High cholesterol doesn’t usually cause symptoms at first. It builds up silently in your arteries over time. But when it reaches a critical level, it can affect blood flow—especially to your legs. If you start noticing certain changes in your legs, it may be a warning sign of a condition called Peripheral Artery Disease (PAD).

PAD is a serious health condition. It happens when plaque, made up of cholesterol and other substances, narrows the arteries in your legs. This limits blood flow. Without enough blood, your leg muscles and tissues start to suffer.

Let’s take a closer look at the symptoms you might notice in your legs and why they should never be ignored.

Leg Pain When Walking (Claudication)

One of the first signs of PAD is pain or cramping in your legs when you walk. This is called claudication. It usually happens in the calf muscles but can also affect your thighs or buttocks.

The pain often starts after you walk a certain distance and goes away when you rest. That’s because your muscles need more blood during activity. When arteries are blocked, blood can’t reach them fast enough.

Some people think it’s just a normal part of aging or arthritis. But leg pain that appears with activity and goes away with rest is a classic warning sign of PAD.

Numbness or Weakness in the Legs

Blocked arteries reduce oxygen supply to your leg muscles and nerves. This can cause numbness, tingling, or weakness—especially after walking or standing for long periods. Some people describe it as a heavy or tired feeling in their legs.

This is your body’s way of telling you that something isn’t right. If your legs often feel weak or “fall asleep,” it’s time to get checked.

Cold Legs or Feet

If you touch your legs or feet and one feels much colder than the other, it could be due to poor circulation. In PAD, less warm blood reaches the limbs, which can make one leg or foot feel unusually cool.

This is more noticeable when you’re resting or lying down. It may also happen even in warm temperatures.

Slow-Healing Sores or Ulcers

Good circulation is essential for healing. When blood flow is reduced, your body struggles to repair tissue damage. As a result, sores or ulcers on your legs or feet may take a long time to heal—or not heal at all.

These wounds are usually painful and prone to infection. In severe cases, they can lead to serious complications, including tissue death.

If you have diabetes along with high cholesterol, your risk of non-healing ulcers is even higher.

Shiny Skin or Hair Loss on Legs

Another subtle but important sign of PAD is changes in the appearance of your legs. Look for shiny, thin, or tight-looking skin. You may also notice that hair on your legs or feet starts to disappear.

These changes happen because your skin and hair follicles aren’t getting enough nutrients. The lack of blood flow slows growth and affects how your skin looks and feels.

Weak or Absent Pulse in the Legs

In a physical exam, your doctor will usually check for a pulse in your feet or ankles. If blood flow is reduced, the pulse may be weak—or even absent altogether. This is a strong indicator of PAD.

Sometimes, this is only found with a special test called the ankle-brachial index (ABI). It compares blood pressure in your ankle to that in your arm.

Leg Discoloration

Poor circulation from PAD may also cause changes in skin color. Your legs or feet may appear pale, bluish, or purplish, especially when you elevate them. In some cases, they may turn red or flushed when you lower them back down.

This happens because oxygenated blood isn’t reaching the skin evenly. It’s a clear signal that something is wrong with your circulation.

Toe or Foot Pain at Rest

In more advanced cases of PAD, you may feel burning pain in your toes or feet even while resting. This pain often becomes worse at night and may improve slightly if you dangle your legs off the bed.

This is a sign that blood flow is severely limited. It requires immediate medical attention.

When to See a Doctor

If you recognize any of these symptoms, don’t ignore them. These leg changes may seem small, but they point to a much larger issue—plaque buildup in your arteries. PAD doesn’t just affect your legs. It raises your odds of heart attack, stroke, and limb loss. Your doctor may recommend lifestyle changes, medication, or, in some cases, procedures to restore blood flow.

Final Thoughts

High cholesterol is often silent, but its impact can be serious. PAD is one way that cholesterol harms your health without warning. Your legs can tell you when something’s wrong—if you know what to look for.

Pay attention to how your legs feel, move, and look. If you notice pain when walking, numbness, cold feet, skin changes, or sores that won’t heal, take it seriously. These symptoms may be your first—and only—clue that your arteries need help.