Skip to main content
Your session has expired. Reloading...
Cardiovascular

Cholesterol/HDL ratio: cholesterol from food, HDL and losing weight

According to the NVKC, cholesterol comes partly from food and is partly made by the liver; the body uses it for tissues, organs, certain hormones and bile acids. According to the NVKC, HDL particles carry cholesterol away from the tissues and organs to the liver. The cholesterol/HDL ratio is total cholesterol in proportion to that HDL cholesterol.

According to Thuisarts, high cholesterol can come from, among other things, unhealthy eating, being overweight and moving little, and when it is too high for years the blood vessels can become blocked without high cholesterol itself giving symptoms. The cholesterol/HDL ratio only becomes visible with a blood test.

According to the NVKC, below 3.5 is the best cholesterol/HDL ratio, with 5 as the limit.

Doctor's Assessment Included

The cholesterol/HDL ratio is the ratio between total cholesterol and HDL cholesterol. According to the NVKC, the ratio should be below 5, and below 3.5 is best.

  • None of the laboratories Star-SHL, Unilabs and Diagnostiek voor U publishes a limit for the cholesterol/HDL ratio itself; they give limits for cholesterol and HDL cholesterol separately.
  • The NHG no longer estimates cardiovascular risk in SCORE2 with the cholesterol/HDL ratio, but with non-HDL cholesterol.
  • According to the NVKC, the assessment of the cholesterol/HDL ratio should also look at the separate results.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Male Your group
mol/mol
Normal < 5 High
Female Your group
mol/mol
Normal < 5 High

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

Cholesterol/HDL Ratio: what this test measures

The cholesterol/HDL ratio compares total cholesterol with HDL cholesterol, and according to the NVKC the total cholesterol test measures LDL and HDL cholesterol together.

Cholesterol/HDL Ratio: why this value matters

The cholesterol/HDL ratio responds to HDL cholesterol, and according to MedlinePlus, the US National Library of Medicine's health site, losing weight can raise HDL cholesterol, especially with a lot of fat around the waist.

Cholesterol/HDL Ratio: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Lipid Screening · €80,- · GLP-1 Check-in Panel · €109,- · GLP-1 Extended Panel · €196,- · GLP-1 Baseline Panel · €214,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Cholesterol/HDL Ratio: when is testing worthwhile?

A fasting blood draw is important according to the NVKC for testing all the fats, from which the cholesterol/HDL ratio also follows, while according to the NHG non-HDL cholesterol can also be measured non-fasting.

Cholesterol/HDL Ratio: symptoms of a high or low value

Low Levels

According to the NVKC, a cholesterol/HDL ratio below 3.5 is the best result. According to Thuisarts, high HDL cholesterol is fine, because it is good for the blood vessels.

High Levels

A cholesterol/HDL ratio at or above the NVKC limit of 5 can go with low HDL cholesterol, and according to MedlinePlus diabetes can lower HDL cholesterol. Thuisarts names kidney damage and peripheral artery disease among the diseases with a greater risk after years of too-high cholesterol.

Cholesterol/HDL Ratio: causes of a low or high value

What lowers the value

  • Regular exercise

    Regular exercise can raise HDL cholesterol and lower LDL cholesterol.

  • Cholesterol-lowering medicines

    Some cholesterol medicines, including certain statins, can raise HDL cholesterol as well as lowering LDL cholesterol.

What raises the value

  • High total cholesterol

    High cholesterol, the number on top of the ratio, can come from unhealthy eating, being overweight, moving little, some diseases such as a slow thyroid, or many people with very high cholesterol in the family.

  • Smoking

    Smoking and second-hand smoke can lower HDL cholesterol, the number the ratio is divided by.

  • Certain medicines

    In some people, beta blockers, anabolic steroids such as testosterone, progestins in some birth control pills and menopausal hormone therapy, and benzodiazepines can lower HDL cholesterol.

  • Diabetes

    Diabetes can lower HDL cholesterol.

Cholesterol/HDL Ratio: lifestyle and this value

Your GP is the place to discuss a cholesterol/HDL ratio that is too high. To raise HDL cholesterol, MedlinePlus advises limiting saturated fat, as in full-fat milk and cheese, fatty meats and foods made with butter, and avoiding trans fats.

Cholesterol/HDL Ratio: frequently asked questions

Can losing weight improve the cholesterol/HDL ratio?

According to MedlinePlus, losing weight can raise HDL cholesterol, especially with a lot of fat around the waist, and a higher HDL cholesterol with the same total cholesterol gives a lower cholesterol/HDL ratio. Thuisarts names losing weight if overweight as one of the most important steps with high cholesterol.

Cholesterol/HDL Ratio: sources

  1. MedlinePlus, HDL: The "Good" Cholesterol, U.S. National Library of Medicine, last updated 2026-08-03, geraadpleegd 2026-10-16 (retrieved 2026) medlineplus.gov
  2. Thuisarts.nl (NHG), Ik heb een hoog cholesterol, geraadpleegd 2026-10-16 (retrieved 2026) thuisarts.nl

Test Products

This marker is included in the following test panels.

GLP-1

GLP-1 Check-in Panel

The 3-month safety and progress check clinics do: pancreas, liver, kidneys, salts and your metabolic progress on GLP-1 medication.

ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) Potassium Sodium Glucose (Fasting) Total Cholesterol Lipase Creatinine Triglycerides eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€109,-
GLP-1

GLP-1 Extended Panel

The 6-month measurement: everything from the check-in plus insulin, ApoB and your nutrients — especially relevant if you have been eating much less for a while.

Insulin (Fasting) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides HOMA-IR eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€196,-
GLP-1

GLP-1 Baseline Panel

Your starting point before the first injection: blood sugar, cholesterol, pancreas, liver, kidneys, thyroid and nutrients in one measurement.

Insulin (Fasting) ALT (Alanine Aminotransferase) TSH (Thyroid Stimulating Hormone) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) Bilirubin (Total) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides Bilirubin (Direct) Bilirubin (Indirect) HOMA-IR eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€214,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab