High Triglycerides: What Your Number Means & How to Lower It

Triglycerides are the main form of fat your body stores and burns for energy. After a meal, your gut and your liver package them into particles that travel through your blood to your muscles, which burn them, and to your fat cells, which hold them for later.3 A high number on your lipid panel means more of those fat-carrying particles are circulating than your body is clearing. The usual reasons are ones you can change: extra sugar and refined carbohydrates, alcohol, extra weight around the middle, and insulin that has to work harder than it should.3

In my Insulin Resistance & Prediabetes protocol, I describe high triglycerides with low HDL as a sign of insulin working overtime, sometimes years before blood sugar moves.7 That makes your triglyceride number an early warning, and one that often starts falling within a month once you change what's driving it.7

My family learned how much a standard panel can miss. My father-in-law died unexpectedly of a heart attack, and it was such a surprise to us, because he'd been getting regular blood work and labs and everything came back normal.8 It's a big part of why I push people to test beyond the standard cholesterol panel.

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What do your triglyceride numbers mean?

The standard classes come from the U.S. National Cholesterol Education Program, and the Endocrine Society's guideline prints them beside its own grades: mild (150 to 199 mg/dL), moderate (200 to 999), severe (1,000 to 1,999) and very severe (2,000 and up). That guideline also notes that the exact level at which triglycerides start to raise heart risk is unknown and may be lower than 150 mg/dL.2 The 2018 U.S. cholesterol guideline counts a level that stays at 175 mg/dL or higher as a factor that raises heart risk.9

A large Danish study points the same way. It followed 116,550 adults for a median 6.7 years and compared people at each non-fasting triglyceride level with people under 89 mg/dL. At 89 to 176 mg/dL, the risk of a heart attack was already 1.6 times higher. The risk of acute pancreatitis was clearly higher from 177 mg/dL, at 2.3 times, and kept climbing with each step up, to 8.7 times higher at 443 mg/dL and above, though it stayed uncommon: 12 cases for every 10,000 people followed for a year.10 Those numbers support a functional target that sits well below the lab's line.

Standard and functional triglyceride ranges for adults (standard classes from the Endocrine Society guideline; functional target from my Type 2 Diabetes Protocol)21

High triglycerides are common. In a U.S. national survey from 1999 to 2004, 33% of nearly 6,000 adults had a level of 150 mg/dL or higher (37% of men and 30% of women), rising to 42% at age 60 and older, and about 2% were above 500.2 If your lab reports mmol/L, multiply by about 88.6 to get mg/dL.

What do high triglycerides and low HDL mean together?

High triglycerides and low HDL are linked, and together they point to insulin resistance, often before blood sugar rises.7

To get your ratio, divide your triglycerides by your HDL, both in mg/dL. Triglycerides of 90 with an HDL of 60 give a ratio of 1.5, right at the line; triglycerides of 200 with an HDL of 40 give 5.0. My functional target is under 1.5, alongside triglycerides under 100 and HDL over 60, and my Type 2 Diabetes Protocol treats the ratio as a cheap, powerful stand-in for insulin resistance.1 In my Insulin Resistance & Prediabetes protocol, a ratio over 3 strongly suggests insulin resistance.7

Research backs that use. In 258 overweight adults without diabetes, researchers measured insulin resistance directly with a lab test and found that a triglyceride level of 130 mg/dL or a triglyceride-to-HDL ratio of 3.0 or higher picked out the insulin-resistant people about as well as the standard criteria for metabolic syndrome.11 My target of 1.5 is stricter than that research cut-point, because a functional range is built to flag the pattern earlier.

The two numbers move together for a reason. As I wrote in my Insulin Resistance & Prediabetes protocol, "High insulin raises triglycerides, lowers HDL and drives the small, dense particles that build plaque."7 Research describes the same trio in type 2 diabetes: a surplus of triglyceride-rich particles, small, dense LDL and low HDL, tied together by the liver's overproduction and slow clearance of those particles.12 Our guide to HDL cholesterol covers the other half of the ratio.

Triglycerides vs. cholesterol: which matters more for your heart?

