A lipid panel is a blood test that measures the main fats and fat-carrying particles linked with artery health, heart attack risk, stroke risk, metabolic health, and inherited cholesterol disorders. Most standard panels report total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Many also report non-HDL cholesterol, VLDL cholesterol, or cholesterol ratios. These numbers do not diagnose heart disease by themselves, but they help estimate how much cholesterol-rich material is circulating in the blood and whether treatment, lifestyle changes, or further testing may help.
A single lipid result is most useful when it is interpreted with age, blood pressure, smoking status, diabetes, kidney disease, family history, medications, and prior cardiovascular events. LDL cholesterol is usually the main treatment focus, triglycerides show how the body handles fat-rich particles, and HDL cholesterol gives additional context. The pattern matters more than any one number in isolation.
- A lipid panel measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides; many reports also include non-HDL cholesterol and VLDL cholesterol.
- LDL cholesterol is usually best below 100 mg/dL for many adults, but lower targets may apply for people with heart disease, diabetes, high risk, or familial hypercholesterolemia.
- Triglycerides are usually considered normal below 150 mg/dL when fasting; levels of 500 mg/dL or higher need prompt medical follow-up because pancreatitis risk rises.
- Fasting is not always required, but a 9–12 hour fast may be requested if triglycerides are high, if prior results were abnormal, or if the lab or clinician specifically asks for it.
- High total cholesterol can be misleading when HDL is very high, so LDL cholesterol, non-HDL cholesterol, ApoB, triglycerides, and overall risk give a clearer picture.
- Urgent care is needed for chest pain, stroke symptoms, or severe upper abdominal pain with vomiting, not simply for a mildly abnormal lipid number.
Table of Contents
- What a Lipid Panel Measures
- Lipid Panel Normal Ranges and Treatment Targets
- How to Prepare for a Lipid Panel
- How to Read Lipid Panel Results
- Common Causes of Abnormal Lipid Results
- Risk Assessment and Follow-Up Tests
- Ways to Improve Lipid Panel Results
- When to Seek Medical Advice
What a Lipid Panel Measures
A lipid panel measures cholesterol and triglyceride-related markers in the blood. These fats cannot travel freely in watery blood, so the body packages them into lipoproteins. Lipoproteins are particles made of fat, cholesterol, protein, and other molecules. Some particles deliver cholesterol to tissues, while others help remove cholesterol from circulation.
The standard lipid panel usually includes four main results: total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. Depending on the lab, it may also include non-HDL cholesterol, VLDL cholesterol, LDL/HDL ratio, total cholesterol/HDL ratio, or calculated remnant cholesterol.
Total cholesterol is the sum of cholesterol carried in several types of lipoproteins. It includes cholesterol in LDL, HDL, VLDL, and remnant particles. Total cholesterol is useful as a quick screening number, but it can hide important differences. A total cholesterol of 220 mg/dL may mean high LDL cholesterol in one person and high HDL cholesterol in another.
LDL cholesterol, often shortened to LDL-C, estimates the amount of cholesterol carried inside low-density lipoproteins. LDL particles can enter artery walls, contribute to plaque buildup, and raise the risk of atherosclerotic cardiovascular disease. LDL-C is still one of the most important markers in routine cholesterol testing. A separate article on LDL cholesterol ranges and targets can help when LDL-C is the main abnormal result.
HDL cholesterol, or HDL-C, measures cholesterol carried in high-density lipoproteins. HDL particles participate in reverse cholesterol transport, a process that helps move cholesterol away from tissues and back toward the liver. Higher HDL-C has historically been linked with lower heart risk, but very high HDL-C does not always mean extra protection. HDL function, genetics, inflammation, alcohol intake, and metabolic health can all influence what the number means.
Triglycerides are the body’s main storage form of fat. After eating, triglycerides rise as the body transports dietary fat. High fasting triglycerides often reflect insulin resistance, excess alcohol intake, obesity, uncontrolled diabetes, hypothyroidism, kidney disease, certain medications, or inherited lipid disorders. Very high triglycerides can also raise the risk of acute pancreatitis, a painful inflammation of the pancreas.
