Can I eat eggs with FH? Understanding your dietary cholesterol limits

January 1, 2026 •

3 min read

Familial Hypercholesterolemia (FH), a genetic condition affecting about 1 in 250 people, causes extremely high levels of LDL cholesterol from birth. Due to this genetic predisposition, people with FH must approach dietary choices differently than the general population, which significantly impacts the question: can I eat eggs with FH?.

Quick Summary

People with FH must manage their dietary cholesterol and saturated fat intake, meaning eggs should be consumed in moderation, unlike for the general population. A heart-healthy diet complements medication to reduce high LDL levels and lower the risk of premature heart disease.

Key Points

FH and Eggs: Unlike the general population, FH patients must limit their egg intake due to impaired cholesterol processing.
Moderate Consumption: Recommended limits for FH patients are typically no more than three or four whole eggs per week, helping stay within daily dietary cholesterol targets.
Egg Whites are Safe: The cholesterol in eggs is concentrated in the yolk. Egg whites contain protein but no cholesterol and can be consumed more freely.
Saturated Fat is Key: Focusing on reducing saturated fat intake from other foods like bacon, butter, and processed meats is often more important than just limiting dietary cholesterol from eggs.
Medication is Necessary: For FH patients, diet complements but does not replace essential, lifelong medication required to manage genetically high LDL cholesterol levels.
Prioritize Heart-Healthy Foods: A diet rich in unsaturated fats, soluble fiber, fruits, vegetables, and lean protein is the most effective eating pattern for managing FH.

Understanding Familial Hypercholesterolemia (FH)

Familial Hypercholesterolemia (FH) is an inherited disorder that prevents the body from effectively clearing LDL ('bad') cholesterol from the bloodstream. This occurs due to a genetic mutation that impairs the liver's ability to process and remove excess cholesterol, leading to significantly elevated levels from a young age. For individuals with FH, high LDL levels pose a lifelong risk of developing early-onset cardiovascular disease, including heart attacks and strokes. While medication is the primary treatment, dietary management remains a crucial supportive strategy.

Eggs and Your Cholesterol: The Difference for FH Patients

For many years, eggs were vilified due to their high cholesterol content, but recent research has clarified that for most healthy individuals, dietary cholesterol has a minimal impact on blood cholesterol levels. The greater culprit for the general population is often saturated fat, which stimulates the liver to produce more cholesterol. However, the situation is different for FH patients, who have a genetic impairment in cholesterol metabolism.

Unlike healthy individuals whose bodies can compensate for dietary cholesterol intake, those with FH have a limited capacity to do so. Therefore, minimizing cholesterol and saturated fat from all dietary sources is important.

How many eggs can someone with FH eat?

While recommendations for the general public have loosened, heart health organizations still advise caution for those with FH. Heart UK and the British Heart Foundation recommend limiting dietary cholesterol intake to no more than 300mg a day, ideally aiming for less than 200mg. Considering one large egg contains approximately 186mg of cholesterol, this means:

Limit your intake: Most guidelines suggest restricting egg consumption to no more than three or four whole eggs per week.
Consider the yolk: The cholesterol in an egg is contained entirely within the yolk. Egg whites contain protein but no cholesterol, making them a safe, protein-rich alternative for FH patients.
Prioritize preparation: The way you prepare eggs matters. Cooking with unsaturated fats like olive oil or poaching and boiling is preferable to frying in butter or serving with high-saturated-fat sides like bacon or sausage.

Navigating a Heart-Healthy Diet with FH

Effectively managing FH involves a comprehensive dietary approach beyond just limiting eggs. The goal is to reduce both dietary cholesterol and, critically, saturated and trans fats, while prioritizing heart-healthy foods.

Foods to Prioritize

Unsaturated Fats: Replace saturated fats with vegetable oils like olive, sunflower, and rapeseed oil. Other sources include avocados, nuts, and seeds.
Soluble Fiber: Found in oats, barley, beans, and certain fruits and vegetables, soluble fiber helps bind cholesterol in the gut and prevent its absorption.
Lean Proteins: Opt for fish (especially oily varieties rich in omega-3s), skinless poultry, legumes, and pulses.
Fruits and Vegetables: Aim for at least five portions daily, as they are naturally low in saturated fat and high in fiber.

Foods to Limit or Avoid

High Saturated Fats: This includes fatty cuts of meat, processed meats (sausages, bacon), full-fat dairy products (butter, cheese), and tropical oils like palm and coconut oil.
Dietary Cholesterol: Be mindful of other high-cholesterol foods besides eggs, such as offal and liver, which should be avoided. While shellfish contains cholesterol, it is low in saturated fat and can sometimes be included in moderation.

Egg Components: A Comparison

To highlight the difference in nutritional content, especially regarding cholesterol, here's a comparison of whole eggs versus egg whites.


Nutrient	One Large Whole Egg (~50g)	One Large Egg White (~33g)
Cholesterol	~186mg (all in the yolk)	0mg
Protein	~6g	~4g
Fat	~5g	0g
Calories	~72	~17

The Crucial Role of Medication

For individuals with FH, diet alone is insufficient to manage their extremely high cholesterol levels. Lifelong medication, often statins or other cholesterol-lowering drugs, is necessary to bring LDL cholesterol into a safe range and significantly reduce cardiovascular risk. A heart-healthy diet is meant to complement, not replace, this essential medical treatment. Consistency in both medication and diet is key to preventing long-term complications.

Conclusion

While for the majority of the population, moderate egg consumption is now considered acceptable, individuals with FH must remain cautious due to their genetic condition. By limiting whole eggs to three or four per week, focusing on egg whites, and prioritizing a broader heart-healthy diet low in saturated fat, FH patients can make a positive impact on their cholesterol levels. These dietary strategies, combined with lifelong medication, form the cornerstone of effective FH management and can dramatically reduce the risk of premature heart disease.

Link to Family Heart Foundation

Frequently Asked Questions

A person without FH can often regulate cholesterol from their diet effectively. Your body, however, has a genetic mutation that prevents it from properly clearing cholesterol, making dietary intake a more significant factor that requires careful management.

Yes, egg whites are an excellent source of protein and contain no cholesterol, making them a safe and healthy option for people with FH. It is the yolk that you need to limit.

Yes, but you should still adhere to the recommended limits (3-4 per week) and monitor your overall dietary cholesterol. Your medication helps manage your genetic condition, but a heart-healthy diet, including moderate egg intake, provides additional benefits.

Both are important, but for most, saturated fat has a more significant impact on blood cholesterol. For FH patients, managing both is critical. It's often the foods paired with eggs—like bacon, sausage, and butter—that contain the most problematic saturated fat.

Yes. Poaching, boiling, or scrambling with olive oil and vegetables are healthier alternatives to frying in butter or serving with high-fat meats. This reduces the amount of saturated fat consumed with your eggs.

Yes, since FH is a lifelong condition, children who are diagnosed with it should also follow a heart-healthy diet and limit foods high in dietary cholesterol from a young age. Always consult with a pediatric specialist or dietitian.

You should also limit your intake of organ meats like liver and consider moderating shellfish consumption. The focus should be on minimizing all sources of both dietary cholesterol and saturated fats.