Cholesterol test: normal range and what the result means (CHOL)

Cholesterol is a fat-like substance the body needs for cell membranes, hormones and vitamin D. It travels through the blood in lipoproteins: low-density lipoprotein (LDL, the "bad" kind) carries cholesterol to the tissues and can build up in artery walls, while high-density lipoprotein (HDL, the "good" kind) returns it to the liver. Total cholesterol is the sum of all fractions, so on its own it does not give the full picture — its composition matters too. That is why doctors assess the whole lipid panel: total cholesterol, LDL, HDL, triglycerides and often non-HDL cholesterol, which is total cholesterol minus HDL. Raised cholesterol causes no symptoms — it is found only by testing. The NHS notes that fasting is not necessary for this test, as it does not greatly affect the result.

• As a preventive check: every 5 years for adults; from age 45 in men and age 55 in women — every 1–2 years; over the age of 65 — every year
• More often if there are risk factors: heart disease in the family, raised blood pressure, diabetes, smoking, excess weight, low physical activity
• In Lithuania — under the cardiovascular disease prevention programme, whose age limits and frequency are set by the National Health Insurance Fund (VLK)
• To follow the change over time, when lifestyle is being changed or treatment has been prescribed

Cholesterol 5–6 mmol/l: slightly above the NHS reference for healthy adults (5 mmol/l). Whether that is significant depends on LDL, HDL, blood pressure, age and other risk factors — a doctor assesses it.

Cholesterol 6–7 mmol/l: clearly above the NHS reference (5 mmol/l). This is usually a reason to assess the whole lipid panel and overall heart risk together with a doctor.

Cholesterol 7–8 mmol/l: well above the NHS reference. For values like these a doctor usually also considers the possibility of inherited hypercholesterolaemia, especially if there has been early heart disease in the family.

Cholesterol above 8 mmol/l: very high. Values like this call for assessment by a doctor and often for family members to be tested for the inherited form.

Raised total cholesterol is most often linked to a diet high in saturated fat, excess weight, low physical activity, smoking, heredity and some illnesses, for example a reduced thyroid function or diabetes. It causes no symptoms, so it is meaningful only together with LDL, HDL and the overall heart risk, which a doctor assesses.

• A diet high in saturated fat
• Excess weight and low physical activity
• Heredity — familial hypercholesterolaemia
• Illnesses: reduced thyroid function, diabetes, kidney or liver disease
• Some medicines
• Smoking and alcohol worsen the lipid composition

What to discuss with a doctor:

• The whole lipid panel: LDL, HDL, triglycerides, non-HDL — total cholesterol alone does not say which fraction is raised
• Overall cardiovascular risk from age, blood pressure, smoking and diabetes — the target value depends on it
• Thyroid (TSH), liver and kidney markers, if the cause is unclear
• Family history: early heart disease or very high cholesterol in relatives

Low total cholesterol is usually favourable. However, a very low value sometimes accompanies an increased thyroid function, liver disease, chronic illness or inadequate nutrition — in such cases a doctor assesses other markers as well.

• Increased thyroid function
• Liver disease
• Chronic illness, inflammation, inadequate nutrition
• Treatment that lowers cholesterol

What is usually looked at then: whether there are other signs, such as weight loss or tiredness, and the thyroid and liver markers, if the value is unexpectedly low.

In Lithuania, cholesterol is tested under the cardiovascular disease prevention programme, whose age limits and frequency are set by the National Health Insurance Fund (VLK). Paying privately, a cholesterol test at the Medicina practica laboratory costs from €6 (September 2026 pricing). If you want to understand the report itself, see how to read blood test results.