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Causes of high and low total cholesterol
Last reviewed: 06.07.2025
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Blood cholesterol levels increase in hypercholesterolemia types I, IIA, IIB, III, IV, V, polygenic hypercholesterolemia, familial combined hyperlipidemia, primary exogenous hypertriglyceridemia, liver diseases, intra- and extrahepatic cholestasis, malignant tumors of the pancreas and prostate, glomerulonephritis, hypothyroidism, nephrotic syndrome, chronic renal failure, alcoholism, isolated deficiency of somatotropic hormone (STH), hypertension, coronary heart disease, diabetes mellitus, gout, glycogenosis types I, III and VI, thalassemia major, analbuminemia, dysglobulinemia, Werner's syndrome, idiopathic hypercalcemia, acute renal failure.
A decrease in blood cholesterol levels is observed in α-lipoprotein deficiency, hypoproteinemia and abetalipoproteinemia, liver cirrhosis, malignant liver tumors, hyperthyroidism, malabsorption syndrome, malnutrition, sideroblastic anemia, thalassemia, chronic obstructive pulmonary diseases, rheumatoid arthritis, intestinal lymphangiectasia, and megaloblastic anemia. A rapid decrease in cholesterol levels in liver disease is a poor prognostic sign, often observed in subacute liver dystrophy. When evaluating the results of total cholesterol testing, it should be taken into account that some medications have a significant effect on its concentration in the blood.
- Increase the concentration of cholesterol in the blood: androgens, chlorpropamide, glucocorticosteroids, ACTH, epinephrine (adrenaline), sulfonamides, meprobamate, phenothiazines, thiazide diuretics.
- Colchicine, haloperidol, and monoamine oxidase inhibitors reduce the concentration of cholesterol in the blood.
When assessing the risk of developing atherosclerosis and its clinical manifestations, indicators are often used that reflect the content of not only total cholesterol, but also lipoprotein cholesterol fractions.