Interpreting my lipid panel results

Answered on September 12, 2014
Created July 08, 2011 at 4:07 PM

So I've had some interesting results, with a very low LDL and high HDL. Normally this is supposed to be good, right? But my HDL is very high and I've seen some research that suggests there can be too much of a good thing... Any experience with this and any advice? I'm a 38 year old Caucasian female.


Total Cholesterol: 187 mg/dl Triglycerides: 109 mg/dl HDL: 118 mg/dl LDL: 41 mg/dl



on July 08, 2011
at 04:35 PM

my HDL was 147 - I am still trying to figure this out. Trigs should be lower I think.

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3 Answers


on July 08, 2011
at 07:19 PM

Hello Kathy,

You might want to check out this link over at PHD - http://perfecthealthdiet.com/?p=3122

Conclusion - There???s little data to evaluate the healthfulness of very high HDL levels, but what data we have suggests that more is better. There???s also a plausible (to me) evolutionary story for why our optimal HDL levels may be far higher than the ones selected by evolution. For most biomarkers I would trust evolutionary selection and let my body do whatever it wants; but for HDL I will make an exception. I think we will benefit from dietary tactics that raise HDL levels above the evolutionary norm. And this is especially true for those with infectious diseases. So my judgment is: let???s be like Richard Nikoley and aim for high HDL

How much do you exercise as it will materially impact your HDL. My wife (just turned 40) is a fitness freak of nature. Her HDL when last checked was 129. Her LDL was ~125 and Triglycerides were ~50. Most notably, her HS CRP was 0.8 (I'm jealous!). What is your HS CRP?

Finally, readings from test to test can vary significantly. I had a physical recently and my triglyceride level was 115. 2 weeks later for additional life insurance I was purchasing, I had blood work - one test came back at 135 and the next one at 90 and the tests were all within a couple weeks!!! So realize that short term variability your carbohydrate and fat consumption can have material impacts on these results.

Finally, I am a cholesterol skeptic. These numbers are reflective of your diet but not necessarily your well-being. I eat a moderate/high carb diet so my trigs are higher than the typical low carber. I don't sweat it as a result. If my HS CRP or HbA1C was high, then I would probably be worried.



on July 08, 2011
at 07:04 PM

In this blog post from Chris Kresser, he suggests that the only number necessary to consider is the ratio between Trigs and HDL, which should be less than 2.

Key quote:

In general I???m not a fan of people worrying about their lipid panel numbers at all. Like Dr. Kurt Harris, I think this compulsive testing and re-testing of lipids that has become common in the Paleo community not only isn???t necessary, but may even be harmful. There???s still a lot we don???t know about how these numbers change on a day-to-day basis. What???s more, it???s not always easy to distinguish between cause and effect. Researchers made the mistake of assuming high cholesterol was the cause of heart disease, when in reality it???s much more likely that high cholesterol is a consequence of it.

But for crying out loud, if you???re going to get your lipds tested at least pay attention to the right numbers. And the most important number on a conventional lipid panel is the relationship between triglycerides and HDL. (Divide triglyercids by HDL to get it.) If that number is less than 2, this suggests you have mostly large, buoyant LDL ??? which is not a risk factor for heart disease. If that number is higher than 3, it suggests you have mostly small, dense LDL ??? which most certainly is a risk factor for heart disease.

For you, this would be 109 / 118 = .92

Is my math correct?



on July 08, 2011
at 04:15 PM

I'd focus on getting those trigs down.

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