My Doctor Says My Triglycerides Are High

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If your doctor tells you that you've got high levels of triglycerides, what are the next steps? Triglyceride is the chemical form that fat takes in the body. It is measured as part of a lipid blood test panel for triglycerides and cholesterol. You can take measures to lower those levels that could make a difference in just a few weeks.

Diet for Triglycerides, Hypertriglyceridemia and Heart Disease

Most people with hypertriglyceridemia (elevated triglycerides) have other risk factors for heart disease, too, such as obesity, high cholesterol and high blood pressure.

You may already be familiar with a heart-healthy diet. Adding a few more principles to it, such as cutting carbohydrates, will customize your food plan so it is also designed to lower triglycerides:

  • Eat less sugar and foods containing sugar. This step alone can make a difference in only 2 or 3 weeks
  • Eliminate saturated and trans fats, and limit even healthy fats to no more than 30% of your overall calories
  • Eat omega-3-rich foods like salmon and tuna 2 to 3 times a week or dose yourself with 1 tablespoon of ground flaxseed every day
  • Enjoy frequent small meals and snacks instead of 3 squares
  • Avoid heavy alcohol use, which increases triglyceride levels.

Lifestyle Changes to Lower Triglycerides

Decreasing triglycerides also involves lifestyle changes:

  • Reach and maintain a healthy weight. It depends on how much you have to lose, but dieting for even 1 month can lower your triglycerides
  • Exercise 30 minutes a day to ward off heart disease and 60 to 90 minutes a day to also lose weight
  • Quit smoking
  • Control diabetes

You may also need to go off oral contraceptives, steroids and diuretics (water pills).

Triglyceride-Lowering Medication

If your triglycerides are very high (500 mg/dL or more), medication is essential to avoid inflammation of the pancreas.

When levels are somewhere between borderline high and the low end of high (150 to 200 mg/dL), and are not joined by other serious conditions, it's possible to decrease triglycerides without drugs.

But most people need medications, such as:

  • Fibrates: These include gemfibrozil (Lopid) and fenofibrate (Tricor). Fibrates work best to lower triglycerides but can interact dangerously with some cholesterol-lowering drugs
  • Niacin: Take prescribed niacin only. Over-the-counter supplements may have too much or too little and there are possibly serious side effects that you should discuss with your doctor.
  • Omega-3 (n-3) fatty acids: You can get these good fats in your diet or you can get high doses in a fish oil supplement or by prescription.
  • Statins: Statins are very effective at lowering cholesterol, but they only work to lower mildly elevated triglycerides.

Bile acid sequestrants, which reduce cholesterol, can actually raise triglyceride levels.

In about 10% of cases, high triglycerides can result from genetic conditions such as familial combined hyperlipidemia (high levels of all blood fats), which becomes apparent in adolescence. The earlier this condition is diagnosed and treatment begins, the more likely a patient will be able to avoid heart attack, stroke and early death.

Sources:

"Familial Combined Hyperlipidemia." nlm.nih.gov. 5/20/2014 National Institutes of Health.<http://www.nlm.nih.gov/medlineplus/ency/article/000396.htm>. 

"Triglycerides" MedlinePlus, U.S. National Library of Medicine, NIH. Updated 10/24/2014.

Lars Berglund, MD, et al. "Assessment and treatment of Hypertriglyceridemia (High triglycerides) Patient Guide." September 2012. Hormone Health Network, the Endocrine Society.

Krause, Ronald. Director of Atherosclerosis Research. Phone interview. 30 Oct. 2008.

"Medications for High Triglycerides." tshc.fsu.edu. 2008. University of Florida. 29 Oct. 2008 

Pownall HJ, Ballantyne CM, Cimball KT, et al. Effect of moderate alcohol consumption on hypertriglyceridemia: a study in the fasting state. Arch Intern Med 1999 May 10;159(9):981.

"Triglycerides." americanheart.org. 2008. American Heart Association. 29 Oct. 2008 

"Triglycerides." med.umich. 2005. University of Michigan. 29 Oct. 2008 

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