How to read a lipid panel: a five-step process without panic
A report with six lines, and your eye lands on “total cholesterol 6,1 — above the normal range.” This is the last line to look at. There is an order of reading in which the paper tells a story about insulin, the liver, and the blood vessels instead of frightening you with one number. Section — cholesterol and the heart.
Five steps
1. Triglycerides
Below 1,0 — excellent; 1,0-1,7 — normal; above 1,7 — sugar, fructose, alcohol, or insulin resistance. The most honest line about food.
2. HDL
Above 1,5 in women — excellent; 1,3-1,5 — normal; below 1,3 — too little fat and movement, too many carbohydrates.
3. TG/HDL ratio
Below 1 — particles are large, risk is low; above 2,7 — small dense particles, insulin resistance. This is the main conclusion from the report.
4. LDL in context
Below 3,0 — standard normal range. Above that — review steps 1-3: with an excellent ratio, the picture is different than with a poor one. Also consider family history and blood pressure.
5. Total cholesterol — last
The total of everything. It increases from HDL just as it does from LDL. On its own, it means almost nothing.
Ranges
| Marker | Excellent | Normal | Attention |
|---|---|---|---|
| Triglycerides, mmol/L | below 1,0 | 1,0-1,7 | above 1,7 |
| HDL, mmol/L (women) | above 1,5 | 1,3-1,5 | below 1,3 |
| TG/HDL | below 1 | 1-1,7 | above 2,7 |
| LDL, mmol/L | below 2,6 | 2,6-3,0 | above 3,0 — in context |
| non-HDL (total minus HDL) | below 3,4 | 3,4-3,8 | above 3,8 |
| ApoB, g/L | below 0,8 | 0,8-0,9 | above 1,0 |
| Lp(a), nmol/L | below 75 | 75-125 | above 125 — genetics, once in a lifetime |
Two tests worth knowing about
ApoB counts atherogenic particles directly, rather than the cholesterol in them; with borderline LDL, it is the deciding argument. Lp(a) is a genetic risk factor, does not depend on food, and is tested once in a lifetime; a high result is a reason to monitor everything else more strictly. Neither is part of a standard lipid panel, so request them separately. An analysis of LDL using the method — cholesterol on a low-carbohydrate diet, the ratio — triglycerides and HDL.
12 h
fasting
3 months
after starting the method
usual
the week before testing
1 time
in a lifetime — Lp(a)
Pitfalls
- Testing without fasting or after alcohol the day before
- Testing during the first 6 weeks of the method
- Reading the report starting with total cholesterol
- Comparing with ranges from different laboratories
- Making decisions about statins based on one number without ApoB and family history
Frequently asked questions
What should you bring to the doctor?
The report, calculated TG/HDL, ApoB if available, blood pressure for the week, waist measurement, and family history. The conversation becomes substantive.
Units: mg/dL or mmol/L?
Cholesterol: mg/dL ÷ 38,7 = mmol/L. Triglycerides: ÷ 88,5. The ranges in the article are in mmol/L.
How often?
Before starting, after 3 months, then once a year. Lp(a) — once.
- Blood Sugar
- Cholesterol and Heart
- Metabolic Flexibility
Reviewed by Anastasia Zhukova, Fitness Trainer • Author of a Nutrition and Training System • Creator of an AI Personal Support Platform
A human has reviewed this material against the method and real client practice.