On my show I've said, "Instead of obsessing over numbers like total cholesterol, look at the real drivers of heart disease."8 That's why I pay more attention to ApoB, cholesterol ratios, triglycerides and C-reactive protein than to LDL alone. The ratios worth knowing are total cholesterol to HDL, triglycerides to HDL, and ApoB to ApoA-I, the main protein in HDL.

The genetic study shows why particle count matters. Researchers compared people by inherited gene variants that lower either triglycerides or LDL, a natural experiment, since your genes are set before you're born. For every 10 mg/dL drop in ApoB-carrying particles, the triglyceride-lowering variants and the LDL-lowering variants lowered the odds of coronary heart disease by the same amount, about 23%. For the triglyceride-lowering variants, each such step came with a drop of about 70 mg/dL in triglycerides. Once ApoB was accounted for, triglycerides and LDL no longer tracked with risk.13 Test ApoB alongside your triglycerides. Our guides to normal cholesterol levels and heart disease tests cover the rest of the panel.

What causes high triglycerides?

Here's how the excess builds, step by step:

Your liver sits at the center of this. As I've said on my show, "Excess sugar, refined grains and excess carbohydrates are, I believe, the single biggest driver of liver fat accumulation."15 I've also pointed out that metabolic markers such as triglycerides, fasting insulin, HbA1c and HDL can tell you a lot about a fatty liver, often before the standard liver markers do.15 Our guide to liver function covers the rest of that picture.

Causes of high triglycerides, and what to check

Even very high levels usually have a cause you can find. In a hospital review of 57 people admitted with pancreatitis from triglycerides above 880 mg/dL, 55 had a secondary cause, led by diabetes (70.2%), obesity (47.3%), heavy alcohol use (26.3%) and chronic kidney disease (22.8%).16 If a thyroid cause is on your list, our guide to thyroid problems covers the full panel.

Do high triglycerides cause symptoms?

Mild and moderately high triglycerides don't cause symptoms you can feel, which is why the number shows up on a blood test first. At very severe levels, above 2,000 mg/dL, the blood can fill with fat-carrying particles called chylomicrons. That state, the chylomicronemia syndrome, can bring belly pain, crops of small yellowish bumps called eruptive xanthomas on the buttocks and the backs of the arms, and brief memory lapses, and left uncorrected it can lead to acute pancreatitis.2 If you have severe belly pain, go straight to When to get care.

How are triglycerides tested?

The expert groups differ on fasting. A European consensus recommends non-fasting tests routinely, because non-fasting and fasting levels predict heart disease about equally.17 The Endocrine Society bases the diagnosis on a fasting level, recommends screening adults with a lipid panel at least every 5 years, and recommends checking anyone with a raised fasting level for the causes behind it, including hormone conditions and medications.2

Ask for these markers with your triglycerides. The functional ranges come from my protocols. Conventional ranges reflect what's typical in the population; functional ranges are narrower, so they flag a pattern earlier.18

The markers to pair with your triglycerides

Add fasting insulin, glucose and HbA1c to the same draw, since they show how hard your body works to control blood sugar, along with TSH for your thyroid and liver and kidney function.72 The 25 Root-Cause Bloodwork Markers protocol covers each one.

How can you lower triglycerides naturally?

These steps follow the order of my Insulin Resistance & Prediabetes protocol, because the same habits bring down insulin and triglycerides.7

Cut sweet drinks, added sugar and refined carbs

Start here, because sugar raises triglycerides even when your weight doesn't change. In a review of randomized trials, 37 of which measured blood fats, eating more sugar raised triglycerides by about 10 mg/dL (0.11 mmol/L), and the link was strongest in trials that held calories and weight steady.4

In my protocol, the first 30 days take out soda, juice and sweet coffee drinks, white bread, pastries and cereal, and candy and desserts. Whole fruit stays: berries, apples and citrus are on the eat-freely list.7 Read labels for hidden sugar and high-fructose corn syrup, and swap white flour and sweet snacks for vegetables, beans and whole fruit.

