This article has been updated since it was originally posted to include additional expert insight.
High cholesterol is one of those health issues that may go unnoticed for a long time. While some conditions come with immediate, more obvious symptoms, elevated cholesterol levels often remain undetected—sometimes for years—until they contribute to something more serious. That’s why experts stress the importance of regular blood work, even if you feel completely fine.
“High cholesterol is not something most people feel or can see without getting blood work,” explains Michelle Routhenstein, MS, RD, CDCES, CDN, a preventive cardiology dietitian and certified diabetes educator. “It is a key contributor to plaque formation in the arteries. If we don’t test your blood, it can go undetected, silently brew plaque in the arteries, leading to heart attacks and strokes, so please don’t wait until ‘you feel high cholesterol.'”
That said, in some cases—particularly when cholesterol has been high for a long time—your body may start to show subtle visual cues. Here are five signs you should watch for.
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1. Yellow Patches on the Eyelids
One of the most recognizable physical signs of long-term high cholesterol is the appearance of yellowish patches on or around the eyes. These are called xanthelasmas and are caused by cholesterol deposits building up under the skin.
"Cholesterol can deposit under the skin, showing up as soft yellow patches on the eyelids," Routhenstein says. While they’re typically painless, they can be a signal that cholesterol levels have been high for a long time.
2. A Gray or White Ring Around the Eye
Another potential sign is a pale gray or white ring on your iris, sometimes referred to as corneal arcus.
According to Routhenstein, cholesterol buildup can also present "as a pale gray or white ring around the colored part of your eye." While this can be a normal part of aging in older adults, in younger people it may indicate high cholesterol levels that should be evaluated.
3. Firm Bumps on Joints or Tendons
Cholesterol deposits can also appear as small, firm bumps on certain parts of the body, particularly over joints or along tendons like the Achilles.
Routhenstein notes that these may show up "as small, firm bumps over joints and along the Achilles tendon." Known as xanthomas, these growths are another sign that cholesterol has been elevated for a long time and may require medical attention.
4. Brain fog and low energy
When LDL (bad) cholesterol levels are too high, it can lead to plaque buildup in the arteries—a condition known as atherosclerosis. This buildup narrows the arteries, reducing blood flow and limiting how much oxygen and nutrients reach your brain and muscles. The result? You may start to feel mentally sluggish, have trouble concentrating, or experience fatigue even after a full night’s sleep.
“If you’re constantly feeling tired or finding it hard to focus, your cholesterol could be restricting blood flow to your brain, which is affecting your oxygen supply,” Sheina (@shiningwithsheina) shared in a video.
5. Leg pain or numbness
When this symptom happens in the arteries that supply your legs, it’s known as peripheral artery disease (PAD). One of the early symptoms of PAD is leg discomfort, cramping, or numbness—typically felt during movement and relieved by rest.
“Poor circulation caused by cholesterol buildup can lead to pain, numbness, or a heavy feeling in your legs, especially when walking,” she adds.
Sheina warns that high cholesterol levels are a “silent killer,” and you should not wait for possible heart attacks in order to take action.
The Bottom Line
Even though these visible signs can occur, they are relatively rare. "Visual signs of high cholesterol typically only appear in people with very high cholesterol levels for many years," Routhenstein emphasizes.
Ultimately, it's important not to rely on symptoms alone. Regular screenings are the most reliable way to catch high cholesterol early and take steps to protect your heart health before complications arise.
Remember, a heart-healthy diet can do a lot!
