High Triglycerides: What Is Your Body Trying to Tell You?

Part 3 of the Faithful Steps Metabolic Syndrome Series

This article is for education only and is not a substitute for medical advice. Talk with your healthcare provider about your own health, medications, and lab results.

When you have blood work done, you may hear, “Your cholesterol is high,” or “Your triglycerides are high.”

You may be given medicine or told to change what you eat.

But what does that actually mean? And why do triglycerides, cholesterol, blood sugar, blood pressure, and weight problems so often seem to show up together?

They are not always separate problems.

Sometimes they are different signs that the way your body handles energy is beginning to change.

Many people hear the word triglycerides and picture grease from food floating in their blood. They may think triglycerides are simply another kind of cholesterol or that only fatty foods can make them rise. Neither idea tells the whole story.

What Are Triglycerides?

Triglycerides are a type of fat found in your blood.

Your body needs triglycerides. They are one way your body stores and moves energy.

When you eat, your body uses some of that food for energy right away. Energy that is not needed right away can be turned into triglycerides and stored in fat cells for later.

When your body needs that stored energy, it can release fat back into the bloodstream.

Triglycerides are not simply fat sitting still in your blood. Your body is constantly moving, using, and storing them. That is important because when too many triglycerides are moving through the blood, it may be a sign that this system is not working as well as it should.

What Does Insulin Have to Do with It?

Most people think of insulin only as something that controls blood sugar.

But insulin does more than that.

Insulin also helps your body decide when to store energy and when to release stored fat.

After you eat, insulin helps tell your body that energy is coming in, so it does not need to release as much stored energy.

When insulin does not work as well as it should, this message becomes weaker. This is called insulin resistance.

Your body may make more insulin to try to get the same job done. At the same time, more stored fat may be released and sent toward the liver.

The liver can package some of that fat into triglycerides and send it back into the bloodstream. That is one reason high triglycerides and insulin resistance often appear together.

Where Does Cholesterol Fit In?

The important question is not simply whether cholesterol is present. It also matters how cholesterol is being carried through your blood and where it is going.

This is where HDL and LDL come in.

HDL and LDL are tiny carriers made of fat and protein. They carry cholesterol and other fats through your bloodstream.

HDL is often called the “good” carrier because it helps move cholesterol away from the arteries.

LDL is often called the “bad” carrier because it can leave cholesterol in the artery walls.

Higher HDL levels are generally linked with lower heart risk. Too much LDL can increase the chance that cholesterol will build up in artery walls over time.

When triglycerides are high, HDL is often lower too. This is one reason doctors look at the whole lipid panel instead of only one number.

How Does This Connect to Metabolic Syndrome?

For metabolic syndrome, a triglyceride level of 150 mg/dL or higher—or taking medicine for high triglycerides—counts as one of the five findings doctors look for. Low HDL can be another part of the same pattern.

These numbers should not be considered by themselves. Together with blood pressure, blood sugar, and waist size, they can help show how well your body is handling and storing energy.

Can High Triglycerides Block an Artery?

When you hear that triglycerides are a type of fat in your blood, you might picture blobs of fat floating around and sticking together until they block an artery.

That is not what happens.

Triglycerides do not clump together and plug your arteries.

Triglycerides travel through your blood inside tiny carriers. As your body uses the triglycerides, some of these carriers become smaller. What is left is called a remnant.

Think of a remnant as what is left after some of the triglycerides have been removed from the carrier.

These remnants still contain cholesterol. Some can get into the walls of your arteries.

Over time, cholesterol and other materials can build up there and form plaque.

Plaque can make an artery narrower. Sometimes a plaque can also break open. Your body sees the damaged area and tries to repair it by making a blood clot.

The clot can become large enough to suddenly stop the flow of blood.

If blood flow to part of the heart is blocked, that part of the heart does not get the oxygen it needs. The heart muscle can begin to become damaged or die.

That is a heart attack.

If blood flow to part of the brain is blocked, that part of the brain does not get the oxygen it needs. Brain cells can begin to become damaged or die.

That is one type of stroke.

Not every stroke is caused by a blood clot. Some strokes happen when a blood vessel in the brain breaks and bleeds.

How High Is Too High?

Your triglyceride level is measured with a blood test. You may see the result on your lab report listed as TG or triglycerides.

Different medical groups may use slightly different words for triglyceride ranges. A simple way to think about the numbers is:

• Below 150 mg/dL: generally considered a healthy level for adults.

• 150 to 499 mg/dL: elevated. The higher the number, the more important it is to look for the reason.

• 500 mg/dL or higher: severely elevated and needs medical attention because the risk of pancreatitis rises.

• 1,000 mg/dL or higher: especially concerning for pancreatitis and usually needs prompt medical treatment.

A triglyceride level that is a little high does not mean you are having an emergency. But it is worth paying attention to.

When Triglycerides Become Very High

When triglycerides become very high, we start worrying about something besides the heart and blood vessels.

We also worry about the pancreas.

The pancreas is an organ that sits behind your stomach. One of its jobs is to make insulin. It also makes substances that help you digest food.

Very high triglycerides can increase the risk of pancreatitis (inflammation of the pancreas). Pancreatitis can become a serious medical problem.

This is one reason triglyceride levels of 500 mg/dL or higher should be discussed with a healthcare provider, and levels around 1,000 mg/dL or higher are especially concerning.

Why Are My Triglycerides High?

