Metabolic

Cholesterol (Total, HDL, LDL & ApoB)

A cholesterol panel measures the fats circulating in your blood — total cholesterol, HDL ('good' cholesterol), LDL ('bad' cholesterol), triglycerides, and increasingly ApoB, the protein that carries LDL particles into artery walls. Together, these markers paint the most accurate picture of your cardiovascular risk and metabolic health available from a blood test.

Optimal Ranges

Clinical (NHS) Range

Total: below 5 mmol/L, LDL: below 3 mmol/L

mmol/L (lipids), g/L (ApoB)

Performance-Optimised Range

ApoB: below 1.0 g/L, LDL: below 2.6 mmol/L, HDL: above 1.2 mmol/L

mmol/L (lipids), g/L (ApoB)

The clinical range defines what is considered medically “normal” — broad enough to cover 95% of the population. The performance range reflects where research and clinical experience suggest most people feel and function at their best.

Why It Matters

Why Cholesterol matters for performance

Heart and circulatory disease is the UK's second biggest killer, responsible for around 160,000 deaths each year according to the British Heart Foundation. What most people don't realise is that cardiovascular damage accumulates silently over decades — by the time symptoms appear, significant plaque build-up has already occurred. For men in their 30s and 40s, a lipid panel is less about diagnosing disease today and more about understanding your trajectory. Modern cardiology has shifted focus from total cholesterol to ApoB and non-HDL cholesterol as stronger predictors of risk. An ApoB level below 1.0 g/L is considered optimal by the European Society of Cardiology, yet most standard NHS health checks don't test it.

Symptoms

Signs your levels may be off

Low / Deficiency

  • Very low cholesterol (rare) may impair hormone production
  • Low HDL increases cardiovascular risk
  • Fatigue and mood disturbances at extremely low levels

High / Excess

  • Usually asymptomatic until advanced disease
  • Xanthomas (fatty deposits under skin or around eyes)
  • Chest pain or angina (late-stage)
  • Erectile dysfunction (early vascular sign)
  • Peripheral artery disease (leg pain when walking)

Dietary Sources

Foods that support Cholesterol levels

Oily fish — salmon, mackerel, sardines (raise HDL, lower triglycerides)Extra virgin olive oil (monounsaturated fats)Nuts — almonds, walnuts, pistachiosOats and barley (beta-glucan fibre)AvocadoLegumes — lentils, chickpeas, kidney beansBerries and citrus fruits (soluble fibre and polyphenols)

Supplementation

Evidence-based supplementation

Omega-3 fish oil (2-4g EPA+DHA daily) is the most evidence-based supplement for improving triglycerides and HDL. Plant sterols and stanols (2g/day) can reduce LDL by 7-10% — Benecol and similar products deliver this dose. Red yeast rice contains a natural statin (monacolin K) but should only be used under medical supervision due to variable potency. Psyllium husk (5-10g/day) adds soluble fibre that binds bile acids, lowering LDL. Niacin (vitamin B3) was once widely used but has fallen out of favour due to side effects. Lifestyle interventions — reducing refined carbohydrates, increasing exercise, and maintaining healthy body composition — remain the foundation of lipid management.

Research

Key study

Apolipoprotein B and cardiovascular disease: biomarker and potential therapeutic target

Sniderman AD, Thanassoulis G, Glavinovic T, et al.

The Lancet (2019)

DOI: 10.1016/S0140-6736(19)32519-0

Related Biomarkers

Inflammation

hs-CRP (High-Sensitivity C-Reactive Protein)

Optimal: Below 1.0 mg/L

Metabolic

HbA1c (Glycated Haemoglobin)

Optimal: 20-34 mmol/mol (below 5.4%)

Vitamins & Minerals

Vitamin D (25-OH)

Optimal: 100-150 nmol/L

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Complete Guide to Blood Tests

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This content is for educational purposes only and does not constitute medical advice. Your data suggests areas for optimisation, but any concerns should be discussed with a qualified healthcare professional. If your results flag values outside safe ranges, we recommend consulting your GP.