High Cholesterol does not come with warning signs. No pain. No symptoms. But it’s quietly one of the top risk factors behind heart attacks and strokes. Millions of people walk around with dangerously high levels of cholesterol and don’t have any idea. If you have never checked your cholesterol levels, it’s time to take cholesterol seriously.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance that circulates in your bloodstream. Your body needs it to build cells, produce hormones, and aid digestion. But, having too much cholesterol or high cholesterol can raise your risk of heart disease and stroke.
Symptoms of Having High Cholesterol
High cholesterol is commonly called a “silent” condition because it usually shows no symptoms. It happens when there’s too much cholesterol circulating in your blood, particularly Low-Density Lipoprotein (LDL), often called “bad cholesterol.” Although your body requires cholesterol to produce hormones and generate cells, too much of the wrong kind can be harmful.
Too much LDL cholesterol builds up in your arteries and forms plaque, a thick, sticky substance that narrows the vessels and slows blood flow. This process, called atherosclerosis, makes you more likely to have a heart attack, stroke, or other heart problems.
Because it doesn’t show any symptoms, high cholesterol is even more dangerous. You won’t feel plaque forming in your arteries. You won’t notice your cholesterol levels getting higher.
The only way to know if you have high cholesterol is with a blood test, specifically, a lipid panel. This test measures your:
- Total cholesterol
- LDL cholesterol
- HDL cholesterol
- Triglycerides
Regular screening is highly important. Doctors recommend getting your cholesterol checked starting at age 20 and every 4 to 6 years after that, especially if you have risk factors like obesity, smoking, diabetes, or a family history of heart disease.
What Causes High Cholesterol?
High Cholesterol can result from unhealthy lifestyle habits, underlying health issues, and inherited attributes. Some factors are in your control, while others aren’t.
Here are the causes of high cholesterol:
Lifestyle Factors
- Unhealthy Diet: Eating foods high in saturated fats and trans fats, like red meat, butter, and processed foods, can increase bad cholesterol.
- Physical Inactivity: Not exercising regularly can lower good cholesterol and increase bad cholesterol levels.
- Smoking: This harms blood vessels and reduces good cholesterol, which can lead to heart disease risk.
- Stress and Adrenal Fatigue: Chronic stress may trigger hormonal shifts that raise cholesterol, resulting in bad habits like smoking, overeating, and poor sleep. Over time, prolonged stress may lead to Adrenal Fatigue, a condition in which the body has trouble handling stress. This can worsen symptoms like fatigue, sleep issues, and weight gain, which are all associated with poor cholesterol control.
- Excessive Alcohol: Drinking too much alcohol could increase triglycerides and total cholesterol levels.
Medical Conditions
- Obesity: Being overweight can increase bad cholesterol and decrease good cholesterol.
- Diabetes: High blood sugar levels affect cholesterol balance.
- Hypothyroidism: Low thyroid hormone levels slow down cholesterol metabolism.
- Kidney or Liver Disease: These affect how the body processes and clears cholesterol.
Genetic Factors:
- Familial Hypercholesterolemia: An inherited condition causing very high LDL levels from a young age.
- Lipoprotein(a) [Lp(a)]: A genetic variation of LDL that increases cardiovascular risk. About 20% of people have elevated Lp(a) levels, unaffected by lifestyle changes.
- Age: As you become older, particularly after 40, your liver gets less efficient at removing LDL cholesterol.
- Inherited Conditions: Regardless of lifestyle, some medical problems and genetic conditions, such as hormone deficiency, early menopause, or polycystic ovary syndrome (PCOS), may contribute to high cholesterol levels.
Why is High Cholesterol a Silent Threat to Your Heart?
High cholesterol is a silent threat to your heart. It builds up over time without symptoms, increasing the risk of heart disease, heart attacks, and strokes.
The Global and National Reality of Heart Disease
Cardiovascular disease isn’t just a personal health issue; it’s a global emergency. According to the World Health Organization (WHO), Cardiovascular diseases (CVDs) are the leading cause of death globally, claiming 17.9 million lives each year.
Over 80% of these deaths are due to heart attacks and strokes, and 1 in 3 deaths occurs prematurely in people under age 70.
