Blood Triglyceride Fasting Levels: Current Guidelines
The NCEP advises that adults have their blood lipids checked at least once every five years, starting at age 20. However, if you are over 40 you should get your triglycerides tested at least once a year. Diabetics must have their triglycerides measured every three (3) months.
Elevated blood triglycerides, as a part of lipid management, have become a major medical problem. This website is intended to allow you to become an informed patient who can manage your own care, ask the right questions, insist on adequate management and information, and seek an optimal outcome for yourself. Perhaps it will even help the health professionals who are giving care to better understand and, hopefully, incorporate into their practice the nutritional approach to high blood triglycerides.
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 your blood lipid profile, triglycerides in particular. If you are tempted to think the suggestions are too complicated or simplistic, or even biased, we assure you they are not.
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.
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 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 and intervention
2.3 - 4.6 mmol/L (203.1 - 407.1 mg/dL) with high LDL cholesterol (greater than 4.1 mmol/L, or 160 mg/dL)
Requiring aggressive treatment
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:
Keep in mind these recommendations are only guidelines. The ranges were developed based on the entire population and may not apply to individuals.
It should also be noted 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.
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.
"Optimal" Blood Triglyceride Levels
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.
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.
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.
In people with diabetes, a triglyceride level of 100 mg/dL, or 1.1 mmol/L is considered to be a target value.
"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.
Baseline Fasting Triglycerides Measurement
There are many, common and uncommon causes of high blood triglycerides, including dietary indiscretion, metabolic disease, drugs, or rare genetic mutation of an enzyme in the lipid metabolism pathway (type I hyperlipoproteinemia).
However, the commonest cause of an elevated triglyceride level is -- inadequate patient fasting, since a recent meal will cause fat in the form of triglycerides to be transported from the gut to the rest of the body. Once a non-fasting specimen has been eliminated as a possible cause of increased triglycerides, the other causes should be considered.
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
As opposed to circulating HDL-"good" and LDL-"bad" cholesterol, triglyceride blood concentrations change significantly with food intake.
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, 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, that high-fat junk "meal" could catapult your triglycerides to 300 mg/dL (3.4 mmol/L), 400 mg/dL (4.6 mmol/L), or even 500 mg/dL (5.7 mmol/L), 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.
As far as a blood test determining triglyceride levels is concerned, for 12 to 14 hours before the test, only water (no coffee!) is permitted.
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"
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].
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.
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.
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. (
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.
Measurement Units: Mg/dL Vs. Mmol/L
American blood laboratories use a different version of the metric system than does most of the rest of the world, which uses
the Système International d'Unités (SI units).
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.
In some cases translation between the two systems is easy, but the difference between the two is most pronounced in the measurement of chemical concentration.
The American System: mg/dL
The American system generally uses mass per unit volume (milligrams per deciliter of blood). By considering the weight of a substance in the blood, it is less accurate.
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).
A deciliter is one tenth (1/10) of a liter (a liter being just over a quart) or about 1/4 of a pint.
The SI System: mmol/L
The SI system (Système International) - in Canada, Australia, Europe, and other countries - uses moles per unit volume (millimoles per liter of blood). By considering the number of molecules of a substance in the blood, it is more accurate then.
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.
Since mass per mole varies with the molecular weight of the substance being analyzed, conversion between the American and SI units requires many different conversion factors.
Triglycerides Conversion:
from mg/dL to mmol/L:
multiply by (x) 0.01129
from mmol/L to mg/dL: multiply by (x) 88.6
.
Cholesterol Conversion:
from mg/dL to mmol/L:
multiply by (x) 0.02586
mmol/L to mg/dL: multiply by (x) 38.7.
Glucose (GLU) Conversion:
For diabetics wishing to converse in American sugar lingo, the conversion is 18. For example, a blood sugar reading of 7.5 mmol/L multiplied by 18 yields 135 mg/dL.
Conversion Simplified
If you are a Canadian snowbird heading south who may feel shut out in the poolside medical exchange, this may help.
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.
According to medical studies, people with high blood triglycerides do benefit from dietary, nutritional supplements.
Triglyceride Reduction TGs Formula is a comprehensive multiple vitamin and mineral supplement that provides optimal levels of nutrients to support people with high blood triglycerides.
Nutritional factors are naturally occurring substances, not drugs whose substances are foreign to the body. And, according to orthomolecular nutrition, if the right building blocks (nutrients) are present in the body - in the right amounts and at the right time - the body will do the rest.
In other words, Triglyceride Reduction TGs Formula has been designed to bring the triglycerides down to normal by providing optimal concentrations of all necessary vitamins, anti-oxidants, lipotropic factors, chelated minerals, trace minerals, and digestive enzymes.
As a complete food supplement, Triglyceride Reduction TGs Formula consists of:
nutrients involved in fat metabolism (assisting in burning hepatic and intestinal triglycerides), such as inositol, choline and dl-Methionine
nutrients directly involved in lowering triglycerides levels, such as niacin (vitamin B3), chromium, calcium and vitamin E (Diabetes Care 1994;17:1449–52. Postgrad Med 1995;98:183–93 [review]. Lipids 1972;7:202–6. J Nutr 1991;121:165–9)
methyl donors, such as folic acid, vitamins B6 and B12
all essential vitamins and minerals, such as vitamin C, E, niacin, magnesium, zinc, chromium, selenium
glandular concentrates, such as adrenal, liver, pancreas, and
nutrients supporting bile flow and the healthy liver function, such as L-Cysteine.
As you can see, there is no one "miracle" ingredient in Triglyceride Reduction TGs Formula. It is a specialty complex orthomolecular combination of strong lipid-lowering natural factors.
All nutrients are present in specific ratios and amounts in order to correct longer standing deficiencies and imbalances that are known to contribute to elevated levels of blood fats such as triglycerides.
Thousands of users have proven the efficacy of this approach. There has not been a single reported harm done by taking our Triglyceride Reduction TGs Formula.
So far, we have introduced our proprietary Triglyceride Reduction TGs Formula to our clients and customers in 44 countries: the United States (including Virgin Islands, Hawaii, and Guam), Malaysia, Australia, the United Kingdom, South Africa, Thailand, New Zealand, Germany, Belgium, Trinidad, Mexico, Italy, Pakistan, Singapore, Mauritius, Suriname (South America), France, Bolivia, Russia, Croatia, Poland, Portugal, Denmark, United Arab Emirates, Brunei Darussalam, Hong Kong, Macau, St. Lucia (West Indies), Norway, Saudi Arabia, Philippines, Brasil, Yemen, Kingdom of Bahrain, Turkey, China, Guatemala, Kuwait, Japan, Thailand, Taiwan, Jordan, Cyprus and Fiji Islands.
We know you will join them. Sooner or later...
Fantastic Results in Six Weeks
May 6, 2008
Dear Sirs:
I have been telling everybody about the fantastic results I got from the reduce triglyceride formula. I didn't change anything and I lost eight pounds in 6 weeks.
My triglycerides went from 310 [mg/dL, or 3.5 mmol/L] to 125 [mg/dL, or 1.4 mmol/L], and the rest of my blood tests were perfect according to the doctor.
Even though I don't have any problem with my cholesterol, my total cholesterol went from 201 to 149. My glucose went from 108 to 94, so I am very happy with your product.
Thank you!
Sincerely,
Alex C.
Boynton Beach, Florida
The testimonial above has been presented as a true story. However, it has not been reviewed and is the sole opinion of the listed individual.
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