Although medical establishments consider blood triglyceride levels of 10 - 150 mg/dL, or 0.1 - 1.7 mmol/L normal, or good, according to many experts, desirable or favorable fasting blood triglyceride levels should be 50 - 150 milligrams per deciliter (mg/dL), or 0.6 - 1.7 millimoles per liter (mmol/L) of blood.

"Normal", however, does NOT necessarily mean "healthy" as it may include both healthy and many unhealthy people. We want "healthy", not just "normal" serum triglyceride (and other lipid) levels.

Therefore, in order to avoid future cardiovascular health problems, the "ideal" or beneficial (healthy) range of trigycerides should be much tighter than the often quoted "normal" triglyceride range referred to by your doctor, that is below 150 mg/dL, or 1.7 mmol/L.

This is important as elevations of the blood triglycerides, particularly in association with decreased HDL-"good" cholesterol, outside this range are the key marker for heart disease and stroke.

"Research shows that levels above 100 mg/dl significantly increase your risk for heart attack," says Bruce Holub, PhD, nutrition researcher at the University of Guelph in Ontario, Canada.

For each mmol/L increase in triglycerides - which translates into 88.5 mg/dL - the risk of coronary artery disease (CAD) increases by 37 percent in women and 14 percent in men.

All else being equal, a man with a triglyceride level of 300 mg/dL would have a risk of cardiovascular events roughly 28 percent higher than that of an otherwise comparable man who has a level of 100 mg/dL (a meta-analysis by John Hokanson and Melissa Austin, 1996).

For example, if your triglyceride level is about 50 mg/dL, or 0.6 mmol/L after eating a classic fast-food "meal" of a hamburger, French fries, and milkshake, your triglycerides may increase by 15 percent to 20 percent.

In other words, the triglyceride level may rise to 70 mg/dL (0.8 mmol/L), 80 mg/dL (0.9 mmol/L), or perhaps 90 mg/dL (1.0 mmol/L) - but still will remain within the optimal range (below 100 mg/dL, or 1.1 mmol/L).

If your baseline triglyceride level is greater than 200 mg/dL, or 2.3 mmol/L

By applying these guidelines, you will be able to take control of your health care, just as we all should do.

Unfortunately, your doctor may have you take the blood test without informing you of all factors that might affect the results.

You never know when even a “highly regarded” doctor might be rushed or inexperienced, or simply overly comfortable with a procedure, then end up taking a short cut at your expense, recommending a drug or an uncomfortable, invasive procedure based solely on a suspect or false test result.

Overnight fasting is essential for an accurate measurement of blood triglycerides!

In addition, alcohol should not be consumed for the 24 hours just before the test.

You are also not supposed to take any vitamin supplements 24 hours prior to your fasting blood work. If you are currently on antihistamines, antibiotics or cortisone treatment only, you need to call the lab or your doctor for more information on how to proceed.

Anything taken in, other than water, during that time can elevate the blood triglycerides as they change dramatically in response to meals. Without the proper fasting, they can easily be high enough to prompt your doctor to prescribe drugs.

Daily concentrations of blood triglycerides vary more than the concentrations of most other metabolites and can be affected especially by:

• previous alcohol (ethanol) consumption
• dehydration, and
• other factors, such as some drugs and ascorbic acid/vitamin C (they can decrease triglyceride measurements).

Another factor that affects triglyceride measurement is postural change; the level can vary by as much as 15 percent, depending on whether your were standing or supine when the blood was drawn, because of associated shifts in plasma volume.

Yet another factor is laboratory variability, which can range between 5 percent and 10 percent on a daily basis.

Finally, intraindividual variability can be another 5 percent to 10 percent.

Those variations, however, will not matter as much in those who have an optimal baseline triglyceride value as they will in people who have an elevated value, in whom the variability will tend to be much more dramatic.

It should also be noted that test for blood (serum) triglycerides should not be performed on specimens collected between 24 hours and 8 weeks after myocardial infarction (heart attack), as levels will be lower than usual.