Additionally, the Centers for Disease Control and Prevention (CDC) reports that in the United States, heart disease is the leading cause of death for men and women. In 2022 alone, 702,880 people died from heart disease; that’s 1 in every 5 deaths.
Every 33 seconds, someone dies from cardiovascular disease. It also costs the country about $252.2 billion annually in healthcare and lost productivity.
High cholesterol is one of the major drivers behind all this. And yet, most people with it don’t even know they have it.
How High Cholesterol Harms the Heart
- It Builds Dangerous Plaque in Arteries: Excess LDL creates fatty deposits that harden into plaque. This causes atherosclerosis — when arteries lose flexibility and become clogged.
- It Triggers Heart Attacks: When a plaque ruptures, the body treats it like an injury. A blood clot forms and can suddenly block the artery completely. If this happens in a coronary artery, it causes a heart attack.
- It Can Cause Strokes: If a clot blocks blood flow to the brain, it results in a stroke. This can lead to permanent disability or death within minutes.
- It Raises Blood Pressure: Clogged arteries force the heart to work harder to push blood through. This leads to high blood pressure, which further damages blood vessels and increases the risk of heart failure.
Understanding Cholesterol Tests: Traditional and Advanced Markers
Cholesterol testing is one of the most common tools used to evaluate heart health but not all tests are created equal. While the traditional lipid panel has long been a staple in routine checkups, it only tells part of the story. Today, advanced testing goes deeper, measuring the size, number, and type of cholesterol-carrying particles, as well as inflammation markers that signal hidden cardiovascular risk.
Traditional Cholesterol Tests (Basic Lipid Panel)
A lipid panel measures four main values: Total Cholesterol, LDL, HDL, and Triglycerides. These are the traditional markers doctors have used for many years to assess heart health:
- Total Cholesterol: The sum of LDL, HDL, and 20% of triglyceride levels.
- LDL (Low-Density Lipoprotein): Often termed “bad” cholesterol, high levels can lead to arterial plaque.
- HDL (High-Density Lipoprotein): Known as “good” cholesterol, it helps remove LDL from the bloodstream.
- Triglycerides: A type of fat in the blood; high levels can also increase heart disease risk.
| Marker | Optimal Range | High-Risk Range |
|---|---|---|
| Total Cholesterol | Less than 200 mg/dL | Greater than or equal to 240 mg/dL |
| LDL Cholesterol | Less than 100 mg/dL | Greater than or equal to 160 mg/dL |
| HDL Cholesterol | Greater than 60 mg/dL | Less than 40 mg/dL (men) Less than 50 mg/dL (women) |
| Triglycerides | Less than 150 mg/dL | Greater than or equal to 200 mg/dL |
The Importance of Cholesterol Ratios
While individual values are helpful, certain ratios can provide a clearer picture of your cardiovascular health:
- Triglyceride/HDL Ratio: A powerful indicator of insulin resistance and metabolic health.
- Total Cholesterol/HDL Ratio: Reflects the balance between total cholesterol and protective HDL.
| Ratio | Optimal Range | High-Risk Range |
|---|---|---|
| Triglycerides / HDL Ratio | Approximately 1.0 or lower | Greater than or equal to 3.0 |
| Total Cholesterol / HDL Ratio | Less than 3.5 | Greater than or equal to 5.0 |
Advanced Cholesterol Testing: What Your Basic Lipid Panel Isn’t Telling You
Advanced lipid testing goes beyond traditional cholesterol tests. Instead of measuring how much cholesterol is in your blood, it looks at the particles carrying that cholesterol.
This testing focuses on key biomarkers:
| Marker | Optimal Range | High-Risk Range |
|---|---|---|
| Apolipoprotein B (apoB) | Less than 90 mg/dL | Greater than or equal to 130 mg/dL |
| Lipoprotein(a) [Lp(a)] | Less than 75 nmol/L | Greater than 125 nmol/L |
| LDL Particle Number (LDL-P) | Less than 1,000 nmol/L | Greater than or equal to 1,600 nmol/L |
| HDL Particle Number (HDL-P) | Greater than approximately 30 µmol/L | Less than approximately 30 µmol/L |
- Apolipoprotein B (apoB): Found on every atherogenic particle: LDL, VLDL, IDL, and Lp(a). Measuring apoB gives you a direct count of harmful particles. Elevated levels are tied to higher cardiovascular risk, especially in people with diabetes, metabolic syndrome, or insulin resistance.
