LDL Cholesterol Calculator

Three formulas (Friedewald, Martin-Hopkins, Sampson) in mg/dL and mmol/L

Prepared by the Nutricity editorial teamLast updated:

LDL cholesterol is traditionally calculated with the Friedewald formula: LDL = Total Cholesterol − HDL − (Triglycerides / 5), with values in mg/dL.

Calculator

Standard method (TC − HDL − TG/5). Not reliable above triglycerides of 400 mg/dL.

RangeInterpretation
>189Very high
160-189High
130-159Borderline high
100-129Near optimal/above optimal
<100Optimal

LDL cholesterol calculation formula: Friedewald, Martin-Hopkins and Sampson/NIH

LDL is usually not measured directly: it is estimated from the lipid panel (total cholesterol, HDL and triglycerides). All three formulas share the same logic — LDL = total cholesterol − HDL − VLDL cholesterol — but estimate VLDL cholesterol differently.

1. Friedewald (1972)

LDL = total cholesterol − HDL − (triglycerides / 5)  (in mg/dL; in mmol/L the divisor is 2.2).

This is the historic formula, still the most used in laboratories. It assumes a fixed triglyceride-to-VLDL ratio of 5, an assumption that becomes inaccurate when triglycerides are high or LDL is very low.

2. Martin-Hopkins (2013)

Same structure, but the triglyceride divisor is not fixed at 5: it is an adjustable factor picked from a 180-cell table based on non-HDL cholesterol and triglycerides. This makes the estimate more accurate especially with low LDL and high triglycerides.

3. Sampson/NIH (2020)

A closed-form equation developed at the National Institutes of Health, designed to stay accurate even with hypertriglyceridaemia: it is validated up to triglycerides of 800 mg/dL, well beyond the Friedewald limit.

For a complete picture of the atherogenic profile see also non-HDL cholesterol.

Which formula to choose (and when Friedewald breaks down)

The most important limit to know concerns triglycerides. The Friedewald formula is unreliable when triglycerides exceed 400 mg/dL (about 4.5 mmol/L): in those conditions it tends to underestimate LDL, so the calculator does not show the result and prompts you to switch method. This is a check many online calculators skip.

SituationRecommended formula
Standard lipid panel, triglycerides < 400 mg/dLFriedewald (reference method)
Low LDL and/or high triglycerides (up to 400 mg/dL)Martin-Hopkins
Triglycerides between 400 and 800 mg/dLSampson/NIH
Triglycerides > 800 mg/dLDirect LDL measurement

With very high triglycerides it is worth also checking the metabolic picture: see metabolic syndrome, the HOMA-IR index and the TyG index.

How to interpret the result

The table above shows the reference bands used by this calculator. In short (NCEP ATP III classification, mg/dL):

LDL (mg/dL)Category
< 100Optimal
100 – 129Near optimal
130 – 159Borderline high
160 – 189High
≥ 190Very high

Important: the LDL target is personalised to your overall cardiovascular risk: people at high risk (e.g. diabetes, previous heart attack) have lower targets. The result is not a diagnosis and should be interpreted by a doctor.

Why it matters

LDL is the so-called "bad cholesterol": high levels promote atherosclerosis and raise the risk of heart attack and stroke. It is one of the most common reasons for checking a lipid panel, especially with a family history, high blood pressure, diabetes or familial hypercholesterolaemia.

Because weight and metabolism affect the lipid profile, it can help to also check your BMI, your non-HDL cholesterol and your HOMA-IR index.

How the test is done

  • Estimated LDL requires a lipid panel: total cholesterol, HDL and triglycerides.
  • The blood draw is traditionally done after a 9–12 hour fast, mainly for the triglyceride measurement.
  • You can enter the values in mg/dL or mmol/L: select the unit that matches your lab report.

What to do about your result

  • Lifestyle: a diet low in saturated fat, physical activity, weight control and not smoking all lower LDL.
  • Treatment: depending on risk, your doctor may consider medication (e.g. statins). Do not start or stop treatment on your own.

When to see a professional: consult a doctor if your LDL is high, or if you have a family history of cardiovascular disease or other risk factors. Setting the treatment target is the doctor's role.

Limitations of the formulas

  • They are estimates, not a direct measurement of LDL.
  • Friedewald is unreliable with triglycerides above 400 mg/dL or a non-fasting sample, and tends to underestimate LDL when triglycerides are high.
  • Martin-Hopkins is more accurate at low LDL and high triglycerides, but its factor table is validated for triglycerides below 400 mg/dL.
  • Sampson/NIH extends validity up to 800 mg/dL of triglycerides; above that a direct measurement is needed.

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Frequently asked questions

What is a normal LDL cholesterol level?
Under the NCEP ATP III classification, LDL below 100 mg/dL is optimal, 100-129 near optimal, 130-159 borderline high, 160-189 high and 190 mg/dL or more very high. The real target is personalised to your overall cardiovascular risk (people with diabetes or a previous heart attack have lower targets) and should be set by a doctor.
How is LDL cholesterol calculated, and what is the formula?
LDL is estimated from the lipid panel (total cholesterol, HDL and triglycerides). With the Friedewald formula: LDL = total cholesterol − HDL − (triglycerides / 5) in mg/dL (divisor 2.2 in mmol/L). With high triglycerides, Martin-Hopkins or Sampson/NIH are preferable. It is an estimate, not a direct measurement.
Which LDL formula is the most accurate?
It depends on the lipid profile. Friedewald is the reference method with triglycerides below 400 mg/dL, but it tends to underestimate LDL when triglycerides are high or LDL is very low. Martin-Hopkins (JAMA, 2013) is more accurate in those cases, while Sampson/NIH is validated up to 800 mg/dL of triglycerides; above that a direct measurement is needed.
What is the Friedewald formula?
It estimates LDL cholesterol from total cholesterol, HDL and triglycerides. In mg/dL: LDL = total − HDL − (triglycerides / 5); in mmol/L the triglyceride divisor is 2.2.
When is the Friedewald formula unreliable?
When triglycerides exceed 400 mg/dL (about 4.5 mmol/L) or the sample is non-fasting: in those cases it tends to underestimate LDL. That is why the calculator does not show a Friedewald result above that threshold and suggests Martin-Hopkins or Sampson.
What is the difference between Friedewald, Martin-Hopkins and Sampson?
Friedewald uses a fixed divisor (5) to estimate VLDL. Martin-Hopkins uses an adjustable divisor picked from a 180-cell table based on non-HDL and triglycerides, more accurate at low LDL and high triglycerides. Sampson/NIH is a closed-form equation validated up to triglycerides of 800 mg/dL.
Which units can I use?
You can calculate LDL in either mg/dL or mmol/L: just select the unit on your lab report. The calculator applies the correct conversion for each formula.
Does the result replace blood tests or a doctor's opinion?
No, it is an informational estimate that should always be interpreted by a doctor together with the other tests.

Sources

  1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499-502.
  2. Martin SS, Blaha MJ, Elshazly MB, et al. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA. 2013;310(19):2061-2068.
  3. Sampson M, Ling C, Sun Q, et al. A new equation for calculation of low-density lipoprotein cholesterol in patients with normolipidemia and/or hypertriglyceridemia. JAMA Cardiol. 2020;5(5):540-548.
  4. Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2020;41(1):111-188.
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