HDL in Serum

HDL, aka "good cholesterol", reflects cholesterol carried in HDL particles (reverse cholesterol transport). Affected by smoking and exercise.

This HDL-C test measures cholesterol cargo, not HDL function, i.e. how well HDL particles remove cholesterol from cells, carry it toward the liver, and provide anti-inflammatory or antioxidant effects.

Also known as:
High-density lipoprotein cholesterol
S-HDL
HDL-C
HDL cholesterol
.

HDL ranges for

Interpret your result
"Normal" lab range for HDL is above 39 mg/dL:
39
According to Peter Attia, HDL should be above 50 mg/dL:
50
According to OptimalDX, HDL should be between 55 and 93 mg/dL:
55
93
Optimal range
Optimal range for HDL appears to be between 55 and 90 mg/dL for males:
20
40
55
90
100
150
Why this optimal range?
Preliminary range is based on functional health organizations including but not limited to those listed above.

What a low value may mean:

Common reasons for low HDL:

  • Metabolic pattern: insulin resistance, high triglycerides, excess adiposity, type 2 diabetes, and low physical activity commonly lower HDL-C, especially when triglycerides are elevated.

    Lifestyle and inflammation: cigarette smoking, acute or chronic inflammation, severe illness, malnutrition or malabsorption, liver disease, kidney disease, and hyperthyroidism can reduce HDL-C or impair HDL function.

    Medications and genetics: androgens, progestins, anabolic steroids, some beta blockers, thiazide diuretics, and rare disorders such as apoA-I deficiency or Tangier disease can cause very low values.

    ,

What a high value may mean:

Common reasons for high HDL:

  • Genetics and alcohol: familial high HDL, CETP-related variants, and higher alcohol intake can raise HDL-C; very high HDL-C does not necessarily mean better HDL function.

    Hormonal and inflammatory: hypothyroidism, menopause-related changes, chronic inflammation, infection, and some liver or biliary disorders can be associated with high or dysfunctional HDL.

    Less common: endurance training, medications, or markedly elevated HDL-C above about 100 mg/dL should be interpreted with apoB, triglycerides, liver enzymes, thyroid status, and family history.

    ,

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Zsolt Szabo
Zsolt Szabo
Precision Health Consultant for Longevity Clinics

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I am particularly interested in research on biomarkers associated with all-cause mortality and on defining optimal reference ranges.