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October 2021

What to Do About Low HDL Cholesterol

If your healthcare provider says that your high-density lipoprotein (HDL) cholesterol level is too low, take heart. There are steps you can take to improve this “good” cholesterol—and boost your cardiovascular health. Here’s some information you can use to begin discussing a plan with your provider.

Understanding the role of HDL cholesterol

Although you may hear a lot about lowering cholesterol numbers, HDL cholesterol is one type of cholesterol that you want as high as possible. That’s because HDL cholesterol is thought to carry low-density lipoprotein (LDL), or “bad,” cholesterol away from the arteries and back to the liver, where it’s removed from the body.

Healthy blood cholesterol levels vary by age and gender. For women age 20 or older, experts suggest aiming for an HDL cholesterol level of 50 mg/dL or higher. For men age 20 or older, the recommendation is an HDL cholesterol level of 40 mg/dL or higher. Healthy levels are believed to offer protection against heart disease and stroke.

Boost HDL with lifestyle changes

There are a number of lifestyle changes you can make to improve your HDL cholesterol level. Keep in mind: The higher your HDL level, the better. Thankfully, most of these steps lower your LDL level at the same, providing extra heart-healthy benefits. Try to:

  • Aim for a healthy weight. Being overweight is a risk factor for heart disease. Losing weight can reduce your LDL cholesterol level while also increasing your HDL level.

  • Get moving. Not only can exercise boost your HDL level, it can also help you shed pounds. Try to get at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity every week. This can include taking a brisk walk, riding a bike, or playing a sport. Break down the 150 minutes into as many smaller sessions as needed.

  • Clean up your diet. Saturated and trans fats are thought to lower your HDL cholesterol level, as well as raise LDL cholesterol. Limit both by eating leaner cuts of meat, low-fat or fat-free dairy products, and fewer desserts and packaged or fried foods. Focus instead on eating lots of fresh fruits and vegetables.

  • Kick the habit. Smoking is linked to lower HDL cholesterol, as well as higher LDL cholesterol. Improving your cholesterol levels is just one more reason to quit. Ask your provider for resources that can help.

Explore medical treatment

If you’re unable to increase your HDL levels with positive lifestyle changes alone, ask your provider about the benefits of taking medicine. Many medicines work to reduce LDL cholesterol, but some also improve your HDL level. One includes niacin (Niaspan), a B vitamin that can boost HDL cholesterol when taken in prescription strength. Fibrates, such as gemfibrozil (Lopid) and fenofibrate (Antara), work to reduce triglycerides and help improve your HDL level.

Remember, you have the power to help increase your HDL level through choices you make every day. Make your heart a priority and talk with your provider for help in getting started. 



Online Medical Reviewer: Brian McDonough, MD
Online Medical Reviewer: Ray Turley, MSN, BSN
Date Last Reviewed: 9/1/2021
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