High cholesterol is a common health condition that doesn’t usually cause symptoms. But over time, it can start to block your blood vessels, leading to serious problems like heart disease or stroke if left untreated. 

The good news? With the right lifestyle changes and treatment, it’s possible to manage your cholesterol and protect your health in both the short and long-term – but it can be tricky to know where to start. So, whether you’re looking for cholesterol-lowering treatments, ways to get tested or you just want advice on keeping your levels in check, we’re here to help you take practical steps towards a healthier heart. 

What is high cholesterol? 

Cholesterol is a fatty substance found in your blood. We all have it, and your body needs some cholesterol to function properly – it plays a key role in building cells, producing hormones and helping with digestion.  

But having high cholesterol means there’s too much of it in your bloodstream, and that can raise your risk of serious health problems like heart attacks and strokes. 

There are two different types of cholesterol:  

• High-density lipoprotein (HDL) - often called “good” cholesterol, as it helps remove excess cholesterol from the blood 
• Low-density lipoprotein (LDL) - often called “bad” cholesterol, as it can build up in the arteries and increase your risk of heart problems and other conditions 

You might also hear the term non-HDL cholesterol, which includes LDL and other harmful types of cholesterol. It’s a broader measure which doctors sometimes use to assess your overall risk. 

A high cholesterol level usually means there’s too much LDL cholesterol in your bloodstream. This can lead to fatty deposits building up in your arteries, making it more difficult for blood to flow through them. 

Your cholesterol and HDL ratio can also give insight into your heart health. A high ratio could mean you have more bad cholesterol than good, which may need attention.  

If you’ve had a blood test and see results like 5.7mmol/L or 7.1mmol/L, you might then be wondering if that’s too high.  

In general, a cholesterol level of 5mmol/L or above could be a sign that changes are needed – but it’s important to speak to a healthcare professional, such as your GP, for personalised advice. 

Why you might have high cholesterol 

There are several reasons why you might develop high cholesterol. Many of them come down to lifestyle, but for some it can be genetic.  

One of the most common causes is diet. Eating too many foods high in saturated fats or trans fats can raise your cholesterol levels over time. These include processed meats, fried foods, full-fat dairy and certain oils.  

While artificial trans fats are now much less common in UK foods, there’s no outright ban on them. It’s therefore still important to check labels – especially on baked goods and fried snacks – for ingredients like partially hydrogenated oils. 

Other causes of high cholesterol include:  

• being overweight 

• not getting enough exercise 

• drinking too much alcohol 

• smoking 

• an underlying health condition such as diabetes or an underactive thyroid 

High cholesterol can also run in families.  

A genetic condition called familial hypercholesterolaemia means your liver can’t remove excess LDL cholesterol from the blood as it should. This leads to high cholesterol levels from a young age, even if you eat well and stay active.  

It’s worth speaking to your doctor if there’s a family history of the condition. 

Symptoms 

High cholesterol doesn’t usually cause any noticeable symptoms – which is why many of us don’t realise we have it until it’s picked up through a routine health check or blood test.  

Over time, though, excess cholesterol can lead to serious health conditions like heart disease, stroke or narrowed arteries, all of which present symptoms. 

That’s why it’s important to be aware of any potential signs of high cholesterol, especially if you’re at higher risk.  

Signs of high cholesterol in males 

In men, high cholesterol often goes unnoticed until it contributes to other complications. However, there are some possible warning signs to be mindful of: 

• Chest pain or angina 

• Shortness of breath 

• Erectile dysfunction, which can be linked to poor blood flow 

Symptoms of high cholesterol in females  

Possible signs include: 

• Pain or tightness in the chest 

• Dizziness or fatigue 

• Yellowish patches around the eyes (xanthelasma) 

These signs could be related to a number of other health conditions too, so if you’re unsure, it’s always best to speak to your GP.  

And remember, high cholesterol often remains silent, so regular blood tests are vital – especially if you have risk factors or a family history of high cholesterol. 

Prevention 

While high cholesterol can sound scary, it’s often preventable – and manageable – through simple lifestyle changes.  

