Healthcare provider explaining what VLDL cholesterol is to a patient

What is VLDL cholesterol?

Medically reviewed on March 17, 2023 by Jordan Stachel, M.S., RDN, CPT. 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.


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If you’re an adult who regularly sees a healthcare provider, odds are you’ve taken a cholesterol test. However, even if you’ve routinely taken this test for years, it’s still possible to be perplexed when you see the results. High density lipoprotein (HDL), very low density lipoprotein (VLDL), and triglycerides—what do these terms mean? And how do they affect your health?

VLDL cholesterol, or very low density lipoprotein cholesterol, is one of the main types of cholesterol stored within your body [1]. Some VLDL is vital for your body to function, but high levels of VLDL are linked to a number of negative health consequences, from heart disease to chest pain [2]. Because high VLDL levels can be silent, yet dangerous—often presenting no symptoms until risky conditions develop—knowing how to interpret these test results can be helpful for you and your health.

To protect your well-being, it’s important to stay informed about VLDL and other types of cholesterol. In this guide, we’ll explore the function, risk factors, and regulation of VLDL cholesterol for the body.

How is VLDL cholesterol different from other types of cholesterol?

A diagnosis of “high cholesterol” makes cholesterol sound like a single substance—but this is not true. Cholesterol comes in a few different forms, some healthier for your body than others [3].

So, what is VLDL cholesterol in comparison to other types of cholesterol? VLDL is commonly categorized as one of the “bad” types of cholesterol—but the situation is a little more complicated than that [2]. To gain a better understanding, let’s dive deep into the different types of cholesterol.

What is cholesterol?

All cholesterol is a waxy, fatty substance made of lipids, the building blocks of fats.2 Cholesterol enters your body through two ways—the liver (which creates cholesterol) or the diet (from foods that contain cholesterol). The liver accounts for 80% of all cholesterol production, while cholesterol-rich foods, such as high-fat meats and eggs, can provide the rest [3].

While cholesterol has a bad reputation, it plays a vital role in your health. Cholesterol exists within every cell of your body to help with [3]:

  • Vitamin production (especially vitamin D)
  • Hormone production (particularly steroid hormones and sex hormones)
  • Cell membrane formation
  • Bile production

As a lipid, cholesterol doesn’t dissolve in water. This allows cholesterol molecules to travel through the bloodstream by linking with proteins and triglycerides (another type of lipid), forming a lipoprotein [3]. Each type of cholesterol lipoprotein has its purpose, risks, and target levels in your body.

Types of cholesterol

If you’ve ever had a lipid panel completed, you’ve likely seen the acronyms HDL and LDL (low density lipoprotein). These acronyms indicate different types of cholesterol lipoproteins, which carry cholesterol within the bloodstream and throughout the body. However, each type of lipoprotein contains a different ratio of proteins and lipids—with some ratios being better than others.

Let’s examine the different types of cholesterol and what ratio of proteins and lipids they contain:

  • VLDL (very low density lipoprotein) – Containing about 90% lipids and 10% proteins, VLDL cholesterol is considered a “bad” cholesterol due to the health risks from its high lipid count [4].
  • LDL (low density lipoprotein) – This other “bad” cholesterol consists of 75% lipids (mostly cholesterol) and 25% proteins [5].
  • HDL (high density lipoprotein) – Known as the “good” cholesterol, HDL is about 55% lipids and 45% proteins [6]. This lipoprotein type helps rid excess cholesterol molecules from the bloodstream, taking them to your liver to be “recycled”—a process called reverse cholesterol transport [3].
  • Triglycerides – While not technically a type of cholesterol, triglycerides play an important part on your lipid panel. This type of fat is used for energy, traveling through your blood to reach cells [7]. Triglycerides are also used to form lipoproteins by pairing with cholesterol and proteins.

Altogether, these cholesterol levels are combined to measure total cholesterol [3]. The higher your total cholesterol, the more likely you’ll experience cholesterol-related health conditions [7].

Can VLDL cholesterol be harmful?

So, is VLDL cholesterol harmful? The answer is—it can be [3].

Technically, VLDL cholesterol is not a harmful substance on its own. However, if your VLDL levels are too high in your bloodstream (over 30 mg/dL), it can lead to some serious health conditions, particularly for your heart [2]. Let’s explore the mechanism, symptoms, and conditions related to high VLDL cholesterol in the body.

