Think you know everything about cholesterol? We’ll be separating fact from fiction
Cholesterol is often misunderstood and despite its importance, there are many myths on the role it plays in our bodies.
What is cholesterol?
Cholesterol is a fatty substance in the blood. It helps our bodies to function properly by making certain hormones and vitamin D, as well as making bile, which helps to support the digestion of our food.
Our livers make cholesterol which can help with these processes, but we can also absorb cholesterol from our diet. A diet high in saturated fat can cause high cholesterol in some people.
What is high cholesterol?
Having high cholesterol basically means having too much cholesterol in your blood. Cholesterol in your blood isn’t harmful, but when it’s in excess, it can cause trouble. You might’ve heard of the word “hypercholesterolaemia”. This just means having too much cholesterol in your blood. This excess can block your blood vessels, causing problems for your heart like a heart attack or stroke.
How do I know if I have high cholesterol?
Having high cholesterol normally doesn't normally cause any symptoms. The only way to find out if you have high cholesterol is by getting tested. You can speak to your GP or pharmacist if you’d like to find out more.
If you’re aged between 40 and 74, you don’t have any pre-existing health conditions and you live in England, you should be invited to an NHS Health Check by your GP or local council every five years. Some pharmacies also offer NHS Health Checks.
Understanding cholesterol levels
Various factors like your age, health, weight, blood pressure, family history and ethnicity can affect your cholesterol.
As a general guide for healthy adults, cholesterol levels should be something like this:
It’s a good idea for all adults to keep an eye on their cholesterol, regardless of how healthy they feel.
You can speak to your GP about what your cholesterol level should be.
The testing process
When it’s time to get your cholesterol tested, there are different ways to get it done.
• The finger prick test: A pinch to your finger and you’re given the results right there and then
• A blood test: The blood is taken from your arm then taken to be analysed
You might be asked to fast for your cholesterol tests, but most people don’t need to fast.
Boots also sell home self-test kits which can give an indication of your cholesterol levels.
You can learn more about cholesterol in our Health Hub.
Myth buster time!
Now it’s time to debunk some myths that you might’ve heard about cholesterol.
The myth: Cholesterol is always bad
The truth: There are two main types of cholesterol. Your HDL (high density lipoprotein) cholesterol (‘good’ cholesterol) helps to remove the cholesterol from your arteries. It takes cholesterol to the liver where it can be removed by the body.
Non-high-density lipoproteins or non-HDL cholesterol is known as ‘bad’ cholesterol. Having too much non-HDL cholesterol can lead to a build-up of fatty deposits in your arteries. Too much of this cholesterol in your arteries can cause a build-up of plaque which is known as atherosclerosis. This can block your arteries. LDL is a type of non-HDL cholesterol.
The myth: You don’t need to check your cholesterol
The truth: High cholesterol doesn’t usually cause any symptoms so it’s important to get your cholesterol tested. Getting tested is the only way you can check your cholesterol levels. If you want to get your cholesterol levels tested, you can speak to your GP surgery.
The myth: I can’t do anything to change my cholesterol levels
The truth: High cholesterol could be caused by lifestyle habits which we can control. Keeping an eye on lifestyle factors can help you reduce your cholesterol.
You can start making changes today by:
• Lowering the amount of saturated fat in your diet and replacing it with moderate amounts of unsaturated fat
• Getting active and exercising more
• Reducing your alcohol intake, if you drink
For more tips, you can take a look at our advice for reducing your cholesterol at home.
The myth: If you have low cholesterol, you won’t have a heart attack
The truth: Having high cholesterol can increase your risk of a heart attack and other circulatory problems but it isn’t the only risk factor. Others include:
• Having high blood pressure
• Having diabetes
• Excess weight or obesity
• Smoking
• Being physical inactive
The good news is that all these factors can be changed, controlled or treated.
The myth: I would feel it if I had high cholesterol
The truth: There are usually no signs or symptoms of high cholesterol, but if it’s left untreated, it can increase your risk of a heart attack or stroke. If you have familial hypercholesterolaemia, an inherited condition which causes high cholesterol, you might have some visible signs which include:
• Tendon xanthomata (swellings which are made of cholesterol) – these could be on your knuckles, knees or Achilles tendon
• Xanthelasmas – small, yellow lumps of cholesterol near the inner corners of your eyes
• Corneal arcus – a pale white ring around your iris (the coloured part of your eye)
The myth: High cholesterol only affects men
The truth: Anyone can have high cholesterol as there are many different causes, however if you were assigned male at birth, you’re more likely to have it.
