How to Tell If Your Cholesterol Is Too High
Experts say that the only way to know for sure that your cholesterol is too high is to get a blood test to check your levels. “There isn’t a reliable physical sign, unfortunately,” explains Dr. Kevin Shah, a cardiologist and program director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute. “High cholesterol is typically silent, which is what makes it dangerous. Most people don’t have symptoms until plaque buildup leads to a cardiovascular event.”
The fact that high cholesterol is so difficult to detect is one of the reasons that the American College of Cardiology and the AHA released new guidelines on the management of high cholesterol, adds Dr. Tracy Paeschke, a preventive cardiologist. She notes that the new guidelines suggest a lipid panel for children between ages 9 and 11 and for adults every five years beginning at age 19. They also suggest that all adults have their lipoprotein (a) levels measured at least once. High Lp(a), which is mostly determined by genetics, is associated with a 140% higher risk of heart attack or stroke over a lifetime, per the AHA.
While early high cholesterol does not cause any physical symptoms, if you’ve had it for a long time without treatment, physical signs may start to appear, says Dr. Shah. “Symptoms like chest discomfort, shortness of breath, or reduced exercise tolerance should prompt evaluation,” he says. “But these are usually signs of more advanced disease, not early high cholesterol itself.”
Likewise, Dr. Paeschke says that there are some genetic disorders that can cause very high cholesterol that do have some unique physical symptoms. According to the National Library of Medicine, these include familial hypercholesterolemia, familial combined hyperlipidemia, familial hypertriglyceridemia, and familial dysbetalipoproteinemia. Symptoms can include yellow fatty deposits on the skin or eyelids, a white, blue, or gray ring around the iris, chest pain, calf cramps while walking, sores on the toes that don’t heal, and sudden stroke-like symptoms. Per the NLM, most people with these disorders respond well to treatments such as diet changes, exercise, and medication.
The Bottom Line
Unless you have advanced cardiovascular disease or an inherited disorder, it’s nearly impossible to tell if your cholesterol is too high without a blood test. “A blood test is the only way to know for sure, which is why routine screening in people without symptoms is so important,” says Dr. Shah. In the meantime, making smart choices to improve your cholesterol and your heart health, such as choosing the best foods to eat for better cholesterol, maintaining a regular exercise routine, and not smoking, can go far towards keeping your cholesterol levels in a healthy range.