High Triglycerides

High Triglycerides

Topic Overview

What are triglycerides?

Triglycerides are a type
of fat found in your blood. Your body uses them for energy.

You
need some triglycerides for good health. But high triglycerides might raise your
risk of heart disease and may be a sign of
metabolic syndrome.

Metabolic syndrome is
the combination of high blood pressure, high blood sugar, too much fat around
the waist, low HDL ("good") cholesterol, and high triglycerides. Metabolic
syndrome increases your risk for heart disease, diabetes, and stroke.

A blood test that measures your
cholesterol also measures your triglycerides. For a
general idea about your triglycerides level, compare your test results to the
following:footnote 1

  • Normal is less than
    150.
  • Borderline-high is 150 to
    199.
  • High is 200 to 499.
  • Very high is 500 or higher.

What causes high triglycerides?

High
triglycerides are usually caused by other conditions, such as:

  • Obesity.
  • Poorly controlled
    diabetes.
  • An underactive thyroid (hypothyroidism).
  • Kidney
    disease.
  • Regularly eating more calories than you
    burn.
  • Drinking a lot of alcohol.

Certain medicines may also raise triglycerides. These
medicines include:

In a few cases, high triglycerides also can run in
families.

What are the symptoms?

High triglycerides usually
don't cause symptoms.

But if your high triglycerides are caused by
a genetic condition, you may see fatty deposits under your skin. These are
called xanthomas (say "zan-THOH-muhs").

How can you lower your high triglycerides?

You can
make diet and lifestyle changes to help lower your levels.

  • Lose weight and stay at a healthy weight.
  • Limit
    fats and sugars in your diet.
  • Be more active.
  • Quit
    smoking.
  • Limit alcohol.

You also may need medicine to help lower your
triglycerides. But your doctor likely will ask you to try diet and lifestyle
changes first.

Frequently Asked Questions

Learning about high triglycerides:

Being diagnosed:

Getting treatment:

Living with high triglycerides:

Cause

The most common causes of
high triglycerides are
obesity and poorly controlled
diabetes. If you are overweight and are not active,
you may have high triglycerides, especially if you eat a lot of
carbohydrate or sugary foods or drink a lot of
alcohol.
Binge drinking of alcohol can cause dangerous spikes in triglyceride levels
that can trigger inflammation of the
pancreas (pancreatitis).

Other causes of high
triglycerides include
hypothyroidism, kidney disease, and certain
inherited lipid disorders.

Estrogen therapy, which may be used for
menopause symptoms, may also raise triglyceride levels. Certain medicines may
also raise triglycerides. These medicines include:

High triglycerides rarely occur on their own. They are
usually associated with other conditions.

High triglycerides are
a part of
metabolic syndrome, a group of medical problems that
increase your risk of heart attack, stroke, and diabetes. Metabolic syndrome
includes:

  • High triglycerides.
  • Low HDL ("good")
    cholesterol.
  • High blood pressure.
  • High blood
    sugar.
  • Too much fat, especially around the waist.

Symptoms

High triglycerides by themselves do not cause symptoms. If your high
triglycerides are caused by a genetic condition, you may have visible fatty
deposits under the skin called xanthomas.

In rare cases, people
who have very high triglyceride levels may develop inflammation of the
pancreas (pancreatitis),
which can cause sudden, severe abdominal (belly) pain, loss of appetite, nausea and
vomiting, and fever.

Triglycerides are categorized as
follows:footnote 1

Triglyceride levels
Normal Less than 150 milligrams per deciliter (mg/dL)
Borderline-high 150 to 199 mg/dL
High 200 to 499 mg/dL
Very high 500 mg/dL or higher

If you have high triglycerides, you may also have
high cholesterol. In many cases, people don't know
that they have high triglycerides until they have a blood test called a
lipoprotein analysis to check their cholesterol
levels.

If your triglyceride levels are high, your doctor will
also check for and treat other associated conditions that may be linked to high
triglycerides. These conditions include
diabetes,
hypothyroidism,
kidney disease, and
metabolic syndrome.

Treatment Overview

You can use diet and lifestyle
changes to lower triglyceride levels.

Diet and lifestyle changes include:

  • Losing weight and staying at a healthy weight.
  • Limiting fat and
    sugars.
  • Being more active.
  • Limiting alcohol.

You may also take medicines to lower triglyceride levels.
Medicines may be used if you have risk factors for
coronary artery disease (CAD).

For more information on cholesterol treatment, see the topic
High Cholesterol.

Initial treatment

Diet and lifestyle changes are the first steps you will take to lower
triglyceride levels.

