You’ve probably heard the expression that “you can’t be too rich or too thin.” We would disagree with the idea that you can’t be too thin. Just ask health professionals who treat people with anorexia nervosa. Many physicians go one step further. They believe that you can’t have too low cholesterol naturally. If that does not occur, they like to add cholesterol-lowering drugs. Millions of people are taking statins for precisely that reason. Are there any complications if your cholesterol levels go really low? That’s this reader’s question.

He Has Low Cholesterol Naturally

Q. I am 46 years old. For as long as I can remember, I have had low cholesterol on my blood work.

I donated blood last week and my total cholesterol was 107. While most people would say, “Wow, that’s great,” I heard that too low cholesterol could be bad. Should I be concerned or be happy with this low number? If it is a problem, what should I be watching for?

A. A cardiologist we know likes to say you can’t have too low a golf score or cholesterol level. That is certainly the prevailing view.

There is research, however, suggesting that very low cholesterol naturally may increase the risk of hemorrhagic (bleeding) stroke (Neurology Clinical Practice, June, 2018; Stroke, July, 2013).

Fortunately, such strokes are relatively rare. Heart attacks are far more common. That said, you should discuss your concerns with your doctor. It is unlikely, though, that you will be advised to eat foods that might raise your cholesterol levels. A recent review found that when Japanese people eat more saturated fat, their risk of stroke drops (Journal of Atherosclerosis and Thrombosis, May 1, 2018).  This does not appear to hold for people who are not Japanese.

If you ever experience possible symptoms of hemorrhagic stroke, including sudden severe headache, dizziness, one-sided weakness, nausea and vomiting or trouble speaking or swallowing, treat it as a medical emergency.

Low Cholesterol Naturally and Risk of Death?

My friend the cardiologist who is fond of a low golf score and cholesterol level never saw this article in The Lancet (Aug. 4, 2001).  It was titled “Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study.” The researchers measured lipid and cholesterol levels in Japanese Americans in Hawaii. They tracked changes over 20 years and compared them with mortality stats. This work relates to older people rather than middle-aged folks.

The authors write:

“Our data accord with previous findings of increased mortality in elderly people with low serum cholesterol, and show that long-term persistence of low cholesterol concentration actually increases risk of death. Thus, the earlier that patients start to have lower cholesterol concentrations, the greater the risk of death.”

Needless to say, these researchers were puzzled by their results. They wondered if this might be a Japanese thing:

“Is this low/low effect unique to individuals of Japanese ethnic extraction? There is no evidence to support such a contention. Risk factors for atherosclerosis in Japanese are much the same as those for whites.”

Dr. Steve Nissen on Low Cholesterol:

Dr. Nissen is a world-famous cardiologist. We recently spoke to him about cholesterol-lowering drugs and lifestyle approaches to heart health. Dr. Nissen loves statins, but he also emphasizes the need to lower cholesterol naturally. Why not listen to this free interview at this link. You can stream the audio for free by clicking on the green arrow above Dr. Nissen’s photograph. You can also download the FREE mp3 file.

Learn more about the low cholesterol and statin side effects in our Guide to Cholesterol Control & Heart Health.

Share your thoughts and experiences with low cholesterol in the comment section below.

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