Blood test

Low total cholesterol level in the blood

Blood test
Low total cholesterol level in the blood

What is low cholesterol level in the blood called?

  • Hypocholesterolemia

What is the normal cholesterol level in the blood?

If you need to know which are the cholesterol reference ranges or you require more information about the role of cholesterol in the blood you can visit: Normal cholesterol level in the blood

What does a low cholesterol level in the blood mean?

Hypocholesterolemia is a very rare situation in clinical practice.

Cholesterol is essential for some important functions in the body. For that reason, a low cholesterol level in the blood is also a health risk. People with hypocholesterolemia are twice as likely to have an intracerebral hemorrhage (ICH).

The main reason for hypocholesterolemia is an excessive pharmacological treatment for hypercholesterolemia or malnutrition. If the cause is an excessive cholesterol-lowering drugs, it is recommended to decrease the dose.

In some cases, it can be due to hyperthyroidism or liver disorders.

Cholesterol values are usually given in mg/dl but sometimes you can see those values in mmol/l following the International System of Units (SI). In case your values are in mmol/l you can convert them using this tool:

  • Mild hypocholesterolemia (120 - 100 mg/dl in adults):

    Cholesterol level in the blood is a bit low and it is not a matter for concern.

    If you have suffered hypercholesterolemia, you should keep an eye in the dose of cholesterol-lowering drugs. In this case, you should visit your doctor to decrease the dose.

    In case you have not previously suffered hypercholesterolemia, it can be the consequence of an unbalanced diet with low consumption of fats. It is common in vegetarian diets.

  • Moderate hypocholesterolemia (100 - 50 mg/dl in adults):

    Cholesterol level in the blood is very low. It is necessary to study the possible causes. The main possibilities are:

    • Hyperthyroidism: It is advisable to study the TSH level in the blood. If case of hyperthyroidism TSH will be lower than normal.
    • Liver disorder: Such as liver failure or hepatitis. It is advisable to study the transaminases (AST, ALT and GGT) in the blood.
    • A low fat diet or fat malabsorption.
    • Endocrine disorders such as celiac disease.
  • Marked hypocholesterolemia (<50 mg/dl in adults):

    Cholesterol values below 50 mg/dl are extremely rare and it is usually a sign of a genetic disorder that prevents the correct absorption of fats. For example, it may be a consequence of abetalipoproteinemia (Bassen-Kornzweig syndrome) or familial hypobetalipoproteinemia.

    Marked hypocholesterolemia requires follow-up by a specialist familiar with lipid disorders.

Which factors can reduce the cholesterol level in the blood?

To suffer a particular health situation or taking some drugs can reduce your cholesterol level in the blood:

  • Malnutrition
  • Excessive cholesterol-lowering drugs
  • Malabsorption
  • Drugs
    • Alpha blocker
    • Antibiotics
      • Kanamycin
      • Neomycin
    • Anticoagulants
      • Heparin
    • Antiepileptic drugs
      • Valproate
    • Antiestrogens
      • Tamoxifen
    • Antituberculars
      • Isoniazid
    • Calcium channel blocker
    • Statin
    • Lipid-lowering agent
      • Nicotinic acid

Which diseases can reduce your cholesterol level in the blood?

The following diseases can explain a cholesterol level in the blood lower than normal:

  • Hyperthyroidism
  • Celiac disease
  • Bone marrow failure
  • Hereditary spherocytosis
  • Liver failure
  • Viral hepatitis
  • Thalassemia
  • Pernicious anemia
  • Abetalipoproteinemia
  • Familial hypobetalipoproteinemia
  • Malabsorption

What can I do to increase the cholesterol level in the blood?

In case you are taking cholesterol-lowering drugs, you should reduce the dose or take a less potent drug.

In case the cholesterol in the blood is low because of a low fat diet, you can slightly increase the consumption of animal fats. Pork, egg yolks or fatty dairy products such as butter or cheese usually provide a high concentration of cholesterol.

Where can I find more information about cholesterol level in the blood?

You can visit our pages about:

Which values are considered a low cholesterol level in the blood?

The following values are considered to be below the normal range:

IMPORTANT: These levels are expressed in mg/dl. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Total cholesterol
Mild hypocholesterolemia
119 mg/dl118 mg/dl117 mg/dl116 mg/dl115 mg/dl114 mg/dl113 mg/dl112 mg/dl
111 mg/dl110 mg/dl109 mg/dl108 mg/dl107 mg/dl106 mg/dl105 mg/dl104 mg/dl
103 mg/dl102 mg/dl101 mg/dl100 mg/dl    
Moderate hypocholesterolemia
99 mg/dl98 mg/dl97 mg/dl96 mg/dl95 mg/dl94 mg/dl93 mg/dl92 mg/dl
91 mg/dl90 mg/dl89 mg/dl88 mg/dl87 mg/dl86 mg/dl85 mg/dl84 mg/dl
83 mg/dl82 mg/dl81 mg/dl80 mg/dl79 mg/dl78 mg/dl77 mg/dl76 mg/dl
75 mg/dl74 mg/dl73 mg/dl72 mg/dl71 mg/dl70 mg/dl69 mg/dl68 mg/dl
67 mg/dl66 mg/dl65 mg/dl64 mg/dl63 mg/dl62 mg/dl61 mg/dl60 mg/dl
59 mg/dl58 mg/dl57 mg/dl56 mg/dl55 mg/dl54 mg/dl53 mg/dl52 mg/dl
51 mg/dl50 mg/dl      
Marked hypocholesterolemia
49 mg/dl48 mg/dl47 mg/dl46 mg/dl45 mg/dl44 mg/dl43 mg/dl42 mg/dl
41 mg/dl40 mg/dl39 mg/dl38 mg/dl37 mg/dl36 mg/dl35 mg/dl34 mg/dl
33 mg/dl32 mg/dl31 mg/dl30 mg/dl29 mg/dl28 mg/dl27 mg/dl26 mg/dl
25 mg/dl24 mg/dl23 mg/dl22 mg/dl21 mg/dl20 mg/dl19 mg/dl18 mg/dl
17 mg/dl16 mg/dl15 mg/dl14 mg/dl13 mg/dl12 mg/dl11 mg/dl10 mg/dl
9 mg/dl8 mg/dl7 mg/dl6 mg/dl5 mg/dl4 mg/dl3 mg/dl2 mg/dl
1 mg/dl0 mg/dl      
foto de Dr. Javier Muga Bustamante
Written by

Dr. Javier Muga Bustamante

Last update: 24/04/2020


  • Concise Book of Medical Laboratory Technology: Methods and Interpretations. 2nd Edition. 2015. Ramnik Sood. ISBN: 978-93-5152-333-8. Pag. 481.
  • Tietz. Fundamentals of Clinical Chemistry. Carl A. Burtis, Edward R. Ashwood, David E. Bruns, Barbara G. Sawyer. WB Saunders Company, 2008. Pag 402. ISBN: 978-0-7216-3865-2.
  • Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0.Published: November 27, 2017. U.S. Department of health and human Services. Disponible en:

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