High cholesterol: Symptoms, causes, diagnosis, diet, prevention

Are you aware of the silent health threat that could be lurking in your body right now? High cholesterol, often undetectable through symptoms alone, poses a significant risk to millions globally. 

This article provides essential knowledge about high cholesterol, including symptoms, causes, diagnosis, prevention, and diet.

Being health-conscious, your actions can play a crucial role in managing this condition.

Here, you’ll find not just information but a guide to making informed decisions for your health and well-being. 

Let’s begin exploring the complex topic of high cholesterol together, ensuring you are well-equipped to take control of your health.

What is cholesterol?

Cholesterol might seem like a health villain, but it’s essential to remember that your body needs it to function correctly. 

It’s a waxy substance found in your blood, crucial for building cells and producing certain hormones. However, not all cholesterol is created equal.

LDL cholesterol: The ‘bad’ cholesterol

Low-Density Lipoprotein (LDL) is often labeled as ‘bad’ cholesterol. Why? 

When there is an excess amount of cholesterol in your blood, it can accumulate on the inner walls of your arteries.

This buildup, known as plaque, narrows arteries and increases heart attack and stroke risks.

HDL cholesterol: The ‘good’ cholesterol

High-Density Lipoprotein (HDL), on the other hand, earns its ‘good’ reputation. It helps transport cholesterol away from your arteries back to the liver, where it’s processed and removed from your body. High levels of HDL are beneficial and can lower the risk of heart disease.

What are the signs of high cholesterol?

One of the most deceptive aspects of high cholesterol is its lack of noticeable symptoms. 

Often termed a ‘silent’ condition, high cholesterol stealthily affects your body without any obvious signs, making it a hidden danger to your health. This is why understanding and identifying potential indicators is so vital.

Although high cholesterol itself does not cause any symptoms, it leads to conditions and physical signs that can be indicative of its presence. Here are some of the potential indicators:


These are fatty deposits that can appear on your skin, especially around the eyes, elbows, knees, or buttocks. Xanthomas are not painful but can be a telltale sign of high cholesterol levels [1].

Corneal Arcus

This condition is characterized by a gray or white arc visible around the cornea of the eye [2]. While more common in older adults, its presence in younger individuals can indicate high cholesterol.

Chest pain or angina

If high cholesterol causes plaque buildup in the arteries, it can limit blood flow and cause chest pain or discomfort, especially during physical activity.

Symptoms of heart attack or stroke

In severe cases, cholesterol buildup in arteries can cause heart attacks or strokes. Immediate medical attention is necessary for symptoms like chest pain, shortness of breath, numbness, weakness, or sudden difficulty speaking.

Symptoms of heart attack or stroke

What are the causes and risk factors of high cholesterol?

Understanding what elevates cholesterol levels is crucial in managing and preventing high cholesterol. 

While some factors are within your control, others, such as genetics, are not. Here’s a deeper look into what influences cholesterol levels:

Genetic predispositions

Heredity plays a significant role in your cholesterol levels. If family members have high cholesterol, you may be more likely to have it, too. 

Conditions like familial hypercholesterolemia, a genetic disorder, can cause extremely high cholesterol levels from a young age [3].

Dietary influences

What you eat has a direct impact on your cholesterol levels. Full-fat dairy products, red meat, and fried foods can increase your LDL (bad cholesterol) levels as they are high in trans fats, saturated fats, and cholesterol. 

Conversely, a diet rich in whole grains, fruits, vegetables, and lean proteins can promote healthier cholesterol levels.

Physical activity

Lack of physical activity may lead to weight gain, potentially elevating LDL (bad cholesterol) levels while decreasing HDL (good cholesterol) levels.

Regular exercise helps improve cholesterol levels by helping to lower LDL and raise HDL.

Smoking and alcohol consumption

Smoking harms your blood vessels, increasing their susceptibility to the buildup of fatty deposits, and can additionally reduce levels of HDL (good cholesterol).

Similarly, excessive alcohol consumption can lead to higher cholesterol levels and other health issues like heart disease.

Other health conditions

Certain conditions can influence your cholesterol levels. For example, diabetes can lower HDL levels and raise LDL and triglycerides. 

Obesity is another key factor; it tends to raise LDL levels, lower HDL levels, and increase total cholesterol.

What happens if cholesterol is too high?

Excessively high cholesterol is a silent but serious threat to your health, carrying consequences that can impact not just the heart but the entire body. 

It’s crucial to recognize these risks to appreciate the importance of managing cholesterol levels.

Atherosclerosis and its complications

The primary concern with high cholesterol is its role in the development of atherosclerosis, a condition where plaque builds up in your arteries. 

