Total cholesterol is 232..ldl direct is 150..tc/hdl cholesterol ratio is 5.4...do i need medication or is it normal?

A little high: Your cholesterol levels are a little high, particularly an LDL at 150. Whether you need medication depends on things like your lifestyle and medical history, but it probably wouldn't be a bad idea. Maintaining regular physical activity and a diet low in saturated fats can help as well.

Depends on Particles: More than cholesterol, cardiovascular disease (CVD) is related to the number of LDL (LDL-P) and HDL particles (HDL-P). Because cholesterol in LDL and HDL particles is highly variable cholesterol levels often disagree with particle number. When cholesterol and particle number disagree CVD risk tracks with high LDL-P and/or low HDL-P, not LDL-C or HDL-C. Talk to your doctor about next steps.