Triglycerides: high levels, pancreatitis risk and what helps

Triglycerides are a form of fat. After a meal, the gut packages dietary fat into particles and the liver packages fat it makes into other particles; both carry triglycerides through the blood to muscle and fat tissue. Lab Tests Online UK says they are included as part of a lipid profile, and that unlike cholesterol, which is clearly an important cause of cardiovascular disease, the relationship between triglycerides and cardiovascular disease is less marked but still important.

Because they are carried in particles such as VLDL, triglyceride levels also affect how reliably LDL cholesterol can be calculated.

The commonest reason is as part of a lipid profile to estimate risk of cardiovascular disease, offered by your GP when you reach 40, or earlier if you have diabetes, high blood pressure, smoke or are overweight. They are also checked to look for an underlying cause in pancreatitis, since high triglycerides can lead to that serious condition, though there are many other causes.

The NHS adds that high cholesterol does not usually cause symptoms and can only be found by a blood test, and that the NHS Health Check for people aged 40 to 74 includes a cholesterol test.

Previously a 12-hour fast was recommended, because triglycerides rise for several hours after a meal. Lab Tests Online UK says studies now show readings after a meal are just as useful as fasting levels, so no fasting is routinely required, although your doctor may sometimes ask for it. Triglyceride levels may change dramatically after a meal and even fasting levels vary considerably from day to day, so modest differences between tests on different days are not unusual or abnormal.

If you have diabetes with uncontrolled blood glucose, triglycerides will be very high.

Causes include a high fat or high sugar diet, high alcohol intake, obesity and diabetes, plus genetic factors and secondary causes such as pregnancy, kidney disease, liver disease and an underactive thyroid. Rare inherited conditions such as lipoprotein lipase deficiency or familial chylomicronaemia syndrome cause very high levels from birth and pancreatitis; specialised treatment now exists, but management is mostly based on very low fat diets.

A result of at least 10 to 15 mmol/L indicates a risk of pancreatitis, so it is important to lower the level, using drugs or lifestyle changes depending on the cause. Severe upper abdominal pain spreading to the back, with vomiting, needs urgent assessment through NHS 111 or A&E.

Lifestyle changes can be very effective. Cutting back on alcohol, sugar and refined carbohydrates, reducing excess weight and being active all lower triglycerides. Lab Tests Online UK says exercise especially lowers triglycerides and raises HDL, and helps lower LDL even without weight loss. Drug treatments are available if lifestyle changes are insufficient, and the NHS notes that statins are the most common cholesterol medicine; specialists decide on others for high triglycerides.

Home triglyceride monitors exist, but the source says there is currently no clinical indication for which this is recommended.

A raised value is usually put into the context of overall cardiovascular risk, with blood glucose or HbA1c, thyroid and liver tests checked for causes. Very high levels may need a specialist lipid clinic. Do not stop prescribed medicines without advice.