Should I worry about too-low cholesterol?

June 11, 2007 8:43 PM

Should I be concerned about too low cholesterol?

My cholesterol tested last week at 118, and the results sheet I was given says normal is 125-200. I have been around Google, and some sites say that people have scores as low as 100 and do fine, while others seem to freak at a low score of 130.

I am obese and trying to eat healthier, but I'm not following any particular diet... just trying to make better choices and eat smaller portions. My fasting glucose and thyroid both tested normally. Wikipedia says hypocholesteremia can be a sign of hyperthyroidism (apparenlty not in my case) or liver problems.

Should I just be happy with my cholesterol, or should I worry?

Also, I'd like an answer to this previous unanswered AskMe if anyone knows - how much does cholesterol vary over the day or week?

posted by IndigoRain to health & fitness (11 comments total)

I don't know - both the NIH and the American Heart Association just say under 200 is good, nothing about 125-200. I wouldn't worry a whole lot.

As for variation, anecdotally the last couple of times I've donated blood they gave me a free cholesterol test and at least three times the number has been within one mg/dL of each other. So I don't know how much cholesterol varies in a given day. But my anecdote seems to indicate - not much.
posted by jourman2 at 9:18 PM on June 11, 2007

As a follow up these two articles from the mayo clinic answer your question. The jist I can get is that it really depends on what your LDL/HDL breakdown is. If the LDL (bad cholesterol) doesn't make up most of your cholesterol count then you can have a,

"LDL cholesterol level between 40 and 50 mg/dL and a total cholesterol level of 100 mg/dL — and they do just fine."

Other then that the article ends off with the canonical advice

"If you have questions about your cholesterol levels, consult your doctor. He or she can explain what cholesterol levels are appropriate in your specific situation."
posted by jourman2 at 9:30 PM on June 11, 2007

Yeah, total cholesterol is really not enough information, you need to get the HDL/LDL breakdown. If your HDLs are over like 45, then it sounds like you're super-healthy, though obviously it's never a bad idea to consult a doctor about stuff like this.
posted by rkent at 9:38 PM on June 11, 2007

Your results sheet should have the breakdown of HDL & LDL cholesterol. You mainly need to focus on having enough "good" cholesterol (HDL) and not too much "bad" cholesterol (LDL). As for your total cholesterol, 118 doesn't seem shockingly low. I would imagine that your doctor would contact you if he or she noticed something unusual or worrying in your test results, that's what mine always does at least. Based on that, I think you should relax. However if you are concerned, there is nothing wrong with calling your doctor and asking to discuss the results.
posted by tastybrains at 9:49 PM on June 11, 2007

HDL was 46, LDL 56, but that only adds up to 102... dunno where the other 16 points come from.
posted by IndigoRain at 10:21 PM on June 11, 2007

dunno where the other 16 points come from.

On a whim, I googled "MDL", and what do you know, it seems to exist. One example article contains references to VLDL, very low density lipoprotein; LDL, low density lipoprotein; HDL, high density lipoprotein; IDL, intermediate density lipoprotein; “MDL”, medium density lipoprotein(PDF). As a random internet nerd and not a doctor, I have no idea if that's really what's going on, but 16 points of IDL/MDL seems like the obvious answer.
posted by IvyMike at 10:41 PM on June 11, 2007

Go figure!
posted by IndigoRain at 10:52 PM on June 11, 2007

dunno where the other 16 points come from.

LDL is a calculated value (that is calculated from other directly measured values) as opposed to a measured value. The calculation is the Friedewald equation (mg/dL):

[LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/5))

Of course, LDL can be directly measured, but in most laboratories this is how it is usually performed.
posted by i_am_a_Jedi at 3:44 AM on June 12, 2007

Hey Indigo. I also have very low cholesterol-- I think I tested at 107 total last year.

My doctor told me that with such low total numbers it is difficult to reach an optimum level of HDL, and low HDL has been associated with heart disease and other problems. She suggested I increase my cardiovascular to bring it up. Thus far that has been ineffective.

Also, low cholesterol has been associated with depression in a few clinical studies, but I think the jury is still out on that.

I don't think you should worry about liver or other problems, 118 doesn't qualify as hypo, really, just unusually low.

In my family, this is a genetic quirk. My father is the same way, and neither of us limits our cholesterol intake or anything like that. Although we do both eat a lot of vegetables.

Anyway. That was a long answer, and I am not a doctor, but I would ask yours the next time you go in, but not worry too much in the meantime.
posted by miss tea at 7:53 AM on June 12, 2007

This comes up perenially. The latest thinking, last I looked into it, was that the ratio of LDL to HDL was the most important factor - the lower the better - but for people with a very low total cholesterol, the risk of events was mitigated so much that the ratio became less significant. The events in question are stroke and heart attack, of course.

Very low total cholesterol seems to be correlated with excess death by violence (homicide and suicide.) The finding is statistically robust and replicated, but there's a lot of argument over whether there is a causal relationship or whether the relationship is "confounded" by other factors. The most plausible explanation I've heard is that seriously mentally or physically ill people tend to be both malnourished (lowering their total cholesterol) and more likely to die by violence (a lot of chronically ill people commit suicide), and that is what these population-based studies are detecting.
posted by ikkyu2 at 10:30 AM on June 12, 2007

Very low total cholesterol seems to be correlated with excess death by violence (homicide and suicide.)

Really? Eeek. Never knew that.
posted by miss tea at 10:33 AM on June 12, 2007