Triglycerides

What Is Triglycerides?

Triglycerides are the most common type of fat in your body. When you eat, your body converts any calories it does not need to use right away into triglycerides, which are then stored in your fat cells. Between meals, hormones signal the release of triglycerides from fat stores to provide energy. In other words, triglycerides are your body's way of banking calories for later use. While this system is perfectly normal, having too many triglycerides circulating in your blood can raise your risk for heart disease and other health problems.

What Does It Measure?

A triglyceride test measures the concentration of triglyceride molecules in your bloodstream, reported in milligrams per deciliter (mg/dL). This number tells your doctor how efficiently your body is processing the fats and sugars you eat. Triglycerides are included in a standard lipid panel alongside total cholesterol, LDL, and HDL. Because triglyceride levels can spike temporarily after eating, this is the test that most often requires fasting — your doctor will typically ask you to avoid food and drink (other than water) for 9 to 12 hours before the blood draw.

Normal Ranges

| Group | Range | Unit | |---|---|---| | Normal (adults) | Less than 150 | mg/dL | | Borderline high | 150 - 199 | mg/dL | | High | 200 - 499 | mg/dL | | Very high | 500 and above | mg/dL | | Children under 10 (normal) | Less than 75 | mg/dL | | Children 10-19 (normal) | Less than 90 | mg/dL |

Triglyceride levels tend to rise with age and are generally higher in men than in women until after menopause, when women's levels often catch up.

What Does a High Level Mean?

Elevated triglycerides, known as hypertriglyceridemia, are common and can stem from a variety of causes. Here is what high levels may point to:

• Increased cardiovascular risk. High triglycerides contribute to the thickening and hardening of artery walls (atherosclerosis), raising your risk of heart attack, stroke, and peripheral artery disease. This risk is especially significant when high triglycerides are paired with low HDL and high LDL — a combination sometimes called the "lipid triad."
• Metabolic syndrome. Elevated triglycerides are one of the five criteria for metabolic syndrome, alongside low HDL, high blood sugar, high blood pressure, and excess abdominal fat. Having three or more of these significantly increases your risk of heart disease and type 2 diabetes.
• Type 2 diabetes and insulin resistance. High blood sugar and insulin resistance interfere with the body's ability to clear triglycerides from the blood. People with poorly controlled diabetes often have very high triglyceride levels.
• Diet high in sugar and refined carbs. Sugary drinks, white bread, pastries, and other refined carbohydrates are rapidly converted into triglycerides. This is one of the biggest dietary drivers of elevated triglycerides — even more so than dietary fat in many cases.
• Excess alcohol consumption. Alcohol is calorie-dense and stimulates the liver to produce more triglycerides. Even moderate drinking can noticeably raise levels in some people.
• Hypothyroidism. An underactive thyroid slows the clearance of triglycerides from the blood.
• Kidney disease and liver disease. Both can impair triglyceride metabolism.
• Certain medications. Beta-blockers, corticosteroids, diuretics, estrogen, retinoids, and some HIV medications can raise triglycerides.
• Pancreatitis risk. When triglycerides climb above 500 mg/dL, there is a real risk of acute pancreatitis, a painful and potentially dangerous inflammation of the pancreas. Levels above 1,000 mg/dL make this risk even more serious.

High triglycerides usually do not cause symptoms unless levels are very high. At extremely elevated levels, some people may develop eruptive xanthomas (small yellowish bumps on the skin).

Recommended next steps: Your doctor will evaluate your full lipid panel, blood sugar, thyroid function, and overall lifestyle. Treatment usually starts with dietary and lifestyle changes, with medications added if needed.

What Does a Low Level Mean?

Low triglycerides (generally below 50 mg/dL) are uncommon and are not typically a problem. In fact, lower triglycerides are generally associated with better metabolic health. However, very low levels can occasionally point to:

• Malnutrition or very low-fat diets. If you are not consuming enough calories or fat, your body may have fewer triglycerides to store and circulate.
• Malabsorption conditions. Celiac disease, Crohn's disease, and other digestive disorders can impair fat absorption and lead to low triglycerides.
• Hyperthyroidism. An overactive thyroid speeds up metabolism and can reduce triglyceride levels.
• Rare genetic conditions. Some inherited disorders, like abetalipoproteinemia, cause very low triglycerides.

