Health Assessment Report
ExampleGeneral checkup · 13 biomarkers
Patient details
- Name
- Daan Willemsen
- Gender
- Man
- Age
- 44 years
- Date of birth
- 14-05-1982
Test details
- Test Date
- 06-07-2026
- Report date
- 09-07-2026
- Location
- Utrecht Oost
- Laboratory
- Star-SHL
13
Total Markers
7
In Range
6
Needs Attention
Overall Assessment
Your General checkup shows a mixed picture. Nine of the thirteen values tested fall within the reference range. Four values need attention: your cholesterol profile is elevated, your fasting glucose is slightly high, your vitamin D is low and your hsCRP sits just above the cutoff.
Together these results point to an elevated metabolic risk. That responds well to diet, movement and a follow-up check where needed.
Key Findings
Cholesterol profile elevated
AttentionYour total cholesterol is 6.3 mmol/L, your LDL 4.2 mmol/L and your triglycerides 2.1 mmol/L. All three sit above the reference value. Your HDL, at 1.3 mmol/L, is normal.
Fasting glucose slightly high (6.2 mmol/L)
AttentionJust above the upper limit of 6.0 mmol/L. This can point to reduced glucose tolerance, especially alongside the cholesterol profile above.
Vitamin D low (52 nmol/L)
AttentionBelow the target of 75 nmol/L. This is very common in the Netherlands, especially outside the summer months.
hsCRP slightly high (3.4 mg/L)
AttentionJust above the cutoff of 3.0 mg/L. This value is sensitive to low-grade inflammation and fits the risk profile the other values also show.
Thyroid, liver and kidneys in order
GoodTSH, ALT and eGFR all sit comfortably within the reference range. There is no sign of a thyroid, liver or kidney problem.
Detailed Analysis
Vitamins
AttentionYour vitamin D is 52 nmol/L, below the target of 75. Your vitamin B12, at 410 pmol/L, is well sufficient.
Vitamin D is made mainly in the skin through sunlight. Outside the summer months that is barely possible in the Netherlands, which makes a lower value very common. Vitamin D plays a role in bone strength, muscle function and the immune system.
Minerals
NormalYour ferritin is 145 µg/L and falls within the usual range. There is no sign of an iron shortage or surplus.
Hematology
NormalYour hemoglobin is 9.6 mmol/L and falls within range. There is no anemia.
Heart & Vessels
AttentionYour total cholesterol is 6.3 mmol/L, well above the limit of 5.0. Your LDL is 4.2 mmol/L, above the limit of 3.0, and your triglycerides are 2.1 mmol/L, above the limit of 1.7. Your HDL, at 1.3 mmol/L, is normal.
This combination fits an elevated long-term risk of cardiovascular disease. Diet and movement usually have the biggest effect here.
Thyroid
NormalYour TSH is 2.1 mU/L. That sits in the middle of the 0.27 to 4.20 reference range and fits a normally functioning thyroid.
Metabolism
AttentionYour fasting glucose is 6.2 mmol/L, just above the upper limit of 6.0. One measurement is not yet a diagnosis, but combined with the cholesterol profile it is a signal worth watching.
Inflammation
AttentionYour hsCRP is 3.4 mg/L, just above the cutoff of 3.0. This test is more sensitive than standard CRP and is used to detect low-grade inflammation.
Liver
NormalYour ALT is 28 U/L, comfortably within range. This enzyme is released when liver cells are damaged; a normal value fits a healthy liver.
Kidneys
NormalYour eGFR is 94 mL/min/1.73m². This is a calculated measure of how much blood your kidneys filter per minute, and this value is normal for your age.
Recommendations
Work on your cholesterol profile
Less saturated fat, more fiber and regular movement have the biggest combined effect on cholesterol and triglycerides. Have your profile retested after three to six months to see if it is working.
Top up your vitamin D
Take 25 to 50 micrograms (1000 to 2000 IU) of vitamin D3 daily, with a meal that contains some fat, which improves absorption. Retest the value after three months.
