Causes and Risk Factors of High Triglycerides

Hypertriglyceridemia is the clinical name for elevated triglycerides. Diet, smoking, thyroid disease, a family history of hyperlipidemia, and a host of other lifestyle, genetic, and health risk factors—many of which are quite prevalent—can cause or contribute to rising levels. It's not uncommon for people with high triglycerides to have more than one cause factoring into their condition.

High triglyceride levels increase your chances of developing conditions like cardiovascular disease and pancreatitis, so finding out if your levels are in a normal range or not—and, if needed, knowing how to lower triglycerides—can help keep certain serious illnesses from developing.

What you eat and other lifestyle choices you make play a major role in maintaining normal triglyceride levels, and they are often the main driver behind increased levels.

The type of food you eat affects your triglyceride levels. Two highly influential types of foods are carbs and fats.

• Carbohydrates: Experts have found that carbohydrates with a lower glycemic index (fruits, vegetables, and whole grains) reduce your triglyceride levels, while high glycemic index carbohydrates (donuts, French fries, foods with added sugar) raise your triglyceride levels.
• Fats: Interestingly, the impact of dietary fat intake on triglycerides is not completely clear. That isn't a green light to eat all the fat you want, however. Foods that are high in saturated fats and trans fats increase cholesterol (also a lipid), and high cholesterol leads to cardiovascular disease.

A lipid-lowering diet consisting of plenty of fruits, vegetables, lean proteins, and complex carbohydrates can help keep your triglyceride levels in check. In terms of foods to avoid when working to manage triglyceride levels, cut out or minimize your consumption of highly processed products, deep-fried foods, and high-calorie fats and carbohydrates.

Smoking has a complex effect on triglycerides. It may cause insulin resistance, a condition in which your body doesn't respond to insulin. While insulin is more closely associated with glucose metabolism, it also helps break down triglycerides. So a decreased response to insulin raises triglyceride levels.

Smoking cessation can not only lower your risk of developing high triglycerides but it can also help prevent other medical conditions, such as heart disease, emphysema, and lung cancer.

Some excess calories get converted to triglycerides then stored in fat cells. This is your body's reserves, if you will: An energy storage it can call upon at a later date, if ever needed. Other triglycerides simply circulate in the bloodstream. As such, the more you weigh—i.e., the more your energy stores aren't tapped—the higher your triglyceride levels are likely to be.

Being overweight also alters your metabolic function, which affects how triglycerides are processed by the body (see "Health Conditions" below).

Studies have shown that losing between 5% and 10% of your total body weight can lower your triglyceride levels by up to 20%.

Exercise uses energy. Stored and circulating triglycerides are broken down and used for this purpose. When you don't use much energy, the triglycerides remain in the blood, leading to higher-than-normal levels.

Research shows that getting regular aerobic exercise lowers triglyceride levels. Even a moderate level of aerobic exercise, when consistent over the course of months, is enough to reduce your levels.

Physical activity helps lower your triglycerides. But a sedentary lifestyle adds to the harmful effects of not exercising and can even prevent you from getting the benefits of exercise, especially if you exercise infrequently.

A research study showed that people who normally sit for more than 13 hours per day or take fewer than 4,000 steps per day do not experience the expected decrease in triglyceride levels after doing a burst of exercise.

Limiting the amount of alcohol that you consume can help keep your heart—and triglyceride levels—healthy. Studies have shown that alcohol can adversely affect your lipids in incremental amounts, so it is suggested that you limit your alcohol to one drink per day if you are a woman, or two drinks per day if you are a man.

Experts suggest that the relationship between alcohol and triglyceride levels is related to alcohol's effect on the pancreas and liver.

Any condition that causes your body to produce more triglycerides than necessary or prevents the normal breakdown of triglycerides can increase the levels of this lipid in your blood.

Several medical conditions are associated with elevated lipids, including triglycerides. These illnesses may cause a variety of symptoms and effects, with triglyceride elevation among many others.

Illnesses that cause high triglycerides include:

• Diabetes mellitus (DM): DM is characterized by elevated blood glucose. While lipid levels are not considered in the diagnostic criteria of DM, the condition is commonly associated with increases. Diabetes type l is characterized by low insulin and diabetes type ll is characterized by insulin resistance. Since insulin helps break down triglycerides, both of these conditions lead to high triglyceride levels.
• Metabolic syndrome: Metabolic syndrome is characterized by high blood pressure, high body mass index (BMI), insulin resistance, and elevated lipid levels. The high BMI and insulin resistance associated with this condition can lead to high triglyceride levels.
• Hypothyroidism: A deficiency in thyroid hormones interferes with the normal metabolism of lipids.
• Pregnancy: Generally, a mildly elevated triglyceride level during pregnancy is not considered dangerous, but your doctor may advise dietary changes or medication for very high triglyceride levels. Hormones such as estrogen, progesterone, and lactogen stimulate the release of triglycerides from stored fat to be used in the formation of the placenta. Circulating triglycerides can be elevated in any healthy pregnancy, but levels tend to be higher for women who have gestational diabetes (diabetes only during pregnancy) or a high BMI.
• Nephrotic syndrome: A type of kidney failure, nephrotic syndrome can interfere with the body's elimination of lipids. This condition can also increase the liver's production of lipids.
• Paraproteinemia: This condition, which is often associated with lymphoma, causes a disruption of lipid metabolism.
• Systemic lupus erythematosus (SLE): SLE is an autoimmune disease that can affect the kidneys, gastrointestinal (GI) system, and joints. This condition can be associated with high lipids due to the involvement of the kidneys and GI system.

Several genetic conditions are associated with elevated triglyceride levels, and you can also have an inherited predisposition to high triglycerides even if you don't have an illness associated with hypertriglyceridemia.

Inherited conditions that cause high triglycerides include:

• Familial combined hyperlipidemia: This is the most common type of hyperlipidemia. It is a hereditary condition that may cause high triglycerides and/or high LDL cholesterol levels.
• Dysbetalipoproteinemia: This relatively common hereditary condition is inherited in an autosomal dominant pattern. It is characterized by elevated cholesterol and triglyceride levels, which leads to premature heart disease.
• Familial hypertriglyceridemia: This is a familial condition that causes high triglyceride levels without elevated levels of cholesterol.
• Familial chylomicronemia syndrome (FCS): FCS is a rare hereditary condition that prevents the breakdown of fat. This severe disorder is associated with serious effects of elevated lipid levels, including life-threatening pancreatitis.

In addition to these genetic conditions, rare mutations affecting the genes that code for lipoprotein lipase (an enzyme that breaks down triglycerides) or apolipoprotein C2 can also cause increased triglycerides.

Certain medications can affect your lipid metabolism, resulting in high triglyceride levels. There are a number of different categories of medications associated with this side effect.

Medications that can raise triglyceride levels include:

• Steroids
• Estrogens
• Tamoxifen
• Anabolic steroids
• Non-cardioselective beta-blockers
• Thiazide diuretics
• Cyclophosphamide
• Cyclosporine
• Protease inhibitors
• Bile acid sequestrants
• Clozapine
• Atypical antipsychotics
• Antidepressants

Keep in mind that you might not necessarily develop high triglycerides if you take one or more of the medications that can have this side effect.

Triglycerides and other lipids can be elevated due to a variety of risk factors. Triglycerides can be elevated independently of other lipids, or you might have high triglycerides and high cholesterol. If you have a lipid panel blood test, you will learn your triglyceride level, along with your total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL).