Question: I have what I think is an unusual problem. My cholesterol is really low. My total cholesterol is 76, HDL 49, LDL 22, triglycerides 22. I am severely overweight and contemplating a gastric bypass, but my doctor says he needs to find the cause of the unusual cholesterol numbers. Can you provide any direction? Thanks!

Dr. Hibberd’s answer:

Your doctor is correct. You should have further evaluation, and this should include thyroid and liver evaluation as well as direct measurement of your total cholesterol numbers.

Cholesterol is normally synthesized in the liver, and your low level is concerning. Likewise your triglyceride level is far below the expected value of 100 or more, and may suggest an abnormality of the small bowel area responsible for absorption of fatty acids.

Many vitamins (vitamins A, D, E, and K) are fat soluble, and I would like to be sure that you don’t have health condition that is causing your cholesterol levels to be so low.