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HDL Cholesterol Level Chart: Symptoms and Causes
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HDL Cholesterol: 23 – Causes and Symptoms
HDL Cholesterol Level Chart: Symptoms and Causes

HDL Cholesterol: 23 – Causes and Symptoms

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Written by Edibel Quintero, RD | Medically reviewed by Medically reviewed by Rosmy Barrios, MD check
Published on May 26, 2023
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6 min

Regularly measuring your cholesterol levels is important for protecting the heart. Low HDL cholesterol could cause health complications, so what does a reading of 23mg/dL imply? Learn more about the causes and symptoms of this measurement.

What Does an HDL 23mg/dL Mean?

An HDL cholesterol reading of 23mg/dL is low and may be dangerous for your health. 

Not having enough high-density lipoprotein in the body can increase the risk of heart disease1, diabetes, and metabolic syndrome. You need more HDL cholesterol to move low-density lipoprotein from the blood and transport it to your liver for waste disposal.

People won’t show any symptoms of low HDL cholesterol. This is why it’s important to take a blood test regularly to measure your good and bad triglyceride levels. 

HDL cholesterol levelsmg/dL
Low❌<60
Optimal  ✅61–99 
High ✅100<

How Often Is It Recommended to Measure HDL Cholesterol Levels?

Getting a blood test called a lipid panel, or lipid profile, ensures you’re taking the right steps to improve your long-term health. People with a family history of low HDL levels need to get their blood cholesterol checked more often, which is usually a few times every 12 months.

Most healthy adults only need a test every 4–6 years2. The National Heart, Lung, and Blood Institute (NHLBI) recommends people aged 45–65 get tested every 1–2 years, while those 65 and higher can commit to annual tests when managing their heart health. 

To stay on track with your HDL levels, consider getting the Cardi Health app. You can document any heart-related progress to understand the benefits of dieting and exercise. It’s a great app to track vital symptoms that might need further medical attention from a professional. 

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Cardi Health is about storing heart health information like heart rate, blood pressure, medication, and cholesterol levels, including HDL. Keeping tabs on any changes will help doctors understand your condition. Constant monitoring is key to preventing heart disease and type 2 diabetes. 

What Causes Low HDL Cholesterol?

There are several factors that can change your HDL levels. Smoking, eating sugary food, not getting enough exercise, and managing diabetes poorly are just a few factors. To balance HDL levels and increase 23mg/dL, try to make some changes regarding the below points.

  • Smoking: Cigarette smoking stops HDL cholesterol3 from transporting LDL cholesterol out of your blood and into the liver. This will increase bad triglyceride levels, which promotes coronary artery disease, stroke, and peripheral polyneuropathy. 
  • Diet: A diet high in saturated fats4, sugar, refined carbs, and trans fats will lower HDL levels. Bad fats increase LDL cholesterol due to significant metabolic changes. Gaining weight from a high-fat diet will further disrupt your HDL levels.
  • Weight: Retaining excess fat around the waist can contribute to low HDL cholesterol levels. Visceral fat, which wraps around important organs, influences blood lipids5. In time, LDL cholesterol will rise while your HDL level struggles to stay afloat. 
  • Diabetes: People with diabetes usually have more LDL cholesterol6 due to the changes in their triglyceride levels. Studies have shown that not managing diabetes properly can severely lower HDL levels and increase the risk of heart attack or stroke.
  • Medication: Certain medications like beta-blockers, anabolic steroids, birth control pills, hormone therapy, and benzodiazepines can negatively impact your blood cholesterol. If this is the case, you should consult your doctor about alternative treatments.
  • Genetics: There might be family members who have a low HDL level. Sometimes, this can be genetic, which causes those unbalanced triglyceride levels. Genetics can’t always control your HDL level, so it’s worth consulting your doctor about treatment.

Symptoms of Low Cholesterol

Not all the symptoms of low HDL cholesterol are easily recognizable. This is another reason why you should measure mg/dL regularly to ensure you’re healthy. However, due to unbalanced blood cholesterol affecting the heart, you might experience various symptoms in your body.

Some of these symptoms might be:

  • Chest pain 
  • Shortness of breath
  • Mental confusion 
  • Severe sweating 
  • Chest tightness 
  • Heart palpitations
  • Chronic fatigue

Remember that these symptoms could be a sign of a heart attack. The lack of HDL cholesterol means your body cannot remove plaque buildup efficiently. More plaque will restrict blood flow in the arteries and induce a sudden heart attack, so seek immediate medical attention if you are experiencing anything unusual.

How to Increase the Amount of HDL Cholesterol

Lower HDL cholesterol can be alarming and dangerous. It’s very important that you take precautionary steps when managing triglyceride levels. Of course, testing mg/dL levels is the first step, but the rest is about making healthy lifestyle changes and habits. 

Here are four ways you can increase HDL cholesterol:

#1 Get enough exercise

Getting enough exercise can boost enzymes7 that improve the cholesterol transportation process. This means that HDL levels increase once low-density lipoprotein has shrunk. Running, walking, swimming, and cycling are all great exercises for raising your HDL levels.

It’s recommended that adults get at least 30 minutes of exercise8 a day. Regular physical activity is especially important if you want to lose weight. You don’t need strenuous workouts to balance out HDL levels, so try to go for a simple walk in the morning or afternoon. 

#2 Drink more water

Water should be an essential part of anyone’s balanced diet. Adequate hydration can stop you from developing heart disease while balancing HDL levels9. On the other hand, not getting enough water could give LDL cholesterol a chance to thrive in your blood vessels.

