The Essential Blood Test is a comprehensive, quick and reassuring way of assessing your current state of health. Key tests include full blood count, kidney function, liver health, cholesterol, diabetes, iron status & inflammation.
Who is this test for?
This blood test is ideal for people of all ages. It is an excellent entry-level health screen for people young and old.
What to test?
Red Blood Cells
Haemoglobin carries oxygen and gives the red blood cell its red colour. This test measures the amount of haemoglobin in the blood and is a good measure of the blood's ability to carry oxygen around the body.
A high haemoglobin result can mean increased red cell production to compensate for chronically low oxygen levels in the blood caused by lung disease or living at altitude. While it can also indicate "blood doping" other causes can include dehydration, smoking and bone marrow disorders.
A low haemoglobin result indicates anaemia which can have many causes including pregnancy, blood loss, liver damage, iron deficiency and much more. A low haemoglobin level should be investigated in line with other symptoms and results.
HCT (haematocrit) measures the amount of space (volume) red blood cells take up in the blood.
Raised levels can result from pregnancy, living at altitude, dehydration as well as low availability of oxygen through chronic lung disease and even sleep apnoea.
Low levels indicate anaemia.
Red blood cell (RBC) count analyses the number of red cells in the blood. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so that it can be exhaled.
A high count (thicker blood) means there is a chance that the red blood cells will clump together and block tiny blood vessels. This also makes it difficult for your red blood cells to carry oxygen.
A low count (anaemia) means that your body may not be getting the oxygen it needs and can be caused by nutritional deficiency (lack of iron, folic acid, vitamin B12), over-hydration as well as bleeding and bone marrow disorders.
MCV (mean corpuscular volume) reflects the size of your red blood cells.
A high result may indicate a vitamin deficiency of folate or vitamin B12 and is often seen in excessive alcohol consumption associated with liver inflammation.
A low result indicates anaemia, often caused by iron deficiency.
MCH (mean corpuscular haemoglobin) is the average amount of haemoglobin contained in your red blood cells.
Together with MCV and MCHC, MCH results can help in the diagnosis of different types of anaemia.
MCHC (mean corpuscular haemoglobin concentration) is the average concentration of haemoglobin in your red blood cells.
A high level can indicate the presence of spherocytes (a type of red bood cell with too much haemoglobin) or a deficiency of folic acid or vitamin B12 in the diet.
A low level can indicate chronic blood loss or iron deficiency.
RDW (red cell distribution width) shows whether the cells are all the same size or different sizes or shapes. Normally cells are fairly uniform, although a raised RDW result (indicating greater variation in cell size and shape than is normally seen) can be caused by deficiency in iron, vitamin B12 or folic acid.
White Blood Cells
White Cell Count
White blood cells are key to your body's immune or defence system. They fight infections and protect your body from foreign invaders such as harmful germs and bacteria.
A raised white blood cell (WBC) count can indicate recent infection, inflammation, trauma and even stress. Your WBC can also be raised when taking certain medications.
A decreased WBC can result from a vitamin deficiency such as folate or vitamin B12, as well as liver disease and diseases of the immune system.
Neutrophils are a type of white blood cell that are responsible for helping your body fight infection. When neutrophils are low you can be more vulnerable to illness and infection.
Neutrophils can be raised after severe stress on the body from a bacterial infection, recent exercise or sudden kidney failure.
Low neutrophils can be caused by a deficiency in vitamin B12 or folic acid, severe bacterial infection and some autoimmune diseases.
Lymphocytes are a type of white blood cell which fight bacterial and viral infections. They include T cells, B cells and natural killer cells.
Lymphocytes can be elevated for many reasons but it is common for them to be raised after recent infection, particularly after the flu. They can also be raised due to autoimmune disorders and some cancers.
The most common cause for lymphocytes to be depleted is the common cold.
Monocytes are a type of white blood cell that engulf and remove pathogens and dead or damaged cells from our blood. The heat and swelling of inflammation is caused by the activities of these cells.
Elevated monocytes can indicate chronic inflammatory disease, chronic infection, parasitic infection and Cushings disease.
