How is your "good cholesterol"? All about HDL cholesterol!

When you check your cholesterol, you may have heard of ' good cholesterol ' and 'bad cholesterol'. That 'good cholesterol' is what HDL is. So, since many people find this a bit confusing, shall we talk about HDL cholesterol simply, in our own language?

What is HDL?

Simply put, HDL stands for 'High-Density Lipoprotein' . These are tiny particles that travel around in our blood. Think of them as a 'courier service' inside our bodies.

These lipoproteins are made up of lipids – fats – and proteins. Their main job is to transport the fats in our bodies, especially cholesterol, to where they are needed, to the cells. These fats cannot travel through the blood on their own, because their chemical nature does not allow them to. That is why they need the help of these "vehicles" called lipoproteins.

Is HDL cholesterol the same thing?

Yes, HDL and HDL cholesterol actually mean the same thing. People often use both terms to talk about these particles and how they affect our heart health.

Although these HDL particles contain fats as well as proteins, people recognize them by the type of fat they carry, which is cholesterol. That's why they're also called HDL cholesterol.

Why is HDL called "good cholesterol"?

There's a reason why HDL is called 'good cholesterol'. That is, HDL helps remove excess cholesterol from our bodies . This process can reduce our risk of developing cardiovascular disease, such as heart disease and stroke.

Normally, cholesterol enters the blood from our liver. From there, the aforementioned lipoproteins carry cholesterol to various cells in the body. Because cholesterol is needed for many important functions, such as building cell membranes and producing hormones.

However, sometimes our blood accumulates too much cholesterol. That is, more than the body needs. That's when a process called 'reverse cholesterol transport' comes to the rescue.

This 'reverse cholesterol transport' is a somewhat complex process. Scientists are still figuring out when and how HDL contributes to this. As far as we know, HDL particles can carry excess cholesterol in the blood back to the liver. The liver then breaks down this cholesterol and removes it from the body through our stool.

This is a good thing, because when cholesterol levels in the blood increase, fat deposits build up on the walls of our blood vessels, causing them to become clogged. This is what we call ' atherosclerosis '.

So, HDL is called 'good' or 'helpful' cholesterol because it removes excess cholesterol. Not only that, HDL cholesterol also works against inflammation and oxidants in our body, helping to keep our cells strong. HDL also plays a role in preventing blood clots.

How do I know my HDL level?

This is easy to find out. Your doctor can order a blood test called a 'lipid panel' . The report will give you some information about your different types of cholesterol, including your HDL level.

How much HDL is good?

The ideal situation is for your HDL level to be 60 milligrams per deciliter (mg/dL) or higher . Research has shown that having high HDL levels like this can reduce your risk of developing cardiovascular disease , which means heart disease and stroke.

The normal range for HDL cholesterol levels in adults varies slightly by gender:

• For men: 40 mg/dL or higher.
• For women: 50 mg/dL or higher.

However, the most important thing is to talk to your doctor about the results of your lipid panel report and understand exactly how they affect you.

Isn't it good to have low HDL?

Yes, it's not really good to have HDL levels that are not in the normal range, that is, low. We say that people with low HDL levels have 'low HDL'. That's bad for health.

Is increasing HDL also a problem?

Here's another important point. It's not good for HDL levels to be too high. That is, if they go much higher than 80 mg/dL, it can accelerate the hardening of the arteries called atherosclerosis that we mentioned earlier. Other underlying medical conditions can cause HDL levels to be abnormally low or high.

What are the causes of low HDL?

