Triglycerides are a type
of fat found in your blood. Your body uses them for energy.
need some triglycerides for good health. But high triglycerides might raise your
risk of heart disease and may be a sign of
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
triglycerides are usually caused by other conditions, such as:
Certain medicines may also raise triglycerides. These
In a few cases, high triglycerides also can run in
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").
make diet and lifestyle changes to help lower your levels.
You also may need medicine to help lower your
triglycerides. But your doctor likely will ask you to try diet and lifestyle
Learning about high triglycerides:
Living with high triglycerides:
Health Tools help you make wise health decisions or take action to improve your health.
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
Binge drinking of alcohol can cause dangerous spikes in triglyceride levels
that can trigger inflammation of the
Other causes of high
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
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
which can cause sudden, severe abdominal (belly) pain, loss of appetite, nausea and
vomiting, and fever.
Triglycerides are categorized as
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
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
kidney disease, and
You can use diet and lifestyle
changes to lower triglyceride levels.
Diet and lifestyle changes include:
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.
For more information on cholesterol goals and treatment for high cholesterol, see the topic
Interactive Tool: Are You at Risk for a Heart Attack?
to calculate your risk of a heart attack based on your cholesterol levels and
Diet and lifestyle changes are the first steps you will take to lower
Diet and lifestyle
Eating fish or taking fish oil (omega-3 fatty acid) supplements 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.
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.
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
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
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.
triglycerides are very high even after lifestyle changes, your doctor may first
use medicine to lower your triglycerides to prevent damage to your
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.
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 for
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 functioning normally. If you have any muscle problems or pain,
report it immediately to your doctor.
Diet and lifestyle changes can help
triglycerides. For example:
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides 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.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
CitationsGrundy S, et al. (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (NIH Publication No. 02–5215). Bethesda, MD: National Institutes of Health. Also available online: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf.Other Works ConsultedAmerican Heart Association (2006). Diet and lifestyle recommendations revision 2006. Circulation, 114(1): 82–96. [Erratum in Circulation, 114(1): e27.]Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497.Grundy SM, et al. (2004). Implications of recent clinical trials of the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation, 110(2): 227–239. [Erratum in Circulation, 110(6): 763.]Miller M, et al. (2011). Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation, 123(20): 2292–2333.U.S. Preventive Services Task Force (2007). Screening for lipid disorders in children. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspschlip.htm.U.S. Preventive Services Task Force (2008). Screening for lipid disorders in adults. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspschol.htm.
June 29, 2012
Kathleen Romito, MD - Family Medicine & Robert A. Kloner, MD, PhD - Cardiology
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