HDL cholesterol: normal range and what low HDL means

An HDL cholesterol test measures the cholesterol carried by high-density lipoprotein (HDL) particles, which take cholesterol from the rest of the body back to the liver for removal. A low HDL is linked with higher heart risk, which is why it sits in every lipid profile, but raising the number with medicines has not been shown to prevent heart events, so HDL is read as a marker rather than a target.

What HDL cholesterol measures

HDL particles collect cholesterol from other parts of the body and carry it back to the liver, which removes it. Their main protein is apolipoprotein A1 (ApoA1). This return route is why HDL is often called the "good" cholesterol.

The link between low HDL and heart disease is one of the most consistent findings in population studies. Genetic studies, though, have not shown that HDL itself provides the protection, and trials of medicines that raised HDL, some of them more than doubling it, did not reduce heart events beyond what their small effect on ApoB would predict. The 2019 ESC/EAS guideline therefore uses HDL to sharpen a risk estimate and sets no HDL goal.

Normal range

For HDL, higher is usually better up to a point, and the low cut-off differs between men and women.

Reading	mmol/L	mg/dL
Low, men	Below 1.0	Below 40
Low, women	Below 1.2 (NHS) or 1.3 (MedlinePlus)	Below about 46 (NHS) or 50 (MedlinePlus)
Usually read as favourable	About 1.6 or above	60 or above
Extremely high	Above about 2.3	Above about 90

The EAS and EFLM consensus asks labs to flag HDL at 1.0 mmol/L (40 mg/dL) or below, and allows sex-specific cut-points. For people aged 19 or younger, MedlinePlus lists above 45 mg/dL as healthy. Ranges vary by lab and method, and your report's own range is the one to read your result against.

What a low result usually points to

Low HDL usually travels with other metabolic signs. Extra weight, especially around the waist, little physical activity, smoking and diabetes all lower it. The 2019 ESC/EAS guideline describes a cluster of high triglycerides, more ApoB-carrying particles and low HDL in type 2 diabetes and insulin resistance, and notes that raised triglycerides or low HDL are seen in about half of people with type 2 diabetes. Some medicines lower HDL as well, including beta-blockers, anabolic steroids such as testosterone, progestins and benzodiazepines.

A doctor typically reads a low HDL with triglycerides, blood sugar results such as HbA1c, and ApoB, to see whether it is part of that pattern. A very low HDL, below about 0.2 mmol/L (10 mg/dL), is rare and can come from inherited conditions such as LCAT deficiency or Tangier disease; the EAS and EFLM consensus suggests a lipid specialist reviews these.

What a high result usually points to

A high HDL is usually read as favourable. Above about 2.3 mmol/L (90 mg/dL), though, the 2019 ESC/EAS guideline notes that heart risk appears to rise again, so HDL at that level is not used to predict risk. Some very high values are inherited: in CETP deficiency, HDL typically sits at 2.0 to 2.3 mmol/L in people with one copy of the gene change and reaches 5 mmol/L or more in people with two, without a link to artery disease.

What moves it

• Weight. Once weight loss has stabilised, HDL rises by about 0.01 mmol/L (0.4 mg/dL) for every kilogram lost.
• Activity. Aerobic exercise equal to about 25 to 30 km of brisk walking a week may raise HDL by 0.08 to 0.15 mmol/L (3.1 to 6 mg/dL).
• Smoking. Smoking and second-hand smoke lower HDL, and stopping can raise it if weight gain is avoided.
• Diet. Very low fat intakes may reduce HDL, and very high carbohydrate intakes tend to lower it too.
• Menopause and pregnancy. HDL usually falls after menopause, and it rises by about 20% to 40% during pregnancy.
• Medicines. Beta-blockers, anabolic steroids, progestins and benzodiazepines can lower HDL; some statins raise it.
• Your last meal. HDL does not change after an ordinary meal, so fasting makes no difference to it.

Preparing for the test

HDL does not need a fasting sample. In Clare's panel the draw is fasting anyway, because fasting glucose and fasting insulin share it, so follow the fasting instructions you are given, and mention any medicines or a pregnancy to the person taking the sample.

How Clare's panel handles it

In Clare's panel, HDL cholesterol is measured by the lab, and it feeds six of Clare's calculated results. Clare subtracts it from total cholesterol for non-HDL cholesterol and remnant cholesterol, and divides by it for the total cholesterol / HDL ratio, the LDL / HDL ratio and the triglycerides / HDL ratio. The atherogenic index of plasma is the base-ten logarithm of triglycerides divided by HDL, both in mmol/L: AIP = log10(TG/HDL).

Why it matters in the UAE

Low HDL was common in the UAE National Diabetes and Lifestyle Study: 42.5% of 824 Emirati adults in the Northern Emirates had HDL below 1.0 mmol/L (men) or 1.3 mmol/L (women), on fasting samples taken in 2012 and 2013. Diabetes and weight carried around the waist were both linked with low HDL. The study covered Emirati nationals, not the whole population.

Price

HDL cholesterol is usually sold within a lipid profile test. When we read public prices on 11 October 2026, a lipid profile cost from 89 to 199 at six UAE providers. VAT was rarely stated, and some prices included a home visit while one provider added a collection fee on smaller orders.

Related tests

Apolipoprotein A1 (ApoA1) counts the HDL particles rather than their cholesterol. Triglycerides belong in the same glance, since high triglycerides and low HDL often appear together, and the Total Cholesterol / HDL Ratio weighs HDL against everything else. For the blood sugar side of that picture, see HbA1c, glucose and insulin: reading them together.

Why the number means more over time

Because HDL tracks weight, activity and smoking, the direction across several tests says more than one low reading. Repeat testing follows the usual lipid schedule: MedlinePlus suggests adults are tested every 5 years from age 20 and more often from middle age, and NICE recommends a repeat 2 to 3 months after starting or changing lipid-lowering treatment. Clare is opening with a waitlist at clare.health.