I have gone to my heart doctor and had my cholesterol checked and my
overall cholesterol is good,it is 136 and my LDL is 96(bad cholesterol), but my
(good cholesterol) HDL is only 13.  The first time I had it checked in
2005 my HDL was 20 and my doctor put me on niacin 500mg, and then 6
months later I had it checked again and my HDL was 16, so he increased
my niacin to 1000mg, and now six months later my HDL is 13.  My doctor
said he has never seen HDL so low in a person, I am only 41.  I am
really getting worried and I don't fully understand why this is
happening and what to do about it?

Hi!!


Your condition has a name:
Hypoalphalipoproteinemia: 
"A low HDL cholesterol level is often inherited. Obesity, physical
inactivity, cigarette smoking, diabetes, or kidney disorders (such as
nephrotic syndrome) may contribute to a low HDL cholesterol level.
Drugs such as beta-blockers and anabolic steroids can lower the HDL
cholesterol level. Having a low HDL cholesterol level increases the
risk of atherosclerosis (see Atherosclerosis). Therefore, lifestyle
changes to eliminate conditions that lower the HDL cholesterol level
are advised when applicable: losing weight, increasing physical
activity, and stopping smoking. Some lipid-lowering drugs increase the
HDL cholesterol level and may be used in people who also have high LDL
cholesterol or triglyceride levels."
From "Hypolipoproteinemia: Cholesterol Disorders: Merck Manual Home Edition":
http://www.merck.com/mmhe/sec12/ch157/ch157c.html


According to other reputed sources it also increases the risk of
coronary heart disease (CHD).

Read the following articles for further information:
"Patient Information - Familial Hypoalphalipoproteinemia":
http://www.lipid.org/clinical/patients/1000003.php
 
"eMedicine - Low HDL Cholesterol (Hypoalphalipoproteinemia)": 
Article by Vibhuti N Singh, MD, MPH, FACC, FSCAI (I strongly suggest
you to read this one and discuss your finds with your dosctor).
http://www.emedicine.com/med/topic3368.htm

"How to increase your HDL levels":
http://heartdisease.about.com/cs/cholesterol/a/raiseHDL.htm


The following keywords will give you a plethora of pages where you can
find more info:
"Low HDL cholesterol"
hypoalphalipoproteinemia


I hope this helps you. 

Regards,
livioflores-ga

I have heard that some new research (in the US) claims that the
absolute levels of Good v Bad are not as important as previously
thought.

Instead, it's the ratio of Good to Bad that really matters.

I haven't got a citation, yet ... but when I do I will share it with you ...

Unless, of course, someone beats me to it.

All the Best

Bryan

Sorry to be so long in giving you the latest thinking on Cholesterol.

It's all in The Framingham Papers.

Here's one summary:

http://www.avoidheartattack.com/755280.html

Makes you think?