How Do I Raise My HDL?
MY HDL cholesterol is 50 and I was told to bring it up. How do I do this? I was told to drink 4 ounces of red wine at night. How else can I increase my HDL? Susie Cranor
Robert Gabbay, MD, PhD, responds: You bring up a very important question for people with diabetes—the role of cholesterol in reducing the risk for cardiovascular disease. HDL (the "good" cholesterol) can help lower your risk of heart disease, but it is often difficult to increase HDL levels on your own. One way to do it is through exercise. Red wine also seems to have some beneficial effect on HDL levels, but physicians generally do not ask people to go out and start drinking wine if they are not already doing so (extra calories being one of the downsides). Medications can sometimes be helpful as well—the "fibrates" (fenofibrate and gemfibrozil) and niacin all can increase HDL cholesterol, particularly when triglyceride levels are high. Most important, controlling your blood glucose and lowering your A1C (an estimate of average blood glucose over the past two to three months) can also raise your HDL and lower your triglycerides—one more reason to strive for good blood glucose control.
Finally, we should not forget how important LDL (the "bad" cholesterol) is in determining cardiovascular risk. Statins like Lipitor, Zocor, and Vitorin are very effective in lowering LDL cholesterol. The goal for LDL cholesterol is usually less than 100 mg/dl, but if you already have heart disease, LDL of less than 70 is probably best.