What is high cholesterol? Causes, symptoms & treatment
High cholesterol means there’s too much cholesterol in your blood, which can increase your risk of heart disease, stroke, and other health conditions.
This can happen for a number of reasons — from genetics to lifestyle factors like diet, movement, smoking, or weight. Often, it’s a combination of things, and making small, sustainable changes can make a big difference.
If your BMI is over 35, you may be eligible for Oviva’s NHS-funded weight management programme. You’ll receive tailored support to help reduce your cholesterol levels, feel more confident in your food choices, and if appropriate, access weight loss medication like Wegovy.
Key Takeaways:
- High cholesterol can be caused by eating too much saturated fat, not moving enough, carrying excess weight, or genetics.
- Cholesterol that’s too high raises your risk of heart disease and stroke.
- It usually has no symptoms and is detected through a blood test.
- You may be able to lower it by changing your diet, losing weight, moving more, and cutting back on alcohol.
What is high cholesterol?
High cholesterol means the level of cholesterol in your blood is too high.
Cholesterol is a fatty substance made by the liver and also found in some foods. It’s important for cell health, but too much can become a problem.
When cholesterol levels rise above what’s healthy, it’s called hypercholesterolemia—sometimes referred to as hyperlipidaemia. This may mean high total cholesterol or high non-HDL cholesterol, which is the type linked to health risks.
Cholesterol types
Cholesterol is typically broken down into two main types:
- HDL cholesterol – sometimes referred to as ‘good’ cholesterol
- Non-HDL cholesterol – sometimes referred to as ‘bad’ cholesterol
These ‘good’ and ‘bad’ descriptions are a little simplistic, but can be useful for understanding the key differences between these two types.
HDL cholesterol helps to remove non-HDL cholesterol you don’t need by returning it to the liver. HDL cholesterol can make you less likely to have heart problems.
Non-HDL cholesterol, on the other hand, can build up inside your blood vessels, making you more likely to experience health problems, including cardiovascular disease and stroke.
You may also see references to LDL cholesterol. This is the main type of non-HDL cholesterol and used to be referred to as the ‘bad’ type of cholesterol. However, we have since learned that other types of non-HDL cholesterol can also have a negative impact on your health.
What is a high cholesterol reading?
You can check your cholesterol levels with a blood test or lipid profile, which measures the different types of fats in your blood—including cholesterol and triglycerides.
Depending on the test, blood may be taken from your arm or through a finger-prick test. You may be asked to fast for up to 12 hours beforehand to get the most accurate results.
Here’s a quick look at healthy and unhealthy cholesterol levels:
| Healthy level | Unhealthy level | |
| Total cholesterol | Below 5.0 mmol/L | 5.0 mmol/L or above |
| Non-HDL cholesterol | Below 4.0 mmol/L | 4.0 mmol/L or above |
| LDL cholesterol | Below 3.0 mmol/L | 3.0 mmol/L or above |
| HDL cholesterol | Above 1.0 mmol/L for men
Above 1.2 mmol/L for women |
Below 1.0 mmol/L for men
Below 1.2 mmol/L for women |
| Triglycerides | Below 2.0 mmol/L | 2.0 mmol/L or above |
What causes high cholesterol?
High cholesterol is often linked to a combination of lifestyle and health factors. Common causes include:
- Poor diet, especially with too much saturated fat
- Living with excess weight
- Not getting enough exercise
- Smoking
- Drinking too much alcohol
- Living with high stress levels
Cholesterol can also be caused by genetics, like family history.
In some cases, this may be due to a condition called familial hypercholesterolaemia (FH), where the body struggles to regulate cholesterol properly. If you have FH, standard treatments may be less effective, so it’s important to work closely with your healthcare provider on the right plan for you.
Certain health conditions can also increase cholesterol levels, including:
- Diabetes
- Kidney disease
- Hypothyroidism
- Liver disease
Who is at risk of high cholesterol?
