A total cholesterol test is a rough measure of all the cholesterol and triglycerides in your blood.
Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a little bit of cholesterol to work properly. But too much cholesterol can clog your arteries and lead to heart disease.
Some cholesterol is considered "good" and some is considered "bad." Different blood tests are needed to individually measure each type of cholesterol.
Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.
Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.
Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.
In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.
How to prepare for the test:
To get accurate results, you should not eat or drink anything for 9 to 12 hours before the test. You may drink water, but other beverages such as coffee, tea, or soda should be avoided.
Your health care provider may tell you to stop taking drugs that can affect the test. Never stop taking any medicine without first talking to your doctor.
Drugs that may increase total cholesterol measurements include:
ACTH
Anabolic steroids
Beta-adrenergic blocking agents
Corticosteroids
Epinephrine
Birth control pills
Phenytoin
Sulfonamides
Thiazide diuretics
Vitamin D
Drugs that may decrease total cholesterol measurements include:
Allopurinol
Androgens
Captopril
Chlorpropamide
Colchicine
Colestipol
Erythromycin
Fibrates
Isoniazid
MAO inhibitors
Neomycin
Niacin
Nitrates
Statins
How the test will feel:
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performed:
This test is often done to determine your risk for coronary artery disease. High blood cholesterol and triglycerides have been linked to heart attack and stroke.
Experts recommend that you have a complete cholesterol and triglycerides analysis every 5 years starting at age 20.
The total cholesterol test is usually done as part of a lipid profile , which also checks for LDL, HDL, and triglycerides.
Additional conditions under which the test may be performed:
Total cholesterol is an important measure of both bad and good cholesterol. Other lab tests are done to measure specific amounts of good (HDL) and bad (LDL) cholesterol. A cholesterol breakdown including LDL and HDL is preferred.
The total cholesterol values listed below are used to target therapy:
Desirable: Under 200 milligrams per deciliter (mg/dL)
Borderline high: 200 to 239 mg/dL
High risk: 240 mg/dL and higher
What abnormal results mean:
In general, a total cholesterol value over 200 mg/dL may mean you have a greater risk for heart disease. However, LDL levels are a better predictor of heart disease, and they determine how your high cholesterol should be treated.
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks, although rare, may include:
Excessive bleeding
Fainting or feeling light-headed
Hematoma (blood accumulating under the skin)
Infection (a slight risk any time the skin is broken)
Special considerations:
Any acute illness can raise or lower your total cholesterol number. If you have had an acute illness in the 3 months before having this test, you should have it repeated in 2 or 3 months. Even a flare-up of arthritis can affect your cholesterol level.
Other conditions associated with high cholesterol include:
Pregnancy
Removal of the ovaries
References:
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497.
Review Date: 1/22/2008 Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, and Private practice specializing in Cardiovascular Disease, Watertown, MA. Review provided by VeriMed Healthcare Network.
