Please note that this website is not intended for “most people”. It is written for those who want to stand out in self-health care. If you are such a person, we strongly advise that you give serious thought to all of the suggestions about how to improve you blood lipid profile, triglycerides in particular. If you are tempted to think the suggestions are too complicated or too simplistic, or even biased, we assure you they are not.
Triglyceride Levels: Where Your Triglycerides Should Be
The purpose of this website is to present, to all who want the knowledge, a natural, safe and dependable method through which individuals can lower their elevated blood triglyceride levels. If you put your mind to it you can achieve astonishing results. By having the whole page printed, you can read it in a nice easy chair, away from that glaring monitor.
Where our triglycerides should be is sort of the million dollar question. It's actually being debated. |
Triglycerides test results are reported as numerical values rather than as "high" or "low", or "normal". Therefore, it is necessary to know the reference range for the test which may vary by person's age, sex, etc.
What does the fasting triglyceride test result mean? How high is high?
As triglyceride levels in the blood vary a great deal, right now, the general figure ("normal" range) is based on a fasting level of under 150 mg/dL, or 1.7 mmol/L.
In May, 2001, the U.S. National Cholesterol Education Program (NCEP), a division of the National Institutes of Health (NIH), released recommendations on who should be treated for elevated triglyceride levels.
The NCEP 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.
The NCEP advises that adults have their blood lipids checked at least once every five years, starting at age 20. |
It should be noted, however, that the usually quoted "normal" blood lipid levels do change as they depend upon the levels found in the majority of the population as well as upon what... health officials decide is normal.
Therefore, the declared "normal" triglyceride levels -- that your doctor will use to tell you whether your various serum/blood levels are "normal" -- do NOT necessarily mean "healthy" levels.
Here is the American Cholesterol Education Program Expert Panel’s current policy on fasting blood triglyceride levels in adults:
| less than 150 mg/dL (<1.7 mmol/L) | Normal |
| 150 - 199 mg/dL (1.7–2.3 mmol/L) | Borderline-high |
| 200 - 499 mg/dL (2.3–5.64 mmol/L) | High |
| higher than 500 mg/dL (>5.64 mmol/L) | Very high |
Here are the Canadian guidelines on fasting blood triglyceride levels in adults:
| less than 2.0 mmol/L (<177.2 mg/dL) | Optimal |
| 2.0 - 2.5 mmol/L (177.2 - 221.5 mg/dL) | Acceptable |
| higher than 2.5 mmol/L (>221.5 mg/dL) | Compromised |
According to some European guidelines, blood triglyceride levels in adults should be categorized as follows:
| less than 1.7 mmol/L (<150.1 mg/dL) | No risk |
| between 1.7 - 2.3 mmol/L (150.1 - 203.1 mg/dL) | Suspect |
| fasting 1.7 - 2.3 mmol/L (151.1 - 203.1 mg/dL) | Requiring attention, intervention/treatment |
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2.3 - 4.6 mmol/L (203.1 - 407.1 mg/dL) LDL cholesterol greater than 1.5 mmol/L (>58 mg/dL) |
Aggressive |
The following "normal" blood triglyceride reference ranges are based on someone's age:
| Age | "Normal" Triglyceride Range |
| 10 - 29 years | 53 - 104 mg/dL, or 0.6 - 1.2 mmol/L |
| 30 - 39 years | 55 - 115 mg/dL, or 0.6 - 1.3 mmol/L |
| 40 - 49 years | 66 - 139 mg/dL, or 0.7 - 1.6 mmol/L |
| 50 - 59 | 75 - 163 mg/dL, or 0.8 - 1.8 mmol/L |
| 60 - 69 | 78 - 158 mg/dL, or 0.9 - 1.8 mmol/L |
| > 70 years | 83 - 141 mg/dL, or 0.94 - 1.6 mmol/L |
Here's another example of the "normal range" of blood triglycerides based on gender and age. Many health professionals find it quite accurate:
| Adult Males | Upper level: 130 mg/dL + age; Maximum: 200 mg/dL, or 2.3 mmol/L |
| Adult Females | Lower level: 80 mg/dL + age; Maximum: 165 mg/dL, or 1.9 mmol/L |
| Adult Males and Females | Lower level: Your age |
| Adult Males and Females | Below 100 mg/dL, or 1.1 mmol/L: Ideal level |
PLEASE NOTE: Fasting values should be based on two serial measurements of serum (blood) triglycerides. Serial measurements are important because of intraindividual triglyceride variability which is 5 times that of cholesterol.
Healthy and Beneficial Blood Triglyceride Levels
The average triglyceride level in the United States is 134 mg/dL, or 1.5 mmol/L and is considerably higher than triglyceride levels below 100 mg/dL, or 1.1 mmol/L commonly observed in countries where heart disease rates are low.