This plaque is a buildup of cholesterol, fats, and other substances that can harden and narrow your arteries, leading to restricted blood flow and serious complications.

Coronary artery disease is a complication of atherosclerosis that reduces blood flow to the heart due to narrowed arteries.

This can cause chest pain (angina), and if a blood clot blocks these arteries, it can lead to a heart attack. When atherosclerosis affects arteries leading to the brain, it can cause a stroke.

Increased risk of heart disease and stroke

High levels of LDL cholesterol increase the risk of developing heart disease. This is because the LDL can accumulate in artery walls, leading to plaque buildup.

Stroke risk is also heightened due to narrowed or blocked arteries, which can prevent oxygen-rich blood from reaching parts of the brain.

Peripheral Artery Disease (PAD)

PAD occurs when atherosclerosis affects the arteries that supply blood to your limbs, usually your legs [4]. 

This can lead to symptoms like leg pain when walking and, in severe cases, can result in tissue death requiring amputation.

Impact on overall health and longevity

The effects of high cholesterol go beyond the heart and arteries. It can also influence longevity and quality of life. 

High cholesterol can lead to a reduced life expectancy, primarily due to increased risks of heart attack and stroke.

Furthermore, it can affect your body’s ability to function optimally, impacting daily activities and overall health.

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How is high cholesterol diagnosed?

Diagnosing high cholesterol is a crucial step in averting its associated risks. This process primarily revolves around blood tests and understanding their results. 

Additionally, knowing how often to get tested and the role of healthcare professionals can guide you effectively through this journey.

Blood tests and interpreting cholesterol readings

Cholesterol levels are measured through a blood test known as a lipid panel or lipid profile. 

This test provides readings for total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides (a type of fat in the blood).

Total cholesterol levels under 200 mg/dL are considered desirable. LDL should be under 130 mg/dL, while HDL should be 50 mg/dL or higher [5]. Triglycerides are ideally less than 150 mg/dL [6].

Understanding these numbers is vital as they provide insights into your heart health. Elevated LDL or low HDL levels can increase the risk of heart disease and stroke.

Testing frequency recommendations

Adults aged 20 and older at low risk for heart disease should get their cholesterol checked every 4 to 6 years [7].

People with cardiovascular risk factors like diabetes, high blood pressure, or a family history of heart disease may need more frequent testing [7].

Children and adolescents should also have their cholesterol checked at least once between 9 and 11 and again between 17 and 21, especially if there’s a family history of high cholesterol or heart disease [7].

The healthcare professional’s role

Healthcare professionals are crucial in diagnosing high cholesterol, as they evaluate your test results, medical history, and risk factors to offer a thorough assessment.

They can also guide you through lifestyle changes or medications necessary to manage high cholesterol.

Regular consultations ensure that your cholesterol levels and overall cardiovascular health are closely monitored and managed effectively.

This proactive approach is key to maintaining your heart health and preventing the severe consequences of high cholesterol.

What should you eat and avoid if you have high cholesterol?

Managing high cholesterol often starts on your plate. The foods you choose to eat can have a significant impact on your cholesterol levels and overall heart health.

Here’s a guide to reshaping your diet, focusing on what to limit and what to include, along with a sample plan to get you started.

Foods to limit

  • Saturated fats

Found in red meat, full-fat dairy products, and many baked goods, saturated fats can raise your LDL (bad cholesterol) levels. Limiting these foods is key in cholesterol management.

  • Trans fats

Often present in fried foods, processed snacks, and baked goods, trans fats increase LDL and decrease HDL. Always check food labels for hydrogenated oils – a sign of trans fats.

Foods to eat 

  • Fibers

Soluble fiber, found in oats, beans, lentils, apples, and pears, can help lower LDL levels. Aim for at least 25 to 30 grams of fiber per day.

  • Omega-3 fatty acids

These heart-healthy fats, found in fatty fish like salmon, mackerel, and sardines, can help lower triglycerides and improve heart health.

  • Nuts and seeds

Almonds, walnuts, and flaxseeds are rich not only in nutrients but also in good fats that can help reduce cholesterol.

  • Fruits and vegetables

Rich in vitamins, minerals, and fibers, various fruits and vegetables can aid in cholesterol control.

fruits and vegetables
Photograph: wirestock/Envato

Sample diet plan

  • Breakfast: Oatmeal topped with berries and almonds.
  • Lunch: Grilled salmon salad with mixed greens, avocado, and olive oil dressing.
  • Dinner: Stir-fried vegetables with tofu or chicken, served with brown rice or quinoa.
  • Snacks: Apple slices with peanut butter or a handful of walnuts.

