Can Your LDL Cholesterol Be Too Low?

Updated July 2026

With cholesterol guidelines pushing LDL targets lower than ever, it's fair to wonder whether there's a floor, a point where low becomes too low. A widely covered study raised exactly that worry, so it's worth walking through what it actually found.

Can your LDL cholesterol be too low?

For the vast majority of people, no. The concern traces to a 2019 study that found women with an LDL under 70 mg/dL had about double the rate of hemorrhagic stroke, the less common type of stroke caused by bleeding in the brain (as opposed to an ischemic stroke caused by a blocked blood vessel). Very low triglycerides (under 74) were also linked to higher hemorrhagic stroke risk. It was a large, careful study, over 27,000 women followed for about 19 years, which is why it made headlines.

How big is the risk, really?

Small, and this is the part the headlines skipped. Over those 19 years, 0.8% of women with very low LDL had a hemorrhagic stroke, compared with 0.4% of women with higher LDL. The rate doubled, but the absolute chance stayed remote either way. (For triglycerides, it was 0.6% versus 0.4%.) Doubling a very small number still leaves a very small number.

What the study couldn't account for

A few things are worth knowing before you change anything:

• Researchers used only the first cholesterol reading, taken at the start, and didn't track what happened over the next 19 years. If some higher-LDL women later went on statins and dropped their levels, that alone could undercut the comparison.
• Known risk factors for bleeding stroke, like migraine with aura and a history of preeclampsia, weren't accounted for between the groups.
• It is the cumulative risk of all events that matters, and many large studies show better overall outcomes with lower LDL.

So how low should your LDL be?

The same guidance holds. For people at high risk for heart disease, an LDL under 70 is the target, while under 55 is the goal for those with established heart disease (like a history of heart attack, ischemic stroke, bypass surgery or stent). These are well-supported goals, because the benefit of fewer heart attacks and ischemic strokes far outweighs the tiny absolute change in bleeding-stroke risk.

This blog has been focused primarily on analyzing one study. However, what one study can't do, however large, is overturn the fundamentals.

And the fundamentals are these: people who live long well do so because they live well, and chasing a perfect LDL number without a better lifestyle is an incomplete solution. Lower LDL is safe and worthwhile for nearly everyone, but when you reach it through the food and habits that lower risk on every front at once, is when you're truly winning.

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