What causes low cholesterol? Health risks, symptoms, and treatment of hypocholesterolemia

low cholesterolLow cholesterol or hypocholesterolemia is something we don’t hear a lot about. Cholesterol, of course, is that fatty substance that can clog arteries and lead to heart attack or stroke when levels are high; however, low cholesterol can also be a health hazard.

When cholesterol levels are high, it can interfere with blood flow, causing a heart attack or stroke. If cholesterol levels are low, then other conditions such as cancer and depression can become a problem.


Understanding cholesterol and how it can impact the human body is important if you want to protect your health. For instance, cholesterol is a substance that the body actually needs. It plays a vital role in making certain hormones and making some of the substances that we need to digest food, but LDL is “bad” cholesterol, as it clogs our arteries. While lowering “bad” cholesterol is a good idea, having hypocholesterolemia (too low) can be concerning. Keep in mind that HDL is “good” cholesterol. It helps remove LDL from the body.

What are the causes of low cholesterol?

What is low cholesterol? In simple terms, a low level means less than 40 milligrams per deciliter of HDL. Now that we have described low cholesterol, we can outline what causes low cholesterol. Sometimes, it can be an inherited condition, but the following list includes the main hypocholesterolemia causes:

Liver disease

The liver is a key organ when it comes to the management of cholesterol in the body. Any damage to the liver can cause a significant increase or decrease in cholesterol levels. Liver disease happens to be one of the top causes of low cholesterol.


Although this cause continues to be researched, we know that the condition can lead to low cholesterol levels. Thyroid hormones circulate throughout the body and can cause various health conditions. People with hyperthyroidism often complain about weight loss, sweating, fatigue, and difficulty concentrating.


Some conditions, such as Celiac disease, can cause malabsorption. People who suffer from malabsorption often have low cholesterol levels in their blood. It is important to remember that no matter how much you eat if you have a malabsorption problem, you could still have low cholesterol.

Tangier disease

This is a genetic disorder where a person has low or no HDL level and a low total cholesterol level.

Familial hypobetalipoproteinemia

A genetic disorder that includes low total cholesterol, low LDL cholesterol, normal HDL cholesterol, and low triglyceride level.


A genetic disorder characterized by low total cholesterol levels and low triglyceride level.

What are the health risks of low cholesterol (hypocholesterolemia)?

There has been a lot of research conducted on low cholesterol risks and low cholesterol side effects. When cholesterol falls for no clear reason, it is something that should not be ignored; it should be discussed with a healthcare professional. Some studies suggest low cholesterol levels are linked to specific medical conditions.

A study that was presented to the American College of Cardiology Scientific Sessions six years ago found a possible association between low cholesterol and cancer risk. Research is ongoing on this topic. There are other low cholesterol health risks to keep in mind, such as the number of studies on different autoimmune diseases that have indicated a prevalence of low cholesterol values. Some experts suggest that since cholesterol is anti-inflammatory, decreases in cholesterol can be associated with a higher chance of experiencing oxidative stress, infections, inflammation, and free radical damage. An autoimmune disease patient suffers from these.

Studies show that LDL or “bad” cholesterol is able to reduce pathogens and infectious bacteria. Certain toxins can bind to LDL particles. When this happens, they are inactivated. It is also believed that when the toxins bind to LDL, they are not able to produce a pro-inflammatory response. So if there is low cholesterol, a person may be at higher risk for infection.

Symptoms and risk factors of low cholesterol

So how does someone know they are suffering from low cholesterol? Hypocholesterolemia symptoms are different for each individual.

Symptoms of low cholesterol really center on conditions linked to those low levels. There is some suggestion that depression and anxiety could be related to low cholesterol. Symptoms of depression and anxiety include hopelessness, changes in mood or sleep, confusion, agitation, and difficulty making decisions.

If you experience any of the signs outlined here and think it might be because of low cholesterol, see a doctor as soon as possible. Also, remember that a family history of low cholesterol is a risk factor, and so is being on statins or other blood pressure treatments.

Also read: Causes of low HDL cholesterol levels

Diagnosing and treating hypocholesterolemia

Blood tests are the standard way to diagnose cholesterol levels. Most doctors will consider an LDL cholesterol level less than 50 milligrams per deciliter or a total cholesterol level less than 120 mg/dL as low cholesterol. Total cholesterol is LDL and HDL added together and 20 percent of a person’s triglycerides, which are another type of fat found in the bloodstream. You might be interested in knowing that an ideal LDL level is between 70 and 100 mg/dL.

If you haven’t had your cholesterol checked within the last two years, you should do so.

Let’s say that you are diagnosed with low cholesterol – what do you do? Low cholesterol treatment is only prescribed after a doctor has taken a close look at your diet, lifestyle, other potential health conditions, as well as your
mental health.

Often times, low cholesterol is caused by something in the diet or a physical condition, so hypocholesterolemia treatment will focus on either foods or the physical ailment. In many cases, just eating cholesterol-rich foods won’t solve the problem. Adjustments to diet often need to be coupled with other treatments. When cholesterol level is having an impact on a person’s mental health or vice versa, an antidepressant may be prescribed.

During an evaluation, the doctor will also go over any medications that you might be taking. Some statin medications can cause cholesterol levels to decrease. In these situations, it is usually a matter of changing the dose or the medication.

Prevention and prognosis of low cholesterol

Low cholesterol prevention isn’t something that most people think about because it is usually high cholesterol that makes the headlines. The best way to keep cholesterol levels in balance is to get regular check-ups. Maintaining a heart-healthy diet and living an active life can also go a long way in keeping your cholesterol levels in check. It is also helpful to be aware of any family history connected to cholesterol problems and pay close attention to symptoms of anxiety, particularly if they make you feel really aggressive or violent.

If you or someone in your family shows signs of low cholesterol, you might be concerned about low cholesterol prognosis. It is true that low cholesterol has been associated with some serious health complications, such as intracerebral hemorrhage, but this typically happens in older adults. Women with low cholesterol also run the risk of having low birth weight or even premature babies. Sadly, low cholesterol has also been deemed a risk factor for suicide.

If you are ever diagnosed with low cholesterol, don’t be afraid to talk to your doctor about your concerns. It is important to remain open and report all of your symptoms, including any feelings of anxiety or depression, so that
your health care provider can guide you to the best possible treatment.



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