High Cholesterol

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Table of content

What is High Cholesterol?

According to the CDC, approximately 1 in 3 American adults have high cholesterol. Cholesterol is a waxy, fat-like material made by your liver. Your body needs cholesterol to perform vital functions like making hormones and digesting fatty foods. Your body is able to naturally make all the cholesterol it needs, which is why experts advise people to eat as little cholesterol as possible in their diet. Dietary cholesterol can be found in animal foods like meat, seafood, poultry, eggs, and dairy products.

High cholesterol is a condition in which the levels of bad fats or lipids are too high in your blood. This condition is typically caused by lifestyle factors like diet or genes inherited from your parents, or some combination of both. High cholesterol can also be less commonly caused by other medical conditions or certain medications. Cholesterol travels through your body on proteins in the blood called lipoproteins. The two types of lipoproteins that carry cholesterol through your body include:

  1. LDL (low-density lipoprotein) -  also known as “bad” cholesterol, this makes up most of your body’s cholesterol. If you have higher levels of LDL this increases your risk for heart disease and stroke.
  2. HDL (high-density lipoprotein) - also known as “good” cholesterol, absorbs cholesterol and brings it back to your liver. The liver then flushes the cholesterol from your body. High levels of HDL cholesterol can decrease your risk of heart disease and stroke.

 You could be diagnosed with high cholesterol if you consistently have high levels of “bad” LDL cholesterol in your blood from a routine blood test called a lipid panel. If your body has too much LDL cholesterol it can build up on the walls of your blood vessels, which is called plaque. When your body builds up plaque over time the inside of your vessels narrow which blocks blood flow to and from your heart and other organs.

What Causes High Cholesterol?

The most common cause of high cholesterol is leading an unhealthy lifestyle. Other causes of high cholesterol could be your genetics, other medical conditions, or certain medications.

Unhealthy Lifestyle

  • Unhealthy diet - like eating high amounts of saturated or trans fats, this is known to increase levels of “bad” LDL cholesterol
  • Lack of physical activity - spending too much time during the day sitting while watching TV or working, this is associated with lowering levels of “good” HDL cholesterol
  • Smoking - is known to lower “good” HDL cholesterol while increasing “bad” LDL cholesterol


Sometimes high cholesterol develops in which an individual’s genes mutate or change. These mutations make it more difficult for the body to remove LDL cholesterol from the blood or break it down in the liver. One inherited form of high cholesterol is called familial hypercholesterolemia that causes high blood levels of LDL cholesterol and may cause a heart attack at an early age.

Medical Conditions

These medical conditions could cause high cholesterol:

  • Chronic kidney disease
  • Diabetes
  • HIV
  • Hypothyroidism
  • Overweight and obesity
  • Polycystic ovary syndrome
  • Inflammatory disease like psoriasis, lichen planus, pemphigus, histiocytosis, lupus erythematosus, and rheumatoid arthritis


Certain medications taken for other medical conditions can increase your cholesterol, the medications include:

  • Diuretics
  • Immunosuppressive drugs
  • Steroids
  • Retinoids
  • Antiretroviral medications
  • Antiarrhythmic medications

How to Screen for and Prevent High Cholesterol

There are many ways for you to be screened for high cholesterol, as well as many steps you can take to prevent high cholesterol. Your doctor can order a routine blood test called a lipid panel to screen you for high cholesterol. The frequency of this blood test all depends on your age, risk factors, or family history of high cholesterol and other cardiovascular diseases.

  • Lipid Panel - this test measures your total cholesterol, HDL cholesterol, and LDL. Health blood cholesterol varies by age and gender:
    • Age 19 or younger - screening begins at 9-11 and test should be repeated every 5 years
      • Total Cholesterol - less than 170 mg/dL
      • LDL - less than 100 mg/dL
      • HDL - more than 45 mg/dL
    • Men aged 20 or older - young men should be screened every 5 years and ages 45-65 should be screened every 1 to 2 years
      • Total Cholesterol - 125-200 mg/dL
      • LDL - less than 100 mg/dL
      • HDL - 40 mg/dL or higher
    • Women aged 20 or older - young women should be screened every 5 years and ages 55-65 should be screened every 1 to 2 years
      • Total Cholesterol - 125-200 mg/dL
      • LDL - less than 100 mg/dL
      • HDL - 50 mg/dL or higher
  • Heart-healthy Lifestyle - this includes eating healthy, being physically active, quit smoking, and manage stress levels.

