Hypertriglyceridemia

What is hypertriglyceridemia?

Hypertriglyceridemia is a condition in which you have too many triglycerides in your blood. Triglycerides are lipids (fats) that provide energy to your body. You get some triglycerides from foods you eat (like butter and oils). Plus, when you consume more calories than you need, your body converts them into triglycerides. Your body can access these triglycerides later on when you need energy.

So, triglycerides are important fats that give you energy. But high levels of triglycerides raise your risk of cardiovascular disease. That’s why it’s important to learn about hypertriglyceridemia and how to keep your numbers low.

How many triglycerides should you have?

A normal triglyceride level in adults is below 150 milligrams per deciliter (mg/dL). A triglyceride level below 100 mg/dL is ideal. It’s important that triglycerides are measured while you’re fasting.

Hypertriglyceridemia means your triglyceride level is 150 mg/dL or higher.

The chart below shows the guidelines for fasting triglyceride levels in adults.

The target range is different for children and teens. The normal fasting triglyceride level in children ages 10 to 19 is below 90 mg/dL. If your child has high triglycerides, talk with their provider about how to lower their level.

What is severe hypertriglyceridemia?

Severe hypertriglyceridemia means your triglycerides are 500 mg/dL or higher. People with severe hypertriglyceridemia face an increased risk of acute pancreatitis. This is an inflammation of your pancreas that requires medical care.

Is hypertriglyceridemia serious?

Hypertriglyceridemia is important and needs treatment. But in most cases, it’s not a medical emergency. Your healthcare provider will work with you to help you lower your numbers. Doing so can help you avoid complications that affect your heart or pancreas.

Is hypertriglyceridemia the same as high cholesterol?

No, hypertriglyceridemia isn’t the same as high cholesterol. These are two different conditions. But they both relate to lipid levels in your blood.

Lipids are fatty substances that perform important jobs in your body. Triglycerides and cholesterol are both types of lipids. And they both travel through your blood in lipoproteins.

Hypertriglyceridemia means you have too many triglycerides in your blood. Hypercholesterolemia means you have too much cholesterol.

Many people who have hypertriglyceridemia also have high total cholesterol. Hypertriglyceridemia is especially dangerous if you also have these cholesterol numbers:

• Low HDL (“good”) cholesterol.
• High LDL (“bad”) cholesterol.

Talk with your healthcare provider about what your numbers mean and how to get them back in the healthy range.

How common is hypertriglyceridemia?

About 1 in 5 adults in the U.S. have elevated triglyceride levels (above 150 mg/dL). But your risk goes up as you get older. Hypertriglyceridemia affects 42% of adults age 60 and above, according to research.

What are the symptoms of hypertriglyceridemia?

Most people with hypertriglyceridemia have no symptoms. People with severe hyperglyceridemia may develop xanthomas. These are skin bumps that form when lipids build up under your skin. The xanthomas usually appear around your eyelids. But they may also appear on your knees, elbows or palms of your hands.

What causes hypertriglyceridemia?

Hypertriglyceridemia has many causes, including:

• Lifestyle factors.
• Underlying medical conditions.
• Medications.
• Genetic lipid disorders.

Lifestyle factors that can raise your triglycerides

Lifestyle factors have a powerful effect on your triglyceride level. That’s because your body converts extra calories into triglycerides. So, if you’re consuming sugars, fats or alcohol that your body doesn’t use right away, your triglycerides can go up.

Factors that can lead to high triglycerides include:

• Drinking too much alcohol.
• Eating too many refined carbohydrates (like white bread) or sugars.
• Eating too much saturated fat.
• Not moving around enough (sedentary lifestyle).

Medical conditions that can raise your triglycerides

Many different medical conditions can raise your triglycerides. These include:

• Diabetes.
• Hypothyroidism.
• Insulin resistance.
• Kidney disease.
• Liver disease.
• Lupus.
• Metabolic syndrome.
• Nephrotic syndrome.
• Overweight or obesity.
• Rheumatoid arthritis.

Women and people assigned female at birth (AFAB) have additional risk factors. These include:

• Menopause.
• Pregnancy (especially in your third trimester).

Medications that can raise your triglycerides

Certain medications can cause elevated triglycerides. These include:

• Antipsychotic drugs (second-generation) such as clozapine and olanzapine.
• Antiretroviral (ART) protease inhibitors to treat HIV.
• Beta-blockers (nonselective).
• Corticosteroids.
• Cyclophosphamide.
• Oral estrogen.
• Tamoxifen.
• Thiazides.

If a medication raises your triglycerides, your healthcare provider will find a solution. This may include changing your dosage or switching to another medication. Never stop taking a medication without talking to your provider first.

