If you’re concerned about your cholesterol levels, you may be wondering what symptoms to watch out for. Unfortunately, just like with high blood pressure (which is also implicated in poor cardiovascular outcomes) high cholesterol has no reliably noticeable symptoms. The only way to be sure of your cholesterol levels is to have them tested using a blood sample.

While “high LDL cholesterol symptoms” are lacking, there are certain possible clues that could suggest that all is not right with your lipid levels. None of them in isolation can be used to determine that your cholesterol is higher than normal, and it would be entirely possible for you to be walking around with dangerously high cholesterol without experiencing any of them. Instead, the presence of these conditions can be taken as a general indicator that a person may be at risk of high cholesterol.


A xanthoma is a particular type of painless skin lesion that usually appears on the elbows, buttocks, knees, hands, or feet. Xanthomas are waxy, yellowy or orange raised papules, occurring individually or in clusters, and can vary from tiny to up to three inches in diameter. They indicate high blood lipid levels caused by some underlying condition including hypercholesterolemia, or high cholesterol. Other possible underlying conditions include uncontrolled type 2 diabetes, thyroid problems, pancreatitis, liver problems, and certain cancers.

If you think you have xanthomas, get them checked out. Because they’re pain-free, people sometimes try to ignore them, dismissing them as a cosmetic blemish or perhaps an unfortunate aspect of aging. But it’s extremely important to find out what’s causing them, since the underlying condition could be very serious.


While it would be far from true to suggest that anyone with obesity must also have high cholesterol…and even farther from the truth to say that thin people must not have high cholesterol…it is true that the two conditions often go hand-in-hand. Obesity, especially abdominal fat, is linked to greater risk of high LDL (“bad”) cholesterol and low HDL (“good”) cholesterol. It also, of course, drives up your risk of high blood pressure and your overall cardiovascular risk.

Obesity is one component of a condition doctors refer to as “metabolic syndrome.” This syndrome has several elements which, clustered together, significantly increase your risk of heart attack, stroke, and diabetes. Those elements are large waist circumference, high blood sugar, high blood pressure, low HDL levels, and high levels of triglycerides.

To be clear, neither obesity nor metabolic syndrome is a symptom of high cholesterol. But if you suffer from obesity or other elements of metabolic syndrome, you should certainly get your cholesterol levels checked.


High cholesterol and type 2 diabetes often occur together. In fact, 70% of people who have been diagnosed with diabetes also have high or borderline-high levels of total cholesterol, as do 77% of people with undiagnosed diabetes.

Diabetes appears to cause HDL (“good”) cholesterol levels to fall and LDL (“bad”) cholesterol to rise. It’s also associated with an increase in triglyceride levels. These associations may be driven by a mechanism whereby diabetes damages the blood vessels, causing surface irregularities to appear on their inner linings which allow LDL cholesterol to find purchase, collect, and form plaques.

As with obesity, diabetes is not a symptom of high cholesterol but rather a disease often associated with it. People who have diabetes should carefully monitor their cholesterol levels.

Sexual dysfunction

Human sexuality is decidedly complex, and when things don’t function quite the way we’d like, sorting through the possible causes can be a difficult task. Yet we know that one frequent cause is a lack of proper circulation to the sexual organs.

How is cholesterol implicated in such a scenario? When cholesterol plaques accumulate in your arteries—a condition known as atherosclerosis—they begin to restrict blood flow as the arteries narrow over time. Erectile dysfunction may be a “canary in the coal mine” when it comes to atherosclerosis, since the small blood vessels leading to the penis may become partially blocked several years before this happens in the larger coronary arteries.

But it’s not just men who may experience sexual dysfunction as a result of atherosclerosis. The condition can also cause reduced flow through the arteries that supply blood to the vagina and vulva, causing vaginal dryness and disrupting arousal, orgasm, and sexual satisfaction.

If you begin to experience sexual dysfunction, talk to your doctor, who will likely assess your cardiovascular risk, including your cholesterol levels.  

Chest pain

Patients whose high cholesterol has gone untreated may have plaque on the insides of their arteries that has hardened, or “calcified,” causing the formation of what’s known as a “stable plaque.” When this happens, patients sometimes first become aware of a problem when they experience chest pain from exertion which goes away when they’re at rest. This condition is known as “stable angina.”

Such pain is not trivial, since it signals that your atherosclerosis has progressed to a dangerous state known as atherosclerotic cardiovascular disease (ASCVD) putting you in danger of heart attack or stroke. If you experience this kind of pain, have it checked as soon as possible to begin treatment that may stave off a major cardiovascular event.

Of even more immediate concern is unstable angina, chest pain that comes on suddenly and doesn’t go away when you stop exerting yourself. This, too, is caused by ASCVD, often when a plaque ruptures, forming a blood clot that partially or fully blocks a blood vessel. This is extremely dangerous, and you must seek immediate medical attention.

As should be clear, these forms of chest pain are acute symptoms, not so much of high cholesterol as of ASCVD, which is the culmination of years of cholesterol buildup. Just because someone does not have ASCVD or its symptoms by no means indicates that they don’t have high cholesterol.

Long before these acute ASCVD symptoms develop, you should learn your cholesterol levels by visiting a doctor for regular physical examinations that include bloodwork.

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