High Triglycerides

As the main storage form of fat in the body, triglycerides provide energy and serve as building blocks for cells; however, high triglycerides in the blood can increase your risk for developing certain medical conditions, including heart disease. High triglycerides (over 200 mg/dL) occur in about 10 percent of people. Inadequate fasting prior to a lipid test may cause triglyceride levels to appear high, even when they're not. Factors associated with high triglycerides include obesity, lack of physical activity, a very high carbohydrate diet, and excessive alcohol use. People with extremely high triglycerides can develop other conditions, such as fatty liver and pancreatitis.

 

High Triglycerides: An Overview

Triglycerides are the main storage form of fat in the body, and are very important for the overall functioning of the body. However, high triglycerides in the blood (known as hypertriglyceridemia) can lead to health problems.
 

Understanding Triglycerides

Triglycerides have two important uses within the body:
 
 
  • Creating energy
  • Serving as building blocks for cells.
     
Triglycerides come from the fats in foods (saturated fat and unsaturated fat). Triglycerides are also made in the liver from carbohydrates and proteins. Triglycerides are mostly stored in fat cells, but other cells (such as muscle cells) store some triglycerides. To get to these cells, triglycerides are transferred with complexes called lipoproteins (specifically chylomicrons and VLDL).
 
Triglyceride levels in the blood are categorized below:
 
Triglyceride Levels                                           Triglyceride Category
Less than 150 mg/dL
Normal
150-199 mg/dL
Borderline-high
200-499 mg/dL
High
500 mg/dL or above
Very High
 

How Common Are High Triglycerides?

High triglycerides (over 200 mg/dL) occur in about 10 percent of people. Very high levels of triglycerides (over 1,000 mg/dL) are rare. High triglycerides appear to be more common in men than women. High triglycerides also appear to be more common in Caucasians than in African Americans.
 

Causes of High Triglycerides

Probably the most common cause of high triglycerides is inadequate fasting prior to a lipid test. Triglycerides in the blood increase following a meal; they can remain high for up to 10 hours. If fasting does not occur, the person will have artificially high triglycerides. This is why healthcare providers do not want a person to eat food or drink coffee for at least 12 hours prior to triglyceride and cholesterol testing.
 
Other factors that are associated with high triglycerides include:
 
  • Obesity
  • Physical inactivity
  • Excessive alcohol use
  • Very high carbohydrate diet
  • Birth control pills
  • Other drugs (including diuretics and steroids)
  • Genetic disorders (such as familiar hypertriglyceridemia)
  • Certain diseases, including:

 

High Triglycerides: Symptoms and Diagnosis

High triglycerides do not cause symptoms, so many people are unaware that their triglyceride levels are too high. Most people learn that they have high triglycerides through a blood test, such as a lipid panel.
 

High Triglycerides: Possible Complications

High triglycerides can increase your risk for developing certain medical conditions, including heart disease and heart attack. When triglycerides in the blood are high, they can build up on your artery walls (as can cholesterol and other debris). This buildup is called plaque. Over time, plaque can narrow the blood vessels, and sometimes this buildup may even block your blood vessels completely. Plaque buildup on your blood vessel walls is called atherosclerosis.
 
For people with very high levels of triglycerides in the blood (over 1,000 mg/dL), high triglycerides can also cause other conditions, including:
 
  • Xanthomas, which are fat deposits under the skin
  • Fatty liver
  • Pancreatitis, which is an inflammation of the pancreas.
     

Lowering High Triglycerides

When results of a lipid panel (or other tests that measure triglycerides) indicate high levels of triglycerides, the healthcare provider will first make sure that the person fasted prior to the test, as triglyceride levels increase following a meal. The healthcare provider may also recommend that the person be retested. If the second fasting test also comes back high, the doctor will consider several factors before recommending treatment for high triglycerides. Some of these factors include a person's:
 
  • Triglyceride level
  • HDL level
  • Weight
  • Diet
  • Daily alcohol usage
  • Other medical conditions
  • Current medications.
     
The main goal of treatment for high triglycerides is to lower triglycerides enough to reduce the risk of developing heart disease or having a heart attack. For people with high triglycerides and low HDL, treatment will be more aggressive, since these factors significantly increase a person's chance for heart disease.
 
Depending on a person's particular situation, options for lowering triglycerides can include:
 
  • Getting medical conditions under control
  • Replacing medications that are known to cause high triglycerides.
     
Lifestyle changes may also be recommended for lowering triglycerides. These changes can include:
 
  • Losing weight
  • Changing your diet
  • Decreasing alcohol consumption
  • Exercising.
     
People with high triglycerides also tend to respond well to fish or fish oil in their diet. For most people, these steps will lower triglycerides to a normal level. If these steps are not effective in lowering triglycerides, your healthcare provider may recommend medications.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD