Everything in this guide
Updated November 15, 2026.
The plans
How do I lower my cholesterol naturally?
Swap butter, fatty meat and cheese for vegetable oils and build up to 10 g of psyllium a day. Each takes about 10 to 13 points off LDL. Retest in 6 to 12 weeks.
How do I lower triglycerides fast?
Cut alcohol and sweet drinks first, walk 150 minutes a week, lift twice and lose a little weight if you carry extra. Retest in 4 weeks. At 500 or more, see a doctor.
The guide
Cholesterol is LDL times years
Plaque builds from how high your LDL is and how many years it stays there. Know your goal, get under it early and stay there. The map of everything on this site.
Does LDL really matter?
Yes. LDL particles build plaque, and lowering LDL the ways trials tested cuts heart attacks. How you lower it matters, and it's never LDL alone. Both sides, fairly.
What the numbers on your panel mean
Total, HDL and triglycerides are measured. LDL is usually worked out from them, and non-HDL is total minus HDL. Your goal depends on your risk, which labs can't see.
What should my LDL be?
Under 100 mg/dL at borderline or intermediate risk, under 70 at high risk, under 55 after a heart attack or stroke, and non-HDL 30 points higher (2026 US guideline).
Why LDL is a lifetime number
Plaque builds with how high your LDL is and for how many years. People born with modestly lower LDL had up to 88% less heart disease, so lower it early.
Where cholesterol comes from and where it goes
Your body makes all the cholesterol it needs, mostly in the liver, which also pulls LDL out of the blood through receptors. Food and medicine work on that drain.
What lowers LDL, ranked by size
The fat swap (about 2 mg/dL per 1% of calories), psyllium (13), weight loss (8) and oats (7), each from its own trials. Six popular supplements did nothing in 28 days.
Triglycerides and HDL: the numbers food moves fastest
Alcohol, sugar, weight and walking move triglycerides within weeks. HDL is a warning sign when low, but drugs that pushed it up didn't prevent heart attacks.
When it's your genes: FH, Lp(a) and ApoB
FH affects 1 in 250 to 300 people and up to 9 in 10 don't know. An LDL of 190 is the line to see a doctor, and every adult should test Lp(a) once.
How to test, and how to tell if it changed
You usually don't need to fast. Test at the same lab, 4 to 12 weeks after a change, and know that two LDL results can differ about 19% with nothing changed.
When medicine is the conversation to have
The 2026 guideline turns to medicine for heart disease, LDL of 190 or more, diabetes from 40 and higher 10-year risk. Your prescriber decides any start, stop or change.
What changed in the 2026 cholesterol guideline?
LDL goals are back: under 100, 70 or 55 by your risk. A new risk calculator, Lp(a) tested once, newer LDL math, and no supplements. The March 2026 changes.
Can I lower my cholesterol with lifestyle, or do I need medicine?
It depends on your gap to goal. Food changes take off about 7 to 13 points each, the portfolio diet about 29%. Who should start medicine regardless, and how to tell.
Statins and other cholesterol medicines: the case for and against
What statins do, sized by your LDL drop and risk, the side effects blinded trials found, the costs and alternatives, with a list of questions to take to your doctor.
Every cholesterol and heart test, and which ones you need
The lipid panel, ApoB, Lp(a), hs-CRP, a calcium scan, CT angiography and more. What each measures, who needs it, the risks, the cost and what to do next.
The story of cholesterol, from rabbits to the 2026 guideline
From Anitschkow's rabbits in 1913 to the 2026 guideline: each study that changed what we know about cholesterol, in order, and what it taught us.
The 10 studies that shape what we know about cholesterol
The ten studies behind our view of cholesterol, ranked: PCSK9 families, statin trials, ApoB genetics, the HDL failure, the diet trials. What each found, and its limits.
Questions
Is 220 cholesterol bad?
On its own it can't tell you. A 220 can be mostly HDL or mostly LDL, and the 2026 guideline sets no goal for the total. Put your other numbers in.
Is an LDL of 130 bad?
It's over every 2026 goal: under 100, 70 or 55 by your risk, and low risk has no number goal. The biggest single food changes take off about 7 to 13 points.
What should my LDL be?
Under 100 at borderline or intermediate risk, under 70 at high risk, under 55 after a heart attack or stroke (2026 US guideline). The lab's range ignores your risk.
What is non-HDL cholesterol?
Total minus HDL: the cholesterol in every particle that can clog an artery. Its goals sit 30 points above LDL's, and it still works when triglycerides are high.
Is an LDL of 190 dangerous?
It's the line where the 2026 guideline looks for causes, checks your family for FH and recommends a statin. Book a doctor visit before you plan a diet.
Do you need to fast for a cholesterol test?
Usually not. A meal moves LDL about 8 points and triglycerides about 26, and the 2026 guideline accepts either. Fast if your triglycerides were 400 or more.
Why does my report say my LDL is calculated?
Most labs work LDL out from your other three numbers. The 1972 formula slips when triglycerides are high or LDL is low, so the guideline now prefers two newer ones.
How often should you check your cholesterol?
At least every 5 years from age 19, once as a child at 9 to 11, and 4 to 12 weeks after starting or changing a medicine. More often with risk factors or a change.
Why did my cholesterol go up when I didn't change anything?
Two LDL results can differ by about 19% by chance, and now and then 29%. Real causes include menopause, fast weight loss, keto, thyroid and some medicines.
Are home cholesterol tests accurate?
They can be close to a lab for total and HDL if you follow the steps exactly. The LDL is calculated, and the evidence on meters is thin. Confirm a surprise at a lab.
Do I need a calcium scan?
Maybe, if you're 40 or older (men) or 45 (women), your risk is borderline or intermediate, and you're unsure about a statin. A zero can let you wait. About $50 to $250.
Do eggs raise cholesterol?
Not much for most people. Saturated fat moves LDL more than the cholesterol in food, the 2026 guideline says. Watch the bacon and butter that come with the eggs.
Does saturated fat matter for cholesterol?
Yes, for LDL. Moving 1% of calories from saturated fat to vegetable oils takes about 2 points off. What you swap it for decides whether your heart gains.
High LDL on keto: should I worry?
Take it seriously, without panic. LDL often rises on keto, mostly from saturated fat. Check ApoB, ask about a calcium scan. The "it's harmless" study was retracted.
What foods lower cholesterol?
Two changes do the most: vegetable oils instead of butter, and soluble fiber (10 g of psyllium a day took off about 13 points). Oats, beans, soy and nuts help too.
Does oatmeal lower cholesterol?
A little. About 3.5 g of oat beta-glucan a day lowered LDL about 7 points across 58 trials. Check the label for grams of beta-glucan, not bowls.
How much psyllium should I take to lower cholesterol?
About 10 g of husk a day, split over meals with water, lowered LDL about 13 points in 28 trials. Build up over a week, and keep it apart from some medicines.
Does coffee raise cholesterol?
Unfiltered coffee can. In 14 trials, more coffee meant higher LDL, mostly with boiled coffee, while paper-filtered coffee did very little. If your LDL is high, use paper.
What foods should I avoid with high cholesterol?
The saturated fats: butter, fatty red meat, full-fat dairy, coconut and palm oil (2026 guideline). Replace them with olive or vegetable oils, nuts and fish, not sugar.
Does alcohol raise triglycerides?
Yes. About 2 drinks a day raised triglycerides about 6 points on average in 42 studies, more in some people. At 500 or more, the guideline says no alcohol at all.
Does sugar raise triglycerides?
Yes. In 37 trials, higher-sugar diets raised triglycerides about 10 points and LDL about 5, even when weight didn't change. Sweet drinks are the easiest place to start.
What triglyceride level is dangerous?
150 fasting or 175 after eating is high. At 500 the risk of pancreatitis starts to rise and at 1000 it's high, so see a doctor soon. Severe belly pain is the ER.
How do I raise my HDL?
Move. Aerobic exercise raised HDL about 2.5 points across 25 trials, more with longer sessions. Don't chase the number with pills. LDL and non-HDL are the goals.
How long does it take to lower cholesterol?
Triglycerides can drop in weeks, and LDL fell 28.6% within a month on the portfolio diet. Retest LDL 6 to 12 weeks in, at the same lab, and allow for noise.
Can you lower cholesterol without medication?
Yes, by a measurable amount: single food changes took off about 7 to 13 points, the full portfolio diet 28.6% in a month. If your gap is bigger, talk about medicine.
