What is cholesterol?

Cholesterol is a waxy, fat-like substance your body uses to build cell membranes, make hormones, produce vitamin D, and aid digestion.

There are two main types:

1. LDL (low-density lipoprotein): the "bad" cholesterol. High levels lead to plaque buildup in arteries, which raises the risk of heart disease, stroke, and other problems.
2. HDL (high-density lipoprotein): the "good" cholesterol. It removes LDL from your bloodstream and carries it to the liver, where it's processed and removed.

Cholesterol travels through your bloodstream in particles called lipoproteins. Each particle is fat on the inside and protein on the outside. They carry cholesterol and triglycerides (another fat) around the body.

Balance is the goal. High LDL drives atherosclerosis (plaque buildup), which causes coronary artery disease and stroke. High HDL helps lower that risk.

Can high cholesterol cause dizziness?

High cholesterol doesn't cause dizziness directly. The conditions it leads to can.

Conditions caused by high cholesterol

1. Coronary artery disease (CAD): high LDL leads to plaque buildup in your arteries (atherosclerosis). The plaques narrow the coronary arteries that feed your heart. When your heart doesn't get enough oxygen, you can feel dizzy along with symptoms like chest pain or shortness of breath.
2. Stroke: high cholesterol also raises stroke risk. A stroke happens when blood flow to part of your brain is blocked or reduced. A plaque can break off an artery and travel to the brain. Sudden dizziness, loss of balance, and confusion are common symptoms.

How narrowed blood vessels cause dizziness

Plaque buildup narrows arteries (atherosclerosis), restricting blood flow. Blood carries oxygen and nutrients to your organs and tissues. When blood flow to the brain drops, dizziness can follow.

The mechanism:

• Reduced blood flow: narrowed arteries mean less blood gets through.
• Oxygen deprivation: less blood reaching the brain means less oxygen and fewer nutrients.
• Dizziness: the brain needs constant oxygen. When it's deprived, you feel dizzy, lightheaded, or unsteady.

Symptoms of related conditions

CAD symptoms:

• Dizziness: often from reduced blood flow to the brain.
• Chest pain: known as angina, caused by oxygen-starved heart muscle.
• Shortness of breath: can show up with or without chest pain.

Stroke symptoms:

• Sudden dizziness: a key sign that blood flow to the brain has been interrupted.
• Loss of balance or coordination: hard to stand or walk.
• Confusion: trouble speaking or understanding speech.

Keeping cholesterol in check keeps your blood vessels clear and your brain getting the blood flow it needs.

How is high cholesterol diagnosed?

Medical history and physical exam

Diagnosis starts with a visit to your doctor for a history and physical exam.

• Medical history: your doctor will ask about diet, exercise, smoking, alcohol intake, and family history of high cholesterol or heart disease.
• Physical exam: the doctor may look for physical signs like xanthomas, which are fatty deposits that show up as bumps on the skin.

Lipid panels

A lipid panel measures cholesterol levels in your blood, often as part of a metabolic panel. It needs a small blood sample.

• Total Cholesterol: Measures all cholesterol in your blood.
• LDL (Low-Density Lipoprotein): Often called "bad" cholesterol because high levels can lead to plaque buildup in your arteries.
• HDL (High-Density Lipoprotein): Known as "good" cholesterol as it helps remove LDL from your bloodstream.
• Triglycerides: A type of fat in your blood. High levels can increase your risk of heart disease.

For those in Canada, provincial insurances such as OHIP usually fully covers the cost.

Additional tests

If you have a family history of heart disease, your doctor may want more tests.

• Lipoprotein(a): measures Lp(a) in your blood. High Lp(a) raises heart disease risk. Often recommended with a strong family history of heart issues.

As this test is not usually covered by insurance, the out-of-pocket cost is usually $15 to $30 depending on the lab provider.

Regular screening

How often you need a cholesterol screening depends on age and risk factors:

• Children and teens: every five years, starting at ages 9 to 11.
• Young adults (20-39): every five years, more often with other risk factors.
• Middle-aged adults (40-65): men start at 45 and screen every 1-2 years. Women start at 55.
• Older adults (65+): annual screening.

