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Causes of low HDL?

Answered on August 19, 2014
Created December 02, 2012 at 1:52 AM

I've been on a low-carb, paelo-style diet since June. Since then, I've lost 65 pounds.

And I've seen significant improvements in mood, energy, ability to exercise, etc., and I've seen a number of chronic problems improve or disappear: acid reflux, sleep apnea, acanthosis nigricans, etc.

And my A1C, which was 5.8 back in June, as of this morning is 5.0.

My lipids, though, concern me. Not so much total cholesterol or LDL, but my HDL. My triglycerides had been high - > 200 on occasion. This morning they were 70. Which is fine.

My HDL has always been low. Prior to my starting Atkins, they'd never been higher than 33. In August they were up to 36. Since then they've been declining, 31 at beginning of October, 28 at the beginning of November, and this morning the reading came back <15.

What could be causes such a low reading? I'd always thought that HDL and triglyceride production were inversely related - if you were producing too many trigs, you weren't able to produce much HDL. But my trigs have come down significantly, and my HDLs are declining as well.

Could this be a transient phenomenon? That my HDL levels are low not because I'm not producing them, but because they're being consumer while fixing whatever it is they're supposed to be fixing? I'm still losing 10 pounds/month, so my body and metabolism are very much still in flux. A large part of me is saying that I shouldn't worry about this at all, until I stabilize, too much is changing right now for these numbers to mean much.

But part of me is worried, and is wondering what could be going on, whether I should try to "fix" it, and whether there is anything I could be doing.

Suggestions? Thoughts? Comments?

8af1e83ec3ea5a39f050baf362708a78

(253)

on January 01, 2013
at 02:11 AM

Everything I've read indicates that there's almost no relationship between dietary cholesterol and serum cholesterol.

197651282ddd8d675b974ee811d2269e

(1836)

on December 03, 2012
at 05:46 AM

Agreed. My total cholesterol was higher when I was on a vegan diet than when I did the Atkins years ago, according to my medical records. My HDL was a lot higher after I started Atkins and exercising. Haven't done any blood work since going Paleo 3 months ago, waiting for 6 month mark.... I would recommend vitamin D level & testosterone ( if you are a man) and maybe find another doctor.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on December 02, 2012
at 11:56 PM

Corrected my errors. Thanks, thhq.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on December 02, 2012
at 11:53 PM

Oops, I meant HDL.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 06:12 PM

I'm supplementing D3 and K2, and I eat a fair amount of hard cheese. And coconut oil.

Medium avatar

(10611)

on December 02, 2012
at 05:59 PM

I've only had the particle size work done for the last two years, and the insulin resistance score comes from those tests. My theorizing is a result fo having that information. I'd suggest getting them if they're available to you.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 05:07 PM

My TC has been bouncing around between 212 and 257. If things go as they have, I'll be at goal in 4-6 months. I plan on doing an NMR Lipoprofile about three months after that. If statins or other interventions are warranted, I'll decide then, after things have stabilized and I have real data. But in the meantime, I'm wondering what I could be doing, that I'm not already doing, to bring up my HDLs. So far, the only suggestion that I'm not doing is niacin.

Medium avatar

(10611)

on December 02, 2012
at 01:54 PM

30 LDL? Seems low. Or do you mean HDL?

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 09:53 AM

To this point, my doctor's only advice has been to eat less saturated fat and less cholesterol - which seems absurd. (Dietary cholesterol haa almost nothing to do with serum choleeterol, and while saturaed can raise LDL, it's supposed to raise HDL, as wel,

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 09:46 AM

Yes to all of that.

197651282ddd8d675b974ee811d2269e

(1836)

on December 02, 2012
at 06:42 AM

Definitely warrants a consult with your doctor, maybe check vitamin and sex hormone levels to see what the cause may be. Please update when you do.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 05:17 AM

I've been exercising, since June. After my last lipid panel, a month ago, I stepped up considerably, and my HDL went down. And I am supplementing D. I tried drinking a glass of red wine everyday, but it stalled my weight loss, so I stopped.

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11 Answers

best answer

1
75d65450b6ff0be7b969fb321f1200ac

(2506)

on December 02, 2012
at 01:12 PM

Gosh, I'd like to know the answer as well. My HDL is typically in the 30s. One time, about 20 years ago, it was 42 but that was when I was doing hard cardio workouts. The last time I checked it was 34, and this was after being on a paleo diet for a few months. (I should add that courtesy of the paleo diet my other cholesterol values, which were always normal, have been lowered by 10-15%).

In my case I don't feel there is a dietary or lifestyle reason for my low HDL; the same might be for you. However unlike you, my HDL value doesn't fluctuate much, and it is not THAT low of a value. In your case I would definitely discuss with situation with a doctor. Taking megadoses of niacin might be warranted if you are deemed at high risk of cardiac disease. (For myself, my doctor just said "exercise more". ... I already workout 7x/week.)

_Lazza

75d65450b6ff0be7b969fb321f1200ac

(2506)

on December 02, 2012
at 11:53 PM

Oops, I meant HDL.

Medium avatar

(10611)

on December 02, 2012
at 01:54 PM

30 LDL? Seems low. Or do you mean HDL?

75d65450b6ff0be7b969fb321f1200ac

(2506)

on December 02, 2012
at 11:56 PM

Corrected my errors. Thanks, thhq.

