Man getting his cholesterol checked
Illustration by Whitney Williams

Everyone has good and bad cholesterol. Foods you eat can make these substances in your body.

A certain level of cholesterol is okay, but too much can cause health problems.

In this article, you will learn about the differences between the types of cholesterol, why cholesterol can be harmful, what the ideal ranges are for LDL cholesterol, and how to lower your cholesterol naturally and with medications.

“Low-density lipoprotein is a substance that can be found in your body. Your body’s cholesterol making system helps move the blood and tissues.”

Cholesterol can be found in food. Too much of certain cholesterol can affect your health.

LDL cholesterol is usually referred to as “bad cholesterol.” It’s made up of a combination of fats and proteins that can easily build up in your blood vessels.

If you develop too much cholesterol in your blood vessels, it can make it difficult for blood to pass through the vessels to different parts of your body. Blood vessels that become narrowed by cholesterol can make your heart need to work harder to pump blood.

There are also dangerous plaques. If pieces of the plaques break, they can cause problems.

Not all cholesterol is bad.

High-density lipoproteins — or HDL cholesterol — is often referred to as the “good” cholesterol.

While you can build up your blood vessels with LDL cholesterol, it can be carried to your liver where it can be removed.

According to clinical guidelines, most people should aim for LDL cholesterol levels below 100 mg/dL.

The American College of Cardiology and the American Heart Association recommends LDL levels under 70 mg/dL in order to avoid long-term health problems, especially for people living with conditions like diabetes that increase their risk of developing cardiovascular disease.

Everyone is unique, though. A healthcare professional can make recommendations for you based on your individual health and cardiovascular risk factors.

LDL cholesterol numbers

An LDL test will determine your levels of LDL cholesterol. Many doctors rank levels in the following way:

  • Ideal: Less than 100 mg/dL
  • Near optimal/above optimal: 100–129 mg/dL
  • Borderline high: 130–159 mg/dL
  • High: 160–189 mg/dL
  • Very high: 190 mg/dL and above

If you have a test results that show a problem, a doctor can suggest changes to your diet, lifestyle or medication.

A blood sample is taken in a lab or medical office to determineCholesterol is tested by having a blood sample taken in a lab or medical office

A cholesterol test, or lipid panel, can be done with or without fasting. If your doctor requests a fasting test, you will need to avoid eating or drinking anything other than water for about 12 hours beforehand.

According to the National Library of Medicine, your first cholesterol test is typically done when you’re between 9 and 11 years old. If you have a family history of high cholesterol or heart conditions, you may be tested as early as age 2.

The initial test is recommended every 5 years. After 45 for men and 55 for women, cholesterol tests should be increased.

Things can affect your cholesterol levels. Some things contribute to higher levels of cholesterol.

  • eating foods high in cholesterol, saturated fats, and trans fats
  • Low levels of exercise or inactive.
  • Either overweight or obese.
  • cigarette smoking
  • Older age.
  • A family history is a collection of genes.
  • There are certain underlying medical conditions.
  • Certain drugs.
  • The race is on.
  • Sex.

Although you cannot control all of these risk factors, your doctor may make recommendations focusing on the ones you can, such as diet and lifestyle changes.

A heart-healthy diet, exercise, and weight loss are the most common lifestyle recommendations for lowering cholesterol levels. These are typically recommended first if your cholesterol levels are elevated or moving in that direction.

The levels of LDL that are considered high are treated with medication. A doctor may recommend a combination of medication, diet, and exercise for someone with high LDL levels.

Medical management of cholesterol aims to reduce LDL levels by about 50%, especially for people who have an increased risk of developing cardiovascular diseases related to high cholesterol.

Medications that may be used to lower LDL cholesterol levels include:

Medication type Examples
Statins atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevachor or Altoprev), pravastatin (Pravachol), rosuvastatin calcium (Crestor), simvastatin (Zocor)
Cholesterol absorption inhibitors ezetimibe
Bile acid sequestrants cholestyramine (Questran or Prevalite), colestipol (Colestid), colesevelam (Welchol)
PCSK9 inhibitors alirocumab, evolocumab, inclisiran
Adenosine triphosphate-citrate lyase (ACL) inhibitors bempedoic acid (Nexletol), bempedoic acid and ezetimibe (Nexlizet)
Fibrates gemfibrozil (Lopid), fenofibrate (Antara or Tricor), clofibrate (Atromid-S)
Niacin vitamin B3

Some people may also be prescribed omega-3 fatty acid ethyl esters such as Lovaza, Vascepa, Epanova, or Omtryg. However, these are typically used for people with high triglyceride levels and may actually increase LDL levels.

It can take about 3 to 6 months to see your cholesterol levels go down. It depends on what type of medication you use and whether you combine it with lifestyle changes.

You may see your LDL cholesterol drop in as little as 6 to 8 weeks with some medications.

What is the ideal range for LDL cholesterol?

The ideal range for LDL cholesterol is 100 to 100.

Is there a goal LDL level for people with diabetes?

People with diabetes and other conditions that can increase their chances of developing cardiovascular disease should aim for an LDL cholesterol level below 70.

How fast can you lower your LDL levels?

It can take around 2 months with medications or as long as 6 months with lifestyle changes to see a decrease in your LDL levels. Reach out to a doctor to discuss the best treatment options for your individual health and LDL levels.

The type of cholesterol that is considered bad is called low density lipoprotein cholesterol. It is possible that having high LDL cholesterol increases your risk of cardiovascular diseases.

The recommended level of cholesterol for most people is 100 to 100, which is achieved by a balanced diet and exercise. Experts recommend keeping your LDL levels below 70.