cholesterol when to seek care

Overview

Cholesterol is a waxy, fat-like substance your body makes and gets from some foods. Your body needs a little cholesterol to build cells and make hormones. But when levels get too high, it can clog arteries and raise the risk of heart disease and stroke.

Yes. In England, about half of adults have higher-than-recommended cholesterol levels; it is very common across the world.

It can affect people of all ages, but risk increases after age 40. Certain conditions (like diabetes or an underactive thyroid) and a family history of early heart disease also make it more likely.

Symptoms

Common symptoms

• Usually no symptoms. Most people feel fine.
• Occasionally, very high cholesterol can cause fatty deposits under the skin (xanthomas) or a grey ring around the cornea (arcus senilis).

Symptoms in children

• Children with inherited high cholesterol usually have no symptoms either, but some may have visible fatty bumps around tendons or a grey-white ring in the eye.

Symptoms in older adults

• Older adults also typically have no symptoms. The first sign of high cholesterol may be a heart attack, stroke, or leg pain while walking.

Causes

Main causes

• Your liver makes most of your cholesterol; it's needed for normal body functions
• A diet high in saturated fat, trans fat, and refined sugar can raise bad cholesterol
• Not being active, smoking, and heavy alcohol use can also push levels up

Risk factors

• Age (risk rises with age)
• Family history of high cholesterol or heart disease
• Being overweight or obese
• Diabetes, high blood pressure, or kidney disease
• Underactive thyroid (hypothyroidism)
• Polycystic ovary syndrome, and certain medicines can also affect cholesterol

When to see a doctor

See a doctor urgently if:

• If you have new, recurring chest pain or tightness with light activity, or if you've had a recent stroke and have new symptoms, get urgent same-day medical help.

Book a routine appointment if:

• Ask your doctor for a cholesterol test if you are over 40, have a family history of early heart disease or high cholesterol, have diabetes, high blood pressure, or are overweight.
• If you've already had a heart attack or stroke, you should have regular follow-ups to manage your cholesterol.

Diagnosis

To diagnose high cholesterol, a doctor or nurse takes a small sample of blood — usually from your arm. The test is called a lipid (or lipoprotein) panel.

Tests that may be done

• Total cholesterol
• LDL (bad) cholesterol
• HDL (good) cholesterol
• Non-HDL cholesterol
• Triglycerides (another fat in your blood)

What to expect at your appointment

You may be asked to fast (not eat or drink anything except water) for 9–12 hours before the test. The blood draw takes minutes and is mildly uncomfortable at worst. You'll get results within a few days, and your doctor will explain what they mean for you personally.

Treatment

Treatment for high cholesterol focuses on reducing your overall cardiovascular risk. First steps are lifestyle changes. If your risk is high or your levels are very high, your doctor may also suggest cholesterol-lowering medication. You'll usually continue lifestyle efforts alongside any medicine.

Self-care at home

• Eat more vegetables, fruit, wholegrain carbohydrates, beans, nuts, and oily fish
• Cut down on red meat, fried food, butter, cream, and highly processed snacks and takeaways
• Do at least 150 minutes of moderate activity a week, like brisk walking or cycling
• If you smoke, seek help to quit; reduce alcohol to no more than 14 units a week, spread over several days
• If you are overweight, losing even 5–10% of your weight makes a noticeable difference

Medical treatments

Several cholesterol-lowering medicines are available. These are usually taken once a day as a tablet. They work by reducing the amount of cholesterol your body makes or absorbs. Your doctor will choose the right one for you based on your health needs, and you should never stop or change your medicine without speaking to your doctor. Remember that medication works best alongside diet and exercise.

When is surgery considered?

Surgery is not a routine treatment for high cholesterol. However, if your arteries are already very narrowed, doctors may consider a procedure to widen them (angioplasty) or bypass a blockage. This is done after careful assessment of your individual condition.

Living with this condition

Living with high cholesterol means making heart-healthy choices a natural part of your day — like cooking at home more, checking food labels, and planned walks with a friend or family member. Your routine will become easier the longer you keep it up.

Lifestyle tips

• Aim to eat a balanced diet at regular times
• Keep a water bottle with you and limit sugary drinks
• Find physical activities you enjoy, like dancing, gardening, or swimming
• Check your weight and waist measurement regularly
• Take your medicines exactly as prescribed and get regular blood tests

Diet and exercise

Focus on a Mediterranean-style diet rich in vegetables, fruit, legumes, nuts, fish, and olive oil. Limit foods high in saturated fat, such as fatty meats, pastries, and butter. For exercise, shoot for 30 minutes a day on most days. You can split it into 10-minute chunks. Even a daily 20-minute walk reduces your risk.

Mental health and emotional wellbeing

Dealing with a high cholesterol diagnosis can make you feel anxious or worried about your health. These feelings are valid. However, being diagnosed early is actually a positive opportunity — you can take steps to prevent serious disease. If anxiety becomes overwhelming, talk to your doctor about support or counselling.

Prevention

Yes, to a large degree. A heart-healthy diet, regular exercise, not smoking, limiting alcohol, and managing weight can prevent or delay high cholesterol and its complications. Even with a family history, these habits let you influence your risk significantly.

Vaccines

There is no vaccine that prevents high cholesterol. However, staying up to date with recommended vaccines — such as flu and COVID-19 — can reduce your risk of infections that could trigger a heart attack or stroke if you already have heart disease.

Screening programmes

Most adults should have a cholesterol test every 4–6 years starting at age 20. Your doctor may recommend more frequent tests if you have risk factors or a family history. Screening is a simple blood test, often done as part of a routine check-up.

Complications

If left untreated

• Over many years, high cholesterol can cause fatty plaques in your arteries (atherosclerosis)
• This can lead to chest pain (angina), a heart attack, or a stroke
• It can also reduce blood flow to your legs (peripheral artery disease) and affect your kidneys

Long-term outlook

The outlook is excellent for most people. High cholesterol responds well to lifestyle changes and, when needed, medication. By working with your healthcare team, you can lower your risk of heart attack and stroke and stay active well into older age. The most important thing is to stay informed and keep moving forward.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.