HDL function relies on many factors and can be influenced using lifestyle changes or medication. HDL, or high-density lipoprotein, is more commonly referred to as “good cholesterol”. It absorbs the “bad” cholesterol, or LDL (low-density lipoproteins), processes it through the liver and gets it out of your system. A high HDL level indicates a lowered risk for heart disease, heart attack, and stroke. A high LDL level indicates the reverse.
HDL Cholesterol Reference Ranges
| HDL Level | Men | Women | Cardiovascular Risk |
|---|---|---|---|
| Protective / optimal | ≥60 mg/dL | ≥60 mg/dL | Negative risk factor — actually reduces overall risk |
| Acceptable | 40–59 mg/dL | 50–59 mg/dL | Normal; no increased risk at this range |
| Low / concerning | <40 mg/dL | <50 mg/dL | Independent cardiovascular risk factor |
What Raises HDL (Evidence-Based)
- Aerobic exercise: most effective; 30+ min of moderate-intensity exercise 5x/week raises HDL by 5–10%
- Smoking cessation: smoking reduces HDL; quitting raises it 5–10% within weeks
- Weight loss: every 6 lbs lost raises HDL approximately 1 mg/dL
- Replacing refined carbs with unsaturated fats: olive oil, avocado, and nuts raise HDL more than low-fat diets
- Moderate alcohol (optional): 1 drink/day modestly raises HDL; not recommended if you don't currently drink
- Niacin (nicotinic acid): most effective pharmaceutical option; prescription doses raise HDL 15–35%, but cardiovascular outcome benefit has not been consistently shown in trials
The complex relationship between HDL and heart disease involves an understanding of how the different types of cholesterol impact+ blood flow, heart and liver function, and more. Continue reading to learn about the function of HDL, how to measure it with a lipid panel, and how to keep it at an optimum level.
Cholesterol: A Brief History
Doctors did not always understand the difference between high- and low-density lipoproteins. Before the 80s and the work of Framingham, cholesterol was often considered one number. The higher the number, the higher the patient’s presumed risk for coronary heart disease. After Framingham, doctors could separate lipoproteins and determine the levels of risk vs protection.
The “discovery” or recognition of HDL has led doctors to a more nuanced understanding of a patient’s cholesterol levels, including the unique function of HDL in the whole cardiovascular process. Even now, studies conducted by Cardiovascular Drugs and Therapy are considering whether HDL has a causal relationship with a lower risk for cardiovascular complications or is simply a part of a complex process of inflammation response.
Therapies that modify HDL levels will therefore continue to be extensively trialed to learn more about this complex relationship.
How Does HDL Function?
HDL searches your body for extra cholesterol and provides a route to the liver, where it can be processed and flushed out of your system. As we currently understand it, HDL levels are associated with increased cardiovascular health. To measure your HDL levels we perform a test called a lipid panel, there are many components to that panel to find out how to read a lipid panel you can see our blog here.
Healthy levels of HDL vary for different age groups:
- Children 19 and younger should test for more than 45 mg/dl of HDL
- Men 20 and older should test for more than 40 mg/dl of HDL
- Women 30 and older should test for more than 50 mg/dl of HDL
Levels above these minimums are considered protective against a major cardiovascular event, though everyone’s body processes cholesterol differently, influenced by lifestyle and genetic factors. Talk with your doctor about what your levels mean for you, especially after multiple tests.
How to Increase HDL Levels
There are several ways that patients can raise their levels of HDL. If your test came back below the healthy margins listed above, consider these lifestyle changes to make the ratio between HDL and LDL more favorable:
Eat a heart-healthy diet
HDL levels rely on your body absorbing good fats and avoiding bad fats, which often comes down to diet. Avoid:
- Saturated fats in full-fat dairy products like butter and milk and fatty meats like bacon, which contribute to higher levels of LDL and lower levels of HDL
- Trans fats in processed foods like baked goods and fried food
- Carbohydrates, especially sugar
Opt for healthy fats instead, including unsaturated fats found in nuts and olive oil. Balance your fat intake with fiber, which are in many types of bran, oatmeals, beans, and fruits like raspberries and mangos.
Eating the right foods can not only directly impact your HDL levels but also will allow you to lose weight. Excess fat, especially around the abdomen where it is closest to your organs, can contribute to low HDL levels.
Exercise regularly
Regular exercise, in addition to promoting healthy physical function and reducing excess weight, can impact your HDL levels directly. Aerobic exercise intense enough to get your heart elevated is recommended.
Cut out alcohol and cigarettes
Smoking and drinking are known to lower HDL levels in addition to other negative health effects. Even secondhand smoke exposure can cause your cholesterol to increase along with other inflammation processes. Heavy alcohol intake can cause weight gain, causing your HDL levels to fall out of balance.
Reducing both cigarette and alcohol intake while you work on your weight can improve your HDL levels.
Change your medications
Certain types of medications can cause lower HDL levels as well. These include:
- Blood pressure medicine like beta-blockers
- Hormone therapy treatments such as testosterone and anabolic steroids
- Female hormone therapies like progestins
- Birth control pills
- Certain sedatives, such as benzodiazepines
If you present with low HDL levels and are also taking one of these medications, ask your healthcare provider if you can or should change your routine.
What’s Your HDL Function?
Speedy Sticks is a mobile concierge phlebotomy service that provides at-home blood draws and on-site diagnostic/health screenings for businesses and individuals. One of these tests is a Lipid Panel which can be performed by one of our specialists. Book an appointment today to find out your HDL function.
*This content is for informational purposes only and is not meant to replace consulting with a healthcare professional. Please consult with your primary care physician or healthcare provider before engaging in any services offered by Speedy Sticks.
**These are approximations, and experts disagree on some values. Consult your healthcare provider for recommendations suitable for you. It is also important to ensure the levels are given in the same measurements, such as mg/dL, etc.
Track your HDL progress with a home lipid panel. A mobile phlebotomist can collect the fasting draw at your home — no lab trip required.
Sources and further reading
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