It’s a good idea to keep track of your cholesterol. The same is true for your blood pressure, blood sugar levels and waistline. And while you may be used to hearing about “good” (HDL) and “bad” (LDL) cholesterol, triglycerides are an important part of the overall picture too. Triglycerides are one of the four numbers you will see on a standard cholesterol blood (panel) test. When triglycerides are very high, it can spell trouble for your heart and lead to other health issues too.
What are triglycerides?
Triglycerides are a type of fat (lipid) found in your blood.
Your liver makes triglycerides. You also get them through many of the foods you eat. In fact, after you eat, any extra calories that your body doesn’t need right away are converted into triglycerides. These fatty substances are stored in fat cells. They are later released and circulate the bloodstream to be used as energy by cells. But as with LDL cholesterol, too much can be harmful. Most dietary fats are triglycerides.
What are very high triglycerides?
Just as it sounds, having very high triglycerides means that you have too much of this type of fat in your blood. Your doctor may call this condition severe hypertriglyceridemia.
It is detected through a simple blood test called a lipid panel or lipid profile. This test measures your:
You will likely be asked to get your blood taken after fasting—when you haven’t had any food or drink (except water) for eight, and sometimes up to 12 hours. This will show your triglyceride level when your body has cleared any cholesterol from meals you’ve eaten. A triglyceride level done without fasting can also be very revealing because it often shows that your body is not clearing the cholesterol from food.
Your health care provider will likely use your fasting results to guide treatment, but cases can be very different
Like other types of cholesterol, triglycerides are measured in milligrams per deciliter (mg/dL) of blood. There are four categories of triglyceride levels according to the American Heart Association. Someone is diagnosed with very high triglycerides when the amount of triglycerides found in the blood is 500 mg/dL or more; under 150 mg/dL is considered normal.
Triglyceride Level (mg/dL)
500 and Above
What causes VHTG?
A number of factors can raise triglycerides, or cause very high triglycerides. For example, it tends to be more common in people with:
Other things that can raise triglyceride levels include:
Are certain people more likely to develop it?
Yes. As mentioned, some people have a genetic deficiency or family history that makes them more prone to very high triglycerides. The condition is also more common in:
Are there signs and symptoms?
Not usually, though people with very high triglycerides may have coronary disease at an early age. Because there aren’t any overt symptoms, it’s a good idea to ask about routine blood testing to check your blood cholesterol levels.
Why is VHTG dangerous?
Regardless of the cause, having very high triglycerides has been linked to a higher chance of developing heart disease and having a heart attack or stroke. While research is still underway to uncover the exact relationship between triglycerides and cardiovascular disease, we know that very high levels tend to cluster with other risk factors including being obese, high blood pressure, and high cholesterol.
Studies find that very high triglycerides often occur along with:
Taken together, this can set the stage for serious cardiovascular problems.
Extremely high levels of triglycerides can also lead to pancreatitis, a very serious condition in which the pancreas becomes inflamed. This condition can cause significant pain and usually results in hospitalization.
What is the usual treatment for VHTG?
While studies about whether lowering triglycerides can measurably reduce the risk of heart disease or events are still ongoing, most experts say it’s best to keep them within the normal range.
The goal of any treatment program will be to:
The best way to lower triglycerides is by making healthy lifestyle choices, which together can cut triglyceride levels by half! That means reducing triglycerides is largely within your control.
Talk with your doctor about living healthier by taking these 4 steps:
1. Be more active—regular exercise can lower triglycerides and raise good cholesterol
2. Improve your diet—that means trying to:
3. Lose weight and stay at a healthy body weight—losing just 5-10 percent of your weight can lower triglycerides
4. Quit smoking and don’t start
When it comes to lowering triglycerides, lifestyle modifications seem to work well and, in some cases, are as effective as taking medicine for lowering triglycerides. Taking the above steps will help you improve your overall health too.
In some cases, your doctor may also prescribe medications to lower your triglycerides. These might include:
As always, when taking medications:
Important Considerations/Side Effects
Omega-3 fatty acids
Only FDA-approved, prescription strength Omega-3 fatty acids should be used to treat VHTG. While there are dietary supplements (commonly referred to as "off-the-shelf"), these are not the same.
People who have an allergy to fish or shellfish should not take omega-3 fatty acids. If you take the EPA and DHA combination, you may need to get your LDL cholesterol checked because DHA seems to raise this in some people.
Swallow the liquid gel capsule whole and do not take it with a hot beverage.
Tell your doctor if you notice any bruising.
Immediate release formulations of this drug that work quickly in the body can sometimes result in flushing, itching, stomach upsets and raised blood sugar.
Dosages need to be adjusted for people with kidney problems.
You should not take fibrates if you have liver and/or gallbladder disease.
Taking statins and fibrates at the same time can make serious muscle problems more likely. This can lead to kidney failure.
Minimal, if any, positive effect on triglycerides, as research findings are mixed.
Tell your doctor if you also take fibrates.
*This table does not address all concerns or special considerations. Talk with your doctor about the pros and cons of all medications.
There are many new treatments being investigated as well. For example, there data-sf-ec-immutable="" is growing evidence that flaxseed oil may help lower triglycerides in some people. As always, talk with your doctor about the right approach for you.
Questions to ask
It’s always a good idea to be prepared to ask questions about any condition you have. The more you know, the more you can take proactive steps to take care of yourself. Here are a few questions to help get you started: