Triglycerides: The Unspoken Biomarker of True Health

Triglycerides are often underestimated when it comes to their impact on health. Although they are essential for life, elevated triglyceride levels can be devastating to the body. They have the power to cause life-threatening damage to the heart, arteries, pancreas, and liver. Triglycerides are frequently overlooked or overshadowed by other health metrics. However, they are a crucial biomarker for true health. Taking steps to reduce high triglyceride levels can significantly improve the body’s overall function and health.

Triglyceride Levels

• Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
• Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
• High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
• Very high — 500 mg/dL or above (5.7 mmol/L or above)

What are Triglycerides?

A triglyceride is a type of fat molecule made up of one glycerol molecule and three fatty acid molecules. Triglycerides belong to a class of fats known as lipids. They are the main components of adipocytes, or fat cells¹. Excess glucose is converted into triglycerides in the liver and stored as fat, which can later be used as energy. A triglyceride lab test measures the amount of these fats circulating in the bloodstream.

Hypertriglyceridemia

Hypertriglyceridemia is a condition in which there is too much fat, or triglycerides in the blood². It is the medical diagnosis for high triglycerides. The awareness of the health risks associated with hypertriglyceridemia has only recently grown. Unfortunately, this condition is frequently underdiagnosed for a variety of reasons.

First, current guidelines recommend that healthy adults check their triglyceride levels only once every five years. Since hypertriglyceridemia usually has no symptoms, people are often unaware of the condition and may not request routine testing. This means a seemingly healthy person might not discover they have elevated triglycerides for years. Additionally, cholesterol is often seen as the main contributing factor to heart health, overshadowing the serious risks posed by elevated triglycerides. If left untreated hypertriglyceridemia can lead to cardiovascular diseases and several other chronic health conditions including but not limited to arteriosclerosis (hardening of the arteries), pancreatitis³, and nonalcoholic fatty liver disease.

How Triglycerides Interact with Cholesterol

As mentioned, triglycerides are produced in the liver. When carbohydrates are converted into glucose, any excess glucose that reaches the liver is converted into triglycerides. The liver also produces very low-density lipoproteins (VLDL), which is composed of about 85% triglycerides. VLDL is a type of cholesterol that transports triglycerides through the bloodstream releasing it slowly into the blood as it travels. Essentially VLDL cholesterol is a bus and triglycerides are the passengers. As the “bus” travels through the bloodstream, the “passengers” slowly get off throughout their trip through the artery.

After VLDL releases triglycerides into the bloodstream, it is converted into IDL (intermediate-density lipoprotein) cholesterol. IDL is then converted into LDL (low-density lipoprotein) cholesterol⁴. VLDL is classified as “bad” cholesterol because it greatly contributes to plaque buildup in the arteries⁵. Studies have shown that people with high VLDL cholesterol are at a much higher risk of cardiovascular disease and heart attack than people with high LDL cholesterol⁶ due to the triglycerides it carries and releases into the arteries.

Arterial Damage Caused by Triglycerides

When triglycerides accumulate in the arteries, they can cause the arterial walls to become hard and brittle. Like any hard, brittle material, fragile arteries are prone to damage, cracking, and breaking. When this damage occurs, cholesterol in the bloodstream adheres to the cracks to stabilize them, acting as a sort of “arterial bandage.”

However, as the artery sustains more damage caused by elevated triglycerides, additional cholesterol continues to stick to the damaged areas, gradually building up and potentially leading to a blockage. If this blockage is not quickly addressed it can lead to a heart attack. Without hypertriglyceridemia or high triglycerides, cholesterol would generally flow through the bloodstream without accumulating, only adhering to minor arterial cracks that naturally occur with aging.

Why Triglycerides Matter

Triglycerides provide essential fuel for the body during physical activity, exercise, and times of reduced calorie intake. When glycogen (the stored form of glucose or carbs) is depleted, the body turns to triglycerides (or fat) as an alternative energy source. While triglycerides are necessary for various bodily functions, an excess of them can cause significant arterial damage, increasing the risk of cardiovascular diseases including heart attacks, arteriosclerosis, pancreatitis, and pancreatic cancer.

High triglycerides can also cause significant damage to the liver. Triglycerides are fat from excess calories and carbohydrates. Fat or triglycerides are stored throughout the body including in the internal organs such as the liver. When the liver becomes encompassed with fat it begins to lose functionality leading to non-alcoholic fatty liver disease, non-alcoholic steatohepatitis (cell damage of the liver), cirrhosis (end-stage liver disease), and liver cancer.

What Raises Triglycerides?

Elevated triglycerides are caused by excessive caloric intake – primarily carbohydrates and eating too often. The body does not want high levels of glucose or carbohydrates in the blood as this can cause an array of life-threatening health conditions. To avoid excess carbohydrates in the bloodstream the liver converts glucose into triglycerides (fat). Consuming an excess of calories from carbohydrates leads to increased levels of triglycerides in the blood.

Alcohol consumption can also contribute to elevated triglyceride levels. Alcohol can be heavy in sugar (carbs) and calories⁷. The liquid sugar and excess empty calories are converted into triglycerides⁸. Additionally, alcohol can impair liver function, hindering the liver’s ability to remove triglycerides and cholesterol (including VLDL) from the bloodstream. This results in increased levels of both triglycerides and cholesterol in the blood.

Several lifestyle factors can contribute to elevated triglyceride levels as well, including a sedentary lifestyle, obesity or excess visceral (belly) fat, and poor sleep. A sedentary lifestyle slows metabolism, resulting in unused calories being converted into triglycerides. Obesity and excess visceral fat often indicate overeating, particularly of carbohydrates that are stored as visceral fat, which increases triglyceride production. Poor sleep can disrupt hormonal balance, raising cortisol levels and promoting the storage of fat and triglycerides.

Triglycerides: The Unspoken Biomarker of True Health

Triglycerides are an important biomarker of true health. It is essential to ask your doctor to include triglyceride levels in your routine lab tests to monitor for any elevations. High triglyceride levels can cause ongoing damage to the arteries, heart, liver, and pancreas, making it crucial to keep them under control.

If you suspect you may have elevated triglycerides or hypertriglyceridemia, schedule an appointment with your doctor and request lab work to be completed beforehand. This will allow you to review the results together during your visit. In the meantime, consider making lifestyle changes to help improve your triglyceride levels. Be careful not to overconsume carbohydrates, particularly simple carbs like bread, pasta, baked goods, and sugary treats, as these can significantly impact triglyceride levels.

Staying active throughout the day is equally important for managing triglyceride levels. Take frequent walks or jogs and incorporate weightlifting (if physically able) to help your body burn excess calories. Building muscle is particularly beneficial as it significantly improves glucose metabolism, making muscle-building exercises an important tool for lowering triglycerides. At the end of the day, when your body is tired from the increased activity, ensure you get adequate rest by turning in early. Quality sleep supports healthy hormone production and balance, further contributing to healthy triglyceride levels.

High triglycerides are a serious health concern, but the good news is that with a few targeted lifestyle changes, you can effectively manage and even reverse this issue. Stay consistent, take it one step at a time, and trust in your ability to make these positive changes—you’ve got this!

Supporting Research