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Biomarker library / Lipids

Triglycerides (TG)

Also called serum triglycerides, TAG

The main form of fat carried in blood, packaged in chylomicrons after a meal and in VLDL particles made by the liver. Triglycerides are a direct read on how the body is handling energy, and they rise with insulin resistance.

Written by the VitalDecades editorial team Reviewed by the editorial review process Updated

01  /  Reference ranges

What counts as normal

Scale in mg/dL. Cut points from the sources listed below.
Population Adults, fasting (ATP III)
Category Normal
Range under 150 mg/dL
Source NCEP Adult Treatment Panel III, Executive Summary (NHLBI, 2001)

Effective

Population Adults, fasting (ATP III)
Category Borderline high
Range 150 to 199 mg/dL
Source NCEP Adult Treatment Panel III, Executive Summary (NHLBI, 2001)

Effective

Population Adults, fasting (ATP III)
Category High
Range 200 to 499 mg/dL
Source NCEP Adult Treatment Panel III, Executive Summary (NHLBI, 2001)

Effective

Population Adults, fasting (ATP III)
Category Very high
Range 500 or higher mg/dL
Source NCEP Adult Treatment Panel III, Executive Summary (NHLBI, 2001)

Effective

Population Adults, fasting (AHA 2011 statement)
Category Optimal (metabolic-health marker, not a treatment target)
Range under 100 mg/dL
Source AHA Scientific Statement: Triglycerides and Cardiovascular Disease (2011)

Effective

Population Adults, primary prevention (2018 AHA/ACC)
Category Risk-enhancing factor: persistently elevated (ideally 3 measurements)
Range 175 or higher mg/dL
Source 2018 AHA/ACC Multisociety Guideline on the Management of Blood Cholesterol

Effective

Normal vs optimal

Normal is under 150 mg/dL (ATP III). Optimal is under 100 mg/dL (AHA 2011), stated as a parameter of metabolic health rather than a goal to treat toward. A nonfasting value under 200 mg/dL is consistent with normal or optimal fasting triglycerides and needs no further testing per the same statement.

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02  /  Why it matters

What the number tells you

NCEP ATP III set the categories most labs still print: normal under 150 mg/dL, borderline high 150 to 199, high 200 to 499, very high 500 and above. The 2018 AHA/ACC guideline treats persistently elevated triglycerides of 175 mg/dL or higher (ideally three measurements) as a risk-enhancing factor in the statin discussion, and lists 150 mg/dL as the metabolic syndrome cutoff. The AHA's 2011 scientific statement added optimal under 100 mg/dL as a marker of metabolic health, and said explicitly that it is not a treatment target. Very high levels (500 and above) carry pancreatitis risk and are managed as a separate problem.

03  /  In practice

Testing and what moves it

When it is tested

  • On every lipid panel. Fasting samples are used to assign the borderline, high and very high categories; a nonfasting sample is an acceptable screen.

What raises it

  • Refined carbohydrate and alcohol intake, insulin resistance and diabetes, obesity, hypothyroidism, kidney disease, some medications, and genetics.

What lowers it

  • Weight loss, less alcohol and refined carbohydrate, more activity, better glucose control; fibrates, omega-3 prescription products and statins in specific situations.

04  /  Related

Read next

Apolipoprotein B ApoBFasting plasma glucose FPGHDL cholesterol HDL-CHemoglobin A1C A1CLDL cholesterol LDL-C

Frequently asked questions

Do I need to fast for triglycerides? ▼

For a screen, no: the AHA 2011 statement says a nonfasting value under 200 mg/dL needs no further testing. To assign the borderline, high or very high category, a fasting sample is used.

What is a dangerous triglyceride level? ▼

ATP III calls 500 mg/dL and above very high; at that level pancreatitis becomes a concern and the triglycerides themselves are treated first.