What happens to your body when you have high cholesterol

Concerned about your heart health? You might be surprised with this fact: We all need cholesterol to keep us healthy.

"Cholesterol in itself isn't bad. In fact, it is essential for survival," explains David Kovacich, MD, a board-certified cardiologist with Franciscan Physician Network Indiana Heart Physicians in Indianapolis. "Your body requires cholesterol to make cell membranes, hormones, vitamin D and digestive fluids. Cholesterol also supports proper organ function."

But there is "good" and "bad" cholesterol, and those need to be balanced or our risk of heart attack increases.

What Is Cholesterol?

Cholesterol is a waxy substance found in the blood and in cells throughout the body. Your body manufactures 75 percent of its cholesterol, and the rest enters the body through the food you eat.

Cholesterol travels through the bloodstream packaged in bundles called lipoproteins.

There are two main types of cholesterol:

Low-density lipoprotein (LDL) is the "bad," unhealthy cholesterol. It can slowly build up in arteries with calcium and inflammatory cells and create fatty deposits called plaques. LDL cholesterol is a risk factor for heart attack and stroke.

High-density lipoprotein (HDL) is the "good" kind of cholesterol. It carries excess cholesterol away from the arteries to the liver. HDL cholesterol protects against heart attack and stroke.

Generally the lower the LDL and the higher the HDL, the lower your risk of heart disease.

How Can Cholesterol Levels Hurt Your Body?

"Too much LDL cholesterol in the body can create problems," Dr. Kovacich said. "Over the course of time, elevated cholesterol levels can damage the arteries, contribute to heart disease and increase the risk of stroke. It's a good idea to monitor cholesterol levels during regular doctor’s visits and, if necessary, try to reduce high levels through diet, exercise and medication. Exercise by itself can raise the good cholesterol levels but cannot lower the bad cholesterol levels."

Excess LDL, especially in association with other risk factors, such as diabetes, high blood pressure and smoking, can lead to premature development of plaque in arteries throughout the body.

How Can You Tell If You Have Plaque From Cholesterol?

"Until recently, we had no way of detecting plaque until the build-up was pronounced," Dr. Kovacich said. "We can now detect plaque at early stages by using heart scans which measure calcium deposits in the arteries."

Over years, the buildup of plaque in coronary arteries can interrupt the flow of oxygen-rich blood coming to the heart. This can cause symptoms called angina. In some, angina may be manifested by chest pain while in others it might be shortness of breath.  Women often have atypical symptoms and could suffer only from fatigue. Symptoms consistent with angina should lead to an urgent evaluation by your health care provider because ultimately, a clot could form on unstable plaque, leading to a heart attack or stroke.

If this cholesterol plaque breaks free, it can block the flow of blood, causing heart attack or stroke.

What Are Symptoms Of High Cholesterol?

High cholesterol has no symptoms, so your blood cholesterol levels should be checked regularly. This is done through a fasting blood test. Your physician can use this information, along with your other risk factors such as age, weight and smoking, to determine how your cholesterol levels may affect your risk of heart disease.

How Is High Cholesterol Diagnosed?

When a doctor checks your cholesterol level, he or she will usually do a test that's called a lipid panel, which includes measuring your total cholesterol and some of the other fats that are in the blood. This test requires a 14-hour fast to get an accurate reading of the blood fats.

Because the level of triglycerides is affected by many factors, including medications, use of oral contraceptives, alcohol and food intake, and recent exercise, you also should fast for at least 12 hours before testing for triglycerides.

Unfortunately, there's no sharp cutoff point between healthy and unhealthy levels, but ideally, your total cholesterol should be below 200 milligrams per deciliter. Anything between 200 and 239 mg/dL is considered borderline high, and a level of 240 mg/dL or above is high. Check with your doctor about what's right for you.

Starting at age 20, adults should have their lipid panels levels checked at least once every five years. Men over 45 and women over 55 should be checked more often. If you already have high cholesterol or are at risk for heart disease, your doctor may want to measure your cholesterol more often.

How Do The Foods You Eat Impact Your Cholesterol?

When you eat too much fatty foods or drink too much alcohol, the liver produces more cholesterol and releases it in the blood stream. If too many calories are taken in, the liver changes them into triglycerides, storing them as fat.

This is why physicians recommend watching your saturated and trans fats in your diet, as well as the amounts of fast foods and processed foods.

Is Medication Always Needed To Reduce Cholesterol?

Many non-medical options are available to help you reduce your cholesterol.

"The best defense against high cholesterol levels is following a healthy lifestyle, knowing your numbers and discussing them with your health care provider," Dr. Kovacich said. "Desired LDL levels are based on your risk of a cardiovascular event, so recommendations and intensity of therapy differ between patients."

Non-medical measures to reduce blood fats include:

• Stop smoking. Smoking and vaping have been shown to reduce your HDL cholesterol levels, especially among women. Learn about our tobacco cessation programs.
• Maintain a healthy weight. Even a 3 to 5 percent weight loss can be beneficial.
• Cut down on saturated and trans fats in your diet. Eat more fruits and vegetables, whole grains, beans and lentils and limit red meats, butter and other fatty foods. Also limit your intake of fast foods and processed foods.
• Exercise regularly. Regular workouts not only strengthen your heart but can also push your cholesterol levels in all the right directions. Your LDL cholesterol may drop, and your HDL cholesterol may rise. (LDL is primarily lowered by diet, and HDL is primarily increased by exercise, but we usually need to do both.)
• Eat foods low in added sugar or use sugar-free products. Foods high in sugar content should be used sparingly. They include jellies and jams, syrups, sodas, candies, some cereals, pies, cakes and most cookies.
• Limit alcohol consumption. Moderate alcohol consumption is defined as one drink a day for women and no more than two drinks a day for men. One drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits.

If these measures are not effective, your physician may prescribe drug therapy to reduce your cholesterol levels.

How Can Medications Help Cholesterol Levels?

Lifestyle changes can make a difference in cholesterol levels, but many people need medications to bring cholesterol completely under control. Drugs are especially important if you have other risk factors for heart disease, such as diabetes, or if you already have heart trouble.

The most effective cholesterol medications available today belong to a group of drugs called statins. These drugs can dramatically lower cholesterol levels and have few side effects, although some patients complain of constipation, stomach pains, and cramps. In rare cases, a patient may develop significant muscle pain and weakness. (Report any unusual symptoms to your doctor; since some of these drugs interact with other medications, always mention any other drugs or herbs you're taking as well.) A recent study of heart patients found that one statin drug cut the relative risk of heart attacks by more than 60 percent.

HealthDay News contributed information to this article.

Health Risk Assessment

What's your score? Take our HeartAware assessment, and in just minutes, receive a free, confidential analysis of your current risk factors for developing cardiovascular disease.

Does high cholesterol make you tired?

How can high cholesterol affect your body?

How can I lower my cholesterol fast?

What are the worst foods for high cholesterol?