The Cholesterol Guide
Plaque builds from how high your LDL is and how many years it stays there. Your lab prints one range for everyone, but your goal depends on your risk. Here's what your numbers mean and what lowers each one, by how much.
Updated November 15, 2026. 19 guide pages, 33 questions, 8 myths, from 155 published sources.
100, 70, 55The 2026 LDL goals, by your risk. Your lab prints one range for everyone.
13points off LDL with 10 g of psyllium a day, across 28 trials.
88%less heart disease in people born with LDL 28% lower all their lives.
19%An LDL change under 19% can be noise. Past 29%, it's real.
Is my cholesterol bad?
Showing an example panel. Type your own numbers.
Leave LDL blank if your report says calculated.
ApoB, if your report has it
Both sets of changes apply. Start with triglycerides, since they move in weeks.
LDL
The NIH equation, from your other three numbers134mg/dL, 3.5 mmol/L
The newer equation says 134, and many labs would print 129. A gap of 5 mg/dL.
Clears 0 of 3 goal lines. Compared with under 100, the goal at borderline or intermediate risk. Ask your doctor for your PREVENT score to find your rung.
Non-HDL
Total minus HDL: the cholesterol in every particle that can clog an artery177mg/dL, 4.6 mmol/L
Compared with under 130 mg/dL. Its goals sit 30 points above LDL's, and with triglycerides of 150 or more the guideline finds it the better guide.
Triglycerides
Not fasting240mg/dL, 2.7 mmol/L
Over the nonfasting line of 175, the guideline's line for treating triglycerides with lifestyle.
- HDL
- 38Low, under 40. Higher isn't a goal.
- Total to HDL
- 5.7No goal in the 2026 guideline
- Triglycerides to HDL
- 6.3No goal either
- Remnant, an estimate
- 43Total minus HDL minus LDL. Rises with triglycerides
- Total
- 215Under the NCHS line of 240, and the guideline sets no goal for it
You're 34 points from under 100, the goal at borderline or intermediate risk. The biggest single food change in trials takes off about 13. A gap this size is a conversation to have with your doctor.
Next step. Start with alcohol and sweet drinks for your triglycerides, add the fat swap and 10 g of psyllium for your LDL, then retest at the same lab in 6 to 12 weeks. The LDL plan
If you ate before this test, your LDL moved about 8 points at most, your triglycerides about 26.
What to do with your numbers
- First, check for these
- LDL of 190 or more, or triglycerides of 500 or more: see a doctor before any food plan.
- Chest pain, pressure or sudden breathlessness: call 911.
- On a cholesterol medicine: keep taking it. Your prescriber sets your goal.
- Pregnant: cholesterol rises on purpose. Ask your midwife or doctor.
- Find your goal
Ask your doctor for your 10-year risk on PREVENT. It gives your LDL goal: under 100, 70 or 55 mg/dL, and non-HDL 130, 100 or 85. Until you know, hold yours against 100 and 130.
- Compare, and pick one path
- Under your goal. Keep your habits and test again at least every 5 years.
- Over by less than 30 points. Food can close a gap that size. Start the fat swap and 10 g of psyllium, then retest at the same lab in 6 to 12 weeks.
- Over by 30 or more, an LDL of 160 or more, or a parent or sibling with heart disease young. Have the medicine conversation with your doctor now, and do the food changes too.
- Triglycerides over 150 fasting or 175 after eating
Cut alcohol and sweet drinks first, walk most days, and retest in 4 weeks.
- Once in your life, and when numbers disagree
Get Lp(a) tested once. If your triglycerides run high or you have diabetes, ask for ApoB too, since it counts the particles directly (check yours on apob.guide).
This guide helps you understand your numbers and do what food and habits can. It never tells you to start, stop or change a medicine. That's for you and your doctor.
What brought you here?
