Can My Cholesterol Be Too Low?

By Sabina Rebis, MD
Medically reviewed checkmarkMedically reviewed
November 21, 2022

Lower cholesterol is usually better than high cholesterol. But it is possible to have cholesterol that is too low.

In this article, we’ll discuss the causes, risks, and symptoms of having cholesterol levels that are too low. We’ll also discuss how it is diagnosed and treated.

Can Cholesterol Be Too Low?

Most problems with cholesterol come when there is too much of it in the body. Cholesterol is a substance that is found in every cell. The body needs it to make hormones, including vitamin D. Your body can make cholesterol, but it can also come from dietary sources, like egg yolks, meat, and dairy products.

When there is too much cholesterol in the blood, it can stick to the walls of arteries. This is referred to as “plaque formation” and can lead to heart disease because it can lead to deposits that  block blood flow. Because your body needs cholesterol, it is also possible to not have enough. High cholesterol is more common, but low cholesterol can also have a significant effect on health.

Understanding cholesterol levels

Normal cholesterol levels should be in the following ranges:

  • Total cholesterol: 125-200 mg/dL
  • LDL cholesterol: Less than 100 mg/dL
  • HDL cholesterol: 40 mg/dL or higher

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What Causes Low Cholesterol Levels?

Low cholesterol levels can occur for several reasons. They may be short-term, long-term, or rarely, a lifelong condition from a genetic disorder.

Causes of low cholesterol include:

  • Malnutrition
  • Malabsorption (digestive problems when the body cannot absorb nutrients)
  • Anemia (low red blood cells or low iron)
  • Thyroid conditions
  • Liver disease
  • Infections, such as hepatitis C
  • Illness or injury
  • Cancer
  • Genetic disorder

Dangers of Low Cholesterol

High cholesterol is considered dangerous because, over time, it can lead to serious risks of heart attack and cardiovascular disease. But cholesterol that is too low, known as hypolipidemia, can also cause health risks.

What research says

The risks of very low cholesterol levels are not as well understood. In some cases, very low HDL cholesterol, LDL cholesterol, or total cholesterol do not have adverse effects. In other cases, they could be associated with anxiety, depression, or a risk of hemorrhagic stroke.

While low cholesterol is less risky than high cholesterol, if your cholesterol levels suddenly start to fall for no specific reason, this could be seen as a cause for concern. Cholesterol levels are often measured routinely as part of general health check-ups. If you see your medical provider for routine care, you would have cholesterol testing that would identify levels that are out of range or suddenly different.

Symptoms of Low Cholesterol

Cholesterol imbalances do not cause noticeable changes to how you feel until they produce a severe health problem. In cases of high cholesterol, there are usually no signs or symptoms that the arteries are becoming blocked until a serious blockage occurs.

With low cholesterol, the signs are not specific. It may cause symptoms associated with anxiety or depression, or could cause none at all.

Some potential signs that low cholesterol is impacting mental health could be:

  • Changes to mood
  • Sleeping difficulties (or sleeping more than normal)
  • Appetite changes
  • Feelings of hopelessness
  • Nervous feelings
  • Confusion or memory problems
  • Problems with decision making
  • Agitation or irritability

While these are possible symptoms of low cholesterol, these symptoms can be caused by many other things. If you notice mood changes, see your healthcare provider.

Diagnosing Low Cholesterol

The only way that cholesterol can be checked is with a basic blood test. Anything outside of a normal range could be considered low, such as:

  • Total cholesterol: Less than 125 mg/dL
  • HDL cholesterol: Less than 40 mg/dL
  • LDL cholesterol: Less than 60 mg/dL

There are no established guidelines for “low” LDL cholesterol since the primary concern is levels that are too high. Treatment targets for safely managing high cholesterol range between 60-100 mg/dL.

A medical provider will assess your cholesterol results and determine if they appear too low or are potentially contributing to any symptoms you may be experiencing. If you take statins to lower LDL cholesterol, and your cholesterol levels are too low, your dosage will be adjusted.

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Treating Low Cholesterol

Most cases of low cholesterol are not caused by statins. If you experience low cholesterol, a healthcare provider will do a medical exam and health history to determine what could be contributing. Low cholesterol is not treated with a high-cholesterol diet.

If your cholesterol levels are inadequate, and malnutrition or malabsorption are involved, dietary changes can help, but they do not necessarily mean eating lots of high-cholesterol foods. Other reasons for low levels of cholesterol, like genetics, illness, or infection, will be treated based on the specific cause and your symptoms.

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Frequently Asked Questions

What happens when your cholesterol is too low?
Low cholesterol is not as common as high cholesterol. When cholesterol levels are too low, it can impact brain health and increase the risk of bleeding in the brain. It could also impact mental health by making anxiety or depression signs and symptoms worse.
What is the lowest cholesterol level you can have?
Low cholesterol levels are considered to be anything that falls below the normal range. This means total cholesterol lower than 125 mg/dL and HDL cholesterol lower than 40 mg/dL. LDL cholesterol levels can be low from being treated with statins, and in some cases, they can go very low. There is no single “lowest” LDL number, but if your number is less than 60 mg/dL, your cholesterol levels may be considered too low.
What causes cholesterol levels to be low?
Genetics can be a cause of low cholesterol levels, usually associated with disorders that run in families. Other causes of very low cholesterol levels include taking statins, being treated for high blood pressure, or having certain illnesses or other health conditions.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sabina Rebis, MD

Dr. Sabina Rebis is a board certified family medicine physician with over 5 years of primary care and urgent care experience.