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Low cholesterol increases depression and suicide risk
Low cholesterol and depression
Men with low cholesterol have a higher death rate from injury. Although cholesterol-lowering tends to reduce CHD mortality in certain age groups, there is no evidence that low cholesterol reduces total mortality. In populations with naturally low blood cholesterol there is also a significant death rate from 'non-medical' causes. Why is there this association?
A pilot study into blood cholesterol and depression in schizophrenics found a highly significant interaction between low levels of cholesterol and depression. Extreme lowering of cholesterol with drugs altered the functional state of the 'feel good' hormone, serotonin. The authors suggest that: 'the degree of the low cholesterol combined with its duration might be a risk factor for the development of an abnormal mental state.'[1] Dr A Ryman, writing in the British Medical Journal says: 'Our current understanding of the relation between cholesterol metabolism and psychiatric illness is poor . . . The possibility that a low or falling cholesterol concentration is a marker of risk merits further study.'[2]
A large study at the Cholesterol Center, Jewish Hospital, Cincinnati, Ohio aimed to assess the relation between cholesterol levels and affective disorders such as depression, bipolar disorder and schizophrenia disorder.[3] Cholesterol concentrations below 4.16 mmol/L (160 mg/dL) were much more common in patients with these disorders. When paired with healthy people of a similar sex and age, patients had much lower total cholesterol, LDL and HDL.
Dr M Law added confirmation two years later. He writes: 'treating depression has been shown to increase serum cholesterol concentration. . . . Low serotonin concentrations (which accompany and may cause depression) are, not surprisingly, also associated with low cholesterol, people who attempt suicide have low serum cholesterol concentrations, . . . men with declining serum cholesterol concentrations are particularly likely to commit suicide.'[4]
Low cholesterol increases suicide risk
Depression is the main psychiatric illness leading to suicide and there is an observed increase in suicides among those undertaking cholesterol-lowering dietary regimes.
In 1992, Dr H Engleberg proposed a hypothesis to explain this. He suggested that decreases in blood cholesterol affected the balance of the metabolism of fats within the brain and that this could have profound effects on brain function.[5] He showed that low blood cholesterol was found in aggressive people and those with an antisocial personality. These averaged typically 5.04 mmol/L (194 mg/dL).
Mental patients with high blood cholesterol (7.55mmol/L) were less regressed and withdrawn than those with lower (4.80mmol/L or less). And a French study concluded: 'Both low serum cholesterol concentration and declining cholesterol concentration were associated with increased risk of death from suicide in men.'[6]
There are many clinical studies showing that total cholesterol levels below 4.7 mmol/L (180 mg/dL) are associated with depression, accidents, suicide, homicide, antisocial personality disorder in criminals and Army veterans, cocaine and heroin addicts. Low cholesterol is also associated with high relapse rates after detoxification and rehabilitation.[7]
References
1. Dursun SM, Burke JG, Reveley MA. Low serum cholesterol and depression. BMJ 1994; 309: 273-4
2. Ryman A. Cholesterol, violent death, and mental disorder. BMJ 1994; 309: 421-2
3. Glueck CJ, Tieger M, Kunkel R, et al. Hypocholesterolemia and affective disorders. Am J Med Sci 1994; 308: 218-25.
4. Law M. Having too much evidence (depression, suicide and low serum cholesterol). BMJ 1996; 313: 651-2.
5. Engleberg H. Low serum cholesterol and suicide. Lancet 1992; 339: 727-9
6. Zureik M, Courbon D, Ducimetiere P. Serum cholesterol concentration and death from suicide in men: Paris Prospective Study I. BMJ 1996; 313: 649-51.
7. Buydens-Branchey L, Branchey M. Association Between Low Plasma Levels of Cholesterol and Relapse in Cocaine Addicts. Psychosom Med 2003; 65: 86-91.
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