table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Many people have heard of high-density lipoprotein (HDL) cholesterol (“good” cholesterol) and low-density lipoprotein (LDL) cholesterol (“bad cholesterol”). But it’s important to be aware of some other types of cholesterol. One of them is very-low-density lipoprotein (VLDL) cholesterol. VLDL carries triglycerides in your bloodstream and throughout your body.
Learn all about VLDL cholesterol and what it means for your health.
What is cholesterol and why do you need it?
Cholesterol is a waxy substance that’s one of your body’s main building blocks. It’s an essential component of cell membranes found in almost every cell in your body. Cholesterol helps your body make sex hormones, cortisol, bile salts, vitamin D, and other vital substances (Huff, 2021).
Your liver makes all the cholesterol your body requires. You can get cholesterol from the foods you eat, but the amount of cholesterol in your diet has almost no effect on the level of cholesterol in your blood (Soliman, 2018; Blesso, 2018). Because it’s so vital for your body’s healthy functioning, cholesterol moves through your bloodstream between your liver and all the tissues of your body.
What are the different types of cholesterol?
Your cholesterol test might show that you have high cholesterol. But knowing your total cholesterol level isn’t enough. Total cholesterol levels include both HDL and LDL cholesterol, and they can each have a different impact on your health.
Lipid panels break down your blood cholesterol test results into several different types of cholesterol. These types get their names from small particles called lipoproteins, which transport cholesterol in your bloodstream. The main types of cholesterol are (Feingold, 2021):
- High-density lipoprotein (HDL) cholesterol (“good cholesterol”) helps clear unneeded cholesterol from your body by transporting it to your liver. The liver then removes it from your body.
- Low-density lipoprotein (LDL) cholesterol (“bad cholesterol”) makes up about two-thirds of your cholesterol (Huff, 2021). As LDL cholesterol travels through your system, cells in need of cholesterol trap and take in the LDLs. If the cells don’t need the LDL cholesterol, it remains in your bloodstream.
Non HDL cholesterol: what it means for your health
Two other types of cholesterol carry triglycerides throughout your body (Feingold, 2021):
- Intermediate-density lipoprotein (IDL) cholesterol
- Very-low-density lipoprotein (VLDL) cholesterol
VLDL particles are made in the liver and then travel in your bloodstream, where they deliver triglycerides to your body’s cells. They’re larger than HDL, LDL, and IDL particles because they’re rich in triglycerides. The overall size of VLDL particles can vary, depending on how much triglyceride they’re carrying.
What are triglycerides?
Triglycerides are a type of fat. Some of the triglycerides in your body come from the food you eat. Some are made by your body based on the balance between your diet and physical activity. When you consume more calories than you burn off, some of the excess is converted into triglycerides and stored in your body’s fat cells (Venugopal, 2020). When needed, the triglycerides can be released from the fat cells and used for energy.
Why are high VLDL levels dangerous?
Because VLDL carries triglycerides throughout your bloodstream, high VLDL levels are dangerous to your health. High levels of blood VLDL can injure your arteries by causing plaques—hardened, calcified material—to build up in your blood vessel walls. These plaques stiffen and clog the blood vessels—a condition called atherosclerosis. Atherosclerosis can cause cardiovascular diseases such as coronary heart disease, stroke, and heart attack (Packard, 2020).
How is VLDL measured?
There’s no direct way to measure VLDL (Venugopal, 2020). Your VLDL level is usually estimated as a percentage of your triglyceride level.
What are healthy levels of VLDL?
A normal VLDL level is anything up to 30 milligrams per deciliter (mg/dl). However, that figure might need to be lowered for patients with risk factors for disease, for instance, hypertension (high blood pressure) or a family history of cardiovascular disease (Elshazly, 2013).
How to lower cholesterol: medication and lifestyle
How can you lower your VLDL level?
If your lipid panel shows you have elevated VLDL levels, talk to your healthcare provider. Cholesterol-lowering medications are often necessary, but the first-line approach to lowering your cholesterol levels is usually lifestyle changes, such as:
- Reducing your intake of sugars and refined carbohydrates (like white rice and white bread). These types of foods are quickly converted into triglycerides and stored as fat if not used for energy.
- Exercising regularly
- Losing weight if you have overweight or obesity (Huff, 2021)
- Elshazly, M. B., Martin, S. S., Blaha, M. J., Joshi, P. H., Toth, P. P., McEvoy, J. W., et al. (2013). Non-high-density lipoprotein cholesterol, guideline targets, and population percentiles for secondary prevention in 1.3 million adults: the VLDL-2 study (very large database of lipids). Journal of the American College of Cardiology, 62(21), 1960–1965. doi: 10.1016/j.jacc.2013.07.045. Retrieved from https://www.sciencedirect.com/science/article/pii/S0735109713030751?via%3Dihub
- Feingold, K.R. Introduction to lipids and lipoproteins. [Updated 2021 Jan 19]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK305896/
- Huff, T., Boyd, B., Jialal, I. [Updated 2021 Mar 2]. Physiology, cholesterol. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470561/
- Packard, C. J., Boren, J., & Taskinen, M. R. (2020). Causes and consequences of hypertriglyceridemia. Frontiers in endocrinology, 11, 252. doi: 10.3389/fendo.2020.00252. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32477261/
- Venugopal SK, Anoruo MD, Jialal I. [Updated 2020 Oct 27]. Biochemistry, low density lipoprotein. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK500010/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.