Non-HDL Cholesterol
All the cholesterol in your blood except HDL. It is total cholesterol minus HDL, and it counts every particle that can build up in artery walls.
AI-verified against cited sources. Awaiting expert reviewAlso called Non-HDL-C, non-HDL, NHDL-CLOINC 43396-1
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What it is
Non-HDL cholesterol is all the cholesterol in your blood except the protective HDL kind. That includes LDL, VLDL and other particles that can leave cholesterol in artery walls. Labs do not measure it on its own. They subtract your HDL from your total cholesterol. It needs no extra test, it still works when triglycerides are high, and you do not have to fast for it. That is why current US and UK guidance include it in the standard lipid panel.
Why it matters
Cholesterol in LDL and in triglyceride-rich particles can both build up as plaque in your arteries. Non-HDL counts all of it. Experts describe it as a stronger predictor of heart and artery disease than LDL cholesterol alone. The 2026 US guideline sets non-HDL goals that depend on your overall heart risk, and UK NHS lipid guidance also uses non-HDL cholesterol for its targets.
If it’s low
A low non-HDL cholesterol is generally good for heart health, and it is the aim of cholesterol-lowering treatment. A very low level without treatment is unusual. It can go along with an overactive thyroid, liver disease, poor nutrition or poor absorption of fat, or rare inherited conditions.
Common causes
- Cholesterol-lowering treatment or a very low-fat diet
- Acute illness, infection or inflammation, which can lower cholesterol for a while
- An overactive thyroid (hyperthyroidism)
- Severe liver disease
- Malnutrition, or conditions that stop the gut from absorbing fat well (malabsorption)
- Rare inherited conditions that lower cholesterol
What can help
- If you are not on cholesterol-lowering treatment and your level is very low, talk with your clinician, especially if you also have unplanned weight loss or other symptoms
- Ask whether a recheck, or thyroid and liver tests, would help explain it
If it’s high
A higher non-HDL cholesterol means more cholesterol is traveling in particles that can build plaque in your arteries. Higher levels are linked to a greater chance of heart attack and stroke over time. Often the cause is everyday, such as diet, weight, activity, blood sugar or thyroid health. Your clinician can look at it together with your LDL, HDL, triglycerides and overall risk.
Common causes
- Eating a lot of saturated fat, sugar and refined carbohydrates
- Carrying extra weight, or little physical activity
- High triglycerides, which add cholesterol carried in VLDL and remnant particles
- Diabetes or insulin resistance
- An underactive thyroid (hypothyroidism)
- Kidney disease (including nephrotic syndrome), or liver and bile duct disease
- Heavy alcohol use
- Family history of high cholesterol, including inherited conditions such as familial hypercholesterolemia
- Some medicines, including steroids, certain blood pressure pills, retinoids and some HIV and transplant medicines
What can help
- Eat in a heart-healthy way: less saturated fat, sugary drinks and refined carbohydrates, and more fiber from oats, beans, fruit and vegetables
- Be active most days. The CDC recommends 150 minutes of moderate-intensity activity a week for adults
- Work toward a healthy weight if you carry extra weight, and limit alcohol
- Ask your clinician which non-HDL goal fits your overall heart risk, and whether treatment to lower cholesterol makes sense for you
- Ask whether an apoB test, or thyroid, blood sugar, kidney or liver tests, would add useful information
Usual ranges
What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.
The usual range depends on age. Choose an age to see the one that applies.
- 20+up to 129 mg/dL
Sources: Mayo Clinic Laboratories (Extended Catalog copy), Quest Diagnostics (via Fullscript), MedlinePlus (National Library of Medicine), Mayo Clinic, NHLBI / National Institutes of Health, ARUP Laboratories, Circulation (Nguyen, Ahmad, Navar), Life (MDPI), Quest Diagnostics, European Society of Cardiology / European Atherosclerosis Society, JACC: Asia, European Heart Journal (joint EAS/EFLM statement, also in Clinical Chemistry), NHS England Accelerated Access Collaborative
Children and teens 1 ranges
See Non-HDL-C by age and sex, with the U.S. survey numbers where they exist.
NLA/NCEP non-HDL cholesterol categories (adults, as printed by Mayo Clinic Laboratories)
- Desirablebelow 130 mg/dL
- Above desirable130 to under 160 mg/dL
- Borderline high160 to under 190 mg/dL
- High190 to under 220 mg/dL
- Very high220 and above mg/dL
NHLBI non-HDL cholesterol categories (children and adolescents)
- Acceptablebelow 120 mg/dL
- Borderline high120 to under 145 mg/dL
- High145 and above mg/dL
If this applies to you
Non-HDL-C means a little more for some people. Open the one that fits you.
