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Medication For High Triglyceride Levels

What Causes Levels To Fluctuate

Lowering Triglycerides – Mayo Clinic

Triglyceride levels fluctuate naturally in response to many factors, including calorie intake and time of day. Eating a meal can cause an increase in triglycerides, which the body may store to use later when it needs energy.

These fluctuations are typically short-lived, but they are part of the reason why doctors may ask a person to fast before getting a lipid profile blood test.

Some health conditions may increase the risk of higher triglyceride levels. According to the

  • hormone medications
  • immunosuppressant drugs

Anyone who is uncertain about the side effects of their specific medication should speak with their doctor.

A person can use a few treatments to help lower their triglyceride levels.

High Triglycerides Treatment Medications Vs Natural Options

Elevated triglycerides can lead to a greatly increased risk of both heart attacks and strokes. Therefore, reducing them is important for the long term prevention of these serious health complications. High triglycerides treatment always includes dietary and lifestyle changes in order to reduce the levels of these lipids in the bloodstream, and such methods are incredibly effective at reducing triglycerides levels. There are also medications that are used in addition to lifestyle and dietetic changes for lowering triglycerides, or are added when these measures have proven to be not effective enough to reduce them to safe levels.

Fibrates are another class of medications that are used commonly in high triglycerides treatment. Prescription medications like Lopid or TriCor have shown to be effective at reducing the levels of these fats in the blood. Like statins, the use of fibrates is often long term, and this can potentially lead to gallstones. And, while they are not known for causing severe liver damage, they can cause inflammation of the organ, which can lead to the drug being discontinued. More common side effects include nausea and diarrhea. They can also contribute to muscle damage when used in the long term as a means for high triglycerides treatment.

References:

Effect Of Volanesorsen On Lipid And Lipoprotein Levels

FAMILIAL CHYLOMICRONEMIA SYNDROME

A double-blind, randomized 52-week trial evaluated the ability of volanesorsen vs. placebo to decrease TG levels in 66 patients with FCS . The primary end point was the percentage change in fasting TG levels at 3 months. As expected, there was a marked reduction in Apo C-III levels in the volanesorsen group and a small increase in the placebo group. Most importantly patients treated with volanesorsen had a 77% decrease at 3 months in TG levels whereas patients receiving placebo had an 18% increase in TG levels. The decrease in TGs in patients treated with volanesorsen persisted for 52 weeks . Significantly, 77% of the patients in the volanesorsen group vs. only 10% of patients in the placebo group had TG levels of less than 750 mg/dl, a level that would greatly reduce the risk of pancreatitis. In addition, patients who received volanesorsen had decreases in levels of chylomicron TG by 83%, apolipoprotein B-48 by 76%, nonHDL-C by 46%, and VLDL-C by 58% and increases in levels of HDL-C by 46%, apolipoprotein A1 by 14%, LDL-C by 136% , and total apolipoprotein B by 20%.

HYPERTRIGLYCERIDEMIA

DIABETES

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Effect Of High Dose Omega

It should be noted that in this trial mineral oil was used as the placebo. In the placebo group the LDL-C, non-HDL-C, and CRP levels were increased during the trial . The impact of these adverse changes on clinical outcomes is uncertain and whether they contributed to the apparent beneficial effects observed in the individuals treated with EPA is unknown.

4) The OMEMI trial was a randomized trial of 1.8 grams per day of omega-3-fatty acids vs. corn oil placebo in patients aged 70 to 82 years with a recent myocardial infarction . Baseline LDL-C was approximately 76mg/dL, HDL-C was 49mg/dL, and TGs 110mg/dL. The primary endpoint was a composite of nonfatal myocardial infarction, unscheduled revascularization, stroke, all-cause death, and heart failure hospitalization after 2 years of follow-up. The primary endpoint occurred in 21.4% of patients on omega-3-fatty acids vs. 20.0% on placebo . TGs levels decreased 8.1% in the omega-3-fatty acid group and increased 5.1% in the placebo group while changes in LDL-C were minimal in both groups. Thus, similar to the STRENGTH trial no benefits on cardiovascular disease were observed with EPA + DHA treatment.