What should you do if you have high cholesterol?

Adopting a healthy lifestyle is crucial in preventing and managing high cholesterol. It’s not just about what you eat; it’s also about staying active, quitting smoking, moderating alcohol intake, and managing stress. 

Each of these elements plays a significant role in maintaining healthy cholesterol levels and overall heart health.

Exercise guidelines and their effects on cholesterol

Regular physical activity can help improve cholesterol levels by raising HDL (good cholesterol) and lowering LDL (bad cholesterol) and triglycerides.

According to the American Heart Association, it’s recommended to engage in either 150 minutes of moderate-intensity aerobic workouts or 75 minutes of vigorous-intensity aerobic exercises each week, complemented by muscle-strengthening exercises on two or more days [8].

Activities like brisk walking, cycling, swimming, and jogging can significantly benefit your heart health.

Benefits of quitting smoking and moderating alcohol intake

Smoking lowers HDL cholesterol and damages blood vessels, increasing the risk of atherosclerosis. Quitting smoking can rapidly improve your HDL levels and overall cardiovascular health.

Limiting alcohol to one drink per day for women and two for men is generally advised [9].

Chronic stress may indirectly influence cholesterol levels by affecting your habits. Stress can lead to unhealthy eating, increased smoking, or neglecting exercise, all of which can raise cholesterol.

Techniques like meditation, yoga, regular exercise, and adequate sleep can help manage stress. 

Finding healthy ways to cope with stress ensures you don’t resort to habits that negatively impact cholesterol levels.

Is medication necessary for managing high cholesterol?

While lifestyle changes are fundamental in managing high cholesterol, sometimes they might not be enough, and medical treatment becomes necessary. 

Understanding the role of common medications, when they’re needed, and their potential side effects is essential for effective cholesterol management.

Common medications and their roles


These are the most commonly prescribed medications for high cholesterol. Statins work by reducing liver production of cholesterol, thereby lowering LDL (bad cholesterol) and slightly raising HDL (good cholesterol). Examples include atorvastatin, simvastatin, and rosuvastatin.

Bile acid sequestrants

These drugs help lower cholesterol indirectly by binding to bile acids, leading your liver to use excess cholesterol to make more bile acids, which reduces cholesterol levels in the blood [10].

Cholesterol absorption inhibitors

Ezetimibe is a well-known drug in this category that works by reducing the amount of cholesterol absorbed by the intestines [11].

Criteria for medication necessity

The decision to start medication typically depends on your overall risk of heart disease. 

This includes factors like age, blood pressure, smoking status, and whether you have diabetes or a family history of heart disease.

Your doctor will also consider your LDL cholesterol levels and the effectiveness of lifestyle modifications before prescribing medication.

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Potential side effects and medication adherence

While medications like statins are generally safe, they can have side effects. Common ones include muscle aches, digestive problems, difficulty sleeping, headaches, and more [12].

Rarely, statins can cause more serious side effects like liver damage or memory loss. It’s important to discuss these risks with your healthcare provider.

Adherence to medication is crucial for its effectiveness. Skipping doses or stopping medication can cause your cholesterol levels to rise again, increasing the risk of heart disease.

Regular check-ups and blood tests are important to monitor the effectiveness and side effects of the medication.

Medical treatments for high cholesterol can be highly effective, especially when combined with lifestyle changes. 

It’s important to have open and ongoing discussions with your healthcare provider about the best treatment plan for your individual needs.

Are supplements safe and effective for high cholesterol?

In the quest to manage high cholesterol, many turn to supplements, drawn by their natural appeal and the desire for a non-pharmaceutical solution. 

Understanding their efficacy, safety, and how they interact with traditional medications is crucial before incorporating them into your cholesterol-lowering strategy.

Omega-3 fatty acids

Found in fish oil, these supplements are known for their heart health benefits, particularly in lowering triglycerides.

Plant sterols and stanols

These substances, which resemble cholesterol, are found in small amounts in many fruits, vegetables, nuts, and grains. Supplements can block the absorption of cholesterol in the intestine [13].

Fiber supplements

Options like psyllium and methylcellulose can help lower LDL cholesterol by binding with cholesterol in the digestive system and removing it from the body.

Red yeast rice

This has been used in traditional Chinese medicine and contains substances similar to statins, potentially helping to lower cholesterol levels [14].

Efficacy and safety concerns

While some supplements show promise in lowering cholesterol levels, their efficacy can vary. 

For instance, red yeast rice can lower cholesterol but carries risks similar to statins, including potential liver damage.

The quality and concentration of active ingredients in supplements can also vary significantly, raising concerns about their consistency and safety.