Regular exercise, stopping smoking, cutting back on alcohol and maintaining a healthy weight all play a part. Your diet is also one of the biggest factors - and one you can start to adjust right away. 

Foods to eat and avoid for high cholesterol 

Some foods are known to raise cholesterol levels, while others can help lower them. Here’s a quick guide on what to include and what to cut back on in your diet.

Foods to eat: 

• Oats and wholegrains 

• Beans, lentils and pulses 

• Fruits and vegetables – especially apples, citrus fruits and leafy greens such as spinach, kale and cabbage 

• Nuts – especially almonds and walnuts 

• Fatty fish like salmon, mackerel and sardines 

• Plant-based oils such as olive oil and rapeseed oil 

• Foods fortified with plant sterols or stanols 

Foods to avoid or limit: 

• Red and processed meats 

• Full-fat dairy products such as butter, cream and cheese 

• Fried foods 

• Baked goods made with trans fats like pastries, cakes and some biscuits 

• Coconut oil and palm oil 

• Fast food and takeaways 

Foods that contain cholesterol but are low in saturated fat 

Some foods naturally contain cholesterol, but don’t raise your blood cholesterol as much as those high in saturated fat. These include: 

• Lean organ meats, such as liver, kidney, heart and tripe 

• Shellfish, like prawns, crab, lobster, squid and octopus 

• Eggs - most of the cholesterol is in the yolk, while the white is fat-free and high in protein 

For most people, these foods can be enjoyed in moderation as part of a balanced diet. However, if you have familial hypercholesterolaemia, you may need to be more cautious about how often you eat them. 

Taking steps to lower your bad cholesterol and raise your good cholesterol can help protect your heart and reduce your long-term risk of more serious health problems. If you’re not sure where to start with your diet, a pharmacist or GP can help guide you.  

How to get tested 

The only way to know if you have high cholesterol is through a cholesterol test.  

This is usually a simple blood test that checks your levels of HDL, LDL, total cholesterol and other fats in your blood. Your doctor may recommend one based on your age, lifestyle, or risk factors like family history or high blood pressure. This type of blood test is sometimes called a lipid profile. 

You can also check your levels at home with a cholesterol test kit, which involves taking a small finger-prick blood sample.  

These kits can give you a quick readout of whether your cholesterol is raised, although they may not provide the full breakdown you’d get from a lab test.  

Cholesterol test kits can be a convenient first step if you want to monitor your levels at home. But if you get a high reading, it’s important to follow up with your GP for further testing and support. 

Treatment 

If you’ve been diagnosed with high cholesterol, there are several ways to manage it – from lifestyle changes to medication and cholesterol-reducing supplements.  

The right treatment for you depends on how high your cholesterol levels are and your risk of heart disease. 

Lifestyle changes 

For many people, the first step in any treatment plan is making healthier choices. These changes can make a big difference: 

• Eat a diet low in saturated fat and high in fibre 

• Exercise regularly – aim for at least 150 minutes of moderate activity a week, this can include brisk walking, strength training or any type of movement you enjoy 

• Stop smoking 

• Cut back on alcohol 

• Maintain a healthy weight – you can check what this might be for you using a BMI calculator  

Medication and supplements 

If lifestyle changes aren’t enough, your doctor may recommend high cholesterol tablets or other treatments. These might include: 

• Statins – the most common treatment, Statins reduce how much cholesterol your liver makes 

• Ezetimibe – blocks cholesterol absorption from food 

• PCSK9 inhibitors– injectable treatments for those with very high cholesterol or familial hypercholesterolaemia  

Some people also use cholesterol-lowering supplements, such as: 

• Plant sterols and stanols – found in products like Benecol and Flora ProActiv, which can help block cholesterol absorption in the gut 

• Omega-3 fatty acids – found in fish oil capsules or foods like mackerel and salmon, which may help maintain healthy cholesterol levels 

While supplements may support your cholesterol management, they shouldn’t replace prescribed treatments. 

If you’re unsure which option is right for you, speak to your doctor or pharmacist. They can help you understand your results and choose the best way to manage your cholesterol.