Why Is My Cholesterol High?

High cholesterol can be a result of your diet and lifestyle, genetics, or some of both. It can be hard to tell if you have high cholesterol because it doesn't come with any symptoms. Having high cholesterol levels can increase your risk of a heart attack, stroke, and other conditions. In this article, we'll discuss the causes and treatments for high cholesterol and how you can lower your risk of developing it.

What Is High Cholesterol?

Cholesterol is a fatty molecule that your cells need to function. Your liver makes it, but you can also get cholesterol from the foods you eat.

The term high cholesterol usually refers to the amount of cholesterol being carried in the blood by low-density lipoprotein, or LDL (often called "bad cholesterol"). High LDL levels increase your risk of atherosclerosis, where deposits of cholesterol, calcium and white blood cells produce plaques in the walls of arteries. These plaques can reduce blood flow to vital organs like the heart and brain, and produce serious complications like heart attack and stroke.

Why Is My Cholesterol High?

There can be many reasons why your cholesterol is high:

• Genetics: Certain conditions can increase cholesterol levels in your body. Liver diseases and familial hypercholesterolemia—a hereditary form of high cholesterol—can make it hard for your body to get rid of extra cholesterol. While the liver makes cholesterol in your body, it also recycles and removes cholesterol from the body. When your liver isn't working properly or when genetic mutations disrupt this process, too much cholesterol can build up in your body.
• Diet: Cholesterol enters our bodies through the foods we eat, specifically from animal products and foods high in saturated fats, such as meat, cheese, milk, and butter. If you eat too much of these foods, it can increase the cholesterol level in your blood to unhealthy levels.
• Smoking: Smoking can restrict blood flow through your vessels and make them stiff. On top of this, smoking can lead to the destruction of "good" cholesterol, or HDL cholesterol, which helps break down bad cholesterol and balance out levels in your body.
• Other conditions: There are a number of conditions like high blood pressure, diabetes, and thyroid disorders that can contribute to high cholesterol. Talk to your doctor about other conditions you have and the medications you take and how they may affect your cholesterol levels.

Signs and Symptoms of High Cholesterol

High cholesterol on its own doesn't usually cause symptoms. People often don't realize they have high cholesterol until they get tested. However, the complications that high cholesterol causes do. As arteries and other blood vessels narrow and blood flow is slowed or stopped, every part of your body can be affected.

Uncontrolled high cholesterol can lead to the following complications:

• Atherosclerosis, which is a buildup of fatty deposits in your blood vessels
• Carotid artery disease, which is narrowing of the blood vessels in the neck that carry blood from the heart to the brain
• Coronary heart disease, which is damage or disease in the heart's major blood vessels
• Heart attack
• Peripheral artery disease, which is narrowing or blockage of the vessels that carry blood from the heart to the legs
• Stroke

Symptoms of these complications can include:

• Dizziness
• Chest pain
• Shortness of breath
• Circulation problems
• Slow wound healing
• Ulcers or open sores
• Muscle cramps
• Discoloration of your skin
• Confusion
• Loss of balance
• Weakness
• Fatty deposits of cholesterol visible from under the skin called xanthelasmas

Diagnosis of High Cholesterol

In most cases, your doctor will find your high cholesterol through routine screening. A lipid panel usually measures total cholesterol, LDL cholesterol, and HDL cholesterol.

Your doctor may order other tests to help decide whether medicines are needed to lower your risk of heart and blood vessel diseases. These may include a coronary calcium scan, which uses computed tomography (CT) to detect calcium deposits in the arteries of your heart, and blood tests for levels of C-reactive protein (CRP) and lipoprotein-a.

The American Heart Association recommends routine cholesterol screening for all adults after age 20, but your doctor may order lipid tests more often based on your individual and family risk.

Your doctor will ask about your eating habits, physical activity, family history, medicines you are taking, and risk factors for heart or blood vessel diseases. During your physical exam, your doctor will check for signs of very high blood cholesterol, such as xanthomas, or signs of other health conditions that can cause high blood cholesterol.

Treatment for High Cholesterol

Lifestyle changes are one of the first things your doctor will recommend for managing high cholesterol. All medications can cause side effects, including medications to lower your cholesterol, and many people can successfully lower their cholesterol without them. Your doctor will determine which treatment approach is best for you.

Lifestyle changes that can help lower your cholesterol include:

• Avoiding foods high in saturated fats
• Eating plenty of fiber
• Maintaining a healthy weight
• Exercising regularly
• Reducing your alcohol intake
• Stopping smoking
• Controlling your blood sugar

If these changes aren't enough to lower your cholesterol to a safe range, your doctor may prescribe medication. If your doctor prescribes medicines as part of your treatment plan, you still have to continue your healthy lifestyle changes.

Many medications can help lower your cholesterol, including:

• Statins
• PCSK9 inhibitors
• Fibrates
• Bile acid sequestrants
  
• Nicotinic acid
• Selective cholesterol absorption inhibitors
• Adenosine triphosphate-citrate lyase (ACL) inhibitors
  

Ways to Prevent High Cholesterol

You can prevent high cholesterol the same way you can help lower it—by living a healthy lifestyle focused on a heart-healthy diet and exercise. Other strategies that can help prevent high cholesterol include:

• Quitting smoking
• Managing stress
• Getting enough good quality sleep
• Limit alcohol intake

However, if you have familial hypercholesterolemia, you may not be able to prevent it. You can work with your doctor to detect it early and manage it to prevent complications.

Summary

High cholesterol can be caused by a lot of things, from a poor diet to genetics. There are many ways to treat high cholesterol like diet and medications, but addressing it in some way is the most important. Untreated high cholesterol can lead to a number of serious complications, including heart attack and stroke.

A Word From Verywell

If you have high cholesterol or it runs in your family, talk to your doctor about your risks and be sure to have regular screenings. High cholesterol can develop with no symptoms but has serious consequences if left unmanaged.

If you eat a lot of fatty foods or smoke, these are things you can change to try and lower your cholesterol naturally. If that's not enough, talk to your doctor about one of the many medications that can treat high cholesterol.

Correction - August 22, 2022: This article was updated to correctly define low-density lipoprotein cholesterol.