Updated on September 18, 2026.
Triglycerides are a type of fat that come from the foods a person consumes. The body needs a certain amount of triglycerides for energy, but levels that are too high are associated with a variety of health problems.
For adults, optimal blood triglyceride levels are below 150 milligrams per deciliter (mg/dL). Levels above 150 mg/dL can contribute to hardening and thickening of the blood vessel walls, a common type of cardiovascular disease known as arteriosclerosis. Elevated blood triglyceride levels can also be a sign of an underlying health condition, including type 2 diabetes, thyroid disorders, and rare genetic conditions that affect metabolism.
Severe hypertriglyceridemia is a condition characterized by extremely high levels of triglycerides circulating in the blood. People with severe hypertriglyceridemia have blood triglyceride levels of 500 mg/dL or more, and in some cases, levels exceeding 1,000 mg/dL. This can damage the cardiovascular system. It can also cause acute pancreatitis, inflammation in the pancreas. This is a potentially life-threatening complication that often begins suddenly and requires emergency medical care.
What is the pancreas?
The pancreas is a large gland located in the abdomen, behind the stomach and connected to the small intestine through the bile ducts and gallbladder. The pancreas produces digestive enzymes and several hormones, including insulin. It performs two vital functions: helping the body digest food and keeping blood glucose (blood sugar) levels balanced.
How does severe hypertriglyceridemia cause acute pancreatitis?
While acute pancreatitis is a well-known complication of severe hypertriglyceridemia, it is not fully understood how severe hypertriglyceridemia causes acute pancreatitis. Medical research points to a complex process that involves several mechanisms.
One is lipotoxicity. In order to be used as energy, triglycerides are broken down into free fatty acids. When there are severely high levels of triglycerides, large amounts of free fatty acids are created, more than the body can clear away, leading to a toxic buildup of free fatty acids (lipotoxicity) that damages cells and triggers inflammation.
Another mechanism at play involves chylomicrons. These are large bundles of triglycerides, other dietary fats, and proteins that transport triglycerides throughout the body. Elevated levels of chylomicrons can thicken the blood, and block blood vessels in the pancreas.
What are the symptoms of acute pancreatitis?
A person with acute pancreatitis will typically look and feel seriously ill. The main symptom of acute pancreatitis is pain in the upper abdomen. Abdominal pain can:
- Begin suddenly or have a gradual onset
- Radiate to the back and/or shoulders
- Be mild or severe
- Be accompanied by nausea, fever, vomiting, fast heartbeat, shortness of breath, and/or abdominal bloating or swelling
- Overlap with other symptoms of elevated chylomicrons (chylomicronemia), including small yellow-red bumps on the skin (eruptive xanthomas) and/or creamy white/pink changes in eye color (lipemia retinalis)
Though not symptoms of pancreatitis, a person may also have elevated pancreatic enzymes (lipase and amylase).
What is the treatment for acute pancreatitis?
Acute pancreatitis can be a life-threatening medical emergency. A person experiencing significant pain and/or discomfort should seek immediate medical care. This means going to an emergency room or calling 911. Treatment for acute pancreatitis can include intravenous infusions of insulin and plasmapheresis, a procedure that circulates the blood through a special machine to filter out triglycerides. Treatment also includes IV fluids and bowel rest.
How can you prevent acute pancreatitis?
The risk of acute pancreatitis increases as triglyceride levels get higher. Treating severe hypertriglyceridemia can help lower the risk of acute pancreatitis, and avoiding this complication will be a focus of treatment.
Treatment for severe hypertriglyceridemia will vary from person to person. It can include:
- Managing any coexisting conditions that may be contributing to triglyceride levels, such as overweight/obesity, diabetes (especially uncontrolled diabetes), kidney disease, liver disease, thyroid disease, and rare genetic lipid disorders.
- Following a very low-fat diet:
- For triglyceride levels of 500 to 999 mg/dL, added sugars will need to be less than 5 percent of total calories and fats limited to 20 to 25 percent of total calories.
- For triglyceride levels of 1,000 mg/dL or more, added sugars will need to be eliminated completely, and fats limited to 10 to 15 percent of total calories.
- Anyone with severe hypertriglyceridemia will need to completely abstain from alcohol.
- Weekly exercise. Minimum weekly exercise should equal 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic exercise (or an equivalent combination of the two).
- Weight reduction. A recommended weight loss goal of 5 to 10 percent of body weight.
- Medications. One or several medications may be prescribed to reduce triglycerides. These are often used in combination with medications to manage cholesterol levels, blood pressure, and blood glucose, as well as any medications for treating coexisting/underlying conditions.
It’s important to reinforce that treatment is different for every individual. Your best source of information will be your healthcare provider. Conversations about treatment should include a discussion of goals, medication side effects, exercise safety, and dietary guidelines.