Why are high VLDL levels harmful?

Like LDL, VLDL is considered a “bad” type of cholesterol [3]. Why so? VLDL carries more triglycerides and cholesterol throughout your bloodstream than healthy, HDL cholesterol—and that’s bad news for your arteries [2].

High levels of VLDL bring excess lipids into your bloodstream, which can create fatty deposits along the walls of your blood vessels [2]. These deposits narrow your arteries and restrict blood flow, which can lead to serious health risks like stroke and heart attacks [2].

Moreso, these fatty deposits can develop over time into arterial plaque, a substance that consists of [8]:

  • Cholesterol
  • Lipids
  • Cellular waste
  • Calcium
  • Fibrin (a blood clotting material)

Arterial plaque is the result of your body trying to remove any fatty deposits [9]. Despite your body’s best efforts, this dangerous substance can create two severe health risks—arteriosclerosis (the hardening of arteries) and potential blood clots [8].

Your body forms plaque through these steps:

  1. Cholesterol lodges into the artery or blood vessel walls [9].
  2. White blood cells are sent to trap the cholesterol, transforming into foamy cells that release fat and create inflammation [9].
  3. Muscle cells in the artery wall are triggered to multiply and create a cap over the fatty deposits [9].
  4. The plaque underneath the cap either remains soft or hardens. Soft plaque has the potential to “burst” under high blood pressure, forming a blood clot and potentially risking a stroke or heart attack. Hard plaque won’t burst, but it can greatly harden your arteries and restrict blood flow [9].

Health conditions linked to high VLDL cholesterol

While normal VLDL levels may not have any negative health effects, high VLDL levels can lead to some serious—and even fatal—health conditions over time [10].

The longer you have high VLDL cholesterol, the more likely you’ll have fatty buildup or plaque in your arteries [10]. As a result, you may experience restricted blood flow or blood clots, which are the basis of countless health conditions [10]. Depending on the blocked artery, high VLDL cholesterol can lead to:

  • Coronary artery disease (CAD) – The most common form of heart disease, CAD results from hardened coronary arteries preventing enough blood from reaching the heart [11]. This can lead to a heart attack or heart failure down the line.
  • Carotid artery disease – Similar to CAD, carotid artery disease is when a carotid artery hardens from plaque [11]. This restricts the blood flow to your brain, which can lead to a transient ischemic attack (“mini-stroke”) or stroke.
  • Peripheral artery disease (PAD) – If a peripheral artery is blocked, it can cut off blood flow to your legs or arms [11]. PAD is the most dangerous arterial disease, only developing symptoms when at least 60% of the artery is blocked.
  • High blood pressure – The more clogged your arteries are, the harder your heart must work to pump blood through them [11]. This can increase your blood pressure, which increases the risk of any soft plaque bursting and creating a dangerous clot.

The signs of high cholesterol

While many health conditions make themselves known outwardly—making us cough, sneeze, and experience aches and pains—technically, high cholesterol has no symptoms [12]. Only when high cholesterol levels create risky health conditions (such as CAD or high blood pressure) will any symptoms show. This is why the Centers for Disease Control and Prevention (CDC) recommends getting a cholesterol screening at least once every five years [12]. The earlier you can catch high cholesterol, the better you can prevent any related health conditions.

All that said, you may experience symptoms related to health conditions that develop from atherosclerosis (hardened arteries) and high cholesterol, and it’s important to take notice of any signs before these conditions worsen. These symptoms could be [13]:

  • Chest pain (angina)
  • Heart palpitations
  • Jaw pain
  • Digestive issues
  • Gallstones
  • Cold sweats
  • Dizziness
  • Fatigue
  • Memory loss
  • Vision loss
  • Numbness or tingling in the limbs
  • Erectile dysfunction

If you experience any of these symptoms, it’s vital to check with your healthcare provider to determine if high cholesterol could be a cause and ask them how long it takes to lower cholesterol to achieve more balanced levels.

What counts as high VLDL cholesterol?

High cholesterol (or hyperlipidemia) is not a rare condition. According to the CDC, nearly two-fifths of adults and 7% of children (ages 6 to 19) in the United States have high cholesterol [14]. In short, it’s a common condition that deserves to be monitored.

