Can hdl cholesterol ever be too high?

Not that we know: Currently HDL recommendations highlight a minimum number that we like patients to achieve. This numbers by age and sex. There is currently no maximum HDL number, that above which there are associated detrimental effects. Therefore, the current thinking is that the higher the HDL number the better. This number is subject to significant genetic predisposition but can be lowered by diet, smoking, etc.

No: There are no known side effects of a high hdl. Remember HDL - healthy cholesterol.

Hard to tell: High HDL the "good cholesterol" so more should be better.... This is true for groups of patients. For individuals, it is less clear. High HDL levels can occur when we absorb more cholesterol in the gut, and have more building blocks of HDL (apoa1). Very high HDL can sometimes not work as well. High HDL should not prevent treating other risk factors such as high ldl, high blood pressure, etc.