Well, I'm not certain what the great concern would be with regard to your cholesterol. Many folks would give their right arm to have values such as yours. If we're speaking strictly from a technical standpoint, the value of perferable HDL for women is much higher, but you have to realize that these tables are based upon ideal conditions. Based upon the standard criteria, it is desirable for women to have an HDL/LDL ratio of 3.3 or less. So taking your values, we see the following:

109/31 = 3.5

So you would only need to raise you HDL by 3 points to be within the appropriate range:

109/34 = 3.2

So although some practitioners strive for the highest HDL levels possible in order to achieve the greatest protective factors, this target can be very unrealistic for many folks. Unfortunately, your genetic predisposition is the greatest single factor relative to how your body deals with cholesterol, but there are a couple of factors that can drive the levels out of the safety range and I'll mention those in just a minute. Many people will try and make sometimes drastic changes in diet in order to try and achieve the target goal, but realize that diet can influence cholesterol levels about 4% or so at the very most due to the hereditary factors mentioned.

There are many ways to raise HDL and exercise is a good start. A sensible diet that is high in monounsaturated fats and absent trans fats altogether is another good step. You can read about all sorts of dietary products that have been shown to raise HDL, but I would caution you not to go overboard, since the consequences typically produce GI upset or indigestion.

Also, I don't know if you mentioned whether you smoke or not, but smoking has been demonstrated to significantly decrease HDL, which is one of the reasons smoking can lead to heart disease. This is always an irony for folks who smoke because any changes to diet are easily overcome by the effects of smoking to lower HDL.

Other than that, your levels are nothing to be concerned about and I would take modest steps to raise your HDL to within the desired range and if you smoke, then I would strongly urge you to stop.

Best regards and Good Health

Okay, well I certainly won't comment further on the aspect of smoking beyond this response, but I'm never dismayed by the fact that people who are confronted on their habit always respond as though someone has just trespassed into their personal domain, suggesting that their vice is one dissociated from the topic of healthcare. I've never been one to bandy words and I certainly won't refrain here; smoking does more to increase your health risks than any other concern you've shared on the forum. Your defense that it's a great stress reliever is something known as personal fable; it means that people gladly risk long-term health risks for short-term benefits. My young friend, I've been practicing medicine way too long for someone to steer me clear of health issues that they feel are none of my business. You want advice on this forum, you'll get it all, not just what's preferential.

I must tell you also that I've seen just about everything from a medical standpoint in my life, but one of the most striking examples of nicotine addiction and dependence appears in the oncology ward at the hospital system. As a young medical student in my 1st year of clinical rotations, I was casually striding along on my way to the hospital cafeteria, occasionally twirling my stethoscope, when I looked to my left and observed a group of patients standing outside under the patio roof, all smoking cigarettes. My stethoscope suddenly left my grip and went careening down the hallway and I stood frozen in disbelief.

These patients had all undergone various forms of resection from throat cancer and were sharing cigarettes. The stunning factor, however, was that because a tracheotmy was necessary as part of the surgery, they were placing the cigarettes into the tracheotomy to draw on them. I instantly knew that there was nothing elective about smoking for these patients. Only someone addicted could overlook the tragedy of such surgery for the opportunity to continue smoking.

So my final response on the aspect of smoking cigarettes is one that I'll make extremely clear, just as I do with any other topic on the forum; Every cigarette smoker I've encountered as a patient always states that they'll quit when they're ready and that it offers them some type of benefit.

For people who seem so fearful of their health, I'm amazed that they believe themselves ironically impervious to the risks of tobacco products. As a physician, I can tell you with all confidence that your health is at no greater point of risk than while smoking cigarettes.

If you're so afraid that there's something wrong with your heart from some underlying condition, why in the world would you ignore the fact that smoking is the #1 risk of heart attack, stroke and diabetes for everyone who does it?

Lastly, if it's such a great stress reliever, why are you so affected by stress?

You might know by now what I think of the circumstances of smoking while simultaneously being overconcerned otherwise about one's health. I became a physician because I not only love science, but I have a genuine concern for people's welfare. Don't expect me to stifle my passions.

No response necessary. Just wanted you to know directly how I feel about the situation.

Best regards and Good Health