Can cholesterol be too low?

Medically reviewed on February 24, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What is cholesterol?
• What happens when cholesterol is too low?
• What causes low cholesterol?
• Track your cholesterol levels with Everlywell
• Related content

Most people have heard of some of the undesirable side effects of high cholesterol. But low cholesterol can also bring an increased risk for high blood pressure, a higher likelihood of heart disease, and the potential for a heart attack, strokes, and cardiovascular disease to name a few [1]. To avoid those outcomes, many individuals maintain a healthy cholesterol level by establishing a healthy diet and incorporating exercise to lower cholesterol.

But if you think your cholesterol level may be dipping more than it should, you might wonder—can cholesterol be too low?

While it doesn’t occur often, it’s possible for your cholesterol levels to reach a very low number [2]. But just because they’re low doesn’t mean you should worry for your heart health or expect unpleasant side effects to follow.

Read on as we discuss the fundamentals of cholesterol, including what causes it to drop and what happens if it’s too low.

What is cholesterol?

Cholesterol is an essential substance found in the body that helps make hormones, cells, and vitamin D [3]. Although your liver produces cholesterol on its own, you can also receive it through a variety of different foods, like oatmeal, fish, and an array of different nuts.

Cholesterol uses two types of lipoproteins to transport itself throughout your body, including:

• Low-density-lipoprotein (LDL) – Known to many as bad cholesterol, LDL contributes to plaque buildup in your arteries. If you maintain lower levels of LDL or bad cholesterol, you can lessen the likelihood of developing a heart attack, heart disease, or cardiovascular disease in the future. The ideal LDL cholesterol level is approximately 100 or less [4].
• High-density-lipoprotein (HDL) – Often seen as the “good” cholesterol, HDL cholesterol carries extra cholesterol to the liver so that it can filter out the excess. HDL cholesterol numbers of 60 or higher are ideal [4].

What happens when cholesterol is too low?

If your LDL cholesterol levels drop below 50, it can turn into a condition called hypolipidemia. This is a condition that occurs when your body contains a highly reduced amount of cholesterol [2].

Although healthcare physicians don’t yet know the long-term risks of low LDL cholesterol levels, hypolipidemia is usually asymptomatic and doesn’t often cause problems to an individual’s heart health [2].

What causes low cholesterol?

Individuals with very low cholesterol levels usually fall under one of the following categories that cause low LDL.

Primary hypolipidemia

Primary hypolipidemia happens when someone has a genetic condition that predisposes them to lower LDL levels [5]. There are three rare genetic disorders associated with primary low LDL levels, including [5]:

• Abetalipoproteinemia is a disorder that limits your body’s ability to absorb fats, sometimes resulting in a lipid deficiency [7].
• Chylomicron retention disease is a genetic disorder that healthcare providers usually diagnose in babies and children. They identify the disease with symptoms including general malnutrition and failure to thrive [2].
• Hypobetalipoproteinemia is another disorder that makes it difficult for the body to process and absorb fats. There usually aren’t any identifiable symptoms other than extremely low LDL levels [2].

Secondary hypolipidemia

It’s more common to have secondary hypolipidemia, a disorder caused by other underlying health conditions, such as [2]:

• Chronic infections – Hepatitis C is an infection that can lead to very low LDL levels [2].
• Various types of cancer – A recent study linked low HDL levels to a higher risk of being diagnosed with certain types of cancer, including non-Hodgkin lymphoma, breast cancer, lung cancer, and nervous system cancer [9].
• Hyperthyroidism – Hyperthyroidism occurs when your thyroid is overactive and produces too much of the thyroid hormone. In some cases, it can increase the turnover and excretion of cholesterol, lowering your LDL levels [10].
• Malabsorption – Malabsorption is a digestive disorder that prohibits your body from properly absorbing nutrients from your food [11].
• Undernutrition – Undernutrition occurs when the body isn’t receiving an adequate amount of nutrients through the diet. This can occur due to anorexia [14] or extreme consumption of alcohol [5].

If you’re taking a cholesterol-lowering medication—such as a statin—you may notice cholesterol levels that appear too low [3]. If your statin dosage is too high, it may need to be adjusted by your medical provider. An adjusted dose can help your cholesterol levels regulate to a number that falls within the “normal” cholesterol range.

Track your cholesterol levels with Everlywell

In many cases, a low LDL cholesterol level doesn’t have any noticeable negative effects on the body [2]. But if you’re unsure of your existing cholesterol levels or you’re worried that you have high cholesterol, it’s always a good idea to uncover where your total cholesterol numbers stand.

If you’re looking for a simple way to determine your cholesterol levels, try the Everlywell Cholesterol and Lipid Test. Not only does it measure your total cholesterol levels, but it also determines your individual LDL, HDL, and triglyceride levels.

Whether this is your first time learning about your cholesterol levels, or you take statins and are looking for a convenient way to monitor them regularly, you can complete the mail-in kit from the comfort of your home. Simply collect your sample, mail it in to one of our certified labs, and receive easy-to-understand results in days using our secure digital platform.

This test and other tests (including HbA1c and the Heart Health Test) are also available to you when you join the Everlywell+ at-home heart health membership.

With Everlywell, you can gain insights into your health and take action to secure a brighter, healthier future.

Related content

How to use exercise to lower cholesterol levels

How long does it take to lower cholesterol?

What are good cholesterol numbers?

What is non-HDL cholesterol?

What is non-HDL cholesterol?

References

1. LDL and HDL cholesterol and triglycerides. Centers for Disease Control and Prevention. URL. Published October 24, 2022. Accessed February 13, 2023.
2. Davidson MH, Pulipati VP. Hypolipidemia - hormonal and metabolic disorders. Merck Manuals Consumer Version. URL. Published January 31, 2023. Accessed February 13, 2023.
3. Cholesterol in the blood. Johns Hopkins Medicine. URL. Published August 8, 2021. Accessed February 13, 2023.
4. Understanding cholesterol levels and numbers. Cleveland Clinic. URL. Accessed February 13, 2023.
5. Davidson MH, Pulipati VP. Hypolipidemia - endocrine and metabolic disorders. MSD Manual Professional Edition. URL. Published January 31, 2023. Accessed February 13, 2023.
6. Abetalipoproteinemia. National Organization for Rare Disorders. URL. Published January 12, 2023. Accessed February 13, 2023.
7. Chylomicron retention disease - about the disease. Genetic and Rare Diseases Information Center. URL. Accessed February 13, 2023.
8. Pedersen KM, Çolak Y, Bojesen SE, Nordestgaard BG. Low high-density lipoprotein and increased risk of several cancers: 2 population-based cohort studies including 116,728 individuals - Journal of Hematology & Oncology. BioMed Central. URL. Published September 30, 2020. Accessed February 13, 2023.
9. Leonidas DH. Thyroid disease and lipids. Thyroid : official journal of the American Thyroid Association. URL. Accessed February 13, 2023.
10. Malabsorption (syndrome). Cleveland Clinic. URL. Accessed February 13, 2023.
11. Elmehdawi R. Hypolipidemia: A word of caution. The Libyan journal of medicine. URL. Published June 1, 2008. Accessed February 13, 2023.