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Can Cholesterol Be Too Low?

Medically Reviewed by Brunilda Nazario, MD on June 07, 2021

High levels of blood cholesterol can raise your risk of heart attack and stroke, but you don’t want your levels to be too low either. Known as hypolipidemia or hypocholesterolemia, very low cholesterol isn’t common, but it can be a sign of many other health concerns.

How Low Is Too Low?

Cholesterol is a fat-like substance in your blood. In the right amounts, it helps keep you healthy. You have two types of it in your bloodstream.

  • Low-density lipoprotein (LDL) is “bad” cholesterol that can build up in the walls of your arteries over time. Most of the cholesterol in your body is made up of this type.
  • High-density lipoprotein (HDL) is “good” cholesterol that helps remove the “bad” kind from your bloodstream.

A simple blood test can show how much LDL and HDL you have. It also shows your total cholesterol.

What Causes Low Cholesterol?

You could have very low cholesterol because of:

  • A rare disorder that runs in your family
  • Malnutrition (not eating enough, or not eating enough healthy foods)
  • Malabsorption (your body doesn’t absorb enough fat)
  • Anemia (low red blood cell count)
  • Thyroid issues
  • Liver disease
  • Some types of infections (like hepatitis C)
  • Severe illness or injury
  • Cancer

Risks of Low Cholesterol

Most of the time, very low cholesterol doesn’t cause a problem. But there’s some concern that in rare cases, hypolipidemia could lead to:

But many questions remain about the effects of very low cholesterol. Experts say they need more research to prove that it could have these consequences.

Treating Low Cholesterol

If your cholesterol is very low, your doctor will probably do more lab tests to look for the cause. In some cases, treating that issue could bring your cholesterol numbers back to normal levels.

Taking vitamins like A, D, E, and K may also help. Check with your doctor first, and then take the supplements only as instructed. These types of vitamins live in your fatty tissues and can stay in your body for a long time. Too much can be harmful.

Based on the reason for your low cholesterol, your doctor could also decide that you don’t need any treatment.

Just like high cholesterol, low cholesterol doesn’t necessarily have symptoms. You may not realize that your levels are low until you get a test. That’s why regular cholesterol tests are important. Most of the time, a test every 4 to 6 years is enough. If you have heart disease, diabetes, or a family history of cholesterol problems, you’ll need tests more often.

WebMD Medical Reference

Sources

SOURCES:

National Heart, Lung, and Blood Institute: “Blood Cholesterol.”

Mayo Clinic: “Cholesterol level: Can it be too low?” “Cholesterol test.”

Cleveland Clinic: “Cholesterol Numbers: What do they mean?”

CDC: “LDL and HDL Cholesterol: ‘Bad’ and ‘Good’ Cholesterol,” “About Cholesterol,” “Getting Your Cholesterol Checked.”

Libyan Journal of Medicine: “Hypolipidemia: A word of caution.”

Merck Manual: “Hypolipidemia — Consumer Version,” “Hypolipidemia — Professional Version.”

University of Washington Center for Ecogenetics & Environmental Health: “Fast Facts about Fat-Soluble Vitamins: the good and the bad.”

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