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Recognising High Cholesterol Symptoms and How to Manage the Risk Factors

Whether you are slim or overweight, high cholesterol can affect anyone. Learn about high cholesterol symptoms and the risk factors and how to manage them effectively with TCM.

A slim woman and an overweight woman jogging at the park

If you think slim and athletic-looking folks would not have high cholesterol, think again. High cholesterol can happen to anyone, regardless of one’s weight. Like hypertension, this disease is also known as the “silent killer” due to high cholesterol symptoms that aren’t always apparent. Often, we can’t “feel” or “know” if we have high cholesterol.

According to the National Health and Morbidity Survey 2019, high cholesterol, high blood sugar, and high blood pressure are major risk factors for cardiovascular diseases (CVDs). The survey reported that 8 million or 4 in 10 adults in Malaysia have high cholesterol, while 1 in 4 are unaware they have this condition. 

Let’s delve deeper into what causes high cholesterol symptoms and how we can ensure healthy cholesterol levels using Traditional Chinese Medicine (TCM)

Good vs. Bad Cholesterol 

Despite high cholesterol getting a bad rap, cholesterol is an important fat or lipid in our tissue cells. This lipid contributes to cell membrane formation and the synthesis of crucial hormones and cholic acid in our body.

According to CDC, cholesterol travels through lipoproteins in our body. There are two types of lipoproteins: HDL (high-density lipoprotein) or “good” cholesterol, and LDL (low-density lipoprotein), or “bad” cholesterol. 

High levels of HDL cholesterol protect the cardiovascular system, lowering your risk for stroke and heart disease. On the flip side, high LDL cholesterol can cause plaque build-up in blood vessels, which obstructs blood flow to your heart, leading to angina or heart attack.

“A mixture of cholesterol, fat, and other substances can block the arteries, making it difficult for blood to flow through the blood vessels. Sometimes a blood clot appears at the blocked site, completely cutting off the blood flow. When blood supply does not reach the heart, a heart attack can occur. A stroke can also happen if there’s reduced or no blood supply to the brain,” says Eu Yan Sang TCM physician Ignatius Ooi.

Cholesterol in Traditional Chinese Medicine  

In TCM, there is no precise term or definition for cholesterol. This condition usually points to the dysfunction of the spleen and liver due to poor diet and unhealthy lifestyle practices.

“In ancient times, the explanations and characteristics of the human body’s “fat” and “grease” are in line with cholesterol in modern medicine,” Physician Ooi explains. “When we consume high-fat, high-sugar, and high-calorie foods excessively, which is what TCM refers to as ‘greasy and surfeit flavour’, it will result in impaired spleen and stomach functions.”  

“Excessive fats can turn into pathogenic dampness and phlegm, causing qi (vital life energy) and blood flow disorder, visceral dysfunction, and eventually hypercholesterolemia. Although the ancients did not know about the increase in cholesterol, they were already aware that excess fats will harm the human body and may even cause death.” 

TCM also notes that a person’s inability to digest efficiently may affect how the body processes and stores cholesterol. Slower fluid circulation will encourage more or larger cholesterol deposits, while poor blood circulation appears in many types of arthritic disorders and some types of cardiovascular diseases. Excretory system dysfunction is also a huge indicator. The relationship between the liver and bile production is critical to ensure the body can eliminate cholesterol efficiently when it releases bile to digest fats and perform detoxification. 

High Cholesterol Symptoms and Risk Factors 

A man smoking a cigarette with smoke all around his face
Heavy smoking increases your risk of high cholesterol.

Unlike many other diseases, there aren’t obvious high cholesterol symptoms and signs. The only way to tell if you have high cholesterol is to get a blood test. Additionally, doctors would also examine a patient’s risk factors that could potentially point to high cholesterol issues: 


High cholesterol can happen to anyone regardless of their weight. However, being obese often causes an increased risk of cholesterol issues. Obesity can lead to high bad LDL cholesterol and high triglycerides (one of the lipids) levels. If that’s not bad enough, obesity can also lower good HDL cholesterol, which is essential for removing bad cholesterol. 

Type 2 diabetes 

This condition also contributes to high cholesterol as it lowers good HDL cholesterol levels and raises bad LDL cholesterol levels simultaneously.

Unhealthy behaviours 

You are at higher risk of high cholesterol issues if you have a diet high in saturated fat and trans-fat, don’t exercise, and smoke too much.

Genetic conditions 

Familial hypercholesterolemia (FH) is a genetic condition that causes very high LDL cholesterol levels at a young age that, if left untreated, will worsen with age. 

TCM Treatments for High Cholesterol  

TCM can complement western medicine for treating high cholesterol. According to Physician Ooi, TCM clinical research in the past ten over years showed that lipid-lowering Chinese medicines are able to achieve the purpose of lowering blood lipids. Additionally, these Chinese prescriptions may also assist in reducing or preventing the adverse reactions of western medicine and the occurrence of atherosclerosis, cardiovascular, and cerebrovascular diseases.

