Total cholesterol level less than 200 mg/dl- all about it

Total cholesterol level less than 200

Total cholesterol level less than 200 mg/dl is a decrease in plasma cholesterol caused by primary(genetic) or secondary(acquired) factors. 

Acquired hypocholesterolemia may be due to some diseases such as hyperthyroidism, critical illness, chronic anemia, malignancy, malabsorption, chronic liver disease, chronic inflammation, infections etc.

There is no defined base level-line below which hypercholesterolemia becomes life-threatening for the health. However, most of the authors describe the level of 120-130 mg/dl as a baseline.

Hypocholesterolemia does not pose a danger for the development of cardiovascular diseases, but it can cause complications such as sepsis, intracranial hemorrhage, anxiety, depression, malignancy etc.

What does it mean to have total cholesterol level less than 200 mg/dl?

Total cholesterol level less than 200 mg/dl is considered hypocholesterolemia or hypolipidemia. This condition is first described in the year 1911, so it is relatively a “new entry” in the world of medicine.

It is not a common condition, as hypercholesterolemia is. The risk factors of having total cholesterol level less than 200 mg/dl are being under statin treatment or other blood pressure treatment, having a familiar history of the condition and having untreated clinical depression. 

Hypocholesterolemia can cause anxiety, depression, an increased risk of developing cancers, giving birth to low-weight babies, an increased risk of intracranial hemorrhage, an increased risk of developing sepsis, of developing adrenal failure etc.

But, most of the times hypocholesterolemia does not have any symptoms and it is diagnosed coincidentally.

Total cholesterol level less than 200 mg/dl - What are the Causes?


Total cholesterol level less than 200 mg/dl may have primary or secondary causes.

a.    Primary causes - Is caused due to family heritage or spontaneous mutations. It is much rare that secondary hypocholesterolemia. There are three conditions involved: abetalipoproteinemia, hypobetalipoproteinemia, and hypo chylomichron.

b.   Secondary causes - Secondary causes of hypocholesterolemia are much common than primary causes. Following are some of the clinical conditions that can cause total cholesterol level under 200 mg/dl:

   ·   Chronic anemia,

   ·   Hyperthyroidism- thyroid disorders are known to affect lipid metabolism and thus, thyroid dysfunction affects production and transportation of lipoproteins.

   ·   Critical illness- Total cholesterol level drops on the onset of acute illness and returns back to normal levels during recovery.

   ·   Malignancy- There are several studies indicating the inverse relation between levels of total cholesterol in the serum and cancer mortality.

   ·   Malabsorption- Undernutrition or fat malabsorption can lead to hypocholesterolemia due to the fact that dietary fats constitute the exogenous source of body lipids.

   ·   Infections- Both acute and chronic infections can cause hypocholesterolemia due to the chronic effects on proinflammatory cytokines on lipid metabolism.

   ·   Chronic liver disease- Severe chronic liver insufficiency can cause hypocholesterolemia due to the fact that hepatic cells are the most active site of lipid metabolism.

Chronic inflammation- It can cause hypocholesterolemia due to the chronic effect of proinflammatory cytokines in lipid metabolism.

Total cholesterol level less than 200 mg/dl - What is the risk level of such cholesterol levels?

There is no consensus about the level below which a clinically significant hypocholesterolemic becomes dangerous for the health.

Different authors give different levels, however, most of the authors use a cut-off value between 120-130 mg/dl. Having total cholesterol levels under 120-130 mg/dl will seriously damage your health.

Total cholesterol level less than 200 mg/dl - Is there a risk for cardiovascular events?


Having total cholesterol levels under 200 mg/dl (hypocholesterolemia), unlike hypercholesterolemia, does not affect your cardiovascular health. But, hypocholesterolemia has other serious effects on your health.

Following are some of the most common risks of having cholesterol levels under 200mg/dl:

   ·   Intracerebral hemorrhage

   ·   Adrenal failure

   ·   Sepsis

   ·   Increased mortality from all causes

        Anxiety, depression


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