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High Triglycerides: Causes and How to Lower Them

High triglycerides mean more fat circulates in your blood than is healthy, usually 150 mg/dL or higher. Added sugar, refined carbs, alcohol, excess weight, and diabetes cause most cases, and triglycerides respond to changes in those faster than almost any other number on your lipid panel.

What are triglycerides?

Your body stores excess calories (from sugar, alcohol, or fat) mainly as triglycerides, its usable energy reserve. A triglyceride test measures how much of this fat circulates in your blood at that moment, so recent food and drink move triglycerides more than they move LDL-C or ApoB.

What level of triglycerides is high?

These long-standing categories come from the National Cholesterol Education Program:

  • Normal: below 150 mg/dL
  • Borderline high: 150 to 199 mg/dL
  • High: 200 to 499 mg/dL
  • Very high: 500 mg/dL or above, which carries a real risk of acute pancreatitis (a medical emergency) on top of cardiovascular risk

What causes high triglycerides?

Most often diet, alcohol, excess weight, and blood sugar problems. Genes and medicines cause fewer cases.

  • Added sugar and refined carbohydrates, the biggest dietary driver for most people
  • Alcohol, where even moderate regular intake raises triglycerides in many people
  • Excess weight, particularly around the abdomen
  • Diabetes or prediabetes that isn't well controlled
  • A hereditary triglyceride disorder in a minority of people, which produces very high levels whatever the diet
  • Certain medicines, including some birth control pills, steroids, and beta blockers

Do high triglycerides raise heart risk?

High triglycerides link to higher cardiovascular risk, though the link tangles with other factors (low HDL, insulin resistance, excess weight). LDL has a more direct, causal relationship with plaque formation. Very high triglycerides also carry an independent risk of pancreatitis.

The 2026 ACC/AHA guideline counts triglycerides that stay at 150 mg/dL or higher fasting (175 or higher non-fasting) as a risk-enhancing factor. Non-HDL cholesterol (total cholesterol minus HDL) and ApoB capture triglyceride-related particles too, so the guideline uses them alongside LDL when triglycerides run high.

How do you lower triglycerides?

Triglycerides respond to lifestyle changes faster, and by more, than LDL does. Medicine joins in when levels stay high or reach 500.

  • Cut added sugar and refined carbohydrates, which can lower triglycerides substantially within weeks
  • Reduce or stop alcohol, which for some people is the biggest driver
  • Lose excess weight, particularly visceral fat
  • Add omega-3s from fatty fish. For significantly elevated levels, ask your clinician about prescription icosapent ethyl (Vascepa), which reduced major cardiovascular events by 25% in the REDUCE-IT trial in people already on a statin with triglycerides of 135 to 499 mg/dL and either heart disease or diabetes plus other risk factors
  • Bring diabetes or prediabetes under control, since insulin resistance drives triglyceride production

What if my triglycerides are above 500?

Triglycerides above 500 mg/dL need prompt medical attention, well before your next annual visit. At that level the pancreatitis risk becomes a more immediate concern than cardiovascular risk.

Medication (fibrates, high-dose omega-3s) is often needed right away alongside lifestyle changes, to lower pancreatitis risk while the underlying causes get addressed. Your clinician decides what fits you.

Trials in this guide

Each links to a plain summary with a quote from the PubMed abstract.

  • REDUCE-IT (2019) · Icosapent ethyl · 8,179 peopleBenefit

Common questions

▸How can I bring my triglycerides down quickly?

Cutting alcohol and added sugar works fastest, often within days to weeks. Losing weight and reducing refined carbohydrates produce a slower but larger and more durable drop.

▸What foods cause triglycerides to be high?

Added sugar and refined carbohydrates (soda, juice, white bread, pastries) and alcohol drive it most. Excess calories from any source also contribute.

▸Can high triglycerides be cured?

In most people diet, weight, and metabolic factors drive high triglycerides, and changing them can substantially reverse the problem. A minority have a genetic disorder that needs ongoing medication, and even then eating better and cutting alcohol help.

▸Does high triglycerides mean I have fatty liver?

Not always, but the two often occur together, since the liver turns excess sugar, alcohol, and calories into fat. Ask your doctor about fatty liver, especially with excess weight or prediabetes.

The full guideRead the complete, referenced version on Preval Health More detail, every study, and the date each figure was checked.

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Sources

Not medical advice. General education from published trials and drug labels, last updated October 2026. lipid.site is not a healthcare provider and cannot tell you what to take or change. Talk to your clinician before starting or stopping any treatment. If you have chest pain or other signs of a heart attack or stroke, call 911.