The medical term for high triglycerides is hypertriglyceridemia. There are various reasons that cause triglyceride levels to rise and again, there are various side effects and dangers associated with such a rise.
According to the American Heart Association, the amount of triglycerides in the blood is an important barometer of your metabolic health. High levels make you a potential candidate for coronary heart disease, diabetes, and fatty liver disease.
However, you cannot ignore these lipids because of the important functions they perform.
What is the meaning of high triglycerides?
Triglycerides are the major form of fats present in the body. They are the main constituents of natural fats and oils. They provide energy to the body and are indispensable — we cannot do without them.
Having high triglycerides means that your blood levels of triglycerides in the body are high and have risen above the normal range.
Almost one-third of the American adult population has high triglycerides.
Chart showing normal and high triglyceride levels in the blood.
Normal Triglyceride Levels –Less than 150 per deciliter.
Borderline Triglyceride Levels — Between 150 to 200 mg/dl
High Triglyceride Levels — More than 200 mg/dl
Very High Triglyceride Levels — More than 500 mg/dl
Having high triglycerides means having levels above 200 mg/dl. The dangers potentiate more when high triglycerides levels are accompanied by high LDL cholesterol and low HDL cholesterol, which usually is the case.
LDL is the bad cholesterol that can, like triglycerides, cause atherosclerosis.
HDL is the good cholesterol, which removes the LDL from the blood and the atherosclerotic plaques from the arterial walls and takes them to the liver to be processed and then excreted out of the body.
If HDL levels are low, this useful function of HDL falls short and your risk increases. It is always better to have high HDL levels.
There is the third type of lipoprotein called very low-density lipoprotein (VLDL) in which triglycerides form the major portion, almost 85%.
Triglycerides are the main form of fat that are stored in the adipose tissue of the body. They provide energy to the body when it requires it.
How do you know your triglycerides are high? Symptoms
Even if your triglycerides are raised, there are no signs or symptoms that warn you.
They are virtually nonexistent. It is when the complications set in with their symptoms that can warn the doctor of this possibility.
Symptoms and signs of complications that can present are:
- Pancreatitis, which include sudden pain in abdomen, nausea, vomiting, loss of appetite, and fever
- Liver and spleen enlargement
- Fatty deposits in the skin (called xanthomas) in case of a genetic cause
- Heart attack that can present as chest pain
- Stroke that can cause one side of your face to droop, sudden one-sided arm weakness, sudden difficulty in speech and/or vision, severe headache.
Causes of high triglycerides
There are various causes and risk factors that can raise your triglycerides. They can be due to:
- a genetic cause
- wrong dietary habits
- unhealthy lifestyle
- certain medical conditions
- certain medications
1. Hypothyroidism (an underactive thyroid)
An underactive thyroid can cause an unhealthy alteration in your lipid values. It increases your triglycerides and LDL cholesterol, VLDL and decreases HDL cholesterol.
These changes in your lipid values significantly increase your risk of cardiovascular events. Such changes are seen more in obese patients with hypothyroidism.
In hypothyroidism, the body does everything at a slower rate including the use of calories when needed for energy.
Triglycerides are the main fats that provide energy to the body. Since the use of energy is slowed down, more triglycerides remain stored in the fat cells.
2. Poorly controlled diabetes type 2
Your body uses the triglycerides for energy. When the triglyceride levels are high, it indicates that the body is not being able to convert food into energy.
In a normal non-diabetic person, insulin allows for the uptake of glucose in the blood by the body cells. The extra glucose is stored in the liver in the form of glycogen.
In type 2 diabetes, there is what we call insulin resistance, whereby the uptake of glucose by the cells is hampered.
Insulin plays a pivotal role in the conversion of glucose and fats into energy. Triglycerides are the main form of fats that are used by the body for energy. When it cannot do that as in insulin resistance, glucose and triglycerides tend to build up.
This is called diabetic dyslipidemia in which blood levels of triglycerides and glucose are high.
Secondly, the excess glucose in the blood as is the case in diabetes is converted into fatty acids. These fatty acids are converted into triglycerides, which build up in the blood and also contribute to body fat.
About 90% of diabetes patients develop metabolic syndrome, which further increases their chances of developing high triglycerides.
Not all obese people with excess weight are hypertriglyceridemic, but there is a significant relation between obesity and high plasma triglycerides and with low plasma high-density lipoprotein (HDL).
