There’s more to your lipid blood test panel than total cholesterol. Your doctor
will emphasize that keeping your cholesterol and LDL levels within the normal
ranges is good practice. But, if your doctor practices functional medicine, your
LDL and HDL may get a serious look from a comprehensive lipid panel like the
NMR LipoProfile or VAP Cholesterol Test.
If you are male and over forty-five, have a family history of heart attack,
stroke, or a family member who had major heart surgery, look closer at your
other lipids. The most overlooked lipid is triglycerides. Don’t underestimate
the power of high triglycerides to sabotage your cardiovascular health.
What Are Triglycerides?
Triglycerides are a type of blood fat or lipid. They make up most of your body’s
fat deposits, including what accumulates around your waist. Your liver and
pancreas play important roles in metabolizing triglycerides. Gut health is also
important because your microbiome helps control body mass and levels of HDL
High triglycerides are associated with metabolic syndrome, a condition linked
to an increased risk of heart attack or stroke. Metabolic syndrome goes by
other names, including Syndrome X and insulin resistance. It’s also associated
with Type II Diabetes.
Metabolic syndrome may not cause any symptoms. But, even though a silent
disease, it displays characteristics that doctors can recognize.
Signs of Metabolic Syndrome:
- Increased waist-to-hip ratio (“belly fat”)
- High triglycerides
- Low HDL
- High blood pressure
- High fasting glucose
In men, low testosterone and high triglycerides tend to cluster together. But,
boosting testosterone alone will not correct metabolic syndrome.
The Worry of Too Much Triglycerides
Dangerously high triglyceride levels spell trouble. If yours are near or over
1,000 mg/dL, you may also have pancreatic inflammation. Pancreatitis is
associated with alcoholism. Even occasional heavy drinking can increase the
risk for metabolic syndrome and produce higher triglyceride levels. Like with
all blood lipids, your disease risk increases as triglyceride levels go up.
Excess total cholesterol, LDL, and triglycerides circulate in your blood stream
where they interact with the lining of your arteries. High lipid levels eventually
build up along the arterial walls where blood vessel damage develops.
12 Causes of High Triglycerides:
- Too much sugar and fats
- Too much alcohol
- Not enough exercise
- Not enough Omega-3 fatty acids
- Low thyroid hormones
- Reduced kidney function
- Reduced liver function
- Reduced pancreas function
- Insulin resistance
- VLDL overproduction
- HDL underproduction
What Is the Best Level for Triglycerides?
The optimal level on a blood test is the number where there is no evidence
associated with any disease or where there is plenty of evidence for health
benefits including slower aging.
If your triglyceride level is high, aim to lower it as much as possible to reduce
your risk for cardiovascular disease. If you want to have no risk, push
triglycerides even lower.
The HDL Triglyceride Connection
Doctors rely on indirect ways to guess about the health of your arteries.
Research has shown that one of these ways is the ratio between triglycerides
(TG) and HDL – the “good” cholesterol. To calculate your TG/HDL ratio divide
your triglyceride level by HDL level found on your lipid panel.
I’ve found that those with triglyceride levels below 100 mg/dL and an HDL
above 65 almost never have a heart attack or stroke.
How to Lower Triglycerides
- Change your diet. A plant-based diet low in refined carbohydrates and
absent of refined sugar and fruit juices is a start. Eat more fish. If you’re
not allergic to soy, add soy isoflavones. Add healthy fats and oils like
avocados and hazelnuts. But, limit pine nuts and sesame seeds.
- Cut back on alcohol. Drinking promotes liver metabolism of VLDL, the
primary source of triglycerides.
- Lower carbohydrates. If you’re prone to insulin resistance, excess
dietary carbs can metabolize into triglycerides. Eliminate refined sugar
and fruit juices because they quickly turn into triglycerides.
- Exercise regularly. Ramp up your activity raises HDL and lowers
triglycerides. Taking a walk about dinner may help prevent triglycerides
from spiking about your meal.
- Take niacin to raise HDL. Research shows that niacin boosts HDL by
about 30%. It also helps lower triglycerides. However, some find the
flushing effect caused by niacin annoying. However, non-flush forms of
niacin as less effective at raising HDL level.
- Take high EPA omega-3 fish oils. Omega-3 fish oil lowers LDL and
triglycerides, and may boost HDL. To get the full effect, however, you
need at least 3,000 mg daily.
Other Tests That Influence Triglycerides:
- Test your thyroid hormones. Even borderline low thyroid hormone
function is associated with high triglycerides and metabolic syndrome.
- Test testosterone levels. Low testosterone levels and metabolic
syndrome go together.
- Test cortisol. Although there is no scientific consensus, but studies and
clinic evidence suggests a connection between cortisol and HDL levels.
High cortisol usually goes along with low HDL.
- Test liver and kidney functions, and the pancreatic enzymes lipase and
amylase. If your liver, kidneys, or pancreas are compromised, you may
have trouble metabolizing lipids, including triglycerides.
There is no drug that lowers triglycerides, or that fixes the complex
connections associated between metabolic syndrome, inflammation, gut
microbiome, and arterial disease.
Researchers have found that the TG/HDL ratio is the most powerful tool to
estimate your risk for cardiovascular disease. A fasting blood test is the best
way to get the most accurate assessment of your triglyceride levels.