LOW CHOLESTEROL AND HORMONES: WHAT YOU NEED TO KNOW

Medically Reviewed by Dr. Sony Sherpa, (MBBS) - August 19, 2024

While most understand there are cardiovascular consequences of unchecked cholesterol, the connection to hormonal health may not be clear. There is, in fact, a big link between one’s cholesterol levels and those of steroid hormones. Too much or too little can cause hormones to become unbalanced, leading to widespread effects that detract from overall health.

In this article, we will explore the link between cholesterol and hormones, beginning with its role in hormone production and how low cholesterol levels can affect hormones. You can also find tips for maintaining healthy cholesterol levels to improve hormonal health below.

The Role of Cholesterol in Hormone Production

The liver produces cholesterol, a fatty molecule that is needed to build cell membranes, hormones, and bile acids. Being a hormonal precursor is the most obvious connection between cholesterol and hormones. Hormones are produced locally from cholesterol inside their respective endocrine glands, such as the reproductive organs, kidneys, skin, and adrenal glands. ^[1]

Steroid hormones that rely on cholesterol for their production include:

• Sex hormones such as estrogen, progesterone, and testosterone
• Glucocorticoids like cortisol
• Mineralocorticoids, such as aldosterone, which are involved in maintaining blood pressure and kidney water control
• Vitamin D3 is used by the thyroid and many other tissues to regulate overall metabolism and energy output.

Cholesterol is also a component of cell membranes that, depending on its structure, size, and fat composition, can change the fluidity and permeability of cells. This can affect the cell’s receptors at the membrane by changing their shape and binding ability.

Types of Cholesterol

Molecules of cholesterol are divided in accordance with their size and function into HDL and LDL cholesterol.

LDL Cholesterol comprises the larger cholesterol molecules and forms the majority of cholesterol found in the body. These transport fats around the bloodstream to all tissues, ferry fats into cells, are the main precursors to steroid hormones, and store fats that are used to repair the cell wall.

HDL Cholesterol comprises smaller cholesterol molecules with specialized proteins (lipoproteins) that take excess fat from the periphery back to the liver for recycling and removal. HDL is needed to keep LDL levels balanced, which ensures hormones are made in the correct quantities.

How Low Cholesterol Affects Hormones

Low cholesterol, also known as hypocholesterolemia or hypolipidemia, is a condition where both your total cholesterol and LDL (bad) cholesterol levels are abnormally low.^[2]

Low cholesterol can affect your hormone levels in two main ways:

1. Reduced Hormone Synthesis. As cholesterol is the main steroid hormone substrate, it can reduce hormone production in specific tissues. Many studies have shown that reproductive hormones are often the first to become deficient in these states and that the production of cortisol and aldosterone is preferentially preserved. Some organs, such as the brain, do not become deficient in cholesterol unless suffering from severe disease.
2. Altered Cell Structure. Hormone activities can be lost if the fluidity and permeability of cell membranes are altered, which reduces the capacity of hormones to bind to their receptors. If prolonged, the number of receptors will eventually see a decline, rendering hormones useless.

What Causes Low Cholesterol?

The most common causes of low cholesterol pertain to secondary factors, including:

• Cancer
• Hyperthyroidism
• Prolonged anemia
• Extreme malnutrition
• Advanced liver disease
• Severe depression
• Medication side effects

In most of these cases, cholesterol production or absorption may be impaired, or cholesterol may be used in excess for another purpose, such as making red blood cells or supplying tumors.

