High Triglycerides: Mostly Lifestyle Related

Triglycerides (TG) is a form of fat in the body. People with extremely high triglycerides level may have higher risk of heart attack, especially for those with low HDL-cholesterol / high LDL-cholesterol level or those with other risk factors such as diabetes mellitus, hypertension and smoking. 

National Cholesterol Education Program has given a guideline for normal & high triglycerides level:

• Normal               :  < 1.7 mmol/L (150 mg/dl)
• Borderline high    :  1.7 - 2.3 mmol/L (150-199 mg/dl)
• High                    : 2.3 - 5.6 mmol/L (200-499 mg/dl)
• Very high            :  >5.6 mmol/L (> 500 mg/dl)

Some of the causes of high triglycerides:

• Genetics
• Obesity/overweight
• Diabetes Mellitus
• Alcohol
• High carbohydrates/fat diet especially refined carbohydrates
• Hypothyroidism (though more on high cholesterol)
• Nephrotic Syndrome (though more on high cholesterol)
• Some drugs (thiazides, estrogen, tamoxifen, steroids, isotretinoin)

High TG level below 11.3 mmol/L (1000 mg/dl) usually does not produce any signs and symptoms. If the level is above 11.3 mmol/L, it may give rise to recurrent abdominal pain (chylomicronemia), skin lesion (eruptive xanthomas) and increased risk of acute pancreatitis. Hypertriglyceridemia is also related to fatty liver which may cause mild discomfort at the right upper abdomen.

       Eruptive xanthomas: yellow papules on red base

The serum level of TG is well-known to be labile and may fluctuate a lot depending on a person's diet and lifestyle prior to the test. Blood test for TG usually is done together with cholesterol level and fasting of at least 10-12 hours is ideal. Excessive alcohol or high carbohydrates/fat intake for the last 2 weeks prior to the blood test may affect its result. 

If your TG level is high (>5.6 mmol/L), doctors will usually prescribe a medicine to lower it. Medical treatment available currently includes fibrates, high dose niacin and high dose omega3. Level above 11.3mmol/L must be treated in order to reduce the risk of acute pancreatitis.

If TG level is at the high but less than 5.6 mmol/L, then the treatment will depend on the presence of other secondary causes and the cholesterol profile. If the cholesterol (HDL/LDL) level is not favourable, then cholesterol lowering medicine (statin) may be given priority. If secondary cause is identified (such as alcohol, diabetes, obesity etc), then it should be managed or treated accordingly first.

Diet & lifestyle control can do marvel in controlling TG level. Weight reduction, regular exercise, reduce/stop alcohol intake, reduce fat & refined carbohydrates (sugar/white flour) intake can help to improve TG level.

So it is not just too much fat, too much bad carbohydrates/sugar will also raise your TG level.