Abnormal cholesterol labs. What to do with elevated triglycerides?


You see your physician and get a routine cholesterol panel.  The results show that your triglycerides are high.  What should you do?

Fasting lab work should show that your triglycerides should be less than 150. When triglycerides are higher than 150, it increases your risk of cardiovascular (CV) disease. If the levels are severely elevated (500 mg per dL or higher) add the risk of pancreatitis to the risk of CV disease.

What are risk factors for high triglycerides?

  • Metabolic syndrome
  • Type 2 diabetes
  • Obesity

What should you do if your triglycerides are between 150-500.  We suggest “lifestyle modification” as this decreases the 3 risk factors contributing to high triglycerides.  Sometimes I have patients list off to me what they are currently doing… and yet your body needs more healthful changes than you are currently doing.  This means that what you are currently doing is not enough to maintain good triglycerides and decrease your risk long-term of cardiovascular issues.  Decrease intake of carbohydrates, especially refined carbohydrates and increase physical activity.  Aim to have 30 minutes a day of moderate-to-high intensity physical activity.  Increase omega-3 fatty acid intake and increase protein intake.  These lifestyle changes will help improve exercise capacity and overall health. 

If your ASCVD risk (the risk of having a cardiovascular event in 10 years) is borderline or intermediate, then you and your physician can consider starting on a statin drug.  Here is an ASCVD risk calculator.

If you continue to have elevated triglycerides despite lifestyle changes and statins, high-dose icosapent, fibrates, omega-3 fatty acids or niacin can be considered. 

If you are admitted to the hospital with acute pancreatitis from hypertriglyceridemia, your physician may start an insulin infusion or do plasmapheresis.  The goal is to head this off at the pass. 

I hope this helps.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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