The last two posts made several important points about triglycerides.

  1. They are a storage form of fat – 3 fatty acids connected to glycerol (a sugar alcohol).
  2. They are produced in the liver from sugar (lipogenesis) to protect our bodies from a toxic rise in sugar levels and store energy.
  3. When high (>90), they are a marker for serious underlying metabolic dysfunction.

Think of triglyceride production as a normal healthy mechanism which can go terribly wrong. Among the lipids, triglycerides are for energy production and road signcholesterol is for cell membranes and steroid hormone production. Both are critical for health and neither is inherently unhealthy.  It’s just that when they are really high we know that dangerous forces are challenging our bodies. Think of triglycerides as a marker or sign of danger. If you approach a road sign which says, “road out ahead – danger” and you are sensible you will stop your car and find out what is going on and then make further decisions based on accurate information. Imagine instead seeing the sign and removing it then driving forward as if eliminating the sign solved the problem. That has been a common approach to triglycerides. They are a sign of danger, but we have given drugs that seek to lower them and then been shocked when the drugs failed to reduce heart disease. In other words, we have removed the sign and been shocked when our car plunged off the road. We have then expressed confusion about whether high triglycerides have any negative connotation. Articles have appeared in the literature in recent years proclaiming triglycerides as no big deal unless over 500. (Leading to a risk of pancreatitis) Don’t be disheartened by all the confusion. The answer, as I have repeatedly emphasized, lies in well understood physiology. I’ll explain some of that in the next post.