Can your cholesterol go too low? That is a question that we have been asked on many occasions. It seems ludicrous. It’s a bit like asking if you could be too rich or too thin? The truth is that you could be too thin. It can happen when someone is very sick, say with cancer. It can happen with hyperthyroidism or ulcerative colitis. People with anorexia can be too thin. Should people worry if their cholesterol levels go really low? There is a possibility that very low cholesterol could have some unexpected negative health consequences. Should anyone try to raise cholesterol levels? That’s what this reader wants to know.
How Low Is Too Low?
Q. I have low cholesterol. My LDL was 17 when last checked and my total cholesterol was 82. My triglycerides were 32.
I weigh 160 and am 6 feet tall. I cannot find a doctor who thinks my cholesterol numbers are a problem, but I feel awful and have no energy.
How do you raise cholesterol? I have tried shrimp, beef, eggs, butter, bacon etc. So far, I haven’t had any success.
A. Doctors have focused almost exclusively on the dangers of elevated cholesterol. As a result, they may have a hard time conceiving of low cholesterol as a problem. Many health professionals probably think that trying to raise cholesterol levels would be like dancing with the devil.
An Unexpected Risk of Low LDL Cholesterol:
A study published in the journal Neurology (April 10, 2019) suggests that women with LDL cholesterol below 70 are at double the risk for a bleeding (hemorrhagic) stroke. Those with the lowest triglycerides (under 74 mg/dL) were also more susceptible to bleeding strokes.
Data from the Taiwan Stroke Registry involving 40,000 patients demonstrate a link between low total cholesterol and a risk of bleeding in the brain (PLOS One, April 19, 2017).
A study published in the Journal of the American Geriatrics Society (Feb. 2005) disappeared from medical consciousness without a trace. It defies current wisdom.
The investigators set out:
“To investigate the relationship between plasma lipids and risk of death from all causes in nondemented elderly.”
They tracked 2,276 people on Medicare living in Manhattan. What they found was shocking.
The authors noted that:
“Nondemented elderly with levels of total cholesterol, non-HDL-C, and LDL-C in the lowest quartile were approximately twice as likely to die as those in the highest quartile (rate ratio (RR)=1.8…”
In other words, the lower the lipid levels like LDL cholesterol or total cholesterol the higher the death rate.
They concluded their article:
“Low cholesterol level is a robust predictor of mortality in the nondemented elderly and may be a surrogate of frailty or subclinical disease. More research is needed to understand these associations.”
If you would like to read more about LDL cholesterol and bleeding strokes, here is a link to a recent article we wrote on this subject:
Can You Raise Cholesterol Levels?
There are no FDA-approved medications to raise cholesterol. Some drugs do it, but this is an unintentional side effect. Corticosteroids like prednisone can raise LDL cholesterol levels as well as triglycerides. We would never suggest taking prednisone to raise lipid levels. There are way too many other side effects! See this link for more details:
Testosterone can also raise LDL cholesterol. But this male sex hormone should not be used to raise lipids. An immune system suppressing drug called cyclosporine is often prescribed to patients who have had an organ transplant. This medication helps prevent rejection. Cyclosporine can raise cholesterol cholesterol levels, especially LDL cholesterol. Again, this is a heavy-duty drug not to be used for this purpose.
What About a Diet to Raise Cholesterol Levels?
Most health professionals discourage a diet high in saturated fat on the grounds that it might elevate cholesterol and the risk for a heart attack or clotting stroke.
This reader reports what happened when her husband tried to raise cholesterol levels with food:
“My husband tried to raise cholesterol levels. When we got married his cholesterol was under 75. He was denied life insurance coverage because of that.
“He ate eggs, shrimp, beef, etc. with no increase whatsoever. His diet, however, led to pancreatitis. His doctors also diagnosed him with fatty liver disease.
“Doctors did not believe he rarely drank alcohol. When he did have a beer or alcohol, he had pain in the area of the pancreas. His liver was unable to pick up fat and convert it to cholesterol. He also lacks pancreatic enzymes that are crucial for good health. I, on the other hand have MS, and eat a high fat diet for my brain. Cholesterol is important! It definitely can be too low!”
A Healthy Diet?
We keep returning to the Mediterranean diet. It is not low fat. But study after study suggests that it is healthy. It may not raise LDL cholesterol, but it can’t hurt. Please discuss your dilemma with your doctor, bolstered by the recent research.
Share your own thoughts about cholesterol in the comment section below.