Your risk of high cholesterol may be higher if you are:
- Over the age of 40
- A man
- A postmenopausal woman
- From a family with a history of high cholesterol
- From a South Asian or Sub-Saharan African family background
You’re at higher risk if you’re living with obesity, have insulin resistance, or have type 2 diabetes. These conditions often go hand-in-hand and can lead to higher blood glucose levels, which may damage the lining of your arteries—making it easier for cholesterol to build up and increasing your risk of heart disease.
What are the symptoms of high cholesterol?
High cholesterol often has no symptoms and usually only detected with a blood test. However, it can lead to serious health issues, including stroke and cardiovascular disease, which makes early awareness all the more important.
Some of the rare high cholesterol symptoms include:
- Small yellow lumps near the eyes, called xanthelasmas.
- Swelling on your tendons, including on your hands and ankles, called tendon xanthomas.
- White rings around the iris, called corneal arcus.
These symptoms are usually linked to a family history of high cholesterol.
What to do if your cholesterol is high (treatments)
If your cholesterol is high, there are a variety of treatment options to explore — and lifestyle changes are a great start.
First steps
The first thing to do is speak to your GP.
For many people, the first line of treatment is to make changes to your diet and activity levels. In some cases, you may also be prescribed medication, such as a statin.
Can you reduce cholesterol fast?
You can start lowering cholesterol through diet, physical activity, and weight loss — and doing all three together works better than diet alone.
That said, cholesterol levels don’t change overnight. It can take weeks or even months to see measurable improvements through food and lifestyle, so it’s important to be patient and consistent.
Quick fixes like crash diets often backfire. It’s better to focus on sustainable, long-term changes, like those supported by Oviva.
Lifestyle changes to lower your cholesterol
These changes can all help reduce cholesterol levels:
- Eat more fibre-rich foods, like fruit and vegetables, oats, beans, and lentils
- Cut back on saturated fats, found in fatty cuts of meat, butter, and full-fat dairy
- Choose healthy fats, including oily fish, nuts and olive oil
- Include foods with proven cholesterol-lowering effects, like flaxseeds, almonds and avocados
- Look for plant stanols and sterols in fortified spreads and drinks
- Cut back on alcohol and quit smoking
- Move your body daily – even a short walk or light housework can make a difference
- Limit ultra-processed foods where possible
For more advice, read our full guide on how to lower cholesterol or find out if fasting lowers cholesterol.
How weight management can help high cholesterol
Research shows that carrying excess weight, especially around the abdomen, is associated with higher LDL and non-HDL cholesterol and triglyceride levels.
Losing weight can help to improve your cholesterol by:
- Reducing LDL and non-HDL cholesterol
- Increasing HDL cholesterol
- Lowering triglycerides
- Improving insulin resistance, which is associated with elevated non-HDL cholesterol
Even losing 5% to 10% of your total body weight can help to make a significant difference – especially if it’s achieved through a healthier diet and more movement.
Remember, it’s not about perfection – you don’t need to follow a strict diet or completely avoid your favourite foods. It’s about making small, sustainable changes to your diet, exercise habits, and lifestyle, so you can maintain them in the long term and benefit from lasting results.
Here at Oviva, we offer evidence-based weight management support tailored to you.
Lower your cholesterol with expert-led weight loss support
The best way to keep your cholesterol levels under control is to achieve sustainable weight management, and Oviva’s programme can give you the skills and knowledge you need.
We have a team of healthcare professionals – including doctors, dietitians, and psychologists – to help you develop healthy behaviours and habits.
With the Oviva app, you can:
- Track your progress
- Get personalised feedback
- Access helpful tools and resources
You may be eligible if you have a BMI over 35 and a weight-related health condition. Our quick survey can help you to know whether you’re eligible, and you can speak to your GP for a referral. As part of the programme, you may also be able to access prescription weight loss injections.