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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
High triglycerides are usually caused by other conditions, such as:
Certain medicines may also raise triglycerides. These medicines include:
In a few cases, high triglycerides also can run in families.
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").
You can 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 changes first.
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 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 generally categorized as follows:
Less than 1.7 millimoles per litre (mmol/L)
1.7 to 2.1 mmol/L
2.2 to 5.4 mmol/L
5.5 mmol/L 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.
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 High Cholesterol.
Diet and lifestyle changes are the first steps you will take to lower triglyceride levels.
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.
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.
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 lower your triglycerides. For example:
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.
Current as ofJuly 22, 2018
Author: Healthwise StaffMedical Review: Kathleen Romito, MD - Family MedicineDonald Sproule, MDCM, CCFP - Family MedicineMartin J. Gabica, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineElizabeth T. Russo, MD - Internal MedicineAdam Husney, MD - Family MedicineRobert A. Kloner, MD, PhD - CardiologyRakesh K. Pai, MD - Cardiology, Electrophysiology
Current as of: July 22, 2018
Author: Healthwise Staff
Medical Review:Kathleen Romito, MD - Family Medicine & Donald Sproule, MDCM, CCFP - 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 & Robert A. Kloner, MD, PhD - Cardiology & Rakesh K. Pai, MD - Cardiology, Electrophysiology
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