcohol intake;
- Reduce consumption of fatty and sugary foods;
- Choose foods rich in fiber and healthy fats, such as oats, beans, tomatoes, and salmon;
- Exercise regularly, at least 3 to 5 times per week.
If lifestyle changes aren’t enough, your doctor may prescribe cholesterol-lowering medications such as simvastatin or atorvastatin to help regulate total cholesterol levels.