LDL to HDL Cholesterol Ratio
Lipids marker
LDL/HDL Ratio
LDL to HDL Cholesterol Ratio
Calculated ratio of LDL to HDL cholesterol. A higher ratio indicates greater atherogenic risk. Useful as a quick cardiovascular risk assessment.
PED Notes
AAS dramatically worsen this ratio through a dual mechanism: elevating LDL while simultaneously suppressing HDL. Oral 17-alpha-alkylated steroids cause the most severe distortion — ratios of 5-10+ are common on-cycle (vs ideal <2.5). Trenbolone is particularly harsh. Even injectable testosterone at supraphysiological doses worsens this ratio. Post-cycle recovery of this ratio depends primarily on HDL recovery, which can take 3-6 months.
When high
Understanding LDL/HDL Ratio:
- <2.0: Optimal cardiovascular risk
- 2.0-2.5: Near optimal
- 2.5-3.5: Borderline high risk
-
3.5: High risk
-
5.0: Very high risk — common on AAS cycles
Supplements:
- Citrus Bergamot -- 500mg 2x/day (improves both LDL and HDL)
- Omega-3 (EPA/DHA) -- 2-4g/day
- Niacin -- 500-1000mg extended-release (raises HDL, lowers LDL)
Lifestyle:
- Regular cardio 3-5x/week (most effective intervention — improves HDL)
- Increase dietary fibre
- If ratio >5.0 on-cycle, strongly consider shortening cycle or dropping oral AAS
- Monitor recovery post-cycle — ratio should normalise within 3-6 months
Pharmacological options (when supplements insufficient):
- The ratio responds to the same pharmacological stack as its component markers; see LDL, ApoB, and HDL markers for detailed protocols
- Rosuvastatin 5-20mg/day, ezetimibe 10mg/day, bempedoic acid 180mg/day, and PCSK9 inhibitors (alirocumab/evolocumab) lower the numerator
- Discontinuing oral AAS is the most powerful lever on the HDL denominator
- All prescription items require physician oversight and baseline liver/CK panel
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Frequently Asked Questions
Reference Ranges
Standard Range
VitalMetrics Range