What are Triglycerides?
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Today's Newsletter at a Glance:
- What are Triglycerides?
- Why Does Our Body Use Triglycerides?
- When Triglycerides Can Be a Red Flag
- The Bottom Line
Most patients get an annual physical that includes some form of a lipid panel.
At a minimum, a standard lipid panel contains LDL-C, HDL-C, and Triglycerides (TGs).
You've likely heard of LDL and HDL as cholesterol particles, but have you ever wondered how triglycerides fit into this story?
In today's newsletter, we will cover the basics of triglycerides, how and why our body uses them, and why they are a risk factor for heart disease.
By the end, you will have a basic understanding of triglycerides before your next lipid panel.
What is a Triglyceride?
A triglyceride is the main form of fat.
The structure is: one glycerol backbone with three fatty acids attached. "Tri" for three, "glyceride" for glycerol.
Nearly all the fat you eat is in the form of triglycerides.
The fat stored around your waist, hips, and organs is mostly composed of triglycerides.
When your doctor measures "triglycerides" on a blood test, they're measuring how much of this fat is moving through your bloodstream.
The interesting nuance is that triglycerides come from two places: the intestines, which package the fat you eat, and the liver, which produces its own.
Why Does Our Body Use Triglycerides?
Their primary job is energy storage.
We can thank our hunter-gatherer ancestors for that.
From an evolutionary standpoint, this was a survival advantage. When food was unreliable, storing energy efficiently kept us alive.
When food is scarce, our bodies convert our fat into energy via lipolysis.
There are two main pathways for how our body gets triglycerides:
- Exogenous (from the fat you eat)
- Endogenous (from the liver)
Because fat doesn't dissolve in blood, the body packages triglycerides into carriers called lipoproteins.
A lipid panel measures the fats these lipoproteins carry.
Fat (energy) storage was crucial when most people were relying on hunting for their next meal. Now, the convenience of food has put this process on overdrive.
This is where problems arise.
When Triglycerides Can Be a Red Flag
So far, we've seen that triglycerides are key players in storing energy (fat) for later use.
Well, what happens when that energy is never used later? Herein lies the problem and why elevated triglycerides are a risk-enhancing factor for heart disease.
Triglyceride reference ranges:
- Normal: under 150 mg/dL
- Borderline high: 150–199
- High: 200–499
- Very high: 500 and above
"Is consuming too much fat the reason my triglycerides are elevated?"
Usually not. For most people, dietary fat isn't the main driver.
A high triglyceride number is rarely a fat intake problem; it's a sign that the body's fuel management, centered on insulin, is starting to break down.
Here's why:
When we eat excess sugar, refined carbs, alcohol, or calories and don't burn or use them, the liver is forced to metabolize the overload.
The liver converts the excess into fat (triglycerides) and packages it into a VLDL (Very-Low-Density Lipoprotein) particle. VLDL is an ApoB particle.
If you watch my content or read the newsletter, you know that ApoB lipoproteins are the atherogenic (dangerous) cholesterol particles that can penetrate the blood vessel wall. Click here to read more about ApoB.
Elevated triglycerides also signal metabolic problems.
Why? Triglyceride levels are strongly influenced by insulin, and when insulin stops working well (insulin resistance), triglycerides are among the first to rise.
Your triglyceride level can be an early warning sign you are heading towards prediabetes and diabetes long before your fasting blood sugar and HbA1c start to rise.
So how do we lower triglyceride levels?
The most effective levers:
- Cut back on added sugar, especially sweetened drinks
- Swap refined carbohydrates for whole, fiber-rich foods
- Limit alcohol
- Lose excess weight; even 5–10% of body weight can make a meaningful difference
- Move every day, since working muscles pull triglycerides out of your blood
- Keep blood sugar well controlled
The Bottom Line
Triglycerides are your body's fuel reserve. You need them.
But when they stay elevated in your blood, they become a problem.
They add to the particle burden and damage your arteries. They signal metabolic strain, and at extreme levels, they can threaten your pancreas.
The good news? Triglycerides are one of the most responsive numbers on your lipid panel.
For many people, the changes above move the number noticeably within months.
Next time you get your bloodwork, don't skip past it.
Your triglyceride level may be telling you something important.
Knowing Your ApoB Levels
Apolipoprotein B (ApoB) is not included in a standard lipid panel and is rarely included on routine annual labs.
That's starting to change.
The new 2026 ACC/AHA cholesterol guidelines now formally recommend ApoB testing to refine risk assessment in certain patients — because ApoB directly quantifies the number of atherogenic lipoproteins, providing a more accurate measure of atherogenic particle burden than LDL-C.
Essentially, ApoB counts the actual number of artery-clogging particles in your blood, which can be a more accurate measure of risk than LDL-C alone.
Function Health is an all-in-one health platform that starts with 160+ lab tests, covering your heart, hormones, liver, kidneys, thyroid, immune system, cancer signals, toxins, and key nutrients.
That’s about 5× as much testing as standard primary care labs—bloodwork that would normally cost thousands of dollars out of pocket.
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If you want to know your ApoB level, see if Function is a good fit for you.
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Jeremy London, MD
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* Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user’s own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay seeking medical advice for any medical condition they may have and should consult their healthcare professionals for any such conditions.
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