Triglyceride Levels: Old and New Guidelines | How Often Should You Check?

Testing for levels of triglycerides is done by a blood test called the lipid profile or the lipid panel, which is performed on a person or patient who has been fasting for 9 to 12 hours.

Besides triglycerides, it also includes testing for total cholesterol, HDL, and LDL. cholesterols. You get the complete picture of the level of the lipids in your blood.

A nonfasting blood sample will give a false high triglyceride level as triglyceride levels are elevated after eating.

Why you should fast and not drink alcohol before testing for triglycerides?

As mentioned above, you should fast and not eat anything for 9 to 12 hours before giving your blood for the triglyceride test. You can have water to drink because it does not affect the result of the test.

The reason is that triglyceride levels respond dramatically to food and rise as much as 5 to 10 times more than the fasting levels within just a few hours after eating. This, therefore, does not give the true picture of your reining levels.

Again, certain drugs can raise your triglyceride levels. They include corticosteroids, estrogens, beta blockers, diuretics, antiviral drugs, and protease inhibitors for HIV. Talk to your doctor if you are on any of these medications before going in for the blood test.

Thirdly, you should not drink alcohol or any of its forms such as beer or wine 48 hours before the test.

Alcohol stimulates the liver to produce more triglycerides and this will give your doctor the wrong picture. In such cases, he will likely prescribe wrong doses or drugs because of the wrong lipid picture.

Chart of triglyceride levels: old and new guidelines

The following are the normal, borderline and high levels prescribed by the medical fraternity for adults before as recently as April 2011.

Normal levels         — Less than 150 per deciliter.
Borderline levels   — Between 150 to 200 mg/dl
High levels             — More than 200 mg/dl
Very high levels    — More than 500 mg/dl

In April 2011, the medical experts took a second look at these numbers and decided to modify them. A new set of criteria were adopted based on the latest research findings.

The American Heart Association then issued a new set of recommendations. They redefined fasting optimal and normal levels and non-fasting (or random) normal levels as shown below:

Fasting 8 to 12 hours – optimal level — less than 100 mg/dl.

Fasting 8 to 12 hours – normal level – 100 to 150 mg/dl

Non-fasting state        — normal level – under 200 mg/dl

The American Heart Association recommends that you have a baseline established.

To do this, have your levels checked three times at about the same time and in the same fasting state at least a week apart within a two months’ period.

Having high triglyceride blood levels is bad for your heart plus increases your risk of stroke. To make matters worse, high levels do not produce any symptoms and one stays unaware unless a chance blood test tells you that your triglyceride levels have risen to undesirable levels.

High values cause atherosclerosis, which means plaques deposited on the inner walls of the arteries and hardening of the arteries. This reduces blood flow.

Another way your doctor can suspect that your triglycerides have risen is when complications develop and he gets your lipid profile done.

Complications can include a heart attack, stroke, pancreatitis and more – all very life-threatening. The threat of metabolic syndrome also looms large.

Read about the effect of very high triglyceride levels and pancreatitis.

You have to keep triglycerides within normal range. They should also not be allowed to go high or too low because that too will create problems.

Since there is no way besides the lipid profile test to know if you have elevated numbers, you should go in for a blood test as recommended below.

How often should you test for triglycerides?

It is not just your triglycerides, but it is recommended that you also include cholesterol and your blood sugar levels in your routine checkups.

The frequency with which you should test your triglyceride levels depends on a number of factors such as:

  • your age
  • family history
  • the risk of heart disease
  • the risk of diabetes
  • whether you currently have a heart problem
  • whether you currently have diabetes

Age

If you are 40 or more years old, you should have your triglyceride and cholesterol levels checked every year.

However, if your levels are already high, you should check your lipid values every six months, if they have been stabilized with “Therapeutic Lifestyle Changes” (TLC) or medication.

Family history

If you have a history of heart disease, stroke, diabetes or high cholesterol/triglycerides in the family and your levels were normal the first time you checked, you should check every two years.

But, if your values were borderline, you should check every year. Again, uncontrolled diabetic patients should check every year.

Heart disease risk factors

If you are harboring risk factors that can give you a heart attack, you should check once every year provided it was normal the first time you checked.

Diabetes and its risk factors

If you have diabetes or pre-diabetes or entertain any of its risk factors such as obesity, you should check your triglyceride numbers once every year.

A current heart problem

This calls for following up with your doctor regularly and checking your triglycerides and cholesterols possibly every eight weeks.

Once your condition and levels have stabilized, your doctor may ask you to check every six months and then once every year. Triglyceride levels in a patient who has recovered from a heart attack have to be monitored throughout life.

Postmenopausal women

Postmenopausal women increase the risk of developing high cholesterol and triglyceride levels because of the absence of the protective action of the estrogen hormone.

They should check their lipid profile every year if they never had raised levels before.

Maternal triglyceride levels during pregnancy

Measuring units – 1st trimester – 2nd trimester – 3rd trimester

mg/dl                           40 – 159             75 – 382       131 – 432

mmol/L                        0.5 – 1.8               0.9 – 4.3        1.5 – 5.1

As you can see, triglycerides peak during the 3rd trimester. Six to eight weeks after delivery, these levels tend to normalize.

During pregnancy, the metabolism of the mother increases and so does her need for calories. The growing fetus, too, requires more calories.

Between meals, when the calories run low, the triglycerides are released into the bloodstream to feed the need for extra energy. This can lead to raised triglyceride levels in the blood.

 

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