Question:

My lipid profile is very normal S Cholestrol 115 Trigliceride 88 LDL 81 VLDL 21, but my HDL is only 28. I heard that Tricor Fenofibrate helps to increase HDL. I need your guidance.

Answer:

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Cholesterol and triglycerides are essential substrates for cell membrane function and hormone development and they provide the body with a source of free fatty acids needed for the body to function properly. Hyperlipidemia is defined as an elevation of one or more of cholesterol, cholesterol esters, phospholipids, or triglycerides. There is a link between high LDL (low-density lipoprotein) and low HDL (high density lipoproteins) to the development of coronary heart disease (CHD). The role of HDL is to transport cholesterol from the cells of the body to the liver. The desired level of HDL is for =50mg/dl. For every 1mg/dl decline of HDL, CHD risk increases by 2-3%. The other major risk factors that increase the risk outside of LDL cholesterol being too high are cigarette smoking, hypertension (BP 140/90 or on a hypertensive medication), Family history of premature CHD (CHD in male first degree relative <55 years; CHD in female first degree relative <65 years), and Age (men >45 years; women >55 years).

A low HDL is also a component of metabolic syndrome. The first steps in elevating a low HDL are diet and exercise. A diet that is low in carbohydrates and high in protein is encouraged and the inclusion of the cold water fish (e.g. salmon) rich in polyunsaturated fats may help to raise HDL cholesterol. A person that is obese may elevate HDL by decreasing body mass index.  If you smoke or consume alcohol this may also decrease your HDL, cessation of these activities can raise your HDL.

If none of these efforts have success in raising your HDL, your prescriber may decide to use a medication to elevate the HDL. There are a few classes of medications in which HDL is slightly raised. HMG-CoA reductase inhibitors (statins) and fibrates modestly raise HDL levels. Tricor® (fenofibrate) is a fibrate which acts as a lipid regulating agent. It can reduce LDL cholesterol, triglyceride, VLDL cholesterol, and has shown to increase HDL. Niacin is another medication that may be used to elevate HDL. Niacin is the most effective agent that is available to elevate HDL.

On this site, we try to answer general questions about cholesterol and health but cannot diagnose or recommend treatment. You appear to have some very, very specific questions about your HDL and your ability to elevate this value, which can only be answered properly by a physician who is familiar with your medical history, physical exam, and test results. Your questions about the testing results you have been given or the risks, benefits, and alternatives for proposed treatments of this condition need to be directed to your treating physician(s). You should insist that they answer these questions in a way that you are able to understand before consenting to any treatment.

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