Low Cholesterol Levels Increase Mortality

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Interviewer: Every time we go to the doctor and get our cholesterol, and if it's lower and lower we're getting there. It's lower and lower. What's the danger in getting that too low?

Dr. Jonny Bowden: There's something called a "J curve" in statistics and it looks like this. We've looked at the part of the graph that says the lower, the better. I'm trying to draw it backwards. But if you continue the line with a lot of these things, what you find is that the lower now it goes up. It looks like a "U". The risk for death from non-heart disease related things is called all-cause mortality. If you step off the side of a curb and get hit by a bus, that's in your mortality thing; cancer, diabetes, suicide, accidents. The risk for all-cause mortality goes up as your cholesterol goes down. There's sort of a sweet spot. Then the lower it goes, these doctors are going, let's get it lower. Let's get it lower. 

Here is the question of the day. Why would the risk for accidents go up as your cholesterol gets really low? Why would the risk for suicide go up? Potential theory: Because it's involved in the brain. You need cholesterol for the brain. It has to affect neurotransmission, mood, and thinking. There no other logical reason why things like accidents and suicide would increase with very low cholesterol. It's very clear infectious diseases go up because cholesterol is needed for immunity. This is not something where we should be perusing lower and lower and lower. As I said earlier, we're lowering something, we don't even know what we're lower, because LDL could be composed of the purely innocuous molecules or it could be composed of the nasty ones. You need to know that before you go on this lipid-lowering campaign to just get the number a slow as you can get it.


Dr. Jonny Bowden discusses the trend to try and continuously lower cholesterol levels. Dr. Bowden explains his theory as to why all-cause mortality increases as cholesterol gets lower.

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