If you sweeten at all, I recommend raw local honey, about a teaspoon to a tablespoon a day, and it still counts toward your added sugar.19 Scripture puts the principle plainly: "Hast thou found honey? eat so much as is sufficient for thee, lest thou be filled therewith, and vomit it" (Proverbs 25:16, KJV).

Take a break from alcohol

Alcohol raises triglycerides by pushing your liver to release more fat-carrying particles and by slowing their clearance, and extra weight magnifies the effect, including the risk of pancreatitis.20 A clinical review on triglycerides says that with high triglycerides, alcohol should be avoided in any form and quantity.3 In my protocol, alcohol comes out completely for the first 30 days and stays out through the muscle-building phase.7

Build meals around protein and fiber, and eat in order

In my protocol, the day starts with 30 grams of protein at breakfast, from eggs, plain Greek yogurt or kefir, or a protein shake. At meals, you eat vegetables and protein first and carbohydrates last, and you take 5 grams of psyllium before your biggest meal.7 Build your plate from the protocol's eat-freely list: eggs, chicken, turkey, wild salmon and sardines, grass-fed beef and lamb, non-starchy vegetables, beans and lentils, berries, apples and citrus, and olive oil, avocado, nuts and seeds.7 Our list of high-protein foods gives you more options.

Keep red meat fresh, unprocessed and grass-fed. The WHO's cancer agency classifies processed meat of every kind, processed beef included, as a Group 1 carcinogen, largely on colorectal cancer data, and rates red meat itself Group 2A, probably carcinogenic.21 As I've said on my show, the studies that link red meat to poor health mostly reflect grain-fed and processed meat, not the fresh, grass-fed red meat I recommend.22 Our insulin resistance diet has meal ideas built on the same plate.

Walk after meals and strength train

Muscle is your body's biggest sink for blood sugar, and it responds fast.7 Exercise lowers triglycerides on its own, too. In a review of 6 randomized trials with 788 adults whose average triglycerides started in the normal range, aerobic exercise alone lowered triglycerides by 6.0 mg/dL, diet alone by 10.6 mg/dL and the two together by 13.3 mg/dL.23 In 29 randomized trials of progressive strength training with 1,329 adults, triglycerides fell by 8.1 mg/dL.24

Walk 10 to 15 minutes after your two biggest meals and strength train three times a week for 30 to 40 minutes.7 The 90-day plan below adds a daily step target and short breaks from sitting.

Trim your waist

Modest weight loss moves triglycerides a long way. A follow-up analysis of 5,145 adults with type 2 diabetes in the Look AHEAD weight-loss trial grouped people by how much weight they lost in the first year. Against people whose weight stayed within 2% (the comparison group, set at odds of 1.0), those who lost 2% to 5% of their body weight had 1.46 times the odds of a 40 mg/dL drop in triglycerides. The odds kept climbing: 2.20 at 5% to 10%, 3.99 at 10% to 15%, and 7.18 at 15% or more. People who gained more than 2% had 0.80 times the odds, a difference that could have been chance.5

If your waist is growing, our guides to visceral fat and how to lose belly fat go deeper.

Eat fatty fish three times a week

Fatty fish such as wild salmon, sardines, herring and mackerel lower triglycerides on their own, and all of them have fins and scales. In 14 intervention trials with 1,378 adults, eating oily fish lowered triglycerides by 0.11 mmol/L, about 10 mg/dL, and raised HDL by about 2 mg/dL.25

On my show I've put the target plainly: "Consume at least three servings a week of omega-3-rich fish, like wild salmon, sardines, herring or mackerel, in about a palm-sized portion of four to six ounces."26 Our list of omega-3 foods has more choices.

Where does keto fit?

A very-low-carb ketogenic diet lowers triglycerides more than a low-fat diet. Across 13 randomized trials lasting a year or more, it lowered triglycerides by about 16 mg/dL (0.18 mmol/L) more than low-fat diets and raised HDL by about 3.5 mg/dL, while LDL ran about 4.6 mg/dL higher.27 If you use a keto diet, treat it as a short-term tool, build it on whole foods, and check ApoB along the way. If your triglycerides are above 1,000 mg/dL or you take an SGLT2 inhibitor for diabetes, see When to get care before you start.

