Cholesterol Tests – non fasting is OK

Tools for Practice this week confirmed that it is unnecessary (? and cruel) to make our patient fast for a cholesterol test.

The differences between fasting and non fasting levels are not clinically significant.

Bottom-line: Minimal differences exist between fasting and non-fasting HDL, LDL, and total cholesterol (TC). Also, non-fasting HDL and non-HDL levels correlate with future CVD events. Therefore, fasting for lipid testing is not required.

The evidence is outlined here.

I wonder how long it will take this recommendation to be commonly adopted. I bet there are still lines at the path lab at 7.30 each morning for years to come.

Tools for Practice is an excellent service provided by the Alberta College of Family Physicians (ACFP). You can sign up at

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