Medications May Be Needed For High Triglyceride Levels
Sometimes, healthy eating and regular exercise cant lower high triglyceride levels. This may be the case, for example, if you have familial hypertriglyceridemia or if you already have heart disease. Your doctor may prescribe medication such as fibrates or nicotinic acids. Drugs to help lower high blood cholesterol may also be prescribed, if necessary.Suggestions for managing high triglyceride levels with medication include:
- Always take prescription medications exactly as instructed.
- See your doctor if you are having side effects from the medication. Known medication side effects may include indigestion, diarrhoea, fever or muscle problems.
- Dont assume that medications will somehow overcome the hazards of an unhealthy lifestyle. A healthy diet, regular exercise and maintaining an appropriate weight for your height are the most important management strategies for high triglycerides.
Why Lowering High Triglyceride Levels Matters
The national guidelines for fasting triglyceride levels in healthy adults are:
- Normal: Under 150 milligrams per deciliter .
- Borderline High: 151200 mg/dl.
- High: 201499 mg/dl.
- Very High: 500 mg/dl or higher.
When your triglyceride levels are high and you have a high amount of LDL cholesterol or a low amount of HDL cholesterol, all of this could contribute to the development of fatty buildups within the artery walls of the heart. The buildup can increase your risk of heart attack and stroke.
Lowering Triglycerides Without Medication
Unless your triglycerides are extremely high, lifestyle changes are the best place to start. These simple steps can significantly lower triglyceride levels.
- Beware of bad fats. Cutting back on saturated fat and trans fats can lower triglycerides.
- Go for good carbs. Easily digested carbohydrates give triglycerides a definite boost. Eating whole grains and cutting back on soda can help control triglycerides.
- Check your alcohol use. In some people, alcohol dramatically boosts triglycerides. The only way to know if this is true for you is to avoid alcohol for a few weeks and have your triglycerides tested again.
- Go fish. Omega-3 fats in salmon, tuna, sardines, and other fatty fish can lower triglycerides. Having fish twice a week is fine.
- Aim for a healthy weight. If you are overweight, losing just 5% to 10% of your weight can help drive down triglycerides.
- Get moving. Exercise lowers triglycerides and boosts heart-healthy HDL cholesterol.
- Stop smoking. It isnt good for triglyceride levels or for anything else.
About the Author
Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing
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How Are Triglycerides Different From Cholesterol
Triglycerides and cholesterol are both fatty substances known as lipids. But, triglycerides are fats cholesterol is not. Cholesterol is a waxy, odorless substance made by the liver that is an essential part of cell walls and nerves.
Cholesterol also plays an important role in body functions such as digestion and hormone production. In addition to being produced by the body, cholesterol comes from animal foods that we eat.
Pure cholesterol cannot mix with or dissolve in the blood. Therefore, the liver packages cholesterol with triglycerides and proteins in carriers called lipoproteins. The lipoproteins move this fatty mixture to areas throughout the body. An elevated triglyceride level increases the risk of heart disease.
When Can I Eat Or Drink Again
As soon as your blood is taken, your fast is over. You might want to bring a snack and a drink with you so you can eat as soon as possible after the test.
American Academy for Clinical Chemistry: Basic Metabolic Panel,Comprehensive Metabolic Panel,GGT,Glucose Tests,Iron Tests,Lipid Profile,Renal Function Panel,Vitamin B12 & Folate.
British National Health Service: Can I Eat and Drink Before Having a Blood Test?
Crystal Moore, MD, PhD, FCAP, anatomical and clinical pathologist, Chesapeake, VA.
National Heart Lung and Blood Institute: What Are Blood Tests?
Nemours Foundation: Blood Test: Comprehensive Metabolic Panel .
Providence Laboratory Services : Fasting Instructions.
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The History Behind Fasting Cholesterol Tests
When doctors test for cholesterol, we almost always order a group of tests called a lipid panel . This panel typically includes four separate measures:
- Total cholesterol concentration.
