What is non-HDL Cholesterol?
Non-HDL cholesterol is the cholesterol in all particles except HDL. You get it by subtracting your HDL from your total cholesterol; what remains is the cholesterol in LDL, in its precursors VLDL and IDL, and in Lp(a). Those are exactly the particles that carry an apoB protein and that can get stuck in the artery wall. Non-HDL therefore adds up all the cholesterol that can do harm, not only the part in LDL, but also the part in the triglyceride-rich particles that increase after a meal and with belly fat. It is the only cholesterol number you can work out yourself, from two values that are on every report, and at the same time it is the number your risk is estimated with in the Netherlands. If it is not on your report, subtract your HDL from your total; the calculator further down does it for you. And because HDL has been taken off, a high HDL can no longer hide a high LDL, which it can in total cholesterol. What you will not find for non-HDL is a normal value. Labs publish no range for it; they refer to the targets or print them themselves. The table further down shows how.
Why is non-HDL Cholesterol relevant?
Non-HDL is the cholesterol number your risk of cardiovascular disease is estimated with in the Netherlands. There are three reasons. It counts the cholesterol in all the harmful particles, including the triglyceride-rich particles the LDL number misses. It stays reliable with high triglycerides, where the usual LDL calculation breaks down. And it costs nothing extra: total cholesterol and HDL are already on every fat profile, whereas apoB is a separate test that gives comparable information. For anyone who wants to stay healthy, non-HDL is therefore the number that shows most honestly what can end up in your artery wall, and it responds to everything you do yourself: food, weight, exercise. Since 2024 the Dutch risk estimate has used it instead of the ratio of total cholesterol to HDL. Anyone under treatment can steer by it just as well as by LDL; the table further down shows which non-HDL goes with which LDL target.
Non-HDL Cholesterol decision limits
What counts alongside the number:
- What you eat, your weight and how much you move: the levers non-HDL responds to
- Your overall risk: blood pressure, smoking, age, diabetes and a previous cardiovascular event decide which target applies
- LDL: if non-HDL is much higher than LDL, plenty of cholesterol sits in the triglyceride-rich particles
- Triglycerides and HDL, the metabolic pattern behind that difference
- The trend across several measurements, rather than one snapshot
These are targets for people under treatment, not a range a healthy person is supposed to fall inside. Which fits you follows from your overall risk and not from this one number. Do not convert non-HDL to LDL; the difference between the two varies from person to person.
non-HDL cholesterol = total cholesterol − HDL cholesterol, both in mmol/L
CVRM, module on non-HDL-C
mmol/L
− =
Non-HDL Cholesterol high or low: what it means
A high non-HDL means plenty of cholesterol in the particles that build up in the artery wall, and the causes are the same as for LDL: plenty of saturated fat, excess weight and little exercise, inheritance, an underactive thyroid, and rarely a kidney disease or familial hypercholesterolaemia. With belly fat and high triglycerides non-HDL climbs further than LDL, because it also counts the cholesterol in the triglyceride-rich particles; that is exactly where it is sharper. A low non-HDL is favourable, and there is no lower limit. In anyone who eats plant-based and fibre-rich, is lean and exercises a lot, it is the ordinary outcome; in others it is inheritance or the effect of cholesterol-lowering medication. The levers are the same as for LDL: olive oil instead of butter, nuts and oily fish instead of fatty meat and processed meat, fibre from oats, legumes, vegetables and fruit, losing weight around the middle and moving every day. Because non-HDL also counts the triglyceride-rich particles, less sugar and alcohol show up in it sooner than in LDL. For most people without an inherited condition that is the whole solution; with an inherited high cholesterol or existing cardiovascular disease, lifestyle remains the foundation and medication usually joins it. What counts as 'too high' depends on your overall risk, as with LDL. The targets in the table, below 2.6 or below 3.4 mmol/L, apply to anyone under treatment; separately, in non-fasting blood a value above 3.9 mmol/L stands out. If you are not under treatment there is no limit to reach, only a direction, and the levers above.
What lowers it
Usually simply healthy, sometimes treatment.
| Cause | How often |
|---|---|
| Plant-based and fibre-rich eating, a healthy weight, plenty of exerciseThe ordinary outcome of a healthy lifestyle; there is no floor | Often |
| Lipid-lowering medicationStatins and related drugs lower LDL, and with it non-HDL | Often |
What raises it
Diet, weight and inheritance together.
| Cause | How often |
|---|---|
| A diet high in saturated fatFatty meat, butter, full-fat dairy, biscuits and pastry; olive oil, nuts and oily fish in their place lower LDL | Often |
| Excess weight and little exerciseOften alongside high triglycerides and a low HDL; non-HDL counts that cholesterol in | Often |
| Underactive thyroidHypothyroidism is a recognised cause of a raised LDL; TSH shows it | Sometimes |
| Nephrotic syndromeKidney disease with heavy protein loss in the urine; rare, as is the use of anabolic steroids | Rare |
| Familial hypercholesterolaemiaInherited; LDL and non-HDL are then markedly high from a young age | Rare |
How does a non-HDL Cholesterol blood test work?
- Referral
- Not needed. You can have the fat profile that non-HDL follows from measured without going through a doctor first.
- Fasting
- Not needed. Non-HDL can be determined non-fasting too; that is one of its advantages over the calculated LDL.
- The draw
- One tube of blood from a vein in your arm, usually at the inner elbow. Total cholesterol and HDL come from that same tube; we do not use a finger prick.
