Several factors can contribute to low HDL cholesterol levels. Genetics can play a role, as some individuals naturally have lower HDL levels. Lifestyle choices such as poor diet, lack of exercise, smoking, and excessive alcohol consumption can decrease HDL cholesterol. Certain medical conditions, such as obesity, type 2 diabetes, metabolic syndrome, and liver disease, can also be associated with low HDL levels. Additionally, some medications, including beta-blockers, anabolic steroids, and certain hormonal therapies, can lower HDL cholesterol. It's important to address modifiable risk factors through lifestyle changes, such as adopting a heart-healthy diet, engaging in regular exercise, quitting smoking, and limiting alcohol consumption. Consulting with a healthcare professional can provide personalized recommendations based on your specific situation.