What is non-HDL cholesterol?

Total cholesterol minus HDL cholesterol. It counts all the types of cholesterol other than HDL.

Do I need to fast before a cholesterol test?

MedlinePlus says you may need to fast for 9 to 12 hours; the NHS says eating beforehand doesn’t make much difference to the levels. Follow your own instructions.

Why are UK cholesterol numbers so much smaller?

UK labs report in mmol/L and US labs in mg/dL. The units are different, not the cholesterol.

LIPID PANEL

Lipid panel results explained: total cholesterol, LDL, HDL and triglycerides

A lipid panel (cholesterol test or lipid profile) measures the fats in your blood: total cholesterol, HDL (“good”) cholesterol, LDL (“bad”) cholesterol and triglycerides, often with non-HDL cholesterol and a cholesterol:HDL ratio. Doctors use it, with other factors, to estimate your risk of heart and circulation problems.

Why it’s confusing

The same test is reported in different units: US labs usually use milligrams per decilitre (mg/dL), and UK labs millimoles per litre (mmol/L). A healthy number in one looks alarming in the other.

Some lines are measured and some are calculated. LDL is often a calculated estimate, and non-HDL is simply total cholesterol minus HDL.

How to read it

Total cholesterol: all the cholesterol in your blood.

HDL cholesterol: often called “good” cholesterol, because it is carried to the liver for removal. Higher is generally better.

LDL cholesterol: often called “bad” cholesterol; too much is linked with the build-up of plaque in the arteries.

Non-HDL cholesterol: total cholesterol minus HDL — all the “bad” types together.

Triglycerides: another type of fat in the blood.

As a guide for healthy adults, the NHS gives total cholesterol below 5 mmol/L, non-HDL below 4 mmol/L, and HDL above 1.0 mmol/L for men or 1.2 mmol/L for women. It adds that a good target for you depends on your age, health conditions and risk — your doctor will use your results with those factors.

What it does not mean

That one high number means you will have a heart attack. Doctors look at cholesterol with blood pressure, age and other factors.
That numbers in mg/dL and mmol/L can be compared directly. Check the units first.
That you always need to fast. The NHS says it doesn’t make much difference to these levels whether you have eaten, though your doctor may still ask you to fast.

Where you’ll see it

Lipid panel, lipid profile or cholesterol test reports.
NHS Health Check results and GP records.

Questions worth asking

Ask your doctor

What target level is right for me?
How do these results fit with my overall risk?
When should I be tested again?

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Common questions

What is non-HDL cholesterol?: Total cholesterol minus HDL cholesterol. It counts all the types of cholesterol other than HDL.
Do I need to fast before a cholesterol test?: MedlinePlus says you may need to fast for 9 to 12 hours; the NHS says eating beforehand doesn’t make much difference to the levels. Follow your own instructions.
Why are UK cholesterol numbers so much smaller?: UK labs report in mmol/L and US labs in mg/dL. The units are different, not the cholesterol.

Sources

Reading a scan report rather than a blood test or letter? Radily’s radiology report phrase guides explain the wording radiologists use.