What are cholesterol and lipid disorders?
Lipid disorders are conditions in which the levels of fats in the blood differ from what is expected. They cover total cholesterol, LDL, HDL and triglycerides. These values are addressed not on their own but within an overall risk assessment, together with age, blood pressure, blood sugar, smoking and family history.
The World Health Organization (opens in a new tab) reports that an estimated 19.8 million people died from cardiovascular disease in 2022, corresponding to around 32% of global deaths. The same source lists raised blood lipids (together with raised blood pressure, raised blood sugar and excess weight) among the intermediate risk markers that can be measured in primary care.
For this reason, no decision is made by looking at a single line in the report.
The values in the report
| Topic | What it shows |
|---|---|
| Total cholesterol | Shows the total level of cholesterol in the blood (on its own it does not give enough information) |
| LDL cholesterol | Shows the fraction that may contribute to build-up in the artery wall |
| HDL cholesterol | Shows the fraction that plays a part in transporting cholesterol in the circulation |
| Triglycerides | Shows the level of triglycerides in the blood (it may be affected by diet, alcohol use and the course of blood sugar) |
| Non-HDL cholesterol | Shows the total of the cholesterol other than HDL (a calculated value) |
The ranges in reports may vary from laboratory to laboratory and do not indicate the same target for everyone. In people with known cardiovascular disease, diabetes or kidney disease, targets are set differently.
What is examined alongside it
- Age and sex
- Blood pressure readings
- Blood sugar and HbA1c
- Smoking
- Weight and waist circumference
- A family history of cardiovascular disease at an early age
- Kidney and liver function tests
- Thyroid function tests (low thyroid hormone levels may affect blood lipids, so this is assessed first)
- Current medication
The World Health Organization lists the four main behavioural risk factors for cardiovascular disease as an unhealthy diet, physical inactivity, tobacco use and the harmful use of alcohol.
How is it assessed?
- Medical history and family history. A family history of a heart attack or stroke at an early age is asked about in particular.
- Physical examination. Blood pressure, weight and waist circumference are assessed, along with findings such as yellowish raised patches on the eyelids and thickening of the tendons.
- Laboratory. Together with the lipid profile, blood sugar, thyroid, kidney and liver function tests are requested.
- Overall risk assessment. The findings are addressed together rather than one by one.
- Drawing up the plan. Plans are made for diet, activity and smoking; where necessary the medication is adjusted, and the follow-up interval is set.
In which patients is it assessed differently?
- In patients who are pregnant or breastfeeding, blood lipids may rise physiologically; some cholesterol medicines are not suitable at this time
- In patients with known cardiovascular disease, targets are set lower
- In patients with diabetes, targets are set differently
- In patients with kidney or liver disease, the choice of medicine and the dose differ
- In patients with low thyroid hormone levels, this is addressed first
- In patients with a family history of a heart attack at an early age, inherited high cholesterol is investigated separately and family screening may be considered
- In patients who develop muscle pain while taking a cholesterol medicine, the relationship with the medicine is assessed separately
- In patients under 18 years of age, care falls within the field of paediatrics
Follow-up and how often it is needed
Because every patient’s course unfolds differently, it would be wrong to give a definite answer on how often follow-up is needed; the interval is set according to your risk level, the medicine you take and your co-existing conditions. In patients who have been started on a medicine or whose dose has been changed, the tests are repeated after a set period. In those whose course is stable, the interval may lengthen.
What should you do before and after the test?
Before the test: the length of fasting may affect the result, particularly for the triglyceride measurement; ask how many hours you need to fast when the tests are requested. A recent infection, operation or serious illness may temporarily change the readings; please mention this.
After: advice on diet and activity is provided in writing. It generally takes weeks to months for the effect to show in the laboratory.
Risks and points to be aware of
No decision is made by looking at a single value. A single value outside the healthy range does not on its own indicate that treatment is needed; nor does having every value within the healthy range mean there is no risk.
Report any muscle pain, weakness or darkening of the urine while taking a cholesterol medicine. Do not stop the medicine on your own initiative; once the complaint has been assessed, an adjustment is made if necessary.
Herbal products and supplements may interact. Using products said to lower blood lipids without consulting a physician is not appropriate.
Dietary changes may not be enough on their own in some people. In inherited high cholesterol, lifestyle change on its own does not reach the target.
Results vary from person to person.
When should you see a physician without delay?
If you notice these symptoms, consult a physician without delay:
- Yellowish raised patches on the eyelids, or thickening of the tendons
- Muscle pain, weakness or darkening of the urine while taking a cholesterol medicine
- Raised blood pressure or raised blood sugar accompanying raised blood lipids
- A markedly high triglyceride value
In the event of chest pain, shortness of breath, pain radiating to the arm or jaw, sudden loss of strength or difficulty with speech, go directly to the emergency department.
Frequently asked questions
My cholesterol came out high; do I need to take medication?
This is not determined by the cholesterol value on its own. Age, blood pressure, blood sugar, smoking, family history and any known cardiovascular disease are assessed together. For some people, monitoring with changes to diet and activity is preferred first; for others, medication is needed.
Should I fast before a lipid profile?
This depends on the tests requested. The length of fasting may affect the result, particularly for the triglyceride measurement. Ask how many hours you need to fast when the tests are requested.
Will my blood lipids come down with diet?
Diet and activity are among the factors that affect blood lipids. The World Health Organization (opens in a new tab) recommends that saturated fat should not exceed 10% of total energy and trans fat 1%. However, the extent of the change achieved varies from person to person, and for some people it may not be enough on its own.
Is there a relationship between my thyroid and my cholesterol?
There may be. Thyroid hormone levels lower than expected may affect blood lipids. For this reason, thyroid function tests are also assessed in patients who present with high cholesterol.
Can I compare results from different laboratories?
Direct comparison is not recommended. Measurement methods and cut-off values can differ from institution to institution. Using the same laboratory wherever possible during follow-up allows the course to be monitored more reliably.
How often should I have my blood lipids checked?
Because every patient’s course unfolds differently, it would be wrong to give a definite answer to this question. The interval is set according to your risk level, the medicine you take and your co-existing conditions; how often you are seen is determined by your physician.
Sources
- World Health Organization, Cardiovascular diseases (CVDs) fact sheet, 31 July 2025. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (opens in a new tab)
- World Health Organization, Healthy diet fact sheet, 26 January 2026. https://www.who.int/news-room/fact-sheets/detail/healthy-diet (opens in a new tab)
