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Causes and Risk Factors of Severe Hypertriglyceridemia (sHTG)

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By Editorial Team

3 min read

Many people know about cholesterol. However, another type of fat in your blood is also important. This fat is called a triglyceride. When these levels get too high, it is called hypertriglyceridemia. Severe hypertriglyceridemia (sHTG) is a very serious form of this condition. It can lead to heart disease or a painful condition called pancreatitis.1,2

What is severe hypertriglyceridemia?

Triglycerides are a main form of fat in the blood. A simple blood test measures these levels. Doctors measure them in milligrams per deciliter (mg/dL). A healthy level is below 150 mg/dL. Severe hypertriglyceridemia happens when the level is 500 mg/dL or higher.1,2

Some people have levels over 1,000 mg/dL. These very high levels are dangerous. They can cause the pancreas to become inflamed. This is called acute pancreatitis. It is a medical emergency that causes severe stomach pain. High levels also increase the risk of heart attacks and strokes.1,2

What causes severe hypertriglyceridemia?

There are 2 main causes for sHTG. These are primary causes and secondary causes. Primary causes come from your genes. You inherit these from your parents. Secondary causes come from other health conditions or lifestyle choices.1-3

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Primary genetic causes

Some people are born with genes that make it hard to break down fat. One rare genetic condition is familial chylomicronemia syndrome (FCS). People with FCS cannot clear triglycerides from their blood properly. Their levels are often over 1,000 mg/dL from a young age.1-3

Another type is multifactorial chylomicronemia syndrome (MCS). MCS is a severe form of high triglycerides caused by a combination of several minor genetic "glitches" and external triggers like diet, alcohol, or other health conditions.3

Secondary health causes

Many other health issues can raise triglyceride levels. Uncontrolled type 2 diabetes is a common cause. High blood sugar makes it hard for the body to process fats. Overweight or obesity can also play a role.1-3

Other conditions that can lead to sHTG can include:1-3

  • Hypothyroidism (low thyroid levels)
  • Kidney disease
  • Liver disease
  • Lupus
  • Pregnancy

What are the risk factors for severe hypertriglyceridemia?

Risk factors are things that make you more likely to develop a condition. Some risk factors for sHTG are within your control. Others are not.

Lifestyle choices

Diet and exercise have a big impact on your triglycerides. Eating too many simple sugars or refined carbs raises these levels. These include white bread, soda, and candy.1-3

Drinking too much alcohol is also a major risk factor. Alcohol causes the liver to make more triglycerides. Not getting enough physical activity makes it harder for the body to burn fat for energy as well.1-3

Certain medicines

Some medicines used to treat other conditions can raise your triglycerides. These can include:1-3

  • Beta blockers for blood pressure
  • Steroids (corticosteroids)
  • Oral estrogen or birth control pills
  • Certain medicines for HIV
  • Retinoids for skin issues

Age and gender

Triglyceride levels often increase as people get older. Men tend to have higher levels than women before age 50. After menopause, levels in women often rise. Family history is also a key risk factor. If your parents had high triglycerides, you may have them too.1-3

Common symptoms to watch for

Most people with sHTG do not have any symptoms. You may not know your levels are high until a blood test. This is why doctors call it a "silent" condition. However, very high levels can cause physical signs. Some people develop small, yellow-colored bumps on their skin. These are called eruptive xanthomas. They often appear on the eyelids, back, chest, or arms.1,2

Severe stomach pain is another warning sign. This pain often spreads to the back. It may happen along with nausea and vomiting. These are signs of pancreatitis. If you have these symptoms, you must see a doctor right away. Other symptoms can include fatigue or "brain fog."1,2

Treatment options are available

Severe hypertriglyceridemia is a serious health concern, but there are treatment options that can help manage it. Lifestyle choices like diet and alcohol use also matter. Knowing your risk factors is the first step. Regular blood tests can help you and your doctor manage your levels. This helps protect your heart and your pancreas.1

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.

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