Ask The Doctor: Can Hdl Cholesterol Be Too High
Q.I know I need to keep my LDL cholesterol low and my HDL cholesterol high, but can HDL ever be too high?
A. For high-density lipoprotein levels, it does appear that the higher, the betterat least to a point. But you should also think about how you achieve that level. HDL is known as the good cholesterol particle because it functions to clear cholesterol from the arteries and deliver it back to the liver. Higher HDL levels are associated with a lower risk of heart disease. HDL levels lower than 40 milligrams per deciliter are considered worrisome, and levels higher than 60 mg/dL are considered excellent.
One recent study that examined high levels of HDL reported the benefits extended until 90 mg/dL in men, but then leveled off, which suggests no further benefit even with higher levels. A mans HDL level is predominantly determined by genetics, or inherited factors. Moderate-intensity exercise, three to four times a week, is an important mechanism to raise HDL with the bonus of other health benefits. Other methods to raise HDL are not so healthy. For instance, medications or supplements, like niacin, have shown disappointing results in controlled studies. Alcohol intake is known to increase HDL, but consuming more than two standard drinks a day can raise your risk of high blood pressure, heart attack, and stroke.
William Kormos, MD
How Can You Prevent High Cholesterol Levels And Coronary Heart Disease
Prevention methods are very much the same as treatment methods. First, dont smoke. If you do smoke, make plans to quit now. Find ways to add physical activity to each of your days. Take steps to keep your weight in a healthy range. Eat well. Consider following the Mediterranean diet. It is the only diet proven to reduce the risk of heart disease. Take care of any other medical conditions you might have by following your healthcare providers advice and instructions. Learn to really relax and calm down.
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How High Is Too High
In the past, studies showed that lower HDL levels raise the risk of diseases of the blood vessels, while high HDL levels were protective. They suggested that the lower the HDL, the higher the risk of serious events such as heart attack and stroke, and the higher the HDL, the lower the risk. This would mean that raising HDL would lower the risk of illness.
More recent research suggests that HDL levels above 1.4mmol/L may not offer extra protection. In some cases, very high HDL could even raise the risk of serious problems such as a heart attack or stroke.
Some studies also suggest that for people with high LDL cholesterol which is now well-controlled, raising your HDL with medicines does not lower the risk of serious problems such as heart attacks.
Learn about high HDL cholesterol
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Are Home Cholesterol Testing Kits Accurate
The answer is yes if the tests are labeled CDC-certified. This means that the contents have been approved by the Cholesterol Reference Method Laboratory Network, a group that works with test makers, laboratories and the Centers for Disease Control and Prevention to make sure tests are accurate.
For home tests, you will still need to fast for 12 hours and to obtain blood for testing. Some kits come with packages for mailing to a lab for results. Other kits have a monitor so you can get the results at home. The cost of such home kits varies.
Cholesterol Levels For Adults
- Total cholesterol levels less than 200 milligrams per deciliter are considered desirable for adults. A reading between 200 and 239 mg/dL is considered borderline high and a reading of 240 mg/dL and above is considered high.
- LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors. A reading of 130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high. A reading of 190 mg/dL or higher is considered very high.
- HDL levels should be kept higher. A reading of less than 40 mg/dL is considered a major risk factor for heart disease. A reading from 41 mg/dL to 59 mg/dL is considered borderline low. The optimal reading for HDL levels is of 60 mg/dL or higher.
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Types And Function Of Cholesterol
Cholesterol is a type of waxy fat created by your liver or introduced to your body through the foods you eat. Cholesterol is needed by your body to make new cells. Too much cholesterol, though, can be a bad thing.
Whether it’s made by your liver or brought in through your diet, cholesterol circulates through your blood bound to lipoproteins. High-density lipoproteins carry more cholesterol molecules than low-density lipoproteins.
LDL cholesterol is seen as the “bad” version of this substance, because it carries cholesterol into artery walls, depositing cholesterol where it doesn’t belong. This can result in plaques that cause your arteries to narrow and become more rigida condition called atherosclerosis.
Pieces of these plaques can fall off, or blood clots can form in your narrowed vessels. These clots may go on to cause a heart attack or stroke.
HDL cholesterol, on the other hand, is considered “good,” because it helps to clear fats from the bloodstream, returning these molecules to the liver, where they are removed as waste. HDL can even help clear some of the cholesterol deposits left behind in artery walls.
Cholesterol isn’t bad unless there’s too much of it or you have the wrong balance of cholesterol. Cholesterols and triglycerides are the two main types of fats in the body. Cholesterols are only found in animal products, or are produced by the liver.
Hdl Vs Ldl Cholesterol
HDL cholesterol contains a higher proportion of protein and is made up of substances that dont lead to plaque buildup in your arteries. High-density cholesterol also carries LDL cholesterol away from the arteries back to the liver, where its broken down and eliminated from the body.