However, lipid profiles are best avoided following acute myocardial infarct, for up to 3 months, although cholesterol can be measured in the first 24 hours.

As a rule, variability in triglycerides measurement can be decreased if you are instructed to

• fast overnight for at least twelve (12) hours
• abstain from alcohol for two (2) days, and
• consume two cups (473 mL) of water one (1) hour before the collection of blood.

Second, have the blood test repeated to be sure your measurement is accurate. And ask your doctor for specifics regarding factors that can create false positive or false negative test results.

Therefore, the type of standard, conventional medical treatment used to lower cholesterol

The SI is an international standard recognized around the world – except by the United States of America, Liberia, and Myanmar (Burma) who will probably adopt it in due time.

The term "mg/dL" then is the abbreviation for milligrams (mg) per deciliter (dL) and describes how much lipid is present in a specific amount of blood.

Greek and Latin words form the prefixes for the units on most lab tests. A milligram is a thousandth (1/1000) of a gram (a gram is about the weight of a paper clip).

The term "mmol/L" is the abbreviation for millimoles (mmol) per liter/litre (L) and describes how much lipid is present in a specific amount of blood.

A millimole is 1/1,000 of a mole. A mole is an amount of a substance (in this case, triglyceride or cholesterol) that contains a certain number of molecules or atoms.

To convert your cholesterol into Floridian, simply multiply the value by 39. For example, if your cholesterol comes in at 5.2 mmol/L, multiplying this by 39 yields a value 202 mg/dL.

The same conversion factor of 39 applies to HDL and LDL values.

However, your triglyceride values must be multiplied by 89.

Armed with these simple conversion factors you can impress your American neighbours with your bilingual knowledge of lab values, and then exchange stories of how to amazingly improve the numbers without actually following your doctor’s advice.

Triglyceride Conversion Calculator
Enter the Triglyceride level in the spaces provided below and then click the "Calculate" button to convert. Use the "tab" key to move from cell to cell for faster input.

Please treat the results with due care and consideration.

Even in people with severe blood triglycerides - 1000 mg/dL, or 11.3 mmol/L, or acutely and massively elevated triglycerides - results from the physical examination are variable, ranging from normal examination results to one or more of the following findings:

• When sustained elevated triglycerides are well above 1000 mg/dL sometimes eruptive xanthomas are found. These are 1- to 3-mm pin-head yellow papules, or bumps on an erythematous base occurring mostly on the back, buttocks, chest, bony elbows, knees and heels.

• The lesions are caused by accumulations of chylomicrons and will disappear gradually when triglycerides are kept below 1000 mg/dL. If the diagnosis of eruptive xanthomas, a benign condition, is in doubt, obtaining a biopsy of the suspicious lesions will reveal accumulations of fat (not cholesterol).

• Adults with dysbetalipoproteinemia (type III) - a rare lipid disorder with high levels of blood triglycerides (greater than 400 mg/dL or even 1000 mg/dL) and cholesterol - may have palmar xanthomas (yellowish creases of the palms). This type of xanthoma is considered characteristic of this disorder. Tuberous or tuberoeruptive xanthomas, which also may occur in other hyperlipidemias, may arise on the elbows, knees, or buttocks.

• The mid epigastric area or upper right or left quadrants will be tender to palpation, if pancreatitis or the chylomicronemia syndrome is present. Also in people with the chylomicronemia syndrome, memory loss, dementia, and depression have been reported.

• Triglyceride levels of 4000 mg/dL or higher, or >45.2 mmol/L may cause a condition known as lipemia retinalis, in which eye examination reveals retinal blood vessels (and occasionally the retina) that have a pale pink, milky appearance.

The NCEP is a division of the National Institutes of Health (NIH). Its recommendations ("consensus statements") are the products of independent, non-Federal panels of experts and are based on the panels' assessments of medical knowledge available at the time the statements were made.

