HDL Too High?

[SGW811]

I'm a 54 year-old female whose HDL has hovered at about 90 for the last 8 years or so, but shot up to 120 in the last year following amore strict adherence to a Mediterranean diet. (My LDL is 110 and triglycerides 66, for a total cholesterol of 242). I also exercise vigorously on a daily basis (aerobic exercise 6-7 days/week; weight lifting 4 days/ week). Today I saw my cardiologist, a prominent lipid specialist at a major academic medical institution. He said that HDL levels up to 80 or so are protective, but higher than that, they really don't know -- might be protective, neutral, or even harmful. I had assumed my very high levels were protective (against both cardiology and neurologic pathology) but now I'm feeling concerned. (For one thing, there's no healthy way to lower these HDL levels except maybe to reduce exercise which feels counter-productive.) My mother (who was obese for most of her life) also has high HDL but has been on a statin for at least 20 years. For those who follow the lipids research, are you aware of any research-backed information on these very high HDL levels? I am not currently on a statin. Thanks for any info or thought on this.

[apod]

It's intriguing to see HDL levels rise above LDL levels. I'm curious to hear more about your Mediterranean diet -- would this be quite low in SFA, or does it include dairy, coconut, or animal fat? Is this a sort of strict middle-of-the-road MD diet when it comes to net carbs with whole grains and legumes, or are you closer to a strict HFLC end of the spectrum with just a ton of olive oil, nuts, and avocado? Any relevant supplements in your arsenal?

I would look into quantifying sdLDL or small LDL-P (or apoA1 / HDL-P?) to try to get a better look under the hood.

[Orangeblossom]

Hi,

I have the same kind of thing, my HDL has gone up to 108 after following med diet, high fat and exercise etc, I read somewhere it is thought to possibly more of a problem if the overall cholesterol is high (but now sure where I read that!)

So I'm not so worried as my LDL is 70, and therefore overall it is not in a high level, according to the GP. So HDL is higher than LDL, nearly double. Trigs are low-ish. (69) I do lots of exercise too, go to the gym most days for an hour or more, swimming and on the step machines etc. My overall cholesterol has gone down slightly but HDL stayed high, since reducing more refined carbs last year. and adding some low GL grains / oats (still stay roughly under 50g carbs a day)

I have sat fats and legumes / grains in my diet. also coconut oil, very dark chocolate etc and plenty fruit and veg.

I expect you realise higher levels seem to be good in terms of cognition, overall. I did a post about the same thing, will see if can find it as had some links there. Ah here it is viewtopic.php?f=4&t=4214&p=49344&hilit=HDL+high#p49344

In terms of genetics I have some CETP variants seem to be linked to higher HDL, maybe you do too.

[Orangeblossom]

This might also be of interest-

"For HDL cholesterol, a level of 60 mg/dl or higher is best. For LDL cholesterol, a level of 70 mg/dL or lower is recommended"...http://ucdmc.ucdavis.edu/alzheimers/ins ... brain.html

Other studies mention levels above 60mg/l being better, but as you say there isn't much mention if it being too high. Also it seems as we age higher cholesterol in general is better.

[slacker]

Simply speaking, there is the conventional medical opinion on cholesterol (LDL bad, HDL good), and various other perceptions. Dr Peter Attia is often referenced by members on our site (rightly or wrongly). He has written a series of blogs on cholesterol that I find intriguing. His writing is definitely a deep dive and pretty technical. You can find the section on HDL here. It may be helpful to read the prior sections for better understanding, but he does a quick review of "prior episodes" at the start of each section.

[Julie G]

I'm part of the high HDL club too . My HDL is typically around 100. At my last cholesterol test my LDL was 79 and TGs 50. That said, 120 is unusually high! Just to be safe, I like the idea of doing some advanced lipid testing to see your HDL-P and other lipid particle numbers. FWIW, I perceive high functional HDL to be a a good thing. Until the E4 small molecule corrector is ready, we've got the next best thing. Kudos!

[Orangeblossom]

Another thought on the V high HDL, I understand Niacin (Vitamin B3) can raise levels of HDL, maybe if you are taking high amounts of that it could be causing it? Just a thought...

"Niacin can raise HDL cholesterol by more than 30 percent. "

https://www.mayoclinic.org/diseases-con ... t-20046208

However, it also seems to decrease LDL, too

https://www.healthline.com/nutrition/ni ... s#section4

Also, alcohol can increase levels of HDL, and is not a good idea for us E4s anyway...maybe a couple of things to think about dropping down...perhaps... Not sure if it is even a problem (the HDL not the alcohol)

[Fiver]

I'll take any HDL you don't want

....with those numbers you must have HDL oozing from your pores!

[SGW811]

It's intriguing to see HDL levels rise above LDL levels. I'm curious to hear more about your Mediterranean diet -- would this be quite low in SFA, or does it include dairy, coconut, or animal fat? Is this a sort of strict middle-of-the-road MD diet when it comes to net carbs with whole grains and legumes, or are you closer to a strict HFLC end of the spectrum with just a ton of olive oil, nuts, and avocado? Any relevant supplements in your arsenal?

I would look into quantifying sdLDL or small LDL-P (or apoA1 / HDL-P?) to try to get a better look under the hood.

My diet isn't low in saturated fats -- typically my daily diet is between 30-45% sat fat, mostly from evoo, salmon, avocado, and nuts. I do eat protein bars (source of protein is whey), as I am a weight lifter and do not eat any red meat or egg yolks (which I found raise my LDL significantly as a super-absorber of their cholesterol). These bars have 7-8 g. of sat fat each. I also eat chicken breast but only a couple of times/ month. No coconut oil (cardiologist said to stay away); limited oils, really, except evoo. I eat dairy almost daily (mostly fat-free greek yogurt and some cheeses, goat and feta crumbles). White meat chicken on rare occasion. 2-3 servings of fruit daily, focusing on berries, grapefruit, and tomatoes. Lots of greens (romaine, spinach, arugula, kale), veggies (broccoli, cucumbers, green beans, onions, peppers), and legumes (chick peas, black beans, kidney beans). I try to stay away from white carbs but do eat whole wheat pitas (often) and brown rice, quinoa, farrow, and sweet potatoes (occasionally). LDL fell from 130 to 110 after eliminating egg yolks from my diet, though now I worry about not getting enough choline.

[KatieS]

SGW, my HDL is now up to 118, but the particle count and size seems to point towards protective HDL. You might want to consider a lp(a) test as my test runs double normal, but there are preliminary mice studies that super-high HDLs might interfere with the lp(a) tests, skewing the test high. Do other family members run high HDLs? Like you, I'm an exercise fanatic and our diet sounds so similar other than my six runny pastured eggs per week.