Regular check-ups catch changes early, which is the difference between an easy intervention and a hospital trip.

Warning signs and symptoms of high cholesterol

Usually no symptoms

High cholesterol is often called "silent" because it doesn't usually have symptoms. Most people don't know they have it until a blood test, or until something worse like heart disease or stroke.

Symptoms of extremely high cholesterol

At very high levels, some physical signs may appear. These are rare but worth recognizing:

• Xanthomas: These are fatty deposits that appear as yellowish bumps under the skin, often found on the elbows, knees, hands, feet, or buttocks.
• Grayish-White Rings Around the Corneas: Known as corneal arcus, these rings can indicate high cholesterol levels. They appear as a gray or white arc around the cornea of the eye.

Symptoms of related conditions

High cholesterol may be silent on its own, but it leads to conditions that aren't. Stroke, coronary artery disease, and heart attacks all come with noticeable symptoms. Recognize them:

Stroke Symptoms:

• Face Drooping: One side of the face may droop or feel numb.
• Arm Weakness: Sudden weakness or numbness in one arm.
• Speech Difficulty: Trouble speaking or understanding speech.
• Confusion: Sudden confusion or trouble understanding.
• Dizziness: Feeling lightheaded or losing balance.
• Severe Headache: Sudden, severe headache with no known cause.
• Vision Problems: Sudden trouble seeing in one or both eyes.

Coronary Artery Disease (CAD) Symptoms:

• Chest Pain: Discomfort or pain in the chest, often described as pressure or squeezing.
• Lightheadedness: Feeling faint or dizzy.
• Nausea: Feeling sick to the stomach.
• Cold Sweat: Sudden sweating without exertion.
• Shortness of Breath: Difficulty breathing even at rest.

Heart Attack Symptoms:

• Chest Pain or Discomfort: Pain in the center or left side of the chest.
• Pain in Upper Body: Pain that spreads to the arms, back, neck, jaw, or stomach.
• Shortness of Breath: Trouble breathing with or without chest discomfort.
• Cold Sweat, Nausea, or Lightheadedness: These symptoms often accompany chest pain.

Recognizing these symptoms can save a life. If you or someone you know has these signs, get medical attention immediately. Catching high cholesterol early prevents the worst outcomes.

How to prevent high cholesterol

Diet

Diet is one of the most direct ways to manage cholesterol. Make these changes:

• Fruits and vegetables: aim for at least five servings a day. They're rich in fiber, vitamins, and antioxidants.
• Whole grains: oatmeal, brown rice, whole-wheat bread. These help reduce LDL.
• Lean proteins: lean meats, fish, and plant-based proteins like beans and lentils. Salmon and mackerel contain omega-3 fatty acids, which lower triglycerides.

Limit the bad stuff

Cut back on:

• Saturated fats: in red meat and full-fat dairy. These raise LDL. Pick low-fat or fat-free options.
• Trans fats: in processed foods and baked goods. Avoid them.
• Excessive alcohol: stick to moderate consumption (one drink per day for women, up to two for men).

Exercise

Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week. Regular physical activity:

• Helps manage weight: a healthy weight makes cholesterol easier to control.
• Raises HDL: the good cholesterol that clears LDL from your bloodstream.
• Improves overall heart health: lowers risk of heart disease and stroke.

Regular check-ups

• Lipid panels: blood tests for cholesterol levels. At least every five years for adults over 20, more often if you have risk factors.
• Early detection: regular screening catches high cholesterol before complications.
• Personalized advice: your provider can tailor recommendations to your health and family history.

Our metabolic panel includes both a lipid panel and an Lp(a) test, plus other markers, for a full view of your metabolic health. Combine lifestyle changes with regular check-ups and you can keep cholesterol in range.

Disclaimer: This blog post is intended for educational purposes only and should not be taken as medical advice. Always consult your healthcare provider for personal health concerns.