Low HDL cholesterol: causes and what to do

A low HDL cholesterol is common and rarely comes alone. It often goes with high triglycerides, belly fat, smoking or too little exercise. Sometimes it runs in the family. Working on those causes matters more than the number itself.

What low HDL cholesterol means

Low means below the limit printed on your report. The limit varies from lab to lab and is often higher for women.

HDL carries extra cholesterol back to your liver. When it is low, the risk for your heart is usually higher.

But the number on its own is not the target. A low HDL is a signal: something is pushing it down, and that can often be changed.

What causes low HDL cholesterol

Often there is more than one at once.

Symptoms

None. You cannot feel a low HDL: only a blood test shows it.

High triglycerides and rising glucose usually cause no symptoms for years either. That is why it pays to look at them together.

Low HDL cholesterol in people who lift weights

Exercise usually raises HDL. If it comes out very low in someone who trains, one cause to consider is anabolic steroids or high-dose testosterone: they push it down a lot, sometimes to very low levels.

Testosterone prescribed by a doctor can lower it too, but only a little. After stopping steroids, HDL usually comes back up within a few months. Tell your doctor: these drugs also strain the heart and raise blood pressure.

Which tests to read alongside it

These tests help show where it comes from.

What your result means

The lower end of the scale, in mg/dL.

How to raise your HDL cholesterol

You do not need to chase the number: what counts is removing what pushes it down, and the same habits protect your heart. Where to start:

When to worry

Talk to a doctor if:

With Rosa, an HDL below 8 is always flagged to a doctor. It is a very rare result.

Frequently asked questions

Low HDL cholesterol: when should I worry? When it is very low for no clear reason, or when it comes with high triglycerides and glucose. If it is only a little low and everything else is fine, you usually start with your habits.

What should I eat with low HDL cholesterol? Extra virgin olive oil, nuts, legumes, vegetables and fish, with little sugar and refined flour. Food changes the number only a little, but this way of eating protects your heart.

Can low HDL cholesterol be a sign of cancer? Usually not. A low HDL is common and almost always comes from habits or genes. But if it drops a lot for no reason and you are also losing weight without trying, talk to a doctor.

Are there medicines to raise HDL? Some raise it, but in the more recent studies they did not reduce heart attacks or strokes. That is why HDL is not treated on its own: your doctor looks at LDL, ApoB and your overall risk.

How often should it be checked again? If you have changed your habits, usually after about three months: before that the effect barely shows. Rosa measures it twice a year.

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