Various molecules are counted and/or calculated when we do blood work. This article focuses on Triglycerides and how they contribute to heart disease risk. I have written similar articles about HDL and LDL.
What are Triglycerides?
Next to cholesterol, triglycerides are the most important measurement in the lipid panel.
Triglycerides enter our blood from 2 sources:
- They are the end product of digesting and breaking down fat in food
- They are released from the liver
Another factor that influences their release is sugar and insulin metabolism. This is the reason someone with high triglycerides must be told to not only watch their fat intake, but also their sugar intake. In some cases, the person is eating all the right fats, and their high triglycerides are a result of poor sugar metabolism.
How Do High Triglycerides Impact Health?
Whereas LDL and HDL have a relatively clear mechanism to heart health, triglycerides are a bit different. Triglyceride levels are related to many other lipid and non-lipid risk factors, meaning many factors alter their levels. When a doctor sees high triglycerides, they investigate glucose metabolism, thyroid health, kidney function and possible alcohol intake
For the longest time, doctors emphasized lowering LDL-C and increasing HDL-C, with less focus on lowering triglycerides. Now, it’s clear that triglycerides are very important too. Triglycerides are an independent risk factor for cardiovascular disease . As mentioned above, they are closely linked with blood sugar dysregulation in addition to sub-optimal HDL and LDL profiles.
Having low triglycerides is usually okay, but pathologically low values can be due to malabsorption, low intake of dietary fats, or possible autoimmunity .
Conditions associated with High Triglyceride Levels 
- Metabolic syndrome
- Fatty liver
- Alcohol intake (both moderate in some people and alcohol dependence)
- Renal disease, especially uremia or glomerulonephritis
- Pregnancy (notably 3rd trimester where triglycerides may double)
- Paraproteinemias (myeloma, lymphoma, lymphocytic leukemia)
- Autoimmune disorders (systemic lupus erythematosus)
- Several medications, including:
- Estrogens, especially those taken orally
- Antihypertensives (non-cardioselective beta-blockers, thiazides)
- Bile-acid-binding resins
- Antiretroviral regimens, especially for HIV infections
- Psychotropic medications (phenothiazides, second generation anti-psychotics)
- Pancreatitis (is only a risk factor when triglycerides rise dramatically)
Getting Triglycerides Tested
Triglycerides are important to test because there aren’t many symptoms specific to high or low triglycerides. Luckily, they are commonly tested in routine lipid panels.
The National Cholesterol Education Program set guidelines for triglyceride levels :
- Normal levels: Less than 150 mg/dL
- Borderline high: 150 to 199 mg/dL
- High: 200 to 499 mg/dL
- Very high: 500 mg/dL or more
Moderate elevations (150 – 499 mg/dL) may identify those at risk for insulin resistance and elevated cardiovascular risk. Severely elevated (more than 1000 mg/dL) is considered a risk for pancreatitis .
The test is very accurate, however, triglycerides vary throughout the day, so it’s harder to base decisions off of them in isolation. A full assessment, looking at other blood parameters, and completing a physical examination will be required in order to determine how to treat elevated triglycerides.
See a Naturopath for Support
As you can see, elevated triglycerides must be assessed in conjunction with your other body systems and overall health. Triglycerides usually don’t elevate by themselves – there’s always something else going on simultaneously. A naturopath will be able to guide you through the various treatment options to best serve you.
Interested in learning more?
Read on in our series of articles on Heart Health!
About the Author - Dr. Johann de Chickera
Dr. Johann is a licensed naturopathic doctor and co-owner of Absolute Health and Wellness. He completed his 4-year degree at the Canadian College of Naturopathic Medicine (CCNM). His clinical focus lies in chronic disease, such as those related to the Gastrointestinal, Endocrine, and Immune Systems.
His approach to medicine relies on working with the patient to come up with a feasible, multi-factorial approach that addresses all complaints at once. He employs a strong background in diagnostic medicine and human physiology and pathology to diagnose and treat. His treatment involve a combination of nutritional counselling, botanical medicine, eastern medicine (acupuncture), nutraceutical supplementation and hands on physical medicine.
To book in please call us at (519) 442-2206 or click here.