The Warning Signs That Your Cholesterol Could Be High—And How To Fix It

Modern life can be full of indulgence and it’s all too easy to fall into unhealthy habits. While many of these habits might cause overt symptoms which signal when something is wrong, some health concerns offer very few signs of their presence until it’s too late.

One of those common health concerns is high cholesterol, which is thought to affect around 86 million U.S. adults over the age of 20 years old, according to the Centers for Disease Control and Prevention.

Despite being so common among adults, Dr. Norman Lepor, a leading cardiologist, told Newsweek that many people “won’t know if their cholesterol is bothering them until they have an event, in which case it’s often too late.”

Cholesterol is a natural component of the body that’s produced by the liver and transported around the body. A cholesterol level is composed of two elements: high-density lipoproteins (HDLs) and low-density lipoproteins (LDLs). The ideal reading for both should be below 200 milligrams per deciliter, according to the Cleveland Clinic.

As HDL is considered the “good” cholesterol, that level should be above 60 milligrams per deciliter, whereas LDL is thought of as the “bad” cholesterol and should be kept below 100.

Cholesterol levels should be under 200 to be considered healthy, and a higher reading puts the individual at risk of a medical incident. However, anything over 240 is considered highly dangerous.

Dr. Lepor, of Westside Medical Associates in Los Angeles, encourages regular screening for cholesterol levels to ensure that it’s monitored, as it’s often “under-assessed and under-treated.” However, in some instances there might be signs which reveal the extent of the high cholesterol, encouraging people to change their habits.

Sustained high cholesterol can lead to chest pains

When cholesterol is too high for a long time, it can cause the build-up of plaque in the arteries which then leads to complications. One of those problems, significantly, is chest pain or shortness of breath as the plaque obstructs the oxygen flow around the body.

“You’re not going to notice any issues with cholesterol until you have developed a significant buildup of plaque, which then causes the obstruction in the arteries,” Lepor said.

“It’s not until there’s a blockage that there’s problems, and if that occurs in the coronary artery then patients may get some chest discomfort or become short of breath when doing activities that they wouldn’t normally have a problem doing. They might also notice that they can’t quite keep up with friends.”

Many people won’t notice these changes until “very late” in the process, once the artery is “laden with cholesterol” already, he added.

Restricted blood flow can lead to calf pains

In addition to getting out of breath quicker than usual and possible chest pain, high cholesterol over a long period of time can cause leg pain for some individuals.

“If you have plaque in the arteries to the legs, you may find that you’re getting pain in your calves,” Lepor said. “We would call it claudication when you’re walking uphill or walking quickly and there’s pain. Those are certainly important symptoms not to ignore.”

Claudication is defined as a pain or cramp in the muscle which can occur as a result of sustained exercise, but as Lepor notes, it can also be a sign of something far more troubling. If there is a “vascular insufficiency” which is affecting blood flow to the legs, the pain can be the presenting symptom.

“As the cholesterol bathes the arteries, the bad cholesterol can actually seep into the wall of the vessel and it causes this process. I use the analogy of rusting—it causes a rusting of the arteries, or atherosclerosis. This rusting of the artery leaves it ill and predisposed to blood clots forming on it,” he said.

“That’s where you have events like heart attacks and strokes or a need for amputation. Cholesterol plays a very important role in the development of plaque and the complications.”

Rare skin blemishes from a buildup of fat

While those two signs might relate to cholesterol restricting the oxygen flow around the body, there is one other sign that’s associated with high cholesterol levels.

Dr. Bradley Serwer, an interventional cardiologist at Wayne Memorial Hospital, explained to Newsweek how someone with longstanding high cholesterol can experience xanthomas, which is a blemish caused by the buildup of fat beneath the skin.

“It’s important to note that high cholesterol often doesn’t cause noticeable symptoms on its own. In rare instances, people may develop xanthomas, which are fatty deposits that can develop under the skin,” the former cardiologist for the House, Senate and Supreme Court said.

“They can occur particularly around the eyes, but they aren’t very common. It’s vitally important to get regular cholesterol screenings to help identify if levels of cholesterol place a person at increased risk.”

Xanthomas typically look like small bumps on the skin which can appear individually or as a cluster, ranging from red to yellow in some instances.

How can high cholesterol be treated?

While these symptoms often occur once the damage is already done, there are ways of reducing cholesterol levels through lifestyle choices. Serwer explained that a diet that’s heavy in saturated fats, excessive alcohol and smoking will increase cholesterol, so simple changes to remove these factors will reduce the risk.

“If your cholesterol levels are unfavorable, I first recommend assessing your diet and reducing red meat, fatty and fried foods, and considering a plant-based diet,” he said. “Exercise can be beneficial in raising HDL levels which in turn will lower LDL and lower your risk. When diet and exercise have failed then medications may be necessary to lower your levels and risk.

“It is much better to avoid a problem than to treat it after heart attacks and strokes have occurred. Early intervention with diet and lifestyle modification is always recommended, but if these fail to provide adequate improvements, early and aggressive pharmacologic intervention may be necessary.”