What’s Behind Your High Triglycerides? 6 Surprising Causes
Updated on August 25, 2026
Some surprising culprits can contribute to high triglycerides. Triglycerides are a type of lipid, or fat, in your bloodstream, related to cholesterol. Also known as hypertriglyceridemia, high triglycerides can increase your risk for atherosclerosis, or hardened and narrowed arteries, which increase your heart attack and stroke risk. And extremely high levels of triglycerides might lead to pancreatitis, or inflammation of the pancreas.
Lesser known factors, such as how much you sleep, how much alcohol you drink, and even your stress level, can also affect triglyceride levels. There’s not enough evidence to call these direct causes of high triglycerides, says Andrew Freeman, MD, a cardiologist at National Jewish Health in Denver, but they are key players. “When you have high triglycerides, there tend to be other lifestyle factors,” he says.
“Poor diet and exercise, stress, and not sleeping well all take a toll on cardiovascular health, but they are seldom recognized.” No matter the cause, doctors can work with you to reduce your levels, says Douglas Jacoby, MD, a cardiologist with Penn Medicine in Philadelphia.
Here, find out about six possible causes of high triglyceride levels in the blood.
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1. Genetics
As with high cholesterol, people can inherit a risk of abnormally high triglycerides, a condition called familial hypertriglyceridemia. Many people have raised triglycerides and no family history of the condition, meaning it’s likely occurring due to other factors, such as diet. But in some people, high triglycerides are likely to occur because of a combination of genetic anomalies and environmental factors.
Dr. Jacoby says that your triglyceride numbers will provide clues as to whether genetics are behind your hypertriglyceridemia. Triglyceride levels between 200 and 500 mg/dL may be a sign of the condition.And the numbers can go as high as 4,000 mg/dL, Jacoby says, which can increase the risk for pancreatitis.
Doctors typically prescribe lifestyle interventions for people with familial hypertriglyceridemia, such as a diet (preferably one that an individual works out with a registered dietitian). “I recommend that these patients stick to an extremely low-fat diet,” Jacoby says.
Other measures may include taking medications such as gemfibrozil (Lopid), fenofibrate (Antara, Lipofen, Tricor), and niacin (vitamin B3, nicotinic acid) to reduce triglyceride levels.
2. Medication Side Effects
Certain immunosuppressant drugs as well as some antiviral, cardiovascular, antipsychotic, and hormone medications can drive up triglyceride levels anywhere from 5 to 200 percent. Medications that can increase triglycerides include:
- Beta-blockers
- Loop diuretics
- High-dose thiazide diuretics
- Protease inhibitors
- Cyclosporine
- Tacrolimus
- First- and second-generation antipsychotics
- Anticonvulsants
- Retinoids
- Janus kinase inhibitors
“We look through a patient’s medications for those that may be contributing to their elevated levels,” Jacoby says. Although it’s unclear if drug-induced high triglyceride levels pose harm long term, your doctor may consider changing your medication or, if that’s not possible, monitoring your lipid levels during treatment.
3. Simple Carbohydrate and Sugar Intake
A poor diet is by far the most common cause of high triglyceride levels, Dr. Freeman says. “I consider high triglycerides as a marker that someone may not be eating as well as they should,” he says. Excess calories, alcohol, saturated fats, added sugar, and other simple carbohydrates like refined grains become triglycerides before the body stores them in fat cells.
One review found that, compared with participants who ate the least amount of ultra-processed foods, people who consumed the most had a 15 percent greater risk of dying from any cause.“These foods, which include refined grains and added sugar, will also raise triglycerides,” Freeman says. He advises his patients on transitioning to a low-fat, whole-food, plant-based diet.
4. Alcohol
Alcohol adds extra calories, carbohydrates, and sugar to your diet, which can have a particularly negative effect on triglycerides. Research suggests that it can impair the breakdown of fats in the liver, too, leading to an increase in triglycerides in the blood.
“We ask patients to cut down on alcohol intake, and if levels are very high, we will recommend no alcohol for a while,” Jacoby says.
