Overview
What are triglycerides?
Triglycerides are a type
of fat found in your blood. They are a major source of energy and the most
common type of fat in your body.
When you eat, your body uses the
calories it needs for quick energy. Any extra calories are turned into
triglycerides and stored in fat cells to be used
later. The excess calories are stored as fat regardless of what kind of food
you eat-fat, carbohydrate, or protein. If you regularly eat more calories than
you burn, you may have high triglycerides.
In normal amounts,
triglycerides are important to good health. When triglyceride levels are high,
it is not clear whether these high levels directly increase your risk for heart
disease. But high triglycerides are often part of a group of conditions called
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. This
syndrome does increase your risk for heart disease as well as for diabetes and
stroke.
Triglycerides are measured as part of a blood test that
measures your
cholesterol. Normal triglyceride levels are below 150.
High levels are 200 or above.
What causes high triglycerides?
Conditions that
may cause high triglycerides include:
- 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:
Certain types of high cholesterol and high triglycerides
are caused by genetics.
What are the symptoms?
High triglycerides usually
do not cause symptoms.
Sometimes high triglycerides have a
genetic cause. But this is not common. In this case, high triglyceride levels
may occur along with visible fatty deposits under the skin called
xanthomas.
In rare cases, people who have very high levels of
triglycerides may develop inflammation of the
pancreas (pancreatitis).
This can cause sudden, severe abdominal pain, loss of appetite, nausea,
vomiting, and fever.
How can you lower your high triglycerides?
If you
are overweight, losing weight may be the best way to lower triglycerides. You
may be able to lower your triglycerides by eating fewer calories and increasing
your activity. Other diet changes that might help include limiting fats and
sugars, and limiting or not drinking alcohol.
If increasing your
activity and watching calories do not work, you may also need medicine.
Medicines called statins are commonly used to lower LDL ("bad") cholesterol.
But drugs called nicotinic acid (or niacin) and fibrates seem to work better
for lowering triglycerides. If you have high triglycerides, high LDL
cholesterol, and low HDL ("good") cholesterol, you may take more than one type
of medicine that lowers cholesterol.
Frequently Asked Questions
Learning about high triglycerides: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Living with high triglycerides: | |
Health Tools 
Health Tools help you make wise health decisions or take action to improve your health.
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 replacement 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 pain, loss of appetite, nausea and
vomiting, and fever.
Triglycerides are categorized as
follows:
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. These changes may be especially good at
lowering borderline-high levels (150 to 199 mg/dL) back to normal levels (less
than 150 mg/dL).
Diet and lifestyle changes include:
- 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). In this case, your
doctor may first want to lower your
LDL ("bad") cholesterol level and raise your
HDL ("good") cholesterol level before adding medicine
to lower your triglycerides.
Treating LDL and HDL can lower your
risk of heart attack and death, but the risks of high
triglycerides are not as well known. For more
information on target levels and treatment for high cholesterol, see the topic
High Cholesterol.
Use this
Interactive Tool: Heart attack risk 
to calculate your
risk of a heart attack based on your cholesterol levels and other
factors.
Initial treatment
Diet and lifestyle changes are the first steps you will take to lower
triglyceride levels.
Diet and lifestyle
changes include:
- Staying at a healthy weight or
reducing calories to lose weight.
- Limiting
the amount of carbohydrate and unhealthy fat that you eat.
- Being
more active.
- Limiting alcohol.
- Not smoking.
- Keeping blood sugar as close to normal as possible if you have
diabetes.
Adding fish oils (omega-3 fatty acids)
to your diet may lower triglyceride levels.1 You can
add fish oil by eating fish at least 2 times a week or by taking supplements.
Oily fish with lots of omega-3 fatty acids include salmon, tuna, and
mackerel.
