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Cholesterol, total

Lipid Profile · also called TC, Serum cholesterol

What it measures

Total cholesterol measures cholesterol carried in all lipoproteins. It is part of the lipid profile used to estimate cardiovascular risk and to monitor lipid-lowering treatment.

Specimen and preparation

Specimen: Serum or lithium-heparin plasma
Tube: Gold top
Preparation: Fasting 9–12 hours is needed only if triglycerides are high or LDL is calculated; otherwise non-fasting samples are acceptable.

Reference range

Group	Range
Desirable (adult)	<200 (<5.2) mg/dL (mmol/L)
Borderline high	200–239 (5.2–6.2) mg/dL (mmol/L)
High	≥240 (≥6.2) mg/dL (mmol/L)

Reference ranges differ between laboratories, methods and populations. Always use the range printed on your own lab report.

Causes of high values

Familial hypercholesterolaemia
Diet high in saturated fat
Hypothyroidism
Nephrotic syndrome
Cholestasis
Pregnancy

Causes of low values

Hyperthyroidism
Malnutrition and malabsorption
Severe liver disease
Acute illness
Lipid-lowering drugs

Method

Enzymatic colorimetric (cholesterol esterase/oxidase, CHOD-PAP)

Good to know

Risk decisions rely more on LDL, non-HDL cholesterol and overall risk scores than total cholesterol alone.

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