If you’re doing what you can to keep your heart healthy, you probably monitor your cholesterol numbers. Most of the time, high cholesterol (not low cholesterol) is a cause of concern. So if you see low cholesterol levels on lab results, you may wonder what they mean.
Low cholesterol (hypocholesterolemia) is almost never harmful. But sometimes, very low cholesterol levels can be a sign of another health issue. John Chorba, MD, a cardiologist with Banner - University Medicine, helped us understand what’s normal and what low cholesterol numbers could mean.
What is hypocholesterolemia?
Hypocholesterolemia is when you have low levels of total cholesterol or LDL cholesterol. It’s not a disease; it’s a lab finding that usually turns up during routine blood work. If you have low cholesterol, your health care provider will review it in the context of your overall health.
Is low cholesterol always a good thing?
It’s important to understand that the term “cholesterol” can refer to a few different things.
HDL: Your HDL doesn’t usually cause problems and is considered “good.” You don’t want your HDL cholesterol to be too low but that’s not what people are usually referring to when they talk about low cholesterol.
LDL: Your LDL is linked with your risk for heart disease. Generally speaking, your LDL can’t be too low.
Total cholesterol: Total cholesterol includes both HDL and LDL. Most people have more LDL than HDL, so low levels of total cholesterol usually mean low levels of LDL, which is good.
If your cholesterol levels drop, your doctor may want to make sure they are lower for healthy reasons (like diet, exercise or medication) and that they didn’t drop unexpectedly. Drops without a clear cause could need investigation.
In general, your cholesterol levels are linked with your age, overall health, medications, personal history and family history.
Common causes of low cholesterol
A range of factors can cause low cholesterol.
Medical conditions
- Hyperthyroidism
- Chronic infections or inflammation
- Liver disease
- Certain cancers
Digestive or nutrition-related causes
- Malabsorption, which is when your body doesn’t absorb nutrients well
- Poor nutrition
- Weight loss
Genetic causes
- Rare inherited lipid disorders that are often diagnosed earlier in life
Medications
- Cholesterol-lowering drugs
- Combination therapies that lower levels more than expected
Possible symptoms linked to very low cholesterol
Most of the time, low cholesterol is not a concern. It’s considered a positive finding and most people don’t have symptoms from onlylow cholesterol.
If you do have symptoms, they are probably linked to another condition that’s causing low cholesterol. In that case, you may notice:
- Fatigue
- Unexplained weight loss
- Digestive issues
- Hormonal or metabolic changes
Signs your cholesterol levels should be checked
“You should have your cholesterol levels checked at least once in your young adulthood. As you age, you should have them checked periodically. Cholesterol levels tend to go up with age and reducing them lowers risks of heart disease,” Dr. Chorba said.
Be sure to talk to your provider about:
- Very low cholesterol without medication
- A sudden drop compared to previous lab results
- Symptoms along with low numbers
- A personal history of conditions related to low cholesterol
Your provider can help figure out if you need further evaluation.
How doctors evaluate low cholesterol
If your provider thinks your low cholesterol might be concerning because of any symptoms and personal risk factors they may:
- Review your medical history and medications to look for possible causes
- Test your levels again to confirm the results
- Check thyroid, liver or nutritional markers
What to do if your cholesterol is low
Most people don’t need treatment. Review your results with your primary care provider and follow their recommendations. Don’t make major diet or medication changes on your own.
FAQs
Can cholesterol be too low?
Yes but it’s uncommon. Very low cholesterol may sometimes point to an underlying health issue rather than being harmful on its own.
What causes low cholesterol levels?
Causes can include medical conditions, medications, poor nutrition or rare genetic disorders.
Is low cholesterol dangerous?
In most cases, no. It becomes a concern only if it is linked to another condition or symptoms.
What is considered very low cholesterol?
Providers look at your overall health and trends over time rather than a single number.
Can diet cause low cholesterol?
In some cases, yes, especially if nutrition is limited or there is unintentional weight loss.
Should I worry if my cholesterol is low?
Not usually but it’s a good idea to review your results with a provider to rule out underlying causes.
The bottom line on low cholesterol
Low cholesterol is usually not a concerning condition but your cholesterol levels can give you insights into your overall health. If you have questions about your cholesterol results, a Banner Health provider can help you understand what they mean and whether you need any follow-up.
