Triglycerides
TG· also: Triglycerides, Trigs, VLDL
Clinical Overview
Triglycerides are the main form of fat stored in the body and are a major source of energy. They are carried in the blood by VLDL and chylomicrons. Elevated triglycerides (hypertriglyceridemia) are associated with pancreatitis risk, insulin resistance, metabolic syndrome, and cardiovascular disease when combined with low HDL.
Why This Test Matters
Severely elevated triglycerides (>1000 mg/dL) cause acute pancreatitis — a medical emergency. Moderate hypertriglyceridemia (200–499 mg/dL) contributes to residual cardiovascular risk and non-alcoholic fatty liver disease. Triglycerides also affect LDL calculation — when above 400 mg/dL, the Friedewald formula is inaccurate and direct LDL measurement is required.
Reference RangesWHO/IFCC standards
| Age Group | Reference Range | Unit | Notes |
|---|---|---|---|
| Adults (18–64) | 0 – 150 | mg/dL | Normal (fasting) |
| Adults (18–64) | 150 – 199 | mg/dL | Borderline high |
| Adults (18–64) | 200 – 499 | mg/dL | High |
| Adults (18–64) | 500 – 9999 | mg/dL | Very high — pancreatitis risk |
Also reported in: mmol/L.
Critical (Panic) Values
Critical High: > 1000 mg/dL. Values outside these limits require immediate clinical attention.
What Causes Abnormal Results?
High TG Causes
- Diabetes mellitus (insulin resistance increases VLDL secretion)
- Obesity and metabolic syndrome
- Alcohol use
- High carbohydrate and sugar diet (especially fructose)
- Hypothyroidism
- Chronic kidney disease
- Medications: corticosteroids, beta-blockers, thiazides, retinoids, some HIV antiretrovirals
- Genetic: familial hypertriglyceridemia, familial combined hyperlipidemia
Low TG Causes
- Malnutrition
- Low-fat or low-carbohydrate diet
- Malabsorption (celiac disease, inflammatory bowel disease)
- Hyperthyroidism
Signs & Symptoms to Watch For
How to Prepare for This Test
Fasting for 9–12 hours is essential — triglycerides rise dramatically after eating (non-fasting values can be 3× higher). Avoid alcohol for at least 24 hours before testing.
Factors That Can Affect Results
- Non-fasting state (most important — dramatically raises triglycerides)
- Alcohol (raises triglycerides markedly)
- Lipemic samples (very high triglycerides cause a white, milky appearance of blood)
- Estrogen therapy (raises triglycerides)
- Hypothyroidism
Related Topics
Frequently Asked Questions
What triglyceride level causes pancreatitis?
Acute pancreatitis from hypertriglyceridemia typically occurs when triglycerides exceed 1,000 mg/dL (11.3 mmol/L), though some patients develop pancreatitis at lower levels. Hypertriglyceridemia-induced pancreatitis (HTG-AP) accounts for 1–4% of all acute pancreatitis cases. Treatment includes insulin infusion (rapidly lowers triglycerides), nil by mouth, IV fluids, and fibrates/omega-3 fatty acids for long-term prevention.
Can lifestyle changes significantly lower triglycerides?
Yes. Triglycerides are highly responsive to lifestyle: eliminating alcohol can lower triglycerides by 20–50%; reducing refined carbohydrates, sugar, and fructose (including fruit juice) can reduce them by 20–30%; losing weight reduces triglycerides by 5–20%; regular aerobic exercise reduces them by 10–20%. Omega-3 fatty acids (EPA/DHA) at high doses (4g/day) can reduce triglycerides by 20–30% — the REDUCE-IT trial showed icosapentaenoic acid (EPA) reduces cardiovascular events beyond its triglyceride effect.