The Surprising Risks of High Triglycerides
Triglycerides are the most common type of fat in the body. And while you may think all fats, and therefore all triglycerides, are bad, that’s not the case. In fact, triglycerides are actually a key energy source for the body.
“Triglycerides play a very fundamental role in how the body works, and it’s a resource humans have relied on for hundreds of thousands of years,” explains Jorge Plutzky, M.D., director of preventive cardiology at Brigham and Women’s Hospital. “They allow the body to move fatty acids around and be delivered where they’re needed.”
That sounds pretty good! So why all the concern?
When triglycerides reach blood levels higher than 150 mg/dL, the fatty molecules can begin to negatively affect the rest of your body—and your overall health. And though you may have heard your doctor talk about high triglycerides (aka hypertriglyceridemia) in relation to your cholesterol levels at your annual checkup, many people have little clue about their role. We’ve got the skinny on what you need to know.
When Triglycerides Go Bad
First off, how does something the body needs to function become bad for your health? Let’s first look at where triglycerides come from.
When you eat, your liver converts the calories your body doesn’t need to use right away into triglycerides, which then get stored in fat cells, explains Michael Shapiro, D.O., a cardiologist at Wake Forest Baptist Health in Winston-Salem, NC.
When you have a balanced diet, your triglyceride production is usually balanced, too. But if you regularly overeat, those levels will continue to climb. “And if triglycerides are high enough for long enough, they can deposit in areas where they’re not intended,” says Dr. Shapiro. And that’s when they endanger your health.
Triglycerides and Your Cardiovascular System
For most people with high triglycerides, the main concern is how they will affect your risk for attack and stroke. Heart disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention. And having high triglycerides—along with high LDL (“bad”) cholesterol and/or low HDL (“good”) cholesterol—is associated with fatty buildup in your arteries, per the American Heart Association. And if your blood can’t move freely through those arteries, that’s what seriously ups your risk of cardiovascular events like heart attack and stroke.
Triglycerides and Your Cholesterol
Triglycerides and cholesterol are not the same kind of fat, but they are connected: “One of the interesting things about triglycerides is they’re very much linked to the other lipid particles, so as triglycerides come down, the good cholesterol will often go up, and as triglycerides go up, the good cholesterol will go down,” explains Dr. Plutzky. “And there’s lots of evidence that would say that when triglycerides are high, the LDL—the bad cholesterol, which we know is critical for heart disease—may be even more dangerous.”
Triglycerides and Your Muscles
Remember how we said that if you have more triglycerides than your body really needs, it’ll get stored in places it’s not meant to go? The muscles may be one of those places.
According to Harvard Health, it’s possible that having high triglycerides could be a warning sign that your muscles and other tissues in your body are becoming insulin resistant—that’s when your body doesn’t respond to the hormone insulin like it’s supposed too. In fact, some research shows that too much of this fat in the skeletal muscles is associated with insulin resistance, type 2 diabetes, and obesity.
Triglycerides and Your Pancreas
If you have very high triglycerides—over 500 mg/dL—your pancreas can take a serious hit. The pancreas is an organ that helps turn food into fuel in the body. And those with triglycerides this high are at risk for developing a severe form of inflammation called acute pancreatitis.
“It’s a very dangerous situation,” says Dr. Shapiro. “Besides being extremely uncomfortable, very severe acute pancreatitis can be a fatal event. Multiple recurrences of pancreatitis can kill off enough pancreatic beta-islet cells—the ones that produce insulin—that diabetes develops.” Without those beta-islet cells, you can’t produce the insulin your body needs to manage blood sugar. Compared to mildly elevated TG levels that should be managed with diet and exercise, severe elevated TG with pancreatitis is relatively uncommon.
Triglycerides and Your Skin
Another area where very high triglycerides can take a toll? The largest organ in your body—the skin.
In people with genetic hypertriglyceridemia, triglycerides may become trapped in the skin, causing eruptive xanthomas, explains Dr. Plutzky. This rare condition is characterized by pea-sized, waxy bumps ranging in color from red to yellow, according to the National Institutes of Health. Typically, they appear on the buttocks, shoulders, arms, and legs. Once you get your blood-sugar and fat levels (including triglycerides) down, the bumps will go away.
Another indicator of high triglycerides: The creases in your hands appear yellow.
Triglycerides and Your Liver
So you know that your liver makes triglycerides, but when levels are severely high—like around 2,000 mg/dL—it can also lead to harmful fat buildup in the liver, or fatty-liver disease, according to Harvard Health. Fatty-liver disease can lead to severe problems like permanent liver damage and cirrhosis, which is when your liver becomes severely scarred, making it difficult to function.
Triglycerides and Your Eyes
Very high triglycerides can also, in rare cases, accumulate in the retina, which is the back part of your eye that’s sensitive to light. “The retina has very tiny blood vessels, so you can imagine, just like the outlet ducts of the pancreas, they can get clogged with triglycerides,” explains Dr. Plutzky.
This condition is called lipemia retinalis. The buildup can also affect the arteries and veins in your retina and sometimes the surrounding areas, according to the American Academy of Ophthalmology. Thankfully, this usually doesn’t affect your vision—but it’s yet another important sign that you need to work with your doctor.
Remember: Most of These Problems Are Rare
While very high triglycerides can raise your risk of serious health problems, like pancreatitis, it’s important to keep in mind that having very high triglycerides itself is rare.
“To put this in context, if you look at the adult population, only 1% of the population that has triglycerides above 500 mg/dL,” says Dr. Shapiro. The majority of people with high triglycerides are below that range—but even at those lower levels, people are still at increased risk for issues like diabetes, heart attack, and stroke.
How Do You Lower Your Triglycerides?
If you’ve been diagnosed with high triglycerides—or you simply want to be proactive about your health—know that there are steps you can take. In fact, the American College of Cardiology says that lifestyle choices alone may cut your triglycerides by half, especially if you’re in the borderline-high or high range (200-500 mg/dL)—that’s a lot of power!
3 Smart Changes to Lower Triglycerides
- Eat a healthy diet. Put the brakes on soda, bread, potatoes, pasta, alcohol, and juice. “The densest energy foods that we tend to eat are simple carbohydrates,” explains Dr. Plutzky.
- Increase your physical activity. Being inactive can up your risk of high triglycerides “Even little things like walking or going up the stairs can be very effective,” says Dr. Plutzky.
- Quit smoking. Smoking can raise your triglycerides—along with the risk of a host of other serious health problems. If you’re a smoker, the time to quit is now. For free resources on how to quit smoking, call 1-800-QUIT-NOW.
4 Medications That Can Lower Triglycerides
If your triglycerides are over 500 mg/dL, your doctor also may prescribe a medication in addition to lifestyle changes, says Dr. Shapiro. Possibilities include the following, per the American College of Cardiology:
- Statins. These drugs are used to help bring down your LDL cholesterol numbers—but they also may help lower your triglycerides.
- Omega-3 fatty acids. You’ve probably already heard of these supplements—but there are also prescription forms that come in high doses that can help more effectively, says Dr. Shapiro.
- Fibrates. These drugs work by reducing your liver’s triglyceride production.
- Niacin or vitamin B3. Your doctor may suggest these because research shows they may lower your body’s ability to produce triglycerides.