Keep an eye on your fasting glucose
One slightly elevated reading is not diabetes. Movement and fewer fast carbohydrates often help already. Bring the value along to your next checkup.
Retest after three to six months
Cholesterol, glucose and hsCRP respond to diet and movement within a few months. A follow-up check shows whether the approach is working.
Next Steps
There is no reason to rush. Start with the changes to your diet and movement, and have your cholesterol, glucose, hsCRP and vitamin D retested after three to six months.
Contact your GP if you are unsure about the results, or if new symptoms appear. This report does not replace a consultation.
Your Test Results
Cardiovascular
2What It Measures
Cholesterol does not dissolve in blood, so it travels packaged inside lipoproteins: spheres with a fatty core and a protein coat. HDL stands for high-density lipoprotein, the smallest and densest type. The test does not measure those particles themselves, but the amount of cholesterol inside them. That distinction matters more than it looks: the result tells you something about the cargo, not about the number of particles and not about how well they do their job. HDL particles are the collection service of cholesterol transport. They take cholesterol up from cells around the body, including the foam cells in an early plaque in the artery wall, and deliver it to the liver, which disposes of it through the bile. This is called reverse cholesterol transport, and it is why a high HDL was seen as protective for decades. In the Netherlands the result is reported in mmol/l. Unlike LDL, the laboratory prints only a lower limit here, no upper limit, and that lower limit differs by sex: 1.0 mmol/l for men and 1.2 mmol/l for women. The difference is physiological. Oestrogen gives women a higher average HDL, so the bar sits higher for them. The practical consequence: a value of 1.1 mmol/l is normal in a man and too low in a woman. Do not simply compare your number with your partner's. One relationship you need to know in order to read the result: HDL moves inversely with triglycerides. A transfer protein swaps cholesterol out of the HDL particles in exchange for triglycerides from the fat-rich particles. The HDL particle ends up loaded with triglycerides, loses cholesterol and is cleared faster. Anyone with a lot of triglycerides in the blood is therefore left with a low HDL almost automatically. In practice a low HDL is rarely a stand-alone problem; it is usually the shadow of a raised triglyceride value and of the insulin resistance behind it. You do not need to fast for an HDL test. HDL barely changes after a meal, unlike triglycerides.
Lifestyle Tips
Start with the honest message: HDL is not a value you should try to push up directly. The trials in which HDL was raised substantially with drugs did not reduce cardiovascular events. An HDL number that goes up without anything changing in the underlying metabolism gains you nothing. So treat HDL as a yardstick for your metabolic health, and direct your effort at what genuinely improves that health. HDL rising along with it is a pleasant by-product, not a goal. What demonstrably helps: <ul><li><strong>Stopping smoking.</strong> Smoking lowers HDL, and the value recovers after quitting. It is also by far the measure with the largest gain for your cardiovascular risk.</li><li><strong>Less abdominal fat.</strong> Visceral fat and insulin resistance are the main reason HDL drops. Weight loss raises HDL modestly and lowers triglycerides at the same time.</li><li><strong>Endurance training.</strong> Regular aerobic exercise genuinely raises HDL, but modestly: meta-analyses put it at roughly 0.05 to 0.1 mmol/l, built up over months. Duration per session weighs more heavily than intensity.</li><li><strong>Fewer fast carbohydrates and less alcohol.</strong> Both lower your triglycerides, and because HDL moves inversely with triglycerides, your HDL comes up along with it.</li></ul> One thing not to do: drink alcohol in order to raise your HDL. Alcohol does raise the value, but that is a cosmetic effect without health gain, and the downsides of alcohol far outweigh it. If you use androgens or anabolic agents, that is by far the strongest influence on your HDL, and it is an unfavourable one. Discuss it openly with your doctor. And finally: never change anything about cholesterol-lowering medication on your own initiative on the basis of an HDL result. That medication targets LDL and ApoB, not HDL.