“For example, triterpenoids found in Alisma (泽泻, zé xiè) can inhibit the synthesis of endogenous lipids. By reducing the levels of TC and LDL cholesterol, it can significantly increase HDL cholesterol levels and help balance cholesterol levels in the body. It also lowers blood lipids, and helps to prevent fatty liver and water retention,” he says.

Managing High Cholesterol Naturally

Pu’er tea leaves next to a cup of tea and teapot
Pu’er tea is an effective natural remedy to help alleviate high cholesterol symptoms.

Generally, TCM offers a range of treatments that may include herbs, acupuncture, and lifestyle changes to complement cholesterol medication. “Treatments such as herbal prescription, body acupuncture, ear acupuncture, moxibustion, and others can help with regulating blood lipid levels and preventing complications,” says Physician Ooi.


Herbal formulations can also assist with naturally bringing down cholesterol levels while improving our general well-being. Some of the recommended TCM herbs are: 

  • Hawthorn Fruit (山楂, shān zhā) lowers blood lipids and treats certain cardiovascular diseases. For example, dried hawthorn slices are an easy way to consume this fruit.  
  • Red Yeast Rice contains natural statins to invigorate the body, aid digestion, and revitalise the blood, lowering LDL cholesterol. 
  • Cassia Seeds (决明子, jué míng zǐ) promotes bowel movement, inhibits hyperlipidaemic formation, and reduces weight gain from nutritive obesity. It also aids in the detoxification of the liver and improves eye vision. 
  • Danshen Root (丹参, dān shēn) promotes blood circulation, removes phlegm and blood stasis, and lowers total blood cholesterol. However, it is not suitable for pregnant women.  
  • Polygonum (何首乌, hé shǒu wū) dissolves blood vessels impurities, reduces cholesterol absorption, and promotes clearing of cholesterol in the blood through improving bowel movements. Take note that this herb is not for those with reduced liver function.  
  • Coix Seeds (薏苡仁, yì yǐ rén) improve digestion and treat hypolipidemia. 
  • Finger Citron Fruit (佛手, fó shǒu) treats poor digestion, improves appetite, and lowers blood cholesterol. 
  • Pu-erh tea, which contains natural statins, helps with managing high cholesterol. 

Lifestyle and diet  

Treatments should always include good lifestyle and eating habits. Here are some recommendations from Physician Ooi: 

  • Weight control is high on the list because excessive weight or obesity can cause many diseases, such as high cholesterol, diabetes, insulin resistance, dyslipidaemia, high blood pressure, sleep apnea, gout, and others. 
  • Gradually get into a proper exercise routine. It is not advisable to overexert yourself with strenuous activities right away if you have been sedentary.  
  • Have a regular daily routine, maintain an optimistic and happy mood, ensure work-rest balance and adequate sleep, quit smoking, and limit alcohol intake. 
  • Avoid eating cholesterol-rich foods, such as organ meats, shrimp skin, fresh crab yolk, quail eggs, lamb’s head, preserved eggs, salted duck eggs, duck yolks, egg yolks, and pig brains. Opt for fish as it contains many high-grade unsaturated fatty acids, which is beneficial for lowering blood cholesterol. 
  • Maintain a healthy glycaemic index and blood pressure. 

Natural diet teas recipes 

For fat and weight loss, Physician Ooi provides 3 easy diet tea recipes made from natural ingredients:  

  • Hawthorn Rose Tea: Combine 6 g dried hawthorn and 3 g rose buds. Brew with boiling water.  
  • Alisma Tea: Brew 5 g of Alisma in boiling water.  
  • Pu’erh Chrysanthemum Tea: Add 2-3 g of chrysanthemum flowers to 2-3 g of Pu’erh leaves. Brew with boiling water. 

High cholesterol can be a debilitating disease if it is not detected and managed effectively. There are no noticeable high cholesterol symptoms. So, it’s important to get regular blood tests and medical check-ups for early detection. Fortunately, there are many ways to prevent and manage high cholesterol. This include lifestyle changes, an improved diet, and TCM remedies to ensure a better quality of life.

This is an adaptation of an article, “Cholesterol and TCM”, which first appeared on Eu Yan Sang website


  1. Centers for Disease Control and Prevention. 2020. LDL and HDL Cholesterol: “Bad” and “Good” Cholesterol. [Accessed on 29 October 2021]
  2. OKC County Health Department. What is Cholesterol? [Accessed on 29 October 2021]
  3. Centers for Disease Control and Prevention. 2020. Knowing Your Risk for High Cholesterol. [Accessed on 15 November 2021]
  4. NHS. High cholesterol. 2019. [Accessed on 15 November 2021]

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