High Cholesterol Doesn’t Usually Have Symptoms—But Could It Be the Reason You’re So Tired?

If you recently got blood work and found out your cholesterol levels are high (or you suspect they are), and you’ve been feeling especially tired lately, you may wonder if the two are related. Sometimes, it can be hard to tell.

It’s true your body needs some cholesterol to function. There’s even a “good” cholesterol called HDL that helps your body get rid of excess LDL, or “bad” cholesterol. Generally, though, you’ll want your total cholesterol level to be less than 200 milligrams per deciliter (mg/dL). Anything above that can build up in your arteries, increasing your risk of heart disease, stroke, and other health issues, per the National Library of Medicine.

Now that we know the basics, let’s return to the fatigue in question. Can high cholesterol even cause symptoms like tiredness? Here, experts share the most common high cholesterol signs, and how to keep your levels (and energy) in check.

Can high cholesterol cause fatigue?

“High cholesterol does not directly cause fatigue. In fact, one of the biggest challenges with managing cholesterol is that it almost always doesn’t cause any symptoms at all,” says Brett Victor, MD, cardiologist at Cardiology Consultants of Philadelphia in Pennsylvania.

That said, the factors that cause a person to have high cholesterol can leave you feeling sluggish. “When you get high cholesterol, typically, you’re not eating a balanced diet, you’re not exercising, and you may inadvertently be putting on weight,” says Melissa Tracy, MD, a cardiologist at Rush University System for Health in Chicago, Illinois. “So the lifestyle that often comes along with elevated cholesterol could definitely cause fatigue.”

If left unmanaged, high cholesterol can up your risk for heart disease, a condition that can also cause fatigue. “When you start to develop plaque [in your arteries], the heart will start to give you signs that it’s struggling. And one of those signs can be fatigue, as well as decreased exercise tolerance,” adds Dr. Tracy.

Ultimately, it’s not the high cholesterol itself that causes fatigue, but the lifestyle factors that lead to high cholesterol, and the diseases caused from it, that can leave you feeling slow and sluggish.

“The lifestyle that often comes along with elevated cholesterol could definitely cause fatigue.” —Melissa Tracy, MD, cardiologist

Other symptoms of high cholesterol

Again, high cholesterol alone doesn’t usually cause any symptoms. But if you develop heart disease from high cholesterol, that can cause symptoms, says Dr. Victor. Along with fatigue, symptoms of high cholesterol that has progressed to heart disease can include the following, per the Mayo Clinic:

• Chest pain, pressure, or tightness
• Dizziness or lightheadedness
• Heart palpitations
• Shortness of breath
• Pain in the neck, jaw, upper abdomen, back, or throat
• Numbness or weakness in the arms of legs

Other medical conditions that may cause high cholesterol as a side effect can also cause fatigue. These may include the following, per the Mayo Clinic:

• Chronic kidney disease
• Diabetes
• HIV/AIDS
• Hypothyroidism
• Lupus

Risk factors of high cholesterol

Anyone can have high cholesterol, but certain things can make you more prone. As mentioned above, certain lifestyle factors, genetics, and underlying health conditions can contribute to the development of high cholesterol. Here’s a more comprehensive list from the National Heart, Lung, and Blood Institute (NHLBI):

• Eating a diet high in saturated fat
• Having overweight or obesity
• Living a sedentary lifestyle
• Smoking
• Being under chronic stress
• Drinking excessively (more than two drinks per day for most adults)
• Having a family history of high cholesterol
• Having certain medical conditions like chronic kidney disease, diabetes, hypothyroidism, HIV, lupus, PCOS, or sleep apnea
• Being older than 40

Taking certain medications can also raise your LDL or “bad” cholesterol, including the following, per the NHLBI:

• Arrhythmia medicines for irregular heartbeat
• Beta-blockers for angina (chest pain) or high blood pressure
• Chemotherapy
• Diuretics
• Immunosuppressive medicines to treat autoimmune diseases
• Retinoids to treat acne
• Steroids

If you’re on any of these medications, talk to your doctor about your cholesterol levels. They can run routine blood work to make sure you’re at a healthy number.

Long-term effects of high cholesterol

Over time, “high cholesterol levels can build up along the artery walls throughout your heart, body, and brain,” says Dr. Victor. The buildup, called atherosclerosis, can put you at higher risk for a host of serious health problems including heart disease, heart attack, stroke, diabetes, peripheral artery disease, and high blood pressure, says the American Heart Association (AHA).

