Saturday, November 01, 2014
Friday, August 28, 2009 mizzemm, Community Member, asks

Q: Can high HDL account for high total cholesterol?

I am a 33 year old vegetarian who has always had low cholesterol. I do not eat red meat or high saturated fat foods, fast food, junk food, etc. I am relatively active and in shape - I live in NYC and walk a lot. My weight is about 125 at 5'7". However, my last cholesterol reading was 208. The doctor said they could do it over because I had eaten that day and she was sure it was probably a false result. She did not give me the break down of HDL to LDL, but in the past I have always had high HDL and low LDL. Is there any possibility that my HDL might be so high that it is causing my overall cholesterol to be high? And if so, should my overall cholesterol still be under 200? I do eat a lot of cheese, avocado and hummus and I use sugar in my coffee and occassionally butter  - those are the only foods I can think of that might be responsible for raising my cholesterol.  Any help would be appreciated. Thanks.

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Answers (3)
8/28/09 5:02pm

Hi Mizzemm,

 

The formula to calculate total cholesterol is:

 

Total cholesterol = HDL + LDL + Triglycerides

 

So, yes, a high HDL can cause your total cholesterol to be elevated.  It's best to base treatment decisions on cholesterol components (HDL, LDL, and triglycerides) versus total cholesterol.  Also, it's even better to go a step further and have a comprehensive lipid profile.  This provides information on particle size, which is even more beneficial to determine if you are at risk or not.

 

All the best,

Lisa Nelson RD

How to Lower Cholesterol in 8 Simple Steps

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mizzemm, Community Member
8/28/09 5:12pm

Thanks Lisa - I know, I do need to get the breakdown, but I've heard that no matter what, cholesterol should generally be under 200. There don't seem to be many instances of people with cholesterol over 200 where it's due to HDL as far as I can find. So I was curious as to whether it's common or possible that 208 can be a healthy number. Thanks again.   

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mizzemm, Community Member
9/ 3/09 1:08am

Hi Lisa - I just had a physical today and got the breakdown of my cholesterol results: 209 total - HDL 93, LDL 101, which I guess means triglycerides were 15? He didn't point those out and I forgot to ask. I also got my bloodwork done again, since last time I had eaten and I was told that could produce false results. I'm still confused though. Assuming these are accurate results, should I be changing my diet in any way? I'm a vegetarian and eat a lot of cheese because I tend to use it as my only protein/ fat...I would be very sad if I had to cut back, as I am in love with cheese. But I don't want my levels to keep rising as I get older! My father is on medication for HBP and my mother's levels are high. However, I have a very different diet and lifestyle than they do. The doctor suggested cutting back on cheese, but also said that the slightly high LDL is essentially canceled out by the very high HDL...so do I have to beware of cheese or not?! Thanks for your help....

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RachMD, Community Member
1/ 2/11 7:31pm

Hi I just saw this, this is a little late, but quick correction: Total cholesterol = HDL + LDL + TG/5   ; so her cholesterol is actually 75 not 15.

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HH, Community Member
4/ 9/12 7:32pm

Lisa--I'm curious about the same thing but I have more information about my cholesterol than it appears Mizzemm does. My Total Cholesterol is 224, putting me in the "borderline high" category." But here's the kicker; my HDL is 96, so my TC/HDL Ratio is beyond good--it's VERY low. Triglycerides are below 45.  So, should I be worried?  I can't get a straight answer; my primary care doc doesn't seem worried but every other physician I've ever mentioned this to goes through the roof and tells me that at my age (62) I should consider going on medication to lower my cholesterol.  I'm normal weight (5'9"/155 lbs.), very physically active and have low RHR (52), BP of 118/68 and so on.  The idea of medication is simply abhorrent to me--but if it really is called for, I'd do it.

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4/ 9/12 9:38pm

Hi HH,

 

The following post addresses this issue:

 

Can My HDL Be Too High?

 

There are "good" and "bad" forms of HDL cholesterol, even though it's mostly considered to be good if HDL levels are high. However, if your HDL particle size is the unhealthy version then it may still be cause for concern. I recommend discussing a comprehensive lipid panel with your to look at your particle sizes and ensure the HDL particles are healthy.  This will also allow you to access the LDL particles as well. As long as all particles are healthy, then a total cholesterol of 224 would not be of great concern.

 

All the best,

Lisa Nelson RD

How to Lower Cholesterol in 8 Simple Steps

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HH, Community Member
4/ 9/12 9:48pm

Thanks so much for the prompt reply.  I will go ahead and get the comprehensive panel, as you suggest. (Because I have a high deductible insurance policy, it's not going to matter whether my primary care physician recommends it or not, but I certainly will ask him!) I've been thinking about it for some time, and this is the push I needed. 

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Karenf, Community Member
7/16/13 6:14pm

I also found that the formula to calculate total cholesterol is:  

Total cholesterol = HDL + LDL + Triglycerides/5

 

my Cholesterol results this week correlate to this total cholesterol formula:

 

TOTAL 274, HDL 132, LDL 122, TRIG 101

132 + 122 + (101/5) = 274


emphasis - formula includes 20% of your triglyceride count (mg/dL); not the full amount given with lab results.

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Karenf, Community Member
7/16/13 6:15pm

I also found that the formula to calculate total cholesterol is:  

Total cholesterol = HDL + LDL + Triglycerides/5

 

my Cholesterol results this week correlate to this total cholesterol formula:

 

TOTAL 274, HDL 132, LDL 122, TRIG 101

132 + 122 + (101/5) = 274


emphasis - formula includes 20% of your triglyceride count (mg/dL); not the full amount given with lab results.

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veggiemak, Community Member
9/30/09 10:51pm

I am a 32 yo vegetarian who also maintains a relatively healthy diet, exercise routine and weight. My cholesteral just came in at 202. I don't know the exact breakdown, but my Dr. said my bad cholesterol is "low" and my good cholesterol is "very high", so my total number is actually a good thing, although 202 sounds high overall.  I eat quite a lot of soy products, so I wonder if that is why my HDL levels are where they are.

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Karenf, Community Member
7/16/13 6:18pm

you may want to review this article from the MAYO clinic.  I found it helpful.

 

http://www.mayoclinic.com/health/cholesterol-levels/CL00001

 

 

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Kaseydc, Community Member
4/23/12 5:04pm

A reading of a total cholesterol only gives you a small picture of what is going on.  You really need to know what your HDL and LDL are.  Triglycerides are NOT part of total cholesterol. That is incorrect.  Yes, a very high HDL can contribute to a high total cholesterol.  

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Pitcher23, Community Member
8/ 7/12 1:23pm

Triglycerides are most certainly part of total cholesterol. Your total cholesterol is HDL + LDL + 1/5 of total Tryglicerides.

 

You can find a calculator here: http://www.hughchou.org/calc/chol.php

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By mizzemm, Community Member— Last Modified: 05/21/14, First Published: 08/28/09