Interaction with traditional medications

Supplements can interact with prescribed medications, potentially leading to adverse effects. 

For example, red yeast rice should not be taken with statin drugs as it can increase the risk of harmful side effects [15].

Before starting any supplement, it’s essential to consult with your healthcare provider. They can advise on the appropriateness of such supplements in your cholesterol management plan, considering your overall health, existing conditions, and current medications. 

Remember, supplements should complement, not replace, conventional treatments and lifestyle changes.

How can I effectively manage my life with high cholesterol?

Living with high cholesterol requires a comprehensive, long-term strategy that encompasses lifestyle adjustments, regular health monitoring, and adherence to treatment plans. 

Managing this condition is not just about temporary fixes but about sustainable health practices that become a part of your everyday life.

Strategies for long-term cholesterol management

  1. Incorporate a heart-healthy diet. This means plenty of fruits, vegetables, whole grains, and lean proteins while limiting saturated and trans fats.
  2. Be consistent with physical activities. Regular exercise helps lower LDL cholesterol and raise HDL cholesterol. Find an activity you enjoy, and make it a part of your routine, aiming for at least 30 minutes of moderate exercise most days of the week.
  3. Manage your weight. Maintaining a healthy weight can significantly improve cholesterol levels and overall heart health. Even a modest weight loss can have a positive impact.

Regular health check-ups and monitoring

Regular check-ups with your healthcare provider are vital. These appointments are opportunities to assess your cholesterol levels, discuss any concerns, and make necessary adjustments to your treatment plan.

Monitoring your cholesterol levels through recommended blood tests will help track your progress and the effectiveness of your management strategies.

Adhere to lifestyle changes and treatment plans

Consistency is key. Adhering to the lifestyle changes you’ve implemented is crucial for long-term management.

If medication is part of your treatment plan, take it as prescribed. Medication non-adherence can lead to worsening cholesterol levels and increased risk of cardiovascular disease.

Closing thoughts

Managing high cholesterol is a vital aspect of safeguarding your heart health and overall well-being. 

By understanding its causes, recognizing symptoms, and implementing effective lifestyle changes, dietary adjustments, and medical treatments, you can significantly reduce risks and improve your quality of life. 

Regular check-ups and a commitment to your health plan are key. Remember, each step you take, whether it’s adjusting your diet, increasing physical activity, or adhering to medication, is a positive stride toward a healthier heart. 

Your proactive approach today paves the way for a healthier tomorrow.


How to reduce cholesterol fast?

To rapidly reduce cholesterol, adopt a diet rich in fiber and omega-3 fatty acids while eliminating trans and saturated fats. Additionally, engage in regular exercise, quit smoking, and, if prescribed by a doctor, take cholesterol-lowering medications.

What foods lower cholesterol fast?

Foods that can quickly lower cholesterol include oatmeal, fish rich in omega-3 fatty acids, almonds and walnuts, avocados, and fruits like apples and berries, which are high in soluble fiber. Incorporating these into your diet can effectively reduce cholesterol levels.

What should I drink daily to reduce cholesterol?

Drinking green tea daily can help lower cholesterol due to its antioxidants, while plant sterol-fortified orange juice also aids in reducing LDL cholesterol levels. These beverages, along with ample water, support a cholesterol-lowering diet.

Can drinking water lower high cholesterol?

Drinking water itself doesn’t directly lower cholesterol, but staying well-hydrated supports overall metabolism and weight management, which can contribute to maintaining healthier cholesterol levels. Adequate hydration also aids in the effective functioning of bodily processes that regulate cholesterol.

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[1] https://www.mountsinai.org/health-library/diseases-conditions/xanthoma
[2] https://my.clevelandclinic.org/health/symptoms/24243-arcus-senilis
[3] https://www.cdc.gov/genomics/disease/fh/FH.htm
[4] https://www.cdc.gov/heartdisease/PAD.htm
[5] https://www.ncbi.nlm.nih.gov/books/NBK279318/
[6] https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lipid-panel 
[7] https://www.cdc.gov/cholesterol/cholesterol_screening.htm 
[8] https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults 
[9] https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-heart-health-separating-fact-from-fiction
[10] https://www.sciencedirect.com/topics/medicine-and-dentistry/bile-acid-sequestrant
[11] https://www.ncbi.nlm.nih.gov/books/NBK532879/
[12] https://www.nhs.uk/conditions/statins/side-effects/
[13] https://www.bda.uk.com/resource/food-facts-plant-stanols-and-sterols.html
[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822657/
[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500871/

Photograph: Joyseulay/envatoelements
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