What a cholesterol profile measures
Cholesterol is a fat-like substance your body genuinely needs. It sits in the wall of every body cell and is the raw material for hormones, vitamin D and bile. Your liver produces most of it itself, and a smaller part comes from your diet. Because fat and blood do not mix, cholesterol travels packaged in protein particles called lipoproteins. That packaging determines what the cholesterol does in your body, which is why a cholesterol profile measures not one value but several.
A standard profile consists of four tests. Total cholesterol gives the overall amount of cholesterol in your blood and therefore a first impression. LDL cholesterol carries cholesterol from the liver to the tissues and can accumulate in the vessel wall. HDL cholesterol does the opposite and returns surplus cholesterol to the liver, which is why it is often called the protective cholesterol. Triglycerides are a different form of fat in the blood, closely linked to diet, alcohol, weight and your blood sugar balance.
Why LDL takes centre stage
Of the four values, LDL cholesterol receives the most attention. LDL particles can end up in the vessel wall and contribute there to the formation of plaques, the process known as atherosclerosis. This happens gradually and without symptoms, often over decades. The higher your LDL and the longer that exposure lasts, the more strongly this process weighs in your risk of cardiovascular disease. An elevated value is not a diagnosis and says nothing in itself about the state of your vessels, but it is the value that offers the clearest handle for doing something about your risk.
Have your cholesterol profile measured
Total cholesterol, LDL, HDL and triglycerides in a single blood draw, including doctor interpretation and a personal PDF report. No referral required.
Inherited high cholesterol
Cholesterol is largely determined by heredity. In familial hypercholesterolaemia (FH), an inherited condition means the body does not clear LDL from the blood well enough. Cholesterol is then already elevated from a young age, even in people who eat well and exercise a lot. Signs include a strongly elevated LDL, cardiovascular disease at a relatively young age in parents or siblings, or fatty deposits in tendons and around the eyes. If you recognise this, discuss your result with your GP. FH can be traced reliably through family screening and targeted treatment is available.
If you have a strong family history, two additional tests can deepen the picture. Lipoprotein(a), or Lp(a) for short, is almost entirely determined by heredity and barely changes with lifestyle. As a rule, a single measurement in your lifetime is therefore enough. Apolipoprotein B, or ApoB, reflects how many cholesterol-carrying particles are actually circulating in your blood and so complements the LDL picture. Both are included in the Heart & Vessels Extra package.
In-depth testing for inherited risk
Heart & Vessels Extra measures Lp(a) and ApoB, two values that are especially useful when cardiovascular disease runs in the family.
What lifestyle can do
Diet and lifestyle influence all four values, although the effect differs considerably from person to person. Replacing saturated fat with unsaturated fat, eating more fibre from vegetables, fruit, pulses and wholegrain products, losing weight if you are overweight, exercising regularly and stopping smoking are the measures with the strongest evidence behind them. Triglycerides also respond strikingly to alcohol, sugary drinks and fast carbohydrates. Because the body needs time to adapt, it is customary to repeat the measurement only after a few months. Measuring more often mainly shows random fluctuation.
Do you need to fast?
For total cholesterol, LDL and HDL, fasting is usually no longer necessary these days: those values change little after a meal. Triglycerides are more sensitive, because they rise after eating and after drinking alcohol. If you want to assess that value as cleanly as possible, or if your doctor asks for a standardised measurement, a fasting sample may still be requested. So always follow the instruction you receive when booking your appointment, and mention it at the blood draw if you ate or drank shortly beforehand. That allows the reviewing doctor to take it into account.
When should you get tested?
A cholesterol profile is useful when you want to know where you stand and the outcome could change what you do. Think of cardiovascular disease or high cholesterol in the family, being overweight, raised blood pressure, diabetes or prediabetes, smoking, or simply the wish to check periodically from middle age onwards. Anyone who has recently overhauled their diet or exercise routine will also gain insight into the effect by measuring again after a few months. At Bloodworks you have the profile drawn at one of the 800+ collection points in the Netherlands. Every result is reviewed by a doctor and delivered as a personal PDF report, with an explanation of your values and, where there is reason to, the advice to contact your GP.