This test is ideal if you have concerns about heart disease, high cholesterol, or if your standard cholesterol test came back normal but you still have cardiovascular risk factors. It measures small dense LDL particles, a specific type of bad cholesterol that's particularly harmful and often missed by regular cholesterol tests. Many people use this test when they want a more comprehensive understanding of their heart health beyond basic lipid panels.
How should I prepare for this test?
Fasting may be required for this test. It's important to ask your doctor whether you should fast prior to testing, as this can affect the accuracy of your results. If fasting is needed, you'll typically be asked to avoid food and drinks (except water) for 9-12 hours before your blood draw.
What's included in this test?
This test measures sdLDL, also known as small dense low-density lipoprotein. This specialized measurement identifies the most dangerous type of LDL cholesterol particles that are small enough to penetrate artery walls easily, increasing your risk for heart disease and stroke. When used alongside standard cholesterol measurements, it provides a more complete picture of your cardiovascular risk and helps guide more targeted treatment strategies.
What happens after I get my results?
You'll receive detailed doctor notes in simple language explaining what your small dense LDL levels mean for your heart health and cardiovascular disease risk. These notes include personalized recommendations like dietary changes to lower harmful cholesterol, exercise guidelines, and supplement suggestions that can help improve your lipid profile. Along with your standard lab report, you can use our trends feature to track your cholesterol levels over time, especially helpful if you're making lifestyle changes or monitoring treatment effectiveness.
Who should consider getting this test?
This test is particularly valuable for people with a family history of early heart disease, those with diabetes or metabolic syndrome, individuals with normal LDL but elevated triglycerides, or anyone whose standard cholesterol test doesn't fully explain their cardiovascular risk. It's also useful for people already on cholesterol medication who want to ensure they're getting optimal protection against heart disease.
What symptoms indicate I may need this test?
While small dense LDL doesn't cause specific symptoms, you should consider this test if you experience chest discomfort during exercise, unexplained shortness of breath, or fatigue that may indicate cardiovascular issues. It's also important if you have risk factors like high blood pressure, being overweight, family history of heart disease, or if you have type 2 diabetes, even without obvious symptoms.
How can I naturally lower my small dense LDL levels?
Reducing small dense LDL starts with cutting back on refined carbohydrates and sugars, which directly increase these harmful particles. Focus on eating more fiber-rich foods like vegetables, legumes, and whole grains, and include healthy fats from fish, nuts, and olive oil. Regular aerobic exercise, losing excess weight, and avoiding trans fats can also significantly reduce small dense LDL levels over time.
What is small dense LDL and why does it matter?
Small dense LDL refers to tiny, compact cholesterol particles that are more dangerous than regular LDL cholesterol because they can easily penetrate and damage artery walls, leading to plaque buildup. Unlike larger, fluffier LDL particles, these small dense particles are more likely to become oxidized and trigger inflammation, significantly increasing your risk of heart attack and stroke. Standard cholesterol tests don't distinguish between particle sizes, which is why you might have normal LDL levels but still be at increased cardiovascular risk.
What does high small dense LDL mean?
High levels of small dense LDL indicate you have a greater number of the most harmful type of cholesterol particles circulating in your blood, which significantly increases your risk for atherosclerosis, heart attack, and stroke. This pattern is often seen in people with insulin resistance, metabolic syndrome, or type 2 diabetes, even when their total cholesterol appears normal. Elevated small dense LDL suggests you need more aggressive management of your cardiovascular risk factors.
How often should I retest my small dense LDL?
If you're making lifestyle changes or starting new treatments to improve your cholesterol, retesting in 3-6 months helps you see if your interventions are working. For those with established cardiovascular disease or diabetes, testing every 6-12 months is common for ongoing monitoring. If your initial results are optimal and you maintain a healthy lifestyle, annual testing may be sufficient to ensure your levels remain in a healthy range.
How’s this work?
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When you’re ready, visit one of our 4,000 locations. Just bring your ID – no printing or faxing of your lab order is needed, as your order and details will already be in the lab system.
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Is it possible to make changes to my lab order if I made a mistake with the name, date of birth, or any other details?
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Only HSA & FSA is accepted.
Our services are strictly self-pay and cannot be submitted to your health insurance provider except for Health Savings Accounts or Flexible Savings Accounts.
This policy applies to all insurance companies, including federal health insurance programs like Medicare.
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During the ordering process, you’ll be able to select a specific lab near you, with no strings attached!
You can switch it up later easily and visit any of our authorized locations as long as it’s the same lab company you selected your test for (Quest Diagnostics or Labcorp).
Before you proceed with your order, feel free to browse through all our lab locations here. This will give you the peace of mind of knowing that there's a lab nearby your home, office or your favorite gym.
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Demo results
Small Dense LDL (sdLDL)42 mg/dL
Demo results
LowOptimal 0 - 30High
42 mg/dL
What this means
Your small dense LDL level is elevated above the optimal range, indicating a higher concentration of the most harmful type of cholesterol particles. These tiny particles can easily penetrate artery walls and contribute to plaque buildup, increasing your risk for heart disease and cardiovascular events even if your total cholesterol appears normal.
Recommended actions
Reduce refined carbohydrates and added sugars, which directly increase small dense LDL production
Increase soluble fiber intake from oats, beans, and vegetables to help lower particle counts
Engage in regular aerobic exercise like brisk walking or cycling for at least 150 minutes per week
Consider omega-3 supplements from fish oil to help shift LDL particles to larger, less harmful sizes
Retest in 3-6 months after implementing dietary and lifestyle changes
* Regular blood test results (e.g., CBC) typically start arriving the next business day after sample collection. More complex tests, such as hormone panels, may take up to 10–15 business days due to their complexity.
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