June 26, 2000 -- "This can't be right," the medical technician tells me, reading a number off the small display screen. "We'll have to do the test one more time."
"But wait," I object, telling her that my cholesterol level has always been on the low side. No use. Not once but twice, she jabs the tip of my finger and squeezes out a few drops of blood to test. The numbers remain stubbornly low: barely over 120. The average for most people is around 180.
"Help me ... help you. Help me, help you."
That famous line from the film Jerry Maguire may be the best advice a doctor could give his or her patient.
"Some patients have the attitude, 'I'm putting myself in the hands of a professional,'" says Stephen Permut, MD, chairman of family and community medicine at Temple University School of Medicine in Philadelphia. "They want you to make all their decisions for them."
Permut prefers to have patients get involved in their own care and engage the doctor...
As usual, I feel an absurd swell of pride at the results of the blood test, as if I've just passed an exam with flying colors. I've always counted myself lucky. Unlike a lot of men, I don't have to worry about cholesterol -- that notorious clogger of arteries.
Or so I thought. Then, a few months ago I read a headline that made me wonder: Low Cholesterol Linked to Violence, Suicide.
Violence? Suicide? Is it possible that someone's cholesterol level might be too low?
Smashing Cars and Other Things
To find out, I put in a call to Vivian Mitropoulou, PhD, who is studying the link between cholesterol levels and personality disorders at Mount Sinai School of Medicine in New York. The alarm sounded in the mid-1980s, she tells me, after researchers began testing the first drugs designed to lower elevated cholesterol levels. People taking these drugs seemed to be dying at an unusually high rate from causes unrelated to cardiovascular disease, she says.
Unrelated is right. As Mitropoulou says, "A lot of them seemed to be smashing their cars into bridges and doing all sorts of impulsive and violent things."
And there are other reasons to fret. At least a dozen reports show the risk of suicide may be substantially higher in people with low cholesterol. For instance, in a French study that tracked 6,393 men, published in the September 1996 issue of the British Medical Journal, those with low cholesterol were three times more likely than the other men to kill themselves. A study at Payne Whitney Clinic in New York, published in the March 1995 American Journal of Psychiatry, divided participants into four ranges of low to high cholesterol levels. Researchers found that the men with the rock-bottom cholesterol levels were twice as likely as those in the other three ranges to commit suicide.