How Triglycerides Work in Your Body

Triglycerides are a form of fat that the body uses for energy storage and transporting. Triglycerides account for the vast majority of fat stored in the human body.

Blood lipid panel paperwork with close up of pencil
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Triglycerides are comprised of long chains of glycerol molecules, each of which is attached to three molecules of fatty acids (hence the name, “triglyceride”). The different types of triglycerides are named according to the length of the glycerol chains they contain. Some of the names for specific triglycerides you may have heard include oleic acid and palmitic acid.

The fatty acids carried by triglycerides are important because these are the fats that can be ”burned” as fuel for the body’s needs. Triglycerides are best thought of as the means for storing and transporting the fatty acids we need for fuel.

Where Do They Come From?

We get our triglycerides from two sources: from manufacturing them ourselves, and from the food we eat.

Triglycerides we make. Triglycerides are synthesized in our liver and by our fat cells at times when food is plentiful. For instance, when we eat a high-carbohydrate meal, any excess carbs (carbs that are not needed right then for fuel) are converted to triglycerides. The liver releases these newly-made triglycerides into the bloodstream, in the form of VLDL (very low-density lipoproteins). The VLDL delivers the triglycerides to fat cells for long-term storage.

Triglycerides we eat. Most of the fat we eat—whether from animals or from plants—consists of various triglycerides. Our intestines cannot absorb the triglycerides in-tact (since they are very large molecules), so during the digestive process, the triglycerides in our food are broken down into their glycerol and fatty acid components, which are then absorbed by the cells that line our intestines.

Within the intestinal cells, the triglycerides are reassembled and then released, into our bloodstream—along with ingested cholesterol—in "packages" called chylomicrons. The body's tissues then remove the triglycerides from the circulating chylomicrons, either burning it for energy or storing it as fat. Generally, after a meal, the density of chylomicrons in the bloodstream increases for several hours.

This is the reason doctors always ask you to fast for 12 hours before having your blood drawn to measure serum lipid levels. Assessing your risk for cardiovascular disease is based on your "baseline" blood lipid levels—that is, your blood lipid levels at a time when circulating chylomicrons are not temporarily increasing your triglyceride and cholesterol counts. However, elevated non-fasting triglyceride levels have also been found to be associated with cardiovascular risk.

How Are They Used?

Triglycerides are used for transporting and storing fatty acids in the body. 

When food is plentiful, the fatty acids are stored, in the form of triglycerides, in the body's fat cells — and body fat accumulates. During periods of fasting, triglycerides are released by fat cells into the circulation to provide fuel for metabolism.

When are they a problem?

"Too many" triglycerides can become a problem in two general ways.

First, excess body fat, especially fat stored in abdominal tissues, can lead to prediabetes and type 2 diabetes. Being overweight from too much body fat can itself increase your risk for cardiovascular disease.

Second, high triglyceride blood levels, a condition called hypertriglyceridemia, are associated with an increased risk of cardiovascular disease, and very high triglyceride levels can produce pancreatitis (a painful and sometimes dangerous inflammation of the pancreas).

Treating High Levels

If you have been told you have high triglyceride levels, your doctor should be doing a full evaluation to find out why. There are several potential (and usually treatable) causes for elevated triglycerides, including diabetesmetabolic syndromehypothyroidism, kidney disease, and several prescription medications. If you have hypertriglyceridemia, your doctor should look for these conditions and institute treatment if they are found.

In addition, depending on the level to which your triglycerides are increased, your doctor may recommend placing you on therapy specifically aimed at bringing down those elevated levels. Such treatment will certainly include lifestyle changes (diet and exercise), and may include drug therapy specifically aimed at reducing triglyceride levels. This may include a fibrate drug or niacin, or prescription omega-3 fatty acid therapy.

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