Recommended next steps: If your triglycerides are unusually low and your doctor is concerned, they may assess your nutritional status, thyroid function, and digestive health.

When Should You Get Tested?

Triglycerides are measured as part of a standard lipid panel. You should have this test:

• Every four to six years starting at age 20 as part of routine health screening
• More frequently if you have diabetes, metabolic syndrome, heart disease, or a family history of high triglycerides
• If you are overweight, physically inactive, or consume significant amounts of alcohol or sugary foods
• If you are taking medications known to affect triglyceride levels
• When monitoring the effectiveness of lifestyle changes or medications for high triglycerides

Because eating can temporarily double or even triple triglyceride levels, your doctor will usually ask you to fast for 9 to 12 hours before the test. Drinking water is fine during the fast.

How to Improve Your Levels

The good news is that triglycerides are among the most responsive blood markers to lifestyle changes. Many people see significant improvements within just a few weeks.

• Cut back on sugar and refined carbohydrates. This is often the most impactful change. Sugary drinks, candy, white bread, white rice, and pastries are rapidly converted to triglycerides. Replacing them with whole grains, vegetables, and legumes can make a dramatic difference.
• Limit alcohol. Even small amounts of alcohol can raise triglycerides in some people. If your levels are high, try cutting out alcohol entirely for a few weeks and see if your numbers improve.
• Eat more omega-3 fatty acids. Fatty fish like salmon, mackerel, sardines, and herring are rich in omega-3s, which can lower triglycerides by 15 to 30 percent. Aim for at least two servings of fatty fish per week. Fish oil supplements (2 to 4 grams per day) can also help, but talk to your doctor first.
• Exercise regularly. Aerobic exercise for at least 150 minutes per week can lower triglycerides by 20 to 30 percent. Exercise helps your muscles use triglycerides for energy, clearing them from the bloodstream.
• Lose excess weight. Losing just 5 to 10 percent of your body weight can reduce triglycerides by 20 percent or more.
• Choose healthier fats. Replace saturated fats with mono- and polyunsaturated fats found in olive oil, nuts, seeds, and avocados.
• Avoid trans fats. These artificial fats raise triglycerides and LDL while lowering HDL. Check labels for "partially hydrogenated oils."

If lifestyle changes are not sufficient, your doctor may prescribe medications such as fibrates (like fenofibrate), high-dose omega-3 prescriptions (like icosapent ethyl), or statins.

Frequently Asked Questions

Q: Why do I need to fast for a triglyceride test?

Eating, especially meals containing fats and carbohydrates, causes a temporary surge in triglyceride levels that can last several hours. A fasting test gives your doctor a baseline reading that reflects your typical triglyceride level rather than a spike from your last meal. Some newer guidelines suggest non-fasting triglycerides can also be useful, since levels above 175 mg/dL non-fasting may indicate increased cardiovascular risk.

Q: Are triglycerides and cholesterol the same thing?

No, they are different types of blood fats (lipids). Cholesterol is a waxy substance used to build cells and make hormones. Triglycerides store unused calories and provide your body with energy. They are measured together on a lipid panel because both play important roles in cardiovascular health, but they have different functions and are managed somewhat differently.

Q: Can high triglycerides cause a heart attack even if my cholesterol is normal?

Yes. High triglycerides are an independent risk factor for cardiovascular disease, meaning they can increase your risk of heart attack and stroke even when your cholesterol levels look fine. This risk is further amplified when high triglycerides are accompanied by low HDL, which is a very common combination. Treating elevated triglycerides, even in the presence of normal cholesterol, is worthwhile for your long-term heart health.

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This content is for educational purposes only and is not medical advice. Always consult your healthcare provider about your lab results.