Image of Cholesterol Test that checks non-HDL cholesterol

What is non-HDL cholesterol?

Medically reviewed on February 24, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Whether you’re awaiting the results of a recent lipid profile test or preparing for your yearly checkup with a healthcare provider, you might be trying to demystify a frequently discussed element of your health: cholesterol.

Cholesterol is a fat-like substance found in every cell in your body, and there are three different types—high-density lipoprotein (HDL) and two non-HDL cholesterols [1].

What is HDL cholesterol? What is non-HDL cholesterol? What are the recommended levels for each type? In this guide, we’ll explore each of these questions (and more) to help you broaden your knowledge of cholesterol and make empowered decisions about your health and wellness.

Shop Cholesterol Tests Today!

What is cholesterol?

Cholesterol is a substance found in every single cell in your body [1]. Your body needs cholesterol to perform a variety of functions, including:

  • Digestion
  • Vitamin D synthesis from sunlight [2]
  • Hormone production [3]

Luckily, you don’t have to get cholesterol in your diet to maintain the functions above—your body makes its own cholesterol. But since cholesterol is most commonly found in eggs, meats, and cheeses, it’s a normal part of a healthy diet [1].

While cholesterol is necessary for multiple bodily functions, developing high cholesterol can cause significant health problems. If the levels of cholesterol in your blood are too high, other substances can combine with excess cholesterol to form plaque. Plaque sticks to the walls of your arteries, creating buildup and (potentially) blockages [1].

Significant plaque buildup can cause a condition called atherosclerosis, which can lead to coronary artery disease: the narrowing or even complete blockage of arteries [1].

3 types of cholesterol: HDL, LDL, and VLDL

You may have heard of “good” and “bad” cholesterol. There are actually three kinds of cholesterol, but only one of them is considered “good.” Let’s take a closer look at each kind of cholesterol, identify which type is “good,” and break down why two types should be closely monitored.

HDL

High-density lipoprotein (HDL) is one of the three types of cholesterol—it’s the one that healthcare experts consider to be “good” cholesterol [4].

To explain why, we need to explore a few of the basics:

  • Lipids (fats) can’t move through the bloodstream on their own. They need to be attached to proteins, which transport lipids throughout the body. All types of cholesterol are lipoproteins—lipids that have attached to proteins to move around the body.
  • Your body synthesizes all the cholesterol it needs to function. However, if you introduce additional cholesterol through your diet, it needs to move to the liver, where it can be processed and turned into waste.
  • Because it can be densely packed with excess cholesterol, HDL can efficiently move significant amounts of excess cholesterol to the liver—this is why it’s considered “good” cholesterol.

Since HDL is so critical in moving any unused cholesterol to the liver, you actually want your HDL level to be high. This might sound counterintuitive, but when healthcare experts talk about “high cholesterol,” they’re talking about high levels of non-HDL cholesterol.

LDL

Low-density lipoprotein (LDL) is one of two types of non-HDL cholesterol [5]. As you might have guessed, it’s one of two varieties that healthcare experts call “bad” cholesterol.

While HDL transports excess cholesterol to the liver for processing and removal, LDL (low-density lipoprotein cholesterol) generally directs lipids to your tissues and arteries, where they can combine with other substances to form plaque [6].

So, can cholesterol be too low? Yes, it can, however, when it comes to healthy levels (which we’ll discuss in more detail below), healthcare providers generally recommend maintaining a relatively low LDL cholesterol level.

VLDL

The last type of cholesterol is very low-density lipoprotein (VLDL). What is VLDL cholesterol, exactly? Like LDL, healthcare providers generally classify VLDL as “bad” cholesterol [7]. There are a few important elements to understand about VLDL:

VLDL is produced by the liver

It’s not consumed in food. The liver produces VLDL to attach to triglycerides. Triglycerides come from two main sources [8]:

  • They’re found in butter, oil, and other foods
  • Your body converts excess calories (food you eat that your body doesn’t need yet) into triglycerides and stores these until you need more energy

Since VLDL attaches to triglycerides to store them, it doesn’t move to the liver

Instead, it moves to your body’s tissues and arteries, where it can combine with other substances to create plaque [7].

The liver makes enough VLDL to attach to the triglycerides in your body

So when you take a cholesterol test (called a lipid panel), you may see your VLDL level listed as your triglyceride level—they both indicate how much excess fat your body is storing [7].

Like LDL, healthcare providers generally recommend maintaining low levels of VLDL and triglycerides.

How is cholesterol measured?

You and your healthcare provider can monitor your cholesterol levels using a blood test called a lipid panel [9]. Lipid panels typically list some or all of the following metrics about your cholesterol:

  • Total cholesterol – The total measure of your LDL and HDL
  • LDL – A measure of your LDL (“bad”) cholesterol only
  • HDL – A measure of your HDL (“good”) cholesterol only
  • Non-HDL – Your total LDL and VLDL levels
  • Triglycerides/VLDL – Your total triglyceride or VLDL level (these are generally interchangeable, and a lot of lipid panels also give a cholesterol ratio)

When you read your test results, all of these amounts will be listed in the same unit: milligrams per deciliter, or mg/dl.

To develop accurate test results, healthcare providers typically recommend fasting (avoiding food, but not water) for nine to twelve hours before providing a blood sample. Fasting prevents falsely elevated test results that could occur if you eat a fatty meal the day before submitting a sample.

