Could Your Cholesterol Test Be Wrong?

Why Inaccuracies Can Happen and How to Prevent Them

An accurate cholesterol test test can be an important indicator of overall health, risk of conditions such as heart disease and stroke, and a useful factor when determining preventive measures such as dietary changes. If the results of those tests aren't accurate, however, they aren't likely to be helpful.

Two vials of blood to be tested
Andrew Brookes / Getty Images

There are several things you can do to help make certain you get results from a cholesterol test you can trust. A good place to start: Ask your doctor what kind of test will be used to measure your cholesterol. In recent years, testing methods have become increasingly accurate as well as more convenient in that fasting beforehand is no longer always necessary.

Despite best intentions, inaccurate tests can happen and it is helpful to know when it might make sense to ask your doctor if you need a re-test.

Current Cholesterol Tests

The standard "cholesterol test" is a blood lipid test in which a sample of blood is drawn and then analyzed in a lab to measure: 

  • Low-density lipoprotein (LDL) or “bad” cholesterol. Desirable result: Less than 100 milligrams per deciliter (mg/dL)
  • High-density lipoprotein (HDL) or “good” cholesterol. Desirable result: Greater than or equal to 60 mg/dL
  • Triglycerides, a type of fat blood the body uses for energy. Desirable result: Less than 150 mg/dL
  • Total cholesterol, the total amount of cholesterol in the blood based on your HDL, LDL, and triglycerides numbers. Desirable result: Less than 200 mg/dL

Thanks to research showing that HDL/LDL cholesterol and triglyceride levels aren't generally affected by food consumption the day before testing,it's not always necessary to fast the night before a cholesterol test or show up first thing in the morning for a blood draw.

Nonfasting test methods have been shown to be more accurate than the traditional method originally developed and used since the 1970s (known as the Friedewald Estimation), particularly when measuring LDL (bad) cholesterol. Ask your doctor if a non-fasting test might be available and an option for you.

Reasons for Inaccuracy

If you get cholesterol test results you suspect may not be accurate, it's likely due to a temporary change in your body's chemistry that might be the result of any one of a number of situations, including:

  • Certain medications: Corticosteroids and beta-blockers can raise lipid levels, for example. If you take such a drug, tell your doctor before your cholesterol test. It may be you'll need to take a break from the medication for a short period prior to testing to get accurate results.
  • Pregnancy: For the entire nine months, as well as several months after a baby is born, cholesterol levels may be higher than usual. A cholesterol test should not be considered reliable until a new mom is about four months postpartum.
  • Alcohol consumption: Even occasional heavy drinking can negatively affect cholesterol scores. Most experts advise avoiding alcohol for 24 hours prior to testing.
  • Inflammation or infection. Either can skew cholesterol numbers, particularly in chronic cases. Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis may affect scores.
  • Human error: Although uncommon, lab mistakes and reporting mistakes do happen.

Make sure the person who draws your blood asks for your identification, and then labels the tubes with the correctly-spelled information. There are other ways that laboratory errors happen, but misidentification is one you can help prevent.

What to Do

If you suspect your cholesterol results aren't accurate, talk to your doctor and don't hesitate to ask for a repeat test. Again, your cholesterol numbers, along with other factors like blood pressure and body weight, are a key indicator of your overall health and well-being.

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