What Causes Low HDL Cholesterol Levels?

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Although having low triglycerides or LDL-cholesterol can have a positive effect on your heart health, having low levels of HDL cholesterol may count against you. Your HDL, or “good," cholesterol, removes excess cholesterol in the blood and can help to protect you against heart disease. Studies have shown that low HDL levels is a risk factor for developing cardiovascular disease, especially if other lipids in your blood are high, such as LDL cholesterol and triglycerides.

Normal HDL cholesterol levels range between 40 and 60 mg/dL. When your HDL cholesterol levels fall below 40 mg/dL, you may need to take some measures to help increase your levels, which could include treating certain medical conditions or making alterations to your lifestyle. These conditions can cause your HDL levels to be lowered:

  • You have uncontrolled diabetes. Having high blood glucose levels may contribute to lowering HDL cholesterol levels – as well as increasing triglycerides and LDL levels. Getting your blood sugar levels under control may help you to get your HDL levels back within a healthy range – whether it is through 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 you to slightly increase your HDL levels. Some studies suggest that exercising at least 5 days of the week for about 30 minutes per day can increase your HDL by about 5%.
  • You are overweight. Having excess weight can cause a lot of health conditions, including decreasing 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 diseases such as Tangier’s disease or 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 could also influence your HDL levels. Restricting trans fats and refined sugar intake in your diet are a couple of ways you can help increase your HDL.

In most cases, making some simple lifestyle changes can help give your HDL levels a little boost. However, there are other instances where lifestyle changes will not help, including inherited conditions 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 (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation). J Am Coll Cardiol 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. Circ Cardiovasc Qual Outcomes 2016; 9:206.

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