Low levels can be due to autoimmune disorders such as lupus and rheumatoid arthritis as well as drugs which affect the bone marrow such as those used in chemotherapy.
Eosinophils are a type of white blood cell whose function is to remove parasitic infections as well as to regulate inflammation to mark an infected site.
Levels of eosinophils can be elevated if the scale of inflammation is greater than necessary to control the damage (as is the case in asthma and allergic responses) as well as in parasitic and fungal infections, autoimmune diseases and skin disorders.
Low levels of eosinophils are not usually cause for concern and can be caused by the administration of steroids.
Basophils are a type of white blood cell that protect your body from bacteria and parasites such as ticks.
An elevated basophil count can be due to inflammatory conditions such as Crohn's disease, ulcerative colitis and dermatitis, recent infection and hormone imbalance (e.g. hypothyroidism).
A low basophil count can be caused by pregnancy, stress and use of steroids.
Blood Film Report
A blood film report is an examination of the shape, size and number of blood cells under the microscope. Oxygen is carried less effectively by red blood cells if they are of abnormal size or shape, and this can result in anaemia. Too many or too few white blood cells can signify a blood disorder and can affect your body's ability to fight infection.
Platelets or clotting cells are the smallest type of blood cell and are important in blood clotting. When bleeding occurs, the platelets swell, clump together and form a sticky plug (a clot) which helps stop the bleeding.
If platelet levels are raised there is an increased risk of blood clots forming in blood vessels.
If platelet levels are too low there is a risk of easy bruising and uncontrolled bleeding.
MPV (mean platelet volume) is a measurement of the average size of your platelets. New platelets are larger than older ones and a raised MPV result occurs when increased numbers of platelets are being produced. MPV provides an indication of platelet production in your bone marrow.
Erythrocyte Sedimentation Rate (ESR)
Erythrocyte sedimentation rate (ESR or sed rate) is a test that indirectly measures the degree of inflammation present in the body caused by one or more conditions such as infections, tumors or autoimmune diseases; and to help diagnose and monitor specific conditions such as arteritis, endocarditis, systemic vasculitis, Crohn's disease, polymyalgia rheumatica, or rheumatoid arthritis.
This test works by measuring how long it takes for red blood cells to fall to the bottom of a test tube. The quicker they fall, the more likely it is there are high levels of inflammation.
The ESR is not diagnostic; it is a non-specific test that may be elevated in a number of these different conditions. It provides general information about the presence or absence of an inflammatory condition. For this reason ESR is typically used in conjunction with other tests.
Women tend to have a higher ESR, and menstruation and pregnancy can cause temporary elevations.
A low ESR can be seen with conditions that inhibit the normal sedimentation of red blood cells, such as a high red blood cell count (polycythemia), significantly high white blood cell count (leukocytosis), and some protein abnormalities. Some changes in red cell shape (such as sickle cells in sickle cell anemia) also lower the ESR.
ESR test results are measured in mm/hr, or millimeters per hour. The following are considered normal ESR test results:
- Women under age 50 should have an ESR under 20 mm/hr in 1st hr.
- Men under age 50 should have an ESR under 15 mm/hr in 1st hr.
- Women over age 50 should have an ESR under 30 mm/hr in 1st hr.
- Men over age 50 should have an ESR under 20 mm/hr in 1st hr.
- Newborns should have an ESR under 2 mm/hr inn 1st hr.
- Children who haven’t reached puberty yet should have an ESR between 3 and 13 mm/hr in 1st hr.
C-Reactive Protein (CRP) is an inflammation marker used to assess whether there is inflammation in the body. However, it does not identify where the inflammation is located. CRP is produced in the liver. The higher your CRP level, the greater your inflammation.
CRP interferes with the protein synthesis in the muscle cells, hence contributing to the loss of muscle mass.
High Sensitivity CRP (CRP-hs) is a test which is used to detect low-level inflammation which is thought to damage blood vessels which can lead to a heart attack or stroke. Raised levels are a risk factor for cardio-vascular disease.