This is why it’s important to get routine blood work to check on your cholesterol levels, and implement lifestyle changes to help keep it balanced.

“Changing your lifestyle, for the long term, is an important part of lowering your cholesterol.” —Melissa Tracy, MD, cardiologist

Treatment for high cholesterol

Lifestyle changes are the first step for bringing down high cholesterol levels. “They can improve your cholesterol numbers by 20 to 25 percent,” says Dr. Tracy. These steps will have the most positive effect, per the Mayo Clinic:

Eat a balanced diet

Aim to fill your plate with whole grains, fruits and vegetables, healthy fats, and lean, heart-healthy proteins like fish. The more plants, the better. It’s also helpful to increase your soluble fiber and omega-3 fatty acid intake, by adding things like avocados, wheat bran, salmon, fortified cereals, and flaxseeds to your meals.

Limit saturated fats

Try to reduce the amount of foods you eat that have saturated fats, like red meat, full-fat dairy, and tropical oils like coconut and palm oil, i.e., the only plant-based foods with saturated fat. Limiting the amount of ultra-processed foods, fried foods, and baked goods you eat will help, too.

Get active daily

Get at least 150 minutes of moderate-intensity exercise per week (that might look like 30 minutes of moderate-intensity exercise per day, five times per week). This can include aerobic activity like walking or biking, and strength training exercises like lifting weights. It’s best to find the movement you enjoy most, and stay consistent.

Quit smoking and drink in moderation

Quitting smoking is one of the best things you can do for your cholesterol, heart health, and overall health. In fact, within a year of quitting, your risk of heart disease is half that of a smoker, per the Mayo Clinic.

And if you drink alcohol, do so in moderation. This will not only help balance your cholesterol, but also your blood pressure, your heart rate, and reduce your risk of heart failure and stroke.

Maintain a healthy weight for your body size

Not everyone needs to lose weight, but if you’ve talked with a trusted doctor and have determined your body fat percentage is too high, losing five to 10 percent of your excess body weight can bring down your cholesterol levels, per the AHA.

Consider medications

If lifestyle changes aren’t cutting it, and your cholesterol levels are still above 200 mg/dL, your doctor might recommend adding a cholesterol-lowering medicine like a statin. “Statins reduce total cholesterol, LDL cholesterol, and inflammation,” says Dr. Tracy. “This needs to be coupled with a healthy, balanced lifestyle, though. Changing your lifestyle, for the long term, is an important part of lowering your cholesterol.”

How to prevent high cholesterol

The same lifestyle factors that lower cholesterol can also prevent them from getting too high in the first place. Make your health a priority by eating whole foods, getting daily exercise, and working toward a healthy weight for your body.

Small changes that you can keep up for the long term will have a more positive effect than crash diets or overly ambitious exercise plans, too, says Dr. Tracy. “Try to adapt to a new form of living. It has to be a lifestyle where you can say, ‘I can sustain this,'” she adds.

When to see a doctor

If you’re feeling overly fatigued, and you’re not sure why, it’s best to go to the doctor. They can run blood work and make sure your cholesterol levels are normal, and that you don’t have any nutrient deficiencies that cause fatigue or markers for other diseases.

The general rule of thumb is to get your cholesterol checked every four to six years, if you’re a relatively healthy person, per the Centers for Disease Control and Prevention. You may need more frequent checks if you have a family history of high cholesterol, have diabetes, or have pre-existing heart disease.

Bottom line: Your doctor can help get to the root of your fatigue or other symptoms and help decide the course of treatment for you, whether you have high cholesterol or another health issue.

FAQ

How long will it take to lower my cholesterol levels?

It depends on how you’re trying to lower them. “We usually give lifestyle changes at least six months to see an effect on cholesterol,” says Dr. Victor. If you’re taking a statin, you should see a difference within two to three months, he adds.

Can high cholesterol make you feel unwell?

Again, high cholesterol alone doesn’t usually cause symptoms. But the unhealthy lifestyle factors that can cause high cholesterol—like a poor diet and sedentary lifestyle—can make you feel sluggish and lousy. You may also have symptoms like fatigue, dizziness, or difficulty taking deep breaths if your high cholesterol has progressed to heart disease.

—reviewed by Jennifer Gilbert, MD, MPH