A lab report has thirty lines, eleven of them decide the coming decades. What LDL, HDL, triglycerides, HbA1c, fasting glucose, CRP, vitamin D, ferritin, TSH, ApoB and lipoprotein(a) mean and which values to aim for.
In short
- LDL cholesterol and blood pressure determine cardiovascular risk; the target for healthy people is under 116 mg/dl, lower with risk factors.
- HbA1c shows blood sugar over the last three months: under 5.7 percent is normal, 5.7 to 6.4 prediabetes, from 6.5 diabetes.
- CRP under 1 mg/l means little silent inflammation, vitamin D 30 to 50 ng/ml is the target range, ferritin shows iron stores.
- Measure lipoprotein(a) once in your life: it is genetic, common and not part of standard reports.
The blood lipids
LDL cholesterol transports fat into vessel walls and is causal for atherosclerosis. For healthy people a target under 116 mg/dl applies, with elevated risk under 100, after a heart attack under 55. HDL is the return transport; values above 40 for men and 50 for women are desirable, but raising HDL brings little according to newer evidence. Triglycerides under 150 mg/dl are normal; they rise with sugar, alcohol and belly fat. ApoB counts the number of harmful particles and is more precise than LDL; a value under 90 mg/dl is good. Lipoprotein(a) is a genetically determined risk factor that one in five has elevated; measure once in a lifetime, above 50 mg/dl means being more consistent with everything else.
Sugar metabolism
Fasting glucose under 100 mg/dl is normal, 100 to 125 impaired, from 126 diabetes. HbA1c shows the average of the last three months: under 5.7 percent normal, 5.7 to 6.4 prediabetes, from 6.5 diabetes. Whoever sits in prediabetes can return to the normal range within six months through weight, movement and less sugar. Fasting insulin is an early-warning value hardly anyone measures: above 10 mU/l points to insulin resistance years before sugar rises.
Inflammation, vitamin D, iron, thyroid
High-sensitivity CRP under 1 mg/l means little chronic inflammation, 1 to 3 moderate, above 3 elevated cardiovascular risk, provided there is no infection. Vitamin D as 25-OH-D: under 20 ng/ml is deficiency, 30 to 50 the target range, above 100 too much. Ferritin shows iron stores: under 30 ng/ml for women and under 50 for men is too little, very high values point to inflammation or iron overload disease. TSH between 0.4 and 4 mU/l is normal; fatigue, weight gain and sensitivity to cold with a high TSH suggest an underactive thyroid.
What a single value cannot do
A value outside the range is a hint, not a diagnosis. Reference ranges describe 95 percent of healthy people, so one in twenty healthy values falls outside. What matters is the context: high triglycerides, low HDL, high waist circumference and high blood pressure together are the metabolic syndrome, even if each value is only slightly off. And the direction: an LDL that rises from 110 to 150 in three years matters more than one that has sat at 130 for ten years.
Before the appointment
Come fasting, no alcohol and no hard training the day before, bring the values of past years, and prepare three questions: which value is the most important for me, what is the target, and when do we measure again.
Try it
Blood Test CheckCholesterol, LDL, HDL, triglycerides, glucose, HbA1c, vitamin D, ferritin, TSH, CRP, blood pressure: each value with a traffic light and explanation.Longevity ScoreTwelve questions about sleep, movement, food, stress and habits: your estimated biological age and the three levers with the biggest effect.Calorie CalculatorHeight, weight, age, activity: your basal metabolic rate, your daily needs and the calories to lose, maintain or gain.Frequently asked questions
How often should I test blood values?
Healthy people from 35 every two to three years, from 50 yearly, with abnormal values or lifestyle changes after three to six months for control.
Is high total cholesterol bad?
Total cholesterol alone says little because it includes HDL. What matters is LDL and ApoB, together with blood pressure, smoking, diabetes and family history.
What can I change before the next measurement?
In twelve weeks: less sugar and alcohol lower triglycerides, fiber and less saturated fat lower LDL, movement and weight loss lower HbA1c and CRP, vitamin D in winter raises the level.
This article is general information and not medical advice. If you have symptoms or existing conditions, or before changing any medication, talk to your doctor.
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