HDL Cholesterol: What Your “Good Cholesterol” Result Means

HDL (high-density lipoprotein) is the particle that picks up excess cholesterol from tissue and blood vessel walls and returns it to the liver for disposal. That reverse transport is why it is often called the “good” cholesterol.

Your lab reports HDL as milligrams of cholesterol carried by HDL particles per deciliter of blood, usually as part of a lipid panel alongside total cholesterol, LDL, and triglycerides.

Low HDL is one of the strongest lipid-panel signals of increased cardiovascular risk, and it often travels with high triglycerides, extra abdominal weight, and insulin resistance.

Very high HDL is not automatically protective. Above roughly 90 mg/dL the relationship with heart risk flattens and, in some studies, reverses, so unusually high readings deserve a conversation rather than celebration.

HDL is made by your body, not eaten. Levels tend to rise with regular aerobic exercise, unsaturated fats from olive oil, nuts, avocado and fatty fish, and moderating refined carbohydrate intake.

Physical activity, smoking, body weight, insulin resistance, thyroid function, genetics, alcohol intake, and some medications (including anabolic steroids and certain beta blockers) all shift HDL.