5 signs you’ve got high cholesterol

What is high cholesterol?

Cholesterol is a fatty, waxy substance that is crucial to almost every cell in the body. In fact, without it, we would die. The majority of our cholesterol is made by the body and used to make hormones like oestrogen and testosterone and for vitamin D production. We also need cholesterol to make the acids which help us absorb fat from our diets.

However, too much of a certain type of cholesterol increases our chances of atherosclerosis, more commonly known as hardening of the arteries, and this can put us at increased risk of heart attack and stroke. For decades, total cholesterol was believed to be the enemy, but the latest research suggests this is not the whole story and a form known as ‘low density lipoprotein’ or LDL is the problem.

What are the signs and symptoms of high cholesterol?

High cholesterol is largely symptomless, but when left undiagnosed it may lead to a heart attack and stroke. However, there are certain signs that may suggest you are at risk, including lifestyle factors such as being overweight or obese, inactivity, smoking, heavy alcohol consumption, poor sleep and high levels of stress. Other indicators that suggest high cholesterol include a diet high in saturated fats, ultra processed foods, refined carbs and processed meats.

Your family history may also suggest a genetic predisposition to heart conditions, these include a condition known as familial hypercholesterolemia. Over time, as this condition advances, you may present physical symptoms that suggest high cholesterol.

Five signs you may have high cholesterol

1. Cholesterol deposits in the skin or on the eyelids
2. Yellowish lumps or patches on the skin
3. Deposits in a half-moon shape on the cornea of the eye (corneal arcus)
4. Swollen tendons (tendon xanthomata) or bumps around joints, like the knuckles
5. Erectile dysfunction

When should you have a cholesterol test?

Cholesterol is measured by a blood test, if you are over 40 and have not had a cholesterol test before, you’re overweight, have a heart condition such as high blood pressure, have diabetes or high cholesterol runs in your family, then you will be eligible for a test on the NHS.

If you’re aged 40 to 74 and do not have a pre-existing health condition, you may be invited by your GP for an NHS health check. These are typically performed every five years and include a cholesterol test as well as other relevant checks.

Know your numbers

A cholesterol test measures the amounts of different types of cholesterol circulating in your blood. In the UK, cholesterol is measured as millimoles per litre of blood (mmol/L) with the following recommendations:

• Total cholesterol should be below 5mmol/L
• HDL should be above 1.00mmol/L for men and above 1.2mmol/L for women
• Non-HDL should be below 4.00mmol/L (this is largely made up of less favourable forms of cholesterol)
• LDL should be below 3.00mmol/L

You may be told you have high cholesterol (hyperlipidemia) if there is too much total cholesterol in your blood. Always ask your GP to explain the other numbers reported as it’s possible to have a healthy total cholesterol but unhealthy balance of other types.

Tips to lower your cholesterol

The portfolio diet is a plant-based way of eating designed to lower LDL cholesterol by combining specific foods that support heart health. It focuses on four key dietary components with studies suggesting an improvement in LDL cholesterol by as much as 30% within a matter of months.

The diet includes:

• Soy protein
• Nuts
• Viscous fibre (such as that found in oats, barley and psyllium)
• Plant stanols and sterols (found naturally in avocado and legumes, also in fortified foods such as spreads and yogurts).

Diet and lifestyle changes which may be useful:

• Be fat savvy – cut down on the saturated and trans fats and focus instead on mono- and poly-unsaturated fats, these are found in oily varieties of fish, soya, avocado, nuts and seeds
• Cut back on refined and processed foods like pastry, bread and biscuits – too many of these may elevate insulin and lead to the production of LDL cholesterol
• Increase the plant foods in your diet, such as beans, pulses, nuts and seeds – studies suggest those who follow a plant-focused diet may improve their LDL cholesterol levels
• Be more active – aiming for moderate, aerobic activity for at least 30 minutes most days
• If you smoke or vape, stop
• If you enjoy an alcoholic tipple, be sure to keep within government guidelines

Those with a genetic predisposition to high cholesterol may be advised to take medication, such as a statin. This should be discussed with your GP and the decision based on your specific circumstances and family history.

Get more valuable tips to manage cholesterol levels.

When should you worry about your cholesterol?

High levels of 'bad' cholesterol is a largely symptomless condition so may easily go unnoticed. If you have a family history of heart disease or you are over 40, you should get familiar with your cholesterol numbers – failing to do so may put you at an increased risk of heart disease. You might want to consider adopting a plant-focused diet, cutting back on processed foods, exercising a little more active and potentially giving up smoking.

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Kerry Torrens is a qualified Nutritionist (MBANT) with a postgraduate diploma in Personalised Nutrition & Nutritional Therapy. She is a member of the British Association for Nutrition and Lifestyle Medicine (BANT) and a member of the Guild of Food Writers. Over the last 15 years she has been a contributing author to a number of nutritional and cookery publications including Good Food.

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