There is not just one reason triglycerides become high. Sometimes several things are contributing at the same time.

• Blood sugar that stays too high

• Insulin resistance

• Eating a lot of added sugar and refined carbohydrates

• Taking in more energy than your body needs

• Drinking alcohol

• Carrying excess body fat, especially around the waist

• Some medications

• Certain medical conditions, such as thyroid, liver, or kidney problems

• Genetics

That is why seeing a high triglyceride number should lead to another question:

Why is it high?

Finding the reason can help you and your healthcare provider decide what to do about it.

Wait—Can Sugar Really Raise Triglycerides?

YES

This surprises a lot of people.

You may think, “Triglycerides are fat, so they must come from eating fat.”

But that is not the whole story.

When you eat carbohydrates, your body breaks many of them down into glucose. Your body can use that glucose for energy.

When more energy comes in than your body needs, some of that extra energy can eventually be turned into triglycerides. Your liver helps with this process.

This means that eating a lot of added sugar and refined carbohydrates can raise triglycerides in some people.

It also helps explain why blood sugar and triglycerides can start changing at the same time.

What Can I Do to Lower My Triglycerides?

The first step is finding out why your triglycerides are high. There is not one answer that fits everyone.

• Work toward better blood sugar control if high blood sugar is part of the problem.

• Cut back on added sugar and refined carbohydrates.

• Choose more whole, minimally processed foods.

• Add more movement to your day.

• Lose excess weight if needed. Even some weight loss may help.

• Limit or avoid alcohol, especially if your triglycerides are very high.

• Take prescribed medications as directed.

Some people need medication to lower triglycerides.

Do not stop a prescribed medicine or change the dose without talking with your healthcare provider.

Start With One Change

Seeing an abnormal lab result can make you feel as though you need to change everything at once. You do not.

Look at what may be contributing to your triglycerides. Then choose somewhere to begin.

Maybe you replace a sugary drink with water.

Maybe you cut back on sweets or foods made with refined flour.

Maybe you take a short walk after a meal.

Maybe your first step is taking a prescribed medication regularly instead of missing doses.

Or maybe your first step is simply making an appointment and asking, “Why are my triglycerides high, and what can I do to lower them?”

One change may seem small, but one change is still a step forward.

A Patient I Still Remember

Some details have been changed to protect the patient’s privacy.

I once cared for a young man who was only in his late 20s. He came to me after being transferred out of the ICU, where he had been treated for diabetic ketoacidosis (DKA).

His triglycerides had been over 3,000 mg/dL.

This was not his first hospital stay. He struggled to keep his blood sugar under control. He had difficulty taking the medicine that had been prescribed for his triglycerides regularly. He was admitted to the hospital frequently.

During this admission, he received aggressive IV fluids, an insulin drip, and medicine to help lower his triglycerides.

His story stayed with me because he was so young. Serious problems with blood sugar and triglycerides are not limited to older adults.

It also showed me how connected these problems can become.

During DKA, the body does not have enough effective insulin. It cannot use glucose normally, so it begins releasing much more stored fat for energy. More fat travels to the liver, and the liver can send more triglycerides back into the bloodstream. At the same time, the body may not clear triglycerides as well as it normally would.

That does not mean DKA was the only reason his triglycerides were over 3,000. Very high triglycerides can have more than one cause, including genetics and other health or lifestyle factors.

But uncontrolled diabetes can make very high triglycerides much worse.

The insulin drip was needed to treat his DKA. Restoring insulin also helped his body regain control over the release and clearing of fat.

His triglycerides did not have to reach 3,000 before they mattered. Neither do yours.

If your triglycerides are starting to rise, that is the time to ask why and find out what you can still do to bring them down.

One Step at a Time

High triglycerides are not just another number on your lab report. They can be a clue that something in your body needs attention.

The goal is not to become afraid of your lab results. The goal is to understand what your body may be telling you while there is still time to act.

Learn what your numbers mean.

Ask questions.

Find out what may be causing them to rise.

Then choose one change you can begin working on.

“The mind of the prudent acquires knowledge, And the ear of the wise seeks knowledge.” — Proverbs 18:15 (NASB 1995)

Learning about your health is not about becoming afraid of what might happen. It is about gaining the knowledge you need to make better choices with the health you have today.

READ ALSO: The first 2 articles in this series🌻

What Is Metabolic Syndrome?

High Blood Pressure: More Than Just a Number

Check the Studies Yourself

1. American Diabetes Association Professional Practice Committee. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S216–S245.

2. Virani SS, Morris PB, Agarwala A, et al. 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia. Journal of the American College of Cardiology. 2021;78(9):960–993. doi:10.1016/j.jacc.2021.06.011.

3. Ginsberg HN, Packard CJ, Chapman MJ, et al. Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies—a consensus statement from the European Atherosclerosis Society. European Heart Journal. 2021;42(47):4791–4806. doi:10.1093/eurheartj/ehab551.

4. Berglund L, Brunzell JD, Goldberg AC, et al. Evaluation and Treatment of Hypertriglyceridemia: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2012;97(9):2969–2989. doi:10.1210/jc.2011-3213.

5. Newman CB, Blaha MJ, Boord JB, et al. Lipid Management in Patients with Endocrine Disorders: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2020;105(12):3613–3682. doi:10.1210/clinem/dgaa674.

6. National Heart, Lung, and Blood Institute. Metabolic Syndrome: Diagnosis. National Institutes of Health.