Sodium is both an electrolyte and a mineral. It helps regulate the water and electrolyte balance of the body and is important in the operation of nerves and muscles. Sodium levels in the blood are regulated by the kidneys.
Excess sodium in the blood is often due to dehydration but can also indicate that the kidneys are not working properly.
Too little sodium is often caused by fluid retention (oedema) or reflects loss due to vomiting, diarrhoea or excessive sweating.
Urea is waste product produced as the body digests protein and is carried by the blood to the kidneys, which filter the urea out of the blood and into the urine. The urea test examines how well the kidneys are functioning.
Raised levels of urea in the blood can be caused by dehydration or high protein consumption or may indicate that the kidneys are not working properly.
Low amounts of urea in the blood may indicate a low protein diet, excess hydration, malnutrition or liver failure.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Measurement of this is an indicator of the levels of other waste products in the body. Creatinine is an accurate marker of kidney function.
Elevated creatinine can be caused by high intake of animal protein, taking creatine supplements and vigorous exercise but can also indicate that the kidneys are not working properly.
Low creatinine can be caused by a low protein diet, reduced muscle mass or sometime that the kidneys are simply functioning efficiently.
Estimated Glomerular Filtration Rate (eGFR)
Glomerular filtration rate (GFR) is a measure of the function of the kidneys. This test measures the level of creatinine in the blood and uses the result in a formula to calculate a number that reflects how well the kidneys are functioning, called the estimated GFR or eGFR.
The eGFR is a calculation based on a serum creatinine test. Creatinine is a muscle waste product that is filtered from the blood by the kidneys and released into the urine at a relatively steady rate. When kidney function decreases, less creatinine is eliminated and concentrations increase in the blood. With the creatinine test, a reasonable estimate of the actual GFR can be determined.
Early detection of kidney dysfunction can help to minimize the damage. This is important as symptoms of kidney disease may not be noticeable until as much as 30-40% of kidney function is lost.
An eGFR may be repeated if the initial result is abnormal to see if it persists.
A normal eGFR for adults is greater than 90 mL/min/1.73m2, according to the National Kidney Foundation. (Because the calculation works best for estimating reduced kidney function, actual numbers are only reported once values are less than 60 mL/min/1.73m2).
An eGFR below 60 mL/min/1.73m2 suggests that some kidney damage has occurred. The test may be repeated to see if the abnormal result persists. Chronic kidney disease is diagnosed when a person has an eGFR less than 60 mL/min/1.73m2 for more than three months.
A person may have some kidney damage even with an eGFR greater than 90 mL/min/1.73m2. Other evidence, such as increased urine albumin, may indicate some degree of kidney damage. Thus, a person's eGFR should be interpreted in relation to the person's clinical history and presenting conditions.
Another method of evaluating kidney function and potentially estimating GFR involves the measurement of the blood level of cystatin C. There is increasing interest in the use of this test for these purposes and several studies have been performed comparing calculations of eGFR using creatinine, cystatin C, or both.
Could I calculate my own eGFR?
If you have had a recent creatinine or cystatin C measurement, you can calculate the eGFR by using one of the calculators for people 19 years of age or older on the National Kidney Foundation (NKF) web site (https://www.kidney.org/professionals/KDOQI/gfr). If you have questions about the interpretation of your results, it is best to consult with your doctor. For children and teens younger than 19, see the pediatric eGFR calculator on the NKF website.
Other tests that may be done at the same time to help detect kidney damage and/or evaluate kidney function are:
Urine albumin (microalbumin) and albumin/creatinine ratio (ACR): Most of the time, tests for albumin and creatinine are done on a urine sample collected randomly (not timed) and an albumin-to-creatinine ratio is calculated. Here is an online calculator to calculate ACR (https://www.easycalculation.com/health/urine-albumin-creatinine-ratio.php).
Albumin is a protein that is present in high concentrations in the blood. Virtually no albumin is present in the urine when the kidneys are functioning properly.
Creatinine, a byproduct of muscle metabolism, is normally released into the urine at a constant rate and its level in the urine is an indication of the urine concentration.