You may want to try
Therapeutic Lifestyle Changes (TLC) and the
Therapeutic Lifestyle Changes (TLC) diet. TLC is a
combination of diet and lifestyle changes that can lower your cholesterol. The
following information can help you get started with the TLC diet:
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 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 and even raise HDL (good) cholesterol. Typically,
the more a statin lowers LDL, the more the drug lowers triglycerides. When your
LDL is at a desirable level, fibrates or nicotinic acid may be added to target
triglycerides. Both of these medicines can also raise your HDL cholesterol.
If your triglycerides are very high, 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 of developing 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.
Treatment if the condition gets worse
If you have
not previously been taking medicines for high
triglycerides, you probably will start. If you have
been taking medicines, but they have not been effective, your doctor may change
your dosage or add new medicines. The medicines that you might take are:
If you are taking a statin, you need to be extra careful
if you are also taking fibrate medicines. There is a greater risk of developing
a life-threatening muscle problem called
rhabdomyolysis, which can lead to kidney failure.
Before you can take this combination of medicines, your kidneys and liver must
be healthy and function normally. If you have any muscle problems or pain,
report it immediately to your doctor.
Your doctor may prescribe
an omega-3 fatty acids medicine (such as Lovaza). You can get omega-3 fatty
acids from eating oily fish like salmon or tuna. But this medicine is a highly
concentrated form of omega-3 fatty acids, which can lower triglyceride levels.
This medicine is used in combination with diet and lifestyle changes for high
triglycerides. This medicine may raise LDL cholesterol levels slightly, so your
doctor may closely watch your cholesterol levels if you take Lovaza.
You may need to think about how well you are able to follow your plan for
making lifestyle changes. You may need to get some help to meet your goals.
Consider meeting with a registered dietitian or nutritionist who can work with
you to make healthier food choices. Do not overlook the importance of
increasing your activity-join a health club or consult a personal trainer who
can design a program for you to help make exercising interesting, fun, and more
effective. You may want to choose walking to help increase activity in your
life.
Fitness: Walking for wellness
Home Treatment
Diet and lifestyle changes that can
help lower your
triglycerides. For example:
- Stay at a healthy weight. Triglycerides are
stored as fat in your tissues and muscles.
- Eat fewer calories.
Excess calories are converted to triglycerides.
- Eat a
heart-healthy diet. 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. Choose a diet like the
Therapeutic Lifestyle Changes (TLC) diet. For more
information, see:
- Limit alcohol, which has a strong effect on
triglycerides.
- Be more active. Get at least 30 minutes of activity
on most, preferably all, days of the week. Walking is one way to add activity
to your daily life. For more information, see:
- Fitness: Walking for wellness.
- Stop smoking. See the topic
Quitting Smoking for information on how to
quit.
Other Places To Get Help
Organizations
| American Heart Association (AHA) |
| 7272 Greenville Avenue |
| Dallas, TX 75231 |
| Phone: | 1-800-AHA-USA1 (1-800-242-8721) |
| Web Address: | www.americanheart.org |
| |
Call the American Heart Association (AHA) to find your
nearest local or state AHA group. AHA can provide brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support. AHA's Web site also has information on
physical activity, diet, and various heart-related conditions. |
|
| National Heart, Lung, and Blood Institute
(NHLBI) |
|
P.O. Box 30105 |
| Bethesda, MD 20824-0105 |
| Phone: | (301) 592-8573 |
| Fax: | (240) 629-3246 |
| TDD: | (240) 629-3255 |
| E-mail: | nhlbiinfo@nhlbi.nih.gov |
| Web Address: | www.nhlbi.nih.gov |
| |
The U.S. National Heart, Lung, and Blood Institute (NHLBI)
information center offers information and publications about preventing and
treating heart, lung, and blood diseases. |
|
References
Citations
Gaziano JM, et al., (2004). Primary and secondary
prevention of coronary heart disease. In E Braunwald et al., eds.,
Heart Disease: A Textbook of Cardiovascular Medicine,
7th ed., pp. 1057-1084. Philadelphia: Saunders.
Other Works Consulted
Credits
| Author | Robin Parks, MS |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Michele Cronen |
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
| Specialist Medical Reviewer | Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology |
| Last Updated | July 12, 2007 |