Signs and Symptoms of High Cholesterol

High cholesterol does not have distinct symptoms, but people who have high cholesterol may show signs of xanthomas and corneal arcus. Having high cholesterol does lead to atherosclerosis which is the buildup of plaque in your blood vessels. Over time chronic or uncontrolled high cholesterol can lead to serious complications including:

  • Carotid artery disease
  • Coronary heart disease
  • Peripheral artery disease
  • Stroke

How Is High Cholesterol Diagnosed

High cholesterol may be diagnosed by your doctor after reviewing your medical and family history, physical exam, and lipid panel review. If you have consistently high levels of LDL cholesterol on repeated blood tests you may be diagnosed with high cholesterol. Your doctor may order more testing to verify you don’t have other medical conditions that could be causing high cholesterol.

Where to Receive Treatment Online for High Cholesterol

  • Lemonaidhealth
  • Pushhealth
  • Blinkhealth
  • Heydoctor
  • Callondoc
  • Plushcare
  • Teladoc

Treatment Options for High Cholesterol

High cholesterol can easily be treated with heart-healthy lifestyle changes and medications that can control and lower your high cholesterol. There is also a procedure that can be done for those diagnosed with familial hypercholesterolemia called lipoprotein apheresis.

Heart-healthy Lifestyle

  • Heart-healthy diet - it is important to limit the amount of saturated and trans fats consumed. It is important to eat fish that is high in omega-3 fatty acids and vegetables, as these can help lower cholesterol levels. Eating whole grains, fruit, and vegetables is highly encouraged and avoid foods with refined carbohydrates like sugar.
  • Physical activity - There are numerous health benefits to being physically active. It is shown that physical activity can lower LDL cholesterol and triglycerides and that it also increases “good” HDL cholesterol.
  • Aim for a healthy weight - If you are overweight or obese and have high cholesterol you can improve your health and reduce your LDL cholesterol levels while increasing your HDL cholesterol levels by losing 3-5% of your body weight.
  • Manage stress - Chronic stress leads to increased LDL cholesterol and decreased HDL cholesterol.
  • Quit smoking


If you have been unsuccessful at lowering your cholesterol levels with lifestyle changes alone your doctor may recommend a prescription medication, these could include:

  • Statins - this medication inhibits the production of cholesterol in the liver. Statins are the most commonly recommended medication to help reduce high cholesterol. Its major effect is to lower LDL cholesterol. Some common medications include lovastatin, pravastatin, simvastatin, fluvastatin, and atorvastatin.
  • PCSK9 inhibitors - this medication binds to and inactivates a protein in the liver to help lower LDL cholesterol. Some common medications include: alirocumab and evolocumab
  • Bile acid binders - work to cause your intestines to get rid of more cholesterol. Some common medications are cholestyramine, cholestipol, and colesevelam.
  • Ezetimibe - works to inhibit cholesterol from being absorbed in the intestine.
  • Fibrates - this medication is great for lowering triglyceride levels and has a slight effect at lowering LDL cholesterol. Some common medications include gemfibrozil, clofibrate and fenofibrate
  • Niacin (nicotinic acid) - is a B vitamin the works to limit the production of blood fats in the liver. It works to lower triglyceride levels and has a slight effect at lowering LDL cholesterol levels.

Lipoprotein Apheresis

Lipoprotein apheresis is a procedure that may be recommended for those with familial hypercholesterolemia as it works to lower their blood cholesterol levels. This procedure is a dialysis-like process where LDL cholesterol is extracted from the blood by a filtering machine and the remaining blood is then returned into the patient.

Everybody can take steps every day to help prevent or manage high cholesterol. By making healthy choices and managing your other help conditions you can keep your cholesterol levels in a healthy range. If you are struggling with high cholesterol and wish to talk with a healthcare provider to customize a treatment plan for you check out our list of the top online doctors that can help you reach your goals today. With the advancements in technology today there are numerous telemedicine companies that have appointments available the same day with high-quality healthcare professionals. What are you waiting for? Check one out today from the comfort of your own home.