If albumin in the urine (albuminuria) is detected, it should be confirmed by retesting twice within a 3-6 month period. Albumin is one of the first proteins to be detected in the urine with kidney damage. People who have consistently detectable small amounts of albumin in their urine (albuminuria) have an increased risk of developing progressive kidney failure and cardiovascular disease in the future.
Urinalysis: May be used to help detect signs of kidney damage, such as the presence of blood or casts in the urine.
Alkaline phosphatase (ALP) test may be performed to determine how well your liver and gallbladder are functioning or to identify problems with your bones. Elevated ALP is assessed in conjunction with other liver function tests to determine whether the problem lies in the liver or the bones. The normal range of ALP is usually from 20 to 140 U/L, but this can vary from laboratory to laboratory. The normal range runs higher in children and decreases with age.
Pregnancy can also cause raised ALP.
AST (previously called SGOT)
Aspartate aminotransferase (AST) is an enzyme that can be elevated in heart and muscle diseases and is not liver specific. Any injury to the heart or liver, and other bodily tissues, will cause AST to be released into the bloodstream. Levels can be raised following a heart attack or from liver damage caused by alcohol, drugs or viruses (hepatitis). Your doctor may look at your AST and ALT together to see if the result of your AST is specifically related to your liver.
AST can also be elevated after vigorous exercise. The normal range of AST is 0 to 45 U/L.
ALT (previously called SGPT)
Alanine aminotransferase (ALT) is an enzyme which is produced by the liver and can indicate liver damage caused by alcohol, drugs or viruses (hepatitis). Small amounts of ALT are normal, but raised levels may indicate that your liver is inflamed.
ALT is used as a surrogate marker for nonalcoholic fatty liver disease (NAFLD), which is frequently observed among obese subjects. ALT concentrations have a strong association with visceral fat accumulation.
Elevated levels of ALT can also be caused by recent vigorous exercise. The normal range of ALT is 0 to 45 U/L.
CK (creatine kinase) is a muscle enzyme which signifies muscle cell damage and death. CK levels tend to be higher in people with greater muscle mass.
The level of CK in the blood is measured to assess muscle damage - it can rise rapidly after muscle trauma, but will subside as the damage repairs. If CK continues to rise it indicates that muscle damage is not being repaired. If you have been to the gym the day before your blood test you may well exhibit raised levels of CK.
Gamma GT, also known as gamma glutamyltransferase, is an enzyme primarily found in the liver that assists in carrying peptides and amino acids into your cells.
Elevated Gamma GT may be an indicator of heart disease and fatty liver disease, and predicts increased risk of mortality.
Gamma GT test is used in conjunction with ALP to distinguish between bone or liver disease. If GGT and ALP are both elevated, doctors will suspect that you have problems with your liver or the bile ducts. If GGT is normal and ALP is elevated, this could indicate bone disease.
Gamma GT is also used to diagnose alcohol abuse as it is raised in 75% of long term drinkers. Smoking can also increase your GGT level. And it is also influenced by body mass index (BMI), certain drugs and supplements.
The elevation of GGT may also be temporary, perhaps due to medications that you are taking or alcohol ingested within 24 hours of the test.
The normal biologic role of GGT is to reconstitute glutathione, the body’s master antioxidant. Glutathione (or GSH) provides natural protection against harmful oxidative stress. When GGT concentrations are above “low-normal” ranges, excess GGT can catabolize (degrade) glutathione causing critical depletion of this very important antioxidant. When glutathione is depleted, and only insufficient amounts remain to protect the body’s organs from oxidative stress, damage & disease starts to occur.
The high end of normal GGT laboratory ranges are generally 50–70 U/L for men and 40–45 U/L for women.
Bilirubin is a product of haemoglobin breakdown. It is removed from the body via the liver, stored and concentrated in the gallbladder and excreted into the bowel. Elevated levels can cause the skin and whites of eyes to become yellow (jaundice) as the liver is unable to remove enough bilirubin from the blood. This can indicate liver damage.
Bilirubin can also be raised due to a blocked bile duct as well as Gilbert's Syndrome.
