Written by Dr. Sandra Miranda, ND

Most cholesterol concerns are associated with high cholesterol and in all honesty our culture has labelled cholesterol as this evil villain that needs to be erased from our diet and health in order to reduce our risk of heart attacks and strokes.

But is it possible for cholesterol to be too low?

How is it possible that cholesterol affects so many aspects of our health?

Cholesterol is something that our body needs because it is necessary to make certain hormones.  It is involved in making vitamin D and it plays a role in making enzymes to help us digest foods.  Cholesterol is so important to our bodies that the liver is regularly making some.

As a matter of fact, in 2012, as a result of clinical trials, the FDA was required to add a black-box warning on statin drugs (the more common drugs given to lower cholesterol), indicating dangerous effects on cognition and psychological symptoms.  There is a huge connection between cholesterol and brain health.  The brain relies heavily on fats/lipids during growth and development and for optimal daily function.  The increased need of cholesterol during adolescent brain development shows the risk of low cholesterol being linked to psychological problems in teens and young adults.

Low cholesterol reduces function of serotonin (the neurotransmitter that is usually low in cases of depression, anxiety and eating disorders).  Serotonin is essential for the regulation of emotion and decision-making.

Research also suggests that anti-depressant medications may further lower serum cholesterol, possibly counteracting any benefits from the medication (Sahebamani, 2003)

Violent conduct has been linked to low cholesterol levels in patients ranging from teenagers with ADHD (attention-deficit hyperactivity disorder) to war veterans with PTSD (post-traumatic stress disorder) (Vilibic, 2014; Virkkunen, 1984).

So, while different mechanism may be at play, there is no denying that there is a connection between low cholesterol and our mental health and behaviour, most likely due to cholesterol’s influence on our hormones and neurotransmitters.

Cholesterol levels should be monitored in patients with depression, anxiety, self-injury and suicidal thoughts, especially considering the rising number of anti-depressants and cholesterol lowering drugs prescribed nowadays.

There has not been an agreement on what is considered “low total cholesterol” levels yet.  NIH considers a low total cholesterol under 3.2 mmol/L.  Some clinicians prefer not to see their patients under 3.8 mmol/L specially if there is a diagnosis of depression, anxiety or any other mental concerns.

As our knowledge of the link between diet and our mental health grows, now is the time to reverse cholesterol’s erroneous reputation and recognize just how essential it is to our mental health.