HSA | FSA CARDS ARE NOW ACCEPTED

LDL Cholesterol Test: Understanding "Bad" Cholesterol

The LDL Cholesterol Test measures the amount of low-density lipoprotein (LDL) cholesterol in your blood. LDL is often referred to as "bad cholesterol" because excess levels can accumulate on artery walls, forming plaques that increase the risk of heart disease and stroke. Despite its negative reputation, LDL also plays important roles in the body, such as building cell walls, producing hormones, and aiding digestion.

Why the Test is Performed

The LDL test is typically included as part of a full lipid panel, which also measures total cholesterol, HDL cholesterol, triglycerides, and very-low-density lipoprotein (VLDL). Measuring LDL is key to:

  • Assessing the risk of developing cardiovascular disease.
  • Identifying conditions like peripheral artery disease, heart attack, or stroke risk.
  • Monitoring cholesterol management treatments and lifestyle interventions.

Normal Results

In general, lower LDL cholesterol levels are better for health:

  • Desirable level: Below 100 mg/dL (2.59 mmol/L).
  • Borderline to high: 130–189 mg/dL (3.36–4.90 mmol/L), depending on risk factors.
  • Very high: 190 mg/dL (4.92 mmol/L) or above.
  • Children: Ideally less than 110 mg/dL (2.85 mmol/L).

Providers may recommend stricter targets (e.g., under 55 mg/dL) for very high-risk patients. Guidelines differ: some focus on lowering LDL as much as possible, while others emphasize treatment intensity over specific numbers.

What Abnormal Results Mean

High LDL levels may be linked to lifestyle, medical conditions, or genetics. Causes include:

  • High intake of saturated or trans fats.
  • Lack of physical activity.
  • Overweight or obesity.
  • Diabetes or metabolic syndrome.
  • Hypothyroidism.
  • Kidney or liver disease.
  • Familial combined hyperlipidemia (inherited disorder).
  • Certain medications (e.g., corticosteroids, some birth control pills).

If LDL levels are elevated, healthcare providers may recommend lifestyle changes such as adopting a heart-healthy diet, increasing physical activity, losing weight, quitting smoking, and limiting alcohol intake. In many cases, medications like statins may also be prescribed, especially for patients with diabetes or high cardiovascular risk.

If Your Levels Are Low

While low LDL cholesterol is usually desirable, very low levels may sometimes be associated with:

  • Hyperthyroidism or liver disease.
  • Malnutrition or fast metabolism.
  • Use of cholesterol-lowering medications (statins, niacin).
  • Genetic factors that reduce LDL production.

Extremely low LDL may affect hormone balance and overall health, potentially contributing to issues such as fatigue, reproductive concerns, or digestive problems.

Symptoms and Health Impact

High LDL usually does not cause noticeable symptoms until complications occur, such as:

  • Chest pain (angina).
  • Heart attack.
  • Stroke.
  • Circulation problems in the legs (peripheral artery disease).

Symptoms of very low LDL are uncommon but may include fatigue, weight loss, digestive issues, or hormone-related concerns such as menstrual irregularities or erectile dysfunction.

Important Considerations

LDL results can be temporarily influenced by factors such as recent illness, pregnancy, certain medications, or infections. Always discuss your results with your healthcare provider to understand what they mean for your specific health situation.