Which supplements lower triglycerides?

These four are ranked by how much they lowered triglycerides in human trials, and each card's grade shows how solid that evidence is. As my protocol puts it, none of them replace protein, muscle and walking after meals.7

What medications do doctors prescribe for high triglycerides?

These drugs lower triglycerides by different amounts, and their heart results don't always follow the triglyceride drop. The trials below show why ApoB matters.

Statins lower triglycerides modestly, by 5% to 15%, and are prescribed mainly to lower LDL and ApoB.3 The Endocrine Society advises against a statin alone for severe high triglycerides.2

Fibrates, such as fenofibrate, can lower triglycerides by up to 70%, with wide variation from person to person.3 Their heart results are mixed. In the ACCORD lipid trial, 5,518 adults with type 2 diabetes already on a statin took fenofibrate or a placebo for 4.7 years; heart events ran 2.2% a year against 2.4%, a difference that could have been chance, with a possible benefit in a group the researchers planned in advance to look at: people with both high triglycerides and low HDL.39 In PROMINENT, funded by the drug's maker, the newer fibrate pemafibrate lowered triglycerides by 26.2% compared with placebo in 10,497 adults with type 2 diabetes, but ApoB rose 4.8%, and heart events didn't fall (572 against 560). It also brought more kidney side effects and blood clots in the veins, and less fatty liver.40

Prescription omega-3s come at 4 grams a day, and at that dose they lower triglycerides by 30% or more in people with levels of 500 mg/dL and up.41 In REDUCE-IT, 8,179 adults on a statin, with heart disease or with diabetes plus other risk factors and triglycerides of 135 to 499 mg/dL, took 4 grams a day of icosapent ethyl, a purified prescription form of EPA, or a placebo for a median 4.9 years; neither they nor the researchers knew who got what. The combined rate of heart attack, stroke, heart-related death, artery procedures and unstable angina was 17.2% on EPA against 22.0% on placebo, and the drug's maker funded the trial.42 The placebo was mineral oil, and in a later analysis, inflammation markers such as hs-CRP rose 21.9% over 12 months in the mineral-oil group while barely changing on EPA, which has led researchers to ask how much of the gap the placebo explains.43

In STRENGTH, another placebo-controlled trial funded by the drug's maker, 13,078 high-risk adults on a statin took 4 grams a day of a prescription EPA plus DHA or a corn-oil placebo. The trial was stopped early with heart events at 12.0% against 12.2%, and stomach side effects ran 24.7% against 14.7%.44

Both high-dose trials also saw more atrial fibrillation, an irregular heart rhythm; the numbers across the omega-3 trials are under the supplement cautions in When to get care.4244 In REDUCE-IT, serious bleeding ran 2.7% against 2.1%, a difference that could have been chance.42 At a supplement dose, the VITAL trial gave 25,871 U.S. men 50 and older and women 55 and older 1 gram a day or a placebo for a median 5.3 years. Its main measure of heart events didn't differ, while heart attacks, a secondary measure, were 28% lower, with no excess bleeding.45

Niacin raises HDL and lowers triglycerides, but adding it to a statin didn't cut heart events in two large trials. In AIM-HIGH, 3,414 adults with heart disease took extended-release niacin or a placebo; triglycerides fell from 164 to 122 mg/dL and HDL rose from 35 to 42, yet events ran 16.4% against 16.2%, and the trial stopped early at a mean of 3 years.46 In HPS2-THRIVE, 25,673 adults with vascular disease took niacin with laropiprant or a placebo for a median 3.9 years; major vascular events ran 13.2% against 13.7%, with more serious side effects, including problems with blood sugar control, infections and bleeding.47

If your doctor prescribes one of these, keep the food and movement steps going alongside it, since they work on the drivers underneath.

What does traditional Chinese medicine say about high triglycerides?