As the "optimal" levels reflect health, the IDEAL (ie. beneficial) blood triglyceride levels for cardiovascular health seem to be the levels between 70 mg/dL and 100 mg/dL, or 0.8 - 1.1 mmol/L. |
"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).
Therefore, for every percentage your triglyceride level drops, so can your chance of heart disease or stroke.
Familial Hypertriglyceridemia
Familial hypertriglyceridemia is an inherited disorder that causes high triglycerides in the blood, namely, elevated concentration of very low density lipoprotein (VLDL). This leads to increased risk of:
Familial hypertriglyceridemia is caused by a gene mutation which is passed on in an autosomal dominant fashion. This means that if you get the gene from just one of your parents -- you will have the condition.
How exactly the gene mutation causes an elevatation of triglycerides in the blood is unknown though.
Familial hypertriglyceridemia is not contagious. However, children and other family members of the affected person should get regular lipid screenings as this condition does not usually manifest itself until puberty or early adulthood.
It is frequently associated with obesity, or being overveight, hyperglycemia (high blood glucose levels), and high levels of insulin.
The main long-term concern is pancreatitis (the inflammation of pancreas). The pancreas is important because it makes insulin and substances to help digest food. If the pancreas stops working properly, as in pancreatitis, these functions may stop working.
In the United States, familial hypertriglyceridemia occurs in about 1 in 300 individuals.
This condition, however, can be successfully managed by
- lifestyle changes, especially through aerobic exercise
- food changes, especially through low-grain, no-sugar diet and
- specialty nutritional supplementation supporting lipid (fat) and carbohydrate (sugar/starches) metabolism.
Physical Symptoms of High Triglycerides
Most people with borderline-high (150 - 199 mg/dL, or 1.7–2.3 mmol/L) or high triglycerides (200 - 499 mg/dL, or 2.3–5.6 mmol/L) will not have any symptoms. That's what makes it so scary. Because no one feels badly with high triglycerides, a lot of people simply have no clue!
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.
It should be noted that fairly common on the eyelids, xanthomas - yellow, soft and slightly raised non-contagious bumps made of cholesterol deposits - are also a sign of elevated cholesterol levels.
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A close-up of an eruptive xanthoma on the back of a man with a triglyceride level of 4600 mg/dL, or 51.9 mmol/L and acute pancreatitis. |
In all people, eruptive xanthomas are a sign of severely evelvated blood triglyceride levels.
The Critical Role of Blood Sugar
With no any doubt, the most common reason for having elevated blood triglycerides is
One reason for body cells to fail to take up glucose (blood sugar) properly is
- either a lack of insulin (common in diabetes 1, called insulin-dependent or juvenile diabetes) or
- insulin resistance (common in diabetes 2, often referred to as maturity-onset or non-insulin-dependent diabetes), or insulin resistance syndrome, called pre-diabetes syndrome, or
- all the above.
The percentage of Americans with insulin resistance, or pre-diabetes syndrome is closer to 3 per cent of U.S. population. However, a new report from the Department of Health and Human Services multiplies the number of people in the U.S. who are pre-diabetic. The 2004 HHS report puts the new figure at 41 million (that's the population of California and New Jersey combined!).
Insulin is the hormone produced by the pancreas, which helps cells take up glucose from the blood to use as fuel (energy).
If you lack insulin, or if your cells are resistant to insulin, they cannot take up glucose, and so they turn to fatty acids (fats/lipids) for fuel. They get these fatty acids from... triglycerides put by the liver into circulation. |
- heart disease
- non-alcoholic fatty liver
- cancer (colon or ovarian).
You might have pre-diabetes syndrome if you experience such symptoms as:
- increased weight
- high blood pressure
- high blood cholesterol.
High blood triglycerides levels are a common symptom of diabetes or pre-diabetes. Furthermore, you will be considered pre-diabetic if
- your fasting blood sugar level is between 110 mg/dL and 125 mg/dL (diabetes is formally diagnosed at 126 mg/dL).
Some clinics use a fasting blood sugar of 90 mg/dL or higher as a biomarker of coronary heart disease risk. (A fasting blood sugar level test is the simplest and least expensive).
The Blood Test for Triglycerides
In most cases, triglycerides are measured because they are used to calculate the serum (blood) LDL-"bad" cholesterol levels - which determines the need to treat people who have high total cholesterol.
According to the Friedewald equation, LDL-"bad" cholesterol equals total cholesterol minus HDL-"good" cholesterol minus one-fifth of triglyceride level - where all concentrations are given in mg/dL.
This equation, however, is generally unreliable and should not be used when blood triglycerides are elevated (over 400 mg/dL, or 4.5 mmol/L).
