Triglycerides: Why They Matter and How to Optimize Them

Guest Post by Andrew Graham, NP; Image by RitaE from Pixabay

A standard component of annual blood work is the lipid panel, which includes both cholesterol and triglycerides. Most people are pretty familiar with the concept of cholesterol and why it is relevant to health, but a lot less is said about triglycerides. Perhaps you have been told you have high triglycerides and haven’t been quite sure what to make of it. In this article, we’ll go over what triglycerides are, why they are relevant to your health, and how to keep them in optimal range.

What Are Triglycerides?

In the simplest terms, triglycerides are fat. 95% of the dietary fat we consume is in the form of triglycerides. A triglyceride molecule is made up of a glycerol backbone with three fatty acid chains attached—these fatty acids can be saturated, monounsaturated, polyunsaturated or trans fats. When we consume triglycerides, our body separates many of the fatty acid chains off of the glycerol backbone so they can be absorbed, but then re-assembles the triglyceride after absorption. The majority of our stored body fat is made of triglycerides. 

When we have our blood tested for triglycerides, the laboratory is measuring triglyceride levels found in the bloodstream. This level will not necessarily correlate to the total level of triglycerides stored across your body—but the amount in your blood is still relevant to your health.

The primary reason medical providers care about triglycerides is because a high level of triglycerides is a risk-factor for stroke and heart attack. You don’t want high levels of fat circulating in your bloodstream, as this can contribute to atherosclerosis, or the thickening of your arteries. Additionally, very high levels of triglycerides can increase the risk for pancreatitis, a painful inflammation of the pancreas that very often results in hospitalization.

But there are other important reasons to track triglyceride levels, as I’ll outline later in the article.

What Are Healthy Triglyceride Levels?

Triglyceride levels are measured fasting, since measuring them right after a meal will likely lead to a temporarily higher result as the body has just absorbed fat from the meal. In a fasting state, triglyceride levels are typically cited as healthy if <150 mg/dL. Many providers unfortunately take this “the lower the better” approach to both triglycerides as well as cholesterol. And yet, I think intuitively most people would think having a triglyceride level of 0 would not be optimal for human health. 

With that being said, looking at the medical literature more carefully would suggest a fasting triglyceride level of 50-90 mg/dL is generally optimal. One of the better lines of evidence to support this comes from a 2013 meta-analysis. A meta-analysis is a research study that looks at data across many other studies and combines them, creating a more robust data set and more convincing conclusions. Overall, it would appear that <150 is good, and 50-90 is great.

What Do Triglyceride Results Mean?

Triglyceride levels are much more commonly too high than too low. If your triglyceride levels are >90, and especially if they are >150 mg/dL, this could be due to several different things. Potential causes include insulin resistance, hypothyroidism, liver dysfunction, physical inactivity, excessive caloric intake and/or fat intake, or excess alcohol, among other reasons. It’s important to note that triglycerides can go up from consuming excess glucose and fructose, not just excess fat. 

Many of these common causes, including insulin resistance, hypothyroidism, physical inactivity and excess calories are all related to our metabolism. Triglycerides will back up when our body is not efficiently burning calories/fat for energy. It doesn’t make sense for high levels of fat to be circulating in our bloodstream while we are in a fasted state. You can think about this as a similar concept to insulin resistance, which leads to needlessly high levels of sugar circulating in the bloodstream. When healthy, the body does not like to be wasteful, and this is one reason high triglycerides give us a signal that there is some dysfunction in the body. 

While rare, if triglyceride levels are below 50, it could be due to insufficient calories, an issue of malabsorption, or possible autoimmunity. Working with a functional medicine provider can help determine the specific reason in your case.

How to Maintain Healthy Triglyceride Levels

The most important thing you can do to maintain healthy triglyceride levels is eat a whole-foods diet that limits sugars, refined carbs and processed food. Alcohol intake should be reduced or eliminated. Secondarily (and this will likely come as no shock), maintaining a regular habit of exercise is critical. Lifting weights and resistance training will give you the most bang for your buck in terms of improving metabolic health. But regular movement throughout the day, even just walking around the house or periodically getting up from your office chair and moving around, is critical for maintaining insulin sensitivity and healthy lipid levels.

If diet and exercise/movement are adequate and triglyceride levels are still off, it might be worth working with a functional medicine provider to figure out what else needs to be done. You could have some thyroid dysfunction, or may need some assistance with optimizing your gut health. Malabsorptive, dysbiotic or inflammatory gut issues are very common in our modern society. Interestingly, some preliminary research suggests certain strains of probiotics may be effective at lowering triglycerides. The mechanism for this is unclear, but it highlights the principle that improving gut health tends to have far-reaching effects.

Outside of identifying the root cause, some supplements can help with managing healthy levels. The most prominent of these would be a high-quality, high-dose fish oil. Spirulina is another supplement that has some research behind it for lowering triglycerides. It is always preferred to identify and reverse the root cause, but these supplements can be helpful additions to the backbone of a healthy diet and lifestyle.

Here are a couple of products that can be helpful for maintenance of healthy triglyceride levels.

We wrote more about how algae can impact lipids and triglycerides here.