High Cholesterol Signs & Symptoms

Surprisingly, there are no symptoms of hypercholesterolemia (high cholesterol) itself. However, chronically (long-term; several decades’ worth) elevated levels of serum cholesterol when not diagnosed can result in atherosclerosis. Atherosclerosis, also known as arteriosclerotic vascular disease or ASVD, is the narrowing of the blood vessels caused by the build-up of fats such as cholesterol. The formation of fat-comprised plaques in the arteries continues to pile up, resulting in the progressive stenosis (narrowing) and ultimate occlusion (blockage) of the affected arteries.

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Hypercholesterolemia results in extra cholesterol being left in the bloodstream by low-density lipoproteins (LDLs). It is the job of the high-density lipoproteins (HDLs) to clean up the cholesterol deposits in the bloodstream. If the HDLs cannot clean up all the cholesterol left by the LDLs, the cholesterol will build up in the arteries as plaque, resulting in atherosclerosis stenosis or even occlusion.

Atherosclerosis may lead to tissue and organ ischemia (blood supply restriction). Organs and tissue that receive nutrient-rich blood via the clogged arteries suffer diminishing blood distribution, because less blood can be transferred through the arterial stenosis or blockage. Ischemia causes harm to the functioning of organs and tissues.

Hypercholesterolemia can result in the following:

  • atherosclerosis, including the following:
  • arterial stenosis
  • arterial occlusion
  • tissue and organ ischemia, resulting in the following:
  • injury to organ and tissue function

Upon the ischemia-induced tissue or organ impairment, a variety of medical conditions can result, including the following: temporary ischemia of the brain (transient ischemic attack), ischemia of the heart, and ischemia of the eye.
Atherosclerosis in the brain can result in stroke. Signs and symptoms of temporary ischemia of the brain include:

  • temporary loss of vision
  • dizziness
  • balance impairment
  • aphasia (difficulty speaking)
  • weakness
  • numbness or tingling in the body (usually on one side)

The organ most affected by atherosclerosis is the heart. Atherosclerosis in the heart or in a blood vessel that carries blood to the heart (coronary artery) can result in coronary heart disease and result in heart attack or cardiac muscle death. Ischemia of the heart may present in the following ways:

  • chest pain
  • difficulty breathing
  • shortness of breath
  • rapid or irregular heartbeats
  • dizziness
  • light-headedness
  • extreme anxiety
  • nausea
  • vomiting
  • indigestion or heartburn
  • pain or discomfort in areas in the upper body, including the arms, back, stomach, left shoulder, jaw or neck
  • cold sweat
  • extreme weakness

Ischemia of the eye may result in temporary loss of vision.

Familial hypercholesterolemia known as type IIa hyperlipoproteinemia may be associated with the following signs and symptoms:

  • xanthomata (deposits of yellowish material containing cholesterol)
  • xanthelasma palpebrarum (yellowish patches under the skin around the eyelids)
  • arcus senilis (gray or white discoloring of the eye’s cornea.

A form of hypercholesterolemia known as type III hyperlipidemia may be associated with the following signs and symptoms:

  • xanthomata (deposits of yellowish material containing cholesterol) in the palms
  • xanthomata in the elbows
  • xanthomata in the knees

If you experience any of the above symptoms, consult your health care provider. The risk of hypercholesterolemia is increased in those who are obese, maintain unhealthy diets, and have genetic predispositions to hypercholesterolemia. There are medications available for those with high cholesterol. Ways we can all treat and prevent high cholesterol:

  • engaging in physical exercise
  • maintaining a healthy body weight
  • eating nutritious and low fat foods


100-129 mg/dL = Near Optimal/Above Optimal
130-159 mg/dL = Borderline High
160-189 mg/dL = High
≥190 mg/dL = Very High


<40 mg/dL = Low


150-199 mg/dL = Borderline High
200-499 mg/dL = High
≥500 mg/dL = Very High


200-239 mg/dL = Borderline High
≥240 mg/dL = High

Adapted from National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).

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