Triglycerides are a type of fat in your blood and, alongside blood pressure and cholesterol, are a key indicator of your heart health. You might be familiar with monitoring your cholesterol, but understanding your triglyceride levels is equally important for maintaining cardiovascular well-being. Elevated triglycerides can significantly increase your risk of heart disease. The good news is that lifestyle adjustments that benefit your overall health can also effectively lower high triglyceride levels.
Decoding Triglycerides: What Are They?
Triglycerides are a form of lipid, or fat, that circulates within your bloodstream. When you consume food, your body processes the calories you don’t immediately need for energy and converts them into triglycerides. These triglycerides are then stored in your fat cells. Between meals, hormones release these stored triglycerides to provide your body with energy. However, consistently consuming more calories than you burn, particularly from carbohydrate-rich foods, can lead to a condition known as hypertriglyceridemia, or high triglycerides.
What is Considered a Healthy Triglyceride Level?
A simple blood test, usually part of a lipid panel, can determine your triglyceride levels and whether they fall within a healthy range. It’s important to fast before this blood test to ensure accurate triglyceride measurements. The standard ranges are:
- Normal: Less than 150 milligrams per deciliter (mg/dL) or 1.7 millimoles per liter (mmol/L)
- Borderline High: 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
- High: 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
- Very High: 500 mg/dL or above (5.7 mmol/L or above)
Your doctor will typically assess your triglyceride levels as part of a comprehensive cholesterol test, also referred to as a lipid profile or lipid panel.
Triglycerides vs. Cholesterol: Key Differences
While both are lipids circulating in your blood, triglycerides and cholesterol serve different functions:
- Triglycerides: Primarily function to store unused calories, serving as an energy reserve for your body.
- Cholesterol: Is essential for building healthy cells and producing certain hormones.
Why Are High Triglycerides a Concern?
Elevated triglyceride levels can contribute to the hardening and thickening of artery walls, a condition known as arteriosclerosis. This significantly increases the risk of serious cardiovascular events, including stroke, heart attack, and overall heart disease. Furthermore, extremely high triglyceride levels can trigger acute pancreatitis, a painful inflammation of the pancreas.
High triglycerides often coexist with other health issues that are also risk factors for heart disease and stroke. These include obesity and metabolic syndrome, a cluster of conditions characterized by excess abdominal fat, high blood pressure, elevated triglycerides, high blood sugar, and abnormal cholesterol levels.
Beyond these associations, high triglycerides can also be indicative of:
- Type 2 Diabetes and Prediabetes: Insulin resistance, common in these conditions, can lead to increased triglyceride production.
- Metabolic Syndrome: As mentioned, high triglycerides are a core component of metabolic syndrome, further amplifying cardiovascular risk.
- Hypothyroidism (Low Thyroid Hormone Levels): An underactive thyroid can affect lipid metabolism, leading to higher triglyceride levels.
- Rare Genetic Conditions: Certain genetic disorders can disrupt the body’s ability to process fat, resulting in hypertriglyceridemia.
It’s also important to be aware that, in some cases, high triglycerides can be a side effect of certain medications, including:
- Diuretics: Often used to treat high blood pressure, some diuretics can raise triglyceride levels.
- Estrogen and Progestin: Hormonal medications can sometimes affect lipid profiles.
- Retinoids: Medications derived from vitamin A, used for skin conditions, can have this side effect.
- Steroids: Both anabolic and corticosteroids can influence triglyceride levels.
- Beta Blockers: Commonly used for heart conditions and high blood pressure, some beta blockers can increase triglycerides.
- Certain Immunosuppressants: Medications that suppress the immune system can sometimes lead to elevated triglycerides.
- Some HIV Medications: Certain antiretroviral drugs can have an impact on lipid metabolism.
Effective Strategies to Lower Triglycerides
Adopting a healthy lifestyle is the cornerstone of managing high triglycerides. Here are key changes you can implement:
- Regular Exercise: Aim for at least 30 minutes of moderate-intensity physical activity most days of the week. Regular exercise is proven to lower triglycerides and boost beneficial HDL cholesterol. Incorporate activity into your daily routine by taking the stairs, walking during breaks, or engaging in enjoyable activities like dancing or cycling.
- Reduce Sugar and Refined Carbohydrates: Simple carbohydrates found in sugary drinks, processed foods, white bread, and pastries can significantly raise triglyceride levels. Minimize your intake of these items and opt for whole grains, fruits, and vegetables instead.
- Weight Management: If you are overweight or obese, losing even a small amount of weight can make a significant difference in lowering triglycerides. Excess calories, regardless of their source, are converted into triglycerides and stored as fat. Focusing on calorie reduction through diet and exercise is crucial.
- Choose Heart-Healthy Fats: Replace saturated fats, abundant in red meat and full-fat dairy, with healthier unsaturated fats found in plant-based oils like olive and canola oil. Incorporate omega-3 fatty acids by eating fatty fish like salmon and mackerel regularly. Avoid trans fats and foods containing hydrogenated oils, often found in processed and fried foods.
- Limit Alcohol Consumption: Alcohol is calorie-dense and high in sugar, having a particularly strong effect on triglyceride levels. If you have high or very high triglycerides, reducing or eliminating alcohol intake is essential.
When Medication Might Be Necessary
If lifestyle modifications alone are insufficient to bring your triglyceride levels under control, your doctor may recommend medication. Options include:
- Statins: Primarily used to lower cholesterol, statins can also help lower triglycerides, especially if you have other risk factors like high LDL cholesterol, a history of blocked arteries, or diabetes. Examples include atorvastatin (Lipitor) and rosuvastatin (Crestor).
- Fibrates: Medications like fenofibrate (TriCor, Fenoglide) and gemfibrozil (Lopid) are specifically designed to lower triglyceride levels. However, they are not suitable for individuals with severe kidney or liver disease.
- Prescription Fish Oil (Omega-3 Fatty Acids): High doses of omega-3 fatty acids, available in prescription forms like Lovaza, are effective in lowering triglycerides. While over-the-counter fish oil supplements are available, prescription formulations contain higher concentrations of active fatty acids. It’s important to consult your doctor before taking high-dose fish oil supplements, as they can affect blood clotting.
- Niacin: Also known as nicotinic acid, niacin can lower both triglycerides and LDL (“bad”) cholesterol. However, over-the-counter niacin can interact with other medications and cause side effects, so it’s crucial to discuss its use with your doctor.
If your doctor prescribes medication to manage your triglycerides, it’s essential to take it as directed. Remember that medication works best in conjunction with healthy lifestyle habits. While medication can play a vital role in managing high triglycerides, lifestyle changes are fundamental for long-term health and well-being.
References:
- High blood triglycerides. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/high-blood-triglycerides. Accessed Aug. 7, 2018.
- Bonow RO, et al., eds. Risk markers and the primary prevention of cardiovascular disease. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, Pa.: Saunders Elsevier; 2019. https://www.clinicalkey.com. Accessed May 30, 2018.
- Kumar P, et al., eds. Lipid and metabolic disorders. In: Kumar and Clark’s Clinical Medicine. 9th ed. Philadelphia, Pa.: Elsevier; 2017. https://clinicalkey.com. Accessed May 22, 2018.
- AskMayoExpert. Triglycerides (adults). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
- AskMayoExpert. Hyperlipidemia (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
