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title: "High cholesterol: tests and NHS help | HealthAnswers"
description: "High cholesterol usually has no symptoms. Use this UK guide to blood tests, non-HDL, lifestyle steps, statins if risk is high, and when to call 999."
url: https://healthanswers.co.uk/conditions/high-cholesterol/
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---

# High cholesterol: tests and NHS help | HealthAnswers

Health A–Z

High cholesterol usually has no symptoms. Use this UK guide to blood tests, non-HDL, lifestyle steps, statins if risk is high, and when to call 999.

Written by HealthAnswers editorial team Medically reviewed by [Dr Neil Singh MBChB - nMRCGP](https://healthanswers.co.uk/our-doctors/neil-singh/) · GMC 7039648 Reviewed 13 August 2026

## Quick answer

What is high cholesterol and how is it treated in the UK? High cholesterol means too much of a fatty substance in your blood. It usually causes no symptoms and is found with a blood test. Non-HDL is the ‘bad’ cholesterol your GP uses with your wider heart-risk score. Lifestyle changes come first for many people; statins are added if risk is high. Do not stop statins without advice. Call 999 for heart attack or stroke symptoms.

## Who is this page for?

This page is for people in the UK who want a plain-English overview of High cholesterol, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally.

## Who should skip this page?

Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland.

On this page 7 sections

## Key facts about high cholesterol

- High cholesterol usually has no symptoms; only a blood test can find it.
- Non-HDL cholesterol is the “bad” type your GP uses alongside your overall heart and stroke risk.
- Eating less saturated fat, moving more, not smoking and drinking less alcohol can lower it.
- Statins are used when risk is high; do not stop them without medical advice.

## Should I use this page, or skip it?

Use this page if you have been told your cholesterol is high, you are due a check, or you want to know whether lifestyle change or a statin comes next. Skip it and call 999 now for suspected [heart attack](https://healthanswers.co.uk/conditions/heart-attack/) or [stroke](https://healthanswers.co.uk/conditions/stroke/). Chest pain, a drooping face, arm weakness or slurred speech is not a “cholesterol flare”.

High cholesterol almost never announces itself with a symptom you can feel. This guide is for adults in the UK trying to interpret a result and choose the right NHS door. It is not a meal plan, and it is not permission to stop a tablet because you feel well.

If you already have a prescription, read [statins](https://healthanswers.co.uk/treatments/statins/) as well. If you want the test itself explained, see the [cholesterol blood test](https://healthanswers.co.uk/tests/cholesterol-blood-test/) page.

## What does high cholesterol actually mean?

Cholesterol is a fatty substance the body needs in small amounts. High cholesterol means there is too much in the blood. Over time it can contribute to fatty deposits in arteries, raising the chance of heart attack and stroke. It usually causes no symptoms at all.

You are more likely to have it if you are over 50, a man, have been through the menopause, or are of South Asian or sub-Saharan African origin. It can also run in families. Diet, inactivity, extra weight, smoking and alcohol all play a part. Feeling well is not evidence that a result was a mistake. The only reliable way to know is a blood test.

Some people have an inherited form called familial hypercholesterolaemia, which can cause very high levels from a young age. That needs medical assessment, not a wait-and-see diet from a website.

## How is it found, and what is non-HDL?

A [cholesterol blood test](https://healthanswers.co.uk/tests/cholesterol-blood-test/) is the only way to find it, because there are usually no symptoms. Ask your GP if you are over 40, overweight, or heart problems run in the family. Many pharmacies also offer a test, which you may have to pay for.

