Medically Reviewed and Compiled by Dr. Adam N. Khan, MD.

Quick Answer: High cholesterol is often called a “silent killer” because it usually has no symptoms. Most people do not know they have it until they get a blood test or suffer a medical emergency like a heart attack or stroke. In rare cases of extremely high genetic cholesterol, physical signs like yellowish bumps around the eyes (xanthelasma) or white rings around the iris (corneal arcus) may appear.

What Are the Symptoms of High Cholesterol?

If you are looking for a checklist of physical feelings—like a cough for a cold or a fever for the flu—high cholesterol is going to frustrate you. For the vast majority of people, high cholesterol feels like nothing at all.

High cholesterol means you have too many fatty substances (lipids) in your blood. These fats don’t cause pain as they circulate. Instead, they slowly build up inside your arteries, creating a “clog” called plaque. This process is quiet, invisible, and can take decades.

Why Are There No Early Warning Signs?

Your body is remarkably good at adapting. As your arteries narrow due to cholesterol buildup (a condition called atherosclerosis), your heart simply works a little harder to pump blood through the smaller space. You won’t feel this extra effort until the “pipes” are almost completely blocked or until a piece of that fat breaks off and causes a clot.

Rare Physical Signs You Can See

While “symptoms” are rare, there are a few physical markers that show up in people with severe or genetic high cholesterol (Familial Hypercholesterolemia).

Xanthelasmas: These are small, soft, yellowish growths or bumps that appear on the eyelids or the skin around the eyes. They are actually pockets of cholesterol deposits.
Corneal Arcus: This is a white, gray, or blue ring that forms around the colored part of your eye (the iris). While common in older adults, if it appears in someone under age 45, it’s a strong sign of high cholesterol.
Xanthomas: These are fatty bumps that can appear on your knuckles, knees, elbows, or Achilles tendons. They might look like a rash or small warty growths.

The “Silent” Progression: From Cholesterol to Emergency

Since you can’t feel high cholesterol, you usually only feel the complications it causes. By the time symptoms appear, the cholesterol has already caused significant damage to the cardiovascular system.

1. Chest Pain (Angina)

When cholesterol narrows the arteries leading to the heart, the heart muscle doesn’t get enough oxygen-rich blood. This can cause chest pain, pressure, or a feeling of squeezing. This is often triggered by physical activity and goes away with rest.

2. Leg Pain While Walking

This is a sign of Peripheral Artery Disease (PAD). Cholesterol buildup in the legs reduces blood flow. You might feel cramping, aching, or fatigue in your calves or thighs when you walk or climb stairs.

3. Extreme Fatigue and Shortness of Breath

If your heart is struggling to move blood through “greasy” or narrowed arteries, you will tire out much faster than usual. Doing simple tasks like carrying groceries might leave you winded.

How to Catch It Before It Catches You

Since you can’t rely on your body to “tell” you that your cholesterol is high, you must rely on science.

The Lipid Panel

The only way to know your numbers is through a blood test called a Lipid Panel. This test measures:

LDL (Bad) Cholesterol: The kind that builds up in your arteries.
HDL (Good) Cholesterol: The kind that helps scrub the bad stuff out.
Triglycerides: Another type of fat in the blood.

Who Should Get Tested?

According to current health guidelines, most healthy adults should have their cholesterol checked every 4 to 6 years. However, you should get tested more often if you:

Have a family history of heart disease.
Smoke or vape.
Are overweight.
Have diabetes or high blood pressure.

How to Naturally Manage Your Levels

The good news is that high cholesterol is one of the most treatable health conditions. Even if you have a genetic link, lifestyle choices make a massive difference.

Focus on Fiber: Soluble fiber (found in oats, beans, and apples) acts like a sponge, soaking up cholesterol in your gut and carrying it out of the body.
Move Your Body: Just 30 minutes of walking a day can help raise your “good” HDL cholesterol.
Watch the Fats: Swap saturated fats (like butter and fatty meats) for healthy fats (like olive oil, avocado, and walnuts).
Stop Smoking: Smoking makes your LDL cholesterol “stickier,” making it much easier for it to clog your arteries.

Summary of Key Takeaways

Symptoms: Usually none. It is a silent condition.
Rare Signs: Yellow skin bumps (xanthomas) or eye rings (corneal arcus).
The Danger: It leads to heart attacks and strokes if left unchecked.
The Solution: A simple blood test is the only way to be sure.

Don’t wait for a “sign” from your body. By the time high cholesterol starts talking to you, it’s often shouting through a medical emergency. Talk to your doctor about a blood test today—it is the simplest step you can take for a longer, healthier life.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.