Feeling tired, especially in your legs, is one of the symptoms of having high cholesterol levels in your blood. Hence, if you feel tired, you should check your cholesterol level by taking a blood test. Moreover, high cholesterol in the blood can clog your arteries and lead to heart disease.
Introduction
Did you know that if you have high cholesterol, it might make you feel lethargic? However, most people do not have any obvious symptoms, unlike other non-communicable diseases like diabetes, lung diseases, and cancer. As such, they might dismiss high cholesterol levels as a lesser evil.
The main purpose of this article is to alert you to the dangers of high cholesterol, as it is one of the major causes of cardiovascular disease. However, the lack of specific symptoms can lead to complacency.
The British Heart Foundation (BHF) estimates that 1 in 2 adults in the UK are living with high cholesterol levels.1 However, the lack of symptoms caused by high cholesterol levels in your blood means that your first sign of coronary heart disease could be a heart attack. Would you want to risk it?
High Cholesterol Levels > 5mmol/L
1 in 2 adults in the UK
The 3 most important takeaways are:
- Are you feeling tired, especially in your legs?
- Take a simple blood test to find out your cholesterol level.
- Start reducing your cholesterol today to protect your arteries and avoid coronary heart diseases.
What is cholesterol?
Cholesterol is a fatty substance floating through your blood. You can visualise cholesterol as vehicles travelling quickly along a motorway. Occasionally, you will have vehicles breaking down and ending up on the hard shoulder. As a result, traffic flow on the motorway starts to get slower. As more and more vehicles break down, the hard shoulder would be bursting at the seams. A four lane motorway would effectively become three lanes as traffic slows to avoid hitting the breakdown vehicles.
Imagine your arteries being lined up with these sticky materials known as cholesterol, what will happen to your blood flow?
Types of cholesterol
Cholesterol moves into your blood by attaching itself to proteins. When the two combine, you get lipoproteins. There are two types of lipoprotein: HDL and non-HDL.
High-density lipoproteins (HDL) are the good cholesterol as they take the excess cholesterol back to your liver. There, the liver breaks down excess cholesterol into bile and most of it is recycled back to the liver.
Non-HDL is bad cholesterol. It is similar to the breakdown vehicles on the hard shoulder of the M25. Over time, this bad cholesterol sticks to the inside walls of your arteries. Eventually, this leads to fatty material (atheroma) build up. This process is called atherosclerosis.
As it is harder for blood to flow through your arteries, you can increase your chances of a heart attack or stroke. According to BHF, bad cholesterol is linked to 1 in 4 heart and circulatory deaths in the UK.
Bad Cholesterol
1 in 4 heart and circulatory deaths in the UK
What is a high level of cholesterol?
There is no specific cholesterol level because you have to consult with your doctor. Your doctor will assess your risk level of developing heart and circulatory diseases. Nonetheless, the UK national guideline for total blood cholesterol level is 5 mmol/L.
Causes of high cholesterol
It is important to remember that anyone can get high cholesterol levels, and you can even get it at a young age. Moreover, high cholesterol levels could be due to factors that are beyond your control. The table below breaks down the two causes of high cholesterol: controllable and uncontrollable.
Controllable causes | Uncontrollable causes |
---|---|
Eating too much saturated fats | Ageing |
Having too much body fat around your tummy | Ethnic background |
Not exercising enough | Familial hypercholesterolaemia (a form of cholesterol that you’re born with) |
Smoking | Kidney disease |
Obesity | Liver disease |
An underactive thyroid gland |
Fatigue and high cholesterol
High cholesterol usually has no obvious symptoms. However, as the buildup of fatty deposits in the arteries becomes worse, the blood supply to kidneys, stomach, legs, and feet lessens. This leads to a condition called peripheral arterial disease (PAD). PAD is used to denote vascular diseases caused by the thickening of the arteries by a buildup of plaque. This vascular disease affects the abdominal aorta, iliac, and lower body arteries by causing a decrease in blood flow.2
How can high cholesterol cause fatigue?
PAD awareness is low among patients and the general public in the UK. This is despite PAD having five-year mortality rates that are even higher than common cancers and heart attacks.3 PAD ranges from asymptomatic disease to chronic limb-threatening ischaemia. Symptoms of early PAD may include the following:
· Cramping
· Achiness
· Painful ache in your legs during physical activity, which usually disappears after resting for a few minutes (known as intermittent claudication)
· General discomfort in the legs and feet
Although high cholesterol and asymptomatic PAD have no symptoms, leg pain and tiredness are the first signs of high blood cholesterol.
Sleep and high cholesterol
Adults who do not get enough sleep each night are more likely to have lower levels of HDL, or good cholesterol. People who get 8 hours of sleep at night had the highest HDL numbers. The link between sleep and high cholesterol is easy to understand. If you don’t get enough sleep, your body will produce too much of the stress hormone, cortisol, and the appetite boosting hormone, ghrelin. These hormone imbalances will adversely affect your cholesterol levels.4
Furthermore, if your sleep is affected by sleep apnea (a serious sleep disorder that occurs when your breathing stops for over 10 seconds), you might have high total cholesterol and bad cholesterol. Also, burning the midnight oil is guaranteed to raise your blood cholesterol.
How to reduce cholesterol?
BHF provides 4 ways to lower your cholesterol. However, if your cholesterol is very high and the following lifestyle changes are not enough, your doctor might suggest controlling your level with cholesterol medication like a statin.
Diet
It is important to reduce foods that are high in saturated fats like butter, cream, and coconut oil. On the contrary, eating high fibre food like chickpeas, beans and lentils can lower your cholesterol.
Exercise
Being active can help to move the bad cholesterol to your liver where it can be broken down into bile and be recycled.
Stop smoking
Smoking increases your bad cholesterol and lowers good cholesterol. So stop smoking if you have high cholesterol.
Reduce alcohol
Cutting down or stopping drinking alcohol can help your liver to function better, especially at removing the bad cholesterol.
Summary
High cholesterol is usually a condition without any symptoms. As such, many people are not aware of this condition until they develop coronary artery disease. Nevertheless, peripheral arterial disease (PAD) usually has early symptoms like leg pain and tiredness.
References
- British Heart Foundation. BHF UK CVD Factsheet [Internet]. Birmingham: British Heart Foundation; 2022 [cited 2022 Mar 11]. Available from: https://www.bhf.org.uk/-/media/files/research/heart-statistics/bhf-cvd-statistics---uk-factsheet.pdf
- Olin JW, Sealove BA. Peripheral artery disease: current insight into the disease and its diagnosis and management. Mayo Clin Proc [Internet]. 2010 Jul [cited 2022 Mar 11] ;85(7):678-92. doi: 10.4065/mcp.2010.0133.
- Popplewell MA, Fisher O, Benson RA, Garnham A. Atherosclerotic peripheral artery disease: the growing challenge to improve life and limb. Br J Cardiol [Internet]. 2020 [cited 2022 Mar 11]; 27(suppl 1):S4–S8. doi:10.5837/bjc2020.s02
- Webmd. How sleep affects your cholesterol level [Internet] ;2021 [cited 2022 Mar 11]. Available from: https://www.webmd.com/cholesterol-management/how-sleep-affects-cholesterol