Ask the Doctor: Can HDL (good) cholesterol be too high?

A. For high-density lipoprotein (HDL) levels, it does appear that the higher, the better—at least to a point. But you should also think about how you achieve that level. HDL is known as the "good" cholesterol particle because it functions to clear cholesterol from the arteries and deliver it back to the liver. Higher HDL levels are associated with a lower risk of heart disease. HDL levels lower than 40 milligrams per deciliter (mg/dL) are considered worrisome, and levels higher than 60 mg/dL are considered excellent.

One recent study that examined high levels of HDL reported the benefits extended until 90 mg/dL in men, but then leveled off, which suggests no further benefit even with higher levels. A man's HDL level is predominantly determined by genetics, or inherited factors. Moderate-intensity exercise, three to four times a week, is an important mechanism to raise HDL with the bonus of other health benefits. Other methods to raise HDL are not so healthy. For instance, medications or supplements, like niacin, have shown disappointing results in controlled studies. Alcohol intake is known to increase HDL, but consuming more than two standard drinks a day can raise your risk of high blood pressure, heart attack, and stroke.

--William Kormos, MD
Editor in Chief, Harvard Men's Health Watch