Since risk of heart disease is commonly based on cholesterol levels - not triglycerides! - usually, you get tested for triglycerides only:
- during a regular routine medical exam (typically, every five years) or
- if you are being treated for high triglycerides (to see if treatment is working).
However, it is very important to have your triglycerides measured, if you are a diabetic. Diabetes can increase triglycerides significantly, especially when your blood sugar is out of control.
Most healthy people over 40 should get their triglycerides tested at least once a year. But, if your triglycerides are elevated, recheck them every three (3) months until they reach the desirable level.
Baseline Fasting Triglycerides Measurement
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The test for triglycerides - using a blood sample drawn from a vein or a fingertip - should be done after an overnight fasting when no extra triglycerides from a recent meal are present as they are being sent from the gut to body's fat tissue for storage. |
In practice, however, that way of obtaining a true baseline triglyceride measurement is often given no more than lip service.
If you have not been properly fasting when the blood sample was drawn, your physician may dismiss your elevated triglycerides reading as… insignificant |
Whenever you eat a meal that contains fat, your triglyceride levels rise. The degree of the increase depends on the baseline level.
For example, if your triglyceride level is about 50 mg/dL, 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, 80 mg/dL, or perhaps 90 mg/dL - but still will remain within the optimal range (below 100 mg/dL).
If your baseline triglyceride level is greater than 200 mg/dL, that high-fat junk "meal" could catapult your triglycerides to 300 mg/dL, 400 mg/dL, or even 500 mg/dL, and this elevation may be prolonged for several hours beyond the normal eight-hour clearance period.
Stay Alert and Ask Questions
When it comes to health care, you need to stay alert, ask questions, and ultimately rely on yourself for important health care decisions.
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.
The lesson: Always ask your doctor for specifics regarding factors that can create false positive or false negative test results.
Nothing, except water, is allowed from bedtime until you get your triglyceride bloodwork done next morning when a lab opens. |
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.
However, even fasting levels may vary considerably day to day. Therefore modest changes in fasting triglycerides measured on different days are not considered to be abnormal.
"It Turned Out to Be a False Result"
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My blood triglyceride level was alarmingly high 497 mg/dL (milligrams per deciliter of blood). (…)
It turned out to be a false result. A nurse sent to my home by my life insurance company had taken my blood sample just a few hours after I ate lunch.
For an accurate triglyceride reading, even more so than for an accurate blood cholesterol reading, it's important to fast for at least 12 hours before having blood drawn.
(…) a meal that is rich in fat is a meal that is rich in triglycerides, and it will cause a dramatic short-term spike in your blood triglyceride levels.
When my doctor drew my blood after an overnight fast during my annual physical a few months later, my triglyceride level was 97 [mg/dL].
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Larry Lindner
Tufts University School of Nutrition Science & Policy
Variability in Triglycerides Measurements
Due to a lack of standardized measurement, however, variability in triglyceride measurements may occur.
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.
After a weekend of beer and pizza, Monday morning bloodwork readings tend to be higher than on the other days; therefore, take your weekend activities into account when having your test for blood triglycerides done. |
- 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.
In particular, the importance of the two-day abstinence from alcohol is based on significant alterations in the plasma fatty acid pattern that persist twenty-four (24) hours after the consumption of alcohol and elevations in triaglycerides observed as late as nine (9) hours after the consumption of alcohol with dinner. (
J Chromatogr 1992;579:13–24; Alcohol 1998;33:403–10).
What you should do then?
First, before having blood drawn for a triglyceride check, fast - preferably overnight - several (12-14) hours. Fasting is essential for triglycerides (it is not necessary to measure cholesterol though).
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.
Third, tell your physician to also measure LDL and HDL cholesterol. A triglyceride measurement should be accompanied by a complete lipoprotein cholesterol determination.
Extremely Low Triglycerides Levels
There are several known causes of low triglycerides (<50 mg/dL) However, many causes have yet to be discovered.
Extremely low triglycerides levels (less than 10 mg/dL) can indicate the following conditions:
- abetalipoproteinemia - a disorder of lipid metabolism characterized by fat malabsorption, acanthocytosis, retinopathy, and progressive neurologic disease
- hypobetalipoproteinemia - an inherited condition in which blood lipids are present at less than the expected levels regardless of how much fat is eaten; subjects may develop fatty liver
- chronic obstructive pulmonary disease (COPD) - emphysema or chronic bronchitis
- malabsorption syndrome (inadequate absorption of nutrients in the intestinal tract) leading to malnutrition
- malnutrition (inadequate intake or inadequate digestion of nutrients)
- hyperthyroidism (overactive thyroid) - a condition caused by the effects of too much thyroid hormone in tissues of the body, or
- diet too low in fat.