Obese women are also found to be associated with high VLDL levels – a lipoprotein with a major triglyceride component.
There is a dual reason for this occurrence.
In obese hypertriglyceridemic persons, there is increased secretion and severely impaired clearance of VLDL, the very low-density lipoprotein that is most rich in triglycerides.
Increased secretion is due to increased fat in the liver and the subcutaneous tissue and impaired clearance is due to increased plasma levels of apolipoprotein C-III.
Apolipoprotein C-III is a component of very low-density lipoprotein (VLDL) and an inhibitor of lipoprotein lipase.
Lipoprotein lipase plays a critical role in breaking down fat in the form of triglycerides present in VLDL and chylomicrons. When the triglycerides are broken down, they are used for energy or for storage in fat depots.
Due to two two reasons, triglyceride levels are found raised in most obese individuals.
4. Kidney disease
Kidney disease or chronic kidney failure (CKF) adversely affect your lipid levels. It raises both the LDL cholesterol (bad cholesterol) and the triglyceride levels and lowers your HDL cholesterol (good cholesterol) levels.
People with CKF are 35 times at a more increased risk of developing atherosclerosis than healthy people. This puts them at an increased risk of heart disease and stroke.
The reason why reduced renal function increases triglycerides is due to impaired clearance of triglycerides. Though triglycerides are not cleared by the kidneys, they are broken down by liver enzymes and other body tissues.
An inhibitor of these liver enzymes is cleared through the kidneys and due to its accumulation in the body, these clearing enzymes are inhibited to break down the triglycerides, which therefore accumulate.
This accumulation of triglycerides with an increase in LDL cholesterol and decreased levels of HDL significantly contribute to an increased danger of heart disease.
5. Too much alcohol intake
Alcohol consumption can increase triglycerides when consumed beyond the recommended limits and alcohol abuse can have a disastrous effect on your lipid levels.
In a person with excessive alcohol intake, triglycerides and LDL cholesterol get elevated and HDL levels tend to fall. This can be very dangerous exposing you to a potential risk of cardiovascular disease.
Alcohol is rapidly absorbed and taken to the liver for metabolism. The liver cannot metabolize it fast enough and it gets overburdened. The fatty acids, therefore, accumulate in the blood raising the triglyceride levels.
6. Regular high-calorie intake
That means regularly eating high fatty and sugary meals with low physical activity. This results in excess calories being stored. The body does this in two ways:
- It converts the calories into glycogen, which is stored in the liver for use as energy and
- Any excess calories are converted into triglycerides and stored in the fat depots for use when the body requires more energy.
This is how a high-calorie diet and a sedentary lifestyle will increase your triglyceride levels.
7. Familial trait of high triglyceride levels
Familial hypertriglyceridemia is a genetic condition that can cause the triglyceride levels in the blood to get too high.
It occurs due to familial predisposition and is relatively common occurring in about 1 out of 500 people in the United States.
8. Metabolic syndrome
Metabolic syndrome is the name given to a cluster of conditions existing simultaneously. They include high blood pressure, diabetes (raised fasting blood sugar), abdominal obesity with an increased abdominal girth, low HDL levels, and high triglyceride levels.
Metabolic syndrome greatly increases the individual’s risk of developing diabetes, heart disease, stroke, or all three.
9. Certain medications
Certain medications can increase your triglyceride levels
- Contraceptive pills
- Diuretics, mainly hydrochlorothiazide used for hypertension in doses greater than 50 milligrams per day can increase triglyceride levels and lower HDL levels. However, after about a year of use, the levels tend to normalize on their own.
- Antipsychotics given for bipolar and schizophrenia such as clozapine (Clozaril) and olanzapine (Zyprexa)
- Beta blockers again are blood pressure medications that can increase your triglycerides. They are especially the older ones such as atenolol (Tenormin), metoprolol (Lopressor) and propranolol (Inderal)
- Corticosteroids are used to treat a variety of health conditions such as asthma, autoimmune diseases, arthritis, eczema and other skin conditions, and some forms of cancer.
- Tamoxifen, brand name Nolvadex among others, is a medication used to prevent breast cancer in high-risk women and is also used in its treatment in women and men.
- Isotretinoin is a potent drug used to treat stubborn acne that have not responded to other usual treatments. It is also used to treat other skin conditions and certain types of cancer.
- HIV medications
10. Polycystic ovarian syndrome (PCOS)
About 75% of women who suffer from polycystic ovarian syndrome have dyslipidemia, which includes high triglyceride levels and low levels of HDL cholesterol.
