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HDL Cholesterol

Lipids

Good cholesterolHDL-CHigh-density lipoprotein cholesterol

Review status

Currently under review

Pending specialist review and validation.

What it shows

HDL Cholesterol measures the cholesterol carried by high-density lipoproteins in your blood. These particles help transport cholesterol away from arteries to the liver for processing and removal, so they are often called good cholesterol. The test is performed on a blood sample and is frequently included as part of a lipid panel.

HDL levels reflect a mix of particle number and function, which can vary with genetics, age, sex hormones, and lifestyle. Your clinician may ask for this test with or without fasting depending on the full lipid workup, but HDL itself usually changes little with a routine meal.

Why it matters

HDL is one part of your overall cardiovascular risk profile. Lower HDL is linked with a higher likelihood of plaque buildup in the arteries, while very high values are not always protective and can have complex causes. Clinicians use HDL alongside LDL cholesterol, triglycerides, blood pressure, smoking status, diabetes, kidney function, and family history to estimate long-term risk of heart attack and stroke.

This test is ordered during routine checkups, when you have risk factors, or to monitor lifestyle changes and lipid-lowering therapy. If HDL is outside the expected range, your clinician may look for contributing conditions such as thyroid, liver, or kidney disease, inflammatory disorders, or medication effects.

Understanding your results

HDL results are interpreted in the context of your overall health and other lipid measurements. One result is less important than the pattern over time and how it aligns with your personal risk factors. Being outside the reference interval does not by itself diagnose heart disease.

If HDL is lower than expected, plans often emphasize lifestyle measures that support healthy lipids and blood vessels, including regular aerobic activity, nutrition quality, weight management, and not smoking. Medicines that specifically raise HDL have not consistently improved outcomes, so treatment usually focuses on lowering LDL and reducing overall cardiovascular risk. If HDL is unexpectedly high, your clinician may consider alcohol use, medications, or uncommon genetic conditions.

You may be asked to repeat the test or check additional markers if results do not match your clinical picture. Discuss your numbers with your clinician so you can decide together on the next steps.

Reference ranges

0.4 – 1.1 mmol/L
Female
0 days – 15 days
0.4 – 1.1 mmol/L
Male
0 days – 15 days
0.3 – 1.9 mmol/L
Female
15 days – 1 year
0.3 – 1.9 mmol/L
Male
15 days – 1 year
0.9 – 1.7 mmol/L
Female
1 year – 4 years
0.9 – 1.7 mmol/L
Male
1 year – 4 years
1 – 1.9 mmol/L
Female
4 years – 13 years
1 – 1.9 mmol/L
Male
4 years – 13 years
0.9 – 1.9 mmol/L
Female
13 years – 18 years
0.8 – 1.8 mmol/L
Male
13 years – 18 years
0.9 – 2 mmol/L
Female
18 years – 30 years
0.9 – 1.6 mmol/L
Male
18 years – 30 years
0.9 – 2.2 mmol/L
Female
30 years – 50 years
0.9 – 1.8 mmol/L
Male
30 years – 50 years
0.9 – 2.4 mmol/L
Female
50 years – 150 years
0.9 – 2 mmol/L
Male
50 years – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact HDL Cholesterol

  • Fasting, timing, and recent activity

    HDL is relatively stable without fasting, but full lipid panels may still be scheduled fasting. Strenuous exercise just before the draw or acute illness can transiently shift results.

  • Medications and supplements

    Statins, fibrates, niacin, estrogen therapy, anabolic steroids, certain beta blockers, diuretics, SGLT2 inhibitors, and fish oil can change HDL. Always share your medication list with the lab and clinician.

  • Smoking and physical activity

    Cigarette smoking tends to lower HDL, while regular aerobic exercise and improved fitness can raise it over time. Even small, consistent activity changes can make a difference.

  • Weight and diet pattern

    Weight loss, replacing refined carbohydrates with whole foods, and choosing unsaturated fats can support healthier HDL. Very low calorie or unbalanced diets may give misleading short-term results.

  • Alcohol intake

    Moderate intake can raise HDL in some people, but heavy drinking harms the heart and liver and may impair HDL function. Do not start or increase alcohol for HDL without medical advice.

  • Hormones, pregnancy, and menopause

    Sex hormones influence HDL. Levels can change during pregnancy and after menopause. Hormonal therapies, including contraception, may also affect results.

  • Thyroid, liver, kidney, and inflammation

    Low thyroid function, chronic liver or kidney disease, and inflammatory states can lower HDL or alter its function. Treating the underlying condition often improves the lipid profile.

  • Genetics and family history

    Inherited conditions can lead to unusually low or high HDL. Family patterns of early heart disease may prompt more detailed lipid and risk assessment.

2026

References

  1. McGill University Health Centre. (2015, June 18). HDL Cholesterol (Task CD 316598). Laboratory reference ranges.
  2. Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol. Circulation, 139(25), e1082–e1143. External link
  3. Centers for Disease Control and Prevention. (2023). HDL cholesterol: The good kind. External link