Genetic lipid disorders

Lipid disorders may affect both your triglycerides and your cholesterol. Examples include:

• Familial combined hyperlipidemia: High triglycerides, high LDL cholesterol and low HDL cholesterol.
• Familial hypertriglyceridemia (type IV familial dyslipidemia): High triglycerides.
• Familial dysbetalipoproteinemia (type III hyperlipoproteinemia): High triglycerides and high total cholesterol.
• Familial chylomicronemia syndrome (FCS): Triglyceride levels higher than 1,000 mg/dL.

Often, many factors combine to cause hypertriglyceridemia. For example, you might have a genetic disorder along with lifestyle factors. Your healthcare provider will identify what’s causing your high triglycerides and also determine the best treatments.

How is hypertriglyceridemia diagnosed?

Healthcare providers diagnose hypertriglyceridemia through a physical exam and blood test.

Physical exam to diagnose hypertriglyceridemia

Your healthcare provider will perform a physical exam to learn more about your health. They’ll also talk with you about your:

• Family history of heart disease, high cholesterol and high triglycerides.
• Lifestyle factors (like alcohol and tobacco use).
• Medical history.
• Medications you’re taking.

This information will help your provider identify possible causes for hypertriglyceridemia. It’ll also help your provider learn your risk for cardiovascular disease.

Testing to diagnose hypertriglyceridemia

A common blood test called a lipid panel diagnoses hypertriglyceridemia. This test measures your triglycerides and your cholesterol levels.

Your provider may ask you to fast for 10 to 12 hours before your blood test. Fasting means you should consume no foods or drinks except water. Be sure to follow your provider’s instructions so you receive the most useful results.

What is the best treatment for hypertriglyceridemia?

Hypertriglyceridemia treatment includes:

• Lifestyle changes.
• Medications.
• Managing underlying causes of your high triglycerides.

You may need one or more of these approaches. Your provider will recommend the best treatment plan for you.

Lifestyle changes to lower your triglycerides

In general, treatment begins with lifestyle changes. Guidelines include:

• Avoid alcohol.
• Avoid refined carbohydrates and sugars.
• Eat more seafood, especially fish that contains omega-3 fatty acids.
• Exercise more often.
• Lower your calorie intake to help lose excess weight.
• Replace saturated fat and trans fat with healthier fats.

Hypertriglyceridemia medications

You may also need medications to help regulate your triglyceride levels. Drug therapy is especially important for people with severe hypertriglyceridemia. Medications your provider may prescribe include:

• Fibrates such as fenofibrate.
• Prescription omega-3 fatty acids such as icosapent ethyl (IPE).
• Statins.

Managing underlying causes of hypertriglyceridemia

Your healthcare provider will work with you to manage underlying causes. The goal is to make adjustments that’ll help your triglycerides return to a normal level. You may need new medications to manage a medical condition. Or you may need changes to your current drug regimen. Ask your provider if you have questions or concerns about your treatment plan.

How can I prevent hypertriglyceridemia?

Some causes can’t be changed (like aging or certain medical conditions). But there’s still a lot you can do in your daily life to prevent hypertriglyceridemia. Here are some steps you can take to help keep your numbers in the healthy range:

• Eat a heart-healthy diet.
• Get active. This involves planned exercise plus moving around more during your daily routine.
• Keep a healthy weight.
• Limit alcohol (one drink per day for women and people assigned female at birth, two drinks per day for men and people assigned male at birth).
• Reduce sugar and refined carbohydrates.

Ask your healthcare provider for resources to help you manage your triglycerides.

What is the outlook for people with hypertriglyceridemia?

Talk with your healthcare provider about your prognosis. Your outlook depends on many factors, including:

• The causes of your hypertriglyceridemia.
• Your triglyceride level.
• Your underlying medical conditions.

Keep in mind that hypertriglyceridemia is a common condition, and you’re not alone. Many people manage their triglyceride levels by following their provider’s treatment plan.

When should I see my healthcare provider?

Visit your provider for annual checkups. Follow your provider’s guidance on other appointments you may need. Call your provider at any time if you have questions or concerns.

What questions should I ask my provider?

It’s important to learn as much as you can about your condition, its causes and available treatments. Consider asking your healthcare provider the following questions:

• What do my triglyceride numbers mean?
• Do I also have high cholesterol?
• What’s the cause of my high triglycerides?
• How can I lower my triglycerides?
• What’s my risk for cardiovascular disease?
• What kinds of exercise are best for me?
• Should I meet with a dietitian?

When should I go to the ER?

Call 911 or your local emergency number if you have symptoms of:

• Acute pancreatitis.
• Heart attack.
• Stroke.

Hypertriglyceridemia raises your risk of these serious complications. So, it’s important to learn the symptoms and seek help immediately if you experience them.

A note from Cleveland Clinic

Managing hypertriglyceridemia takes some extra work. But the work is well worth your time. You may need to make changes to your daily life, and those changes may feel difficult at times. But start small. Even small changes can add up to a big impact on your heart health. Ask your healthcare provider to connect you with resources and support groups to help you reach your goals.