Can Your Cholesterol Be Too Low?
Unlike a lot of men, the writer never worried about cholesterol -- until some surprising studies linked low cholesterol to violent behavior.
The Serotonin Connection
No one knows for sure whether low cholesterol levels are the cause of these
psychological problems -- or just an innocent bystander. It's always possible,
for instance, that people who are depressed or violent eat less than
psychologically healthy people, which could lower their total cholesterol
But one leading researcher, Beatrice Golomb, MD, PhD, an internist who
specializes epidemiology, is convinced there is a direct link. I reached her at
the University of California, San Diego, where she had reviewed all the
existing studies on low cholesterol and violence for an article in the March
15, 1998 issue of the Annals of Internal Medicine.
The link, Golomb told me, may be the brain chemical serotonin. "We know
that monkeys placed on low-fat or low-cholesterol diets show significantly
lower serotonin activity in their brains. What's more, studies show that
animals with low serotonin activity are more likely to be aggressive."
No one has looked to see whether low-fat or low-cholesterol diets decrease
serotonin in humans. Golomb says there are good data from human studies linking
low serotonin to both aggressive and violent behavior, including suicide. The
connections between low serotonin, depression, and these behaviors are not yet
understood. Antidepressant drugs like Prozac and other selective serotonin
reuptake inhibitors, or SSRIs, are believed to work by increasing the effective
concentration of serotonin in the brain.
Cheeseburger and Fries
When I told Golomb that I had a personal interest in the subject, given my
own low cholesterol, she immediately asked me my level. "Around 120," I
"Hmmm," she murmured.
Uh-oh, I thought.
Luckily, she reassured me. Having low cholesterol doesn't necessarily mean
I'm about to "go postal," or do myself in, she said -- though numbers
as low as mine are associated with an increased risk. The association is not so
strong statistically that anyone plans to use low cholesterol levels as a
single way to screen people for the dangers of becoming depressed or
Instead, Golomb and her colleagues eventually hope to identify other factors
-- a history of impulsive behavior, for instance, or an alcohol problem --
that, together with low cholesterol, might be a tip-off for trouble.
Understanding these additional factors might change treatment decisions for
some people who take medications to lower their cholesterol levels.
That makes sense, yet I was still concerned. Should I try to increase my
cholesterol, I ask her -- say, by helping myself to a cheeseburger and
Nice try, she answers, with a laugh. Given the connection between
cholesterol and heart disease, no medical professional would recommend such a
thing. "Still, as long as your total cholesterol is low and your HDL, or
"good" cholesterol, is high, a cheeseburger now and then won't hurt
If I do find myself feeling depressed or unusually short-tempered, she says,
the more reasonable solution would be to consider some counseling, or perhaps
to take an antidepressant medication.