The myth: I’m healthy, can I still have high cholesterol?
The truth: Even if you’re young, physically fit, eat a healthy diet and exercise regularly, you can still develop high cholesterol. This is because high cholesterol can be caused by a variety of things, including your genes. You can learn more about the causes of high cholesterol with the Health Hub.
The myth: Eating certain foods can’t help to lower my cholesterol
The truth: Some foods can actively help to lower your cholesterol. The more you eat them, the more they can help reduce your cholesterol, especially if you’re also reducing how much saturated fat you eat.
Foods rich in unsaturated fat
Foods like vegetable oils, oily fish and avocado should be added to your diet. You should aim to eat at least 280g of oily fish a week.
Fruit and veg
Fruit and veg is high in fibre and some types of fibre can help to reduce your cholesterol. You should aim for at least five portions (an adult portion is about 80g) of a variety of different fruit and veg a day.
Foods with added plant stanols & sterols
Foods with added plant stanols and sterols are thought to work by blocking some cholesterol from being absorbed which can help lower the cholesterol in your blood. You can buy foods like mini yoghurt drinks, spreads and milk with plant sterols and stanols added to them.
You might see them labelled as “fortified with stanols or sterols”. You should aim for one to three servings of these foods every day along with a healthy diet. This will give you between 1.5g and 3g of stanols and sterols a day. Products vary so check the label to make sure you are getting the right amount. Plant sterols are also available as food supplements for lowering cholesterol.
Plant sterols and stanols are usually safe for most people, however, they aren’t recommended if you don’t have high cholesterol and if you’re breastfeeding, pregnant or for children under five.
It’s important to bear in mind that plant sterols and stanols aren’t a replacement for cholesterol-lowering medications but they can be used in addition to medication. If you’re already taking medicine to lower your cholesterol, you should speak to your doctor or pharmacist before taking them as well.
Oats & barley
Oats and barley are grains which have a soluble fibre called beta glucan. Beta glucan can help limit how much cholesterol is absorbed into your blood. This can help reduce your blood cholesterol as your liver then has to take more cholesterol out of your blood to make bile for digestion. You should aim for three grams a day along with a healthy diet, to help lower cholesterol, which you can achieve with three servings of oat or barley-based products.
Nuts
Nuts are a good source of unsaturated fats. They also contain some fibre which can help block some cholesterol from being absorbed into your blood. Nuts are also filling so this means you’re less likely to snack on other things. You should aim for 28-30g of unsalted nuts a day (this is about a handful).
The myth: If I have high cholesterol, I can’t eat eggs
The truth: People used to think that you should limit the number of eggs you eat to three to four a week as the yolks contain cholesterol. However, current research has shown that for most healthy people, cholesterol in foods like eggs has a small effect on cholesterol levels. Eggs are low in saturated fat and eating up to one egg a day can be part of a healthy diet.
Eggs alone are nutritious, however be mindful of how they’re cooked and the sides you eat them with. For example, scrambled eggs with wholegrain bread is a different meal to fried eggs with bacon and sausages. You only need to cut down on eggs if your doctor or a dietitian has advised you to.
Cholesterol might seem like a mystery, but separating the myths from the facts can help you stay informed. With a few changes, you can embrace a heart-healthy lifestyle to keep your cholesterol under control.
Did you know we can help with your NHS prescription for cholesterol?
HOW DOES IT WORK?
Sign up by registering your personal details and your GP. When your repeat prescription is due, tell us which prescription item(s) you’d like to order
NHS number required for patients in England/Wales
We’ll send your request to the GP. Once checked and approved, they’ll send us back a prescription and we can get your medication ready for you.
Collect your prescription from a Boots pharmacy of your choice, or if you’re in England you can have it delivered for free*. We’ll let you know when your order is ready to collect or on the way and remind you next time you need to reorder – it’s that easy!