A cholesterol and lipid test can measure your total cholesterol and individual types of cholesterol to evaluate your health. Currently, the following levels are recommended for adults [2, 14]:

  • Total cholesterol – 150 mg/dL
  • VLDL cholesterol – 30 mg/dL or less
  • LDL cholesterol – 100 mg/dL or less
  • HDL cholesterol – 40 mg/dL or higher in men; 50 mg/dL or higher in women
  • Triglycerides – 150 mg/dL or less

Can cholesterol levels be too low—a condition known as hypolipidemia? It depends. One study showed that LDL levels as low as 21 mg/dL didn’t create adverse effects [15]. However, low HDL levels were linked to a high risk of death from cardiovascular conditions [16]. Regardless, hypolipidemia is quite rare unless genetically inherited [17].

Check in on your heart with Everlywell

VLDL cholesterol is just one of many substances that helps your body function—but it’s a substance that deserves a watchful eye. Without intervention, high VLDL cholesterol levels could pose a silent risk to your health over time. Testing your cholesterol regularly can help you stay on top of your health, preventing high cholesterol from turning into a more harmful condition.

Luckily, gaining insight into your health is now easier than ever. Learn about your cholesterol levels by taking an at-home Cholesterol & Lipids Test from Everlywell. Simply mail in your test sample, and our network of CLIA-certified labs will quickly deliver your results, helping you understand whether you have optimal levels of:

  • Total cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Triglycerides

If you want to access insightful and life-changing lab tests from home, explore more of our at-home tests and products today.

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References

  1. VLDL. ucsfhealth.org. Accessed February 14, 2023. URL
  2. VLDL Cholesterol. Medlineplus.gov. Published 2019. Accessed February 13, 2023. URL
  3. What Is Cholesterol? Cleveland Clinic. URL
  4. Juarez Casso FM, Farzam K. Biochemistry, Very Low Density Lipoprotein. PubMed. Published 2022. Accessed February 13, 2023. URL
  5. Bancells C, Canals F, Benítez S, et al. Proteomic analysis of electronegative low-density lipoprotein. Journal of Lipid Research. 2010;51(12):3508-3515. doi:10.1194/jlr.m009258
  6. Lund-Katz S, Phillips MC. High Density Lipoprotein Structure–Function and Role in Reverse Cholesterol Transport. Cholesterol Binding and Cholesterol Transport Proteins: Published online 2010:183-227. doi:10.1007/978-90-481-8622-8_7
  7. Centers for Disease Control and Prevention. LDL & HDL: Good & Bad Cholesterol. Centers for Disease Control and Prevention. Published October 31, 2017. Accessed February 13, 2023. URL
  8. American Heart Association. Atherosclerosis. www.heart.org. Published November 6, 2020. Accessed February 13, 2023. URL
  9. Can we reduce vascular plaque buildup? Harvard Health. Published 2021. URL
  10. High Cholesterol Can Be Dangerous Even at Age 35. Time. Published January 26, 2015. Accessed February 14, 2023. URL
  11. Cleveland Clinic. Diseases Caused By High Cholesterol | Cleveland Clinic. Cleveland Clinic. Published 2016. Accessed February 13, 2023. URL
  12. CDC. Cholesterol Myths and Facts. Centers for Disease Control and Prevention. Published January 26, 2021. Accessed February 13, 2023. URL
  13. Atherosclerosis - Symptoms | NHLBI, NIH. www.nhlbi.nih.gov. Published March 24, 2022. Accessed February 13, 2023. URL
  14. Cholesterol Information. CDC. Published 2019. Accessed February 13, 2023. URL
  15. Sabatine MS, Wiviott SD, Im K, Murphy SA, Giugliano RP. Efficacy and Safety of Further Lowering of Low-Density Lipoprotein Cholesterol in Patients Starting With Very Low Levels. JAMA Cardiology. 2018;3(9):823. doi:https://doi.org/10.1001/jamacardio.2018.2258
  16. Low levels of HDL (the “good” cholesterol) appear connected to many health risks, not just heart disease. Harvard Health Blog. Published November 2, 2016. Accessed February 13, 2023. URL
  17. Elmehdawi R. Hypolipidemia: A Word of Caution. The Libyan Journal of Medicine. 2008;3(2):84-90. doi:10.4176/071221
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