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Cholestanol-to-Cholesterol Ratio, Serum/Plasma

Published: August 9, 2026Updated: August 16, 2026

A blood test that compares cholestanol with cholesterol to help evaluate disorders of cholesterol and bile acid metabolism.

Quick summary

["An abnormal cholestanol-to-cholesterol ratio may indicate a condition affecting cholesterol or bile acid metabolism."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
74433-4
Short code
Cholestanol/Cholest SFr SerPl
Synonyms
Cholestanol/Cholest SFr SerPl
Category
lipid
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

What is this test?

This test measures the relative amounts of cholestanol and cholesterol in a blood sample. Cholestanol is a cholesterol-related sterol made during bile acid production.

Why might I need this test?

The test may help evaluate suspected disorders of bile acid or sterol metabolism, including cerebrotendinous xanthomatosis. It is usually ordered by a clinician based on symptoms, family history, or other laboratory findings.

How is the test performed?

A blood sample is collected by venipuncture and separated into serum or plasma. A laboratory then measures cholestanol and cholesterol and calculates their relative relationship.

How do I prepare for the test?

Follow the laboratory's instructions regarding fasting and medication use. Some clinicians request fasting when this test is performed with a lipid profile, so ask whether you should avoid food or drinks other than water beforehand.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Cholestanol-to-Cholesterol Ratio

Frequently asked questions

Is this the same as a standard cholesterol test?
No. A standard lipid panel measures total cholesterol and related lipoproteins, while this test specifically compares cholestanol with cholesterol.
Does an abnormal result confirm a rare cholesterol disorder?
No. An abnormal ratio may suggest a problem but does not confirm a diagnosis by itself. Additional laboratory tests and clinical evaluation are usually needed.
Do I need to fast before this test?
It depends on the laboratory's instructions and whether it is being ordered with other lipid tests. Ask your clinician or laboratory before the blood draw.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy