High-density lipoprotein (HDL) cholesterol is called the good cholesterol because it moves unwanted or bad cholesterol out of your arteries. Most people have to work diligently to raise their HDL level, but is it possible to have HDL that's too high?
"The short answer is yes, but these high levels are probably not from anything you are doing to increase your good cholesterol, like exercising or having a glass of red wine," says John P. Higgins, MD, a professor at McGovern Medical School at the University of Texas and chief of cardiology at Lyndon B. Johnson General Hospital in Houston.
HDL Danger Zone
"Like many things in medicine, there can be too much of a good thing," explains Dr. Higgins. "This is called the U-shaped curve effect."
Dr. Higgins says HDL levels below 40 milligrams per deciliter (mg/dL) are known to increase heart disease risk, while HDLs of 60 mg/dL start to be protective. Yet, at 95 mg/dL or higher, it goes back to being a risk factor. "The sweet spot is between 60 and 80 mg/dL," he says.
"Although there are things you can do to raise your HDL number, none of those things will put you in the danger zone," he says. "You would probably need to be born with genes that get you there."
According to the Mayo Clinic, some people have naturally high HDL and they seem to have a lower risk for hearts attacks and stroke. However, there are other people who have extremely high HDL levels, probably due to a genetic condition, that may put them at higher risk for heart disease.
How to Raise Your HDL
For those who need to boost their HDL, lifestyle changes are the answer. "The best way to raise your HDL is through aerobic exercise, avoiding fatty foods and having a glass of red wine every day," says Dr. Higgins.
Build your diet around vegetables, fruits, lean protein and low-fat dairy as well as heart-healthy nuts, states the Cleveland Clinic. The Mediterranean diet is a great way to put all these choices on the menu. Avoid trans fats, still found in some packaged foods, like cakes and cookies, and fried foods, margarine and saturated fats, found in animal-based foods like beef, full-fat dairy and butter, states the Mayo Clinic.
When it comes to alcohol, Mayo Clinic notes that moderate alcohol use has been linked to higher levels of HDL, but drinking alcohol for this purpose is a slippery slope because too much can cause weight gain, high blood pressure and elevated triglyceride levels. Also, Harvard Health Publishing warns that more than two drinks a day can raise your risk for high blood pressure, heart attack and stroke.
"The best evidence for alcohol increasing HDL is for red wine at about one glass per day," says Dr. Higgins. "Other types of alcohol, like beer and mixed drinks, have less benefit and more empty calories. Don't think you can save up your wine drinking till the end of the week and have seven glasses. If you drink wine, just one glass per day is all you need."
In terms of exercise, try to get moderate-intensity exercise three to four times every week. Though current guidelines urge adults to get 150 minutes a week, the Mayo Clinic notes that even 60 minutes of this type of exercise each week can help increase your HDL.
What Not to Do
You may have heard that taking the B-vitamin niacin in supplement form can help raise your HDL, but according to the Harvard Health Publishing, there's no benefit to using any supplements to get your HDL above the sweet spot.
Finally, the Mayo Clinic suggests these steps: Don't smoke and avoid drugs or supplements that contain testosterone or anabolic steroids, drugs that lower HDL.
Is This an Emergency?
- Harvard Health Publishing: “Ask the Doctor: Can HDL (good) Cholesterol Be Too High?”
- John P. Higgins, MD, professor of medicine, McGovern Medical School, University of Texas, and chief of cardiology, Lyndon B. Jonson General Hospital, Houston
- Mayo Clinic: “HDL Cholesterol: How to Boost Your Good Cholesterol”
- Cleveland Clinic: “HDL: Is It Possible to Raise Your ‘Good’ Cholesterol?”