Pathology Handbook

Cholesterol (Total)


Total Cholesterol

Clinical Indications

High cholesterol levels are an important risk factor for atherosclerosis and interventions to lower elevated levels reduces the risk of coronary disease (primary prevention) and reduces risk of further events in individuals with existing disease (secondary prevention). 
Cholesterol circulates in blood bound to lipoproteins; the two main ones being low density lipoprotein (LDL) and high density lipoprotein (HDL). 

Part of Profile

Fasting lipids, HDL Cholesterol

Request Form

Request on ICE


On request. 

Patient Preparation

If cholesterol is requested as part of a lipid profile then patient must fast for 10 hours prior to blood collection (for follow up tests diabetic patients may not need to fast). Patients do not need to fast if only  cholesterol or HDL cholesterol are requested 

Turnaround Time

Same day




2 ml


Vacutainer gold top

Causes for Rejection

Unlabelled or incorrectly labelled sample

Reference Range

The concept of a reference range is flawed and acceptable levels depend on presence of other coronary risk factors. For patients with established coronary disease or diabetes, total cholesterol levels should be less than 5.0 mmol/L. For primary prevention in other patients use  risk tables 


Ideal levels: <5.2 mmol/L

For secondary prevention: <4 mmol/L

High total cholesterol may be genetic or acquired due to hypothyroidism, cholestatic liver disease, renal failure, nephrotic syndrome which should be excluded. A decision to treat should not be made on a single measurement or on results obtained from non-laboratory instrumentation.