HDL, or high density lipoprotein, is a protective cholesterol that gathers excess fats in the blood and transports them to the liver for disposal. The National Institutes of Health recommend maintaining a level above 40 mg per dL for men and above 50 mg per dL for women. Causes of a rapid decline in HDL include testosterone medication, the body's response to a severe tissue destruction by bacterial infection or trauma, and pregnancy.
Testosterone
Testosterone, the male sex hormone, can be synthesized and prescribed for treating delayed maturation in adolescent males, for the virilization of women undergoing sex reassignment procedures, and as a way of replacing the hormone production lost when the testicles must be removed due to testicular cancer or severe trauma.
Researchers from the University of Washington, reporting in the June 2003 issue of the "American Journal of Physiology, Endocrinology and Metabolism," found a 12.1 percent decline in HDL levels in men who received just three weeks of testosterone replacement therapy.
But although the HDL levels may drop, the overall affect does not result in an increased risk of angina, heart attack or stroke, according to findings reported in a 1997 issue of the "Journal of Clinical Endocrinology and Metabolism." The study concluded that the possibility of creating low HDL levels should not be used as a reason to refrain from testosterone use when it is clinically indicated.
Acute Phase Recovery
A team at the University of Chicago studied what occurs in the various lipids, or fats, when the body is recovering from a tissue-destructive infection or a major trauma. They found that during the acute phase of recovery, C-reactive protein, an indicator of inflammation, elevates significantly. As the team wrote in a 1996 issue of the "Journal of Lipid Research," this increase, together with the elevation in the level of circulating triglycerides, appears to cause the decrease in the relative amount of HDL. The effect was temporary and not associated with an increased risk of cardiovascular events.
Infections that cause acute phase recovery include Kawaski disease in children and Methicillin Resistant Staphylcoccus Aureus, or MRSA. In addition, surgery that causes major trauma, especially if complicated by infection, can also drive HDL levels down.
When the body is engaged in the process of healing from a debilitating illness or injury, many changes occur that would otherwise be reason for concern. The key in managing these situations is allowing the body to heal itself without interference and then rechecking the cholesterol levels after the healing process is complete.
Pregnancy
Erica P. Gunderson, Ph.D., speaking at a 2003 American Heart Association conference, reported the results of a 10-year study of HDL levels after pregnancy. Her team found that a 3 to 4 mg per dL drop in HDL occurred right after delivery and persisted for 10 years in the majority of women.
References
- National Heart Lung and Blood Institute: Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
- "American Journal of Physiology, Endocrinology and Metabolism"; Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk; Karen L. Herbst, et al.; June 2003
- "Journal of Lipid Research"; HDL content and composition in acute phase response in three species: triglyceride enrichment; Veneracion G. Cabana, et al.; 1996
- Family Practice News: Drop in HDL Cholesterol Seen After Childbirth
