by Nicole Evans M.D.

Created on: September 09, 2008   Last Updated: June 22, 2009

More than 100 million Americans have high cholesterol. But would they have ever known that they had high cholesterol if their doctor hadn't tested their cholesterol levels as a part of cardiovascular health screening?

Well, there are actually signs and symptoms that are associated with high cholesterol, or hyperlipidemia, if you know what to look for. Most of us are familiar with the symptoms of atherosclerotic disease: chest pain or dizziness with exertion, strokes or transient ischemic attacks (stroke that lasts less than 24 hours without residual symptoms), coronary artery disease that causes heart attacks and congestive heart failure.

However, there are other physical signs that are sometimes seen in individuals who don't have any symptoms of atherosclerotic disease. These specific physical findings depend on which aspect of your lipid metabolism has given you that high cholesterol.

There are three major types of lipids to consider when your doc tells you that your cholesterol is high: HDL, LDL and VLDL. The bottom line is that we all want high HDL, low LDL and low VLDL, but why and what signs and symptoms are associated with abnormal levels?

LDL:

First, there is the "bad cholesterol" called Low Density Lipoproteins or LDL. If your LDL is high your risk of heart disease and stroke is higher than it should be. Having very high LDL will give you certain physical findings called xanthelasma and xanthoma.

-Xanthelasma: These are painless, non-itchy raised yellow plaques that occur on the eyelids (particularly near the inner eyelid).
-Xanthomas: These are reddish brown papules on the scalp, face, trunk and/or flexor surfaces of the limbs.

HDL:

Second, there is the "good cholesterol" called High Density Lipoproteins or HDL. This HDL grabs cholesterol from your peripheral tissues where it can cause you problems and brings it back home to the liver. If your HDL is high then you're actually lowering your risk of complications from atherosclerotic disease. If your HDL is low then high levels of LDL and VLDL will have a greater negative impact on your health.

VLDL:

The third and last type of lipid to consider if you've been labeled with high cholesterol is called VLDL. This is the carrier for a group of lipids called triglycerides. Having a very high triglyceride level (>750 mg/dL) may cause pancreatitis! Pancreatitis is a pretty miserable illness with severe stomach pain, nausea and vomiting. However, it is unusual to have triglycerides this high and usually suggests a genetic condition.

The encouraging aspect about high cholesterol, no matter your symptoms, is that it's really quite treatable. All that is required of most people are some healthy changes to their diet and exercise routine. For those that don't respond to lifestyle changes there are medications such as statins and niacin that are relatively safe and very effective.

Learn more about this author, Nicole Evans M.D..
Click here to send this author comments or questions.