The normal range is 0 to 20 umol/L or 0.174 to 1.04 mg/dL.
Total Protein represents the sum of albumin and globulin. Abnormal levels can indicate malnutrition as well as a liver or kidney disorder.
Normal range is 60 to 80g/L or 6 to 8g/dL.
Albumin is made mainly in the liver and helps to keep the blood from leaking out of blood vessels. It also helps carry some medicines and other substances through the blood and is important for tissue growth and healing.
Low albumin levels can indicate liver disease and can also be a marker for chronic ill-health, malnutrition and inflammation. It can also occur in kidney conditions such as nephrotic syndrome and diabetes.
Normal range is 38 to 55g/L or 3.8 to 5.5g/dL.
Raised levels are usually caused by dehydration.
Globulin consists of different proteins and is made by the liver and the immune system. Certain globulins bind with haemoglobin while others transport metals, such as iron, in the blood and help fight infection.
Elevated levels of globulin proteins in the blood usually mean excessive inflammation in the liver and/or immune system. Very high levels may be seen in some types of cancers.
Normal range is 20 to 32g/L or 2 to 3.2g/dL.
Calcium is the most common mineral in the body and one of the most important. The body needs it to build and repair bones and teeth, help nerves and muscles to function, blood to clot and also help the heart to work. Vitamin D is essential to absorb calcium.
The majority of calcium in the body is stored in bone, the rest is found in the blood. If the calcium result is abnormal, a corrected calcium calculation is carried out to aid further investigation.
Normal values for calcium levels range from 8.5 to 10.2 mg/dl.
Hint: Blood calcium levels do not indicate levels of bone calcium but rather how much calcium is circulating in the blood.
Around half of the total calcium in your blood is bound by albumin. Corrected calcium estimates your calcium level assuming albumin is a specified normal value.
Uric acid is a waste product from the digestion of protein. Most uric acid is removed from the body by the kidneys and is eliminated from the body in the urine, with the remainder eliminated in the stool.
If too much uric acid is produced or not enough is removed, it can accumulate in the body, causing increased levels in the blood (hyperuricemia). The presence of excess uric acid can cause gout, a condition characterized by inflammation of the joints due to the formation of uric acid crystals in the joint (synovial) fluid. Excess uric acid can also be deposited in tissues such as the kidney, leading to kidney stones or kidney failure.
Uric acid levels are best tested 6 weeks after symptoms appear as they may not be raised at the onset of a gout attack.
High levels of glucose most frequently indicate diabetes, but many other diseases and conditions can also cause elevated blood glucose.
In a person with signs and symptoms of diabetes or hyperglycemia, a non-fasting glucose level (random blood sample) that is equal to or greater than 200 mg/dL (11.1 mmol/L) indicates diabetes.
The following information summarizes the meaning of other test results.
Fasting Blood Glucose:
- From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) - Normal fasting glucose
- From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) - Prediabetes (impaired fasting glucose)
- 126 mg/dL (7.0 mmol/L) and above on more than one testing occasion - Diabetes
HbA1c or Haemoglobin A1c is also known as glycosylated haemoglobin and is a longer term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 8-12 weeks it provides a good indication of the level of sugar in your blood over a 2-3 month period.
This is an important measure for diagnosing type 2 diabetes as well as understanding how well blood sugar levels are being controlled in people who have already been diagnosed with diabetes.
This test measures how much iron is in your blood with the aim of identifying iron deficiency anaemia or iron overload syndrome (haemochromatosis)
The symptoms of too much or too little iron can be similar - fatigue, muscle weakness, moodiness and difficulty concentrating.
A raised result can mean that you have iron overload syndrome, an inherited condition where your body stores too much iron, or that you are over-supplementing or that you have a liver condition.
A low result can mean that you are anaemic or are suffering from gastro-intestinal blood loss (or other blood loss). Anaemia is also very common in pregnant women.
Total iron binding capacity (TIBC) is a measure of the amount of iron that can be carried through the blood.
A raised TIBC result usually indicates iron deficiency whereas low TIBC can occur with iron overload syndrome (haemochromatosis).