- Low-density lipoprotein* cholesterol, often called the bad cholesterol. The amount of LDL in your blood strongly predicts your risk of cardiovascular disease, as higher levels are associated with development of plaque in the arteries.
- High-density lipoprotein cholesterol, often called good cholesterol because higher levels protect against heart disease.
- Triglycerides . High levels of triglycerides are also associated with vascular disease, although this relationship isnt as well defined.
*Lipoproteins are the packages that transport cholesterol in the bloodstream.
Lipids have traditionally been drawn after a fast for two main reasons. The first was to minimize variation, since eating can affect some lipid levels. The second was to produce a better calculation of LDL-cholesterol, which is often derived from an equation thought to provide highly distorted results after eating. However, more recent studies have largely negated these concerns.
Is There Anything Else I Should Know
If you are diabetic and your blood sugar is out of control, triglycerides may be very high.
Triglycerides change dramatically in response to meals, increasing as much as 5 to 10 times higher than fasting levels just a few hours after eating. Even fasting levels vary considerably day to day. Therefore, modest changes in fasting triglycerides measured on different days are not considered to be abnormal.
Certain drugs such as corticosteroids, protease inhibitors for HIV, beta blockers, and estrogens can increase blood triglyceride levels.
There is increasing interest in measuring triglycerides in people who have not fasted. The reason is that a non-fasting sample may be more representative of the âusualâ circulating level of triglyceride since most of the day blood lipid levels reflect post-meal levels rather than fasting levels. However, it is not yet certain how to interpret non-fasting levels for evaluating risk so, at present, there is no change in the current recommendations for fasting prior to tests for lipid levels.
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How Can Triglyceride Levels Be Lowered
If your triglyceride levels are high, the next step is for your doctor to check for potential causes. Certain medications, thyroid function issues, poorly controlled diabetes, liver or kidney disease can all cause triglyceride levels to be higher than normal.
The first steps in treatment to lower triglyceride levels include eating a healthy diet, achieving and maintaining a healthy weight, and aerobic exercise on a regular basis.
To lower your triglyceride levels, your diet should be:
- low in fats
- low in simple carbohydrates
- low in alcohol
If you have high triglycerides and low HDL or high LDL levels, you may need to take medication along with making lifestyle changes. If your triglyceride levels are in the very high range you are at risk to develop other medical problems, so you will most likely need to take medication.
Does A Person Need To Do Anything Else To Prepare For A Cholesterol Test
Before a person has their cholesterol test, they should inform a healthcare professional about their family history of heart health and any symptoms or medical conditions they are currently experiencing.
The person should also let the healthcare professional know about any medications, vitamins, herbal remedies, or supplements that they are taking.
If the person is taking any medications that may affect their cholesterol levels, the healthcare professional may ask them to stop taking them for a period of time before their test.
The person should only stop taking their medication if the healthcare professional asks them to and while under medical supervision.
A cholesterol blood test will measure the amount of each of the following in a persons blood:
- Total cholesterol: This is the sum of the cholesterol content in the blood.
- Low-density lipoprotein cholesterol: This is the type of cholesterol that contributes to the buildup of fats within the arteries, leading to a
- to the buildup in a persons arteries.
According to the , the ideal levels of each type are as follows:
- Total cholesterol: Levels under 200 mg/dl are optimal.
- HDL cholesterol: Levels greater than or equal to 60 mg/dl are optimal.
- LDL cholesterol: Levels under 100 mg/dl are optimal.
- Triglycerides: Levels under 150 mg/dl are optimal.
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How Is It Used
Blood tests for triglycerides are usually part of a lipid profile that is used to help identify an individualâs risk of developing heart disease and to help make decisions about what treatment may be needed if there is borderline or high risk. As part of a lipid profile, it may be used to monitor people who have risk factors for heart disease, those who have had a heart attack, or those who are being treated for high lipid and/or high triglyceride levels.
