Patient's Query
Hello doctor,
I have a concern about my cholesterol levels and the possibility of an underlying condition. I am a 37-year-old female with uncharacteristically low cholesterol. I donate blood regularly, which gives me the opportunity to have my total cholesterol level tested. About a year ago, I created an online account with my area's local blood bank, where I found they keep a record of your past health screenings. It was at that time that I realized how low my cholesterol was. The lowest being 118 mg/dL, which was several years ago when I was in my 20s.
But, most recently and over the past year, my levels have averaged in the 134-137 mg/dL range. For my age, I have been overweight for close to 10 years. I had never been on a diet or limited my cholesterol intake. I began researching online for any information that might explain levels this low. While there is an abundance of information regarding high cholesterol regarding its causes and risks, there is practically no information available regarding low cholesterol levels or causes outside of the obvious low cholesterol intake (vegetarian or vegan diet) or use of cholesterol-reducing medications such as statins.
With one exception: celiac disease. As I began to read through the signs and symptoms of this disease, I could not believe how many I had been experiencing. In fact, some of these were things I never even realized were symptoms of anything. One specific symptom, however, that each and every article I read seemed to use to define celiac disease was weight loss or being severely underweight.
Months later, I stumbled across an article about celiac disease going undiagnosed because of the misconception that with celiac disease you cannot be overweight. So, I decided to raise the question with my GP. Unfortunately, after giving the doctor a rundown of my symptoms and explaining my concerns, as soon as the word "celiac disease" came out of my mouth, he quickly dismissed this as a possibility, stressing that because I am not underweight, it was absolutely out of the question that I could have the condition.
He then dismissed all of my symptoms, saying they were nothing to worry about, and added that the lower my cholesterol was, the better. In his words, I should be thrilled at how low my cholesterol was, and I must have good genes, and with that, he sent me on my way. For close to a year after that appointment, I too dismissed all of these symptoms. Then, six months back, I was admitted into the hospital for an emergency cholecystectomy due to gallstones that caused me to have a severe gallbladder attack.
At the time, I knew nothing about the gallbladder's function or its purpose, so there was no argument from me when the doctor explained that some people just get gallstones and the only way to treat gallbladder disease is to remove the gallbladder. Needless to say, in my week at home following my surgery, I spent a lot of time learning about the gallbladder, and almost immediately I found information describing the correlation between gallstones, gallbladder disease, low cholesterol, and yes, celiac disease.
This past weekend I attempted to donate blood, and for the first time in my life, I was turned away because my iron was too low. I went online thinking my iron counts for previous donations would be noted in my wellness chart, although they were not. My cholesterol result from my previous donation, just 2-3 weeks after my surgery, was down to 128 mg/dL.
Kindly advise.
Hi,
Welcome to icliniq.com.
I welcome you and want to assure you need not worry, as everything is going to be fine if proper care and treatment are opted in for. I have thoroughly gone through your case and can well understand your genuine health concerns. There are a lot of reasons for this to not be celiac disease. Diarrhea in celiac disease is very prolonged, and there are watery stools. Not only are they pale and greasy and floating on the pan, but they are also foul-smelling too. Steatorrhea is a feature of celiac disease, in which large amounts of dietary fats pass undigested.
Yes, weight loss is a feature of celiac disease. I have made my patients get to the same weight or so while having celiac disease, but with a lot of effort and special diet charts to follow and giving them extra calories in their diet and a special high-calorie diet. If a patient keeps the same diet all the time, she definitely will get a decrease in weight. No chances of weight gain with celiac disease unless extra efforts are put in for that. I do not think you took more than 3000 calories of diet to observe, and that was for years. You had a gallbladder issue for a long time.
Firstly, there is only a smudge before the stone's appearance. Before getting symptomatic (painful), stones remain silent, maybe for months to years, and during that time the bladder function deranges without getting the attention of the patient. Your cholesterol levels were also due to this fact. Cholesterol is good if it is low. Genes also play a role in maintaining a set range of blood lipid profiles. So, do not just worry. No one can remain unnoticed for so long if she has had celiac disease. Severe flatulence is also a feature related specifically to celiac disease. Excessive blood donation leads to low lipid profile ranges, iron deficiency, and even anemia sometimes.
You also had the same, and it is due to the same reason. Bleeding diathesis occurs due to the vitamin K deficiency in celiac patients. Other celiac disease symptoms may be dysmenorrhea, dramatically low calcium and potassium levels in serum, muscle weakness, nerve issues, skin disorders, tongue and gum diseases, peripheral nerve issues, etc.
You may ask your PCP (primary care physician) to refer you to a gastroenterologist, and you will not need to convince him. He himself will get you tested for any possibilities if needed. Check your fasting lipid profile, fasting blood glucose levels, CBC (complete blood count) with ESR (erythrocyte sedimentation rate) and differentials, thyroid profile, and get a complete stool analysis.
I hope this helps.
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Answered by Education: MBBS Professional Bio: Dr.Muhammad Majid Hanif is a highly skilled and established physician in the field of Cardiology. He listens to all the patient queries deliberately and is an expert in devising a proper treatment plan. This doctor is not available for online consultations on the platform anymore. Dr. Muhammad Majid Hanif
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Muhammad Majid Hanif
Cardiology
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