Diet and lifestyle
changes include:

  • Losing weight and staying at a healthy weight.
  • Limiting
    the amount of carbohydrate and unhealthy fat that you eat.
  • Being
    more active.
  • Limiting alcohol.
  • Not smoking.
  • Keeping blood sugar in a target range if you have
    diabetes.

Eat a heart-healthy diet that is rich in fruits, vegetables, whole grains, fish, lean meats, and low-fat or nonfat dairy foods.
Limit saturated fat and avoid trans fat. Limit sodium and sugar.

Eating fish may lower triglyceride levels. Eating at least 2 servings of fish each week is part of a heart-healthy diet. Oily fish, which contain omega-3 fatty acids, are best for your heart. These fish include salmon, mackerel, lake trout, herring, and sardines.

Fish oil supplements can also lower triglycerides. But doctors do not agree about whether these supplements can help
protect your heart. If you have very high triglycerides, your doctor may recommend you take fish oil to try to prevent pancreatitis.

To reduce carbohydrate in your diet, you may want to
learn about the
amount of carbohydrate in various foods.

Alcohol has a particularly strong effect on triglycerides. Regular,
excessive use of alcohol or even a one-time drinking binge can cause a
significant increase in triglycerides.
Binge drinking can cause a spike in your triglycerides that may trigger
pancreatitis. Your doctor will want you either to stop
or to limit the amount of alcohol you drink.

Before you increase
your activity, check with your doctor to be sure it is safe. You may also want
to talk with a dietitian to design a nutrition program that is right for you.

Your doctor will also look for anything else that might be
causing your high triglycerides, such as
hypothyroidism, poorly controlled
diabetes, kidney disease, or medicines. Your doctor
may adjust or stop any medicines that might raise your triglyceride
level.

Ongoing treatment

If your
triglycerides are still high after you make lifestyle
changes, you may need to take medicine as well. Whether your doctor prescribes
medicine for high triglycerides depends on more than just your triglyceride
number. Your doctor will also look at your cholesterol levels and other risk factors (things that increase your risk) for heart disease before prescribing a medicine for high
triglycerides.

If you have high cholesterol and other risk factors
for heart disease, you may need a combination of medicines that target the
different types of cholesterol. The medicines that you might take are:

Statins are used to lower LDL (bad) cholesterol. Statins
may also lower triglycerides. If you have both high LDL cholesterol and high
triglycerides, your doctor may first prescribe statins to lower your LDL and
later prescribe a medicine to lower your triglycerides.

If your
triglycerides are very high even after lifestyle changes, your doctor may first
use medicine to lower your triglycerides to prevent damage to your
pancreas.

Fibrates (fibric acid derivatives) should be used with
caution by people who are also taking statins. There is a greater risk for a life-threatening muscle problem called
rhabdomyolysis, which can lead to kidney failure. So
it is important that your kidneys and liver are healthy before you take this
combination of medicines. If you have any muscle problems or pain, report it
immediately to your doctor.

Home Treatment

Diet and lifestyle changes can help
lower your
triglycerides. For example:

  • Lose weight and stay at a healthy weight. Triglycerides are
    stored as fat in your tissues and muscles.
  • Eat fewer calories.
    Excess calories are converted to triglycerides.
  • Limit high-calorie foods and
    carbohydrate, especially high-sugar foods such as cookies, soda, and fruit
    juices.
  • Limit unhealthy fats in your diet, especially saturated
    fat and trans fats.
  • Choose a heart-healthy eating plan.
  • Limit alcohol, which has a strong effect on
    triglycerides.
  • Be active on most days of the week. Try to do
    moderate activity at least 2½ hours a week. Or try to do
    vigorous activity at least 1¼ hours a week.
  • Stop smoking. See the topic
    Quitting Smoking for information on how to
    quit.

Other Places To Get Help

Organizations

National Heart, Lung, and Blood Institute (U.S.)
www.nhlbi.nih.gov

American Heart Association
www.heart.org

References

Citations

  1. Miller M, et al. (2011). Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 123(20): 2292–2333.

Other Works Consulted

  • Eckel RH, et al. (2013). 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1.citation. Accessed December 5, 2013.
  • Miller M, et al. (2011). Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 123(20): 2292–2333.
  • U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/guidelines/default.aspx.

Credits

ByHealthwise StaffPrimary Medical Reviewer Kathleen Romito, MD - Family Medicine Martin J. Gabica, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Elizabeth T. Russo, MD - Internal Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer Adam Husney, MD - Family Medicine

Current as ofDecember 6, 2017

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