Do you know your non-HDL cholesterol?

Reviewing my latest cholesterol test results with my doctor last week, she bandied about a term I’d never before heard: non-HDL cholesterol.

Here is how Discovery Fit & Health describes non-HDL cholesterol (which is VITAL to understand if you have diabetes or other cardiovascular disease risk factors). Unless you’re a doctor, don’t get too fussed about the jargon – I kept it here for those who like all the details.  If that’s not you, just skim over the jargon and keep reading and it should all make sense:

“Non-HDL cholesterol is the total of VLDL and LDL cholesterol, both of which contain atherogenic apolipoprotein B (apo B) particles. Because it approximates the amount of apo B particles, non-HDL cholesterol is a better predictor of the risk of coronary heart disease than a simple measure of LDL cholesterol.

It’s a useful measurement in people with triglyceride levels between 200 mg/dL and 500 mg/dL who likely have substantially more apo B particles.

To calculate non-HDL cholesterol, subtract HDL cholesterol from the total cholesterol. When LDL cholesterol is at goal, non-HDL cholesterol should be lowered to 30 mg/dL greater than the LDL-cholesterol goal.”

Why do I care about this? Why should you? Well, if you have high triglycerides or diabetes or other cardiovascular disease risks, it appears that non-HDL cholesterol is a better predictor of heart disease than total cholesterol or LDL or HDL levels.

Said differently, non-HDL cholesterol appears to be a good way to decide if you need more tests or more aggressive treatment. I’ve been worried I need more tests (and I might) but for now, I felt better after understanding my non-HDL cholesterol level.

It’s easy to calculate. You don’t need a new lab test – just your latest fasting cholesterol test results and a pad/paper…ok, calculator. Here’s what you do:

  1. Calculate your own non-HDL cholesterol by subtracting HDL from your total cholesterol number. Mine was 168: my total cholesterol of 224 minus my 56 HDL.
  2. To calcualte your GOAL for non-HDL cholesterol, just add 30 to your LDL goal. (Your doctor should give you a goal – or you can see it on your lab report.  OR you can figure it out on the Mayo Clinic or American Heart Association sites.) My LDL goal is <130 so my non-HDL cholesterol goal is 160.
  3. Compare — and discuss with your doctor. My non-HDL cholesterol is 168 vs 160 goal (though my doctor calculated my goal as 190 – she started with an LDL goal of 160 not 130 – I need to call her about that.) So I’m either well below 190 goal or slightly above 160 goal.

So my next steps based on all this? Besides following up on that pesky 160 vs 190:

  • Continue going lo-co lifestyle. My doctor asked what I’m doing other than blogging (ha ha) as it IS slowly bringing my cholesterol numbers down. Thus, we agreed that I should continue my (mostly) low-fat/low cholesterol diet, ramped up exercise, and daily doses of both fish oil and Metamucil.
  • Sadly, she wants me to add 2 things to lower my triglycerides: cut starches and impose a limit of 1 glass of wine per night.  UGH. We’ll see about that.
  • Regarding more testing – since all my cousins are on cholesterol meds, she wants me to poll them – find out about their coronary calcium scores, if they had them done. If they are high, she’ll want to send me for more testing. If not, no need.

One last thought – if you have prior test results, it’d be good to do your own non-HDL cholesterol calculation before you meet with your doctor.  It’s a lot of numbers and my doc whipped through this so quickly I didn’t have time to notice – much less ask about – the fact that she listed my LDL goal as 160 but the lab results chart said it was 130. If I’d known about this calculation ahead of time, I’d like to think I’d have caught it and asked.

Hope this is helpful – it was total news to me. Drop me an email or post a comment if you want any further info on non-HDL cholesterol.

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7 Responses to Do you know your non-HDL cholesterol?

  1. Bon says:

    Hi–I liked how easy you made it to understand how to calculate one’s own non-HDL cholesterol, etc. Have you learned anything more about any of this since your post of Nov. 2011? I keep hearing that statins are high-risk and that many people who are on them, don’t actually need them; also that they don’t work as well for women–know anything on any of this? Thanks!

  2. KLS says:

    Hi – I am so glad you found this helpful. I’ve not learned more since this post BUT I am going to the doctor tomorrow and will keep your question in mind and post any more learning! Best – karen

  3. Carol says:

    Doing all the lifestyle changes possible. Low fat everything, and not much dairy as allergic to it. Allergy to eggs as well. Eat only lean meats, dont exercise as much as i should, but have medical issues (edema) and kidney failure. Diab type2, and borderline cholesterol everywhere. How does one get this down? Angio gram was okay. No risks genetiacally but md insists i take 10 mg lipitor. What is your opinion ? What is another MD’s opinion here? I have so many allergies, i have to be careful adding another medication. I realize this is not professional advice.

  4. KLS says:

    Hi Carol, that’s a lot of things going on … and the more medical issues one has (like diabetes) the higher the heart rate risk. So probably a good idea to stick with your doctor’s recommendation – and/or get another medical opinion…

  5. Deborah says:

    I just got my numbers today – are they good? Where do I need to improve. My doctors says they are okay. He doesn’t explain very well.

    Non-HDL cholesterol = 91
    Triglycerides = 157
    Total Cholesterol = 147
    HDL choleserol = 56
    LDL-cholesterol = 60
    chol/ hdlc ration = 2.6

    Thanks ahead of time.

  6. KLS says:

    Best thing to do is discuss with your doctor — though you can easily compare your results with guidelines: check out my ‘Resources‘ page – specifically, click on the ‘Interpreting Cholesterol Test Results: from the Mayo Clinic’ link: that will take you to an informative page explaining how to interpret test results.

  7. KLS says:

    If your doctor says they are OK, then you should be good to go. You can always compare with ‘goals’ – a particularly good resource for that is this Mayo Clinic page.

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