Results of the cholesterol test and other components of the lipid profile are used along with other known risk factors of heart disease to develop a plan of treatment and follow-up. Treatment options may include lifestyle changes, such as diet or exercise programs, or lipid-lowering drugs, such as statins.
Focus On Fruits Vegetables Whole Grains And Beans
Our typical American diet is now abbreviated as SAD by scientists nationwide because its full of foods that do sad things to both hearts and waistlines. Hyperprocessed foods like potato chips and French fries. Sugar-saturated drinks. And fatty, artery-clogging meats and full-fat dairy foods like cheese.
We dont have to become complete vegetarians to get our cholesterol levels into healthy ranges, studies on the Pritikin Program have found, but clearly, the more vegetables, fruits, potatoes, and other naturally-fiber-rich plant foods we eat, the healthier well be.
Plant foods high in soluble fiber are especially beneficial in lowering total and LDL bad cholesterol levels. Good sources include beans , yams, oats , barley, and berries.
For simple tips on bringing more fruits, vegetables, whole grains, and beans into your life, here is a 5-day sample healthy meal plan from the doctors and dietitians at Pritikin Longevity Center.
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Can I Pass Fh To My Kids
If you inherited FH from one parent, theres a 50% chance youll pass it on to your children. If both of your parents passed the FH trait to you, your children will definitely have FH. Thats why its crucial to get children with a family history tested at an early age and begin cholesterol-reducing treatment for those with FH.
People with FH are usually not diagnosed until their 30s or 40s or later. Unfortunately, far too few are diagnosed as children. But early treatment can significantly impact a persons lifetime cardiovascular health by lowering their long-term exposure to high cholesterol levels, Martin advises. The treatment keeps their arteries healthier and prevents premature heart attacks and strokes.
Tactics To Reduce Cholesterol Quickly
For most of us, theres really no need to pack our medicine cabinets with pills to reduce cholesterol levels. Natural, lifestyle-based strategies have proven extraordinarily effective in reducing cholesterol quickly and permanently.
Get the top 5 food and fitness tips recommended by the doctors, dietitians, exercise experts, and other faculty at the Pritikin Longevity Center. Pritikin has been helping people lower cholesterol levels since 1975.
Did you know that for every 10% drop in your cholesterol level, your heart attack risk drops by 20% to 30%? Theres more good news: Most of us can reduce cholesterol quickly, and without the need for medications. Simple lifestyle strategies can be very powerful.
Thats what several studies on thousands following the Pritikin Program of diet and exercise have found. Within three weeks, people were able to lower their cholesterol levels on average 23%, which translates into a 46% to 69% drop in heart attack risk.1
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Risk Factors And Complications
High blood triglycerides can be a risk factor for heart disease. Its unclear whether triglycerides can cause the buildup of plaque in your arteries thats associated with many types of heart disease. At extreme levels of 1,000 mg/dL or more, blood triglycerides can cause acute pancreatitis.
Elevated triglyceride levels can be a sign of metabolic syndrome. Metabolic syndrome is a collection of conditions that include:
- an excessively large waistline, which is defined as greater than 35 inches in women or 40 inches in men
- elevated blood pressure
- low HDL, or good cholesterol
- elevated triglycerides
Each one of these conditions carries risks and complications of its own, and all can be linked to the development of heart disease. Type 2 diabetes, which is characterized by high blood sugar and resistance to the hormone insulin, is also often associated with elevated triglycerides. Other causes of elevated triglyceride levels are:
- hypothyroidism, which is caused by a deficient thyroid gland
Consider The Bigger Picture
Certain health issues can affect your triglyceride level. Type 2 diabetes, for instance, is a risk factor for high triglycerides. So are thyroid issues and kidney diseases like uremia.
If youre concerned about your triglycerides, it makes sense to see your doctor for a head-to-toe checkup to see if any underlying causes could potentially be at play.
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Can You Check Cholesterol Without A Blood Test
During a cholesterol test procedure, a blood sample will have to be taken from a vein in your arm.