- Lipoprotein(a) [Lp(a)]: A genetically driven LDL variant with an added protein, apo(a). High levels of Lp(a) increase the risk of heart disease and stroke. It’s largely unaffected by diet or lifestyle, so experts recommend testing it at least once in adulthood.
- LDL Particle Number (LDL-P) and Size: LDL-P measures how many LDL particles are in your blood. Smaller, denser particles are more likely to penetrate artery walls and oxidize, raising heart disease risk.
- HDL Particle Number (HDL-P) and Size: HDL-P shows how many protective particles are working to remove cholesterol. Bigger HDL particles are more effective.
Inflammation Tests That Reveal Hidden Heart Disease Risk
Inflammation plays a significant role in the development of atherosclerosis and stroke, even when traditional risk factors appear normal.
That’s why inflammation markers like Lp-PLA2, MPO (myeloperoxidase), and hsCRP (high-sensitivity C-reactive protein) are gaining attention as powerful tools to assess cardiovascular risk.
| Marker | Optimal Range | High-Risk Range |
|---|---|---|
| Lp-PLA2 (Activity) | Less than or equal to 123 nmol/min/mL | Greater than 123 nmol/min/mL |
| hsCRP (High-sensitivity CRP) | Less than 1.0 mg/L | Greater than 3.0 mg/L |
LP-PLA2: The Artery Wall Enzyme
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme produced by macrophages. It binds to LDL particles and acts directly within artery walls, breaking down oxidized lipids and triggering inflammatory responses.
High Lp-PLA2 levels have been independently linked to:
- Heart attacks and ischemic stroke
- Progression of white matter disease in the brain (a precursor to stroke and dementia
hsCRP: The General Inflammation Indicator
High-sensitivity C-reactive protein (hsCRP) is a liver-produced protein triggered by IL-6. It’s a broad marker of inflammation and a well-established risk enhancer for cardiovascular disease.
While hsCRP is linked to:
- Heart attacks and strokes
- Progression of white matter disease and dementia
How to Lower High Cholesterol: Best Supplements, Diet, and Exercise
High cholesterol can quietly build up in your body and increase the risk of heart disease, stroke, and other cardiovascular issues.
Here are the most effective strategies to lower high cholesterol:
1. Supplements to Lower Cholesterol
Supplements can support your efforts to manage cholesterol, especially when paired with a healthy diet and exercise. While they do not replace lifestyle changes, the right supplements may help optimize lipid levels, reduce oxidative stress, and support cardiovascular health.
RQ Plus
RQ Plus is a proprietary blend featuring Red Yeast Rice, a natural source of monacolin K, which works similarly to statins by inhibiting cholesterol production in the liver. It also includes CoQ10, which supports cardiovascular health, powers mitochondrial function, and helps reduce the muscle cramping sometimes associated with statins. This formula helps manage cholesterol, protect the liver, and combat oxidative stress.
Asitosterol
Asitosterol is a plant-based blend centered on beta-sitosterol, known for inhibiting cholesterol absorption in the intestines, supporting healthy LDL levels, and promoting prostate and immune health.
BerbeBlast
BerbeBlast is a powerful blend of berberine, bitter melon, and banaba leaf, which can support healthy cholesterol, blood sugar, and metabolism. It acts as a natural PCSK9 inhibitor that helps the liver clear LDL cholesterol from the bloodstream more efficiently. This promotes lower cholesterol levels without the side effects of synthetic drugs. It’s a great addition if one is also dealing with insulin resistance as it can also help control blood sugar levels.
GB Plex
GB Plex is a carefully crafted formula designed to support heart health from multiple angles. It helps maintain healthy cholesterol, blood pressure, and vascular integrity. It has aged garlic that supports blood pressure and overall heart health. Additionally, it contains citrus bergamot, which helps manage cholesterol levels naturally.
