Q. I take simvastatin, and I am concerned that my cholesterol may be too low (143, HDL 46, LDL 75). My mother died at age 64 from a massive stroke. Somewhere I read that very low cholesterol increases the risk of the bleeding type of stroke. How low is low?
A. Do you know if your mother died of a hemorrhagic (bleeding) or a thrombotic (clotting) stroke? The difference is very important.
Controlling cholesterol levels and keeping blood from forming clots are important strategies in preventing a thrombotic stroke, which is like a heart attack in the brain. But a bleeding stroke, which is less common, is associated with low cholesterol and high blood pressure.
A study presented at the American Heart Association Conference on Stroke demonstrated that men with cholesterol below 180 were at twice the risk of hemorrhagic stroke compared with those at 230 or above.
A Honolulu study many years ago showed that middle-age men with cholesterol below 150 had four times the risk of such a stroke.
There are some physicians who believe that you cannot have too low a golf score or too low a cholesterol level. We beg to disagree. Cholesterol is essential for life. Without it, you would die. It forms the building blocks for crucial hormones like testosterone and estrogen. It is also key to the integrity of cell membranes.
We go into far greater detail about the dangers of too low cholesterol levels in our book, Best Choices From The People’s Pharmacy. In addition, we discuss a great many other ways to reduce the risk of heart disease. They include dozens of non-drug strategies. You can learn more about Best Choices by clicking here.
Do not stop taking simvastatin, but please discuss this issue with your physician. Aiming for a total cholesterol between 180 and 200 may be more desirable than getting it as low as you can.