Non-HDL cholesterol is calculated by subtracting HDL cholesterol from total cholesterol. It includes LDL, VLDL, IDL, lipoprotein(a), and remnant particles. In plain terms, non-HDL cholesterol estimates the cholesterol carried by potentially artery-forming particles. It is especially useful when triglycerides are elevated, because LDL-C alone may underestimate risk.
VLDL cholesterol is usually estimated from triglycerides. VLDL particles carry triglycerides from the liver into the bloodstream. High VLDL cholesterol often travels with high triglycerides, low HDL-C, fatty liver, insulin resistance, and metabolic syndrome.
Lipid Panel Normal Ranges and Treatment Targets
Lipid panel ranges are not all used the same way. Some ranges describe population categories, while treatment targets depend on a person’s cardiovascular risk. A healthy 28-year-old with no risk factors and a 68-year-old with prior heart attack should not interpret the same LDL-C number in the same way.
The table below uses common adult categories in mg/dL, with approximate mmol/L equivalents. Laboratories may use slightly different cutoffs, and clinicians may set lower targets for people at higher risk.
| Marker | Common range or category | Approximate mmol/L | Usual meaning |
|---|---|---|---|
| Total cholesterol | Desirable: less than 200 mg/dL | Less than 5.18 mmol/L | Generally favorable, but LDL-C and HDL-C still matter |
| Total cholesterol | Borderline high: 200–239 mg/dL | 5.18–6.18 mmol/L | Needs interpretation with LDL-C, HDL-C, and risk factors |
| Total cholesterol | High: 240 mg/dL or higher | 6.21 mmol/L or higher | Often reflects elevated LDL-C or non-HDL-C |
| LDL cholesterol | Optimal for many adults: less than 100 mg/dL | Less than 2.59 mmol/L | Often a favorable level for lower-risk adults |
| LDL cholesterol | Borderline high: 130–159 mg/dL | 3.37–4.12 mmol/L | May need lifestyle changes and risk-based treatment discussion |
| LDL cholesterol | High: 160–189 mg/dL | 4.14–4.89 mmol/L | Raises concern, especially with family history or other risks |
| LDL cholesterol | Very high: 190 mg/dL or higher | 4.92 mmol/L or higher | Suggests severe hypercholesterolemia; familial hypercholesterolemia should be considered |
| HDL cholesterol | Low: less than 40 mg/dL in men; less than 50 mg/dL in women | Less than 1.03 mmol/L in men; less than 1.29 mmol/L in women | Often linked with insulin resistance, smoking, inactivity, or high triglycerides |
| HDL cholesterol | Higher: 60 mg/dL or higher | 1.55 mmol/L or higher | Often favorable, but not a guarantee of low risk |
| Triglycerides | Normal fasting: less than 150 mg/dL | Less than 1.7 mmol/L | Usually favorable |
| Triglycerides | Borderline high: 150–199 mg/dL | 1.7–2.25 mmol/L | Often reflects diet, weight, insulin resistance, alcohol, or genetics |
| Triglycerides | High: 200–499 mg/dL | 2.26–5.63 mmol/L | Raises cardiovascular risk and may make LDL-C calculation less reliable |
| Triglycerides | Very high: 500 mg/dL or higher | 5.65 mmol/L or higher | Needs prompt follow-up because pancreatitis risk rises |
| Non-HDL cholesterol | Often desirable: less than 130 mg/dL | Less than 3.37 mmol/L | Lower targets may apply for high-risk and very-high-risk patients |
LDL-C targets have become more risk-based. Many lower-risk adults aim for LDL-C below 100 mg/dL. People with high cardiovascular risk often need LDL-C below 70 mg/dL. People at very high risk, such as those with established cardiovascular disease and repeated events or multiple high-risk conditions, may have targets near or below 55 mg/dL, depending on the guideline and clinical setting.
Non-HDL cholesterol often follows a similar risk pattern. A common practical target is about 30 mg/dL higher than the LDL-C target. For example, when LDL-C target is below 100 mg/dL, non-HDL-C target is often below 130 mg/dL. When LDL-C target is below 70 mg/dL, non-HDL-C target is often below 100 mg/dL.
HDL-C is different. Raising HDL-C with medication has not reliably lowered heart attack risk in the same way that lowering LDL-C does. Low HDL-C still gives useful risk information, especially when it appears with high triglycerides, abdominal weight gain, high blood glucose, or high blood pressure. For more detail, see the guide to HDL cholesterol normal and optimal ranges.
