Triglycerides are the main form of fat in your blood. A fasting level below 150 mg/dL is considered normal. Higher levels are linked to more heart attacks and strokes, mostly because of the cholesterol-rich particles that travel with them.
That last point shapes how the number is used. A raised triglyceride level is a signal to look at your particle count, measured by ApoB or non-HDL cholesterol, and at what is driving the rise. Very high levels are a separate problem, because they can inflame the pancreas.
Key takeaways
- Fasting triglycerides under 150 mg/dL are normal, 150 to 499 is a mild-to-moderate rise, and 500 or more is severe.
- High triglycerides mark the presence of remnant particles, which carry cholesterol into artery walls.
- Lowering the triglyceride number does not by itself lower heart risk unless the particle count falls too.
- Blood sugar control, alcohol, weight, thyroid function and some medicines all affect the level.
What triglycerides are
Triglycerides are fat molecules your body uses and stores for energy. Some come from food. Others are made by your liver, especially when you take in more calories, sugar or alcohol than you burn.
Fat does not mix with blood, so triglycerides travel inside carrier particles. As these particles deliver their fat to muscle and fat tissue, they shrink into smaller particles called remnants. Remnants have less triglyceride and proportionally more cholesterol, and they are small enough to enter the artery wall.
Triglyceride level categories
| Fasting triglycerides | Category | Main concern |
|---|---|---|
| Below 150 mg/dL | Normal | None from this number |
| 150 to 499 mg/dL | Mild to moderate elevation | Heart and artery risk |
| 500 mg/dL or higher | Severe elevation | Pancreatitis as well as heart risk |
The 2026 ACC/AHA guideline treats 150 to 499 mg/dL as mild-to-moderate elevation, where the aim is lowering cardiovascular risk, and 500 mg/dL or more as the range where preventing pancreatitis also becomes a goal.1
The risk of pancreatitis, a painful inflammation of the pancreas, becomes the immediate priority at 1,000 mg/dL and above. Levels that high need prompt medical attention.
Timing matters a little. After an ordinary meal, triglycerides rise by about 26 mg/dL on average at their peak.2 For a sample taken without fasting, a European consensus statement advises labs to flag results of 175 mg/dL or higher.2 The clinic asks for a fasting sample. See fasting before heart labs.
How triglycerides relate to heart risk
Raised triglycerides are common. About 27% of adults have triglycerides above 176 mg/dL.3
The link with heart disease is clear at the extremes. In general population studies, people with non-fasting triglycerides of 580 mg/dL had about five times the heart attack risk of people at 70 mg/dL.3
Yet triglycerides themselves are probably not what damages the artery. In a pooled analysis of 302,430 people, triglycerides no longer predicted coronary heart disease once other conventional risk factors were accounted for.4 The number appears to work as a marker. It tells you that remnant particles are circulating, and those particles do the harm.
Triglycerides, remnants and ApoB
Every remnant particle, like every LDL particle, carries one ApoB protein. So ApoB counts both. In a study of about 390,000 UK adults, triglycerides predicted heart attack on their own, but once ApoB was taken into account they no longer did.5
Two treatment trials make the same point from the other direction.
- In a trial in people with type 2 diabetes, a triglyceride-lowering drug cut triglycerides by 26% but did not reduce cardiovascular events, and ApoB rose by about 5%.6
- In another trial, a purified prescription omega-3 did lower cardiovascular events in statin-treated people with raised triglycerides. The benefit was greater than would be expected from the modest reduction in triglycerides alone.1 Hospital stays for atrial fibrillation were more frequent in the treated group.
Experts read these results together as showing that the triglyceride number is not the target. What counts is whether the number of artery-entering particles comes down. The second result applies to the specific prescription product that was tested. It should not be assumed for fish oil supplements.
This is also why a raised triglyceride level makes two other numbers more useful than LDL cholesterol: non-HDL cholesterol, which you can work out from a standard panel, and ApoB.
What raises triglycerides
Guidelines advise looking for a cause before anything else. The 2026 guideline lists these contributors to check:
- poorly controlled blood sugar;
- heavy alcohol intake;
- obesity;
- an underactive thyroid;
- chronic kidney disease;
- a diet high in refined carbohydrates;
- medications that raise triglycerides.
Several of these trace back to insulin resistance, which pushes the liver to make more triglyceride. The lifestyle steps in the guideline follow from the list: weight loss where appropriate, physical activity, less alcohol and better overall diet quality.1
If you take a medication that may be involved, do not stop it on your own. Raise it with your prescriber.
Checking the bigger picture with Cardio Res-Q
A triglyceride result is most useful next to the tests that explain it. Both Cardio Res-Q assessments measure ApoB together with insulin, glucose and A1c, which covers the particle count and the metabolic drivers. The Comprehensive Assessment is $775, and the Enhanced Assessment is $999 with imaging added. The program page does not itemize a standard lipid panel, so ask our team whether triglycerides are drawn at your visit or whether to bring a recent result.
The clinic asks you to fast for 10 to 12 hours before labs. To book, go to the Cardio Res-Q program page.
Are You a Candidate for Cardio Res-Q?
Three quick questions about the risk factors we screen for. Your answers stay between you and the clinic.
Frequently asked questions
Do I need to fast for a triglyceride test?
Our clinic asks for a fasting sample. Elsewhere a non-fasting sample is often accepted, since a normal meal raises the level only modestly, but a very high non-fasting result is usually rechecked fasting.
My triglycerides are 180 mg/dL. Is that dangerous?
It is a mild elevation, not an emergency. It is worth asking what is driving it and whether your ApoB or non-HDL cholesterol is also raised, because those numbers say more about artery risk than the triglyceride figure does.
Can alcohol raise triglycerides?
Yes. Heavy alcohol intake is one of the recognized causes, and cutting back is part of standard advice for anyone with a raised level.
Should I take fish oil for high triglycerides?
That is a decision for you and your prescriber. Over-the-counter supplements are not the same as the prescription product tested in trials, and we do not recommend supplements as a treatment for heart risk.
Related reading
This article is for general education and is not medical advice. Decisions about testing and medication should be made with your clinician. If you have chest pain or other symptoms of a heart attack, call 911.
