What Causes Low HDL Cholesterol Levels?

Maintaining HDL Levels Is Good for Your Heart

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Although having low triglycerides and LDL-cholesterol can have a positive effect on your heart health, having low levels of HDL cholesterol may count against you. That's because HDL is considered “good cholesterol." It removes excess cholesterol in the blood and can help protect you against heart disease.

Studies have shown that low HDL levels are a risk factor for developing cardiovascular diseases.

This is especially true if other lipids, such as LDL cholesterol and triglycerides, in your blood are high.

What Is a Normal HDL Level?

Normal HDL cholesterol levels range between 40 and 60 milligrams per deciliter (mg/dL). When your HDL falls below 40 mg/dL, you may need to take measures to help increase your levels. This may include treating certain medical conditions or making alterations to your lifestyle.

Causes for Low HDL

There are a number of conditions and lifestyle choices that play a role in lowering HDL levels. While these may not be a factor for you, it's something to think about and discuss with your doctor. 

  • You have uncontrolled diabetes. Having high blood glucose levels may contribute to lowering HDL cholesterol levels. It can also increase triglyceride and LDL levels. Getting your blood sugar levels under control may help get your HDL levels back within a healthy range. This can be done by modifying your lifestyle or taking medication to treat it.
  • You smoke. The chemicals found in cigarettes can lower your HDL cholesterol. Quitting smoking can help increase your HDL as well as prevent other chronic diseases, including cardiovascular disease.
  • You are sedentary. Adding moderate exercise to your daily routine may help increase your HDL levels slightly. Some studies suggest that exercising at least 30 minutes a day for five days of the week can increase your HDL by about 5 percent.
  • You are overweight. Having excess weight can cause a number of health conditions, including a decrease in your HDL levels. If you are overweight or obese, losing weight may help increase these levels and lower your risk of heart disease.
  •  It’s in your genes. Sometimes, very low HDL cholesterol levels can be inherited. Medical conditions that severely lower HDL levels include Tangier’s disease and familial hypoalphalipoproteinemia.
  • You live a stressful lifestyle. Long-term stress can lower your HDL levels. Losing sleep (due to stress or other factors) can also lower your HDL.
  • You are consuming a poor diet. What you eat can also influence your HDL levels. Restricting trans fats and refined sugar in your diet are a couple of ways you can help increase your HDL.

How You Can Boost HDL

In most cases, making some simple lifestyle changes can help give your HDL levels a little boost. Regular exercise, healthy eating, and lowering your stress levels are good places to begin.

However, there are other instances where lifestyle changes will not help. These include inherited and medical conditions that cannot be managed by lifestyle changes alone. In these cases, your healthcare provider may decide to place you on medication that helps increase your HDL and lower other aspects of your lipid profile.


Acharjee S, Boden WE, Hartigan PM, et al. Low Levels of High-Density Lipoprotein Cholesterol and Increased Risk of Cardiovascular Events in Stable Ischemic Heart Disease Patients: A Post-Hoc Analysis From the COURAGE Trial. Journal of the American College of Cardiology. 2013; 62:1826.

Bartlett J, Predazzi IM, Williams SM, et al. Is Isolated Low High-Density Lipoprotein Cholesterol a Cardiovascular Disease Risk Factor? New Insights From the Framingham Offspring Study. Circulation: Cardiovascular Quality and Outcomes. 2016; 9:206.

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