Triglycerides also need risk-based interpretation. A level of 170 mg/dL may suggest insulin resistance or recent food intake, but it is not an emergency. A level of 650 mg/dL deserves faster attention. A level above 1,000 mg/dL can indicate a much higher risk of pancreatitis, especially if the person also has uncontrolled diabetes, heavy alcohol use, or an inherited triglyceride disorder. A focused explanation of triglyceride ranges and targets may be useful when triglycerides are the main concern.
How to Prepare for a Lipid Panel
Many lipid panels can be done without fasting. Total cholesterol and HDL-C change little after ordinary meals, and nonfasting triglycerides can still provide useful risk information. Nonfasting testing is also easier for children, older adults, people with diabetes, and anyone who may feel unwell after skipping food.
Fasting is still useful in certain situations. Your clinician or lab may ask you to avoid calories for 9–12 hours before the test if:
- You previously had high triglycerides.
- A nonfasting triglyceride result was above 400 mg/dL.
- You are being evaluated for a genetic lipid disorder.
- You have a history of pancreatitis.
- Your clinician needs the most consistent baseline before starting or adjusting treatment.
- The local lab protocol requires fasting for calculated LDL-C.
Water is allowed during a fasting lipid panel. Black coffee may be allowed by some labs but not others, so water is the safest choice. Avoid alcohol for at least 24 hours before testing when possible, because alcohol can raise triglycerides. A very high-fat meal the night before the test can also push triglycerides upward, especially in people who already have insulin resistance or high triglycerides.
Take prescribed medications unless your clinician tells you otherwise. Do not stop a statin, fibrate, thyroid medicine, diabetes medicine, hormone therapy, or blood pressure medication just to “see the natural number” unless that is part of a supervised plan. Stopping treatment can make the result harder to interpret and may increase risk in some people.
The timing of the test can also matter. Lipids may temporarily change during acute illness, after major surgery, during pregnancy, after major weight loss, or after a recent heart attack or stroke. Pregnancy commonly raises cholesterol and triglycerides, especially later in pregnancy. After severe illness, clinicians may repeat the lipid panel once the body has returned to a stable state.
For routine monitoring after starting or changing cholesterol-lowering therapy, many clinicians repeat the lipid panel after about 4–12 weeks. Once results are stable, testing every 6–12 months is common for treated patients, while lower-risk adults with normal results may be checked less often.
How to Read Lipid Panel Results
A lipid panel is easiest to understand when you look at the pattern, not just the flagged highs and lows. Lab flags are based on general reference categories, while your personal target depends on your risk.
Start with LDL-C and non-HDL-C. LDL-C estimates cholesterol inside LDL particles, while non-HDL-C includes cholesterol in all major artery-forming particles. If LDL-C is high, the result often points toward higher lifetime exposure to atherosclerotic particles. If non-HDL-C is high while LDL-C looks only mildly elevated, triglyceride-rich remnants may be contributing to risk. The separate guide to non-HDL cholesterol explains why this marker can be especially helpful when triglycerides are elevated.
Next, look at triglycerides and HDL-C together. High triglycerides with low HDL-C often suggests insulin resistance, metabolic syndrome, fatty liver tendency, or high intake of refined carbohydrates or alcohol. This pattern can appear even when LDL-C is not extremely high. In that case, glucose markers, waist circumference, blood pressure, and family history become important. A broader metabolic syndrome blood test panel may help connect lipid results with insulin resistance and cardiometabolic risk.
Then, look at total cholesterol. Total cholesterol alone can overstate or understate risk. A high total cholesterol caused mostly by high LDL-C or high non-HDL-C is more concerning than a high total cholesterol caused by high HDL-C. A normal total cholesterol can also be falsely reassuring if HDL-C is very low and triglycerides are high. For a deeper explanation, see total cholesterol ranges and targets.