Let’s explore a summary of healthcare experts’ recommendations for cholesterol levels [9].

People 19 years old and younger should have:

  • LDL less than 100 mg/dl
  • VLDL less than 30 mg/dl
  • HDL more than 45 mg/dl

Males 20 years old and up should have:

  • LDL less than 100 mg/dl
  • VLDL less than 30 mg/dl
  • HDL 40 mg/dl or higher

Females 20 years old and up should have:

  • LDL less than 100 mg
  • VLDL less than 30 mg/dl
  • HDL 50 mg/dl or higher

It’s important to note that these are the recommendations for average, generally healthy people. Speak to your healthcare provider about how your personal health history could impact your cholesterol levels and your health goals.

I have high non-HDL cholesterol—what should I do?

If you recently provided a blood sample for a lipid panel and have a high non-HDL cholesterol level and it exceeds the recommendations above, what should you do?

Anytime you have a question about your health, you should make an appointment with a healthcare provider. Providers have the expertise and knowledge to help you interpret your results, consider your lifestyle and personal health history, and develop individually-tailored plans to meet your health benchmarks.

In addition to speaking with a provider, consider the following common tactics for lowering non-HDL cholesterol.

Adjust your eating habits

When it comes to lowering your LDL, triglycerides, and VLDL, healthcare experts highly recommend adjusting your diet. The following changes could help you reduce your non-HDL cholesterol levels [7]:

  • Cutting down on alcohol
  • Switching from butter and “unhealthy” fats to “healthier” fats (like vegetable, nut, and seed oils; avocados; fish)
  • Reducing your sugar intake

It’s also important to remember that your body produces VLDL—one type of non-HDL cholesterol—in response to triglyceride intake (or conversion of excess calories into triglycerides). By increasing your caloric burn (via exercise to lower cholesterol) and/or decreasing your overall calorie intake, you could decrease both your triglycerides and your VLDL levels.

Add exercise to your routine

Let’s explore a point made above—that exercise could help you decrease your non-HDL cholesterol [7].

Exercise could help you reduce your LDL, triglycerides, and VLDL because:

  • Exercise burns calories – If you live a generally sedentary lifestyle, and you have high cholesterol, you might be eating more calories than you need to fuel your everyday lifestyle. By burning additional calories with exercise, you could prevent excess calories from being converted into triglycerides for storage.
  • Exercise can burn fat – If you have high triglycerides, your body may be storing excess calories as fat. By making certain dietary adjustments (like operating at a calorie deficit) and incorporating exercise, your body could begin to burn these stores, reducing your triglyceride level [10].

Most importantly, remember to discuss any changes to your diet and/or exercise plan with your healthcare provider before making any changes to your routine.

Consider cholesterol-lowering medication

While your lifestyle, diet, and activity level certainly impact your overall cholesterol level, these aren’t the only factors to consider in your pursuit of healthy cholesterol. After all, only 25% of cholesterol in your body comes from the food you eat—the rest is produced by the body [6].

If you’ve already tried changing your diet or adding exercise to your daily routine without any noticeable changes in your cholesterol levels, genetic factors or your personal health history may be at play. If you and your healthcare provider determine that this is the case, you may be a candidate for cholesterol-lowering medications.

These medications aren’t available over the counter—ask your healthcare provider if prescription medication might help you achieve your cholesterol goals.

Access cholesterol testing, telehealth services, and more with Everlywell

What is non-HDL cholesterol? HDL cholesterol is generally considered “good” cholesterol, while the other two varieties—LDL and VLDL—are considered “bad” cholesterol.” Achieving a healthy balance of all types of cholesterol may not always be simple, but understanding your own health history and making informed choices about your healthcare can help you achieve your wellness benchmarks.

When you need simple, streamlined, and accessible healthcare, Everlywell has your back. We offer mail-in cholesterol and lipids test kits, access to telehealth services, and an all-in-one health platform to help you create, track, and reach your goals.

Buy Cholesterol Test

How to use exercise to lower cholesterol levels

Can cholesterol be too low?

How long does it take to lower cholesterol?

References

  1. Cholesterol. MedlinePlus. URL. Accessed February 13, 2023.
  2. Vitamin D and your health: Breaking old rules, raising new hopes. Harvard Health. URL. Published September 13, 2021. Accessed February 13, 2023.
  3. Craig M, Yarrarapu S, Dimri M. Biochemistry, cholesterol - statpearls - NCBI bookshelf. National Library of Medicine. URL. Published August 15, 2022. Accessed February 13, 2023.
  4. HDL: The "good" cholesterol. MedlinePlus. URL. Accessed February 13, 2023.
  5. LDL: The "bad" cholesterol. MedlinePlus. URL. Accessed February 13, 2023.
  6. What is the difference between good and bad cholesterol? Keck Medicine of USC. URL. Published September 1, 2022. Accessed February 13, 2023.
  7. VLDL cholesterol. MedlinePlus. URL. Accessed February 13, 2023.
  8. Triglycerides. MedlinePlus. URL. Accessed February 13, 2023.
  9. Cholesterol levels: What you need to know. MedlinePlus. URL. Accessed February 13, 2023.
  10. Physical activity for a healthy weight. Centers for Disease Control and Prevention. URL. Published June 16, 2022. Accessed February 13, 2023.
Everlywell makes lab testing easy and convenient with at-home collection and digital results in days. Learn More