Total cholesterol is the sum of the HDL, LDL and VLDL fractions, and is considered high when its levels are above 190 mg/dL, which is verified through a blood test.
Generally, high total cholesterol is caused by unhealthy habits, such as excessive consumption of alcoholic beverages, fatty foods and sweets. However, it can also arise due to diabetes, hypothyroidism, genetic changes and the use of some medications, such as corticosteroids and antiretrovirals.
In case of changes in the cholesterol test, it is important to consult a general practitioner or cardiologist to carry out an assessment and check the need for treatment with medication, in addition to changing habits, to control cholesterol levels.
Read too: Cholesterol: what it is, types, values (and how to lower it)

Types of cholesterol
The main types or fractions of cholesterol are:
- HDL or high-density lipoprotein, also known as good cholesterol, works by contributing to the elimination of fat from the body;
- LDL or low-density lipoprotein, also called bad cholesterol, can accumulate in the arteries, increasing the risk of cardiovascular disease;
- VLDL or very low density lipoprotein, is also a type of bad cholesterol, just like LDL, and contributes to the formation of cholesterol plaques in the vessels;
It is important that the amount of LDL, HDL and VLDL are ideal, to ensure the formation of new cells and some hormones and prevent diseases, such as atherosclerosis.
Symptoms of High Total Cholesterol
High total cholesterol does not normally cause symptoms, however it can cause the accumulation of fat in the body, leading to the appearance of fat balls on the skin, swelling of the abdomen and the development of a gray ring in the eyes, for example. See more details on the symptoms of high cholesterol.
Total cholesterol test
The total cholesterol test measures the total amount of cholesterol in the blood. Furthermore, when it is carried out, the types of cholesterol are usually also measured and, therefore, this test is also known as measuring total cholesterol and fractions.
To carry out this test, it is necessary to collect a blood sample in the laboratory, and it is recommended to fast for 8 to 12 hours before collecting the blood.
The reference value for total cholesterol is 190 mg/dL in the blood, and it is considered high when it is above this value. Check the reference values for total cholesterol and its fractions.
Do you have questions about your exam results?
To find out if your total cholesterol is normal, enter your test results into the calculator below:
Is total cholesterol above 200 mg/dL serious?
Having total cholesterol above 200 mg/dL can be serious, especially in men and in case of smoking, high blood pressure, and when low HDL and high LDL levels are identified, as there is a greater risk of cardiovascular diseases, such as atherosclerosis, heart attack and stroke.
Possible causes
The main causes of high total cholesterol are:
- Food rich in fat and sugar;
- Sedentary lifestyle;
- Excessive consumption of alcoholic beverages;
- Uncontrolled diabetes;
- Hypothyroidism;
- Genetics.
In addition, some medications, such as corticosteroids, thiazide diuretics, hormonal contraceptives and antiretrovirals, can also cause high cholesterol. See more causes of high cholesterol.
How to lower high total cholesterol
To lower high cholesterol it is recommended:
- Lose weight, in case of overweight or obesity;
- Reduce the consumption of alcoholic beverages;
- Reduce your intake of fatty or sugar-rich foods;
- Prefer foods rich in fiber and healthy fats, such as oats, beans, tomatoes and salmon. See more foods to lower cholesterol;
- Practice physical exercise regularly, at least 3 to 5 times a week;
In addition, the doctor may also recommend the use of medications, such as simvastatin or atorvastatin, to regulate cholesterol levels, especially when changes in habits are not enough. Find out more about cholesterol-lowering remedies.
Bibliography
- PETERS, Sanne AE et al. Total cholesterol as a risk factor for coronary heart disease and stroke in women compared with men: A systematic review and meta-analys. Atherosclerosis. Vol.248. 123-131, 2016
- STATPEARLS. Cholesterol Levels. 2022. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK542294/>. Accessed on 21 Dec 2022
- STATPEARLS. Physiology, Cholesterol. 2022. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK470561/>. Accessed on 21 Dec 2022
- STATPEARLS. Hyperlipidemia. 2022. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK559182/>. Accessed on 21 Dec 2022
- NATIONAL HEART, LUNG AND BLOOD INSTITUTE. BLOOD CHOLESTEROL – Symptoms. Available at: <https://www.nhlbi.nih.gov/health/blood-cholesterol/symptoms>. Accessed on 21 Dec 2022
- CDC. About Cholesterol. Available at: <https://www.cdc.gov/cholesterol/about.htm>. Accessed on 21 Dec 2022
- BRAZILIAN SOCIETY OF CARDIOLOGY. Update of the Brazilian Guideline on Dyslipidemia and Prevention of Atherosclerosis. 2017. Available at: <https://www.scielo.br/pdf/abc/v109n2s1/0066-782X-abc-109-02-s1-0001.pdf>. Accessed on September 15, 2020