Traditional Chinese medicine reads the pattern behind high triglycerides in its own terms, and its advice lines up with the plan on this page. My protocol maps the two traditions side by side. Where Western medicine sees high triglycerides with low HDL, the traditional view sees two patterns: Spleen Qi deficiency with Damp, marked by heaviness and fatigue, and Phlegm-Damp, marked by extra weight and a fatty liver.7

The traditional advice is to eat regular, moderate meals, avoid sweet, greasy food and alcohol, use bitter herbs and green tea, move after eating and rest well.7 Its core steps are the ones the trials above support, from cutting sugar and alcohol to walking after meals.

A 90-day plan to lower your triglycerides

Four overlapping phases, in order: steady your meals, build muscle, add targeted support, then retest and protect your progress.

When to get care

High triglycerides are thought to cause 1% to 10% of acute pancreatitis episodes.3 If you've had pancreatitis, our pancreatitis diet guide covers eating during recovery.

Medications. Never stop or change a prescription on your own. If you take insulin or another blood-sugar medication, berberine and the other supports on this page can add to its effect, so check with your prescriber first; the dose may need adjusting as your blood sugar improves.7 If you take an SGLT2 inhibitor for diabetes, check with your prescriber before you try keto, since these drugs' labels list a ketogenic diet among the triggers of ketoacidosis.49 If a medication on the causes list may be raising your triglycerides, bring it up with the doctor who prescribed it.

Supplement cautions:

• Omega-3s. In heart-outcome trials of older adults, omega-3 supplements went with more atrial fibrillation, and more so at higher doses: across 7 trials with 81,210 people, the risk was 12% higher at 1 gram a day or less and 49% higher above 1 gram.50 If you've had atrial fibrillation, ask the doctor who manages it before you take more than 1 gram a day. If you take a blood thinner, check with the doctor who prescribes it before you go above food amounts.

• Berberine. Stomach upset was more common on berberine than on placebo in the trials (2% to 23% of people, against 2% to 15%).28 Skip it during pregnancy and while breastfeeding: the NIH's integrative health center says goldenseal shouldn't be used then and that its berberine can be harmful to newborns.35

• Garlic. My herbs protocol notes that garlic thins the blood: if you take a blood thinner, ask your prescriber first, and stop it 7 days before surgery. It can also cause heartburn.37

• Apple cider vinegar. Always dilute it. If you have reflux, my GERD protocol notes that vinegar helps some people and worsens others and can irritate an already inflamed esophagus, so skip it while reflux is active.51