To do so, a tourniquet is tied around your arm just above the elbow. A needle is then inserted into a vein in your arm near the inside of your elbow. Once the needle is positioned, a small amount of blood is withdrawn and collected in a vial or a syringe.
After the blood is collected, the needle is removed from the vein, and the tourniquet is removed from your arm. A small cotton ball is pressed over the puncture site to stop any bleeding. A Band-Aid may be placed to protect clothing should a small amount of blood leak out of the puncture site.
How long does a cholesterol take?
Having blood tests drawn takes only a few minutes.
Does a cholesterol test hurt?
Blood tests cause a minimal amount of discomfort. Some people do have anxiety about having blood drawn and it may be worse than the pain of the procedure.
Nonfasting Levels Might Be Better
After you eat, your digestive system converts some of the carbohydrates and fats into triglycerides. Their level in the bloodstream rises, then gradually falls. If the triglyceride level rises too much, its a signal that the body has trouble metabolizing food. Think of eating as a stress test for metabolism. Thats something you cant see if youve been fasting.
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How Should You Prepare For A Cholesterol Test
How to prepare. As a general rule, you should fast for 9 to 12 hours before the test, without food or liquids other than water. Some cholesterol tests do not require you to fast, so follow your doctors instructions.
Who does not love spicy food. Most people are fond of spices but have you ever thought what does spicy food do to your stomach? Although there may be some serious health benefits to eating spicy food such as prevention from cancer, good heart health, loss of extra calories, but it may also mess up your system, especially your stomach. It can cause gastric ulcers, loss of appetite and even acute gastritis. So, you might want to think twice if you have been over-indulging in hot and spicy foods.
What Is Vldl And How Does It Relate To Triglyceride
Very low-density lipoprotein is one of the major lipoprotein particles. Others include high-density lipoprotein and low-density lipoprotein . Each one of these particles contains a mixture of cholesterol, protein, and triglyceride but in varying amounts unique to each type of particle. LDL contains the highest amount of cholesterol. HDL contains the highest amount of protein. VLDL contains the highest amount of triglyceride. Since VLDL contains most of the circulating triglyceride and since the compositions of the different particles are relatively constant, it is possible to estimate the amount of VLDL-cholesterol by dividing the triglyceride value by 5. At present, there is no simple, direct way of measuring VLDL-cholesterol, so the estimate calculated from triglyceride is used in most settings. This calculation is not valid when the triglyceride is greater than 400 mg/dL. Increased levels of VLDL-cholesterol have been found to be associated with increased risk of heart disease and stroke.
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When Should You See A Doctor
Because high triglyceride levels usually do not cause any symptoms, theyre typically spotted when a doctor orders a blood test that includes a lipid panel.
If you do not have high risk factors, including health conditions and some lifestyle factors, a doctor will order a lipid panel every few years to check cholesterol and triglyceride levels.
If your lipid panel results show above normal triglyceride levels, a doctor may suggest lifestyle changes focused on diet and exercise. If diet and exercise do not have the desired effect, they may recommend medication such as statins or fibrates.
Where Should Cholesterol Be Checked
Its best for your primary care doctor to do the test. As noted, your cholesterol levels represent just one of many factors affecting your cardiovascular health. Your primary care physician will have a fuller understanding of your personal and family history, as well as any other risk factors that might apply.
If your cholesterol is checked at a public screening, they may measure your HDL cholesterol and total cholesterol. But if HDL cholesterol isnt measured, knowing your total cholesterol levels still gives you valuable information. Getting your blood cholesterol, blood pressure, body mass index and fasting blood sugar measured regularly should be part of your overall personal care plan.
If you obtain cholesterol screening results from a source outside of your doctors office, be sure to share those with your primary care physician. Additional data points help to establish your cardiovascular risk. This is particularly important for people who smoke, have other health conditions such as diabetes or inflammatory conditions, or have a family history of heart disease, high blood pressure or stroke.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
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