It’s a good idea to keep track of your cholesterol. The same is true for your blood pressure, blood sugar levels and waistline. And while you may be used to hearing about “good” (HDL) and “bad” (LDL) cholesterol, triglycerides are an important part of the overall picture too.
Triglycerides are one of the four numbers you will see on a standard cholesterol blood (panel) test. When triglycerides are very high, it can spell trouble for your heart and lead to other health issues.
What are Triglycerides?
Triglycerides are a type of fat (lipid) found in your blood.
Your liver makes triglycerides. You also get them through many of the foods you eat. In fact, after you eat, any extra calories that your body doesn’t need right away are converted into triglycerides.
These fatty substances are stored in fat cells. They are later released and circulate the bloodstream to be used as energy by cells. But as with LDL cholesterol, too much can be harmful. Most dietary fats are triglycerides.
What are Very High Triglycerides?
Just as it sounds, having very high triglycerides (VHTG) means that you have too much of this type of fat in your blood. Your doctor may call this condition severe hypertriglyceridemia.
It is detected through a simple blood test called a lipid panel or lipid profile. This test measures your:
- Overall cholesterol
- LDL cholesterol
- HDL cholesterol
- Triglycerides
You will likely be asked to get your blood taken after fasting—when you haven’t had any food or drink (except water) for eight, and sometimes up to 12 hours. This will show your triglyceride level when your body has cleared any cholesterol from meals you’ve eaten. A triglyceride level done without fasting can also be very revealing because it often shows that your body is not clearing the cholesterol from food.
Your health care provider will likely use your fasting results to guide treatment, but cases can be very different
Like other types of cholesterol, triglycerides are measured in milligrams per deciliter (mg/dL) of blood. There are four categories of triglyceride levels according to the American Heart Association. Someone is diagnosed with very high triglycerides when the amount of triglycerides found in the blood is 500 mg/dL or more; under 150 mg/dL is considered normal.
| Classification | Triglyceride Level (mg/dL) |
| Healthy | Below 150 |
| Borderline High | 150-199 |
| High | 200-499 |
| Very High | 500 and Above |
What Causes VHTG?
A number of factors can raise triglycerides, or cause very high triglycerides. For example, it tends to be more common in people with:
- Low thyroid levels (hypothyroid)
- Poorly controlled diabetes
- Kidney disease
- A genetic predisposition where the body produces an excess amount of triglycerides
Other things that can raise triglyceride levels include:
- Certain medicines, including some birth control pills, beta blockers, antipsychotics and corticosteroids
- A diet that is high in carbohydrates, processed or sugary foods
- Alcohol
- Not exercising
Are There Signs and Symptoms?
Not usually, though people with very high triglycerides may have coronary disease at an early age. Because there aren’t any overt symptoms, it’s a good idea to ask about routine blood testing to check your blood cholesterol levels.
Why Are VHTG Dangerous?
Regardless of the cause, having very high triglycerides has been linked to a higher chance of developing heart disease and having a heart attack or stroke. While research is still underway to uncover the exact relationship between triglycerides and cardiovascular disease, we know that very high levels tend to cluster with other risk factors including being obese, high blood pressure, and high cholesterol.
Studies find that very high triglycerides often occur along with:
- Lower levels of “good” or HDL cholesterol that help clear cholesterol from the bloodstream
- Smaller particles of the “bad” cholesterol that can speed up atherosclerosis
- Changes to the body’s ability to break down blood clots, which can increase the risk of stroke
- Metabolic syndrome
Taken together, this can set the stage for serious cardiovascular problems.
Extremely high levels of triglycerides can also lead to pancreatitis, a very serious condition in which the pancreas becomes inflamed. This condition can cause significant pain and usually results in hospitalization.