There are a number of reasons why your HDL cholesterol levels may be low. Let's take a look at what they are:

• Tangier disease: This is a genetic condition that causes your HDL cholesterol levels to drop significantly.
• Familial combined hyperlipidemia: This is also a genetic condition. In this, HDL levels are reduced and LDL levels, also known as bad cholesterol, are increased.
• ApoA1 deficiency: People with this genetic condition do not produce enough of a protein called apolipoprotein A1, which is a major component of HDL.
• Metabolic syndrome: This is a combination of several risk factors for cardiovascular disease, including lower than normal levels of HDL.
• Body mass index (BMI) greater than 25 (overweight/obesity): When body weight increases, it can lead to lower HDL levels.
• Smoking or tobacco use: Nicotine, a chemical found in tobacco, lowers HDL levels. This adverse effect is seen not only in cigarettes and bidis, but also in all tobacco products, including e-cigarettes.
• Insulin resistance: When body fat increases, it becomes harder for our body's insulin to properly control blood sugar levels. This can also lower HDL levels.
• Some medications you take: Some medications, for example, beta-blockers, certain hormones, or certain diuretics (medicines that increase urination) can also lower HDL cholesterol levels.

What are the causes of increased HDL?

An abnormally high HDL level is defined as a level above 80 mg/dL. This is called 'elevated HDL'.

One reason your HDL cholesterol levels may be high is a genetic mutation . Changes in some genes can cause your body to make too much HDL cholesterol or have problems removing it from your body. For example, a change in the CETP gene can cause HDL levels to be higher than 150 mg/dL.

There are several other reasons why HDL may be abnormally high:

• Hyperthyroidism: This means increased activity of the thyroid gland.
• Primary biliary cholangitis: This is a disease that affects the bile ducts of the liver.
• Alcohol use disorder: Excessive drinking.
• Some medications.

If your HDL level is abnormally high, your doctor will investigate the cause and decide whether you need treatment.

How to increase HDL levels?

This is a question that many people have. The best thing to do is talk to your doctor and get advice tailored to your health and any other medical conditions you may have. But in general, there are some lifestyle changes that can help increase your HDL levels. Let's take a look at what they are:

• Eat a heart-healthy diet: Research has shown that the Mediterranean diet is good for overall heart health and can help control cholesterol levels. This diet includes plenty of fruits, vegetables, legumes (like beans and lentils), and whole grains. Foods high in omega-3 fatty acids also help raise HDL cholesterol. For example, oily fish like salmon and mackerel, flaxseeds, and walnuts.
• Avoid or limit unhealthy foods: Avoid fried doughnuts or baked goods that contain trans fats (also called partially hydrogenated oils). Also, limit foods that contain saturated fats . For example, sausage, cheese, bacon, and butter.
• Exercise: Aerobic exercise can help raise HDL cholesterol. Aim to exercise for at least 30 minutes a day, five or more days a week. If you haven't exercised much before, that's okay. Start with five to ten minutes a day and gradually increase. But be sure to talk to your doctor before starting a new exercise plan.
• Maintain a healthy weight that suits you: Losing weight, especially belly fat, helps improve HDL levels.
• Avoid all tobacco use: Smoking, vaping, and using other tobacco products lower HDL. So, if you don't currently use tobacco, don't start. If you do, it's important to try to quit. Talk to your doctor about ways to help you quit. Secondhand smoke is also harmful. If you live with someone who smokes, support them in quitting – it's good for them and good for you.
• Taking medications: Sometimes your doctor may prescribe medications like 'PCSK9 inhibitors' or 'ezetimibe' to help increase HDL levels.

What we want to take home from this story

Understanding your cholesterol test report can sometimes feel a little confusing, right? There are a lot of words to learn, and it can be hard to remember what's 'good' cholesterol and what's 'bad' cholesterol.

When talking about HDL, remember that the 'H' stands for 'Helpful'. HDL cholesterol is good because it helps remove excess cholesterol from your blood.

That's why maintaining healthy HDL levels can help reduce your risk of heart disease. If your HDL levels are not at the right levels, be sure to talk to your doctor about ways to improve them. Don't worry, most of the time, you can control this condition by making small lifestyle changes and, if necessary, taking some medication prescribed by your doctor. Good luck!

` Cholesterol, HDL, good cholesterol, heart disease, blood tests, healthy lifestyle, diet