The following patterns are common:
| Pattern | Possible meaning | Common next step |
|---|---|---|
| High LDL-C with normal triglycerides | May reflect genetics, saturated fat sensitivity, hypothyroidism, kidney disease, or diet pattern | Assess cardiovascular risk, family history, thyroid status, and need for LDL-lowering treatment |
| High triglycerides with low HDL-C | Often linked with insulin resistance, weight gain, diabetes risk, fatty liver, alcohol, or refined carbohydrates | Check glucose markers, liver markers, blood pressure, waist circumference, and alcohol intake |
| High total cholesterol with high HDL-C | Total cholesterol may look high even when LDL-C is not severely elevated | Focus on LDL-C, non-HDL-C, ApoB, family history, and overall risk |
| LDL-C 190 mg/dL or higher | Possible severe hypercholesterolemia or familial hypercholesterolemia | Repeat if needed, assess secondary causes, consider family screening and treatment |
| Triglycerides 500 mg/dL or higher | Pancreatitis risk becomes more important, especially as levels rise toward 1,000 mg/dL | Prompt medical follow-up, fasting repeat test, review alcohol, diabetes control, medications, and diet |
| Very low LDL-C on treatment | May be expected with intensive lipid-lowering therapy in high-risk patients | Interpret with clinical history, medication plan, and clinician guidance |
Calculated LDL-C deserves one extra caution. Many labs estimate LDL-C using a formula rather than measuring it directly. The older Friedewald calculation works reasonably well for many fasting samples, but it becomes less reliable when triglycerides are high, LDL-C is very low, or the sample is nonfasting. Newer calculations, such as Martin/Hopkins or Sampson methods, often perform better in these situations. If triglycerides are very high, the lab may not report calculated LDL-C or may recommend a direct LDL-C measurement.
Cholesterol ratios can provide context but should not replace LDL-C, non-HDL-C, or risk-based assessment. A total cholesterol/HDL ratio below about 3.5 is often considered favorable, while higher ratios may suggest more risk. Still, ratios can mislead when HDL-C is unusually high or unusually low. They are best used as supporting information.
Common Causes of Abnormal Lipid Results
Abnormal lipid results often come from a mix of genetics, diet, body weight, hormones, medications, medical conditions, and age. A person can eat carefully and still have high LDL-C because of inherited cholesterol handling. Another person may have normal LDL-C but high triglycerides because of insulin resistance, alcohol intake, or diabetes.
High LDL-C is commonly linked with:
- Familial hypercholesterolemia or other inherited lipid disorders
- Diets high in saturated fat for people who are sensitive to it
- Hypothyroidism
- Nephrotic syndrome or chronic kidney disease
- Cholestatic liver disease
- Weight gain or menopause-related lipid changes
- Certain medications, including some diuretics, immunosuppressants, and hormonal therapies
LDL-C of 190 mg/dL or higher is important even if the person feels well. It can suggest lifelong exposure to high LDL particles and may point toward familial hypercholesterolemia, especially if there is a family history of early heart attack, stroke, stents, bypass surgery, or very high cholesterol.
High triglycerides have a different pattern of causes. They often rise with excess calories, frequent sugary drinks, high refined carbohydrate intake, alcohol, insulin resistance, uncontrolled diabetes, obesity, hypothyroidism, kidney disease, pregnancy, and certain medications. Medications that can raise triglycerides include some beta blockers, thiazide diuretics, corticosteroids, estrogen therapy, retinoids, antipsychotics, HIV medications, and immunosuppressants.
Low HDL-C often appears with high triglycerides. It is common in insulin resistance, type 2 diabetes, smoking, sedentary lifestyle, abdominal weight gain, and inflammatory states. Very low HDL-C can rarely reflect inherited disorders, but lifestyle and metabolic causes are much more common.
High HDL-C is not always harmful, but it is not automatically protective. HDL-C can rise because of genetics, regular exercise, moderate alcohol intake, certain medications, and hormone effects. Very high HDL-C, especially above 90–100 mg/dL, may not reduce risk in the expected way in every person. In that situation, LDL-C, non-HDL-C, ApoB, blood pressure, smoking, diabetes, and family history become more useful than assuming high HDL-C cancels out other risks.
Low total cholesterol or low LDL-C can occur with intensive lipid-lowering treatment, chronic illness, hyperthyroidism, malabsorption, undernutrition, some liver diseases, and certain genetic traits. In people on statins, ezetimibe, PCSK9 inhibitors, inclisiran, or bempedoic acid, low LDL-C may be intentional and beneficial, especially after a heart attack or in very-high-risk cardiovascular disease.
