The Importance of Triglycerides

Tim | April 11, 2011

Triglycerides

Just how important are triglycerides in the grand scheme of your lipid profile?

When looking at their lipid profile most people and doctors concentrate on the LDL cholesterol level with the hopes that it is below 100mg or with the goal of bringing it down to that level or lower. Then we tend to look at the HDL cholesterol level in hopes that it is above 40mg or with the goal of raising it higher because we all know HDL level below 40mg are associated with a greater risk for heart disease.

The triglyceride level is just as an important factor as the LDL and HDL levels. Triglyceride levels have also been linked to increased risk of heart disease as well as stroke and many people don’t know that normal triglycerid levels should be less than 150mg.

Testing for triglycerides be done with the patient in the fasting state because a recent meal or even a cup of coffee can raise the triglyceride level. High triglyceride levels, 200-499, are important because they can deteriorate to severe hypertriglyceridemia with levels from 500 to the thousands. This is of particular concern because it could lead to pancreatitis, and therefore must be treated immediately.

Triglycerides are complex molecules that are considered to be the primary type of fat in the body and in the diet. They are the body’s main source of stored energy. They are manufactured by the liver or, if they come from the diet, are ingested by the liver. They are then transported through the circulation by lipoproteins.

Hypertriglyceridemia is the condition where the triglycerides are elevated above 150 mg/dl. It is a common condition often triggered by uncontrolled diabetes, obesity and insufficient exercise. It is especially related to cardiovascular disease when it is present along with a low HDL and/or elevated LDL levels, but can even be a problem without that combination. Elevated triglycerides can contribute to atherosclerosis by their negative effects on LDL molecules. Hypertriglyceridemia usually is not associated with symptoms until the triglyceride levels are greater than 1,000-2,000, at which time pancreatitis becomes a consideration.

The causes of elevated triglycerides are genetic, uncontrolled diabetes, obesity, hypothyroidism, certain kidney problems, excessive alcohol intake, high carbohydrate diets and physical inactivity. Commonly used drugs such as certain diuretics, anti-hypertensives, oral estrogens, etc., can cause elevated triglycerides.

Good programs are available for control of abnormal triglyceride levels. However, diet (low fat, weight reduction) and exercise should form the basis for any program. Omega-3 fatty acids from fatty fish and some plants (flaxseed) can be helpful. Alcohol should be eliminated or greatly restricted. Several drugs are also effective in reducing triglyceride levels when non-drug therapies are insufficient. These drugs include the statins, niacin, omega-3 fatty acids and a class of medicines called fibrates. Unfortunately, in spite of the benefits of the above therapies, many patients do not follow the treatment programs and often discontinue their medications, leading to occasionally serious, avoidable problems and higher triglycerides levels.