2
197651282ddd8d675b974ee811d2269e

on December 02, 2012
at 04:29 AM

Exercising will raise your HDL. Doesn't have to be strenuous. You can start by walking at comfortable pace for 30 minutes per day and increase time, distance, and intensity over time, as you become more fit.

197651282ddd8d675b974ee811d2269e

(1836)

on December 02, 2012
at 06:42 AM

Definitely warrants a consult with your doctor, maybe check vitamin and sex hormone levels to see what the cause may be. Please update when you do.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 09:53 AM

To this point, my doctor's only advice has been to eat less saturated fat and less cholesterol - which seems absurd. (Dietary cholesterol haa almost nothing to do with serum choleeterol, and while saturaed can raise LDL, it's supposed to raise HDL, as wel,

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 05:17 AM

I've been exercising, since June. After my last lipid panel, a month ago, I stepped up considerably, and my HDL went down. And I am supplementing D. I tried drinking a glass of red wine everyday, but it stalled my weight loss, so I stopped.

197651282ddd8d675b974ee811d2269e

(1836)

on December 03, 2012
at 05:46 AM

Agreed. My total cholesterol was higher when I was on a vegan diet than when I did the Atkins years ago, according to my medical records. My HDL was a lot higher after I started Atkins and exercising. Haven't done any blood work since going Paleo 3 months ago, waiting for 6 month mark.... I would recommend vitamin D level & testosterone ( if you are a man) and maybe find another doctor.

1
8af1e83ec3ea5a39f050baf362708a78

(253)

on December 31, 2012
at 08:15 PM

Just an update:

Since Dec 1, when my HDL levels tested so low, I've been taking 500mg of niacin twice a day. Not the extended release, not niacinimide or any fancy stuff, just plain niacin.

And yes, I've been getting flushes. But I took a bit of aspirin with it, at first, and it was tolerable, and the intensity of the flushes dropped rapidly after the first few days.

So today, I went for another test, and my HDLs were 47. Putting me in the healthy range for the first time, ever.

So for me at least, this seems to be the answer.

I want to thank everyone for their advice.

0
C141108cb277522fe4ee6ddf9169a338

on May 15, 2013
at 04:19 AM

I got my lipid test 2 dys bfore..my hdl is 29 ..is thz bcoz i take a lipo 6 for a month? Plz tell me if some one have a same problem...m so stress full....

0
2ad6f1f6cbedbd9530fd46db8280beaa

on December 31, 2012
at 08:50 PM

Eat egg yolks and grassfed cow liver. You need to eat more cholesterol. Don't fear cholesterol. Don't eat too much fiber because fiber reduces cholesterol.

8af1e83ec3ea5a39f050baf362708a78

(253)

on January 01, 2013
at 02:11 AM

Everything I've read indicates that there's almost no relationship between dietary cholesterol and serum cholesterol.

0
366c23d69eadce094a2b22299c58a424

(2988)

on December 02, 2012
at 04:18 PM

Pastured butter & coconut oil, along with a "sit less" regimen, brought my HDL up about 20 points.

But have not seen any big relationship with trigs personally, more just that trigs go down as carb intake goes down.

0
1963db946ae415764d9044222fbf4c5b

on December 02, 2012
at 02:41 PM

Have you had your D levels tested? Maybe eat/take more butter/hard cheese/K2?

Coconut oil is supposed to raise HDl, so you could try that.

Otherwise just wait til your weight stabilizes and then work on the HDL.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 06:12 PM

I'm supplementing D3 and K2, and I eat a fair amount of hard cheese. And coconut oil.

0
Medium avatar

(10611)

on December 02, 2012
at 01:51 PM

What has happened to your TC levels? Exercise raised my HDL from 30 to 80, but nothing has changed my TC very much, and year after year it stays 200-230. I theorize that diet has very little to do with the TC, and that exercise shifts the cholesterol particle size larger. I think diet (50% carbs, much of which is high glycemic) combined with exercise may have more to do with improving ability to process carbs. My last TG was 49, and insulin resistance score (LP-IR) was 5.

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 05:07 PM

My TC has been bouncing around between 212 and 257. If things go as they have, I'll be at goal in 4-6 months. I plan on doing an NMR Lipoprofile about three months after that. If statins or other interventions are warranted, I'll decide then, after things have stabilized and I have real data. But in the meantime, I'm wondering what I could be doing, that I'm not already doing, to bring up my HDLs. So far, the only suggestion that I'm not doing is niacin.

Medium avatar

(10611)

on December 02, 2012
at 05:59 PM

I've only had the particle size work done for the last two years, and the insulin resistance score comes from those tests. My theorizing is a result fo having that information. I'd suggest getting them if they're available to you.

0
Af3e3615beba642bcafd0f21d64d74f7

on December 02, 2012
at 07:54 AM

Eating/taking: veggies, fish, fish oils, fats, probiotics, rest between exercises?

8af1e83ec3ea5a39f050baf362708a78

(253)

on December 02, 2012
at 09:46 AM

Yes to all of that.

0
D41bd7b3d3b962eb0146f471eb632f56

on December 02, 2012
at 06:30 AM

I have heard that weight loss will temporarily lower HDL, and that levels may return when weight stabilizes. I don't have a source for this information, though.

0
0faecc3397025eab246241f4dcd81f5e

(2361)

on December 02, 2012
at 04:56 AM

Vitamin D and alcohol also bring up HDL - have you checked your D levels?

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