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What is a Good Cholesterol Ratio?

By Darrell Laurant
Updated: Mar 03, 2024

Cholesterol is not a bad thing in itself. It is, in fact, essential for proper cell function, being a key component of cell membranes. Cholesterol is carried in the blood but cannot be dissolved in it, which means that it must use "vehicles" called lipoproteins for moving about the body. In figuring cholesterol rates, lipoproteins and the cholesterol they contain are essentially interchangeable.

The liver is the engine that churns out the body's cholesterol, producing it in the form of bile. As with many things in the body, however, too much of this good thing can be detrimental. Processing a modern fat-rich diet can create a higher than normal level of cholesterol. Since blood cannot dissolve or wash the cholesterol away, the excess begins accumulating on artery walls and restricting blood flow. This is especially dangerous inside the heart.

Based on medical research, it turns out that the lipoprotein has a split personality -- or, if you will, an evil twin. The High-Density Lipoproteins (HDL) carry "good cholesterol," which performs its function efficiently and is disposed of regularly with the help of the liver. The higher the HDL level, with 34 milligrams of cholesterol per deciliter of blood as a generally accepted baseline, the better. Low Density Lipoproteins, by contrast, are married to a type of cholesterol that tends to accumulate, which means that the lower the level, with 160 being the highest healthy range, the better.

The cholesterol ratio was developed as a means of quantifying the overall status of that substance in the body. One commonly employed cholesterol ratio divides the rate of HDL into the figure for LDL. Another divides the overall cholesterol rating, arrived at through adding the HDL and LDL levels together, by the amount of HDL.

With the aid of the cholesterol ratio, the total cholesterol rating can be interpreted and broken down. For example, a seemingly high total rating with a high level of HDL could actually be encouraging. Conversely, a low HDL score or high LDL numbers hiding within the total are always a red flag.

With the LDL to HDL comparison, a cholesterol ratio of 2.3-4.9 would be normal, below 2.3 very positive, and above 7.2 a definite danger sign. In terms of the ratio of HDL to the total cholesterol ranking, the "average" range is between 3.9-4.7, with 6.0 being dangerously elevated. Some cardiologists are also beginning to experiment with yet a third cholesterol ratio, one that divides the overall rating by the amount of bad cholesterol.

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Discussion Comments
By anon941543 — On Mar 23, 2014

See Zoe Harcombe on cholesterol, and also read "The Great Cholesterol Con" by Dr. Malcolm Kendrick.

By amypollick — On Nov 12, 2013

@anon354878: Take the medicine your doctor prescribes. You can also take fish oil capsules. This will also help raise your HDL. There are several good cholesterol meds on the market. Your doctor can recommend the one that is right for you.

By anon354878 — On Nov 11, 2013

My total cholesterol is 244. My Hdl is 58 and Ldl is 169. What medicine can I use?

By anon294458 — On Oct 01, 2012

I am 22 and recently had bloodwork, which gave me my last cholesterol reading of 130. I would like to know what I can do to keep it at the healthy levels?

My hair fell out in chunks starting about two years ago but I don't think that cholesterol had anything to do with it.

By anon281493 — On Jul 24, 2012

My chlosterol level was measured at 2.3. Where does this lie in the acceptable range?

By Georgesplane — On Aug 16, 2010

@Aplenty- When you get your results from your doctor, you usually get your LDL, HDL, combined, and triglyceride levels per deciliter of blood. An HDL level above 60 mg/dl is the best, but it should be above 40 to be considered safe. HDL protects your heart, so anything less than 40 mg/dl puts you at a higher risk. An HDL of 37 mg/dl would be borderline high risk.

LDL should be below 100 mg/dl to be considered optimal. Anything above 130 mg/dl is considered borderline high to high. Borderline is not horrible, but if your LDLs remain borderline for years, you are at a higher risk for a heart attack.

Your combined cholesterol reading should be below 200 mg/dl. This was probably your highest reading.

The last score is your triglycerides. Under 150 mg/dl is normal. Dietary changes should be able to correct your cholesterol readings by the time you take your next blood test.

By aplenty — On Aug 16, 2010

What are the risks of having too high an LDL cholesterol ratio? I don't quite understand cholesterol, and the last time I had blood work done I was given four cholesterol numbers by my doctor. I only remember that my good cholesterol was 37 and the other three numbers were around 120 to 150. She said that I needed to raise my good cholesterol levels above 40, and bring down one of my high cholesterol levels just a little bit. Can someone help me understand cholesterol test results a little better?

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