What It Measures
LDL stands for low-density lipoprotein, a particle that carries cholesterol through the blood. The LDL cholesterol result tells you how much cholesterol sits inside all of those particles together. It is a measure of cargo, not of particle number; that number is better approximated by non-HDL cholesterol and apolipoprotein B. What most people do not know is that LDL is rarely measured in a routine lipid panel. It is calculated. The classic Friedewald equation subtracts HDL from your total cholesterol and then subtracts the cholesterol sitting in the triglyceride-rich particles: LDL = total cholesterol minus HDL minus triglycerides divided by 2.2, with everything in mmol/l. That divisor of 2.2 is a fixed assumption about the ratio between triglycerides and VLDL cholesterol. The assumption is what makes a lipid panel cheap, and it is also the reason an LDL result can simply be wrong. The equation fails in four predictable ways. <table><thead><tr><th>Situation</th><th>What happens to the calculated LDL</th></tr></thead><tbody><tr><td>Triglycerides above roughly 4.5 mmol/l</td><td>The equation is no longer valid; most laboratories will not report a calculated LDL at all</td></tr><tr><td>A low LDL together with raised triglycerides</td><td>The equation underestimates LDL, precisely in treated high-risk people who can least afford an underestimate</td></tr><tr><td>A non-fasting sample</td><td>The meal raises triglycerides, and that rise feeds straight into the division</td></tr><tr><td>Type III dysbetalipoproteinaemia</td><td>The fixed triglyceride-to-VLDL ratio does not hold in this rare disorder, which makes the result unusable</td></tr></tbody></table> More accurate alternatives exist. The Martin-Hopkins method replaces the fixed divisor with a factor that varies with a person's own triglycerides and non-HDL. The Sampson-NIH equation holds up to roughly 9 mmol/l of triglycerides. There is also a direct LDL assay, which measures the cholesterol in LDL particles itself and therefore does not depend on triglycerides; direct assays are, however, less well standardised between manufacturers, so two laboratories can report different numbers for the same blood. So always know which kind of number you are holding. A calculated LDL is no more reliable than the three values it was built from.
When Levels Are High
A high LDL does not hurt and causes no symptoms. That is exactly what makes it dangerous: the damage to the artery wall builds up silently over years to decades, and the first noticeable sign can be a heart attack or a stroke. Anyone waiting for symptoms is waiting for the complication. There is one exception. With very high, inherited values, visible cholesterol deposits can develop over time: thickening of the Achilles tendon or of the tendons on the back of the hand, yellowish patches around the eyelids, or a grey-white ring around the cornea at a young age. Signs like these are a reason to see a doctor promptly, but they are absent in most people with a raised LDL. Beyond that: chest pain, chest pressure or sudden breathlessness never belong with a blood test. With those symptoms you call the emergency number.
Lifestyle Tips
Start with the cause, not with the diet. If your LDL has risen unexpectedly, have an underlying cause ruled out first, with the thyroid at the top of the list. Only then does a conversation about food make sense. The biggest effect on LDL comes from the type of fat in your diet, not the amount. Replacing saturated fat, meaning butter, hard cooking fats, fatty meat and full-fat dairy, with unsaturated fat from vegetable oils, nuts, seeds and oily fish measurably lowers LDL. Swapping saturated fat for fast carbohydrates instead does not produce that effect. Soluble fibre helps as well: oats and barley, pulses, fruit and vegetables bind bile acids in the gut, which makes the liver pull more cholesterol out of the blood. Plant sterols and stanols, added to some margarines and dairy products, also lower LDL; discuss with your doctor or pharmacist whether that makes sense in your situation. Exercise and weight loss mainly improve your triglycerides and your HDL and usually lower LDL only modestly. They remain worthwhile, because your risk is determined by more than one number. Stopping smoking does not lower LDL, but it lowers your cardiovascular risk faster than anything else you can do. One firm boundary to close on: never adjust lipid-lowering medication on your own, and do not stop it after a favourable self-ordered result. That result is often favourable precisely because of the medication.
Heart & Vessels
2Hematology
1Inflammation
1Kidneys
1Liver
1Metabolism
1Minerals
1Thyroid
1Vitamins
2Assessed by a BIG-registered doctor
This report was prepared by a BIG-registered doctor. It does not replace a personal medical consultation. Always consult your general practitioner if you have questions.