Receiving blood test results can be confusing, especially when they present a mixed picture of your health. A common example is a lipid panel showing both low triglycerides and low high-density lipoprotein (HDL) cholesterol. Triglycerides are a type of fat in your blood that the body uses for energy. High-density lipoprotein, often called “good” cholesterol, helps remove other forms of cholesterol from your bloodstream. While low triglycerides are a positive health indicator, this result paired with low HDL levels can signal an underlying health issue that requires a closer look.
Understanding the Lipid Results
A standard lipid panel provides values for different types of fats in your blood to help assess cardiovascular health. For triglycerides, a level below 150 milligrams per deciliter (mg/dL) is considered normal, while levels under 50 mg/dL may be flagged as unusually low. For HDL cholesterol, levels below 40 mg/dL for men and 50 mg/dL for women are considered low and are associated with an increased risk for heart disease.
The combination of low triglycerides and low HDL presents a unique situation. Low triglycerides are beneficial because high levels are a risk factor for atherosclerosis, the hardening of the arteries. Conversely, low HDL is unfavorable because it suggests the body is less efficient at clearing excess cholesterol from blood vessels. This apparent contradiction often prompts healthcare providers to investigate further.
This specific lipid profile is not as common as other combinations, such as high triglycerides and low HDL. The presence of both low triglycerides and low HDL cholesterol can point away from typical diet-related lipid issues and toward other systemic or metabolic conditions.
Underlying Causes of Low Triglycerides and Low HDL
Several medical conditions and lifestyle factors can lead to the combined finding of low triglycerides and low HDL. One of the primary drivers is malnutrition or a very low-fat diet. When the body doesn’t receive enough dietary fats and carbohydrates, it has fewer building blocks to produce triglycerides, which can result from inadequate food intake or significant weight loss.
Malabsorption syndromes are another cause. Conditions like celiac disease or Crohn’s disease damage the intestinal lining, impairing the body’s ability to absorb nutrients like fats from food. This impaired absorption reduces the amount of lipids available in the bloodstream, leading to low levels of both triglycerides and HDL.
An overactive thyroid gland, or hyperthyroidism, can also cause this lipid pattern. Hyperthyroidism accelerates the body’s metabolism, causing it to burn through fats at an abnormally high rate, which can deplete both triglycerides and HDL. In some cases, certain medications used to manage high cholesterol, such as statins or fibrates, may also lower triglyceride levels. Rarely, genetic conditions can be the root cause of very low HDL levels.
Associated Health Implications
The health risks associated with low triglycerides and low HDL are often tied more to the underlying cause than to the lipid levels themselves. For instance, if malnutrition or a malabsorption syndrome is the cause, the health implications relate to nutrient deficiencies and the effects of the untreated primary condition. These can include fatigue, weight loss, and other symptoms like digestive distress in the case of celiac disease.
Even with the benefit of low triglycerides, a low HDL level remains an independent concern for long-term cardiovascular health. HDL plays a part in reverse cholesterol transport, a process that removes cholesterol from artery walls and transports it to the liver for disposal. When HDL levels are low, this clearing process is less effective, which can contribute to the gradual buildup of plaque in the arteries over time, a process called atherosclerosis.
Medical Evaluation and Management
If your blood test reveals low triglycerides and low HDL, consulting a healthcare provider is the next step to determine the cause. The evaluation begins with a thorough review of your medical history, diet, lifestyle, and any medications you are taking. A physical examination can also provide clues, such as signs of weight loss or symptoms related to a specific condition.
To investigate further, your provider may order additional blood tests. These could include a thyroid panel to check for hyperthyroidism or tests for celiac disease antibodies. These diagnostic tools help pinpoint the underlying issue influencing your lipid levels.
The primary management strategy focuses on treating the identified cause. If hyperthyroidism is diagnosed, treatment will be aimed at regulating the thyroid gland. If a malabsorption disorder is found, management will involve specific dietary changes. Once the underlying condition is addressed, lifestyle adjustments can help raise HDL levels, such as incorporating healthy fats into your diet, engaging in regular aerobic exercise, and stopping smoking.