Very High Triglycerides
It’s a good idea to keep track of your cholesterol. The same is true for your blood pressure, blood sugar levels and waistline. And while you may be used to hearing about “good” (HDL) and “bad” (LDL) cholesterol, triglycerides are an important part of the overall picture too.
Triglycerides are one of the four numbers you will see on a standard cholesterol blood (panel) test. When triglycerides are very high, it can spell trouble for your heart and lead to other health issues.
Questions to Ask Your Doctor
- How are triglycerides different from cholesterol?
- What is my triglyceride level?
- How often should this and my other cholesterol levels be checked?
- Why do you think my triglyceride level is so high?
- How can high triglycerides affect my heart health?
- What is the best thing I can do to lower triglycerides?
- What changes can I make to my diet that will help?
- Do sugars cause high triglycerides?
- How can I better control other risk factors for heart disease?
- How is the prescription form of omega-3 fatty acids different from what I can get in the grocery store or pharmacy?
What Increases Your Risk?
Some people have a genetic deficiency or family history that makes them more prone to very high triglycerides. The condition is also more common in:
- People who are very overweight/obese
- Women, especially those who are pregnant, are taking estrogen or hormone replacement therapy, or have polycystic ovary syndrome
- People who develop heart disease before age 50
- Mexican-American men
- Indian Americans
Treatment
While studies about whether lowering triglycerides can measurably reduce the risk of heart disease or events are still ongoing, most experts say it’s best to keep them within the normal range.
The goal of any treatment program will be to:
- Lower the amount of triglycerides in the blood
- Control conditions that can raise triglyceride levels (for example, obesity, diabetes, hypothyroidism, kidney disease)
The best way to lower triglycerides is by making healthy lifestyle choices, which together can cut triglyceride levels by half! That means reducing triglycerides is largely within your control.
Talk with your doctor about living healthier by taking these 4 steps:
1. Be more active—regular exercise can lower triglycerides and raise good cholesterol
2. Improve your diet—that means trying to:
- Cut out excess calories by limiting unhealthy fats; dietary fat should only make up 25-35 percent of your total diet
- Eat fiber-rich carbohydrates such as vegetables and whole grains and limit simple carbohydrates (white breads, pasta, potatoes)
- Limit alcohol, which can cause triglycerides to spike in some people
- Eat foods rich in Omega-3 fatty acids, available in certain fish (salmon, tuna, lake trout, and sardines), fish oil or flaxseed
- Avoid refined sugars
3. Lose weight and stay at a healthy body weight—losing just 5-10 percent of your weight can lower triglycerides
4. Quit smoking and don’t start
When it comes to lowering triglycerides, lifestyle modifications seem to work well and, in some cases, are as effective as taking medicine for lowering triglycerides. Taking the above steps will help you improve your overall health too.
In some cases, your doctor may also prescribe medications to lower your triglycerides. These might include:
- Omega-3 fatty acids – prescription forms of high-dose omega-3 fatty acids that are naturally found in fish can lower triglycerides, but researchers don’t know exactly how yet. There are several FDA-approved omega-3 fatty acid formulations for VHTG; most include both EPA and DHA as active ingredients. These tend to be well tolerated and have been shown to reduce triglycerides by as much as 50 percent.
- Fibrates – medications that work by impairing the liver’s ability to release triglycerides
- Niacin or vitamin B3 – may work by reducing the activity of a chemical needed for the body to produce triglycerides.
- Statins – used to lower LDL cholesterol and may also lower triglycerides
As always, when taking medications:
- Take them exactly as directed
- Let your health care team know about all of the other medicines you take
- Report any side effects or concerns
|
Medication |
Important Considerations/Side Effects |
|
Omega-3 fatty acids |
Only FDA-approved, prescription strength Omega-3 fatty acids should be used to treat VHTG. While there are dietary supplements (commonly referred to as "off-the-shelf"), these are not the same. People who have an allergy to fish or shellfish should not take omega-3 fatty acids. If you take the EPA and DHA combination, you may need to get your LDL cholesterol checked because DHA seems to raise this in some people. Swallow the liquid gel capsule whole and do not take it with a hot beverage. Tell your doctor if you notice any bruising. |
| Niacin |
Immediate release formulations of this drug that work quickly in the body can sometimes result in flushing, itching, stomach upsets and raised blood sugar. |
| Fibrates |
Dosages need to be adjusted for people with kidney problems. You should not take fibrates if you have liver and/or gallbladder disease. Taking statins and fibrates at the same time can make serious muscle problems more likely. This can lead to kidney failure. |
| Statins |
Minimal, if any, positive effect on triglycerides, as research findings are mixed. Tell your doctor if you also take fibrates. |
*This table does not address all concerns or special considerations. Talk with your doctor about the pros and cons of all medications.
There are many new treatments being investigated as well. For example, there is growing evidence that flaxseed oil may help lower triglycerides in some people. As always, talk with your doctor about the right approach for you.
Source: https://www.cardiosmart.org/topics/very-high-triglycerides
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