High cholesterol or heart risk
Non-HDL cholesterol is total cholesterol minus HDL, so it counts the cholesterol in all the particles that can build plaque. The 2026 U.S. guideline sets non-HDL goals next to LDL goals, each 30 mg/dL above the matching LDL goal, and supports reporting it with every lipid panel.
How common is your level?
NHANES describes the US civilian, non-institutionalized population, not a 'healthy' reference group. People with disease, on medication, fasting or not (except fasting-subsample markers), smokers and so on are all included. A percentile says where a value sits among Americans of that sex and age, not whether it is normal.
Use the left and right arrow keys to read each age. Shift moves five years.
Reference data derived from CDC/NCHS National Health and Nutrition Examination Survey (NHANES), cycles 2015-2016, 2017-March 2020 (pre-pandemic), August 2021-August 2023. Analysis by bloodtesttracker.com; not endorsed by CDC, NCHS or HHS.
Explore Non-HDL-C by age and sex: every percentile as a table, with a download.
What can affect your result
- Meals: non-HDL cholesterol is about 8 mg/dL (0.2 mmol/L) lower on average after eating, so fasting is usually not needed
- It is calculated, so a change in either total cholesterol or HDL cholesterol moves it
- Triglycerides: more triglyceride-rich particles mean more cholesterol in VLDL and remnants, which raises non-HDL
- Diet, body weight, physical activity and alcohol
- Thyroid, liver, kidney and bile duct conditions, and diabetes
- Medicines such as thiazide diuretics, beta-blockers, retinoids, steroids and some HIV and transplant medicines
- Age: cutoffs are lower for children and teens (below 120 mg/dL)
- Pregnancy, acute illness or a recent heart attack
- Non-HDL cholesterol is calculated from two separate measurements, so any error in total cholesterol or HDL cholesterol carries into it.
- High levels of N-acetylcysteine (a medicine used for acetaminophen overdose), and the acetaminophen byproduct NAPQI at overdose levels, can make the total cholesterol part read falsely low on some assays.
- Acute illness, infection or inflammation can lower cholesterol for a while. Labcorp suggests avoiding a full lipid panel for about three months after a heart attack.
- Pregnancy can raise cholesterol, so a higher result during pregnancy is expected.
A few weeks. Changes in diet, activity, weight or medicine are usually rechecked 4-12 weeks later.
When to talk to a clinician
Talk with a clinician about a non-HDL cholesterol of 190 mg/dL (4.9 mmol/L) or higher. For a child or teen, the same applies at 145 mg/dL (3.7 mmol/L) or higher, which is the high category for children. This number cannot tell you whether you have heart disease. If you have chest pain or pressure, trouble breathing, or signs of a stroke such as face drooping, arm weakness or trouble speaking, call 911 or your local emergency number.
Questions you could ask
- Do you follow my non-HDL or my LDL cholesterol, and how often should I recheck?
- Which non-HDL cholesterol goal fits my overall heart risk?
- Would an apoB test add useful information for me?
- Could my triglycerides, blood sugar, thyroid or medicines be playing a part?
- Should we recheck this after a few months of lifestyle changes?
- Is a low level expected given my treatment and diet?
Questions people ask
How is non-HDL cholesterol different from LDL cholesterol?
LDL is one kind of "bad" cholesterol. Non-HDL includes LDL plus the cholesterol in VLDL and other particles that can build up in artery walls. It is especially helpful when triglycerides are high, because LDL can look lower than the real total of harmful cholesterol.
How do I work out my non-HDL cholesterol?
Subtract your HDL cholesterol from your total cholesterol, using the same unit for both. For example, a total of 200 mg/dL and an HDL of 55 mg/dL gives a non-HDL of 145 mg/dL. The same subtraction works in mmol/L.
Do I need to fast for non-HDL cholesterol?
Usually not. Eating changes non-HDL cholesterol only a little, by about 8 mg/dL lower on average. UK and European guidance accepts non-fasting samples for routine lipid profiles. Follow the instructions your lab or clinician gives you.
Why is my non-HDL goal 30 higher than my LDL goal?
Cholesterol in VLDL particles up to about 30 mg/dL is considered normal. Guidelines add that 30 mg/dL to the LDL goal to set the non-HDL goal. For example, an LDL goal of 100 pairs with a non-HDL goal of 130.
What non-HDL number should I aim for?
