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This test measures the total amount of cholesterol in the blood. It is generally done together with blood tests that measure a person's HDL, or"good cholesterol" and LDL, or "bad cholesterol".

Since high levels of cholesterol are often associated with cardiovascular disease, the test is done to evaluate a person's heart disease risk. It may also be ordered to detect disorders of the thyroid gland, kidney or other body organs.

Cholesterol is attached to fatty molecules called lipoproteins, which are carried in the bloodstream. The two major lipoproteins are low-density lipoproteins (LDL) and high-density lipoproteins (HDL). HDL transports excess cholesterol to the liver for excretion in the bile, a liver product that helps with fat absorption and that excretes waste products. It is known as the "good" cholesterol. LDL leaves fatty deposits on the wall of the arteries, a condition called atherosclerosis, and is known as the "bad" cholesterol. Therefore, the ratio of LDL to HDL is a measure used to evaluate risk for heart disease. A low LDL:HDL ratio means lower risk, and vice-versa.

Normal values for total blood cholesterol range from 140 to 310 milligrams per deciliter (mg/dl). The best range is from 140 to 220 mg/dl.

Abnormally high levels of blood cholesterol may indicate:

  • atherosclerosis

  • biliary cirrhosis, which is scarring and blockage of the bile ducts

  • familial hyperlipidemia, a condition in which high blood lipids run in a family

  • high-cholesterol diet

  • high stress

  • low thyroid activity, called hypothyroidism

  • heart attack, known as myocardial infarction

  • nephrotic syndrome, which is a kidney disease resulting in loss of protein in the urine

  • uncontrolled diabetes

Abnormally low levels of cholesterol may indicate:

  • an overactive thyroid, called hyperthyroidism

  • liver disease

  • inadequate absorption of nutrients from the intestines, or malabsorption

  • malnutrition

  • pernicious anemia, which is low red blood cell count from vitamin B12 deficiency

  • infection




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