Your GP may also suggest a test because of [high blood pressure](https://healthanswers.co.uk/conditions/high-blood-pressure/) or diabetes. People aged 40 to 74 may have a check as part of an NHS Health Check. The result can include total cholesterol, HDL (“good”), and non-HDL. Non-HDL is total minus HDL. The NHS calls non-HDL the “bad” cholesterol. Ask for that split if you are only quoted a total. Most people do not need to fast. Lab results often come back in a few days. A finger-prick check can give a quicker reading.

| Result | NHS guide level for healthy adults |
| --- | --- |
| Total cholesterol | Below 5 mmol/L |
| HDL (good) | Above 1.0 mmol/L for men, or above 1.2 mmol/L for women |
| Non-HDL (bad) | Below 4 mmol/L |

These figures are a guide. Your own target depends on age, other conditions, and your risk of cardiovascular disease. A GP may give you a QRISK score: an estimate of how likely you are to have a heart or circulation problem over the next 10 years. Treatment follows that bigger picture, not one scary number on a printout.

## What can I change before, or alongside, a statin?

Lifestyle is the first step for many people, and it still matters on a statin. Cut saturated fat and eat more vegetables, wholegrains, nuts, seeds, oily fish and unsaturated oils. These changes help, but they do not replace a statin if one has been advised.

Eat less fatty meat, butter, lard, ghee, cream, cheese, cakes, biscuits, and foods high in coconut or palm oil. Eat more fruit, brown rice, wholegrain bread, wholewheat pasta, and olive or rapeseed oil. Move more. The NHS suggests at least 150 minutes of moderate activity a week, such as brisk walking, swimming or cycling, or 75 minutes of vigorous activity. Stop smoking; your GP or an NHS stop-smoking service can help. Keep alcohol within 14 units a week, spread out, with drink-free days.

None of this is a moral test. It is also not a reason to refuse a statin if your clinician has already judged your risk to be high. Diet does not “replace” medicine in someone who has already had a heart attack, or whose inherited cholesterol is very high.

## When are statins used, and why must I not stop them on my own?

[Statins](https://healthanswers.co.uk/treatments/statins/) are the usual medicine if cholesterol has not come down with lifestyle change, or if you are at high risk of heart attack or stroke. They reduce how much cholesterol the body makes. You take a tablet once a day. The NHS says you usually need to take them long term.

A GP should talk through benefits and side effects before you start. Most people take statins without trouble. Muscle aches, headache or tummy symptoms can happen. If they bother you, ask for a review — a different statin or a change in dose may be possible. Seek urgent advice for severe unexplained muscle pain, tenderness or weakness, especially with a fever or dark urine.

Do not stop a statin because a blood test looks better, because you have started a new diet, or because you feel well. The protection is ongoing. Stopping without advice puts the risk back up. If you cannot swallow tablets, hate the idea of “lifelong medicine”, or have read something alarming online, say so in clinic rather than quietly discontinuing.

If a statin is not suitable or not enough, other medicines exist, including tablets such as ezetimibe and some injections. Those are specialist or GP decisions, not over-the-counter swaps.

## When is this an emergency, and when is it a routine GP job?

Routine GP or nurse care is for getting tested, understanding a result, starting lifestyle change, reviewing a statin, and checking [blood pressure](https://healthanswers.co.uk/conditions/high-blood-pressure/) at the same time. Bring your medicines list. If you need a fit note, that is a different problem from cholesterol itself.

Call 999 for a suspected [heart attack](https://healthanswers.co.uk/conditions/heart-attack/): sudden chest pain, pressure or tightness, pain spreading to an arm, neck, jaw or back, especially with sweating, sickness or breathlessness. Call 999 for a suspected [stroke](https://healthanswers.co.uk/conditions/stroke/): face drooping on one side, inability to raise both arms, or slurred or strange speech. Do not wait to see if it passes, and do not drive yourself.

A cholesterol appointment cannot treat a heart attack. Conversely, feeling anxious about a mildly raised result is not an A&E problem. Use NHS 111 if you are unsure and it is not an obvious emergency.

## Who is this page not for?

This page is not for someone with chest pain or FAST stroke signs. It is not a full specialist pathway for familial hypercholesterolaemia, though it should prompt you to mention a strong family history. It is not personalised dietetics, and it will not tell you which supermarket spread to buy.