-
I want to lower it without medicineThe plan trials ran, every change sized in points -
My doctor brought up a statinThe case for and against, and questions to take back -
I've heard LDL doesn't matterThe skeptics, the genes and the trials, side by side -
My triglycerides came back highFour weeks, drinks and sugar first -
I just got my results backYour panel against the goal for your risk -
It went up around menopauseThe jump in the year around your last period -
I keep hearing about eggs and butterWhich foods move LDL, and which barely do -
It runs in my familyFH, the 190 line and the Lp(a) test you take once -
I'm losing weight, or on a GLP-1What weight loss does to each number -
My LDL shot up on ketoWhy it happens, and what to check -
Can I fix it without medicine?Your gap against what food can do -
Do I need a calcium scan?Who it helps, what it costs, what a zero means -
I eat well, so why is it high?Your liver makes most of it -
I'm young. Does it count yet?Why the years before 40 count the most -
It jumped since my last testNoise, a meal, or something real -
Is my number normal for my age?How common high cholesterol is at every age -
I heard the guidelines changedWhat the March 2026 guideline changed - I've had a heart attack or a stentThe lowest goal, under 55
The questions people ask
Your numbers
- Is 220 cholesterol bad?On its own it can't tell you. A 220 can be mostly HDL or mostly LDL, and the 2026 guideline sets no goal for the total. Put your other numbers in.
Is an LDL of 130 bad?It's over every 2026 goal: under 100, 70 or 55 by your risk, and low risk has no number goal. The biggest single food changes take off about 7 to 13 points.
What should my LDL be?Under 100 at borderline or intermediate risk, under 70 at high risk, under 55 after a heart attack or stroke (2026 US guideline). The lab's range ignores your risk.
What is non-HDL cholesterol?Total minus HDL: the cholesterol in every particle that can clog an artery. Its goals sit 30 points above LDL's, and it still works when triglycerides are high.
Is an LDL of 190 dangerous?It's the line where the 2026 guideline looks for causes, checks your family for FH and recommends a statin. Book a doctor visit before you plan a diet.- What's a normal cholesterol level for my age?Your goal doesn't change with age. LDL under 100, 70 or 55 by your risk. What changes is how common high numbers are, and after 60 women overtake men.
Testing
Do you need to fast for a cholesterol test?Usually not. A meal moves LDL about 8 points and triglycerides about 26, and the 2026 guideline accepts either. Fast if your triglycerides were 400 or more.
Why does my report say my LDL is calculated?Most labs work LDL out from your other three numbers. The 1972 formula slips when triglycerides are high or LDL is low, so the guideline now prefers two newer ones.
How often should you check your cholesterol?At least every 5 years from age 19, once as a child at 9 to 11, and 4 to 12 weeks after starting or changing a medicine. More often with risk factors or a change.
Why did my cholesterol go up when I didn't change anything?Two LDL results can differ by about 19% by chance, and now and then 29%. Real causes include menopause, fast weight loss, keto, thyroid and some medicines.
Are home cholesterol tests accurate?They can be close to a lab for total and HDL if you follow the steps exactly. The LDL is calculated, and the evidence on meters is thin. Confirm a surprise at a lab.
Do I need a calcium scan?Maybe, if you're 40 or older (men) or 45 (women), your risk is borderline or intermediate, and you're unsure about a statin. A zero can let you wait. About $50 to $250.
Food
Do eggs raise cholesterol?Not much for most people. Saturated fat moves LDL more than the cholesterol in food, the 2026 guideline says. Watch the bacon and butter that come with the eggs.
Does saturated fat matter for cholesterol?Yes, for LDL. Moving 1% of calories from saturated fat to vegetable oils takes about 2 points off. What you swap it for decides whether your heart gains.
High LDL on keto: should I worry?Take it seriously, without panic. LDL often rises on keto, mostly from saturated fat. Check ApoB, ask about a calcium scan. The "it's harmless" study was retracted.
What foods lower cholesterol?Two changes do the most: vegetable oils instead of butter, and soluble fiber (10 g of psyllium a day took off about 13 points). Oats, beans, soy and nuts help too.
Does oatmeal lower cholesterol?A little. About 3.5 g of oat beta-glucan a day lowered LDL about 7 points across 58 trials. Check the label for grams of beta-glucan, not bowls.
How much psyllium should I take to lower cholesterol?About 10 g of husk a day, split over meals with water, lowered LDL about 13 points in 28 trials. Build up over a week, and keep it apart from some medicines.
Does coffee raise cholesterol?Unfiltered coffee can. In 14 trials, more coffee meant higher LDL, mostly with boiled coffee, while paper-filtered coffee did very little. If your LDL is high, use paper.- What foods should I avoid with high cholesterol?The saturated fats: butter, fatty red meat, full-fat dairy, coconut and palm oil (2026 guideline). Replace them with olive or vegetable oils, nuts and fish, not sugar.
