Total Cholesterol

Desirable total cholesterol is under 200 mg/dL (under 5.2 mmol/L), borderline high is 200-239 mg/dL (5.2-6.2 mmol/L), and high is 240 mg/dL or above (6.2 mmol/L or above). Total cholesterol is a screening number, though, and the components matter more: two people with the same total can have very different risk depending on their LDL, HDL, and triglycerides.

Multiply the mmol/L value by 38.67 to get mg/dL, and divide mg/dL by 38.67 to go the other way. For example, 5.2 mmol/L is about 200 mg/dL and 6.2 mmol/L is roughly 240 mg/dL. US labs usually report mg/dL, while UK, European, and Scandinavian labs report mmol/L.

A total cholesterol of 220 mg/dL (about 5.7 mmol/L) is in the borderline-high band of 200-239 mg/dL, not the high band. On its own it is not alarming, and what matters is the breakdown: a 220 driven by high HDL is very different from one driven by high LDL. Your physician reads it alongside LDL, HDL, triglycerides, and your overall cardiovascular risk.

A high total cholesterol can reflect diet, genetics, an underactive thyroid, some medications, or anabolic steroid use, but the number alone does not tell you which cholesterol is elevated. Because it sums LDL, HDL, and part of VLDL, a high value should prompt a look at the individual components and ideally ApoB or LDL particle number, which track cardiovascular risk more directly. Discuss the pattern with your physician rather than treating the single figure.

Injectable testosterone at replacement doses usually does not change total cholesterol dramatically, but it often modestly lowers HDL, the protective fraction. Because total cholesterol includes HDL, a small drop in HDL can even nudge the total down while your risk picture is unchanged or slightly worse. This is why ApoB and LDL particle number are better guides on TRT than the total number alone.