Question: Could low LDL hurt female fertility?
I haven't seen evidence of it, but that would not surprise me at all given that cholesterol is what you make sex hormones from. If you see levels that low, I don't know that it's intrinsically a problem. You kind of want to start looking at what are the reasonable things you could expect to happen from that that affect female fertility? Fat-soluble vitamins could be relevant. Sex hormones could be relevant. I'd start looking at those things.
I doubt that the LDL being that low itself in and of itself is going to be the thing that compromises fertility. This is the thing. Is the LDL low because of really good clearance from the blood, or is it low because of really low production? If it's low because of really low production, then you definitely have problems with fat-soluble vitamin transport. Because if the liver is not making lipoproteins as much, the fat-soluble vitamins are staying trapped in the liver and they're not getting to other tissues that need them.
While there's no evidence for it, it makes perfect sense that dietary cholesterol would help that because dietary cholesterol is very helpful in Smith-Lemli-Opitz syndrome, where the exact same defect is 1,000X to produce a devastating result. It makes total sense that in someone who is a carrier for SLOS, Smith-Lemli-Opitz syndrome, who has defective cholesterol synthesis in their gonadal tissues and therefore has defective sex hormone synthesis, it makes total sense of eating cholesterol would help those people. So, I would try it.
Egg yolks. That's what most people are going to eat for cholesterol. But this all hinges on the question of the LDL is low, so what? Is it because it's being cleared rapidly or because it's not entering the blood due to lack of synthesis? Whether that person is going to have infertility as a result of it and whether that's going to be helped by dietary cholesterol, it's all going to get a hinge on that. But the good news is for both people, it's probably completely harmless to eat some eggs. Eating eggs might just be the thing that helps.
This Q&A can also be found as part of a much longer episode, here: https://chrismasterjohnphd.com/podcast/2019/03/30/ask-anything-nutrition-march-4-2019
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