Cholesterol is a fatty substance that circulates in your blood. Your body makes some cholesterol, and you get the rest from foods you eat.

Your body needs some cholesterol to build healthy cells and make hormones. But when you have too much cholesterol, it collects inside your arteries and blocks the flow of blood. Having untreated high cholesterol can increase your risk for heart disease, heart attack, and stroke.

There are two types of cholesterol:

  • Low-density lipoprotein (LDL) cholesterol is the unhealthy kind that builds up inside your arteries.
  • High-density lipoprotein (HDL) cholesterol is the healthy kind that helps clear LDL cholesterol from your blood.

If your LDL or total cholesterol levels are too high, your doctor can recommend lifestyle changes and medications to improve them. Here are seven tips to help bring your numbers into a healthy range.

High cholesterol might not be the only threat to your heart. Having any of these risk factors can increase your chances of having a heart attack or stroke:

  • a family history of heart disease
  • high blood pressure
  • smoking
  • a lack of physical activity
  • obesity
  • diabetes

If you have any of these risk factors, talk to your doctor about ways to manage them.

Ask your doctor how much you need to lower your LDL cholesterol levels and raise your HDL cholesterol levels. The following levels are ideal:

  • total cholesterol: less than 200 mg/dL
  • LDL cholesterol: less than 100 mg/dL
  • HDL cholesterol: 60 mg/dL or higher

Your target cholesterol levels may be slightly lower or higher, depending on your age, gender, and heart disease risks.

Making a few changes to your diet can help bring your numbers under control. Avoid or limit foods that contain these types of fats:

  • Saturated fats. Animal-based products increase LDL cholesterol. Red meat, whole-fat dairy, eggs, and vegetable oils like palm and coconut oils are all high in saturated fat.
  • Trans fats. Manufacturers produce these artificial fats through a chemical process that turns liquid vegetable oil into a solid. Foods high in trans fats include fried foods, fast foods, and baked goods. These foods are low in nutrition, and they’ll put on weight and raise your LDL cholesterol level.

Many of the foods listed above are also high in cholesterol, including red meat and whole-fat dairy products.

On the other hand, certain foods can help either lower LDL cholesterol directly or block your body from absorbing cholesterol. These foods include:

  • whole grains like oats and barley
  • nuts and seeds
  • avocados
  • beans
  • healthy vegetable oils like sunflower, safflower, and olive oil
  • fatty fish like salmon, mackerel, and herring
  • soy
  • fruits like apples, pears, and berries
  • orange juice, margarine, and other products fortified with sterols and stanols

A fast walk or bike ride each day can boost your HDL cholesterol levels, which helps to sweep excess LDL out of your bloodstream. Try to get in at least 30 minutes of moderate-intensity aerobic exercise five days a week.

Carrying extra weight around your middle section can increase your LDL and lower your HDL levels. Losing just 10 percent of your body weight will help bring down your numbers. Better nutrition and regular exercise can help you shed extra weight.

In addition to raising your risk for cancer and COPD, smoking can negatively affect your cholesterol levels. People who smoke cigarettes tend to have high total cholesterol, high LDL, and low HDL levels.

Quitting is easier said than done, there are many options. If you’ve tried a few methods and failed, ask your doctor to recommend a new strategy to help you stop smoking for good.

Prescription medication is an option if lifestyle changes alone haven’t improved your cholesterol levels. Speak with your doctor about the best options for you. They will consider your heart disease risks and other factors when deciding whether to prescribe one of these cholesterol-lowering medications:

Statins

Statin drugs block a substance your body needs to make cholesterol. These medications decrease LDL cholesterol and increase HDL cholesterol:

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol XL)
  • lovastatin (Altoprev)
  • pitavastatin (Livalo)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)

Side effects of statins include:

  • muscle pain and soreness
  • increased blood sugar levels
  • nausea
  • headaches
  • diarrhea
  • constipation
  • stomach cramps

Bile acid sequestrants

Bile acid sequestrants block bile acids in your stomach from being absorbed into your blood. To make more of these digestive substances, your liver has to pull cholesterol from your blood, which lowers your cholesterol levels.

These drugs include:

  • cholestyramine (Prevalite)
  • colesevelam (Welchol)
  • colestipol (Colestid)

Side effects of bile acid sequestrants include:

  • heartburn
  • bloating
  • gas
  • constipation
  • nausea
  • diarrhea

Cholesterol absorption inhibitors

Cholesterol absorption inhibitors lower cholesterol by blocking the absorption of cholesterol in your intestines. There are two drugs in this class. One is ezetimibe (Zetia). The other is ezetimibe-simvastatin, which combines a cholesterol absorption inhibitor and a statin.

Side effects of cholesterol absorption inhibitors include:

  • stomach pain
  • gas
  • constipation
  • muscle soreness
  • tiredness
  • weakness

Niacin

Niacin is a B vitamin that can help raise HDL cholesterol. Prescription niacin brands are Niacor and Niaspan. Side effects of niacin include:

  • flushing of the face and neck
  • itching
  • dizziness
  • belly pain
  • nausea and vomiting
  • diarrhea
  • increase in blood sugar levels

A variety of lifestyle changes can help you treat high cholesterol levels. This include eating a heart-healthy diet, exercising regularly, and maintaining a healthy weight. If those changes aren’t enough, speak with your doctor about prescription medications that can help treat high cholesterol.