The total cholesterol test measures, directly in blood, all the cholesterol carried in LDL, HDL, VLDL and remnant particles. Practitioners use it as the starting figure of the lipid profile, mainly to derive non-HDL cholesterol and to see which particle type is behind a high value. Pregnancy, an underactive thyroid, kidney or liver conditions and recent acute illness can all change it.
| Test type | Measured in a blood sample |
|---|---|
| Measurements required | Total Cholesterol only |
| Sample and collection | Blood draw at a collection centre |
| Preparation | This test doesn't need fasting on its own. |
| Turnaround | 3 to 5 business days |
| Available through | Lipid Studies, part of the Baseline Health Check. Also in: Full Body Health Check, Weight Management Test. |
| Pricing | Included in the $99 Baseline Health Check |
| Results | Returned in the Vively practitioner platform, beside your client's other markers |
What are the Total Cholesterol reference and optimal ranges?
| Typical lab reference | Vively optimal | |
|---|---|---|
| Adults | 3.6 to 5.6 mmol/L | 3.9 to 4.9 mmol/L |
Labs differ, and many Australian labs flag total cholesterol above 5.5 mmol/L, so read the result against the range on the client's report (RCPA). The optimal range is a target for long-term health, not a treatment threshold.
Check a client's Total Cholesterol result
Enter the value from your client's lab report to see where it sits against the typical lab range and the Vively optimal range.
A guide only, not a diagnosis. One result is a starting point: read it with symptoms, history and a repeat test. Labs differ, so check the result against the range on your client's report. Nothing you enter is stored or sent.
How do you arrange Total Cholesterol testing through Vively?
- Get verified. Practitioners with a recognised qualification or membership (ATMS, NHAA, ANTA, Dietitians Australia, NSA, CMA or Ahpra registration) can request free practitioner access.
- Choose a panel. Log in to the practitioner platform and pick a panel that includes Total Cholesterol, or build your own. It is included in the $99 Baseline Health Check.
- Client collects. Your client collects at a partner collection centre, with their request on their phone or printed.
- Review results. Results come back to you in the practitioner platform, beside your client's other markers, ready for the follow-up consult.
Which Vively panels include Total Cholesterol?
Log in to the practitioner platform to view a panel in full, or build and save your own from 100+ tests and panels.
- Baseline Health Check74 markers across 11 lab groups$99
One fasting blood draw.
Full Blood CountUrea, Electrolytes & CreatinineLiver Function TestsCalcium, Phosphate & MagnesiumLipid StudiesDiabetes & Glycaemic StudiesIron StudiesThyroid Function Tests+3 moreLog in to view this panel - Weight Management Test27 markers · Heart & metabolicPrice on sign-upTotal CholesterolLDL CholesterolHDL CholesterolNon-HDL CholesterolTriglyceridesFree testosteroneSHBGTotal testosterone+19 moreLog in to view this panel
- Log in to view this panelFull Body Health Check87 markers · Health checksPrice on sign-up
Why does the optimal range sit there?
Our 3.9 to 4.9 mmol/L range sits inside the lab range at both ends: lower at the top to prompt dietary work, higher at the bottom to flag other causes.
Total cholesterol adds protective HDL to atherogenic LDL and remnants, so two clients at 5.4 mmol/L can carry very different risk. Our ceiling sits below the usual lab flag to prompt early dietary work.
A total cholesterol well under the usual range can reflect undernutrition, malabsorption, hyperthyroidism or liver disease.
Vively's clinical view is that cholesterol is one of more than 20 cardiovascular risk factors and also says something about metabolism and liver function. Absolute risk follows the 2023 Australian guideline.
What should Total Cholesterol be read with?
- ContextTotal cholesterol above optimal, high HDL, non-HDL in range
Possibly a large HDL fraction lifting the total, with atherogenic load still in range.
- ContextTotal cholesterol above optimal with high LDL or ApoB
Often seen with diet-related or inherited high LDL.
- ContextTotal cholesterol above 7.5 mmol/L
Possible familial hypercholesterolaemia and needs GP review.
