High Triglycerides: What You Need to Know

Medically Reviewed by Zilpah Sheikh, MD on March 22, 2024
6 min read

You’ve probably heard of cholesterol. You might even know if your levels are too high. But what do you know about your triglycerides? More than a third of adults in the U.S. have high levels of triglycerides, a type of fat (lipid) in the blood that your body uses for energy.

Triglycerides are the most common type of lipid in your body. They come from fatty foods such as butter and from unused calories that your body stores in fat cells. When your body needs energy, it gets it from triglycerides. You do need some triglycerides to be healthy, but you don't want too many.

Studies have consistently linked high triglyceride levels to heart disease, heart attacks, and stroke, especially in people with low levels of "good" HDL cholesterol and those with type 2 diabetes. So if you have diabetes, high blood pressure, or other things that make you more likely to get heart disease, your doctor will likely want to keep a check on your triglyceride levels.

The good news is that there's a lot you can do on your own to lower your triglyceride levels and improve your health.

HDL (high-density lipoprotein) is the "good" cholesterol. It helps remove "bad" cholesterol, or LDL (low-density lipoprotein) from your bloodstream. Cholesterol is a waxy compound found in your cells that is carried through your bloodstream via proteins called lipoproteins.

Having high levels of HDL is associated with a lower risk of heart disease. High levels of LDL can clog the walls of your blood vessels, which may lead to a heart attack or stroke.

Triglycerides and HDL are usually inversely related. That means the higher your number of triglycerides, the lower your HDL. And the higher your HDL, the lower your triglycerides. But it's possible to have high triglyceride levels without having low HDL. Research shows that high triglycerides are a risk factor for heart disease regardless of your HDL level.

Some of the risk factors for high triglycerides include:

  • Being overweight or obese
  • Not getting enough exercise
  • Eating foods that are high in fat or sugar
  • Drinking too much alcohol
  • Taking medications for HIV, breast cancer, and rarely, high blood pressure
  • Living with HIV
  • Being of South Asian ancestry (from India, Pakistan, Bangladesh, and other countries in the region)
  • Having a disorder that prevents the body from breaking down lipids (fats, cholesterol, etc.)
  • Having conditions such as diabetes, kidney disease, thyroid disease and liver disease

A blood test called a lipid panel checks both your triglyceride and cholesterol levels. Usually, your doctor will tell you to fast (meaning you should not eat or drink anything other than water) for 9-12 hours before the test. You’ll get blood taken from a vein in your arm. Some labs offer non-fasting lipid panels, or they may prick your finger for blood.

Here are the levels based on a fasting blood test:

  • Normal: Less than 150 milligrams per deciliter (mg/dL)
  • Borderline: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very high: 500 mg/dL or above

Anyone over age 20 needs to get regular tests to track their cholesterol and triglyceride levels, according to the American Heart Association.

Anything above 500 mg/dL is considered very high. Very high levels of triglycerides are associated with liver and pancreas problems.

Triglyceride levels above 1,500 mg/dL are considered extremely high and may cause the body to stop breaking down fats. This may result in memory loss, liver and spleen swelling, and stomach pain.

High triglycerides tend to show up along with other problems, such as high blood pressure, diabetes, obesity, high levels of LDL cholesterol, and low levels of HDL cholesterol. Research now shows that increased triglyceride levels are associated with an increased risk of cardiovascular events such as heart attacks and strokes, so steps should be taken to bring them down.

Finding out that you have high triglycerides might be upsetting. But there's a lot you can do on your own to lower them. Making changes to your lifestyle can have a dramatic benefit. Here are some suggestions:

Get more physical activity. Exercise can have a big impact on triglyceride levels. Experts advise that everybody should get at least 30 minutes of exercise five times a week. If you're out of shape, start slowly. Begin with a quick walk three times a week and then build up from there.

