Do your eyes glaze over every time your doctor mentions your “cholesterol level”? Are you ready to get yours to a healthy spot but not sure how to do it? Still wondering WTF cholesterol actually is? We’ve got you.

Cholesterol usually comes up only when it’s a problem, but you couldn’t live without this lipophilic (fat-loving) molecule. If you have high cholesterol, though, that means you have too much of it in your blood, which can lead to health problems down the road.

Here’s how to keep your cholesterol levels in check.

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Cholesterol is a wax-like substance that’s an essential part of the membrane that surrounds your cells.

Every cell in your body can make a small amount of cholesterol, but your liver does most of the heavy lifting. You can also get cholesterol through the food you eat.

Cholesterol is necessary for the production of vitamin D, sex hormones (like estrogen and testosterone), and steroid hormones (like cortisol and aldosterone).

Cholesterol also gets converted into bile acids. Your body needs those to absorb fat-soluble nutrients like vitamins A, D, E, and K.

So yeah, cholesterol does a lot for your bod.

Cholesterol loves fat, but fat doesn’t like water. So how does cholesterol get around inside your very water-like blood? It gets packaged with lipoproteins.

Lipoproteins are a combo of lipids (fats) and protein. They work like tiny trains that take cholesterol where it needs to go in your body.

There are five main types of lipoproteins in your blood. But only two of these types get measured during a cholesterol check: high-density lipoprotein (HDL) and low-density lipoprotein (LDL).

HDL

HDL is a “good” lipoprotein. Why does it get a gold star? Because having optimal HDL levels is associated with a lower risk of heart disease. HDL helps collect excess cholesterol and bring it back to your liver so it can be removed or recycled.

LDL

LDL is commonly thought of as a “bad” lipoprotein. That’s because having too much LDL may mean plaque is more likely to build up in your arteries. That excess plaque can increase your risk of heart disease.

Total cholesterol

Total cholesterol includes the total amount of HDL and LDL in your blood.

What’s normal?

Here’s how to tell if your cholesterol levels fall into the healthy range:

  • Total cholesterol: 125 to 200 mg/dL
  • LDL: less than 100 mg/dL
  • HDL: 40 mg/dL or higher for men and 50 mg/dL or higher for women

These numbers apply for everyone age 20 or older.

High cholesterol (aka hypercholesterolemia) is very common. It just means you have an elevated level of total cholesterol and/or LDL in your blood.

Your cholesterol is considered high if you have:

  • LDL greater than 190 mg/dL
  • LDL greater than 160 mg/dL with one major risk factor
  • LDL greater than 130 mg/dL with two heart disease risk factors

Risk factors for high cholesterol

There are a bunch of risk factors for developing high cholesterol, including:

  • older age
  • family history of certain types of heart disease
  • high blood pressure
  • diabetes
  • smoking cigarettes (another great reason to try to quit smoking!)
  • low HDL cholesterol levels

Another measure of heart health is the total cholesterol to HDL ratio, or TC/HDL-C.

A ratio greater than 4.5 is associated with an increased risk of heart disease. You can decrease this ratio by lowering your LDL levels and raising your HDL levels.

What affects your cholesterol levels?

Many factors can impact your cholesterol levels, including:

Several inherited disorders can lead to elevated cholesterol, including familial hypercholesterolemia (FH). FH is a genetic disorder caused by a defect in a specific chromosome. This defect impacts how the body processes cholesterol, leading to abnormally high LDL levels.

FH affects about 1 in 250 people.

Related health conditions

What’s the big deal about high cholesterol? It’s linked to an increased risk of certain medical conditions, including:

  • heart disease
  • stroke
  • peripheral vascular disease (a blood circulation disorder)

If you have high cholesterol levels, don’t worry! There are a ton of healthy, science-backed ways to lower your cholesterol.

Here are a few tips:

  • Eat a healthy diet. Make sure your diet is rich in whole foods, especially foods high in fiber, such as veggies, fruits, and beans. Studies have shown that high fiber diets are associated with healthy cholesterol levels and lower heart disease risk.
  • Load up on the right kind of fats. Think: olive oil, fatty fish, nuts, seeds, and avocado. You can still enjoy saturated fats like full-fat yogurt, but try to choose unsaturated fats when you can.
  • Get moving. Regular physical activity can help lower your cholesterol levels. This doesn’t mean you have to go all-out in the gym. Just make sure you’re active on a daily basis. Aim for at least 150 minutes of moderate-intensity activity each week.
  • Don’t smoke cigarettes. Smoking is bad for your health, period. If you’re having trouble quitting smoking, try to cut back in order to improve your cholesterol levels.
  • Maintain a moderate body weight. Staying active and fueling your body with nutritious foods can help you reach and maintain a healthy body weight, which is important for heart health and optimizing cholesterol levels.

The only way to tell if your cholesterol levels are high is to have a doctor do a blood test called a lipid panel. This is usually part of a routine yearly checkup with your primary care physician.

Your doc will review your lab results and let you know if anything is abnormal. If your cholesterol is high, you and your doctor can create a plan that works for you.

High cholesterol is typically treated through lifestyle changes, but cholesterol-lowering medication is also available.

If you have an inherited disorder (like FH) or certain medical conditions (like heart disease or diabetes) you’re more likely to need cholesterol-lowering medications to keep your cholesterol levels under control.

Cholesterol is very important for your health. Maintaining healthy LDL and HDL levels can help you stay healthy and reduce your risk of developing certain health conditions, such as heart disease.

If you’re curious what your cholesterol levels are, make an appointment with a healthcare professional to get your cholesterol checked.