Many labs call below 130 mg/dL (3.4 mmol/L) desirable. Mayo Clinic describes it as optimal for most people. Current guidelines use lower goals for higher risk: below 100 mg/dL (2.6 mmol/L) at high risk, and below 85 mg/dL (2.2 mmol/L) for people at very high risk with established heart or artery disease. Your clinician can tell you which goal fits you.
Show the science and sources
Units
- 1 mg/dL = 1 mg/dL
- 1 mg/dL = 0.02586 mmol/L
- 1 mg/dL = 0.01 g/L
Open the Non-HDL-C unit converter
Is a change real?
Non-HDL-C naturally varies about 6.88% from test to test in the same healthy person. Between two results from the same lab, a change of roughly 20% or more is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: The European Biological Variation Study (EuBIVAS): a summary report.
For clinicians and researchers
Non-HDL-C = total cholesterol - HDL-C. It is the cholesterol in all ApoB-containing particles: VLDL, remnants, IDL, LDL and lipoprotein(a), plus chylomicron remnants in non-fasting samples. Unlike Friedewald LDL-C, it needs no triglyceride-dependent correction, and it can be calculated accurately from a non-fasting sample (mean change after habitual meals is about -0.2 mmol/L, or 8 mg/dL; EAS/EFLM 2016). ATP III made it a secondary target when triglycerides are 200 mg/dL or more, with a goal 30 mg/dL above the LDL goal on the premise that VLDL cholesterol up to 30 mg/dL is normal. The 2026 ACC/AHA guideline (the first full revision since the 2018 blood cholesterol guideline) includes non-HDL-C in the standard lipid panel and sets goals of <130, <100 and <85 mg/dL for borderline or intermediate risk, high risk and very high risk, each 30 mg/dL above the matching LDL-C goal. ESC/EAS 2019 sets secondary goals of <3.4, <2.6 and <2.2 mmol/L (130, 100 and 85 mg/dL) for moderate, high and very high risk. A review of the 2026 guideline notes that lipid goals are practical treatment objectives derived from the totality of evidence rather than cut-offs tested one by one. ApoB counts particles, whereas non-HDL-C counts their cholesterol content, so the two can disagree, more often with high triglycerides, diabetes or cardio-kidney-metabolic syndrome. ESC/EAS 2019 recommends non-HDL-C for risk assessment, particularly with high triglycerides, diabetes, obesity or very low LDL-C, and the 2026 ACC/AHA guideline suggests ApoB testing once LDL-C and non-HDL-C goals are met. Mayo reports it as a calculated result, and Mayo and ARUP both use LOINC 43396-1. NAC and NAPQI can bias the total cholesterol input low. In children, the NHLBI panel found non-HDL-C as powerful a predictor of atherosclerosis as any other lipoprotein cholesterol measure.
LOINC 43396-1 (primary), 70204-3. Specimen: calculated.
Sources
- Lipid Panel, Serum (test ID LPSC1), Mayo Clinic Laboratories (Extended Catalog copy) (2026)
- Lipid Panel with Ratios, Quest Diagnostics (reference ranges as listed by Fullscript), Quest Diagnostics (via Fullscript)
- Lipid Panel (test 0020421), ARUP Laboratories
- Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Executive Summary, NHLBI / National Institutes of Health (2001)
- Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report, NHLBI / Pediatrics (2011)
- 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary, ACC/AHA Task Force on Clinical Practice Guidelines (2019)
- The 2026 ACC/AHA Dyslipidemia Guideline: A Critical and Transatlantic Perspective on Personalized Lipid Management, Life (MDPI) (2026)
- Understanding the new dyslipidemia guidelines, Quest Diagnostics (2026)
- 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk, European Society of Cardiology / European Atherosclerosis Society (2019)
- Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cutpoints. A joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine, European Heart Journal (joint EAS/EFLM statement, also in Clinical Chemistry) (2016)
- Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD (version 7), NHS England Accelerated Access Collaborative (2024)
- Cholesterol Levels: MedlinePlus Medical Test, MedlinePlus (National Library of Medicine)
- Cholesterol ratio or non-HDL cholesterol: Which is most important? (read from a 2025 Internet Archive copy), Mayo Clinic
- Dyslipidemia (Hyperlipidemia), Merck Manual Professional Edition
- Cholesterol (PubChem CID 5997), PubChem (National Library of Medicine)
- Lipid Profile Testing and Interpretation (summarizes the 2026 ACC/AHA Dyslipidemia Guideline), Circulation (Nguyen, Ahmad, Navar) (2026)
- Importance and Management of Non-High-Density Lipoprotein Cholesterol in Dyslipidemia Treatment, JACC: Asia (2026)
- Adult Activity: An Overview, US Centers for Disease Control and Prevention
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.