Very low-density lipoprotein that carries triglycerides
16 of 22 providers
Lipid Panel / Cardiovascular Health
Normal:5-40 mg/dL
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.
| Range Type | Level | Significance |
|---|---|---|
| Indicates metabolic health and insulin sensitivity | Contributes to atherogenic dyslipidemia pattern | Precursor to atherogenic remnant particles |
| Optimal VLDL-C Ranges | Standard:2-30 mg/dL | Functional/Optimal:<20 mg/dL |
| Clinical Concern:>40 mg/dL | VLDL-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 Sensitivity | Achieve 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. |
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.
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.
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).
Low VLDL (<10 mg/dL) rarely causes symptoms and may indicate optimal metabolic health with low triglyceride production
Low carbohydrate intake, optimal metabolic health, hyperthyroidism, malabsorption disorders, severe liver disease, genetic lipodystrophy, aggressive lifestyle or pharmacological intervention
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
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
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
Source:None
| Provider | Includes | Annual Cost | Biomarkers |
|---|---|---|---|
| ✓ | $199 | 100+ (150 with ratios) | |
| — | $349 | 65 | |
| — | $398 | 30+ | |
| ✓ | $486 | 40+ | |
| — | $468 | 83 | |
| ✓ | $349 | 100+ | |
| — | $680 | 54 | |
| ✓ | $365 | 100+ | |
| ✓ | $250 | 65 | |
| ✓ | $495 | 70+ | |
| ✓ | $895 | 100+ | |
| ✓ | $1950 | 150+ | |
| — | $399 | 100+ | |
| — | $Varies | 75+ | |
| ✓ | $190 | 100+ | |
| — | $99 | 50 | |
| ✓ | $125 | 60 | |
| ✓ | $199 | 50 | |
| ✓ | $499 | 120+ | |
| ✓ | $4188 | 80+ | |
| ✓ | $375 | 85 | |
| ✓ | $700 | 129 |
16 providers include this biomarker in their panels
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.