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Why Are Your Triglycerides Low? Link to LDL & HDL Levels

Written by Ana Aleksic, MSc (Pharmacy) | Last updated:
Medically reviewed by
Jonathan Ritter, PharmD, PhD (Pharmacology), Puya Yazdi, MD | Written by Ana Aleksic, MSc (Pharmacy) | Last updated:

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Triglycerides Test Low Levels

While most people worry about high triglycerides, your levels are low. What does this mean? If triglycerides are harmful, how can your levels be too low? Read on to understand why low levels can be dangerous and how to interpret them together with your HDL and LDL cholesterol values.

Can Triglycerides be Too Low?

Low Levels Tend to Be Protective

It is well known that high triglycerides are dangerous, but little is known about the influence of low levels on health. In healthy people, low triglyceride levels are probably beneficial. Low triglycerides are probably also good for people with diabetes and might also be protective against heart attacks [1, 2].

One study even suggests that the lower a person’s triglycerides are, the less likely they will be to die from any cause. People with triglycerides below 89 mg/dL–that’s almost twice lower than the borderline-normal value of 150 mg/dL–had a 41% lower risk of dying than people with high levels [3+]

We know little about the health effects of low triglyceride levels. Studies suggest low levels are beneficial in healthy people.

So can your levels ever be too low to do any harm?

We still don’t have any definitive answers, but we can turn to some clues.

Low Levels May Be Harmful in Some People

Some recently published studies have revealed that low triglycerides might be harmful in specific circumstances. In one study, people with heart failure and lower levels were more likely to die from heart complications. The levels associated with risk were around 120 mg/dL on average, while levels of 130-149 mg/dL were considered protective [4].

Upon further analysis, the researchers concluded that only women with heart failure and low triglycerides may be at an increased risk of dying. According to them, triglyceride levels below 70.5 mg/dL might be too low in women with heart failure. Low triglyceride levels may point to more advanced stages of heart failure [4].

In another study, people with lung scarring (pulmonary fibrosis) had triglycerides under 57 mg/dL, which was about 60% lower than the values of healthy controls [5].

Similarly, people with autoimmune disease had 50-70% reduced triglyceride levels compared to healthy people in a different study. Researchers suggested that low triglyceride levels might actually be a marker of autoimmunity and an overactive immune response [6].

In people with specific diseases, very low levels have been linked with worse outcomes.

What is Considered Low Triglycerides?

There isn’t an official cutoff for low triglycerides. Most labs will consider any value below 150 mg/dL normal.

But based on the studies above, people who have 50-70% lower triglyceride levels than the average healthy person might have an underlying health problem. In such cases, lower-than-normal levels may predict worse outcomes. More research is needed, but triglycerides below 70 mg/dL may not be beneficial in certain diseases (heart failure, lung scarring, autoimmune disorders) [4, 5, 6].

If you are healthy and your values are lower than normal, you probably have nothing to worry about–on the contrary. But if your levels are abnormally low and you have an underlying health problem, you should speak to your doctor. He or she will probably run additional, more specific tests.

Based on highly limited evidence, triglycerides below 70 mg/dL might be too low in people with certain diseases. However, labs consider any value below 150 mg/dL normal.

Low Triglycerides High Cholesterol: What Does it Mean?

High LDL

It’s rare for people to have low triglycerides and high LDL, and the high LDL values are usually a mistake [7, 8].

When blood triglycerides are lower than 100 mg/dL, low-density lipoprotein (LDL) cholesterol levels are highly overestimated based on the formula labs use. That means your triglyceride levels are correct, but your LDL may be lower than what the results show. The lab may need to perform a different analysis to give you a precise LDL value [7, 8].

High HDL

This combination is usually beneficial. It has been linked with reduced risk of heart attacks [2]

High LDL in people with low triglycerides is usually a false result. High HDL and low triglycerides are beneficial.

Causes of Low Triglycerides

Low blood triglycerides have been associated with heart and autoimmune diseases [9, 10, 6].

1) Genes

Genetic variations can be responsible for low blood triglyceride levels, including [11, 12, 13]:

Genetic variations in the LPL gene (rs1801177, rs118204057, rs268, rs301, rs326, rs10096633),  responsible for low blood triglycerides were associated with decreased risk of all-cause death and lower risk for heart disease [14, 15].

Mutations in the ANGPTL4 gene (E40K and T266M) and the APOC3 gene were associated with lower blood triglyceride levels [16, 17, 18, 19, 20, 21].

In 595 healthy Taiwanese subjects, people with the APOE genetic variant (rs429358 – TT) had significantly lower blood triglycerides [22].

In 80,111 Icelanders, a variant of the ASGR1 gene (del12 in intron 4) was associated with low blood triglycerides [23].

