LDL Cholesterol Calculator
Three formulas (Friedewald, Martin-Hopkins, Sampson) in mg/dL and mmol/L
LDL cholesterol is traditionally calculated with the Friedewald formula: LDL = Total Cholesterol − HDL − (Triglycerides / 5), with values in mg/dL.
| Range | Interpretation |
|---|---|
| >189 | Very high |
| 160-189 | High |
| 130-159 | Borderline high |
| 100-129 | Near optimal/above optimal |
| <100 | Optimal |
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.
| Situation | Recommended formula |
|---|---|
| Standard lipid panel, triglycerides < 400 mg/dL | Friedewald (reference method) |
| Low LDL and/or high triglycerides (up to 400 mg/dL) | Martin-Hopkins |
| Triglycerides between 400 and 800 mg/dL | Sampson/NIH |
| Triglycerides > 800 mg/dL | Direct 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 |
|---|---|
| < 100 | Optimal |
| 100 – 129 | Near optimal |
| 130 – 159 | Borderline high |
| 160 – 189 | High |
| ≥ 190 | Very 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?
How is LDL cholesterol calculated, and what is the formula?
Which LDL formula is the most accurate?
What is the Friedewald formula?
When is the Friedewald formula unreliable?
What is the difference between Friedewald, Martin-Hopkins and Sampson?
Which units can I use?
Does the result replace blood tests or a doctor's opinion?
Sources
- 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.
- 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.
- 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.
- 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.