The daily water intake10 is 9 cups for women and 12 cups for men. Some more benefits11 of high hydration levels include better brain function, improved energy, stronger digestive health, and smooth skin. If you want those LDL levels to stay low, achieve your water intake every day.

#3 Reduce bad habits like smoking

Smoking is known to lower your HDL cholesterol level over time. This is what causes that low mg/dL reading on your test. Cigarettes also reduce lecithin-cholesterol acyltransferase12 –  an important enzyme that expands HDL cholesterol and helps it to transport waste disposal.

Alongside smoking, try to cut out other bad habits that may decrease the mg/dL reading. This will dramatically improve your long-term health. Some of these habits might be eating packaged snacks, frying your food, drinking too much alcohol on nights out, or going to bed late. 

#4 Eat a clean diet

Your body needs nutrient-dense foods to function properly. A clean diet is a key to preventing high LDL levels in the long term. On a balanced diet, it’s important to eat foods like whole grains, leafy green vegetables, whole fruits, fiber-rich nuts, legumes, seeds, and lean poultry. 

To raise your HDL mg/dL reading, take the time to build a healthy diet plan. Avoid products containing saturated fat, added sugar, and refined grains. These are all common ingredients that put you at a higher risk of hypertension, diabetes, and heart attack or stroke.

Other ways to increase HDL cholesterol include: 

  • Consuming olive oil
  • Avoiding fried foods
  • Following a low-carb diet
  • Taking omega-3 supplements
What may happen if my HDL cholesterol levels are low?

You will have an increased risk of developing heart disease if your HDL levels aren’t right. Clogged arteries is another dangerous symptom, so always make sure to test your HDL level regularly and avoid foods with saturated fats, trans fats, preservatives, and added sugars.

What foods should I eat if my HDL cholesterol levels are at 23mg/dL?

Some great foods that lower LDL cholesterol and increase HDL include apples, pears, salmon, mackerel, flax seeds, avocado, kidney beans, lentils, brown rice, olive oil, and almonds. Most of these contain dietary fiber and omega-3 fatty acids, which are both crucial to increasing your HDL level.

References
  1. K. Mahdy Ali,  A. Wonnerth, K. Huber, and J. Wojta. (2012). Cardiovascular disease risk reduction by raising HDL cholesterol – current therapies and future opportunities. National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504986/
  2. Mayo Clinic Staff. (2021). An overview: cholesterol test. Mayo Clinic: http://mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
  3. Bai-mei He, Shui-ping Zhao, Zhen-yu Peng. (2013). Effects of cigarette smoking on HDL quantity and function: implications for atherosclerosis. Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1002/jcb.24581 
  4. Sally Chiu, Paul T. Williams, and Ronald M. Krauss. (2017). Effects of a very high saturated fat diet on LDL particles in adults with atherogenic dyslipidemia: A randomized controlled trial. Journal. ‘Plos One’: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0170664 
  5. Michel R Hoenig, corresponding author Gary Cowin, Raymond Buckley, Christine McHenery, and Allan Coulthard. (2011). Low-density lipoprotein cholesterol is inversely correlated with abdominal visceral fat area: a magnetic resonance imaging study. Research. Lipids in Health and Disease: https://lipidworld.biomedcentral.com/articles/10.1186/1476-511X-10-12 
  6. Dan Farbstein and Andrew P Levy. (2012). HDL dysfunction in diabetes: causes and possible treatments. A review. Taylor Francis Online: https://www.tandfonline.com/doi/full/10.1586/erc.11.182 
  7. Jonathan J. Ruiz-Ramie, Jacob L. Barber, and Mark A. Sarzynski. (2019). Effects of exercise on HDL functionality. National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492243/
  8. Edward R. Laskowski, M.D. (2021). How much should the average adult exercise every day? Expert answer by Mayo Clinic: https://www.mayoclinic.org/healthy-lifestyle/fitness/expert-answers/exercise/faq-20057916#
  9. Guohua Song, Min Li, Hui Sang, Liying Zhang, Xiuhong Li, Shutong Yao, Yang Yu, Chuanlong Zong, Yazhuo Xue, and Shucun. Qin. (2013). Hydrogen-rich water decreases serum LDL-cholesterol levels and improves HDL function in patients with potential metabolic syndrome. A research. Journal of Lipid Research: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679390/
  10. Arend-Jan Meinders, Arend E Meinders. (2010). How much water do we really need to drink? National Center for Biotechnology Information: https://pubmed.ncbi.nlm.nih.gov/20356431/
  11. Get the Facts: Data and Research on Water Consumption. (2022). Centers of Disease Control and Prevention: https://www.cdc.gov/nutrition/data-statistics/plain-water-the-healthier-choice.html
  12. Adam D. Gepner, MD, Megan E. Piper, PhD, Heather M. Johnson, MD, Michael C. Fiore, MD, MPH, Timothy B. Baker, PhD, and James H. Stein, MD. (2010). Effects of Smoking and Smoking Cessation on Lipids and Lipoproteins: Outcomes from a Randomized Clinical Trial. A clinical investigation. ScienceDirect: https://www.sciencedirect.com/science/article/abs/pii/S0002870310008926?via%3Dihub
HR_author_photo_Edibel
Written by
Edibel Quintero is a medical doctor who graduated in 2013 from the University of Zulia and has been working in her profession since then. She specializes in obesity and nutrition, physical rehabilitation, sports massage and post-operative rehabilitation. Edibel’s goal is to help people live healthier lives by educating them about food, exercise, mental wellness and other lifestyle choices that can improve their quality of life.
Medically reviewed by Rosmy Barrios, MD
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