The bottom line

High triglycerides: frequently asked questions

References

1. Axe J. The Type 2 Diabetes Protocol. DrAxe.com protocol. 2026. P. 20, "Test, don't guess" (functional ranges for triglycerides, HDL and the triglyceride/HDL ratio; the pull-quote line).
2. Berglund L, Brunzell JD, Goldberg AC, Goldberg IJ, Sacks F, Murad MH, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(9):2969-89. doi:10.1210/jc.2011-3213. PMID:22962670
3. Laufs U, Parhofer KG, Ginsberg HN, Hegele RA. Clinical review on triglycerides. Eur Heart J. 2020;41(1):99-109c. doi:10.1093/eurheartj/ehz785. PMID:31764986
4. Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J Clin Nutr. 2014;100(1):65-79. doi:10.3945/ajcn.113.081521. PMID:24808490
5. Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-6. doi:10.2337/dc10-2415. PMID:21593294
6. Wang T, Zhang X, Zhou N, Shen Y, Li B, Chen BE, et al. Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2023;12(11):e029512. doi:10.1161/JAHA.123.029512. PMID:37264945
7. Axe J. Insulin Resistance & Prediabetes: The 90-Day Healing Protocol. DrAxe.com protocol. 2026. Cited: p. 3 (timeline), p. 4 (how insulin resistance takes hold: high insulin drives fat into the liver), p. 5 (high triglycerides with low HDL), p. 7 (what high insulin does to blood fats), p. 10 (traditional Chinese medicine map), p. 14 (tests ranked, including the triglyceride-to-HDL ratio), the four phases (pp. 16 to 19; p. 18, Reverse: "Vinegar in water before your biggest meal") and p. 20 (ranked supports and doses).
8. Axe J. The Truth About LDL & Heart Disease. The Dr. Josh Axe Show. 2026. Quoted and cited lines at 0:00, 31:33 and 31:49. YouTube: https://www.youtube.com/watch?v=MpzqVv_b4OU
9. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139(25):e1082-e1143. doi:10.1161/CIR.0000000000000625. PMID:30586774
10. Pedersen SB, Langsted A, Nordestgaard BG. Nonfasting Mild-to-Moderate Hypertriglyceridemia and Risk of Acute Pancreatitis. JAMA Intern Med. 2016;176(12):1834-1842. doi:10.1001/jamainternmed.2016.6875. PMID:27820614
11. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139(10):802-9. doi:10.7326/0003-4819-139-10-200311180-00007. PMID:14623617
12. Taskinen MR, Borén J. New insights into the pathophysiology of dyslipidemia in type 2 diabetes. Atherosclerosis. 2015;239(2):483-95. doi:10.1016/j.atherosclerosis.2015.01.039. PMID:25706066
13. Ference BA, Kastelein JJP, Ray KK, Ginsberg HN, Chapman MJ, Packard CJ, et al. Association of Triglyceride-Lowering LPL Variants and LDL-C-Lowering LDLR Variants With Risk of Coronary Heart Disease. JAMA. 2019;321(4):364-373. doi:10.1001/jama.2018.20045. PMID:30694319
14. Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119(5):1322-34. doi:10.1172/JCI37385. PMID:19381015
15. Axe J. Hidden Signs Your Liver Is Sluggish (And What To Do Before It Becomes Serious). The Dr. Josh Axe Show. 2026. Quoted and cited lines at 12:14 and 52:21. YouTube: https://www.youtube.com/watch?v=PiOaEva8EBc
16. Qureshi TM, Khan A, Javaid H, Tabash A, Hussein MS, Othman MO. Secondary Causes of Hypertriglyceridemia are Prevalent Among Patients Presenting With Hypertriglyceridemia Induced Acute Pancreatitis. Am J Med Sci. 2021;361(5):616-623. doi:10.1016/j.amjms.2021.01.005. PMID:33618838
17. Nordestgaard BG, Langsted A, Mora S, Kolovou G, Baum H, Bruckert E, et al. Fasting is not routinely required for determination of a lipid profile: clinical and laboratory implications including flagging at desirable concentration cut-points-a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine. Eur Heart J. 2016;37(25):1944-58. doi:10.1093/eurheartj/ehw152. PMID:27122601
18. Axe J. The 25 Root-Cause Bloodwork Markers That Matter Most. DrAxe.com protocol. 2026. Markers 04 (Omega-3 Index: functional range) and 18 (ApoB: functional and conventional ranges).
19. Axe J. What Happens In Your Body If You Eat Honey Every Day? The Dr. Josh Axe Show. October 20, 2025. Lines at 7:34 (raw, local or Manuka honey) and 20:40 ("if you're going to add a sweetener in, honey is the best. A teaspoon up to a tablespoon.") in the episode transcript.
20. Klop B, do Rego AT, Cabezas MC. Alcohol and plasma triglycerides. Curr Opin Lipidol. 2013;24(4):321-6. doi:10.1097/MOL.0b013e3283606845. PMID:23511381