A genetic variation in the LPL gene (-93T/G) was associated with lower triglyceride blood levels in 124 pregnant African-American women, and 66 Hispanic and 42 African-American adults [24, 25].

Several genetic variations may lower triglyceride levels, thus likely reducing the risk of heart disease and death from any cause.

2) Ethnicity/Race

The Pima are Native Americans who live in what is now central and southern Arizona and parts of Mexico. They have enormously contributed to scientific advances through their willingness to participate in research [26].

The Pima were adapted to surviving in the desert, directing water, engaging in physical labor, growing vegetables, and eating a low-fat, high-carbohydrate diet. Once white settlers brought an abundance of fatty foods and a sedentary lifestyle to their communities, their prevalence of diabetes skyrocketed [26].

In a study from 1980, 15 obese Pima Indians had a reduced rate of Very-Low-Density Lipoprotein (VLDL)-containing triglyceride production and increased rate of triglyceride breakdown, compared 10 obese whites [27].

This means that Pima Indians made fewer triglycerides and broke them down faster than the white subjects. Yet they are more obese, more prone to diabetes, and less prone to heart disease. They were adapted to a life of scarcity, one in which it was important to store energy well [27].

They were, however, not adapted to the modern lifestyle. These findings shaped the “thrifty gene” hypothesis: populations who have struggled with periods of limited resources and famine were more likely to survive if they were “metabolically thrifty” and stored calories efficiently. This gave them a genetic advantage, but in modern times, it puts people at risk of diabetes and obesity [26].

The Pima have thrifty genes: they’re adapted to scarcity and efficiently storing calories. Now that they live a sedentary, modern lifestyle, they suffer from diabetes despite having low triglycerides.

3) Metabolic Profile

In 1,002 heart disease patients, metabolically healthy people had lower triglyceride levels compared to people with an abnormal metabolic profile, regardless of their body fat [28].

4) Personality

Personality traits may play a role in triglyceride levels, based on a study of 5,532 Italian adults who completed a personality test. People who were more self-disciplined, careful, and deliberate had lower triglyceride levels [29].

People with a good metabolic profile and self-disciplined personality have lower triglyceride levels.

5) Other Diseases

Lower blood triglyceride levels were found in Parkinson’s patients in a retrospective study of 520 adults. This may explain the reduced incidence of stroke in Parkinson’s patients [30].

Health Risks of Low Triglycerides

1) Death from Heart Disease

In 2 studies of 1,310 and 863 stroke patients, low blood triglycerides were associated with an increased risk of death and severity of stroke [10, 31].

Low blood triglyceride levels were predictive of death from heart failure in 637 women and increased the risk of in-hospital death and side effects in 247 heart attack patients [32, 33].

Very low triglyceride levels may increase the risk of death in people who suffered a stroke and in women with heart failure.

2) Possible Link With Autoimmune Diseases

Low blood triglycerides were compared in lean and obese people with and without autoimmune disease. Low levels were associated with [6]:

  • Chronic thyroid disease
  • Hepatitis C
  • Hepatitis B
  • Lupus-like syndrome
  • Rheumatoid arthritis
  • Asthma
  • Skin disease (atopic dermatitis)
  • Other autoimmune disorders

Additionally, low levels of blood triglycerides were associated with scarring of lung tissue (pulmonary fibrosis)  in 44 patients [5].

Remember, if you are worried your triglyceride levels are too low, speak with your doctor. He can order more tests to determine what the underlying cause is, and what this means to your health.

Learn More

Takeaway

Low triglyceride levels are usually beneficial. If you are healthy and your levels are relatively low, you have nothing to worry about. You may even be at a reduced risk of heart disease and death from any cause.

Abnormally low triglyceride levels have been linked with worse outcomes in women with heart failure and people who suffer a stroke. Very low levels are usually in the range of 50-70 mg/dL, which is about 60% less than the average values in healthy people.

However, labs consider any value below 150 mg/dL normal. More research is needed before we can determine if very low values might be harmful.

If you got your lab results and your triglycerides came back as low but LDL as high, you may need to go for another test. The lab probably overestimated your LDL by mistake.

High HDL cholesterol and low triglycerides are beneficial and lower the risk of heart attacks.

Genes, ethnicity, and personality can also impact your triglyceride levels. Pima Natives, for example, have “thrifty genes” that make them prone to lower triglycerides but higher rates of diabetes and obesity.

Irregular Triglyceride Levels?

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About the Author

Ana Aleksic

MSc (Pharmacy)
Ana received her MS in Pharmacy from the University of Belgrade.
Ana has many years of experience in clinical research and health advising. She loves communicating science and empowering people to achieve their optimal health. Ana spent years working with patients who suffer from various mental health issues and chronic health problems. She is a strong advocate of integrating scientific knowledge and holistic medicine.

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