Therefore, they provide "snapshots in time" of the state of knowledge of the topics (new knowledge, however, is inevitably accumulating through medical research).

It should be noted, however, that the usually quoted "normal" blood lipid levels do change as they depend

Simply said,

• LDL carries cholesterol for cell building needs, but leaves behind any excess on artery walls and in tissues;
• HDL helps to prevent narrowing of the artery walls by removing the excess cholesterol and transporting it to the liver for excretion.

For this reason, their blood levels are important markers for cardiovascular health and disease.

LDL-"bad" cholesterol level:

• less than 100 mg/dL (<2.6 mmol/L) is considered optimal
• 100 mg/dL - 129 mg/dL (2.6 mmol/L - 3.4 mmol/L) - near optimal or above optimal
• 130 mg/dL - 159 mg/dL (3.4 mmol/L - 4.1 mmol/L) - borderline high
• 160 mg/dL - 189 mg/dL (4.1 mmol/L - 4.9 mmol/L) - high
• 190 mg/dL and above (4.9 mmol/L and greater) is considered very high.

HDL-"good" cholesterol level:

• 60 mg/dL (>1.6 mmol/L) or higher is considered desirable (it reduces the risk of heart disease, even if total or LDL cholesterol is high)
• 40 mg/dL - 60 mg/dL (1.0 mmol/L - 1.6 mmol/L) - acceptable
• below 40 mg/dL (1.0 mmol/L) is considered low (it increases the risk for coronary artery disease in people who also have high total cholesterol levels).

Low levels of HDL-"good" cholesterol are associated with an increased risk of congnitive impairment and dementia - a chronic or persistent deterioration of intellectual function and cognitive skills.

Symptoms of dementia include memory loss, personality changes, lack of interest in personal care, impaired reasoning ability and disorientation. As cardiovascular disease and stroke are important risk factors for dementia, the optimal levels of HDL cholesterol may help to prevent dementia. (Van Exel, E., et al. Association between high-density lipoprotein and cognitive impairment in the oldest old. Annals of Neurology.Vol. 51, Issue 6, June 2002:716-721).

It is the ratio between the level of HDL-"good" cholesterol and total cholesterol.

Therefore, in adults, the HDL-"good" cholesterol/total cholesterol ratio should be higher than 0.24 (just divide your HDL level by your cholesterol).

Or more precisely, the HDL/total cholesterol ratio:

• 0.24 or higher is considered ideal
• under 0.24 - low
• less than 0.10 - very dangerous.

Generally speaking, the higher the ratio, the better (the lower your risk of a heart attack).

However, HDL is closely related to triglycerides. It appears common for people with high triglycerides to have low HDL’s, and these same people also tend to have high levels of clotting factors in their blood stream, which is unhealthy in protecting against heart disease.

Therefore, in adults, the triglyceride/HDL-"good" cholesterol ratio should be below 2 (just divide your triglycerides level by your HDL).

Or more precisely, the triglyceride/HDL ratio:

• 2 or less is considered ideal
• 4 - high
• 6 - much too high.

And, since HDL (high density lipoprotein) is protective against heart disease, the lower the ratio, the better. In other words, the lower your triglycerides, or the higher your HDL, the smaller this ratio becomes.

It is now believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease. A Harvard-lead study author reported:

"High triglycerides alone increased the risk of heart attack nearly three-fold. And people with the highest ratio of triglycerides to HDL -- the "good" cholesterol -- had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL in the study of 340 heart attack patients and 340 of their healthy, same age counterparts.

The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio (Circulation 1997;96:2520-2525)."

However, association between triglycerides and HDL cholesterol is the most difficult to sort out. It turns out that whenever triglycerides are increased, HDL cholesterol decreases.

So is the increased risk seen with high triglycerides due to the triglycerides themselves, or to the associated reduction in HDL-“good” cholesterol and increase in LDL-“bad” cholesterol. So far, nobody can say for sure.