Hypocholesterolemia can be caused by rare genetic diseases such as abetalipoproteinemia, hypobetalipoproteinemia, and chylomicron retention disease. In these cases, genetic mutations are responsible for impaired dietary absorption and liver production of fats and cholesterol, resulting in widespread deficiency.^[3]

In the case of hyperthyroidism, the increase in thyroid hormones (not made from cholesterol) causes most cells to go into hyperdrive, which effectively increases cholesterol excretion to the point of deficiency.^[4]

HDL Deficiency, High Cholesterol, and Hormones

While these conditions can cause low LDL cholesterol levels, low HDL cholesterol is a far more common scenario that leads to excessive LDL and liver fat, increases in systemic inflammation, and hormonal deficits. If severe enough, these changes can eventually go on to cause liver disease, impair fat absorption, and give rise to hypocholesterolemia.^[5]

For this reason and more, people taking cholesterol-lowering medications, such as statins and PCSK9 inhibitors, may need to take extra care to improve their hormone levels, as treatment may keep hormone levels suppressed or exacerbate hormonal deficiencies related to metabolic syndromes.^[6]

Consequences of Hormonal Imbalances Induced by Low Cholesterol

Low cholesterol symptoms are nonspecific and likely to differ in every affected person.

Early scenarios in which LDL is high, yet HDL is low, are likely to present with symptoms of metabolic syndrome, diabetes, cardiovascular disease, and liver disease.

In those with low total and LDL cholesterol, symptoms are likely to begin with a decline in reproductive hormones, mimicking the effects of reproductive disorders or aging.

Men and women may experience these states differently, although both may be susceptible to:

• Mood swings and depression
• Reduced libido and infertility
• Difficulties regulating blood sugar levels
• Muscle loss and weight fluctuations, including changes in body compositions

Severe Symptoms of Cholesterol Deficiency may begin to impact more vital hormone systems, leading to more severe symptoms, including:

• Suppressed immunity, leading to chronic infections or malignancies
• Hypotension
• Fatigue and weakness
• Rapid weight loss
• Brittle bones
• Digestive difficulties
• Dehydration and eventual kidney damage

Tips for Maintaining Healthy Cholesterol Levels and Hormonal Balance

If you have symptoms of low cholesterol and hormonal imbalances, you may need to consult your doctor for proper diagnosis and treatment. Depending on the cause and severity of your condition, you may need to adjust your diet, lifestyle, medication, or supplements to restore your cholesterol and hormone levels to normal ranges. You may also want to discuss cutting down on cholesterol-lowering agents with your doctor if these appear to be promoting hormone deficiencies.

Here are some suggestions to help you maintain healthy hormone and cholesterol levels:

• Eat a balanced diet containing lean proteins, fruits, vegetables, fiber, and healthy fats from nuts, seeds, and fatty fruits. These meals supply the body with balanced amounts of cholesterol precursors (sterols), which support both HDL and LDL, as well as a number of nutrients that help to control hormone levels and fat metabolism. You may want to consume more nutrient and sterol-rich foods to replenish after fighting a severe infection or undergoing major stress, such as surgery.
• Avoid Non-Nutritious Foods that are heavy in added sugars, processed grains, trans fats, and saturated fats. These can destabilize the gut microbiome, directly interfere with fat metabolism, and promote unbalanced hormone production.
• Exercise regularly to improve your blood circulation, metabolism, muscle mass, and mood. Aim for at least 150 minutes of moderate-intensity physical activity per week.
• Get Enough Sleep to allow your body to repair and regenerate. Your circadian rhythm can be affected by sleep deprivation, which can change how your hormones are produced and regulated.
• Reduce Stress by utilizing relaxation methods, such as yoga, meditation, breathing exercises, or hobbies. Your hormone balance, cholesterol levels, and the release of cortisol can all be impacted by stress.

It is also important to check your cholesterol and hormone levels regularly with your doctor. If you have a history of unbalanced cholesterol, you may want to get them checked annually after a severe infection, surgery, or other similar situation that may increase inflammation and affect liver function.

Conclusion

Cholesterol is a vital substance for hormone production and cellular function. While rare, having low total cholesterol can greatly affect your hormone levels and cause various health problems. You can maintain good cholesterol levels and a balanced hormonal system by following a healthy lifestyle. Always talk to your doctor before changing your food, way of life, or medicine.  

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