Your Guide to High Cholesterol and How to Lower It

Medically Reviewed By Lauren Castiello, MS, AGNP-C
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High cholesterol, or hyperlipidemia, is when the blood contains too much cholesterol. Cholesterol is a type of fat, or lipid, which is important for a variety of functions in your body. Around 38% of people in the United States have high cholesterol. Your liver makes all of the cholesterol you need to make hormones, vitamin D, and digestive substances. However, you can get extra cholesterol by eating animal products, such as meat, poultry, and dairy.

Read on to learn more about high cholesterol. This guide includes information about how to tell if you have high cholesterol and how to lower your cholesterol.

What are the types of cholesterol?

A woman is chopping vegetables.
Boris Jovanovic/Stocksy United

There are two main types of cholesterol: “bad” cholesterol, also known as low-density lipoprotein (LDL), and “good” cholesterol, known as high-density lipoprotein (HDL).

LDL cholesterol

When too much LDL is present in your blood, it can build up in a substance called plaque on the walls of the arteries. This increases your risk of developing cardiovascular conditions, including:

HDL cholesterol

In contrast, higher levels of HDL can help prevent LDL from clogging your arteries and help reduce your risk of heart disease, heart attack, and stroke.

Vs. triglycerides

Triglycerides are the most common type of fat found in the body. They are different from cholesterol, as their main role is to store and provide energy.

However, if you have a high triglyceride level and either a high LDL level or low HDL level, this can increase your risk of fatty buildup in the artery walls. This, in turn, makes you more likely to have a heart condition, such as a heart attack or stroke.

How do I lower my cholesterol?

You can work with your doctor to develop an effective treatment plan. This may include lifestyle changes, medication, or both.

Lifestyle changes

Making lifestyle changes can help lower your cholesterol. This may include:

  • reducing your intake of saturated fats so that they account for less than 6% of your daily caloric intake
  • eating a heart-healthy diet with fruits, vegetables, and whole grains
  • increasing the amount of physical exercise you do
  • quitting smoking if you currently smoke
  • reducing your alcohol intake
  • losing 5–10% of your body weight if you are overweight or have obesity

Contact your doctor for advice before making any major changes to your routine.

Medication

In some cases, your doctor may prescribe medications to lower your cholesterol levels. These can include:

  • bile acid resins or sequestrants, such as cholestyramine (Questran) and colesevelam (Welchol), which help your body eliminate or remove cholesterol from the blood
  • ezetimibe, which prevents the absorption of cholesterol from the foods you eat
  • fibrates, such as fenofibrate (Tricor) and gemfibrozil (Lopid), which help reduce triglycerides and increase the amount of HDL in your blood
  • niacin or nicotinic acid, a type of vitamin B, which helps your body increase HDL levels while decreasing the amount of LDL levels and triglycerides in your blood
  • statins, such as simvastatin (Zocor) and atorvastatin (Lipitor), which reduce the amount of cholesterol the liver produces

Find out more about medications for high cholesterol.

What diet can lower my cholesterol?

Eating a heart-healthy diet can help lower your cholesterol and reduce your risk of heart-related conditions. This includes eating more of the foods that are good for your heart and reducing your intake of foods that are bad for your heart.

Eat more fiber and whole grains

Fiber helps reduce how much cholesterol your intestine absorbs into your bloodstream. Aim to eat 5 portions of fruits and vegetables per day, as they contain fiber and other nutrients that are good for you.

Adding more whole grains into your diet can also help boost your fiber intake. This can include:

  • whole grain bread
  • oatmeal
  • bran flakes
  • muesli with no added sugar

Replace saturated fats with unsaturated fats

Limit your intake of foods that are high in saturated fats. Saturated fats come from animal products such as cheese and fatty meats as well as tropical oils such as palm oil.

Instead, choose alternatives that are low in saturated fat, trans fat, added sugars, and salt. This can include:

  • lean meat
  • seafood
  • low fat or fat-free dairy products
  • whole grains
  • fruits
  • vegetables

Reduce your alcohol intake

Consuming alcohol can increase both your cholesterol and your triglycerides levels, which increases your risk of high cholesterol and heart conditions.

Avoid alcohol or limit your intake. The Dietary Guidelines for Americans 2020–2025 recommends either not drinking or drinking in moderation. They define this as two drinks or fewer per day for males and one drink or fewer per day for females.

