Taiwan medical case: Starvation causes extreme cholesterol spike

A woman in her 30s in Taiwan was diagnosed with extremely high LDL cholesterol levels, reaching 276 mg/dL, which initially led doctors to suspect familial hypercholesterolemia due to her family history of stroke.

However, clinical examination revealed the patient had a very low BMI of approximately 17, low blood pressure, a slow heart rate, and amenorrhea. Further investigation by endocrinologists discovered the patient was consuming only about 500 calories per day, primarily consisting of fish and congee.

This severe caloric deficiency caused “starvation hypercholesterolemia,” a condition where the body’s energy-saving mechanisms and decreased liver metabolism of LDL lead to elevated blood cholesterol. After adjusting her diet under medical supervision, her LDL levels dropped by approximately 100 mg/dL within three weeks.