What causes cholesterol to get high? Various hyperlipidemia causes include: Smoking. Drinking a lot of alcohol. Eating foods that have a lot of saturated fats or trans fats. Sitting too much instead of being active. Being stressed. Inheriting genes that make your cholesterol levels unhealthy. Being overweight. Medications that are helpful for some problems can make your cholesterol levels fluctuate, such as: Beta-blockers. Diuretics. Hormonal birth control. Steroids. Antiretrovirals for HIV. Medical problems can also affect how much cholesterol you have. These include: Liver disease. Pancreas disease. Multiple myeloma. Polycystic ovary syndrome (PCOS). Hypothyroidism. Primary biliary cholangitis. Chronic kidney disease. Diabetes. Lupus. Sleep apnea. HIV.