Cholesterol and anxiety

[typ0]

Dr.,

I've suffered from anxiety most of my life.  My mother withdrew me from preschool when I was 4 because of anxiety.  It wasn't until I was in college in the 90's, when anxiety started to become understood in the general medical community, that I received treatment for the condition.  I have been taking Paxil for approximately 15 years to help control the condition.

Recently, I took a cholesterol test.  I have always had really low cholesterol despite any real effort to maintain a highly healthy diet.  The recent test returned a total cholesterol level of 158 mg/dl.  On a whim, I googled low cholesterol and discovered that quite a bit of research is being conducted on the relation of cholesterol to psychological health.  Specifically, the impact of low cholesterol on cellular membrane structures and how this impacts the serotonin receptors.  Most of the research that I have found uses 160 mg/dl as the point where they start to see a correlation to anxiety and depression.  However, as far as I can tell, the researchers have not come to a consensus in the matter.  There are some other circumstances that further my curiosity regarding the relationship:

1. My sister recently had a baby and experienced severe anxiety afterwards.  She also has low cholesterol levels.  Some of the papers I have read suggest that a cholesterol drop that occurs after childbirth could be a factor in postpartum issues.

2. I have a couple spots under my eyes which were diagnosed as xanthelasma or lipid storage disorder.

I'm not sure if either of these have much bearing.

I would like to get an opinion on the relationship between cholesterol and anxiety/depression.  Also, If you think the effort is warranted, I would like to investigate the matter further and possibly experiment a little with cholesterol levels.  I'm not really sure how I would go about this.  What kinds of doctors should I talk to?  What kinds of tests should be done? etc...

[Ashish Mittal, MD]

Dear typ0,

Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:

- Long duration of anxiety symptoms
- Good response to Paroxetine (paxil)
- Family history of post partum anxiety and depression in sister
- Presence of Xanthelasma
- Serum cholesterol level 158mg/dl
- Worry related to anxiety and serum cholesterol level

First serum cholesterol and anxiety disorder are both determined by genetic factors. This may be  the reason why both you and your sister have experienced low cholesterol and anxiety, although your sister developed the symptoms in postpartum period because illness onset and duration differ person to person.

According to guidelines total blood cholesterol level should be:

•     less than 200 mg/dL - normal blood cholesterol

•     200–239 mg/dL -  borderline-high

•     greater than 240 mg/dL  - high cholesterol



I think 158 mg/dl cholesterol level is normal in your case. Do  not worry about it being the cause of your anxiety. Xanthelasma occurs in high cholesterol in blood. As you already have Xanthelasma, it indicates that your cholesterol was high at some point of time. I think, now it is a good sign that your cholesterol is normal. Currently no standard data is available about relationship between cholesterol level and anxiety. Therefore I would not recommend working on blood cholesterol levels to deal with anxiety. You should continue Paxil as your symptoms have improved with that.

So my final message to you is: Do not worry about your cholesterol level and continue Paxil as you have improved with that.

I hope this information has been both informative and helpful for you.

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Best Regards,
Dr. Ashish Mittal