21. Bouvard V, Loomis D, Guyton KZ, Grosse Y, Ghissassi FE, Benbrahim-Tallaa L, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599-600. doi:10.1016/S1470-2045(15)00444-1. PMID:26514947
22. Axe J. 10 Biblical Superfoods That Can Add Years to Your Life. The Dr. Josh Axe Show, Episode 393. September 28, 2026. Red meat studies and grain-fed meat at 21:03 (YouTube captions). YouTube: https://www.youtube.com/watch?v=9AnNi1umufc
23. Kelley GA, Kelley KS, Roberts S, Haskell W. Comparison of aerobic exercise, diet or both on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials. Clin Nutr. 2012;31(2):156-67. doi:10.1016/j.clnu.2011.11.011. PMID:22154987
24. Kelley GA, Kelley KS. Impact of progressive resistance training on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials. Prev Med. 2009;48(1):9-19. doi:10.1016/j.ypmed.2008.10.010. PMID:19013187
25. Alhassan A, Young J, Lean MEJ, Lara J. Consumption of fish and vascular risk factors: A systematic review and meta-analysis of intervention studies. Atherosclerosis. 2017;266:87-94. doi:10.1016/j.atherosclerosis.2017.09.028. PMID:28992469
26. Axe J. You Were Lied To About Fat: Your Cells Are Paying the Price. The Dr. Josh Axe Show. 2026. Quoted line at 11:04. YouTube: https://www.youtube.com/watch?v=TKHwG0I46k4
27. Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr. 2013;110(7):1178-87. doi:10.1017/S0007114513000548. PMID:23651522
28. Blais JE, Huang X, Zhao JV. Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. Drugs. 2023;83(5):403-427. doi:10.1007/s40265-023-01841-4. PMID:36941490
29. Kondo T, Kishi M, Fushimi T, Ugajin S, Kaga T. Vinegar intake reduces body weight, body fat mass, and serum triglyceride levels in obese Japanese subjects. Biosci Biotechnol Biochem. 2009;73(8):1837-43. doi:10.1271/bbb.90231. PMID:19661687
30. Behrouz V, Zahroodi M, Clark CCT, Mir E, Atashi N, Rivaz R. Effects of Garlic Supplementation on Cardiovascular Risk Factors in Adults: A Comprehensive Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutr Rev. 2026;84(1):1-35. doi:10.1093/nutrit/nuaf090. PMID:40580481
31. Axe J. The Hypothyroidism Protocol. DrAxe.com protocol. 2026. Phase 4, Cool (days 14 to 30), and the tiered supplement protocol: "Omega-3 (EPA/DHA) — 2–3 g daily, with food".
32. Axe J. 7 Foods That Quiet Inflammation Better Than Supplements. The Dr. Josh Axe Show. 2026. Quoted lines at 8:48 and 9:47. YouTube: https://www.youtube.com/watch?v=JFeUM50IzBI
33. U.S. Department of Agriculture, Agricultural Research Service. Fish oil, cod liver. FoodData Central, SR Legacy, FDC ID 173577 (per 100 g: vitamin A 30,000 mcg RAE; EPA 6.9 g; DHA 11.0 g; 1 tsp = 4.5 g; 1 tbsp = 13.6 g). Accessed October 8, 2026.
34. National Institutes of Health, Office of Dietary Supplements. Vitamin A and Carotenoids: Fact Sheet for Health Professionals (Tolerable Upper Intake Levels for preformed vitamin A: 3,000 mcg RAE for adults 19 and older). Updated March 10, 2025.
35. National Center for Complementary and Integrative Health. Goldenseal. National Institutes of Health; last updated February 2025.
36. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CCT, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complement Med Ther. 2021;21(1):179. doi:10.1186/s12906-021-03351-w. PMID:34187442
37. Axe J. Top 50 Healing Herbs & Essential Oils: A Field Guide to God's Pharmacy. DrAxe.com protocol. 2026. Garlic profile ("How to Take It": fresh, 1 to 2 cloves daily, crushed and rested 10 minutes; "Use Caution": thins the blood, ask first with blood thinners, stop 7 days before surgery, can cause heartburn).
38. Axe J. Signs That You Have a PARASITE (How to Cleanse Naturally) | The Worm Queen. The Dr. Josh Axe Show. 2025. Dr. Axe on eating raw garlic all the time with a weak digestive system.
39. Ginsberg HN, Elam MB, Lovato LC, Crouse JR 3rd, Leiter LA, Linz P, et al. Effects of combination lipid therapy in type 2 diabetes mellitus. N Engl J Med. 2010;362(17):1563-74. doi:10.1056/NEJMoa1001282. PMID:20228404
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Dr. Josh Axe, DC, DNM, CNS

Doctor of Natural Medicine · Founder, DrAxe.com

Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

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