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Niacin can be taken at lower doses rather than prescription levels, but supplementation can cause unwanted niacin side effects, especially when taking at high dosages. Some negative results of taking niacin include experience flushing, an uncomfortable feeling of heat, itching or tingling in the skin. Other side effects can include gastrointestinal, muscle and liver problems.
An easy way to make the switch from trans fats is by replacing them with unsaturated fats, which don’t increase your LDL cholesterol, according to WebMD. Unsaturated fats are found in olive oil, canola oil, vegetable and sunflower oils, as well as fish, nuts, seeds and avocados. Just as unsaturated fats are healthy choices, unsaturated fats are not. Be sure to limit your intake of unsaturated fats, which are found in fatty meats, cold cuts, whole milk, whole-milk cheeses and many store-bought baked goods and snacks. Instead, enjoy lean cuts of meat, skim milk, low-fat cheeses and yogurt, and wholesome snacks to trim down your cholesterol levels.
It’s harder to increase HDL or "good" cholesterol than it is to lower LDL or total cholesterol. It’s estimated that up to 80 percent of the variation in HDL from person to person is due to genetic factors. But the following steps have been shown to boost HDL—and they are worth taking because they also lower total cholesterol and help protect the heart in many ways beyond their effect on HDL.
HDL is plasma’s smallest and densest lipoprotein. The major apolipoproteins of HDL are apo A-I and apo A-II, the alpha lipoproteins. An elevated concentration of apo A-I and apo A-II, known as hyperalphalipoproteinemia (HALP), is associated with a lower risk of CHD. Conversely, hypoalphalipoproteinemia increases the chances of CHD development.  HALP generally does not produce any unusual clinical features (although corneal opacity has been associated with the condition), and it should not be considered a disease entity but rather a fortuitous condition that can increase longevity because of the related decrease in CHD incidence. 
Foods high in monounsaturated fats (such as olive oil, nuts, and the oils in many salad dressings) seem to boost HDL best; it’s likely that foods high in omega-3 fatty acids (such as cold-water fish) do so as well. Saturated fats, the kind in meat and dairy foods, are likely to drive up harmful LDL, so take this opportunity to cut way back. Worst of all are trans-fatty acids, the hardened oils often found in margarine, crackers and other snack foods-a substance Harvard Medical School nutrition expert Walter C. Willett, M.D., author of Eat, Drink, and Be Healthy, calls “uniquely bad.” These foods can do exactly the opposite of what you want, lowering HDL while raising LDL.
Do you dread opening up the white envelope of lab results after your annual physical only to discover a jumble of numbers, red ink, and arrows pointing every possible direction? Lipid or cholesterol panel results can be confusing to comprehend, and when numbers come back “out of range” it can only further fuel feelings of discouragement and helplessness.
Trans fats are a byproduct of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. These fats have no nutritional value — and we know for certain they are bad for heart health. Trans fats increase LDL cholesterol and triglyceride levels while reducing levels of HDL cholesterol.
Although this breakfast choice may not satisfy your kid (or your kid-at-heart), high fiber cereals are an easy way to improve your cholesterol profile. An American Journal of Clinical Nutrition study found that high fiber oat cereals lower LDL particle number without decreasing HDL concentrations, thus improving your ratio and giving HDL levels a percentage increase. Look for a product with a minimal amount of sugar and at least 5 grams of fiber per serving. A great oat-based choice is Barbara’s Morning Oat Crunch, which has 5 grams of fiber and 6 grams of protein per cup.
Could one of your current prescriptions be a cause of your low HDL levels? Possibly! Medications such as anabolic steroids, beta blockers, benzodiazepines and progestins can depress HDL levels. If you take any of these medications, I suggest talking to your doctor and considering if there is anything you can do that could take the place of your current prescription.
For women after menopause, a study published in August 2016 in the journal Diabetes & Metabolism found that high intensity interval training (on a bicycle) led to better HDL cholesterol levels as well as significant weight loss. And a study published in May 2016 in the journal Applied Physiology, Nutrition, and Metabolism found that obese men who engaged in aerobic interval training (running on a treadmill) or resistance training (with weights) just three days a week for 12 weeks had significantly increased HDL cholesterol when compared with obese men who did no training.
George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society