5. Sleeping Too Little (or Too Much)
Freeman recommends that patients sleep at least seven hours per night, which aligns with advice from medical organizations like the National Sleep Foundation.A consistent lack of sleep has links to high blood pressure as well as type 2 diabetes and obesity — conditions that might contribute to high triglycerides.
Obstructive sleep apnea, a sleep disorder that involves brief but disruptive pauses in breathing throughout the night, may also have links to increased triglycerides and LDL (“bad”) cholesterol. One study of 90 people found that participants with severe sleep apnea had significantly higher triglycerides, LDL, and total cholesterol than those with moderate or mild forms of the disorder. The authors suggest that treating sleep apnea may reduce the risk of heart disease.
A study of over 130,000 people found that sleeping more than 10 hours per night is associated with metabolic syndrome, a cluster of conditions that raises your risk for heart disease, stroke, and other health issues, including elevated triglycerides. The authors of an earlier study that had similar results write that sleeping too long may be a marker of poor sleep quality and has links to fatigue and lower physical activity levels. In turn, this may impact blood lipid levels.
6. Stress
The link between stress and heart disease is not completely clear. But stress may drive us toward less-healthy habits, such as drinking alcohol and eating a poor diet, that in turn increase triglyceride levels.
And according to research, chronic stress is linked to inflammation. Inflammation is connected to a change in how fats and lipoproteins are metabolized, which leads to an increase in the production of triglycerides. For stress relief, Freeman recommends:
- Practicing mindful stress reduction such as meditation or yoga for 30 minutes per day
- Connecting with your social support network
- Engaging in 30 minutes of physical activity — ideally, something that leaves you out of breath — every day
Speak to a doctor if you still have concerns about triglyceride levels or if they don’t decrease in response to lifestyle changes.
Resources We Trust
- Mayo Clinic: Cholesterol: Top Foods to Improve Your Numbers
- Cleveland Clinic: Triglycerides
- American College of Cardiology: Healthy Diet, Physical Activity Are First Line of Treatment for High Triglycerides
- Mass General Brigham: Triglyceride Levels: What the Numbers Mean for Heart Health
- NewYork-Presbyterian: High Triglycerides: What They Mean for Your Heart and How to Lower Them
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Triglycerides: Why Do They Matter? Mayo Clinic. January 21, 2026.
- Familial Hypertriglyceridemia. MedlinePlus. April 28, 2026.
- Herink MC et al. Medication Induced Changes in Lipids and Lipoproteins. Endotext. September 2, 2025.
- Triglycerides. Cleveland Clinic. August 9, 2023.
- Liang S et al. Ultra-Processed Foods and Risk of All-Cause Mortality: An Updated Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Systematic Reviews. March 3, 2025.
- Ferdouse A et al. Pathogenesis of Alcohol-Associated Fatty Liver: Lessons From Transgenic Mice. Frontiers in Physiology. July 4, 2022.
- National Sleep Foundation Reaffirms Landmark Sleep Duration Recommendations. National Sleep Foundation. June 10, 2026.
- Sleep Deprivation: A Cause of High Blood Pressure? Mayo Clinic. July 9, 2024.
- Fatouh Tantawy R et al. Obstructive Sleep Apnea Syndrome: Prediction of Lipid Panel in Relation to Apnea- Hypopnea Index. Indian Journal of Otolaryngology and Head & Neck Surgery. November 7, 2024.
- Prakaschandra DR et al. The Association of Cardiometabolic Disorders With Sleep Duration: A Cross-Sectional Study. African Health Sciences. December 23, 2022.
- Kim CE et al. Association Between Sleep Duration and Metabolic Syndrome: A Cross-Sectional Study. BMC Public Health. June 13, 2018.
- Stress Can Increase Your Risk for Heart Disease. University of Rochester Medicine.
- Jurgens SM et al. Inflammatory Biomarkers Link Perceived Stress with Metabolic Dysregulation. Brain, Behavior, & Immunity - Health. December 2023.
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