VLDL Cholesterol

Very low-density lipoprotein that carries triglycerides

16/22Providers
Lipid Panel / CCategory
Normal:5-40 mg/dLReference

Widely Available

16 of 22 providers

Category

Lipid Panel / Cardiovascular Health

Reference Range

Normal:5-40 mg/dL

What is VLDL Cholesterol?

Very Low-Density Lipoprotein cholesterol (VLDL-C) represents the cholesterol content within VLDL particles, which are produced by the liver to transport triglycerides and cholesterol to tissues throughout the body. VLDL particles are the largest and least dense of the lipoproteins, consisting primarily of triglycerides (about 50-65% by weight) with smaller amounts of cholesterol, phospholipids, and proteins. As VLDL travels through the bloodstream, enzymes remove triglycerides, converting VLDL into smaller, denser particles that eventually become LDL.

VLDL-C is typically not directly measured in standard lipid panels but is calculated using the Friedewald equation:VLDL-C=Triglycerides ÷ 5 (in mg/dL). This calculation assumes a fixed ratio between triglycerides and cholesterol in VLDL particles, which holds reasonably well when triglycerides are below 400 mg/dL. When triglycerides are very high, this calculation becomes less accurate, and direct VLDL measurement via ultracentrifugation or advanced testing (NMR, ion mobility) may be needed.

Elevated VLDL-C indicates increased hepatic production of triglyceride-rich particles, often associated with metabolic syndrome, insulin resistance, obesity, and high carbohydrate intake. While VLDL itself contributes to atherosclerosis, elevated VLDL also leads to increased small dense LDL particles and decreased HDL levels—a particularly atherogenic lipid pattern. VLDL-C is closely linked to triglycerides, and interventions that lower triglycerides typically reduce VLDL proportionally.

Why VLDL Cholesterol Is Essential

  • Marker of hepatic triglyceride and lipoprotein production

Optimal vs Standard Ranges

Range TypeLevelSignificance
Indicates metabolic health and insulin sensitivityContributes to atherogenic dyslipidemia patternPrecursor to atherogenic remnant particles
Optimal VLDL-C RangesStandard:2-30 mg/dLFunctional/Optimal:<20 mg/dL
Clinical Concern:>40 mg/dLVLDL-C is typically calculated as Triglycerides ÷ 5. Normal range is 2-30 mg/dL, with optimal levels <20 mg/dL. Levels >30-40 mg/dL indicate overproduction of triglyceride-rich particles. Since VLDL-C correlates closely with triglycerides, focus often shifts to triglyceride management. Direct VLDL measurement via advanced testing may provide additional insights.Reduce Carbohydrate Intake
Lower consumption of refined carbohydrates, sugars, and high-glycemic foods. Excess dietary carbohydrates are converted to triglycerides in the liver and packaged into VLDL particles. Emphasize complex carbohydrates with fiber, which minimally affect VLDL production.Weight Loss and Insulin SensitivityAchieve healthy body weight and reduce visceral adiposity through diet and exercise. Weight loss of 5-10% significantly reduces hepatic VLDL production. Improve insulin sensitivity through lifestyle modifications or medications like metformin if appropriate.
Standard lab range: Normal:5-40 mg/dL

How to Optimize VLDL Cholesterol

1. Limit Alcohol Consumption

Reduce or eliminate alcohol intake, as alcohol strongly stimulates hepatic triglyceride and VLDL synthesis. Even moderate drinking can elevate VLDL in susceptible individuals. Complete abstinence may be necessary for optimal VLDL control.

2. Omega-3 Fatty Acids

Supplement with high-dose omega-3s (2-4g EPA+DHA daily) from fish oil or consume fatty fish 2-3 times weekly. Omega-3s reduce hepatic VLDL production and increase VLDL clearance. Prescription omega-3s provide higher doses for severe elevations.

3. Fibrate Medications

For persistent elevations, fibrates (fenofibrate, gemfibrozil) effectively reduce VLDL and triglycerides by 30-50% through multiple mechanisms including increased lipoprotein lipase activity. Often used in combination with statins for mixed dyslipidemia (use fenofibrate to avoid muscle side effects).

4. Usually asymptomatic;very high levels (VLDL-C >100 mg/dL, corresponding to triglycerides >500 mg/dL) may cause eruptive xanthomas, lipemia retinalis, hepatomegaly, and acute pancreatitis

Low VLDL (<10 mg/dL) rarely causes symptoms and may indicate optimal metabolic health with low triglyceride production

5. Obesity, metabolic syndrome, insulin resistance, type 2 diabetes, high-carbohydrate diet, excessive alcohol, sedentary lifestyle, genetic disorders (familial combined hyperlipidemia), hypothyroidism, chronic kidney disease, medications (corticosteroids, beta-blockers, thiazides, estrogen)

Low carbohydrate intake, optimal metabolic health, hyperthyroidism, malabsorption disorders, severe liver disease, genetic lipodystrophy, aggressive lifestyle or pharmacological intervention

Symptoms of Abnormal VLDL Cholesterol

Low VLDL Cholesterol

  • Retest 2-3 months after lifestyle modifications or medication changes. If very high (>50 mg/dL or triglycerides >250 mg/dL), retest in 4-8 weeks. Once stable and optimal, annual testing with standard lipid panel is typically sufficient.

