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Why Your Cholesterol Test May Show False High or False Low Levels?

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Cholesterol​‍​‌‍​‍‌​‍​‌‍​‍‌ blood tests are generally reliable if done under the supervision of a healthcare provider, but there might be some rare false-high or false-low results. Sometimes, the test results might be perceived as inaccurate when in reality they are correct due to factors such as the use of medications, lifestyles, or temporary physiological changes being ignored.
Different factors including drinking alcohol, pregnancy, and even problems at the laboratory can change cholesterol test readings. By recognizing these factors, you will be better prepared to give the right information to your doctor, who will then be able to accurately interpret your tests.
This write-up also discusses the reasons behind the inaccuracy of cholesterol test results under certain conditions and points out some of the main diseases and situations that can cause cholesterol levels to go up even if the measurement is correct.

What Do Cholesterol Tests Measure?

Lipid profile or cholesterol test refers to a set of blood tests that evaluate the amount and types of fat molecules your blood contains. The fats tested are:

  • Low-density lipoprotein (LDL) commonly known as “bad” cholesterol, ideally it should be less than 100 mg/dL.
  • High-density lipoprotein (HDL) or “good” cholesterol, levels of at least 60 mg/dL are recommended.
  • Triglycerides, a type of fat that is metabolized for energy, levels should be below 150 mg/dL.
  • Total cholesterol, which is a sum of LDL, HDL, and triglycerides levels, should not exceed 200 mg/dL.

Is Fasting Required for Cholesterol Tests?

New studies suggest that the consumption of food prior to a cholesterol test has little effect on the levels of HDL, LDL, or triglycerides in most individuals. Actually, non-fasting cholesterol tests might even give more accurate LDL results than those obtained through traditional fasting tests.
As a result, waiting is mostly not necessary anymore before a cholesterol test. Still, it is advisable to check with your doctor if you can take the test without fasting.

Causes of Inaccurate Cholesterol Test Results.

Cholesterol test results are designed to help in the diagnosis of diseases, but nothing is perfect, and inaccurate results may go as far as the causes:

Human Error.

Errors can be made in the process of blood withdrawal, labeling, or managing samples. Confirming the patient’s identity along with ensuring that samples are correctly labeled can contribute to the reduction of errors.

Laboratory Equipment Issues.

The instruments used for testing need regular servicing and calibration. In some cases, the equipment which is either faulty or antiquated can give misleading results.

Sample Mix-Ups.

It is very unlikely for patients’ samples to be mislabeled or mixed with each other, but it does happen sometimes. If there is no medical explanation for your abnormally high or low results, then your doctor might request a repeat test to ascertain the accuracy.

When High Cholesterol Results Are Actually Correct?

Sometimes the cholesterol test results may be quite high but they are actually true to what is going on inside your body. You may have one or more of these temporary or permanent factors raising your cholesterol levels:

Medications.

There is a variety of drugs that may raise the cholesterol level, such as corticosteroids, treatments for HIV, and contraceptive pills. Your doctor will assess whether the benefits of these drugs outweigh their potential impact on the cardiovascular system.

Pregnancy.

During pregnancy, the level of cholesterol in the blood increases, and for some time after the baby is born, it can still be high. The cholesterol test results are more trustworthy about four months after the ​‍​‌‍​‍‌​‍​‌‍​‍‌delivery.

Alcohol​‍​‌‍​‍‌​‍​‌‍​‍‌ Intake.

One of the effects of heavy or recent drinking might be the rise of cholesterol and triglyceride levels in the blood. Stay away from alcohol for at least 24 hours if you are going to have a test.

Inflammation or Infection.

Rheumatoid arthritis, lupus, and psoriasis are examples of chronic inflammatory or autoimmune disorders which may affect the cholesterol figures.

Being Underweight.

Extremely thin people suffering from anorexia or the chronically ill are sometimes found to have increased cholesterol levels. The levels usually return to normal when the patient is getting well.

Recent Intense Exercise.

Oniside regular physical activity, while also helping you to control your cholesterol for a good period of time, doing vigorous exercise close to a cholesterol test (within 12–24 hours) can result in a temporary rise in the cholesterol levels.

Genetics.

The majority of people may live even without being aware that they have inherited genetic abnormalities responsible for high LDL and low HDL cholesterol levels regardless of their lifestyle habits. For example, familial hypercholesterolemia (FH) is a genetic disorder that leads to high cholesterol levels throughout life and, in turn, members of that family carry a much higher risk of developing heart disease at a young age.

Key Takeaway.

An unexpected cholesterol test result doesn’t have to be wrong. In fact, your body number will always be the reflection of the complex web of factors coming from your medical condition, lifestyle, and genes. Only by agreeing to be completely open about your health with your doctor will you be able to have your lab work results well interpreted, making it much easier for your doctor to decide on the right treatment or lifestyle ​‍​‌‍​‍‌​‍​‌‍​‍‌change.

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Our team of experts continuously reviews and updates our content as new evidence emerges. See Our Editorial Process

Current Version
Dec 25, 2025

Written By: Nebadita

Dec 25, 2025

Written By: Nebadita

The results from this health calculator are estimates and should not be considered medical advice. Calculations are based on general formulas and may not reflect your unique health needs. Always consult a doctor or certified health professional before making any changes to your fitness, diet, or medication plan. Know More

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This content is based on scientific research and written by experts.

Our team of licensed nutritionists and fitness experts endeavor to be unbiased, objective, honest and to present each sides of the argument.

This article contains scientific references. The numbers in the parentheses (1,2,3) are clickable links to peer-reviewed scientific researches.

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