Can cholesterol go too low?

Q. My total cholesterol is 140, my LDL is 55 and my HDL is 47. I am on simvastatin.

My chiropractor believes that my numbers are too low for me to be on medication. He says the brain is made up of cholesterol, and we need a certain amount.

I am confused.

My doctor thinks these numbers are great and wants me to stay on the drug.

A. This topic is highly controversial. Many physicians believe that the lower the cholesterol, the healthier the heart.

Cholesterol is essential for every cell in the body. It is a building block for hormones like estrogen, testosterone and vitamin D.

Although studies are scarce, there is evidence that low total cholesterol (below 180) is associated with a higher risk of death in older people (Lancet, Aug. 4, 2001; Journal of the American Geriatrics Society, July 2003).

In addition, low LDL cholesterol (below 80) has been linked to a higher risk of bleeding stroke (Circulation, Apr. 28, 2009).

For more information on this complex topic, we are sending you our Guide to Cholesterol Control with the pros and cons of medications and nondrug approaches.

Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027.

It also can be downloaded for $2 from our Web site: www.peoplespharmacy.com.

Don’t stop your medicine without discussing this issue further with your doctor.

Q. Recently, I heard that there was a cream or ointment for getting rid of age spots.

I think I heard it referred to as Hydroxycordone, but I am not sure.

Is there such a product that can be bought over the counter?

I would like to get rid of my brown sun spots.

A. The compound you heard of is hydroquinone. It is a bleaching agent that is applied to darker areas of skin (such as age spots or liver spots) to lighten them.

Such spots are usually a result of sun damage.

Hydroquinone is available in many OTC lightening or fade creams.

The compound is controversial, however.

It has been banned in Australia, Europe and Japan because of concerns about possible cancer-causing activity.

The Food and Drug Administration proposed a ban on hydroquinone several years ago, but has not yet taken any action.

More research has been initiated, but it will be years before there is a definitive answer about the safety of this chemical.

One possible alternative is tretinoin (Avita, Retin-A, Renova).

This prescription acne cream also can smooth wrinkles and help fade age spots (American Journal of Clinical Dermatology, August 2009).

Although the brand name is pricey, you can get this cream as a generic for around $40 a tube.

Regardless of how you try to lighten your spots, avoid the sun or use a sunscreen.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Favorite Foods From The People’s Pharmacy: Mother Nature’s Medicine.”

2010 King Features Syndicate Inc.