- HighRaised total cholesterol with high TSH
Possible hypothyroidism raising cholesterol.
- ContextTotal cholesterol below 3.6 mmol/L without a statin
Possible low intake, malabsorption, hyperthyroidism or liver disease; check albumin and thyroid markers.
What can affect a Total Cholesterol result?
- Pregnancy, which raises cholesterol.
- Hypothyroidism, nephrotic syndrome and cholestatic liver disease, which raise it.
- Acute illness, surgery or a recent heart attack, which lower it for several weeks.
- Statins, ezetimibe and plant sterols lower it; corticosteroids, retinoids and some antiretrovirals and immunosuppressants raise it.
- Menopause, as falling oestrogen raises LDL and total cholesterol.
When should you refer the client to their GP?
- Total cholesterol above 7.5 mmol/L, or LDL 5.0 mmol/L or above.
- A family history of heart disease before 55 in men or 60 in women.
- Raised cholesterol with diabetes, kidney disease, high blood pressure or smoking, for absolute risk assessment.
- Very low cholesterol with weight loss or poor intake.
How should a client prepare for a Total Cholesterol test?
Copy or print this to send to your client.
Preparing for your Total Cholesterol test
- This test doesn't need fasting on its own.
- If your practitioner has requested the Baseline Health Check, fast for 8 to 12 hours before a morning collection (water is fine).
- Take your pathology request to any of 4,000+ collection centres. Bring it printed or on your phone.
- Keep taking prescribed medicines as usual unless your doctor tells you otherwise.
- Results usually take 3 to 5 business days and come to your practitioner. Book your results appointment for after that.
How do practitioners use Total Cholesterol with clients?
Total cholesterol responds mostly to diet, along Mediterranean lines: vegetables, fruit, wholegrains, legumes, nuts, seeds and oily fish, with less saturated and trans fat from processed meats and highly processed foods. Show clients their non-HDL and LDL alongside it, so they can see which fraction is changing.
Total Cholesterol FAQs
Can a dietitian, naturopath or nutritionist order total cholesterol through Vively?
Yes. Add it to a client panel on the Vively practitioner platform. It is part of Lipid Studies in the $99 Baseline Health Check, and is also in Full Body Health Check and Weight Management Test. No account yet? Request free access.
Why read non-HDL cholesterol alongside the total?
Non-HDL is the better risk marker because it removes HDL from the total, leaving the cholesterol in LDL, VLDL and remnant particles. A client with total cholesterol of 5.8 mmol/L and HDL of 2.5 mmol/L has a non-HDL of 3.3 mmol/L, inside our reference range even though the total is flagged.
Is low total cholesterol a concern?
Sometimes. A low result in a client on a statin or a mainly plant-based diet is usually expected. Below 3.6 mmol/L with no obvious reason, look at intake, weight change, albumin, thyroid function and liver markers, and discuss it with the client's GP if any of those are also abnormal.
Do pregnancy or menopause change how I read total cholesterol?
Yes, both raise it. Pregnancy lifts cholesterol, and falling oestrogen across menopause raises LDL and total cholesterol. A rise in these clients may reflect physiology rather than diet. Look at the non-HDL and LDL components, and note the life stage when comparing results over time.
When is total cholesterol high enough to involve the GP?
Refer when total cholesterol is above 7.5 mmol/L or LDL is 5.0 mmol/L or above, as this can point to familial hypercholesterolaemia. Also refer with a family history of heart disease before 55 in men or 60 in women, or when raised cholesterol sits alongside diabetes, kidney disease, high blood pressure or smoking.
References
- Royal College of Pathologists of Australasia. RCPA Manual: Lipids.
- Pathology Tests Explained. Cholesterol.
- Commonwealth of Australia. Australian guideline for assessing and managing cardiovascular disease risk. 2023.
- Watts GF, Sullivan DR, Hare DL, et al. Integrated guidance for enhancing the care of familial hypercholesterolaemia in Australia. Heart, Lung and Circulation. 2021.