Other names: vLDL-C, Very Low Density Lipoprotein (VLDL), VLDL, CALCULATED
VLDL (Very-Low-Density Lipoprotein) is a type of lipoprotein made by your liver. Its primary job is to carry triglycerides, a form of fat, through the bloodstream to your tissues where they are either used for energy or stored as fat. Like LDL (low-density lipoprotein), VLDL is often referred to as "bad cholesterol" because elevated levels contribute to plaque buildup in the arteries, a condition known as atherosclerosis.
Although both VLDL and LDL are considered atherogenic (they promote plaque formation), they differ in what they carry:
VLDL transports mostly triglycerides
LDL carries mostly cholesterol
Both are formed from the breakdown of lipoproteins in the liver and are necessary for normal body function, but in excess, they increase the risk of heart disease and stroke.
VLDL cholesterol (VLDL-C) refers to the amount of cholesterol found within VLDL particles. These particles are essential for:
Energy delivery to cells
Storing fat for later use
Regulating blood pressure and other body functions
However, too many VLDL particles can overwhelm the body, contributing to plaque buildup in the arteries and increasing the risk of cardiovascular disease.
There is no direct test for VLDL-C. Instead, VLDL is typically estimated from triglyceride levels using the formula:
VLDL-C (mg/dL) ≈ Triglycerides ÷ 5
This estimate is included in most lipid panels ordered during routine blood work. Your doctor may specifically look at VLDL if you have abnormal cholesterol levels or risk factors for heart disease.
Normal VLDL-C: Less than 30 mg/dL
Elevated VLDL-C: 30 mg/dL or higher
High VLDL levels suggest elevated triglycerides and a greater risk for atherosclerosis and other cardiovascular conditions.
Elevated VLDL levels are often the result of:
Diets high in saturated fat, sugar, or refined carbs
Excessive alcohol consumption
Obesity or being overweight
Sedentary lifestyle
Type 2 diabetes or insulin resistance
Hypothyroidism
Certain medications (e.g., beta blockers, steroids)
Genetic lipid disorders
If your VLDL is high, you may be at greater risk for cardiovascular disease, especially if you also have:
High LDL ("bad") cholesterol
Low HDL ("good") cholesterol
High blood pressure
Diabetes or prediabetes
Family history of heart disease
Smoking
Physical inactivity
Poor diet
Your healthcare provider may recommend additional tests to assess cardiovascular risk:
Lipid panel (Total cholesterol, LDL-C, HDL-C, Triglycerides)
Electrocardiogram (ECG)
Echocardiogram
Stress test
Cardiac catheterization
Atherosclerosis occurs when cholesterol, triglycerides, and other substances build up inside your artery walls, forming plaques. These plaques narrow the arteries, restrict blood flow, and increase the risk of:
Heart attacks
Strokes
Coronary artery disease
Peripheral artery disease
Aortic aneurysms
When VLDL levels are elevated, the breakdown products (called remnant particles) can be especially harmful because they easily become trapped in artery walls, intensifying plaque growth.
Triglycerides are a type of fat used to store excess energy from food. VLDL particles carry triglycerides through the bloodstream. When you eat more calories—especially from sugar and refined carbs—than your body burns, these calories are converted into triglycerides and stored in fat cells.
High triglyceride levels are linked to:
Plaque buildup in arteries
Inflammation
Metabolic syndrome
Nonalcoholic fatty liver disease (NAFLD)
The American Heart Association recommends that adults age 20 and older have their cholesterol checked every 4 to 6 years if risk is low, and more frequently if:
You have cardiovascular risk factors
You’re being treated for high cholesterol
You’ve already had a heart attack or stroke
VLDL cholesterol is a type of "bad" cholesterol that carries triglycerides in the blood.
High VLDL levels can contribute to plaque buildup, increasing your risk of heart disease and stroke.
VLDL is estimated using your triglyceride level, usually part of a standard lipid panel.
Lifestyle changes—like a healthy diet, regular exercise, and weight loss—are the first line of defense.
In some cases, medications like statins, fibrates, or omega-3 fatty acids may be recommended.
Balling M et al. J Am Coll Cardiol. 2020;76(23):2725-2735.
Ginsberg HN et al. Eur Heart J. 2021;42(47):4791-4806.
Grundy SM et al. J Am Coll Cardiol. 2019;73(24):e285-e350.
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Elevated VLDL (very-low-density lipoprotein) cholesterol levels indicate that there is an excessive amount of triglyceride-rich lipoproteins circulating in the blood. This condition often reflects a metabolic imbalance and is typically associated with high triglyceride levels, poor diet, lack of physical activity, obesity, type 2 diabetes, insulin resistance, hypothyroidism, excessive alcohol consumption, and certain medications such as corticosteroids or beta blockers. Elevated VLDL contributes to the buildup of plaque inside arteries—a process called atherosclerosis—which narrows and hardens the blood vessels, increasing the risk of heart attack, stroke, coronary artery disease, and peripheral artery disease. When VLDL levels are high, the body may also generate excess LDL ("bad") cholesterol and cholesterol-rich remnant particles, both of which further drive plaque formation and vascular damage. The combination of high VLDL and LDL levels is particularly dangerous and can accelerate cardiovascular complications. Because VLDL is not measured directly, it is estimated from triglyceride levels during a routine lipid panel. A VLDL cholesterol level above 30 mg/dL is generally considered elevated. Managing high VLDL involves addressing the root causes through lifestyle changes—such as reducing intake of sugars and saturated fats, increasing physical activity, quitting smoking, limiting alcohol, and managing blood sugar and thyroid function. In some cases, lipid-lowering medications like statins, fibrates, or omega-3 fatty acids may be prescribed. Regular monitoring of lipid levels is essential to assess progress and reduce long-term cardiovascular risk.
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Laboratories do not report a level of VLDL that is too low. Nevertheless, chronic infections and certain autoimmune diseases can cause very low triglyceride levels and, in turn VLDL-C levels. In rare cases, low VLDL is caused by a genetic condition. It is also possible that they are experiencing a severe disease such as cancer or severe anemia. Low VLDL levels do not cause symptoms on their own, but the disease that is causing the low VLDL will cause its own, specific symptoms.
Some specific causes of a low VLDL are:
- Hereditary abetalipoproteinemia
- Hypobetalipoproteinemia
- HIV/AIDS
- Hepatitis (chronic, active hepatitis B, hepatitis C)
- Hyperthyroidism
- Malnutrition and undernutrition
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
Karin
Advanced Plan Member since 2020
What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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