Triglyceride Levels Explained

High triglycerides, especially when coupled with high low-density lipoprotein (LDL) cholesterol (also known as "bad" cholesterol), might place you at risk for heart disease.

This article explains what triglycerides are, what a normal level is, and how the problem can be prevented.

What Are Triglycerides?

Triglycerides are a type of fat, or lipid, that accounts for the majority of fat in a diet. Triglycerides are important because they provide the body with the energy it needs to function on a daily basis. If you have an excess of triglycerides, they will usually be stored as fat.

Triglycerides are either made in the liver or consumed in the diet and then absorbed into the body through the small intestine. But triglycerides never travel to their destination in the body alone. They attach to a protein and become a lipoprotein referred to as a chylomicron, or a very low-density lipoprotein (VLDL).

These lipoproteins are not very dense, or heavy. Therefore, along with low-density lipoproteins, they run the risk of potentially contributing to heart disease. (By contrast, high-density lipoprotein (HDL) cholesterol is known as the "good" cholesterol. It's so named because high HDL levels can lower the risk of heart disease and stroke.)

What Should My Triglyceride Levels Be?

Elevated levels of triglycerides are a risk factor for heart disease. According to the U.S. National Library of Medicine:

• Triglyceride levels should be below 150 mg/dL (1.69 mmol/L).
• Levels between 150 mg/dL (1.69 mmol/L ) and 199 mg/dL (2.25 mmol/L) are considered borderline high.
• Levels between 200-499 mg/dL (2.26-5.63 mmol/L) are considered high.
• Levels above 500 mg/dL (5.64 mmol/L) are considered extremely high.

Risk Factors

There are primary and secondary causes of high triglyceride levels, also known as hypertriglyceridemia. Primary causes include various genetic disorders that affect the metabolism of triglycerides and/or cholesterol. Secondary causes are usually due either to excessive fat in the diet or underlying conditions that include:

• Diabetes
• Excessive alcohol consumption
• Hypothyroidism (an underactive thyroid)
• Metabolic syndrome (a group of conditions that increase the risk of heart disease, stroke, and type 2 diabetes)
• Nephrotic syndrome (clinical findings in people with kidney disease)
• Obesity
  

If any of these risk factors are present, your healthcare provider probably will recommend that you have a lipid panel performed more frequently (once every one or two years as opposed to once every five years). A lipid panel is a test that measures different types of fat in the blood. It's also referred to as a cholesterol test.

Health Effects of High Triglycerides

High triglycerides may place you at increased risk for coronary heart disease, especially if you have high blood pressure or diabetes or you smoke. According to Harvard Health: "Research is now showing that high triglycerides are an independent risk factor for cardiovascular disease, no matter what the HDL is."

Elevated triglyceride levels are also strongly associated with a number of conditions that clearly do increase cardiovascular risk, such as diabetes, metabolic syndrome, elevated LDL levels, and obesity. This means that most people who have high triglycerides are at elevated risk for these conditions, too, and should take aggressive steps to reduce this risk. 

In addition, very high triglyceride levels can produce pancreatitis, or inflammation of the pancreas, which can be a dangerous condition.

Metabolic Syndrome Lurks

A high triglyceride level also can contribute to metabolic syndrome. This is not one but a group of risk factors for heart disease, stroke, and diabetes. Some people have only one risk factor from a list of five. But when at least three risk factors apply to you, you have metabolic syndrome:

• A high triglyceride level
• A large waistline, known as abdominal obesity
• A low HDL level
• High blood pressure
• High fasting blood sugar, often a warning sign of diabetes

Treatment

While the verdict is still out on whether high triglyceride levels alone can cause heart disease, it's still important to restore it to a normal range.

High triglyceride levels are initially treated with a low-fat, low-carbohydrate diet and lifestyle modifications. When this does not work, your healthcare provider may prescribe medication to help lower your triglyceride levels. In the meantime, the American Heart Association recommends the following steps to keep triglyceride levels low:

• Lose weight: A 5% to 10% weight loss can reduce triglyceride levels by 20%.
• Eat right: Limit salt, sugar, and full-fat dairy products and eat more fruits, vegetables, fiber-rich grains, lean meats and poultry, and beans, nuts, and seeds.
• Embrace Omega-3 fatty acids: Fish like salmon, mackerel, and herring can lower triglyceride levels. So can flax, chia seeds, and walnuts.
• Abstain from alcohol: People with high triglyceride levels can compound the problem by drinking.
• Move more: The effect of physical activity on triglyceride levels depends on your level of intensity, how long you stay in motion, and your daily caloric intake. But any extra activity (beyond what you're doing now) could help lower your triglyceride levels.

Summary

Triglycerides are a type of fat, or lipid, that accounts for the majority of fat in a diet. Elevated levels of triglycerides are a risk factor for heart disease. Plus, there are primary and secondary causes of high triglyceride levels, mostly in the form of other health conditions. It hasn't been proven beyond all doubt that high triglyceride levels alone can cause heart disease, but you're much better off playing it safe and keeping your levels within a normal range. Medication is an option, but the American Heart Association offers a set of sensible diet and lifestyle steps that you may wish to try first.

A Word From Verywell

It wasn't that long ago that you couldn't address cardiovascular risk and heart disease without mentioning LDL and HDL cholesterol levels. Now triglycerides have entered the mix, and many physicians say it's about time. Until research fully validates the importance of triglycerides, heed the practical advice of Harvard Medical School: "Recent evidence suggests you should work to reduce triglyceride levels if they are higher than normal, especially if you have heart disease or have other risk factors such as diabetes, high blood pressure or smoking."