helvy.co.uk

Metabolic

Cholesterol (Total, HDL, LDL & ApoB)

In the UK, the standard clinical (NHS) reference range for Cholesterol (Total, HDL, LDL & ApoB) is Total: below 5 mmol/L, LDL: below 3 mmol/L, with ApoB: below 1.0 g/L, LDL: below 2.6 mmol/L, HDL: above 1.2 mmol/L considered the performance-optimised range. A result within these ranges suggests typical status; only a qualified clinician can interpret an individual reading.

A cholesterol panel measures the fats circulating in your blood — total cholesterol, HDL ('good' cholesterol), LDL ('bad' cholesterol), triglycerides, and increasingly ApoB, the protein that carries LDL particles into artery walls. Together, these markers paint the most accurate picture of your cardiovascular risk and metabolic health available from a blood test.

Last reviewed: 11 June 2026


Optimal Ranges

What is the optimal range for Cholesterol?

Clinical (NHS) Range

Total: below 5 mmol/L, LDL: below 3 mmol/L

mmol/L (lipids), g/L (ApoB)

Performance-Optimised Range

ApoB: below 1.0 g/L, LDL: below 2.6 mmol/L, HDL: above 1.2 mmol/L

mmol/L (lipids), g/L (ApoB)

Cholesterol (Total, HDL, LDL & ApoB) reference ranges (UK)
RangeValueUnit
Clinical (NHS) reference rangeTotal: below 5 mmol/L, LDL: below 3 mmol/Lmmol/L (lipids), g/L (ApoB)
Performance-optimised rangeApoB: below 1.0 g/L, LDL: below 2.6 mmol/L, HDL: above 1.2 mmol/Lmmol/L (lipids), g/L (ApoB)

The clinical range defines what is considered medically “normal” — broad enough to cover 95% of the population. The performance range reflects where research and clinical experience suggest most people feel and function at their best. A result in either range suggests typical status and is not a diagnosis; any individual reading should be interpreted by a qualified clinician.


Why It Matters

Why Cholesterol matters for performance

Heart and circulatory disease is the UK's second biggest killer, responsible for around 160,000 deaths each year according to the British Heart Foundation. What most people don't realise is that cardiovascular damage accumulates silently over decades — by the time symptoms appear, significant plaque build-up has already occurred. For men in their 30s and 40s, a lipid panel is less about diagnosing disease today and more about understanding your trajectory. Modern cardiology has shifted focus from total cholesterol to ApoB and non-HDL cholesterol as stronger predictors of risk. An ApoB level below 1.0 g/L is considered optimal by the European Society of Cardiology, yet most standard NHS health checks don't test it.


Symptoms

What are the symptoms of low or high Cholesterol?

Low / Deficiency

  • Very low cholesterol (rare) may impair hormone production
  • Low HDL increases cardiovascular risk
  • Fatigue and mood disturbances at extremely low levels

High / Excess

  • Usually asymptomatic until advanced disease
  • Xanthomas (fatty deposits under skin or around eyes)
  • Chest pain or angina (late-stage)
  • Erectile dysfunction (early vascular sign)
  • Peripheral artery disease (leg pain when walking)

Dietary Sources

Which foods support Cholesterol levels?

Oily fish — salmon, mackerel, sardines (raise HDL, lower triglycerides)Extra virgin olive oil (monounsaturated fats)Nuts — almonds, walnuts, pistachiosOats and barley (beta-glucan fibre)AvocadoLegumes — lentils, chickpeas, kidney beansBerries and citrus fruits (soluble fibre and polyphenols)

Supplementation

How do you improve Cholesterol levels?

Omega-3 fish oil (2-4g EPA+DHA daily) is the most evidence-based supplement for improving triglycerides and HDL. Plant sterols and stanols (2g/day) can reduce LDL by 7-10% — Benecol and similar products deliver this dose. Red yeast rice contains a natural statin (monacolin K) but should only be used under medical supervision due to variable potency. Psyllium husk (5-10g/day) adds soluble fibre that binds bile acids, lowering LDL. Niacin (vitamin B3) was once widely used but has fallen out of favour due to side effects. Lifestyle interventions — reducing refined carbohydrates, increasing exercise, and maintaining healthy body composition — remain the foundation of lipid management.


Testing

How is Cholesterol tested in the UK?

Cholesterol is measured from a blood sample. With Helvy, that means a finger-prick kit taken at home and posted to a UKAS-accredited UK laboratory, with results in around 5 days, reviewed by a qualified clinician. Your result is reported against both the clinical range (Total: below 5 mmol/L, LDL: below 3 mmol/L) and the performance-optimal range (ApoB: below 1.0 g/L, LDL: below 2.6 mmol/L, HDL: above 1.2 mmol/L), so you can see not just whether you are “normal” but whether you are optimal. If you make a change, retest after 8-12 weeks to confirm it worked.


Research

Key study

Apolipoprotein B and cardiovascular disease: biomarker and potential therapeutic target

Sniderman AD, Thanassoulis G, Glavinovic T, et al.

The Lancet (2019)

DOI: 10.1016/S0140-6736(19)32519-0

Related Biomarkers


Related Guides

Explore Cholesterol in depth


Test your Cholesterol levels

Cholesterol is included in the Helvy 50+ biomarker panel. Get your results in 5 days with a personalised protocol.

Order Your Test

This content is for educational purposes only and does not constitute medical advice. Your data suggests areas for optimisation, but any concerns should be discussed with a qualified healthcare professional. If your results flag values outside safe ranges, we recommend consulting your GP.