High VLDL Cholesterol

  • Research demonstrating that VLDL remnant particles are highly atherogenic and contribute significantly to cardiovascular disease risk, particularly in metabolic syndrome where remnant accumulation is common.

Causes of Abnormal VLDL Cholesterol

Low Levels

  • VLDL and Insulin Resistance

High Levels

  • Studies showing strong association between elevated VLDL production and insulin resistance, with hepatic VLDL overproduction being a key feature of metabolic syndrome and type 2 diabetes.

When to Retest

  • Taskinen &Borén, "Why Is Apolipoprotein B-Containing Lipoprotein Increased in Type 2 Diabetes?,"Current Diabetes Reports, 2015

Scientific Evidence

Carbohydrate Restriction and VLDL Reduction

Clinical trials demonstrating that low-carbohydrate diets significantly reduce hepatic VLDL production and VLDL-C levels, with effects appearing within days to weeks of dietary change.

Source:Volek et al., "Carbohydrate Restriction Improves the Features of Metabolic Syndrome,"Nutrition &Metabolism, 2005

Omega-3 Effects on VLDL

Meta-analysis showing that omega-3 fatty acids reduce VLDL production and triglycerides by 20-50%, with dose-dependent effects and greatest benefits at doses ≥2g EPA+DHA daily.

Source:Harris et al., "Omega-3 Fatty Acids and Cardiovascular Disease,"Arteriosclerosis, Thrombosis, and Vascular Biology, 2008

Fibrates for VLDL and Triglyceride Lowering

Clinical trials demonstrating that fibrate medications effectively reduce VLDL and triglycerides through increased lipoprotein lipase activity and reduced hepatic VLDL production, particularly beneficial in metabolic syndrome.

Source:Staels et al., "Mechanism of Action of Fibrates on Lipid and Lipoprotein Metabolism,"Circulation, 1998

None

None

Source:None

Which Providers Test VLDL Cholesterol?

Full Provider Comparison

ProviderIncludesAnnual CostBiomarkers
SuperpowerSuperpower$199100+ (150 with ratios)
WHOOP Advanced LabsWHOOP Advanced Labs$34965
Labcorp OnDemandLabcorp OnDemand$39830+
Life ExtensionLife Extension$48640+
EverlywellEverlywell$46883
Mito HealthMito Health$349100+
InsideTrackerInsideTracker$68054
Function HealthFunction Health$365100+
Marek Health BaseMarek Health Base$25065
Marek Health ComprehensiveMarek Health Comprehensive$49570+
Marek Health CompleteMarek Health Complete$895100+
Marek Health ExecutiveMarek Health Executive$1950150+
BlueprintBlueprint$399100+
Quest HealthQuest Health$Varies75+
Empirical HealthEmpirical Health$190100+
Oura Health PanelsOura Health Panels$9950
SiPhox HealthSiPhox Health$12560
Hims Labs BaseHims Labs Base$19950
Hims Labs AdvancedHims Labs Advanced$499120+
HealthspanHealthspan$418880+
Vitality Blueprint StandardVitality Blueprint Standard$37585
Vitality Blueprint EliteVitality Blueprint Elite$700129

Ready to Test VLDL Cholesterol?

16 providers include this biomarker in their panels

Frequently Asked Questions

What does VLDL Cholesterol test for?
VLDL Cholesterol is a lipid panel / cardiovascular health biomarker. Very low-density lipoprotein that carries triglycerides The normal reference range is Normal:5-40 mg/dL.
Which providers include VLDL Cholesterol?
16 of 22 providers include this test:Superpower, Blueprint, Mito Health, Function and others.
How often should I test VLDL Cholesterol?
For most people, testing 2-4 times per year is recommended to establish baseline levels and track trends. Consult your healthcare provider for personalized recommendations.
What is the optimal range?
The standard reference range is Normal:5-40 mg/dL. Many functional medicine practitioners recommend tighter optimal ranges for peak health. Your ideal range may vary based on age, sex, and health goals.
Why is VLDL Cholesterol important?
Carries triglycerides from liver to tissues. Elevated levels contribute to plaque buildup. Usually calculated as triglycerides/5.

Medical Disclaimer

This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.