It is for adults. A child with suspected inherited high cholesterol needs paediatric or specialist advice, not this page’s lifestyle list alone. If your main issue is blood pressure readings, start with [high blood pressure](https://healthanswers.co.uk/conditions/high-blood-pressure/).

## ! When to see a GP about high cholesterol

Ask your GP surgery for a cholesterol test if you have not had one and you are over 40, overweight, or high cholesterol or heart problems run in your family. Discuss results and whether treatment is needed rather than guessing from a single number. Call **999** for heart attack symptoms such as sudden chest pain, or stroke symptoms such as a drooping face, arm weakness or slurred speech. Do not wait for a cholesterol appointment.

## Common questions about high cholesterol

Does high cholesterol have symptoms? Usually not. Most people feel well, which is why a blood test is the only reliable way to know. Very high inherited cholesterol can sometimes cause visible signs, such as fatty lumps around tendons, but you should not wait for a sign you can see. A heart attack or stroke is not a ‘symptom of cholesterol’ — it is an emergency. What is non-HDL cholesterol? Non-HDL is total cholesterol minus HDL, the ‘good’ cholesterol. The NHS treats non-HDL as the ‘bad’ cholesterol that can build up in arteries. A guide level for healthy adults is below 4 mmol/L, but your personal target depends on age, other conditions and overall risk. Ask for the split result, not only a total. Do I need to fast before a cholesterol blood test? Most people do not. The NHS says it does not make much difference to the usual guide levels whether you have eaten. Some people are still asked to fast, for example if triglycerides need a closer look. Follow the instructions you are given, and see the cholesterol blood test page for more detail. Will I need a statin? Not always. Lifestyle changes are the first step for many people. A GP looks at cholesterol plus age, blood pressure, smoking, diabetes and other factors, sometimes using a QRISK score. If your risk of heart attack or stroke is high, or lifestyle change is not enough, a statin is the usual medicine. Do not start or stop one on a forum’s advice. Are statins safe, and can I stop them if I feel well? Statins are widely used to lower cholesterol and cut heart attack and stroke risk. Most people take them without problems. Some get muscle aches or other side effects; a GP can change the dose or the type. Do not stop without advice, even if you feel well, because the protection is long term. What lifestyle changes actually help? Cut down on saturated fat (fatty meat, butter, ghee, cream, biscuits) and eat more vegetables, wholegrains, nuts, seeds, olive or rapeseed oil, and oily fish. Aim for at least 150 minutes of moderate activity a week, or 75 minutes of vigorous activity. Stop smoking and keep alcohol within 14 units a week. These steps sit alongside medicines, not instead of them, if a statin has been advised. What is familial hypercholesterolaemia? It is an inherited condition that causes very high cholesterol from a young age and raises early heart-attack risk. Clues include very high readings, close relatives with heart disease at a young age, or fatty deposits around tendons. It needs medical assessment and usually medicine, not diet alone. HEART UK has patient information; a GP can refer you. When should I call 999 if I have high cholesterol? High cholesterol itself does not feel like an emergency. Call 999 for suspected heart attack — sudden chest pain, pressure or tightness, especially with sweating, sickness or breathlessness — or suspected stroke using FAST: face drooping, arm weakness, speech difficulty, time to call 999. Do not drive yourself.

## Sources

- [NHS — High cholesterol](https://www.nhs.uk/conditions/high-cholesterol/)
- [NHS — Cholesterol levels](https://www.nhs.uk/conditions/high-cholesterol/cholesterol-levels/)
- [NHS — Getting tested](https://www.nhs.uk/conditions/high-cholesterol/getting-tested/)
- [NHS — How to lower your cholesterol](https://www.nhs.uk/conditions/high-cholesterol/how-to-lower-your-cholesterol/)
- [NHS — Medicines for high cholesterol](https://www.nhs.uk/conditions/high-cholesterol/medicines-for-high-cholesterol/)
- [NHS — Statins](https://www.nhs.uk/conditions/statins/)
- [NICE — Cardiovascular disease, risk assessment and lipid modification (NG238)](https://www.nice.org.uk/guidance/ng238)