Q: I had blood tests done recently. My LDL cholesterol is normal, my triglycerides are normal, but my HDL cholesterol is abnormally low. Is there anything I can do to improve my HDL?
A: Some people have a genetic tendency for low HDL, even when all their other cardiovascular risk factors are normal. Although this might seem harmless, it can throw off your cholesterol ratio and may indicate a future risk of heart problems.One of the simplest and most effective ways to boost HDL is through exercise. I recommend you engage in at least 30 minutes of physical activity most, if not all, days of the week. Also follow the diet and lifestyle recommendations in Using Food to Lower Your Cholesterol. These steps will help ensure that your blood vessels stay as healthy as possible.
In addition, I recommend taking low dosages of omega-3 fatty acids (see 4 Supplements to Consider). You may also want to consider adding extended-release formulations of niacin (such as Niaspan, which is available only by prescription) to your regimen. Extended-release niacin has been shown to raise HDL cholesterol by up to 35 percent. In addition, niacin can help lower triglycerides and LDL cholesterol.
It is important to talk with your doctor before beginning niacin treatment. Although niacin is a powerful treatment for boosting HDL cholesterol, it can be dangerous for people with diabetes, gallbladder disease, gout, glaucoma, peptic ulcer, or impaired liver function, or who are pregnant or have had a recent heart attack. In addition, niacin can interact with other medications, and it may cause some uncomfortable side effects, including flu-like symptoms, rash, and flushing so intense that it can temporarily leave you looking sunburned (and, if you’re a woman, you may think you’re having hot flashes!). Because the side effects can be serious and need to be monitored by a physician, you should not take over-the-counter niacin supplements to treat cholesterol on your own.
Prescription niacin comes in many forms and doses and is sometimes combined with other cholesterol-lowering medications; your doctor will decide which formulation is best suited for you.