contraceptives, estrogen, and cholestyramine (a drug
used to treat high cholesterol levels) may increase
blood triglyceride levels, while vitamin C (ascorbic
acid) asparaginase (an enzyme used in the treatment of
cancer) and various drugs to treat high levels of blood
lipids may decrease blood triglyceride levels. Triglycer-
ide levels can also be affected by the menstrual cycle,
time of day, and recent exercise. A person should have
two or three tests, one week apart, for the most accurate
results.
The normal range of blood triglyceride levels
depends on age and gender, with women naturally hav-
ing higher levels, especially when pregnant. As people
age and gain weight, triglyceride levels usually increase.
According to the guidelines promulgated by the
National Cholesterol Education Program, a division
of the National Heart, Lung, and Blood Institute, a
normalfastinglevel foradultsislessthan150 milligrams
per deciliter (mg/dl), with levels below 101 considered
desirable. Levels of 150 - 199 mg/dl are considered
borderline high, levels of 200 - 499 mg/dl are considered
high, with levels greater than 500 mg/dl considered very
high. Such high levels may indicate liver disease (cirrho-
sis), underactive thyroid activity, uncontrolled diabetes,
pancreatitis, kidney disease, or a diet too low in protein
and too high incarbohydrates.
Extremely low levels of triglycerides (less than 10
mg/dl) may indicate malnutrition, malabsorption, a
diet too low in fat, or an overactive thyroid.
High triglyceride levels may be due to several
causes, including:Lifestyle factors
Weight gain
Lack of exercise
Smoking
Skipping meals
Eating large portions of food at one time
Dietary factors
Excessive intake of alcohol, saturated and trans fats,
sugar, starch, and calories
Medical conditions
Medicines, including birth control pills, steroids, and
diuretics
Illnesses, including poorly controlled diabetes, insu-
lin resistance (a precursor to diabetes), polycystic
ovary syndrome (PCOS), hypothyroidism, kidney
disease, and liver disease
Age
Hereditary may also play a role in elevated levels
of triglycerides. Familial hypertriglyceridemiais a
common inherited disorder in which the level of tri-
glycerides in a person’s blood is higher than normal.
This disorder is an autosomal dominant disorder, that
is, if one parent has an abnormal gene and the other
parent a normal gene, there is a 50% chance each child
will inherit the abnormal gene and therefore the dom-
inant trait. Some people with this condition also have
high levels of very low density lipoprotein (VLDL),
the ‘‘bad’’ cholesterol.Obesity, hyperglycemia (high
blood glucose levels), and high levels of insulin are
often associated with this condition and may result in
even higher triglyceride levels.
Familial hypertriglyceridemia is not usually
detected until puberty or early adulthood. Symptoms
include a mild-to-moderate increase in blood triglycer-
ide levels and premature coronary artery disease. Per-
sons with this condition are also at increased risk for
pancreatitis.
Familial hypertriglyceridemia occurs in about 1 in
500 individuals in the United States. Risk factors are a
family history of hypertriglyceridemia or a family his-
tory of heart disease before the age of 50. If triglyceride
levels cannot be not controlled by dietary and lifestyle
changes, medication may be needed. Nicotinic acid
and gemfibrozil have been shown to effectively reduce
triglycerides in persons with familial hypertriglyceri-
demia. Screening family members for elevated levels of
triglycerides may help to detect the disease early.
A nutritionist or dietitian may be consulted to
help develop a dietary plan to help control triglyceride
levels. In general, to lower or prevent high levels of
triglycerides, a person should:KEY TERMS
Adipose tissue —A type of connective tissue that
contains stored cellular fat.
Malnutrition —Poor nutrition because of an insuf-
ficient or poorly balanced diet or faulty digestion or
utilization of foods
Malabsorption —Poor absorption of nutrients by
the intestinal tract
Pancreas—A long, irregularly-shaped gland near
the stomach that secretes a digestive fluid into the
intestine through one or more ducts and that
secretes the insulin, glucagen, and somatostatin
into the bloodstream.
Polycystic ovary syndrome—A condition in which
cysts in the ovary interfere with normal ovulation
and menstruationTriglycerides