When Should You Start Getting Your Cholesterol Levels Tested?

Cholesterol is an important component of cardiovascular health. But many people don’t know what their cholesterol levels are, how to get them checked, or even why they matter.

“It’s not necessarily an urgent test, but it should be done,” Sanjiv Patel, MD, board-certified interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, told Verywell.

Your initial results can dictate a lot, including how often you should have your cholesterol tested and certain lifestyle modifications, if needed, he said.

But when should you start getting your cholesterol levels tested? Here’s what you need to know.

Cholesterol Basics

Cholesterol is a waxy substance that your body uses to build cells and make vitamins and other hormones. While some cholesterol is helpful, too much can be problematic.

Cholesterol circulates in your blood and, if it’s high, it raises your risk of heart disease, stroke, and other cardiovascular diseases.

There are two forms of cholesterol: LDL (“bad”) cholesterol and HDL (“good”) cholesterol. Having too much LDL cholesterol and not enough HDL cholesterol increases the risk that cholesterol will build up in the walls of the arteries that supply blood to your heart and brain, potentially causing a blockage.

Cholesterol either comes from your liver or animal foods, like meat, poultry, and dairy products, or from tropical oils like palm oil or coconut oil. Foods that are high in saturated and trans fats, including baked goods, cause your liver to make more cholesterol than it typically would and can raise your risk of having bad cholesterol levels that are too high.

When to Start Having Your Cholesterol Levels Tested

If you’re considered low risk for heart disease, cholesterol testing should begin at age 20.

According to the Centers for Disease Control and Prevention (CDC), a few cardiovascular disease risk factors are indicators that you should get your cholesterol levels checked earlier or more frequently than usual, like diabetes, obesity, and a family history of heart disease or high blood cholesterol.

In addition, men and older adults are at a higher risk of elevated LDL cholesterol.

“A decision on when to start screening for cholesterol should be discussed with your primary care physician, despite general recommendations, as screening times vary by patient and their medical history,” Sabrina Barata, MD, a primary care doctor at Mercy Personal Physicians at Lutherville, Maryland, told Verywell.

The testing process itself is simple.

“Your primary care physician can order a lipid panel—or blood test,” Arashdeep Litt, MD, an internal medicine physician at Spectrum Health, told Verywell.

How Often Should You Test Your Cholesterol?

The general recommendation for cholesterol testing frequency is every five years. However, your doctor will want to screen you more often than that if you have risk factors for high cholesterol or a personal history of high cholesterol, Alfred Tallia, MD, MPH, professor and chair of the Department of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School, told Verywell.

“You should get a yearly blood test if your cholesterol is high,” Patel said.

What Are Healthy Cholesterol Levels?

Cholesterol numbers are measured in milligrams per deciliter (mg/dL), and healthy ranges vary by age.

In people age 19 or younger:

• Total cholesterol should be less than 170 mg/dL
• LDL cholesterol should be less than 100 mg/dL
• HDL cholesterols should be more than 45 mg/dL

In men age 20 or older:

• Total cholesterol should be 125 to 200 mg/dL
• LDL cholesterol should be less than 100 mg/dL
• HDL cholesterols should be 40 mg/dL or higher

In women age 20 or older:

• Total cholesterol should be 125 to 200 mg/dL
• LDL cholesterol should be less than 100 mg/dL
• HDL cholesterols should be 50 mg/dL or higher

What to Do If Your Cholesterol Is High

The Centers for Disease Control and Prevention (CDC) specifically recommends you do the following to keep your blood cholesterol levels healthy:

• Limit foods that are high in saturated or trans fats, sugar, and salt. Instead, focus on foods that are high in fiber, like fresh fruits and vegetables, and in unsaturated fats, like avocados and nuts. 
• Focus on getting least two hours and 30 minutes of moderate exercise, like biking or brisk walking, every week.
• Avoid smoking, which damages the blood vessels and increases the risk for heart disease and stroke.

“If you have an elevation in your cholesterol, the first step is to recommend those lifestyle changes we all should be doing anyway—maintaining an ideal body weight watching your diet, and exercising regularly,” Tallia said.

If you’ve done everything right and your cholesterol levels are still high, it’s important to talk to your doctor.

“There are medications to bring it lower, if diet and exercise are not enough,” Litt said.