Lose some weight. If you're overweight or obese, shed a few pounds and try to maintain an ideal body weight. Exercise will help, but you also need to focus on diet. The key is to eat fewer calories -- whether they come from fats, carbs, or protein. Focus on a diet that's high in fruits, vegetables, lean proteins, and low-fat dairy products. Cutting down on sugary foods, such as sodas, could help, too.

Choose better fats. Pay more attention to the fats you eat. Eat fewer foods with unhealthy fats (found in meat, butter, and cheese), trans fats (in processed foods and margarines), and cholesterol. Eat more healthy monounsaturated and polyunsaturated fats, which are found in olive oil, nuts, and some fish. Studies suggest that the omega-3s in fatty fish -- such as tuna, salmon, mackerel, and sardines -- are particularly good at lowering triglyceride levels. Because even healthy fats are high in calories, you still need to eat these foods in moderation.

Cut down on alcohol. Even small amounts of alcohol seem to cause big spikes in triglyceride levels. Limit yourself to one alcoholic drink a day.

People with heart disease and high triglycerides may need medication to bring down their levels.

  • Fibrates can lower triglycerides. They modestly improve cholesterol levels, too.
  • Fish oil with omega-3 fatty acids can help keep triglycerides under control. Ask your doctor whether you should use prescription fish oil. Omega-3 acids from plant sources such as flaxseed may help, too.
  • Niacin (nicotinic acid)can lower triglycerides by up to 50%. It's available as a nonprescription supplement and as a prescription drug.
  • Statins can reduce triglycerides levels by 20%-40%. If you take statins to lower your cholesterol level, you'll get this side benefit.
  • Bempedoic acid, a new cholesterol-lowering drug, is an option when statins don't work. A study showed it lowered triglycerides by 15%.

Remember that to stay healthy and keep your triglycerides down, you still have to focus on improving your lifestyle.

When you talk to your doctor, discuss all of the medicines, supplements, and vitamins you take. Some common drugs, such as beta-blockers, birth control pills, and diuretics, can raise triglyceride levels as a side effect.

A healthy diet can help lower your triglyceride levels. This means limiting fatty and sugary foods and eating lots of whole grains, fruits, vegetables, and fatty fish.

Foods to eat with high triglycerides

These foods will help lower triglyceride levels:

  • Whole-grain breads and cereals
  • Brown rice
  • Oats
  • Dried peas and beans (chickpeas, pinto beans, black beans, etc.)
  • Small amounts of vegetable oil (olive, canola, or safflower oils)
  • Avocados
  • Nuts and seeds
  • Nut butters
  • Fatty fish (salmon, mackerel, sardines -- twice a week)
  • Colorful fruits and vegetables (broccoli, Brussels sprouts, carrots, red peppers, watermelon, berries, cantaloupe, etc.)

Foods to avoid with high triglycerides

Limit high-fat and high-sugar foods, including:

  • Cookies
  • Candy
  • Soda
  • Ice cream
  • Pastries
  • Sports and energy drinks
  • Fruit juices that are high in sugar
  • Butter
  • Beef, pork, and lamb
  • Fried foods
  • Whole milk and 2% milk

When it comes to cholesterol and triglycerides, perhaps the most important thing is to get regular screenings. See your doctor and get your lipid profile done. If your triglycerides are high, you and your doctor can decide on a treatment plan -- medications, changing your eating habits, and exercising can bring those levels down.

How often should my triglycerides be tested?

If you’re a healthy adult, you should get a lipid profile every 4-6 years. Children should have it done at least once between the ages of 9 and 11, and one more time between 17 and 21. If you’re making changes to your diet or taking medication for high cholesterol or triglycerides, get a lipid profile afterward.

Are high triglycerides worse than high cholesterol?

Both increase the risk of heart attack and stroke. However, changing your diet or taking a statin to lower your high cholesterol will likely lower your high triglycerides as well.

Can high triglycerides cause fatigue?

High triglycerides usually don't cause any symptoms. But if they aren't treated and you get heart disease, then you may feel tired as a side effect.