HDL Cholesterol

What is HDL?

HDL stands for high-density lipoprotein. It’s a type of lipoprotein that circulates in your blood.

Lipoproteins are particles made of lipids (fats) and proteins. Their main job is to transport fats, like cholesterol, throughout your body to the cells that need them. Fats need a ride because their chemical structure keeps them from traveling solo through your blood. They need help from lipoproteins to get where they need to be.

What is HDL cholesterol?

HDL and HDL cholesterol are the same thing. Most people use both terms to talk about these particles and the role they play in your heart health.

People know HDL particles by the type of fat they carry (cholesterol), even though they contain fats and proteins.

Why is HDL called “good cholesterol?”

HDL is the “good cholesterol” because it helps your body get rid of extra cholesterol. This process can lower your risk of cardiovascular disease.

Cholesterol normally travels from your liver to your bloodstream. From there, lipoproteins carry the cholesterol to different cells in your body to support important functions (like helping your body form cell membranes and produce hormones).

But sometimes, there’s too much cholesterol in your blood. It’s more than your body needs. That’s when reverse cholesterol transport helps.

Reverse cholesterol transport is a complex body process, and researchers continue to explore how and when HDL plays a role. What we know is that HDL particles can transport excess cholesterol from your bloodstream back to your liver. Your liver then breaks down this cholesterol and gets it out of your body through your poop.

This is a good thing because too much cholesterol in your blood raises your risk of plaque buildup in your artery walls (atherosclerosis).

Getting rid of extra cholesterol makes HDL the helpful cholesterol. But that’s not all it does. HDL cholesterol also works against inflammation and oxidants to keep your cells strong. And it plays a role in preventing blood clots.

How can I find out my HDL cholesterol level?

Your healthcare provider can order a lipid panel blood test for you. You’ll get numbers for different kinds of cholesterol, including your HDL.

What is a good level of HDL?

Ideally, your HDL should be 60 milligrams per deciliter (mg/dL) or higher. Research shows this can lower your risk of cardiovascular (heart and blood vessel) diseases like heart disease and stroke.

What is an unhealthy level of HDL?

An unhealthy level of HDL cholesterol doesn’t fall within the normal range. People who have low HDL have an unhealthy level. But a level that’s too high also isn’t good because it can allow atherosclerosis to progress faster. HDL levels that are too high or low can happen because of other medical issues going on.

What is the HDL cholesterol normal range?

Normal HDL cholesterol ranges for adults vary depending on whether you’re assigned male at birth (AMAB) or assigned female at birth (AFAB).

It’s important to talk to your healthcare provider about your lipid panel results so you understand what they mean for you.

What does low HDL cholesterol mean?

There are many reasons why your HDL cholesterol may be low, including:

• Tangier disease. This genetic condition causes your HDL cholesterol to be too low.
• Familial combined hyperlipidemia. This genetic condition causes your HDL cholesterol to be too low and your LDL cholesterol to be too high.
• ApoA1 deficiency. People with this genetic condition don’t have enough Apolipoprotein A1. This is a key component of HDL.
• Metabolic syndrome. This is a combination of cardiovascular disease risk factors including lower-than-normal HDL levels.
• A body mass index (BMI) greater than 25 (overweight/obesity). Having extra weight can lower your HDL level.
• Smoking or tobacco use. Tobacco contains nicotine, which lowers your HDL level. All tobacco products, including e-cigarettes, have this harmful effect.
• Insulin resistance. Excess fat can make it difficult for insulin in your body to manage your blood sugar well. This can cause a low level of HDL.
• Medicines you take. Some drugs, like beta-blockers, certain hormones or some diuretics, can lower your HDL cholesterol level.

What does it mean if I have high HDL?

An elevated, or abnormally high, HDL level is anything above 80 mg/dL.

One thing that can make your HDL cholesterol high is a genetic mutation. Some mutations to your genes can cause your body to produce too much HDL cholesterol or have trouble getting rid of it. For example, a mutation to the CETP gene can cause your HDL to be higher than 150 mg/dL.

Other causes of abnormally high HDL can include:

• Hyperthyroidism.
• Primary biliary cholangitis.
• Alcohol use disorder.
• Certain medications.

Your healthcare provider will investigate the cause of your elevated HDL and tell you if you need treatment.

How do I raise my HDL?

It’s best to talk to your healthcare provider for advice tailored to your specific needs and any medical conditions you might have. In general, certain lifestyle changes can help improve your HDL level. These include:

• Eating heart-healthy foods. Research supports the Mediterranean Diet as a way to improve your overall heart health, including your cholesterol numbers. This plan includes lots of fruits and veggies, legumes (beans and lentils) and whole grains. Foods rich in omega-3 fatty acids can raise your HDL cholesterol, too.
• Avoiding or limiting unhealthy foods. Skip fried doughnuts or baked goods that contain trans fats (partially hydrogenated oils). Limit how much saturated fat you eat, like sausage, cheese, bacon and butter.
• Exercising. Aerobic exercise can help raise your HDL cholesterol. Aim for at least 30 minutes of exercise five or more days per week. If you haven’t exercised much in the past, it’s OK. Start with just five or 10 minutes per day and gradually build up. But be sure to talk to your provider before starting any new exercise plan.
• Staying at a weight that’s healthy for you. Losing body weight, especially around your midsection, helps improve HDL levels.
• Avoiding all tobacco use. Smoking, vaping and using other tobacco products lowers your HDL. So, if you don’t currently use tobacco, don’t start. And if you do, it’s important to work on stopping. Talk to your provider about strategies to help you quit. Secondhand smoke is also harmful. If you live with someone who smokes, offer your support to help them quit — for their benefit and yours.
• Taking medicines. Your provider may prescribe medication like PCSK9 inhibitors or ezetimibe to help increase your HDL.

A note from Cleveland Clinic

Making sense of your cholesterol test results can be confusing. There are many terms to learn, and it can be hard to remember which cholesterol is “good” or “bad.” When it comes to HDL, remember “h” for “helpful.” HDL cholesterol is good because it helps move extra cholesterol out of your blood. This is why healthy levels of HDL can help lower your risk for heart disease. If your HDL level isn’t where it should be, talk with your provider about ways to improve it.