Very low LDL cholesterol... should I be concerned?

In My Humble Opinion
1

To start with, I’m an overweight diabetic in perimenopause, with depression and panic disorder. (Sorry boys, I’m taken!)

In 2017, I worked on my health to eat better and get my diabetes under control (via (low carbs, medium fat, high-ish protein; exercise was walking), resulting in a loss of about 50lbs and going from an A1C of 10.5 to 6.9 (still too high but better).

However, over the past year or so I had some issues that led me to revert to my old ways, eat terribly and gain the weight I’d lost back again… and bouncing up to an A1C of 11, which is just frickin’ crazy. Anyway, I’m finally taking back the reins and getting the diabetes et al. under control. First step was going back to my GP and facing the music vis-à-vis my various blood/urine tests.

What worries me is my lipids result. For some reason (maybe genetics) my cholesterol has usually been better than expected given my horrible diet. Not triglycerides, though… that’s the number I need to work on.

For the sake of comparison, here were my numbers before I’d lost the weight, after I’d lost the weight (and went on a 10mg statin–Lipitor), and now:

6/17 - Pre-lifestyle change

Triglycerides: 342
Total Chol: 188
HDL: 40
LDL: 80

11/17 - After going on modified Atkins/South Beach type diet (low carb), adding 10mg of Lipitor:

Triglycerides: 223
Total Chol: 174
HDL: 42
LDL: 60

3/18 - After horrible, stressful year of gaining all the weight back. Still on 10mg Lipitor.

Triglycerides: 252
Total Chol: 123
HDL: 43
LDL: 30.
My doctor was pleasantly surprised by the latter cholesterol numbers (not so much the Triglycerides, obviously). However, that super-low LDL is scaring me. How could it possibly be lower after eating terribly and barely exercising? I consulted Dr. Google, which I know is a bad thing to do because I am very fatalistic and prone to anxiety.

Apparently Very Low LDL (<40) is sometimes “associated” with undiagnosed cancer, hemorrhagic stroke, depression (already got) and anxiety (ditto).

(Gotta say it bugs me that the studies seem to focus on men. What the hell, researchers?)

So far the consensus appears that “more research is needed” but there does appear to be a connection. I’m holding out hope that the fact that I have been very depressed and anxious over the past year (three cancer scares, all negative hallelujah) might be the cause, even though all the research seems to talk about effects. Does it go the other way? I can’t tell from the research.

I wouldn’t be quite as worried if I’d been on a healthy diet that would explain the low LDL. But I haven’t, so… here I go into my panic mode.

Anyway: has anyone experienced LDL this low before? How worried should I be, and how can you go looking for undiagnosed cancer if you don’t have any symptoms (yet)?

2

IANAD but my understanding of cholesterol is that the ratio of your total cholesterol as it bears to your HDL and LDL can be more important and your ratios look good.

Your HDL/LDL ratio is 1.43 and preferably, it is recommended a good ratio is over 0.3, ideally over 0.4.

Your total HDL ratio is 2.86 and preferably should be under 5.0, ideally under 3.5.

Triglycerides look a little high so you may want to discuss with your doctor but since your doctor is aware of all of these readings, apparently he/she sees no apparent issue there.

Most people would be delighted with your numbers overall.

3

IANAD.

HDL is the good cholesterol (H=Healthy to help you remember.) The last time I had my cholesterol checked it was high but my ratio of good to bad cholesterol was good, so no need to worry.

Check with your doctor.

4

Thanks Dereknocue67 and ivylass! Yeah, if I were a normal human I’d probably be very happy with the numbers (triglycerides aside–working on that!), especially since I don’t deserve them–although I know I have to get my “good” HDL up, it’s seemingly stuck in that lower-40 area (if I’d shown my results since 2003 you’d see that it’s always been 40 - 43–barely over the recommended level of >40).

It’s just the weird low LDL, which normally everyone wants low, but “in rare cases” acc. to what I’ve read, something this low is a precursor to the aforementioned problems, especially undiagnosed cancer, so that’s freaking me out. Can statins really make that much of a difference? The LDL only went down 20pts during my “healthy lifestyle/weight loss” phase, but since I went into freefall by pigging out and having stress/depression, they’ve lowered 50%.

I will talk to my doctor again, although we did discuss the test results a few days ago when I first got 'em back.

Anyway I know it’s unlikely one of our doctor Dopers will see this, but I was just wondering if anyone else had experienced anything like this here. Thanks very much for your replies, folks!

5

IANAD, but looking it up, it seems that the low LDL was only found to increase cancer risk in the future, not act as an indicator. So just talk to your doctor about testing. You also obviously aren’t having a hemorrhagic stroke. But you do have anxiety and depression, so those make the most sense as possible causes.

Though, of course, just your body being weird is normal, too. As someone with an anxiety disorder myself, I’ve found out that a lot of changes in the body just seem to have no known cause, and ultimately do not affect health status. I personally suspect that the reason my cholesterol is healthier than anyone expects is because of my gut microbiome and how well I absorb food.

6

I’d rejoice. I got my LDL down to the 40’s and that seems to have greatly slowed if not reversed the progress of my coronary artery disease.

And I’m not concerned about low LDL in 99.999% of my patients; the benefits of low LDL thus far outweigh the (still very tenuously associated, if at all) risks of it.

But what do I know . . . .

7

Thanks for taking the time to research, BigT! I appreciate that. :slight_smile: And a hug, if consent is granted, to you, Qadgop the Mercotan. (Don’t worry, I’m so weary with relief that it won’t be a very strong hug.)

The apparent low LDL / mood link fascinates me, especially because most of the articles I’ve read conclude that LDL is therefore responsible for the depression. Sample from Psychology Today

The author leaps to a conclusion but never considers the possibility that many depressed people have low appetites and lose weight, and perhaps that’s the reason for their low cholesterol? I mean, they’re probably right, but shouldn’t they be adding a proviso to these articles that they’re not sure if this is cause or effect? (Some do, most don’t.) I dunno, I just find it interesting.

Again, thanks all for the spirit-boosting, gang!

8

Here’s an article that says that the lower your LDL levels, the better.

9

I used to have great cholesterol, but in the past few years it wasn’t that great. About 5 months ago my LDL was a hundred or so. Doctor put me on the generic version of Lipitor and when I was tested yesterday my LDL was 50.

10

Although you need some cholesterol so that your body can make membranes and natural steroids/hormones, most cardiologists seem to think lower LDL is better; but they don’t know how low is too low. I am not your doctor, this is not my field. But it seems to me your lower LDL is a pretty good thing.