Causes of High Cholesterol

Diet is often a cause of high cholesterol but not the only one. Learn about causes of high cholesterol and how to keep your numbers in the healthy range.

If you don’t know whether your cholesterol level is high or in a healthy range, it’s important to have it checked. There are no symptoms of high cholesterol, the Centers for Disease Control and Prevention (CDC) points out. Elevated cholesterol, also called hypercholesterolemia, puts you at risk for the two leading causes of deaths in Americans — heart disease and stroke.

The good news is you can work with your doctor to lower high cholesterol. But you first need to know why your cholesterol is high.

Lifestyle choices, including an unhealthy diet, are responsible for most cases of high cholesterol, the American Heart Association notes. But there are other causes of high cholesterol, too.

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Food-related causes of high cholesterol

Regularly eating high amounts of saturated fats can increase low-density lipoprotein cholesterol (LDL), also known as the artery-clogging “bad” cholesterol, according to the National Heart, Lung and Blood Institute. Saturated fats are found in animal products (like full fat dairy products and fatty meats) and in tropical oils (such as palm oil).

Failing to eat a fiber-rich diet may be one of the causes of high cholesterol, too. The CDC advises eating foods like oatmeal, beans, and whole wheat — along with unsaturated fats found in foods like olive oil, nuts, and avocados — to help prevent high levels of LDL and increase your “good” cholesterol, known as high-density lipoprotein (HDL).

More lifestyle causes of high cholesterol

Being overweight or obese raises your level of LDL cholesterol because excess body fat changes how your body processes cholesterol. In fact, it hampers your body’s ability to remove the “bad” cholesterol from your blood, allowing it to accumulate.

Are you a couch potato who watches hours of TV at night? Maybe you spend your days sitting at a desk. If you are not getting regular exercise, your sedentary lifestyle can cause high amounts of “bad” cholesterol and low levels of beneficial “good” cholesterol.

Smoking also impacts your cholesterol in a negative way. It lowers “good” cholesterol, especially in women, and increases amounts of “bad” LDL cholesterol in your blood.

Too much alcohol can contribute to elevated and unhealthy cholesterol levels, too. To help keep cholesterol under control, the CDC says men should have no more than two alcoholic beverages per day and women should stick to no more than one.

Medical conditions linked to high cholesterol

Lifestyle changes can’t control all causes of high cholesterol. For example, everyone’s cholesterol tends to increase somewhat as they grow older. In addition, several medical conditions may cause high cholesterol, especially if they are not controlled.

For example, type 2 diabetes lowers “good” cholesterol levels and raises “bad” LDL cholesterol levels, increasing your risk of heart disease and stroke, the CDC points out.

In addition to type 2 diabetes, these conditions can also cause high cholesterol:

• Hypothyroidism (low thyroid)
• Chronic kidney disease
• HIV
• Polycystic ovary syndrome
• Inflammatory diseases such as psoriasis, lupus, and rheumatoid arthritis 

Medication causes of high cholesterol

Certain prescription drugs may raise your cholesterol levels, according to the National Heart, Blood and Lung Institute. These medications include:

• Retinoids used to treat acne
• Diuretics (such as thiazide) prescribed for high blood pressure
• Antiarrhythmic medicines, including amiodarone, used to treat irregular heart rhythms
• Immunosuppressive drugs, such as cyclosporine, to treat inflammatory diseases such as psoriasis or to prevent rejection after an organ transplant
• Steroids like prednisone used to treat inflammatory diseases
• Antiretroviral medicines prescribed to treat HIV

If you have certain medical conditions or need medicine that can elevate your cholesterol, you are not doomed to have unhealthy amounts of cholesterol. Instead, it means you need to work closely with your doctor to control the risk factors you can change — like losing weight if you need to and eating a healthy diet. You may also be a candidate for the cholesterol-lower drugs called statins.

High cholesterol in your family

Some people inherit a genetic defect that interferes with how their body recycles LDL cholesterol, which can lead to very high levels of “bad” cholesterol in their blood.

Known as familial hypercholesterolemia (FH), the condition can be dangerous, causing premature heart disease. Men with FH tend to develop heart disease up to 20 years earlier than men without the condition. Half of men with untreated FH will have a heart attack or angina before they reach 50 – and some will suffer heart attacks even in their 20s.

FH also greatly increases the risk of heart disease in women, and 30 percent of untreated women with FH will experience a heart attack before they are 60.

If you have the familial type of high cholesterol, it can be controlled successfully. In fact, the American Heart Association reports people with FH have an excellent prognosis if they are diagnosed early and their elevated cholesterol is treated aggressively.

Diet and exercise can help lower “bad” cholesterol, but most people with the family-related cause of high cholesterol need medication. Treating FH typically involves taking at least one statin drug. If that’s not enough to lower your cholesterol, you may need a different class of cholesterol-lowering medications, like ezetimibe.

Even people with extremely high LDL due to FH can be helped, thanks to a treatment known as LDL apheresis. This procedure, which works much like dialysis, removes excess cholesterol from your blood every few weeks.

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