Niacin Active by Dr. Lam
Unlike traditional niacin, Niacin Active delivers the full benefits of vitamin B3 without the uncomfortable flushing. It’s a gentler, more sustainable way to support cholesterol levels and overall energy without side effects. It uses Niacinamide, a flush-free form of vitamin B3 that promotes lipid metabolism by facilitating the conversion of fats into usable energy. This helps maintain cholesterol levels already within normal range while fueling cellular energy production.
OmegaMax
Omegamax is a high-potency fish oil designed to target elevated triglyceride levels. It is powered by MaxSimil® monoglyceride technology, which delivers EPA and DHA in a form the body can absorb up to 3 times more efficiently than standard fish oils. These omega-3s help reduce liver fat production and increase fat clearance from the bloodstream, making OmegaMax a highly effective, natural way to lower triglycerides.
2. Diet to Lower Cholesterol
Your diet has a direct impact on your cholesterol levels. Here’s what to eat—and what to avoid.
Foods That Help Lower Cholesterol:
- Oats and barley (rich in beta-glucan)
- Fruits and vegetables (high in fiber and antioxidants)
- Legumes (beans, lentils, chickpeas)
- Nuts and seeds (almonds, flaxseed, chia)
- Fatty fish (salmon, sardines, mackerel)
- Healthy oils (olive oil, avocado oil)
- Foods fortified with plant sterols/stanols
Foods to Avoid:
- Saturated fats (red meat, butter, cheese)
- Trans fats (margarine, baked goods, fried foods)
- Refined carbs (white bread, pastries)
- Sugary drinks
- Processed snacks
3. Exercise to Lower Cholesterol
Being active helps raise good cholesterol and lower bad cholesterol.
How Much Should You Exercise?
Aim for at least 150 minutes of moderate-intensity activity per week. Break it down into 30-minute sessions 5 days a week.
Best Types of Exercise You Can Do:
- Cardio: Brisk walking, jogging, cycling, swimming
- Strength Training: Weights or resistance bands (2–3 times/week)
- Functional Movement: Gardening, housework, playing with kids
Pro Tip:
- Take the stairs.
- Park further from entrances.
- Walk during phone calls.
4. Bonus Tips for Lowering Cholesterol
Quit Smoking: Smoking damages arteries and lowers HDL.- Limit Alcohol: Excess drinking increases triglycerides and LDL.
- Maintain a Healthy Weight: Losing just 5–10% of body weight can significantly improve cholesterol.
- Reduce Stress: Chronic stress raises blood pressure and worsens heart risk.
3 Ways to Prevent High Cholesterol
Preventing high cholesterol starts with small, consistent lifestyle decisions. The earlier you adopt healthy habits, the better your long-term heart health.
1. Lifestyle Habits for Long-Term Heart Health
Eat more fiber, move daily, avoid cigarettes, and keep processed foods in check. Staying active and eating clean helps maintain healthy cholesterol.
2. Regular Screening and Monitoring
Get your cholesterol levels checked every 4–6 years or more often if you have risk factors. Know your numbers, especially LDL, HDL, and triglycerides, and talk with your doctor about your results and next steps.
3. Managing Stress and Other Risk Factors
Chronic stress doesn’t just affect your mood. It can raise cholesterol levels and disrupt your body’s hormonal balance. Over time, prolonged stress may contribute to Adrenal Fatigue, a condition where your adrenal glands struggle to regulate stress hormones like cortisol. This can lead to symptoms such as fatigue, poor sleep, weight gain, and sugar cravings, all of which can make managing cholesterol harder.
Addressing stress through healthy coping habits like deep breathing, regular sleep, daily movement, and time away from screens can support hormone balance, improve cholesterol, and reduce your overall heart risk.
Takeaway Message
High cholesterol is a silent but deadly threat. It develops without symptoms, quietly damaging your arteries and putting you at serious risk for heart attacks and strokes. The good news? You can take control.
Start by getting your cholesterol tested regularly. Then, commit to real change through diet, exercise, and the right supplements. If an unhealthy lifestyle, underlying health issues, and genetic factors are in the picture, they could be silently pushing your cholesterol even higher.
Take the next step toward a stronger, healthier life. If you want guidance that fits your day, reach out to Lam Clinic to set up a visit. Together we will tailor meals, movement, and supplement options to your labs and lifestyle, coordinate with your primary care when needed, and help you make steady, confident changes.
