Triglycerides: What your levels mean and how to lower them

You already know you need to have your cholesterol checked regularly—that’s common knowledge. But you may need to know your triglyceride numbers, too.

According to Catherine McNeal, MD, an internist on the medical staff at Baylor Scott & White Medical Center – Temple, a high triglyceride count can be a marker for a lifestyle that leads to serious health problems. Here’s what you need to know about high triglycerides and what you can do today to improve your numbers.

What are triglycerides?

“Triglycerides are one of the two lipids, or fats, found in your blood,” Dr. McNeal said. “Cholesterol is the other lipid. Whereas cholesterol comes from the fatty foods you eat, triglycerides are metabolized and are the byproducts of the sugars and starches you eat.”

The more sugary and starchy foods you consume, the greater your risk of developing high triglycerides. Leftover calories are converted by your body into triglycerides and stored in your fat cells.

In some cases, a high triglyceride level may be genetic and not dependent on your food consumption. Talk to your doctor about your own health and history to better understand your triglyceride levels.

How are triglycerides measured?

Your triglycerides are measured in a fasting blood test called a lipid profile or cholesterol test. Also checked are your:

• HDL (good cholesterol)
• LDL (very bad cholesterol)
• VLDL (bad cholesterol)
• Total cholesterol

Why triglyceride levels matter

Triglycerides are a good measure of your overall health. Dr. McNeal said that a higher triglyceride level (above 150 mg/dL) comes as a “package plan,” called metabolic syndrome, which often includes:

• Low HDL cholesterol (the good cholesterol)
• An increased waist size (above 35 inches for a woman and 40 inches for a man)
• Higher blood pressure
• Blood sugar in the pre-diabetic range

Sometimes just a few of these features are present, but having at least three of these problems markedly increases your chances of developing type 2 diabetes mellitus and increases the risk of developing coronary artery disease.

“In this case, a high triglyceride level is usually due to an unhealthy lifestyle—that is, not being active enough and/or consuming too many calories—which can then lead to type 2 diabetes and heart disease,” Dr. McNeal said.

Certain medications may increase your triglyceride levels, including:

• Some acne medications, especially those containing retinoic acid
• Some oral contraceptives
• Many antipsychotics
• Prednisone
• Beta blockers

If you are taking one or more of these medications and you have high triglycerides, discuss their use with your physician.

How do I lower my triglyceride levels?

Having high triglyceride levels doesn’t have to be a permanent state. Of all the things in the lipid profile, triglycerides are the most easily modifiable and can respond within days to dietary changes and physical activity. The most effective way of lowering triglyceride levels is with a little TLC: therapeutic lifestyle changes.

Limit or avoid starches

• Bread
• Rice
• Potatoes
• Pasta

Limit or avoid sugars

• Sugared beverages
• Fruit drinks
• Sweets of all kinds
• Milk-based products
• High fructose corn syrup

Eat more fish

Replacing red meats with fish is a good place to start.

Avoid alcohol

Even small amounts of alcohol can have a significant impact on your triglycerides.

Swap your fats

Substitute monounsaturated and polyunsaturated fats for saturated fat. For example, use avocado and olive oils rather than butter or bacon fat.

Get at least 150 minutes of exercise each week

“With exercise, after you burn glucose, you burn triglycerides as fuel,” Dr. McNeal said. “That’s how exercise lowers your triglycerides.”

For people with severely elevated triglycerides or with type 2 diabetes and high triglycerides, especially women, a class of drugs called fibrates may be recommended.

How high triglycerides affect total cholesterol

Dr. McNeal said you should use caution when interpreting results of your lipid profile, as high triglycerides can affect your total cholesterol count.

“Your LDL equals your total cholesterol minus your HDL minus your triglycerides, divided by five,” she said.

That means when your triglyceride level is really high, you’ll have a higher total cholesterol level as well. But at the same time, if you bring your triglyceride levels down, it will have an immediate impact on your total cholesterol—and that doesn’t necessarily require medication.

“When your total cholesterol is high because your triglycerides are high, using cholesterol-lowering medications isn’t going to help any,” she said. “It’s more effective to lower the triglycerides using lifestyle changes.”

How often should I have my triglycerides checked?

The American Heart Association recommends a fasting lipid profile for all adults aged 20 or older every five years. Dr. McNeal said you may need to have your triglycerides checked more frequently if:

• Your triglycerides are 200 mg/dL or higher
• You are over age 50
• You have other risk factors for heart disease or type 2 diabetes

If you are concerned about your triglyceride levels, visit your primary care doctor. If you don’t have one, find a doctor near you today.