Your health care provider should check for these if too high or too low triglycerides are discovered.
In general, however, blood triglycerides should be:
- greater than 55 mg/dL, or 0.62 mmol/L in women and
- greater than 45 mg/dL, or 0.5 mmol/L in men.
Blood Fat Levels in Terms of Milk Products
The blood fat level can be better described in terms of milk products:
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Prevalence of High Triglycerides
In the United States, triglycerides are higher in whites compared to African Americans. Triglycerides increase gradually in men until about age 50 years and then decline slightly. In women they continue to increase with age.
Borderline-high triglycerides (greater than 150 mg/dL, or 1.7 mmol/L) are slightly more prevalent in men beginning at age 30 years and women starting at age 60 years.
The prevalence of high triglycerides (greater than 200 mg/dL, or 2.3 mmol/L) is approximately 10% in men older than 30 years and women older than 55 years. However, in the Prospective Cardiovascular Munster study (PROCAM), a large observational study, high blood triglycerides (>200 mg/dL) are more prevalent in men (18.6%) than in women (4.2%).
Prevalence of extremely high triglycerides (greater than 2000 mg/dL, 22.6 mmol/L), is estimated to be to be 1.8 cases per 10,000 adult whites, with a higher prevalence in people with diabetes or alcoholism.
Triglyceride Fasting Levels: Interpretation of Lab Values
High triglycerides are usually accompanied by high total cholesterol. Although risk of heart disease is based on cholesterol levels, the type of drug treatment used to lower cholesterol may differ, depending on whether triglycerides are "high" or "normal".
If you have a coronary heart disease, diabetes mellitus (type 2, or non-insulin-dependent diabetes), or multiple risk factors, your triglycerides goal should be less than 100 mg/dL, or 1.3 mmol/L -- but NOT lower than 70 mg/dL, or 0.8 mmol/L. |
Fasting triglycerides, as a marker for triglyceride-rich lipoproteins, provide valuable information about the atherogenic potential of the lipoprotein profile, particularly when considered in context of HDL-"good" cholesterol levels.
It has been shown that "atherogenic hyperlipidemia" starts at the triglyceride level 150 mg/dL, or 1.7 mmol/L initiating degenerative changes in the cardiovascular system, and the risk of ischemic heart disease (IHD) can be significantly reduced by more aggressively treating elevated blood triglyceride levels.
However, there is still no consensus regarding the value necessitating initiation of triglyceride treatment. According to many physicians the need for implementation of proper dietary habits begins at the triglyceride level over 200 mg/dL, or 2.3 mmol/L and pharmacological (drug) treatment should be started at the triglyceride level over 300 mg/dL, or 3.4 mmol/L.
The Triglycerides/HDL Ratio: Heart Disease Predictor
Association between triglycerides and HDL-"good" 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 and increase in LDL-“bad” cholesterol. So far, nobody can say for sure.
However, it is believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease as HDL is closely related to triglycerides. A Harvard-lead study author reported:
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"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)."
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 bloodstream, which is unhealthy in protecting against heart disease.
Generally speaking, the higher the triglyceride/HDL ratio, the higher your risk of a heart attack. |
- 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 which means the lower your risk of a heart attack. In other words, the lower your triglycerides, or the higher your HDL-“good” cholesterol, the smaller this ratio becomes.
Health Risks Marked by Elevated Triglycerides
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Increased Risk of Heart Attack | | Increased Risk of Ischemic Stroke | | Increased Risk of Fatty Liver and Pancreatitis |
High Triglycerides May Cause Weight Gain
Researchers from Saint Louis University School of Medicine, Missouri have found that high triglycerides block leptin - a hormone secreted by our fat cells - from getting into the brain by impairing its transportation system (Diabetes, 2004: May).
As a result, leptin cannot do its work in turning off feeding and burning calories.
In other words, high triglycerides make the brain "think" the body is starving so we keep eating and... gaining weight. This is probably one of the reasons why so many people are becoming obese.
By lowering triglycerides then, we could help the body's own leptin to work better so we could get skinnier avoiding heart problems, cancer and diabetes - common chronic diseases linked to obesity.
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© 2001-2005 Reduce Triglycerides.com: How to Lower High Triglycerides Naturally. Triglyceride Reduction TGs Formula - A Drug-Free Approach to Elevated Blood Triglycerides. All rights reserved worldwide. This document may not be copied in part or full without express written permission from the publisher. The information on high triglycerides and nutrition provided herein is a general overview on this topic and may not apply to everyone, therefore, it should not be used for diagnosis or treatment of any medical condition. While reasonable effort has been made to ensure the accuracy of the information on high triglycerides reducing diet, Full of Health, Inc. assumes no responsibility for errors or omissions, or for damages resulting from use of the triglyceride information herein.