Does exercise lower cholesterol?
A little. In 148 trials, exercise cut LDL about 7 points and triglycerides about 8, and raised HDL about 2. Aim for 150 minutes a week plus strength work twice.
Does losing weight lower cholesterol?
Triglycerides most, about 1.8 points per pound. LDL falls a little, about 8 points in 6 to 12 month trials, and can rise for a while during fast loss.
Why is my cholesterol high if I eat healthy?
Your liver makes all the cholesterol you need, and genes set how fast it's cleared. FH affects 1 in 250 to 300 people. Thyroid, menopause, keto and some drugs add to it.
Why does cholesterol go up after menopause?
LDL and ApoB jump in the year either side of your last period (SWAN). Over 60, 16% of women have a high total, against 6% of men. The same changes still work.
What's a normal cholesterol level for my age?
Your goal doesn't change with age. LDL under 100, 70 or 55 by your risk. What changes is how common high numbers are, and after 60 women overtake men.
What is Lp(a), and should I get tested?
A particle set mostly by your genes that food barely moves. The 2026 guideline says test it once. About 1 in 5 people are at 125 nmol/L or more, about 40% more risk.
ApoB or LDL: which should I trust?
LDL is the cholesterol inside the particles, ApoB counts the particles. They usually agree. With high triglycerides or diabetes, ApoB is the better guide.
Does high cholesterol have symptoms?
Usually none, which is why the 2026 guideline tests everyone from age 19. Chest pain or pressure is an emergency, so call 911 instead of checking your numbers.
Myths
Your total cholesterol is the number that matters
The total counts your HDL too, and the 2026 guideline sets no goal for it. Two people at 220 can be one fine and one far off. LDL and non-HDL decide.
If your numbers are inside the lab's range, you're fine
The printed range is one line for everyone. The 2026 LDL goal runs from under 100 to under 55 by your risk, and the lab doesn't know your risk.
The higher your HDL, the better
Low HDL is a warning sign, but raising it hasn't helped. Drugs that pushed HDL up didn't cut heart attacks on top of a statin, and neither did genes that raise it.
Cholesterol supplements work about as well as a prescription
In a 28-day trial, six popular supplements, plant sterol pills and red yeast rice among them, didn't lower LDL more than placebo. A 5 mg statin lowered it 35%.
Thin people who eat well don't get high cholesterol
Your genes set how fast your liver clears LDL. FH affects 1 in 250 to 300 people, up to 9 in 10 don't know, and thyroid, menopause and keto raise it too.
Coconut oil is good for your cholesterol
The 2026 guideline lists coconut oil with butter and red meat as saturated fat. Each 1% of calories moved to vegetable oils lowers LDL about 2 points.
Cholesterol only matters when you're older
Plaque builds with LDL and years. LDL creeps up 1 to 2 points a year from your 20s, and people born with lower LDL had 88% less heart disease. Test from 19.
Keto lowers your cholesterol
It usually drops triglycerides fast. But LDL can rise a lot in some people, mostly with plenty of animal fat, and the guideline lists ketosis as a cause of high LDL.
Tools
Is my cholesterol bad?
Your panel against the 2026 goal for your risk: LDL by two equations, non-HDL, the shape and one next step.
Your LDL over the years
Set your LDL and age, try one change from any age, and watch your lifetime LDL total build toward the level linked to heart disease.
What would lower yours?
Tap the changes you would make and see each one at its own trial's size, side by side, never added up.
Which LDL is right?
Slide triglycerides up and watch the LDL equations split apart, in both units.
Did it really go down?
Two panels side by side, and which changes are bigger than the normal test-to-test noise.
Higher or lower?
Ten rounds of two foods. Tap the one with more saturated fat, then see the grams.
mg/dL and mmol/L
Any lipid number in the other unit, with the separate factor for triglycerides.
What is my non-HDL cholesterol?
Total minus HDL, against its 2026 goal for your risk.
What is my cholesterol ratio?
Total to HDL and triglycerides to HDL, and why non-HDL has the goal.
Why is my cholesterol high?
Eight taps with pictures: what's most likely behind your numbers, your top change and your retest date.
Track it in Gyroscope
With Gyroscope One, take a photo of your lab report and watch every cholesterol number over the years.
