Expert: Todd Bublitz, RCEP - 4/19/2007

Question
My HLD is 100, my LDL is 150 and my tri are 49.  The LDL is high, but the others are exceptionally good.  Why is my total cholesterol 260?  My sister's HLD is 72, her LDL is 150 and her tri are 77, but her total cholesterol is 237, I don't get it.

Answer
Cindi,

The difference between the total cholesterol levels of you and your sister is 23 "points" and that is about 10%.  I don't consider that a big difference at all.  Even if you were identical twins and shared ALL the same genes, you could easily have a 10-15% difference in your total cholesterol levels simply by having different diets ("regular diet" vs "low saturated- and trans-fat diet").

There are siblings out there where one has a total cholesterol level three times higher than the other because the one inherited a certain gene that causes increased cholesterol production.

Also, it would be more accurate look at your average cholesterol levels by comparing several tests.  There will be a variability not only fron your diet at the time of the test but also from test to test and from lab to lab that is often around 5% (about 10 "points" for you).

Lastly, the total cholesterol level is the least important.  The LDL level is the one we look at when deciding if treatment is necessary.  The total cholesterol level and the LDL go hand-in-hand.  If you increase or decrease one, the other will go the same direction, but if one is considered "high" the other may not.  For example, I have seen many people with total cholesterol levels around 200-220 mg/dL (not considered "high") but their LDL levels are around 130-150 mg/dL (this would be high for a "moderate risk" person).

You can learn more about "desirable" and "optimal" lipid levels at this page:
http://www.lipid-clinic.com/levels.html

I hope this helps.

Todd
www.Lipid-Clinic.com