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EspañolWhat a lipid profile test measures
A lipid profile, often just called a cholesterol test, measures total cholesterol, HDL cholesterol and triglycerides, then calculates non-HDL cholesterol and LDL cholesterol from them. Non-HDL is simply total cholesterol minus HDL: a calculation from the same tube, not an extra test. Many UK results also print a total cholesterol to HDL ratio.
You may be given only your total cholesterol, especially after a quick finger-prick test. Separate HDL and non-HDL figures are usually available if you ask your GP or nurse, and they say much more than the total on its own.
Healthy cholesterol levels in the UK
These are the levels the NHS gives as a guide for healthy adults. They are not targets for everyone: what counts as good for you depends on your age, your health conditions and your overall risk of cardiovascular disease. Illness, some medicines and recently having a baby can push the numbers up or down.
| Line | Guide level | What it tells you |
|---|---|---|
| Total cholesterol | Below 5 mmol/L | All the cholesterol in your blood, good and bad together |
| HDL cholesterol | Above 1.0 (men) or 1.2 mmol/L (women) | The protective fraction, carried away from the arteries |
| Non-HDL cholesterol | Below 4 mmol/L | Everything that can build up in artery walls |
| LDL cholesterol | Below 3.0 mmol/L | The main part of non-HDL, often calculated rather than measured |
| Total cholesterol : HDL ratio | Below 6 | The lower, the better |
Why your GP looks at QRISK3, not just the number
Your GP uses your cholesterol together with your age, blood pressure, health conditions and other factors to estimate your chance of a heart attack or stroke over the next ten years. NICE asks GPs to use the QRISK3 tool for this in adults aged 25 to 84 without existing heart disease.
That is why two people with the same cholesterol can leave the surgery with different advice, and both be right. NICE recommends offering a statin, atorvastatin 20 mg, when the 10-year QRISK3 score is 10% or more, and says a lower score should not rule treatment out if the person wants it or the risk may be underestimated.
For people who already have heart or circulation disease, the numbers become targets: NICE aims for an LDL of 2.0 mmol/L or less, or a non-HDL of 2.6 mmol/L or less. If your results print a single range for LDL, read it as the laboratory’s default rather than as your target.
Do you need to fast for a cholesterol test?
Most people do not. The NHS says you might be asked not to eat for up to 12 hours, but that most people do not need to fast, and NICE does not require a fasting sample for a full lipid profile. European specialist societies have recommended non-fasting samples as the routine since 2016: after an ordinary meal, triglycerides rise on average by no more than about 0.3 mmol/L and LDL falls by about 0.2, while HDL does not move.
Fasting comes back for specific questions. One NHS laboratory, for instance, asks for 12 to 14 hours without food only to follow up high triglycerides or a suspected inherited high cholesterol, and NICE asks for a fasting repeat when triglycerides come back between 10 and 20 mmol/L. Follow the instruction your surgery gives you.
Wondering why there is no LDL on your results? That laboratory gives no LDL figure on non-fasting samples, and NICE notes that LDL may be left off altogether when triglycerides are above 4.5 or 9 mmol/L, depending on the formula used locally. Non-HDL cholesterol carries the same information and is always available.
How the lines relate
Triglycerides are the line most affected by what you did yesterday: a meal raises them, and so does alcohol the night before. A single raised triglyceride on a non-fasting sample is rarely the finding it appears to be.
HDL moves slowly and is not disturbed by a meal. It is also a line where smoking shows: in a study grouping people by how much they smoked, smokers had higher total cholesterol, triglycerides and LDL with lower HDL, and heavy smokers the most marked pattern.
Non-HDL cholesterol gathers all the cholesterol carried by the particles that can build up in artery walls, which is why the NHS guide lists it alongside total and HDL cholesterol.
What happens if your lipid profile is high?
Most raised results lead to a conversation about diet, activity, smoking and alcohol, and to a QRISK3 calculation. Before any referral, NICE asks GPs to rule out common causes that push lipids up from elsewhere: excess alcohol, uncontrolled diabetes, an underactive thyroid, liver disease and kidney problems that leak protein. A few numbers matter on their own, whatever the rest of your risk looks like.
- Total cholesterol above 9.0 mmol/LOr non-HDL above 7.5 mmol/L: NICE asks for a specialist assessment, even without a family history of early heart disease, because an inherited cause is possible.
- Triglycerides above 20 mmol/LUrgent specialist review, unless the cause is excess alcohol or poorly controlled diabetes.
- Triglycerides 10 to 20 mmol/LA fasting repeat after at least 5 days and within 2 weeks, a search for other causes, and specialist advice if it stays above 10.
- Triglycerides 4.5 to 9.9 mmol/LRisk tools may underestimate your risk, and specialist advice is sought if non-HDL is above 7.5 mmol/L.
Where to get a cholesterol test
Ask your GP surgery if you have never had one and you are over 40, overweight, or high cholesterol or heart problems run in your family. If you are 40 to 74 with no existing heart, kidney or diabetes condition, you should be invited to an NHS Health Check every five years, which includes a cholesterol test.
Pharmacies also offer cholesterol tests, but you may have to pay. As examples of what private tests cost, on 7 October 2026 one pharmacy listed a full lipid profile at £39, sample collection included, and one London clinic listed a total cholesterol test at £32, on top of a GP consultation.
Once you are on a statin, NICE recommends a full lipid profile 2 to 3 months after starting or changing treatment, then an annual profile to inform reviews. Keeping the same laboratory makes the trend easier to read.
What a lipid profile does not tell you
It does not measure the state of your arteries. It measures substances that, over years, contribute to that state. A single profile is one point on a line that only becomes informative once you have several.
And it says nothing about the rest of your cardiovascular risk: blood pressure, smoking, diabetes, family history and age carry weight that no cholesterol line can show, which is exactly why the decision rests on QRISK3 rather than on one number.