How Low is Too Low in LDL-C?

Summary

Experts engaged in a discussion addressing a common concern raised by patients – the safety and necessity of achieving extremely low LDL levels. Manesh Patel, MD was questioned about the possibility of having "too low" LDL levels, prompting a thoughtful response.

Manesh Patel, MD acknowledged encountering patients expressing concerns, often fueled by information found on the internet, regarding potential cognitive issues and the essential role of LDL in cell membranes. In response, he shared insights from studies involving individuals with genetic loss of PCS, highlighting instances where people with consistently low LDL levels experienced no adverse effects and even lived longer without cardiovascular events.

The experts emphasized the importance of individualized approaches to LDL management based on risk profiles. Manesh Patel, MD provided a patient-centric perspective, advocating for pushing LDL levels as low as possible, citing cases of patients achieving LDL levels in the teens without issues. However, he acknowledged the existing concerns about going too low.

The panel supported the discussion by providing additional perspectives. They drew parallels to the low LDL levels in babies, emphasizing their normal neurocognitive development. They debunked the misconception that extremely low LDL levels lead to neurocognitive deficits, explaining that the brain can synthesize the cholesterol it needs independently of peripheral cholesterol.

The conversation concluded with a consensus on the need for continued education and awareness. The experts highlighted the necessity of dispelling misconceptions and encouraging patients, even those reluctant to take medications, to understand that achieving lower LDL levels contributes to reducing their lifetime cardiovascular risk.

Summary was AI-generated and edited for clarity.