Many people ask me what the maximum acceptable level is for blood cholesterol. Recently, however, I was asked the opposite question; what is the minimum healthy amount of cholesterol – in other words, how low can you go? According to the Merck Manual, the definition of hypolipidemia (excessively low cholesterol) is: total cholesterol (TC) less than 120 mg/dL or low-density lipoprotein (LDL) cholesterol less than 50 mg/dL. In SI units the levels are 3.1 mmol/L and 1.3 mmol/L respectively. These would be the minimum acceptable values.
A healthy adult on a low fat, low cholesterol diet will be near these lower limits. However, if your cholesterol is abnormally low, or if it plummets without any reason, (good reasons being exercise, medication etc.) see your doctor and have it investigated as there are numerous primary or secondary causes of low cholesterol. The phrase “secondary cause” essentially means another disease which causes the condition in question. Secondary causes of hypolipidemia must be treated, but the treatment of primary hypolipidemia is often unnecessary. In either case, have it checked out.
What are the risks if the levels are too low? Cholesterol is a necessary component for the functioning of the human body. For example, it is a necessary component of all cell walls, and is the raw material for the production of the steroids and bile that the body needs to function properly. Some research suggests that excessively low levels of low-density lipoprotein (LDL), or “bad,” cholesterol may be associated with an increased risk of certain types of cancer. Other studies associate an abnormally low total cholesterol level with depression and anxiety, perhaps because low cholesterol may reduce levels of the brain chemical serotonin. Pregnant women who have very low total cholesterol may be more likely to give birth prematurely and have babies who have low birth weights.
Finally, it is also important to remember that high-density lipoprotein (HDL), or “good” cholesterol counts too. A high HDL level decreases the risk of heart disease, and because of this risks due to cholesterol are evaluated using both LDL and TC (which includes HDL).
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 Renana Shor; Julio Wainstein; David Oz; Mona Boaz; Zipora Matas; Asora Fux; Aaron Halabe, “Low Serum LDL Cholesterol Levels and the Risk of Fever, Sepsis, and Malignancy”, Annals of Clinical & Laboratory Science Autumn 2007 vol. 37 no. 4 343-348
 Thomas Behrenbeck, M.D., Mayo Clinic
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