Transferrin is made in the liver and is the major protein in the blood which binds to iron and transports it through the body.
Low levels of transferrin indicate iron deficiency while high levels indicate iron overload.
Ferritin is a protein which stores iron in your cells for your body to use later. Measuring ferritin levels gives us a good indication of the amount of iron stored in your body.
Low levels of ferritin can indicate anaemia which can be caused by excessive or chronic bleeding, poor absorption of iron or too little iron in the diet.
Raised ferritin levels can indicate iron overload syndrome (haemochromatosis) or any kind of liver damage. It is also a marker of infection and inflammation.
Triglycerides are a type of fat (lipid) that circulate in the blood. After you eat, the body converts excess calories into triglycerides which are then transported to cells to be stored as fat. Your body releases triglycerides to be used for energy.
Raised triglycerides are thought to be a risk factor for peripheral vascular disease (affecting the blood vessels which supply your arms and legs as well as organs below the stomach) as well as microvascular disease, affecting the tiny blood vessels around the heart.
For adults, triglyceride test results are categorized as follows:
- Desirable: Less than 150 mg/dL (1.7 mmol/L)
- Borderline high: 150 to 199 mg/dL (1.7-2.2 mmol/L)
- High: 200 to 499 mg/dL (2.3-5.6 mmol/L)
- Very high: Greater than 500 mg/dL (5.6 mmol/L)
For children, teens and young adults:
From newborn to age 9
- Acceptable: Less than 75 mg/dL (0.85 mmol/L)
- Borderline high: 75-99 mg/dL (0.85-1.12 mmol/L)
- High: Greater than 100 mg/dL (1.13 mmol/L)
For ages 10-19 years
- Acceptable: Less than 90 mg/dL (1.02 mmol/L)
- Borderline high: 90-129 mg/dL (1.02-1.46 mmol/L)
- High: Greater than 130 mg/dL (1.47 mmol/L)
For young adults older than 19
- Acceptable: Less than 115 mg/dL (1.30 mmol/L)
- Borderline high: 115-149 mg/dL (1.30-1.68 mmol/L)
- High: Greater than 150 mg/dL (1.7 mmol/L)
Note: These values are based on fasting triglyceride levels.
When triglycerides are very high (greater than 1000 mg/dL (11.30 mmol/L)), there is a risk of developing pancreatitis in children and adults. Treatment to lower triglycerides should be started as soon as possible.
Cholesterol is an essential body fat (lipid). It is necessary for building cell membranes and for producing a number of essential hormones. Cholesterol is manufactured in the liver and also comes from the food we eat. Elevated cholesterol is a risk factor for heart disease.
Cholesterol however is made up of both good (HDL) and bad (LDL) cholesterol so it is important to investigate a raised total cholesterol result to determine the cause. High levels of HDL cholesterol can cause a raised total cholesterol result but may actually be protective against heart disease.
For adults, in a routine setting where testing is done to screen for risk, the test results are grouped in three categories of risk:
- Desirable: A cholesterol below 200 mg/dL (5.18 mmol/L) is considered desirable and reflects a low risk of heart disease.
- Borderline high: A cholesterol of 200 to 239 mg/dL (5.18 to 6.18 mmol/L) is considered to reflect moderate risk. If the cholesterol test was done by itself, a healthcare practitioner may decide to order a lipid profile to see if the high cholesterol is due to the amount of bad cholesterol (high LDL-C) or good cholesterol (high HDL-C). Depending on the results of the lipid profile (and any other risk factors), a decision will be made about whether treatment, including lifestyle changes, is necessary.
- High risk: A cholesterol greater than or equal to 240 mg/dL (6.22 mmol/L) is considered high risk. A health care provider may order a lipid profile (as well as other tests) to try to determine the cause of the high cholesterol. Once the cause is known, an appropriate treatment will be prescribed.
For children and adolescents:
- A cholesterol below 170 mg/dL (4.40 mmol/L) is acceptable.
- A result of 170-199 mg/dL (4.40-5.16 mmol/L) is borderline.
