What Causes Low HDL Cholesterol Levels?

You may know that having low levels of triglycerides and low-density lipoprotein (​LDL) cholesterol can have positive effects on your heart health. In healthcare, "low" often means "good."

But not always.

Having low levels of high-density lipoprotein (HDL) cholesterol increases heart risks because HDL is considered "good cholesterol."

HDL plays an interesting role in your body. It removes cholesterol from your arteries and takes it to the liver, which disposes of it. This removal may protect your arteries from clogging up and causing conditions like a heart attack or stroke.

This article explains what HDL is, the role it plays in your health, and natural ways to increase your HDL level.

causes of low HDL cholesterol
Verywell / Emily Roberts

HDL At Work

Studies have shown that low HDL levels are linked to an increased risk of developing cardiovascular disease. This is especially true if other lipids in your blood, such as LDL cholesterol and triglycerides, are also high.

Likewise, research suggests that, to a certain extent, high HDL levels are linked to a lower risk of cardiovascular disease.

It's important to understand that there is no direct, causal relationship found between HDL levels and having a heart attack or stroke, which suggests that other factors may be at play. A person's HDL level is just one piece of the health puzzle.

Optimal HDL Levels

Optimal HDL levels vary for women and men. Anything over 40 milligrams per deciliter (mg/dL) for men is considered optimal; more than 50 mg/dL is the target for women.

However, healthcare providers tend to focus less on the actual HDL number and more on a person's entire heart health. Then they consider how the HDL number fits into the picture.

An example is a person who is overweight and smokes and is found to have a low HDL on a routine blood test. Instead of prescribing a medication to increase the HDL to a "normal" number, a healthcare provider may focus on smoking cessation counseling, exercise, and weight loss. These measures can all raise HDL.

In fact, you may be surprised to learn that there is no substantial scientific evidence out there to support the use of medication to increase a person's HDL level.

Causes of Low HDL

A number of conditions and lifestyle choices play a role in lowering HDL levels:

  • Excess weight: If you are overweight or obese, losing weight can increase HDL levels and lower your risk of heart disease.
  • Genetic factors: Sometimes, very low HDL cholesterol levels can be inherited. Medical conditions that severely lower HDL levels include Tangier’s disease and familial hypoalphalipoproteinemia.
  • Poor diet: What you eat can also influence your HDL levels. Limit saturated fats (for example, butter, cream, whole or 2% milk, beef, pork, chicken with skin) and substitute them with monounsaturated fats, found in olives and avocados, and polyunsaturated fat.
  • Sedentary lifestyle: Adding moderate exercise to your daily routine could slightly increase your HDL levels. Try doing aerobic exercises 40 minutes a day, three or four times a week. "Aerobic" includes activities like swimming, brisk walking, running, bicycling, and dancing.
  • Smoking: 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.
  • Uncontrolled diabetes: Having high blood glucose (sugar) levels may contribute to lowering HDL cholesterol levels. It can also increase triglyceride and LDL levels. Getting your blood sugar under control may help get your HDL levels back within a healthy range.

Cholesterol Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Old Man


HDL is the "good" cholesterol that helps remove cholesterol from your arteries. Higher levels are considered better for heart health. Normal levels are at least 40md/dL for men and 50 mg/dL for women. Often, you can raise your HDL level by improving your diet, exercising, and giving up smoking.

A Word From Verywell

Your HDL level is important, but your healthcare provider will likely focus less on the number and more on what it means. They will interpret your HDL level within the context of your risk factors for heart disease, like your family history, weight, activity level, whether you smoke, and whether you have other medical conditions like high blood pressure or diabetes.

If your provider tells you that your HDL level is too low, try not to be discouraged. Instead, focus your energy on getting healthier, whether that means losing weight, stopping smoking, or adding a jog to your daily routine.

Frequently Asked Questions

  • How are cholesterol levels checked?

    Cholesterol levels are checked with a test called a lipid profile, which requires a blood draw. Lipid profiles test your HDL, LDL, and triglyceride levels. You may have to fast for eight to 12 hours prior to the blood draw to get an accurate test result.

  • How often should cholesterol levels be checked?

    Healthy adults should have a lipid profile test every four to six years. Anyone who has diabetes, heart disease, or a family history of high cholesterol should be tested more frequently. Children and younger adults should have a lipid profile baseline established between ages 9 and 11 and again between ages 17 and 21.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  7. American Heart Association. American Heart Association recommendations for physical activity in adults and kids.

  8. Centers for Disease Control and Prevention. Getting your cholesterol checked.