Low triglycerides, what it means and why it matters

High triglycerides are often recognized as a greater risk factor for health conditions than low triglycerides (hypotriglyceridemia). Hence, most people reduce their fat intake to avoid heart issues. But having triglyceride levels that are too low can also be a problem. Although it's often asymptomatic and benign, persistently low triglyceride levels can sometimes indicate underlying systemic, metabolic, or genetic disorders. Triglycerides are one of the forms in which fat is stored in your body. Other forms of fat are stored as steroids and phospholipids. The unused stored calories provide energy for later use. When triglycerides are low, the body does not store enough energy. This may happen because of diet choices, medical conditions, or metabolism issues.

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Triglycerides Range‍

The significance of triglyceride levels depends on the individual and whether the measurements are taken while fasting or not. The normal range for triglycerides is below 150 mg/dL for adults and lower than 90 mg/dL for children and teens (ages 10–19). Borderline high is between 150–199 mg/dL, and high is 200–499 mg/dL. When triglyceride levels fall below 40 mg/dL, it is considered lower than usual.

What Causes Low Triglycerides?

Dietary factors

• Very low-fat or low-calorie diet or restrictive diet: When you eat food low in fat for a long time, your body uses stored fat, including triglycerides, for energy. Levels drop. Restrictive diets can cause the same.
• Malnutrition: Your body lacks nutrients, including fat, so stored fat is used for energy. Prolonged deficiency leads to depletion.
• Prolonged fasting: The body uses stored energy, reducing triglycerides.

Medical conditions

• Hyperthyroidism: Excess thyroid hormone disrupts fat production, breakdown, and transport, lowering triglycerides.
• Malabsorption syndromes (celiac disease, IBD, cystic fibrosis): Impaired fat absorption lowers triglycerides.
• Liver disease: A damaged liver (e.g., cirrhosis) cannot metabolize fats properly, reducing triglycerides.
• Chronic infection: Ongoing inflammation or illness may lower triglycerides.

Genetic factors
Rare inherited lipid metabolism disorders: Abetalipoproteinemia, Familial Hypobetalipoproteinemia, Chylomicron retention disease, PCSK9 deficiency, ANGPTL3 deficiency, LDLR gain-of-function, Polygenic hypocholesterolemia, Congenital disorder of glycosylation.

Medications
Not only statins but also drugs like interleukin-2 (used in cancer treatment) and some alternative therapies can lower triglycerides.

Symptoms of Low Triglycerides

‍Mild cases are often asymptomatic. Possible signs: constant tiredness, weakness, lightheadedness, difficulty maintaining weight, irritability, brittle nails, poor memory, dry skin, slow wound healing. Symptoms may overlap with hyperthyroidism, malnutrition, liver disease, or malabsorption.

Dangers of Low Triglycerides

• Fat-soluble vitamin deficiencies (A, D, E, K)
• Increased cardiovascular risk
• Higher cancer risks (in type 2 diabetes)
• Metabolic disturbances
• Reduced energy reserves
• Poor brain function (from fatty acid lack)
• Weakened immunity
• Stroke risk
• Muscle loss
• Unexplained fatigue

Diagnosis

• Lipid panel (fasting)
• Liver function tests
• Thyroid function tests
• Nutrient assays (for vitamin levels)
• Genetic testing (if unexplained very low levels, esp. with family history)

Management & Treatment

• Eat a balanced diet with healthy fats (avocado, nuts, olive oil, fatty fish)
• Avoid extremely low-fat diets
• Supplement vitamins A, D, E, K if deficient
• Address underlying conditions
• Adjust fat-lowering medications if needed

Prevention

• Maintain a balanced diet
• Monitor lipid levels (esp. if on medications)
• Watch for symptoms of underlying disease
• Consider genetic counseling in inherited cases

Low Triglycerides but High LDL‍

LDL transports cholesterol from the liver to cells. Triglycerides are stored energy. Low triglycerides + high LDL means low energy reserves but high cholesterol transport. This can cause plaque buildup in arteries, raising risks of heart disease and stroke.

When to See a Doctor

‍Not urgent if asymptomatic, but see a doctor if you have unexplained weight loss, persistent fatigue, digestive issues, or brain fog.

Summary‍

High triglycerides are linked to cardiovascular risks, but low triglycerides can signal nutritional deficiencies, metabolic imbalances, or medical conditions. Diagnosis, intervention, and proper management ensure better long-term outcomes.

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