HDL is the good cholesterol, which protects you from cardiovascular disease and whose lower levels increase your risk to these CVS events.
The reason for high TDG levels is that there is a very high incidence of obesity and insulin resistance in women with PCOS due to which dyslipidemia is commonly prevalent.
11. Wrong dietary habits consisting saturated fats and Trans fats
Foods that are high in saturated fats are rich sources of triglycerides and the bad cholesterol, LDL. They also tend to lower HDL, the good cholesterol.
Such foods include fatty red meat, lard, poultry skin, butter, high-fat dairy products and shellfish. Regular consumption of such foods can over time give your triglycerides a boost in their numbers.
Trans fat foods are another potential reason for increased triglyceride and LDL numbers posing a high risk of serious health problems to the heart, brain and more.
Trans fats are artificially manufactured through a process of hydrogenation. It is an inexpensive way to chemically treat liquid oils and solidify them to improve the taste and texture and increase the shelf life.
Trans fats are added to a variety of foods such as doughnuts, baked goods including cakes, biscuits, pie crusts, cookies, frozen pizza, crackers, and stick margarines and other spreads, lunch meat, hot dogs, snack foods such as french fries, chips.
Dangers of High Triglyceride Levels
High triglyceride levels are often associated with high levels of LDL (bad cholesterol). This is a silent condition in which there is a four-fold increase in the likelihood of you suffering from a heart attack or a stroke.
High triglyceride levels can cause the following complications:
1. Metabolic Syndrome
This condition is associated with a number of health problems which include
- High blood pressure (Hypertension)
- High blood sugar (Diabetes)
- High Triglyceride levels
- Low HDL levels
- Belly fat or abdominal obesity.
Metabolic syndrome makes you a potential candidate for heart attack, diabetes, hypertension, and stroke.
2. Acute pancreatitis
Pancreatitis can be another fallout of very high triglyceride levels — levels that can go up as high as 500 mg/dL or more. Alcoholism is the major cause that can trigger an acute attack and if you have high triglycerides, alcohol can make them rise very high.
Symptoms of pancreatitis include a sudden severe pain in the abdomen, nausea, vomiting, fever, a rapid heartbeat, and fast breathing.
3. Heart Attack
Not all triglycerides are stored as adipose tissue but some of it travels in the bloodstream as VLDL (very low-density lipoprotein).
High blood levels of triglycerides make the blood sludgy and increase the chances of blood clotting and subsequent blockage of the arteries. Blockage of the coronary arteries can precipitate a heart attack.
In the same fashion, decreased blood supply to the brain can precipitate a stroke and cause numbness, dizziness, confusion, blurred vision, or a severe headache.
5. Non-alcoholic fatty liver disease
In this condition, more than ten percent of the liver is replaced by fat. Fatty infiltration of the liver is the most common cause of chronic liver disease leading to scarring of the liver, cancer and liver failure.
Along with diabetes and obesity, high triglycerides form the most common cause of non-alcoholic fatty liver disease.
6. Peripheral artery disease (PAD)
Too much of triglycerides in the blood lead to the development of deposits on the walls of the arteries of the legs. This impairs the blood flow causing pain and numbness in the legs especially when walking.
This type of pain is called claudication pain. PAD greatly increases the risk of infection in the legs and the feet.
7. High triglycerides and dementia
Dementia is another side effect of high triglyceride levels and is seen more in the elderly people. It indicates gradual loss of brain function that can cause impairment of cognition affecting memory, thinking, speech and behavior.
Xanthomas are fatty deposits beneath the skin. They can be small in size or wide measuring 2 to 3 inches in diameter and can vary in shape and color from yellow to orange.
They are commonly seen over joints like elbows and knees, or on the hands, ankles, back and buttocks.
Fatty deposits over the eyelids are called Xanthelasmas.
These fatty deposits do not cause any harm but are an ugly sight. They go away once the triglyceride levels come down to normal. They are mostly seen in people with familial hypertriglyceridemia (high triglycerides due to genetic cause).
9. Eye complications
With triglyceride levels climbing above 4,000 mg/dL, your doctor may detect some changes on examining your eyes. Such high levels can cause a condition known as lipemia retinalis, in which an eye examination with an ophthalmoscope shows retinal blood vessels that have a pale pink, milky appearance.
This is due to lipid infiltration in the retina and results in decreased visual acuity.