Triglycerides and HDL
Does alcohol raise triglycerides?Yes. About 2 drinks a day raised triglycerides about 6 points on average in 42 studies, more in some people. At 500 or more, the guideline says no alcohol at all.
Does sugar raise triglycerides?Yes. In 37 trials, higher-sugar diets raised triglycerides about 10 points and LDL about 5, even when weight didn't change. Sweet drinks are the easiest place to start.
What triglyceride level is dangerous?150 fasting or 175 after eating is high. At 500 the risk of pancreatitis starts to rise and at 1000 it's high, so see a doctor soon. Severe belly pain is the ER.
How do I raise my HDL?Move. Aerobic exercise raised HDL about 2.5 points across 25 trials, more with longer sessions. Don't chase the number with pills. LDL and non-HDL are the goals.
Lowering it
How long does it take to lower cholesterol?Triglycerides can drop in weeks, and LDL fell 28.6% within a month on the portfolio diet. Retest LDL 6 to 12 weeks in, at the same lab, and allow for noise.
Can you lower cholesterol without medication?Yes, by a measurable amount: single food changes took off about 7 to 13 points, the full portfolio diet 28.6% in a month. If your gap is bigger, talk about medicine.
Does exercise lower cholesterol?A little. In 148 trials, exercise cut LDL about 7 points and triglycerides about 8, and raised HDL about 2. Aim for 150 minutes a week plus strength work twice.
Does losing weight lower cholesterol?Triglycerides most, about 1.8 points per pound. LDL falls a little, about 8 points in 6 to 12 month trials, and can rise for a while during fast loss.
Genes, women and ApoB
Why is my cholesterol high if I eat healthy?Your liver makes all the cholesterol you need, and genes set how fast it's cleared. FH affects 1 in 250 to 300 people. Thyroid, menopause, keto and some drugs add to it.
Why does cholesterol go up after menopause?LDL and ApoB jump in the year either side of your last period (SWAN). Over 60, 16% of women have a high total, against 6% of men. The same changes still work.
Myth or fact?
Not the way you think Your total cholesterol is the number that matters
Not the way you think If your numbers are inside the lab's range, you're fine
Not the way you think The higher your HDL, the better
No Cholesterol supplements work about as well as a prescription
No Thin people who eat well don't get high cholesterol
No Coconut oil is good for your cholesterol
Quick calculators
Is my cholesterol bad?
Your panel against the 2026 goal for your risk: LDL by two equations, non-HDL, the shape and one next step.
Your LDL over the years
Set your LDL and age, try one change from any age, and watch your lifetime LDL total build toward the level linked to heart disease.
What would lower yours?
Tap the changes you would make and see each one at its own trial's size, side by side, never added up.
Which LDL is right?
Slide triglycerides up and watch the LDL equations split apart, in both units.
Did it really go down?
Two panels side by side, and which changes are bigger than the normal test-to-test noise.
Higher or lower?
Ten rounds of two foods. Tap the one with more saturated fat, then see the grams.
mg/dL and mmol/L
Any lipid number in the other unit, with the separate factor for triglycerides.
Why is my cholesterol high?
Eight taps with pictures: what's most likely behind your numbers, your top change and your retest date.
The two plans
The LDL plan, as the trials ran it
- 10 g of psyllium a day, built up over a week with water. About 13 points off LDL.
- Olive or vegetable oils in place of butter, fatty meat and cheese. About 2 points for every 1% of calories.
- Retest at the same lab in 6 to 12 weeks.
Four weeks for triglycerides
- Cut alcohol and sweet drinks first. They move triglycerides fastest.
- Walk 150 minutes a week and lift twice, as the guideline asks.
- Retest in 4 weeks, fasted or not the same way as last time.
The guide
Cholesterol is LDL times years
Plaque builds from how high your LDL is and how many years it stays there. Know your goal, get under it early and stay there. The map of everything on this site.
Does LDL really matter?
What the numbers on your panel mean
What should my LDL be?
Why LDL is a lifetime number
Where cholesterol comes from and where it goes
What lowers LDL, ranked by size
Triglycerides and HDL: the numbers food moves fastest
When it's your genes: FH, Lp(a) and ApoB
How to test, and how to tell if it changed
