Does high cholesterol cause symptoms or do I need a blood test to know?

High cholesterol does not cause symptoms on its own, so you need a blood test to know if your levels are elevated.¹²

Why You Need a Blood Test

• Silent condition: High cholesterol builds up gradually as fatty deposits (plaques) inside your arteries without causing pain or warning signs.¹²
• The only way to know: A simple blood test—often called a lipid panel or lipid profile —is required to measure your total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides.¹²
• Rare physical signs: In some people with very high cholesterol or genetic conditions (like familial hypercholesterolaemia), visible physical signs can appear, such as yellowish fatty growths on the skin or eyelids (xanthelasmas) or a pale white ring around the iris of the eye (arcus senilis). However, these are uncommon and usually only show up when levels are severely high.¹²

When to Get Tested

• Age 40 and older: Many health guidelines (including NHS recommendations) suggest routine checks for adults over 40.
• Risk factors: You should get tested earlier or more frequently if you have a family history of high cholesterol or heart disease, diabetes, high blood pressure, or if you smoke or are overweight.
• How to arrange it: You can ask your GP for a routine cholesterol check.¹²³⁴

You can learn more about what the numbers mean on the British Heart Foundation Understanding Your Cholesterol Levels page or read about general guidance on the NHS High Cholesterol page.¹²If you'd like, let me know:

• Your age or whether you have any existing health conditions (like high blood pressure or diabetes)
• If you have a family history of heart disease

I can help you understand what kind of screening schedule or next steps might make sense for you.

High cholesterol is largely a silent condition.¹

Does it cause symptoms?

• No obvious signs: High cholesterol does not usually cause any symptoms. You can feel completely well, active, and healthy while your cholesterol levels are high.¹
• The hidden risk: Instead of causing everyday aches or pains, excess cholesterol gradually builds up as fatty plaques inside your blood vessels (atherosclerosis). This narrows the arteries and significantly raises your risk of serious cardiovascular events down the line, such as a heart attack or stroke.¹

How do you know if you have it?

• You need a blood test: The only way to find out your cholesterol level is through a formal blood test.¹
• How the test works: A healthcare professional will either take a blood sample from a vein in your arm to send to a laboratory (which usually takes a few days for results) or perform a quick finger-prick test (which gives results in minutes, often available via an NHS Health Check or at participating high street pharmacies).¹
• Fasting vs. non-fasting: Depending on the specific panel, you may be asked not to eat or drink anything (except water) for up to 12 hours beforehand, though many standard tests do not require fasting.¹

Who should get tested?

You are more likely to be advised or eligible for a routine check if you:¹

• Are aged 40 to 74 (such as part of the NHS Health Check program).
• Are overweight.
• Have a family history of high cholesterol or early heart disease.
• Have a condition like high blood pressure, diabetes, or a kidney condition.¹

Would you like to know more about how to request a blood test from your GP, or are you wondering about risk factors like diet and genetics?

High cholesterol usually causes no noticeable symptoms at all. You can have very high cholesterol and feel completely healthy.

The only reliable way to know whether you have high cholesterol is through a blood test.

How do you know if you have high cholesterol?

A blood test called a lipid profile measures:

• Total cholesterol: Your overall cholesterol level.
• LDL cholesterol: Often called the bad cholesterol because it can build up in your arteries.
• HDL cholesterol: Often called the good cholesterol because it helps remove cholesterol from your bloodstream.
• Triglycerides: Another type of fat in your blood.

Can high cholesterol cause symptoms?

Usually, no. However, over many years, high cholesterol can cause fatty deposits to build up in your arteries, increasing the risk of:

• Heart attacks.
• Strokes.
• Poor circulation in the legs.

Rarely, people with inherited extremely high cholesterol may develop visible yellowish fatty lumps around their eyes, elbows or tendons.

Should you get tested?

Yes, particularly if:

• You have a family history of high cholesterol.
• You have a family history of heart attacks or strokes at a young age.
• You are overweight or have diabetes.
• You have high blood pressure.
• You haven't had your cholesterol checked for several years.

In Scotland, you can ask your GP practice about a cholesterol blood test.

One important thing: You don't need to have symptoms to have high cholesterol. That's why checking it is so worthwhile.

I can also explain what cholesterol numbers are considered healthy and what levels should be a cause for concern.