Can Cholesterol Be Too Low?

Occasionally you’ll hear that maybe there’s a risk in substantially lowering cholesterol; maybe you’ll suffer emotional problems like mental distress or depression, even suicide. But these concerns have largely been discredited.

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Based on a wealth of compelling data, federal guidelines state that the lower your total and LDL cholesterol, the better – and getting LDL (bad) cholesterol down to 70 or lower is ideal.
Can cholesterol be too low?

Yet occasionally, usually from Dr. Matthew Muldoon at the University of Pittsburgh, you’ll hear that maybe there’s a risk in going too low – maybe you’ll suffer emotional problems, like mental distress or depression, even suicide.

“Muldoon has been making a career of warning people of the dangers of low cholesterol. But by and large his ‘findings’ over time have been discredited,” points out Dr. William McCarthy, UCLA School of Public Health and member of the Pritikin Scientific Advisory Board. “Eventually, good science shows that his speculations have no legs.”

More good science has recently arrived – a mammoth study that followed 3,277 businessmen from Finland for 39 years.* The study began in the 1960s, when all the men were aged 30 to 45 and healthy, free of both cardiovascular disease and diabetes. Scientists measured their total cholesterol levels and measured them again in 1974, 1986, and 2000. They also tracked death rates. In 2000, they also measured quality of life, both physical and mental, among survivors (1,820 men), using an internationally recognized self-assessment survey called the RAND-36 QoL, a 36-item questionnaire.

In summary, the higher the men’s cholesterol levels, the sooner they died. Those who had cholesterol levels below 194 at baseline had a 25% reduction in total mortality.

The results of this Finnish study echo observations from the long-running Framingham Heart Study in the U.S. concerning serum cholesterol levels and the probability of dying from all causes over a 30-year period. The Framingham researchers looked at healthy men in their 30s and found that the 25% of men with the highest cholesterol levels in their 30s were more than twice as likely to be dead from all causes combined in their 60s.**

And in old age, this latest study from Finland found, there was no association between low cholesterol levels and adverse changes in mental health, according to the RAND quality-of-life assessments.

“Low serum cholesterol levels in midlife predicted not only better survival but also better physical function and quality of life in old age, without adversely affecting mental quality of life,” concluded lead investigator Dr. Timo E. Strandberg, Department of Medicine, University of Helsinki.

* Journal of American College of Cardiology, 2004; 44: 1002.
** JAMA, 1987; 257: 2176-80.


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