Total Cholesterol
Sum of all cholesterol fractions in the blood – entry point into the lipid profile
Also known as
Definition
Total cholesterol is the sum of all cholesterol fractions in the blood: LDL cholesterol (~70%), HDL cholesterol (~20%), and VLDL cholesterol (~10%). Cholesterol is essential for cell membranes, steroid hormone synthesis, vitamin D production, and bile acid formation. As a standalone marker, total cholesterol is less informative than a full lipid profile, since a high value may be driven by high HDL.
| Parameter | Value |
|---|---|
| Unit | mmol/l (mg/dl) |
| Reference Range | Normal: < 5.2 mmol/l (< 200 mg/dl) | Borderline: 5.2–6.2 mmol/l (200–240 mg/dl) | High: > 6.2 mmol/l (> 240 mg/dl) |
Agree on your personal target range with your doctor.
Conversion: 1 mmol/l = 38.67 mg/dl. US labs report in mg/dl.
↓ What a low value means
Total cholesterol < 3.0 mmol/l (< 116 mg/dl) occurs in severe malnutrition, hyperthyroidism, severe liver disease, or malabsorption. In individual observational studies, very low values were associated with elevated total mortality, depression, or hemorrhagic stroke; the thresholds differed between study populations, and this does not establish a cause.
↑ What a high value means
Hypercholesterolemia increases atherosclerosis risk, though the predictive value of total cholesterol alone is limited. Familial hypercholesterolemia (FH): total cholesterol > 7.5 mmol/l. Secondary causes: hypothyroidism, kidney disease, diabetes, obesity, diet high in saturated fat.
✓ What can influence this value
Total cholesterol is influenced by diet (saturated fats and trans fats can raise the value; a Mediterranean diet, beta-glucan from oats, and plant sterols can lower it), physical activity (can raise HDL), smoking, body weight, and genetic predisposition. Hypothyroidism, kidney diseases, pregnancy, and lipid-lowering medications such as statins also act on the value. Total cholesterol is informative only together with the LDL, HDL, and triglyceride fractions. The assessment is made by the treating doctor.
When to test
Total cholesterol is measured in the lipid profile, for example at routine checkups or with a family history of heart disease, diabetes, hypertension, or obesity, sometimes fasting. It is assessed together with LDL, HDL, and triglycerides, sometimes also with ApoB. How often it is measured is decided by your doctor.
Frequently asked questions
Is it true that high total cholesterol is not necessarily bad? +
Conditionally yes. High total cholesterol from high HDL ('good cholesterol') is viewed differently than high total cholesterol from elevated LDL. The TC/HDL ratio and especially ApoB are better risk markers than total cholesterol alone. Some FH patients with LDL > 5 mmol/l simultaneously have elevated HDL.
Which foods really raise cholesterol? +
Saturated fatty acids (red meat, butter, coconut fat, palm oil) raise LDL cholesterol most strongly. Trans fats (industrially hydrogenated) raise LDL and lower HDL. Dietary cholesterol (eggs) has minimal effect in most people — genetic 'hyper-responders' react more strongly.
Does coffee raise cholesterol? +
Filtered coffee has minimal effect on cholesterol. Unfiltered coffee (French press, espresso, boiled coffee) contains cafestol and kahweol — diterpenes that raised LDL cholesterol in studies; how much depended on preparation and amount. Scandinavian studies show the strongest effect with boiled coffee.
Total Cholesterol
Sources
Last updated: May 28, 2026
This information is for orientation only and does not replace medical advice. Reference ranges can vary by laboratory, method and country.