Consume fewer foods containing cholesterol

Consuming foods that contain cholesterol will naturally raise your cholesterol levels. Avoiding these foods can help reduce this.

Foods that contain cholesterol include:

  • full fat dairy products, such as:
    • milk
    • cheese
    • cream
    • yogurt
  • animal fats, such as:
    • butter
    • margarine
    • lard
    • ghee
    • suet
    • dripping
  • fatty and processed meat products, such as:
    • sausage
    • deli meat
    • canned meat

What are the symptoms of high cholesterol?

Most people do not experience any symptoms associated with high cholesterol. This means that you will need to have regular tests for high cholesterol.

Familial hypercholesterolemia

If you have inherited high cholesterol, or

familial hypercholesterolemia, you may notice symptoms of the condition.

Symptoms of inherited high cholesterol include:

  • LDL cholesterol levels over 190 milligrams per deciliter (mg/dl) in adults
  • painful or swollen Achilles tendons
  • lumps around your elbows, knees, and knuckles
  • a yellowish color around your eyes
  • a whitish-gray color in a half-moon shape on the outside of your cornea

If you experience these symptoms, it is also important to let your doctor know about any family history of heart conditions.

Learn more about familial hypercholesterolemia.

How is high cholesterol diagnosed?

The Centers for Disease Control and Prevention (CDC) recommends that healthy adults get a routine cholesterol screening every 4–6 years.

A cholesterol screening typically involves a blood test to check your levels of:

  • LDL cholesterol
  • HDL cholesterol
  • triglycerides
  • total cholesterol

You may need to fast for around 8–12 hours before your cholesterol test. Your doctor will advise on if and for how long you need to avoid eating and drinking beforehand.

What the numbers mean

Cholesterol measurements are in mg/dl. Your doctor will look at your cholesterol levels and advise on whether or not you need to take steps to lower your cholesterol.

See the table below for target cholesterol levels.

Test typeTarget level
LDLless than 100 mg/dl
HDL60 mg/dl or higher
triglyceridesless than 150 mg/dl
total cholesterolless than 200 mg/dl

Our high cholesterol appointment guide can help you prepare for your cholesterol screening test.

What causes high cholesterol?

High cholesterol occurs as a result of:

  • there being too much cholesterol in your diet
  • your body making too much cholesterol
  • your body not being able to get rid of enough cholesterol
  • not getting regular exercise, which can lower good cholesterol
  • smoking, which increases bad cholesterol and lowers good cholesterol

In some cases, high cholesterol occurs as a result of a genetic condition passed down through families. This is familial hypercholesterolemia.

What are the risk factors for high cholesterol?

A number of factors can increase your chances of developing high cholesterol. Common risk factors include:

  • having diabetes
  • being overweight
  • eating a diet high in saturated fats
  • not getting enough exercise
  • getting older
  • having underactive thyroid gland
  • having kidney or liver disease
  • having a family history of familial hypercholesterolemia

It is possible to minimize some of these risks, such as by stopping smoking or maintaining a moderate weight. However, it is not possible to avoid some of these risk factors, such as getting older or having a family history of inherited high cholesterol.

Talk with your doctor about your individual risk factors and steps you can take to manage the factors that are in your control.

Are there any complications of high cholesterol?

If you do not lower high cholesterol, this can lead to potential health complications. These can include:

Having regular cholesterol screenings every 4–6 years can help you keep on top of your cholesterol and take steps to lower it when necessary.

Learn more about how high cholesterol affects your heart.

Learn more

View our cholesterol hub for more articles and information about high cholesterol.

Summary

High cholesterol occurs when there is too much LDL, or “bad,” cholesterol in your blood. This increases your risk of developing heart conditions such as heart attack or stroke.

The CDC recommends that you have regular cholesterol screening tests every 4–6 years. Your doctor will test your LDL, HDL, triglycerides, and total cholesterol levels. If your levels of LDL are too high, they will advise on dietary changes to help lower your cholesterol. In some cases, they may also prescribe medication.

Contact your doctor to schedule a cholesterol screening test if you are due one or if you have concerns about your cholesterol.

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Medical Reviewer: Lauren Castiello, MS, AGNP-C
Last Review Date: 2022 May 30
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.