Triglycerides

Triglycerides are a type of blood fat. They are our main source of energy and are essential for good health. But if you have too much in your blood, this can raise the risk of heart disease. 

High triglycerides are known to contribute to the risk of heart disease and other diseases of the heart and blood vessels, and very high triglyceride levels can cause serious medical conditions such as pancreatitis.

What are triglycerides?

Triglycerides are a combination of:

• three fatty acids (i.e. saturated fat, unsaturated fat or both – these are the building blocks of fats) 
• glycerol, a form of glucose (a simple sugar).

Triglycerides are our main source of energy and, as they are so important, we have two supplies: one from our diet and one made by the liver.

How do triglycerides get into the blood? 

When we eat foods containing triglycerides, such as meat, dairy products, cooking oils and fats, they are absorbed by our intestines and packaged into parcels of fats and protein called chylomicrons (a type of lipoprotein). These carry the triglycerides in the blood stream to our tissues to be used for energy straight away, or stored for later. 

The body also makes its own supply of triglycerides in the liver. This form is carried in a different type of lipoprotein known as VLDL (very low density lipoprotein

Finding out your triglycerides levels

Triglycerides are measured with a simple blood test. Triglyceride levels should be measured when you have a cholesterol test as they can also contribute to your risk of developing heart disease, and other disease of the heart and blood vessels.

The triglyceride test measures the triglycerides carried in chylomicrons and VLDL. National guidelines in the UK no longer recommend a fasting blood test (where you fast for a period of time before your blood test).

What should your triglyceride levels be?

HEART UK experts state that we should aim for a non-fasting triglyceride level below 2.0mmol/L.

If your doctor has asked you to fast for a test (usually for 10-14 hours) then your triglyceride level should be below 1.7mmol/L. This "fasting test" number is lower because only the triglycerides made by the liver and carried in the VLDLwill be measured – not the triglycerides you get from food. As you have not eaten, there will be no chylomicrons present in your blood.

 What can raise your triglycerides?

Triglycerides can be raised due to what doctors refer to as 'primary' and 'secondary' causes, explained below.  Some people have a combination of both.  

It is very important that your doctors investigates all these potential causes so that you can start treatment.

Primary causes of raised triglycerides

'Primary' refers to inherited (genetic) conditions which cause raised triglyceride levels. 

• familial hypertriglyceridaemia, where trigylcerides are raised
• familial combined hyperlipidaemia (FCH), where both triglycerides and cholesterol are raised
• type 3 hyperlipidaemia, where both triglycerides and cholesterol are raised
• familial chylomicronaemia syndrome (FCS), a rarer condition where triglyceride levels are extremely high. 

Secondary causes of raised triglycerides

'Secondary' refers to the many other things that can influence triglyceride levels, including diet and lifestyle, certain medical conditions and medications.

Lifestyle causes include: 

• a sedentary lifestyle (lack of physical activity)
• an unhealthy diet, particularly diets high in saturated fats and added sugars
• alcohol – some people may be very sensitive even to small amounts of alcohol, and these can significantly raise their triglyceride levels.

Medical conditions include:

• kidney disease
• non alcoholic fatty liver disease
• gout 
• pregnancy 
• an under-active thyroid.

Medications include: 

• some diuretics
• steroids
• oral (tablets) oestrogen therapy
• retinoids 
• retrovirals.

High triglycerides and low HDL – an unhealthy pattern of blood fats

People with high triglyceride levels often have low HDL cholesterol (good cholesterol) as well. This is an unhealthy combination of blood fats that's often linked with premature heart disease.

It can be inherited, and often occurs in people who:

• are very overweight, especially if they carry their weight around their middle
• have Type 2 diabetes 
• have metabolic syndrome.

People with Type 2 diabetes usually have high LDL cholesterol (bad cholesterol) as well. This type of cholesterol is 'atherogenic', meaning it clogs up the arteries, leading to heart attacks and strokes. 

Lowering your triglycerides

Lifestyle changes

Diet and lifestyle changes are the cornerstones of treatment for raised triglycerides. As with many blood fat conditions, and they tend to have a big impact.

Maintain a healthy weight and shape 

• Carrying too much weight around the middle (being “apple” shape), can raise your triglycerides.
• The combination of losing excess weight and getting regular exercise can often lower triglyceride levels significantly.

Be physically active

• Regular physical activity can help lower your triglycerides, especially aerobic exercise such as walking, jogging, swimming, cycling and dancing. Aim for at least 150 minutes a week at a moderate intensity – so you’re breathing harder but not out of breath. 

Eat a healthy diet

• Replace saturated fats with unsaturated fats. Saturated fats are found in many animal products such as butter, cheese and meat, while unsaturated options include many vegetable oils and spreads, oily fish, nuts and seeds, and avocados.
• Choose wholegrain foods such as wholemeal bread instead of refined starchy foods such as white bread.
• Cut down on added sugars, such as the sugars added to cakes and biscuits. 
• Eat plenty of fruit and vegetables – choose a wide variety and aim for at least five portions a day.
• Choose healthy sources of protein such as beans, peas, lentils, fish, nuts, seeds, poultry and low fat dairy foods. These foods are high in protein and nutrients but low in saturated fat. If you eat red meat, choose lean meat and watch the amount. Aim for two portions of fish a week, one of which should be oily, for example, salmon, mackerel, sardines and pilchards.
• Eat fewer processed foods and drinks that are high in sugar or saturated fat such as biscuits, cakes, chocolates, pastries, fizzy drinks and cordials. Sugary foods can affect blood triglycerides.
• Limit takeaways and ready meals as that are high in fat, and cook from scratch more often.

Limit alcohol

• If you drink alcohol, drink no more than 14 units a week. Triglycerides levels are affected by how much alcohol you drink, and some people with raised triglycerides may need to reduce their alcohol intake even more. Speak to your health professional about a safe amount for you. 

Medicines

If changes to your lifestyle don't lower your triglyceride levels enough or you have been diagnosed with a genetic condition, then you may need medication.

Statins are usually the first line of treatment. Cholesterol specialists may also prescribe medications such as fibrates and omega 3 acid ethyl esters.

Page updated 3rd March 2025 

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