Very high triglyceride levels of 500 mg/dl or thereabout will likely cause inflammation of the pancreas. This condition is called pancreatitis. It is a serious condition that can cause death.

Triglycerides form the major portion of fats present in the body. They perform essential functions in the body and the need to keep them within the normal range is necessary in view of its complications such as heart attack, stroke, metabolic syndrome and more.

Normal, borderline, high and very high triglyceride levels

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

The most common causes of very high triglyceride levels are:

  • a regular diet of saturated fats, high carbohydrate foods, and sugary drinks
  • obesity
  • uncontrolled diabetes
  • physically inactive lifestyle
  • regular high consumption of alcohol.  Binge drinking, especially, can cause dangerous spikes in triglyceride levels that can trigger inflammation of the pancreas (pancreatitis).

According to the National Center for Biotechnology Information (NCBI), the aggregate survival rate for chronic pancreatitis is estimated to be 80% at 3 years and 59% at 5 years.

Why elevated triglyceride levels cause pancreatitis is still unclear. It is believed to be due to increased concentrations of chylomicrons in the blood.

Chylomicrons forms of fats present in the blood or lymph after absorption from the small intestine.  They are lipoprotein particles that consist of a major portion of triglycerides, phospholipids, cholesterol, and proteins.

Chylomicrons are present in the blood about 1 to 3 hours after a meal and are cleared after 8 hours. In people with triglyceride levels of 500 – 1000 mg/dl, they are always present in the blood.

Being low density and large, they may obstruct capillaries leading to local ischemia and acidosis.  This leads to secretion of the pancreatic triacylglycerol lipase, which is an enzyme secreted from the pancreas.

It breaks down the triglycerides into free fatty acids, which can lead to cell injury resulting in further local damage that increases inflammation and free radicals, eventually presenting as pancreatitis.