On the other hand, LDL cholesterol has a higher cholesterol and lower protein composition. When theres an excess of LDL cholesterol from consuming a diet high in calories and fat, excess LDL cholesterol seeps through artery walls and oxidizes .
When oxidation occurs, macrophages consume the oxidized LDL cholesterol in the artery wall and die, leading to inflammation in the artery walls. The body is then triggered to block the increasing macrophage by creating tissue in the artery walls called plaque, resulting in atherosclerosis.
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How To Lower Ldl Cholesterol
Lifestyle and diet changes are the main ways to prevent or lower high LDL. A trial of eating a low-fat diet, regular aerobic activity, maintaining a healthy weight, and smaller waist circumference is an appropriate first step. It is best to set a timeline to achieve your goals with your doctor. In some cases, if those lifestyle changes are not enough, your physician may suggest a cholesterol lowering medication, such as a statin. If you are considering over-the-counter herbal or ayurvedic medications for cholesterol, please discuss those with your physician first as well.
Rarely, very high LDL is genetic and passed down in families. This is called familial hypercholesterolemia and is caused by a genetic mutation that decreases the livers ability to clear excess cholesterol. This condition can lead to very high LDL levels, and heart attack or stroke at a young age in multiple generations. Those individuals may require special medical treatment for prevention and treatment of atherosclerotic cardiovascular disease.
Remember, knowledge is the first step. If you dont know your cholesterol levels, get tested. That will give you and your physician a starting point for lifestyle changes and medications if needed. In the meantime, adopt a heart-healthy lifestyle, and do it with friends and family no matter their ages. Theres no time like the present to prevent heart disease.
What Increases Hdl Cholesterol
Raising your HDL levels by diet alone is very difficult. Your best solution to increase your HDL levels is to eat a heart-healthy diet low in fat and high in fiber. You also can help improve your HDL number if you lose weight, quit smoking, and cut sugar out of your diet.
Some statin medications may potentially increase HDL levels moderately. Discuss this treatment option with your doctor.
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If Cholesterol Is Necessary Why Do We Have To Worry About How Much We Have
Having enough cholesterol to meet your needs is important. Having too much cholesterol can cause problems. If your cholesterol levels are high, the condition is called hypercholesterolemia. If your cholesterol levels are low, the condition is called hypocholesterolemia. It is not common to have cholesterol levels that are too low, but it can happen.
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Targets For Cholesterol Levels
Here are recommended levels of lipids in your blood measured in milligrams per deciliter .
- Total cholesterol: Under 200 mg/dL
- Total triglycerides: Under 150 mg/dL
- LDL cholesterol: Under 130 mg/dL for healthy individuals, or under 100 mg/dL for heart or blood vessel disease, or for those with high total cholesterol
- HDL cholesterol: More than 45 mg/dL for men, or more than 55 mg/dL for women
Statistics about cholesterol include:
- In the United States, cardiovascular disease is the leading cause of death in adults. High cholesterol is a primary risk factor in cardiovascular disease.
- Of adults age 20 and older, 11.8% have a total cholesterol of 240 mg/dL or more.
- The average total cholesterol level for adults over age 20 in the United States is 191 mg/dL.
- Of adults in the U.S., 18% have low HDL cholesterol levels.
- Low HDL cholesterol is more prevalent in the United States among people of Hispanic descent than those from other ethnic groups.
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What Does Hdl Cholesterol Do
HDL clears from the body via the liver. HDL may therefore prevent the buildup of plaque, protect your arteries, and protect you from atherosclerotic cardiovascular disease. It is considered the good cholesterol, and higher levels are better. A good goal to aim for is higher than 55 mg/dL for women and 45 mg/dL for men. The higher your HDL cholesterol numbers, the lower your risk is for heart disease, vascular disease, and stroke.
Medicines To Lower Your Cholesterol Level
Medicines called statins are most often used to lower cholesterol levels. There are other cholesterol-lowering medicines that your doctor might prescribe, like resins, fibrates, and niacin. If you need to take a medicine to lower your cholesterol level, your doctor will help you find the one that works best for you.
Estrogen replacement therapy lowers your bad cholesterol level and raises your good cholesterol level. However, studies have not shown that it lowers the risk of heart disease.
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How Do You Prepare For A Cholesterol Test
In most cases, youll need to fast for nine to 12 hours before the test. Make sure you tell the person drawing your blood how long it has been since you ate or drank anything that wasnt water.
There are some cases when a cholesterol test is done without fasting. This is true for tests done at health screenings and may be true for people younger than 20 or for people who are unable to fast.
Some medical societies believe that fasting is not necessary to get a true picture of lipid levels in the blood, while other associations stand by the belief that fasting gives a better idea of a persons heart disease risk. You should be clear on whether or not you need to fast, and for how long, before you go for the blood test.
Can Bad Cholesterol Levels Be Too Low Can Good Cholesterol Levels Be Too High
It isnt often that people have bad cholesterol that is too low or good cholesterol that is too high. There are studies being done that suggest that extremes of any kind are not healthy for everyone.