One of the most common mistakes is blaming one food or one weekend for the entire lipid panel. A single result reflects recent biology and long-term patterns. Triglycerides can change quickly after alcohol, sugar intake, illness, or poor diabetes control. LDL-C usually changes more slowly, often over weeks to months. That is why clinicians often repeat unexpected results before making major decisions, especially when the result does not match the person’s usual pattern.
Risk Assessment and Follow-Up Tests
A lipid panel estimates risk best when combined with other information. Age is a strong driver of short-term cardiovascular risk, but younger adults with high LDL-C can still have high lifetime exposure. Family history can change the meaning of a borderline result. Diabetes, chronic kidney disease, smoking, high blood pressure, inflammatory disease, and prior cardiovascular events can all lower the LDL-C level at which treatment becomes worthwhile.
Clinicians often use cardiovascular risk calculators to estimate 10-year risk. Some guidelines now also consider 30-year risk, especially for younger and middle-aged adults. These tools usually include age, sex, blood pressure, cholesterol values, diabetes, smoking status, and treatment history. Risk calculators are not perfect, but they help avoid interpreting cholesterol numbers in isolation.
Follow-up testing may be useful when the standard lipid panel does not explain the risk clearly. Common add-on tests include:
- ApoB: Measures the number of major artery-forming particles. ApoB can be especially useful when triglycerides are high, diabetes is present, LDL-C is low on treatment, or LDL-C and non-HDL-C do not agree. The separate guide to ApoB testing explains why particle number can add information beyond LDL-C.
- Lipoprotein(a), or Lp(a): A mostly inherited risk marker that can raise heart attack, stroke, and aortic valve disease risk. Many people need this measured only once, because levels are largely genetic. See the guide to Lp(a) testing for more detail.
- LDL particle number or NMR lipoprotein profile: May help when standard cholesterol values and metabolic risk do not match.
- High-sensitivity C-reactive protein: A marker of low-grade inflammation that can refine cardiovascular risk in selected people.
- Hemoglobin A1c or fasting glucose: Useful when triglycerides are high, HDL-C is low, or insulin resistance is suspected.
- TSH: Screens for hypothyroidism, a treatable cause of high LDL-C and sometimes high triglycerides.
- Liver, kidney, and urine testing: Helps identify secondary causes and guides medication safety.
Coronary artery calcium scoring may also be used in selected adults when the decision about medication is uncertain. This CT scan measures calcified plaque in the coronary arteries. A score of zero can suggest lower short-term risk in some people, while higher scores support more intensive prevention. Calcium scoring is not used for everyone, and it does not replace treatment in people with very high LDL-C, established cardiovascular disease, or clear high-risk conditions.
Follow-up timing depends on the situation. If a result is mildly abnormal, a clinician may suggest lifestyle changes and repeat testing in several months. If LDL-C is 190 mg/dL or higher, triglycerides are 500 mg/dL or higher, or the person already has cardiovascular disease, follow-up should be faster and more structured. If medication is started or changed, repeat testing after 4–12 weeks helps confirm response and adherence.
Ways to Improve Lipid Panel Results
Improving a lipid panel usually means lowering LDL-C, lowering non-HDL-C, reducing high triglycerides, and improving the overall risk pattern. The best approach depends on which marker is abnormal.
For high LDL-C, the strongest dietary changes usually involve replacing saturated fats with unsaturated fats and increasing soluble fiber. Saturated fats are found in butter, high-fat dairy, fatty cuts of meat, coconut oil, palm oil, and many baked or fried foods. Unsaturated fats are found in olive oil, nuts, seeds, avocado, and many fish. Soluble fiber from oats, barley, beans, lentils, psyllium, apples, and some vegetables can modestly lower LDL-C by binding bile acids in the gut.
For high triglycerides, the most effective lifestyle changes often differ from LDL-focused advice. Triglycerides respond strongly to alcohol reduction, weight loss when needed, better diabetes control, fewer sugary drinks, fewer refined starches, and more physical activity. People with triglycerides above 500 mg/dL often need a more urgent, medically guided plan. When triglycerides are very high, even healthy high-fat foods may need temporary restriction until levels are safer.
Physical activity can improve triglycerides, HDL-C, insulin sensitivity, blood pressure, and weight maintenance. A practical target for many adults is at least 150 minutes per week of moderate aerobic activity, plus strength training on two or more days weekly. Even walking after meals can help triglyceride and glucose handling.
