How to read your NHS cholesterol blood test results

Confused by your NHS cholesterol results? We explain what LDL, HDL, triglycerides, and cholesterol ratios mean in plain English.

If you have recently had your cholesterol tested, also referred to as a lipid panel, and are not sure what the results mean, you are not alone. Many people are told their cholesterol is "a bit high" without much explanation, or receive mixed advice about whether it is something to worry about. Part of the confusion is that, like many areas of health and medicine, our understanding of cholesterol continues to evolve.

In this article, we answer:

• What results are often included in an NHS cholesterol test?

• What do the different cholesterol results mean?

• What are cholesterol ratios?

• When should I be concerned about my cholesterol levels?

What results are included in an NHS cholesterol test?

In our previous post, What is cholesterol? We used the analogy of a transport system to explain how cholesterol moves around the body. When everything is balanced, traffic flows smoothly. When there are too many delivery vehicles, not enough recycling vehicles, excess fuel in the system, or a damaged highway, congestion can begin to build. With that picture in mind, here is what your test results might be telling you.

A standard lipid panel (cholesterol test) will usually include the following:

• Total cholesterol

• LDL cholesterol

• HDL cholesterol

• Triglycerides

• Non-HDL cholesterol

Each of these markers gives a slightly different view of how your "transport system" is working.

What do my cholesterol results mean?

What is total cholesterol?

(How busy the road is)

Your total cholesterol number reflects how much overall traffic is on the road, but it does not tell you anything about the type of traffic. A busy road is not always a problem, as long as the traffic is moving freely.

As a general guide, a total cholesterol level below 5 mmol/L is considered desirable. Levels between 5 and 6 mmol/L may be described as borderline and worth monitoring. Levels above 6 mmol/L are generally regarded as raised, though this should always be interpreted alongside the rest of your results rather than in isolation.

What is LDL cholesterol?

(The delivery vehicles)

LDL cholesterol (often referred to as "bad cholesterol") carries cholesterol from the liver out to the cells that need it, acting like delivery vehicles transporting materials around the body. When delivery vehicles outnumber the recycling vehicles (HDL), the risk of a traffic jam increases.

As a general guide, LDL below 3 mmol/L is considered optimal. Levels between 3 and 4 mmol/L are mildly raised, while levels above 4 mmol/L are usually described as raised and may warrant further attention depending on your wider health picture and risk factors.

What is HDL cholesterol?

(The recycling team)

HDL cholesterol acts like the recycling vehicles on the road. It collects excess cholesterol from the bloodstream and returns it to the liver, where it can be processed and removed from the body. Because of this role, higher HDL levels are generally considered protective.

Healthy HDL levels differ slightly between men and women:

• Male: HDL should ideally be above 1.0 mmol/L

• Female: the target is typically above 1.2 mmol/L.

Higher levels generally suggest a more efficient clean-up system, helping to keep cholesterol traffic moving smoothly.

What are triglycerides?

(The fuel in the system)

Triglycerides represent the body's primary form of stored energy and reflect how well the body is handling fuel, particularly sugars and refined carbohydrates from food and drink. While cholesterol often receives most of the attention, triglycerides can provide important clues about metabolic health and blood sugar regulation.

Triglyceride levels below 1.7 mmol/L are generally considered normal. Levels above 1.7 mmol/L may suggest the body is under metabolic strain, particularly if they remain raised over time. Not all NHS cholesterol tests include this figure, but when available, it can offer useful additional insight.

What is non-HDL cholesterol?

(The traffic report)

Non-HDL cholesterol represents all the cholesterol in your blood that is not HDL. This includes LDL and other cholesterol particles that might contribute to cardiovascular risk, providing a broader picture of the particles circulating in the system.

In most cases, non-HDL cholesterol below 4 mmol/L is considered optimal. Levels above 5 mmol/L are usually regarded as raised and may indicate that too many cholesterol particles are circulating in the bloodstream.

What are cholesterol ratios?

While the individual numbers above are useful, the ratios are often the most informative markers for cardiovascular risk. Ratios show how the different types of cholesterol balance each other, rather than simply measuring how much of each is present.

Total cholesterol to HDL ratio

(How well the recycling system keeps traffic moving)

This ratio shows whether there are enough HDL "recycling vehicles" to keep all the traffic moving efficiently. To calculate it, divide your total cholesterol by your HDL figure.

• Below 4 is generally considered optimal

• Between 4 and 6 is usually described as borderline

• Above 6 may be considered more concerning and worth exploring with a practitioner

LDL to HDL ratio

(Delivery vehicles compared with recycling vehicles)

This ratio compares the number of delivery vehicles to the number of recycling vehicles. To calculate it, divide your LDL by your HDL.

• Below 2 is considered optimal

• Between 2 and 3 is borderline

• Above 3 may suggest an imbalance between your delivery and clean-up systems

Triglyceride to HDL ratio

(Fuel load in relation to the recycling fleet)

This ratio provides a useful snapshot of metabolic health, reflecting how well the body is managing blood fats alongside blood sugar balance. Because it is closely linked to insulin sensitivity, it is often influenced by diet, alcohol intake, body composition, and lifestyle. To calculate it, divide your triglycerides by your HDL.

• Around 1 or below is often considered a sign of optimal metabolic health

• Between 1 and 2 is generally acceptable

• Between 2 and 3 may suggest increasing metabolic strain

• Above 3 is commonly associated with insulin resistance and higher cardiovascular risk

When should I be concerned about my cholesterol levels?

What happens when traffic builds up?

Continuing the traffic analogy, when your transport system becomes overloaded with too many delivery vehicles (LDL), not enough recycling vehicles (HDL), and excess fuel (triglycerides), over time cholesterol can begin to settle into the walls of blood vessels.

Think of it like congestion that slowly turns into a blockage. This doesn't happen overnight, and it's not caused by one "bad" result. It’s a gradual process influenced by the overall pattern of your results and your wider health.

It is therefore important that any cholesterol results are looked at as part of a much bigger picture:

• Family cardiovascular history

• Blood sugar balance

• Diet and digestion (learn more about mindful eating)

• Stress and sleep (find out how to get a good nights sleep)

• Lifestyle and movement (learn about the health benefits of walking)

These factors work together to determine how well your body is functioning as a whole. It is entirely possible to have slightly raised cholesterol and still have a healthy overall picture.

If you are concerned about your results, visit our practitioner directory to find a qualified healthcare practitioner who can help you interpret your results and provide you with personalised plans and support that work alongside your GP's recommendations.

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What comes next?

In our next post, we'll take a closer look at the diet and lifestyle approaches that can make a meaningful difference to your cholesterol levels and help keep the traffic running smoothly.