Even though there is no clear-cut number about what LDL level is too low, levels under 40 mg/dL may be associated with certain health issues, including depression/anxiety, and hemorrhagic stroke.
However, there is data from clinical trials to support that there is no evidence of harm when LDLs remain < 40mg/dl on statin therapy.
In some cases, genetic conditions can cause you to have very low cholesterol levels. In other cases, nutritional problems, some cancers, hypothyroidism and certain infections can also cause low cholesterol levels. In any of these types of situations, the underlying issues need to be addressed.
In terms of having too much of a good thing, researchers are studying the effects of too much HDL, the good cholesterol. No conclusions have been reached, but there have been studies into the possible relationship between high HDL and cancer, and a greater risk of heart attack among the high risk. Excessively high HDL may be dysfunctional HDL and not protective.
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Healthdo Doctors Treat Women Differently
El Khoudarys team studied more than 1,100 women over the age of 45 who are taking part in a bigger study of health. Theyd previously found that HDL did not seem to protect women from heart disease after menopause.
The Khoudary study broke it down, and researchers found that the size of the HDL particles was what mattered.
When a woman was close to menopause, the larger particles were associated with a greater risk of atherosclerosis, El Khoudary said.
Women who had more of the smaller HDL particles had a lower risk of developing the early signs of heart disease, as measured by a thickening of the artery walls.
Our findings imply the measure of total cholesterol may not be enough. We need to look more carefully at these particles, she said.
Can You Get Rid Of Cholesterol Deposits
Researchers are working on ways to eliminate plaque from coronary arteries. One method that has been proposed involves using combinations of medicines in healthy people aged 25 to 55 years. It is suggested that getting the levels of cholesterol down very low will allow arteries to clear up and heal up.
Several researchers believe that the way to reverse heart disease, and to prevent it in the first place, is found in a whole food, plant-based diet. Studies have been done that have shown that limiting nutrition to whole foods that are plant-based have been successful in reducing blood cholesterol and even, in some cases, lessening plaque buildup.
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Dha Is Better At Raising Hdls The ‘good’ Cholesterol
Note: DHA is not expected to lower bad cholesterol.
“Clinical studies are now concluding significant benefits associated with DHA-rich microalgae oils versus DHA-poor fish oils. High doses of oil from both fish and microalgae sources are considered safe, result in increased circulation of both EPA and DHA omega-3s, and both oil sources are protective against cardiovascular risk factors. Significantly, DHA-rich microalgae oil formulations are equally or more protective compared to fish oil in nearly all human trials conducted. This is mainly because 90% of the omega-3s in our body is DHA. DHA acts more directly in the system.” – Dr. Doughman, PhD
What Makes Hdl Cholesterol So Good
HDL is short for high-density lipoprotein. Each bit of HDL cholesterol is a microscopic blob that consists of a rim of lipoprotein surrounding a cholesterol center. The HDL cholesterol particle is dense compared to other types of cholesterol particles, so it’s called high-density.
Cholesterol isn’t all bad. In fact, cholesterol is an essential fat. It provides stability in every cell of your body.
To travel through the bloodstream, cholesterol has to be transported by helper molecules called lipoproteins. Each lipoprotein has its own preferences for cholesterol, and each acts differently with the cholesterol it carries.
Experts believe HDL cholesterol may act in a variety of helpful ways that tend to reduce the risk for heart disease:
- HDL cholesterol scavenges and removes LDL — or “bad” — cholesterol.
- HDL reduces, reuses, and recycles LDL cholesterol by transporting it to the liver where it can be reprocessed.
- HDL cholesterol acts as a maintenance crew for the inner walls of blood vessels. Damage to the inner walls is the first step in the process of atherosclerosis, which causes heart attacks and strokes. HDL scrubs the wall clean and keeps it healthy
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Lowering Your Total And Ldl Cholesterol Levels
Here are some things you can do:
Lose weight if you are overweight.
Exercise regularly. For example, walk or ride a bicycle for 30 minutes at least three times a week.
Eat fewer high-fat foods, like butter, cheese, meat, and some vegetable fats . Foods that are high in saturated fat should be less than 7 percent of your total daily calories.
Eat more high-fiber foods, like vegetables, fruits, grains, and whole-grain breads, cereals, and pasta.
Your doctor can help you plan a heart-healthy diet. If exercising and changing your diet do not help enough, you might need to take a medicine to lower your cholesterol level.
How Is The Total Cholesterol Or Blood Cholesterol Test Done
A blood test is a routine test. A phlebotomist is a person whose job is to draw blood. Blood is usually drawn from the vein in your arm. You will sit down and the phlebotomist will wrap a rubber band around your upper arm so that the vein in your elbow sticks out. Then they will use a needle to puncture the vein and remove blood. The blood is sent to the lab to be examined.
Youve probably been at health fairs where testing is offered. In that case, the person performing the test takes a drop of blood from your finger. The finger-stick test uses a small blade to poke a hole in the tip of your finger to get the blood.
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