Weight loss can improve triglycerides and HDL-C quickly in people with excess abdominal fat or insulin resistance. A loss of 5–10% of body weight can produce meaningful changes in triglycerides, blood pressure, glucose, and fatty liver markers for many people. LDL-C may improve too, but the response varies by genetics and diet composition.
Smoking cessation improves HDL-related risk patterns and reduces cardiovascular risk far beyond its effect on the lipid panel. Sleep quality also matters. Short sleep, untreated sleep apnea, and irregular schedules can worsen insulin resistance, weight gain, blood pressure, and triglycerides.
Medication may be appropriate when lifestyle changes are not enough or when risk is high. Statins remain the most common LDL-lowering medicines because they reduce cardiovascular events. Ezetimibe, PCSK9 inhibitors, inclisiran, bempedoic acid, bile acid sequestrants, fibrates, and prescription omega-3 therapies may be used in selected situations. The choice depends on the lipid pattern, risk level, prior cardiovascular disease, triglyceride level, pregnancy plans, side effects, cost, and other medical conditions.
Supplements deserve caution. Some over-the-counter products make strong cholesterol claims but have inconsistent quality or limited outcome evidence. Red yeast rice can act like a low-dose statin but may vary in potency and can cause similar side effects or drug interactions. Fish oil supplements are not the same as prescription omega-3 products used for specific triglyceride or cardiovascular indications. Tell your clinician about any supplement you take, especially before surgery, during pregnancy, or if you use blood thinners.
When to Seek Medical Advice
Mildly abnormal lipid results usually do not require emergency care, but they should not be ignored. The right timing depends on the level, the pattern, and your medical history.
Schedule medical follow-up if LDL-C is 160 mg/dL or higher, especially with family history of early heart disease. Follow up more promptly if LDL-C is 190 mg/dL or higher, because this level can suggest severe hypercholesterolemia or familial hypercholesterolemia. Family members may also need screening if an inherited pattern is suspected.
Contact a clinician promptly if triglycerides are 500 mg/dL or higher. A fasting repeat test, diabetes assessment, medication review, alcohol review, and treatment plan may be needed. Triglycerides near or above 1,000 mg/dL require more urgent attention because pancreatitis risk becomes a major concern.
Seek urgent medical care now if you have symptoms of a heart attack, stroke, or pancreatitis. Concerning symptoms include chest pressure, pain spreading to the arm or jaw, sudden shortness of breath, fainting, sudden weakness on one side, trouble speaking, sudden severe headache, severe upper abdominal pain, persistent vomiting, or abdominal pain that goes through to the back.
People already diagnosed with coronary artery disease, stroke, peripheral artery disease, diabetes, chronic kidney disease, or familial hypercholesterolemia should review lipid results with a clinician rather than relying only on lab flags. Their targets are often lower than standard “normal” ranges.
A lipid panel is a prevention tool. It gives time to act before plaque causes symptoms. The most useful result is not simply “normal” or “abnormal,” but a clear plan: confirm the pattern, identify secondary causes, estimate cardiovascular risk, choose lifestyle steps that match the abnormal marker, and use medication when the expected benefit is strong.
References
- 2026 Guideline on the Management of Dyslipidemia 2026 (Guideline)
- 2025 Focused Update of the 2019 ESC/EAS Guidelines for the management of dyslipidaemias 2025 (Guideline)
- 2024 Guidelines of the Polish Society of Laboratory Diagnostics and the Polish Lipid Association on laboratory diagnostics of lipid metabolism disorders 2024 (Guideline)
- Unraveling the controversy between fasting and nonfasting lipid testing in a normal population: a systematic review and meta-analysis of 244,665 participants 2024 (Systematic Review)
- Lipid Panel Screening for Adults Living With Chronic Conditions 2023 (Review)
- 2021 ESC Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2021 (Guideline)
Disclaimer
A lipid panel should be interpreted with your medical history, medications, family history, and overall cardiovascular risk. Do not start, stop, or change cholesterol or triglyceride medication based only on a single test result without medical guidance. Seek urgent care for symptoms of heart attack, stroke, or pancreatitis, even if your most recent lipid panel was normal.
