By Joy Stephenson-Laws, JD, Founder

I recently saw on Facebook a sponsored healthy, plant-based meal delivery service ad with some interesting benefits. The ad featured a woman who was giving thanks to this service for providing healthy food for her husband whose cholesterol level was now at 110.

“My husband’s cholesterol is down to 110. It’s worth every penny to have more happy years together,” she said.  

Of course, I was happy to learn that she was happy her husband is “healthier,” but my visceral reaction was to question whether a cholesterol level of 110 was healthy.

Cholesterol numbers are measured in milligrams per deciliter (mg/dL). So the appropriate reference above should have been 110 mg/dL. We are all use to hearing about high cholesterol levels well in excess of 200 mg/dL, because high cholesterol puts us at increased risk for cardiovascular diseases. But we really hear less about the health consequences of significantly lower cholesterol levels.

However, it is possible for cholesterol to be too low. And there is credible evidence showing that very low cholesterol levels may put us at increased risk for other diseases, like depression, cancer and anxiety.  

To understand the effects of high or low cholesterol, it is important to understand exactly what cholesterol is and how it works within our bodies.  

Cholesterol is a very necessary waxy, fat-like substance that is found in every single one of our cells. It’s a crucial building block in cell membranes, and every person needs cholesterol to make hormones, vitamin D and substances that help with the digestion of certain foods.

And our bodies, mostly the liver, makes all of the cholesterol we need.

“In fact, cholesterol production is so important that your liver and intestines make about 80% of the cholesterol you need to stay healthy. Only about 20% comes from the foods you eat,” according to Harvard Medical School.

Having too much cholesterol can put us in dangerous health territory.

“When there is too much cholesterol circulating in the blood, it can create sticky deposits (called plaque) along the artery walls. Plaque can eventually narrow or block the flow of blood to the brain, heart, and other organs. Blood cells that get caught on the plaque form clots, which can break loose and completely block blood flow through an artery, causing heart attack or stroke,” according to the University of Maryland Medical Center.

Ideally, you want your total cholesterol level to be less than 200 mg/dL. Levels above 240 mg/dL are usually considered high.

There is really no consensus on how to define very low cholesterol levels. But if your total cholesterol is less than 120 mg/dL (as was the woman’s husband in the ad I saw), you may have low cholesterol.

And there are various studies, which provide us with some guidance on what may constitute very low cholesterol levels.

A 1999 Duke University study of 121 healthy, young women found that those with “low cholesterol levels -- below 160 mg/dl -- were more likely to score high on measures of depression and anxiety than women with normal or high cholesterol levels.”

In that study, normal cholesterol levels were defined as a range of “180 mg/dl to 200 mg/dl.”

Researchers suggested that the low cholesterol levels may reduce the levels of hormone and vitamin D levels, which may affect the health of the brain.  

Another study in 2012, reported by the American College of Cardiology, found a relationship between low cholesterol levels and cancer.

There is also some evidence from a 2015 study that low cholesterol levels are associated with premature births.

“Pregnant women who have very low cholesterol may face a greater risk of delivering their babies prematurely than women with more moderate cholesterol levels,” according to that study.

And in a more recent study from 2017, the issue of low levels of cholesterol is still a popular topic. Because cholesterol is a major constituent of the brain, there is an ongoing discussion about extremely low levels of cholesterol being associated with impaired neurocognitive function, dementia and Alzheimer's despite the reduction of cardiovascular disease.

So to the extent that the lady from the ad I saw is referring to a total cholesterol level of 110 mg/dL, the evidence suggests that her husband may have unhealthily low cholesterol levels.  He should definitely have a talk with a competent healthcare professional to determine the cause of his low cholesterol levels and whether or not that is a healthy level for his particular genetic makeup.  

Low cholesterol levels may be caused by many reasons including genetic makeup, medications, diet and exercise. Clearly, having too low levels may impact mental health and it may be necessary to be screened for depression and anxiety to determine whether the low cholesterol is negatively affecting your health.   

However, the critical takeaway here is the importance of balance in our quest to remain healthy. Having too much cholesterol is harmful for our health, and having too little is not healthy either. We hear so much about eating healthily, exercising and taking medications to maintain a lower cholesterol level. But we can overdo it by restricting too many different types of food or over-exercising. An example of being ‘too healthy’ of an eater is someone who suffers from orthorexia. If your diet is too restrictive, your body will likely not have all of the things it needs to function properly.

Just like it is imperative you get a comprehensive nutrient test in order to ensure the nutrients, like minerals, vitamins, water and protein are balanced in your body, it is also extremely important you get a blood test to check your cholesterol levels.

There are usually no symptoms associated with having high or low cholesterol, so you have to test.

The American Heart Association recommends that all adults age 20 (that’s very young!) or older have their cholesterol and other traditional risk factors checked every four to six years. After that, people should work with their healthcare providers to determine their risk for cardiovascular disease and stroke.

People who have cardiovascular disease or are at higher risk of it may need their cholesterol and other risk factors assessed more often.

Make periodically checking your cholesterol levels a priority even if you “feel fine” or are not overweight. One of the biggest misconceptions regarding cholesterol is that skinny people do not have high cholesterol. People who are thinner may have high (as well as low) cholesterol.

Lastly, there is nothing wrong with taking advantage of health information you find online. But it is crucial that you always do some more ‘digging and investigating.’ And always run things by a competent doctor to ensure you are applying this information in a safe and meaningful manner.

Enjoy your healthy life!

The pH professional health care team includes recognized experts from a variety of healthcare and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.