- A total cholesterol reading greater than or equal to 200 mg/dL (5.17 mmol/L) is considered high.
For young adults:
- A cholesterol below 190 mg/dL (4.92 mmol/L) is acceptable.
- A result of 190-224 mg/dL (4.92-5.80 mmol/L) is borderline.
- A total cholesterol greater than or equal to 225 mg/dL (5.82 mmol/L) is considered high.
Cholesterol should be measured when a person is not ill. Blood cholesterol is temporarily low during acute illness, immediately following a heart attack, or during stress (like from surgery or an accident). Wait at least six weeks after any illness to have cholesterol measured.
Cholesterol is typically high during pregnancy. Women should wait at least six weeks after having a baby to have cholesterol measured.
HDL cholesterol (high density lipoprotein) removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as "good cholesterol".
Raised levels are believed to be protective against heart disease, while low levels are associated with increased risk of a heart attack.
LDL Cholesterol (LDL-C)
LDL cholesterol (low density lipoprotein) carries cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called "bad cholesterol", can cause fatty deposits to accumulate on artery walls, potentially leading to atherosclerosis and heart disease.
- LDL level can be evaluated as follows:
- Less than 100 mg/dL (2.59 mmol/L) — Optimal
- 100-129 mg/dL (2.59-3.34 mmol/L) — Near optimal, above optimal
- 130-159 mg/dL (3.37-4.12 mmol/L) — Borderline high
- 160-189 mg/dL (4.15-4.90 mmol/L) — High
- Greater than 189 mg/dL (4.90 mmol/L) — Very high
According to the American Academy of Pediatrics, the LDL level can be evaluated for youth with no other risk factors as follows:
For children and teens:
- Less than 110 mg/dL (2.85 mmol/L) — Acceptable
- 110-129 mg/dL (2.85-3.34 mmol/L) — Borderline high
- Greater than 130 mg/dL (3.36 mmol/L) — High
For young adults:
- Less than 120 mg/dL (3.10 mmol/L) — Acceptable
- 120-159 mg/dL (3.10-4.11 mmol/L) — Borderline high
- Greater than 160 mg/dL (4.12 mmol/L) — High
LDL Particle Testing (LDL-P)
Traditional lipid testing measures the amount of LDL cholesterol (LDL-C) present in the blood. This is total amount of LDL. However, whilst a high reading is a potential issue, there is a much more effective reading for heart disease risk and that is LDL-P, which is the number of LDL particles not the volume of LDL particles as in LDL-C.
LDL particle number (LDL-P) is a much more accurate predictor of CV disease risk than either LDL-C or total cholesterol.
As well as measuring LDL-P we can also measure Apolipoprotein B. Apolipoprotein B is the major apolipoprotein in LDL. It binds with triglycerides and cholesterol to form LDL, and it is also the receptor that binds with cells so LDL can deliver it’s fats and cholesterol. So in scientific studies Apolipoprotein B levels act as a proxy for LDL-P.
Very low-density lipoprotein cholesterol (VLDL) may be reported to determine risk of coronary heart disease and an important part of cardiac risk assessments.
An elevated level of VLDL cholesterol (>30 mg/dL or >0.77 mmol/L), like elevated LDL cholesterol, is considered a risk factor for heart disease and stroke. The presence of high VLDL in addition to high LDL may affect the choice of therapy used to lower a person's cholesterol, such as lifestyle changes or drug treatment.
Low levels of VLDL cholesterol are not generally a concern.
Non-HDL cholesterol is calculated by subtracting your HDL cholesterol result from your total cholesterol. It therefore includes all the non-protective and potentially harmful cholesterol in your blood, not just the LDL cholesterol. As such, it is considered to be a better marker for cardiovascular risk than total cholesterol and LDL cholesterol. The recommended level of non-HDL cholesterol is below 4 mmol/L.
Heart Disease Risk
HDL % of total
HDL % of total cholesterol is considered to be more indicative of your risk of cardiovascular disease than total cholesterol alone.
A result below 20% indicates an increased risk of cardiovascular disease, while one above 20% indicates a lower than average risk.