Unless your eyelids are forming yellow spots (which can happen in extreme cases), you probably won't know you have high cholesterol. You could be active, eat all the right foods, and still have high cholesterol. Genetics contribute to the condition, so blame your ancestors. In addition, your body also may have trouble properly forming or breaking down lipoproteins. Regardless, you need to get your blood cholesterol level checked, ideally at age 20, and every five years after that. Many of us probably weren't checked when we were 20 and invincible, but it's never too late to get your first cholesterol test.
When you get tested, you'll be asked not to eat or take any food , liquids or medications for 8 to 12 hours beforehand because your body still processes dietary cholesterol several hours after you've eaten a giant cheeseburger. Blood is drawn and analyzed for four different items: HDLs, LDLs, triglycerides (a type of naturally produced fat triggered by smoking, drinking, obesity or bad diet) and Lp(a), a less-understood variant of LDL. These four things will form your total cholesterol count.
For total cholesterol, we're all shooting for a level less than 200 mg/dL. People with a total cholesterol level greater than 240, which is the score for 17 percent of Americans, are twice as likely to have heart disease than people with a count of 200 [sources: AHA, CDC].
Doctors will look at the total number, as well as the individual levels of LDLs and HDLs. A high individual count of HDLs is usually a good thing; they tend to hover around 50 for men and 60 for women. People average a 3-to-1 ratio of LDLs to HDLs. Regardless of your total cholesterol number, you ideally want your LDL number to fall below 100; 130 is nudging into the danger zone. If LDLs go beyond 190, you have a cholesterol crisis on your hands [source: AHA].
But don't panic. There are things you can do to raise the good cholesterol and lower the bad cholesterol. Cutting out excess cholesterol in your diet is a good start. Dietary cholesterol is found in animal products, so limiting the meat, eggs, poultry and dairy products you consume will go a long way toward improving your numbers. In addition, you should watch your step around saturated fats and trans fats, which raise LDL levels. (You can learn more about them by reading How Fats Work.)
Smoking raises cholesterol levels, too, so that's a good reason to quit if you're looking for (another) one. Exercise also can help to increase the amount of good cholesterol. Some people may not be able to quickly lower cholesterol to a safe level solely by embracing these positive lifestyle choices, but they'll certainly have a healthier heart by doing so.
Your doctor may decide that you would benefit from medication that helps to rid your body of cholesterol. There are several different types, and generally, these medications will do one of two things. They may prevent the liver from producing too many fats or trick your body into thinking it needs to increase bile production, which requires using up cholesterol to do so. Statins (which you can learn more about by reading What are statins?) prevent the liver from producing cholesterol. Your doctor will know which medication is right for you, if one is necessary.
Now that you know more about the different types of cholesterol and how they function or malfunction in the body, you can watch what you eat, break a sweat regularly and, most important, feel more informed and confident when you call the doctor to schedule a cholesterol test.
For much more information on cholesterol and heart health, please see the next page.