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  • Q&A with Australian Health Practitioners

    Why do the hdl and ldl not add up to total cholesterol on blood tests?

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    Cardiology & Vascular Health High Cholesterol
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    Dr Simon Easterbrook-Smith

    Health Professional

    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    Cholesterol is carried in the blood by three diffent kinds of lipoproteins (they are complexes of proteins and  lipids (including cholesterol)). They are High Density Lipoprotein (HDL - high values for HDL indicate protection against cardiovascular disease), Low Density Lipoprotein (LDL - high values for LDL are a risk factor for cardiovascular disease), and Very Low Density Lipoprotein (VLDL - high values for VLDL are also a risk factor for cardiovascular disease).

    Total cholesterol is sometimes reported in units of mmoles/litre of blood (this, in effect, means the number of molecules of cholesterol per litre of blood) - a number of less than 5 mmoles/litre is generally seen as a good sign.

    Confusingly, total cholesterol is also sometimes reported in units of mg/litre of blood ( the sum of the mg/litre of the HDL, LDL and VLDL levels in your blood). The difference between mmoles/litre and mg/litre might explain the anomaly.

    It could be that your blood tests did not include an explict measure of VLDL levels (in mg/litre) - this might also explain the discrepancy.

    If you would like to post your numbers here I would be happy to look and try to interpret them (as a scientist, not as a health professional).

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