Elevated levels of cholinesterase are mainly due to excess fat in the body, as elevated fat causes liver damage, and elevated levels of this substance can be checked in serum tests, which can diagnose hyperlipidemia or fatty liver. Neurological disorders or hyperthyroidism, diabetes, or hypertension can also cause elevated levels, all of which affect the normal function of the body’s peripheral nervous system and lead to cholinergic hyperexcitability. Clinical tremor of the hands and feet may occur, as well as local sensory disturbances, such as numbness and pain, which should be treated promptly for the primary cause to avoid affecting the normal function of the limbs. High cholinesterase is seen in a variety of diseases and needs to be diagnosed based on symptoms.