Yes, it happens: People in the 20 something age range can have a cholesterol number of 250, even 300.

This would be alarming for a 20-year-old to hear from their doctor.

But one number alone, even as high as 300, doesn’t always tell the whole story.

“Total cholesterol is a sum of both the bad and good cholesterol, so it is hard to evaluate by itself,” says Dr. Lowell Steen, MD, Interventional Cardiologist at Loyola University Medical Center,
Director of the Interventional Cardiology Fellowship Training Program, and Medical Advisor to 120/Life, a functional beverage with a blend of six natural ingredients that promote normal blood pressure.

“The total needs to be fractionated or have a so-called lipid profile.”

• LDL – low density lipoproteins (“bad” cholesterol)
• Triglycerides (“bad”)
• HDL – high density lipoproteins (“good”)

Dr. Steen explains, “The total may be elevated because the good or HDL is very high, which is a good thing; or it can be high because the bad or LDL is elevated, which is a bad thing.”

• LDL should be under 100 mg/dL.

• LDL of 100 to 129 are non-concerning for healthy adults with no heart disease or risk factors such as diabetes, smoking and obesity.

• LDL of 130 to 159 is borderline high.

• LDL of 160 to 189 is high; and 190 or more is very high.

• Triglycerides should be under 150.

• Triglycerides of 150 to 199 are borderline high, and over 200 is high.

• The “good” cholesterol of HDL should not be under 40 mg/dL, and if it is, this is a major risk factor for heart disease.

• HDL of 41 to 59 is borderline low.

• Ideally it should be at least 60.

You’re age 20 to 29 and just found out your total cholesterol is 250 to 300. What should be your next move?

“If a 20-year-old receives a total cholesterol result of 300 they should seek the advice of a doctor,” says Dr. Steen.

Some patients receive fractionated lab results and not just the one total number — and the component numbers that are not supposed to be high will be flagged, as will be the HDL if it’s low.

In the event of a shockingly high cholesterol total with a poor profile in a young adult, Dr. Steen explains, “This could mean that the patient has a familial or inherited cholesterol problem.

“It could imply the 20-year-old may have a genetic cholesterol problem that causes the liver to manufacture or produce too much cholesterol. Ultimately, this would be the major concern.”