- The result
- A single number in millimoles per litre (mmol/L), usually without a reference interval next to it, because labs do not publish one. If it is not on your report, you work it out yourself. Usually available within 24 hours.
- Repeating
- If you change what you eat or start moving more, measure again after a few months under the same conditions; LDL and non-HDL are equally valid for that.
- Which test
- Non-HDL Cholesterol is in the Heart health test (€69) and in .
- Where to draw
- You can draw at 250+ locations near you, no referral needed. See the locations
Frequently asked questions
What is non-HDL cholesterol?
Non-HDL cholesterol is all your cholesterol except the HDL part. You get it by subtracting your HDL from your total cholesterol. What remains are all the particles that can carry cholesterol into the artery wall, not only LDL. That is why it captures more than LDL alone, without anything extra having to be measured.
What is a normal non-HDL cholesterol level?
There is none: labs publish no range for non-HDL, and for anyone not under treatment there is no limit to reach, only a direction: lower is better. Anyone under treatment finds in the table above the target that goes with their LDL target, below 2.6 or below 3.4 mmol/L.
What does a high non-HDL cholesterol mean?
That plenty of cholesterol is circulating in the particles that can build up in your artery wall, not only in LDL but also in the triglyceride-rich particles. The causes are the same as for LDL: saturated fat, excess weight, little exercise and inheritance, and those are exactly the things you can change yourself. Above 3.9 mmol/L a non-fasting value stands out in any case.
What does a low non-HDL cholesterol mean?
That little cholesterol is circulating in the particles that can build up in your artery wall, and that is favourable. There is no lower limit. In anyone who eats plant-based and fibre-rich, is lean and exercises a lot, it is the ordinary outcome; in others it is inheritance or medication.
How do I lower my non-HDL cholesterol?
With the same levers as LDL: olive oil instead of butter, nuts and oily fish instead of fatty meat and processed meat, fibre from oats, legumes, vegetables and fruit, losing weight around the middle and moving every day. Because non-HDL also counts the triglyceride-rich particles, less sugar and alcohol show up in it sooner than in LDL. With an inherited high cholesterol or existing cardiovascular disease, medication usually joins it.
How do I work out my non-HDL cholesterol?
Subtract your HDL cholesterol from your total cholesterol. Both are in millimoles per litre on your report, so the result is too. The calculator above does the same sum with your own two values and shows the intermediate step.
Why is my risk estimated with non-HDL rather than LDL or the cholesterol ratio?
Because non-HDL counts the cholesterol in all the harmful particles, including where LDL falls short: with high triglycerides, and without a fasting draw. Since 2024 it has therefore replaced the old ratio of total cholesterol to HDL in the Dutch risk estimate. For treatment, LDL and non-HDL are equally valid targets.
Do I have to fast for this test?
No. Non-HDL can be determined non-fasting too, and that is one of its advantages: the usual LDL calculation becomes unreliable with high triglycerides, non-HDL does not.
Is non-HDL cholesterol the same as apoB?
No, but they cover the same particles. Non-HDL counts the cholesterol those particles carry, apoB counts the particles themselves. The information is comparable; non-HDL needs no extra test, apoB is the sharper addition when there are many small particles.
Which tests include non-HDL Cholesterol?
Non-HDL Cholesterol is in the Heart health test (€69, also as an add-on for €39), in the comprehensive test (€229) and in .
Related biomarkers
Read on
Sources
- 1.CVRM, Dutch multidisciplinary guideline on cardiovascular risk management, module on non-HDL-C. 2018. richtlijnendatabase.nl
- 2.CVRM, summary of the guideline on cardiovascular risk management. 2024. richtlijnendatabase.nl
- 3.CVRM, module on non-fasting blood sampling (Dutch), table 1 with the non-fasting cut-offs. 2018. richtlijnendatabase.nl
- 4.CVRM, module on estimating cardiovascular risk. 2024. richtlijnendatabase.nl
- 5.CVRM, module on LDL-C targets up to age 70. 2024. richtlijnendatabase.nl
- 6.CVRM, module on lipid-lowering treatment and LDL-C targets in (frail) older people above 70. 2024. richtlijnendatabase.nl
- 7.CVRM, module on diet. 2018. richtlijnendatabase.nl
- 8.Dutch guideline on (inherited) dyslipidaemia in secondary and tertiary care, module on the differential diagnosis of hypercholesterolaemia. 2018. richtlijnendatabase.nl
- 9.Unilabs, test catalogue (Dutch): non-HDL cholesterol. 2026. bepalingenklapper.nl
- 10.Unilabs, test catalogue (Dutch): cholesterol/HDL ratio, the ratio non-HDL replaced in the risk table. 2026. bepalingenklapper.nl
- 11.Certe, test catalogue (Dutch): cholesterol/HDL ratio. 2026. bepalingenwijzer.certe.nl
- 12.Clinical Diagnostics, lab guide (Dutch): Cholesterol+ratio. 2026. clinicaldiagnostics.nl
- 13.Star-shl, test catalogue (Dutch): the full index. 2026. star-shl.nl
- 14.Certe, test catalogue (Dutch): non-HDL cholesterol. 2026. bepalingenwijzer.certe.nl
- 15.Clinical Diagnostics, lab guide (Dutch): lipid panel including non-HDL. 2026. clinicaldiagnostics.nl
- 16.Clinical Diagnostics, lab guide (Dutch): CVRM panel for starting and monitoring treatment, carrying non-HDL and the Source field. 2026. clinicaldiagnostics.nl
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
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