Cholesterol: normal LDL and HDL values and how to read your results
Normal values for cholesterol, LDL, HDL and triglycerides, why everyone's LDL target is different, whether you need to fast, and when medication is needed.
Lipid results are the most confusing part of a report: there are four values, and the same number can be 'normal' for one person and 'too high' for another. Below is what each value means, how targets are set, and why the decision about medication depends on overall risk.
Key takeaways
- LDL is the value that matters most. The target depends on heart risk: general population <130 · moderate risk <100 · diabetes or high risk <70 · previous heart attack or stroke <55 mg/dL.
- HDL should be ≥40 in men and ≥50 mg/dL in women · triglycerides <150 mg/dL · total cholesterol <200 mg/dL.
- Starting medication is based on 10-year overall risk, not LDL alone. The exception is LDL ≥190, which usually needs medication regardless.
- Non-fasting testing is acceptable for screening, but for an accurate triglyceride reading fast for 9–12 hours.
The four values in a lipid panel
| Value | Role | General cut-offs (mg/dL) |
|---|---|---|
| Total cholesterol (TC) | All lipids combined; the overview | <200 desirable · 200–239 borderline · ≥240 high |
| LDL | Builds up in artery walls; lower is better | <100 optimal · 100–129 near optimal · 130–159 borderline · 160–189 high · ≥190 very high |
| HDL | Helps clear cholesterol from arteries | <40 low (risk) · ≥60 high (protective) |
| Triglycerides (TG) | Fat from excess energy | <150 normal · 150–199 borderline · 200–499 high · ≥500 very high (pancreatitis risk) |
Why LDL targets differ from person to person
How dangerous a given LDL level is depends on the other risk factors that come with it. Treatment guidelines therefore set targets by each person's overall risk. Someone who has already had a heart attack or stroke has a very high risk of another, so LDL must be pushed as low as possible. A healthy 30-year-old with LDL of 140 may not need medication yet, but does need lifestyle changes.
The doctor estimates your 10-year cardiovascular risk from age, sex, blood pressure, smoking, diabetes and lipids. Thailand has its own Thai CV Risk Score calibrated for Thai people.
When medication is needed
- LDL ≥190 mg/dL: usually start medication straight away, because this level is often genetic and lifestyle alone isn't enough
- Diabetes from age 40: most guidelines recommend a statin even if LDL isn't very high
- Previous heart attack or stroke: medication is needed, aiming for LDL <55–70
- General population with high 10-year risk: start medication if lifestyle changes don't reach target within 3–6 months
- Triglycerides ≥500: medication is needed to reduce pancreatitis risk, together with cutting alcohol and sugar
Good to know: Lipid-lowering medication is taken long term. Stopping on your own once values improve sends them back up within 2–3 weeks. If you're worried about side effects such as muscle aches, talk to the doctor about changing the drug or dose rather than stopping.
Do I need to fast?
Current guidance accepts non-fasting tests for general screening, because TC, HDL and LDL change little after a meal. Triglycerides are the value clearly affected; they can rise 20–30%. So if TG was high last time, or the doctor needs an accurate calculated LDL, fast for 9–12 hours (plain water is fine). See how to fast before a health check.
Lifestyle changes that show results within 3 months
- Cut saturated and trans fats: animal skin, fatty meat, coconut milk, bakery goods, reused frying oil. These affect LDL more than dietary cholesterol does
- Add soluble fibre: oats, beans, vegetables and whole fruit can lower LDL by 5–10%
- Cut sugar, refined starch and alcohol, the main drivers of high triglycerides
- 150 minutes of moderate exercise a week, one of the few things that raises HDL
- Stop smoking; HDL rises within weeks
- Lose 5–10% of body weight if overweight; it helps both triglycerides and LDL
Follow-up
After lifestyle changes or starting medication, retest at 6–12 weeks; once on target, every 6–12 months. You don't need to repeat a whole health check. The clinic offers individual lipid tests and ongoing chronic condition care, with the doctor reviewing your medication and changes each time. For the rest of your report, see how to read your blood test results.
Frequently asked questions
LDL is what counts. Total cholesterol can look normal because a low HDL pulls it down. The doctor assesses overall risk from LDL and other factors to decide.
Related services
Related articles
Sources
- Clinical practice guideline on lipid-lowering therapy for cardiovascular prevention The Heart Association of Thailand under the Royal Patronage
- 2019 ESC/EAS Guidelines for the management of dyslipidaemias European Society of Cardiology
- Cholesterol Levels: What You Need to Know MedlinePlus, U.S. National Library of Medicine
This content is general information and does not replace an examination, diagnosis or personal advice from a doctor. Published 20 September 2026
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