Cholesterol is typically asymptomatic; signs like xanthomas or corneal arcus occur mainly with very high levels or inherited disorders. The main danger is atherosclerosis leading to heart attack or stroke. Regular lipid screening, lifestyle changes, and medical treatment when indicated reduce risk.
High cholesterol usually causes no obvious symptoms
High cholesterol itself rarely produces obvious signs. Many people have elevated cholesterol for years without symptoms. Often the first clue is a complication: chest pain from coronary artery disease, a heart attack, or a stroke. That is why screening with a lipid panel is important.
Visible signs when cholesterol is very high
In some cases - especially when levels are extremely elevated or with genetic conditions - cholesterol can produce visible signs. Xanthomas are small, yellowish bumps or nodules formed by cholesterol deposits in the skin. They commonly appear on the elbows, knees, hands, or around the eyes.
A corneal arcus (a pale or yellowish ring near the edge of the cornea) can also be related to cholesterol. In older adults it may be age-related; in younger people it can signal abnormal lipid levels or inherited disorders.
Familial hypercholesterolemia (FH) is an inherited condition that causes very high LDL cholesterol and raises the chance of early heart disease. If you or close relatives had early heart attacks or very high cholesterol at a young age, discuss FH testing with your clinician.
How high cholesterol leads to disease
Cholesterol contributes to atherosclerosis: fatty deposits build up within artery walls over years. This narrows arteries, reduces blood flow, and can cause symptoms of cardiovascular disease such as angina (chest pain), heart attack, or peripheral artery disease.
When plaques break or block blood flow to the brain, they can cause a stroke. Stroke warning signs include sudden numbness or weakness on one side, trouble speaking or understanding, or sudden vision problems.
Remember FAST for stroke:
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call emergency services
Screening, prevention, and when to see a clinician
Have your cholesterol checked with a standard lipid panel. Many clinicians accept nonfasting samples for initial screening, but follow your provider's instructions. How often you recheck depends on age, risk factors (smoking, blood pressure, diabetes, family history), and prior results.
Lifestyle measures reduce cholesterol and cardiovascular risk: healthy eating (emphasizing vegetables, whole grains, and lean proteins), regular physical activity, weight management, and avoiding tobacco. When lifestyle changes are insufficient or risk is high, clinicians may recommend medications such as statins.
If you notice xanthomas, corneal changes, or a family history of early heart disease, see a clinician for evaluation. Routine screening and early treatment lower the chance of heart attack and stroke.