How to Tell If You Have High Cholesterol

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Contrary to what some people think, you cannot feel if your cholesterol levels are elevated. As with other conditions like hypertension or diabetes, the lack of symptoms doesn't mean that you are necessarily OK or have less to worry about.

If you ignore high cholesterol (also known as hyperlipidemia, dyslipidemia, or hypercholesterolemia), it could place you at risk of having a heart attack or stroke.

A doctor consulting his patient about high cholesterol
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Heart disease is today the leading cause of death in the United States, accounting for over 610,000 deaths annually, according to the Centers for Disease Control and Prevention (CDC).

High cholesterol is one of the main risk factors for developing heart disease alongside high blood pressure and obesity. Because there are no symptoms of high cholesterol in the vast majority of cases, having it can place you at risk of a cardiovascular event unless you seek a proper diagnosis and the appropriate treatment.

Signs and Symptoms

There are generally no overt signs or symptoms of high cholesterol. If you do have symptoms, they are generally related to the consequences of the disease rather than the disease itself. You ultimately cannot "feel" high cholesterol if you have it.

For example, high cholesterol can lead to hypertension (high blood pressure). If your high blood pressure becomes severe enough, you can experience fatigue, difficulty breathing, headaches, vision problems, irregular heartbeats, and chest pains.

Only in severe cases might high cholesterol lead to a dermatologic condition known as xanthomas. These are waxy deposits that develop as fat begins to leach out of the skin, particularly around the eyes and eyelids. They can also cause small clusters of bumps on the hands, elbows, and knees.

Xanthomas and similar skin symptoms are primarily associated with a genetic form of the disease known as familial hypercholesterolemia.

How to Tell If You High Cholesterol

The only sure-fire way to tell if you have high cholesterol is through a lipid panel. This is a blood test that measures the level of different lipids (blood fats) in a sample of blood, including:

If your total cholesterol, LDL, or triglycerides are high (or your HDL is too low), your healthcare provider may recommend antihypertensive medications, lifestyle changes, or a combination of interventions to help bring your lipids back to a healthy range.

Current guidelines from the American Heart Association (AHA) recommend that people over the age of 20 should have their cholesterol checked at once at least every four to six years.

However, if you have a family history of high cholesterol and have been diagnosed with a chronic condition such as diabetes, you may need to get your lipids checked more frequently.

High cholesterol is found by accident during a routine checkup, and many people are surprised to be diagnosed with high cholesterol when they are otherwise feeling OK.

Risk Factors

Knowing your risk of developing high cholesterol is important. Because you really cannot tell if you have high cholesterol, knowing your risk factors can help you better understand why testing is recommended even for healthy adults starting at age 20. The more risk factors you have, the greater the need and frequency of lipid testing.

Some risk factors for high cholesterol are things that we can change, such as diet and exercise. Others cannot be changed, such as gender, age, or genetics.

If you have any of the conditions listed below, you are at risk of high cholesterol and should be checked if you have not already done so:

The risk of high cholesterol also tends to increase with age due to changes in metabolism, warranting more frequent monitoring of blood lipids as you get older.

Complications

Some people are tempted to ignore their high cholesterol if they feel well. This is not a good idea since persistently high levels could lead to a number of serious complications.

When cholesterol levels are high, fatty deposits can begin to form in blood vessels. This process, referred to as atherosclerosis, can lead to the partial blockage of blood flow.

The narrowing and hardening of blood vessels not only causes blood pressure to rise but also increases the risk of a heart attack or stroke if a fatty plaque suddenly breaks off and completely obstructs blood flow.

In fact, many people do not know they have high cholesterol levels until they have had their first heart attack or stroke. To prevent this, have your cholesterol levels checked at least as often as the AHA recommends and take whatever measures your doctor advises to gain control of your blood lipids.

Frequently Asked Questions

What are the symptoms of high triglycerides?

Most people will not experience any symptoms if they have high triglycerides. However, on rare occasions, excessively high triglycerides (referred to as hypertriglyceridemia) can cause acute pancreatitis. This generally occurs when triglycerides are in excess of 1,000 milligrams per deciliter (mg/dL).

Hypertriglyceridemia-induced acute pancreatitis (HIAP) is believed to occur in people genetically predisposed to the condition. Severe hypertriglyceridemia is otherwise considered rare in the United States, affecting only around 1.7% of adults.

What are the signs of high cholesterol?

Symptoms of high cholesterol are rare. The only exception is a skin disorder called xanthoma in which fatty growths develop under the skin, most commonly on the knees, elbows, hands, and feet.

Xanthomas aren't painful but can cause bumps ranging in size from a pinhead to a grape. Tenderness and itchiness are not uncommon. In some people, there may also be yellowish waxy deposits outside of the skin called xanthelasmas.

As with HIAP, xanthomas and xanthelasmas tend to affect people with genetic forms of hyperlipidemia.

Can I check my cholesterol at home?

Yes, there are an increasing number of home cholesterol testing kits approved for use by the U.S. Food and Drug Administration (FDA). These include test strip kits that require a blood drop, electronic devices that work much like a glucose meter, and mail-in tests that are sent to a lab.

How can I lower my cholesterol?

Certain lifestyle changes can help lower your cholesterol level whether you are on treatment or not. These include:

  • Eating a diet low in saturated fat and trans fat
  • Exercising on most days of the week
  • Losing weight if you are overweight or obese
  • Quitting cigarettes

If these interventions are unable to normalize your cholesterol, cholesterol-lowering drugs like statins can be prescribed.

A Word From Verywell

Feeling healthy is not necessarily the same thing as being healthy. Neither does having fewer risk factors mean that you are unlikely to experience high cholesterol or develop heart disease.

Having a lipid panel is considered a standard part of medical care and something that requires no more than an occasional blood draw. Don't let discomfort or misconceptions keep you from getting tested and accessing treatment if needed.

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