Cholesterol levels: what the numbers mean and how to improve them

High cholesterol quietly raises your risk of heart attack and stroke. You can’t feel it, but a simple blood test shows whether your cholesterol is working for you or against you. This page explains the numbers, clear targets, and practical steps you can take right now.

Understanding your numbers

Total cholesterol, LDL, HDL and triglycerides are the usual readout. LDL is the “bad” cholesterol — the main target for treatment. Aim for LDL under 100 mg/dL if you’re generally healthy; under 70 mg/dL if you have heart disease or are high risk. HDL is protective: higher is better (40 mg/dL+ for men, 50 mg/dL+ for women). Triglycerides should be below 150 mg/dL; higher levels raise risk and can point to lifestyle issues like excess sugar, alcohol, or weight.

Labs sometimes report non-HDL cholesterol or use mmol/L instead of mg/dL (1 mmol/L ≈ 38.7 mg/dL). If your results are confusing, take a photo and ask your clinician to explain what they mean for your personal risk.

How to lower cholesterol — practical steps that work

Start with diet. Cut trans fats (often in processed foods) and limit saturated fat from full-fat dairy, fatty cuts of meat, and some baked goods. Swap to healthier fats: olive oil, avocados, nuts. Add soluble fiber from oats, beans, apples and carrots — it helps lower LDL. Aim to eat fatty fish twice a week for omega-3s, which lower triglycerides.

Move more. Try 150 minutes of moderate exercise weekly — brisk walking, cycling, swimming. Even 30 minutes five days a week helps raise HDL and lower triglycerides. Losing 5–10% of body weight often improves LDL and triglycerides noticeably.

Cut back on alcohol and quit smoking. Alcohol raises triglycerides; smoking lowers HDL and worsens artery health. Small changes here give big gains.

If lifestyle changes don’t reach your target, medications are common and effective. Statins are the first-line drugs — they lower LDL and reduce heart attacks. If triglycerides stay high, your doctor may add a fibrate like fenofibrate or prescribe prescription omega-3s. Fenofibrate is useful when triglycerides are very high or when combined with other drugs; ask your clinician about interactions and monitoring.

How often to test? If you start medication, labs are typically checked 4–12 weeks later, then every 3–12 months until stable, and yearly after that. If you only change lifestyle, test at 3–6 months to see progress.

When to see a doctor right away: very high triglycerides (>500 mg/dL), chest pain, or a strong family history of early heart disease. For most people, steady small improvements — better food choices, regular movement, and following prescribed meds — add up to big risk drops.

Want specific guidance? Bring your lab results to a clinic or telehealth visit (use a trusted pharmacy if you're filling meds online). A clinician can set targets based on your age, health history, and risk — and build a plan that fits your life.