Effect Of Fibrates On Cardiovascular Outcomes

Triglyceride &  Cholesterol Pro

There have been a number of studies that have examined the effect of a variety of different fibrates on cardiovascular disease. We will describe the major studies below.

A separate meta-analysis has focused on the effect of fibrates on cardiovascular disease in patients with pre-existing disease . It included 13 trials involving a total of 16,112 participants. For the primary composite outcome of non-fatal stroke, non-fatal myocardial infarction, and vascular death, fibrate therapy significantly decreased risk by 12% 0.88, 95% 0.83 to 0.94). Fibrates were effective for preventing myocardial infarction . Fibrates were not effective in lowering all-cause mortality , death from vascular causes , or stroke events . Since clofibrate has been discontinued due to safety concerns, the data were reanalyzed excluding clofibrate trials. Without clofibrate, fibrates no longer significantly reduced the primary outcome but were still effective in preventing myocardial infarctions . Subgroup analyses showed the benefit of fibrates on the primary composite outcome to be consistent irrespective of age, gender, and diabetes mellitus.

SUMMARY OF OUTCOME STUDIES

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Treatments For High Triglyceride Levels

If you have high triglycerides, your doctor’s treatment should include healthy eating and exercise. Avoiding processed and sugary foods is paramount these dietary changes alone can have a tremendous impact on your triglyceride levels. Your doctor may also recommend taking omega 3 fatty acid supplements.

Begin today. Talk to your doctor or other health care provider about exactly what you need to do to start living a healthy lifestyle to lower triglycerides, help prevent a heart attack or stroke, avoid or manage diabetes, and reduce your chances of developing liver disease and pancreatitis.

When To Contact A Doctor

While high triglyceride levels may not usually cause symptoms, anyone who is uncertain or concerned about their triglyceride levels should consult a doctor.

Additionally, any adult who has not had a lipid profile test in the last 46 years should speak with a doctor about their cardiovascular risk factors and possible need for a test. Catching elevated levels of health markers, such as triglycerides or cholesterol, at an early stage may help a person make changes earlier to address the underlying issue.

9 sourcescollapsed

  • Arnett, D. K., et al. . 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines.

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Follow A Lower Carb Diet

Much like added sugar, extra calories from carbs in your diet are converted into triglycerides and stored in fat cells.

Not surprisingly, low carb diets have been linked to lower blood triglyceride levels .

A review of 12 randomized controlled trials found that people following reduced carb diets typically saw a reduction in triglyceride levels at 6, 12, and 24 months. Across these studies, triglyceride levels decreased the most 6 months after starting a reduced calorie diet .

A 2020 review compared low fat and low carb diets. Researchers found that 612 months after starting their relative diets, those on the low carb diet had greater decreases in triglyceride levels than those on a low fat diet .

Summary

Following a low carb diet can lead to a significant reduction in blood triglyceride levels, at least in the short term, when compared with a low fat diet.

How To Take Fibrates

High Triglycerides (Part 1) – Medication vs. Lifestyle – Eicosapent Ethyl

Take your medicine as directed. It is generally taken 1 time per day. Do not stop taking your medicine without first talking with your health care provider.

The medicine comes in liquid-filled capsule or tablet form. Do not open capsules, chew, or crush tablets before taking.

Read the instructions on your medicine label. Some brands should be taken with food. Others may be taken with, or without food.

Store all of your medicines in a cool, dry place.

Follow a healthy diet while taking fibrates. This includes eating less fat in your diet. Other ways you can help your heart include:

  • Getting regular exercise

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Establish A Regular Meal Pattern

Insulin resistance is another factor that can contribute to high blood triglycerides.

After you eat a meal, the cells in your pancreas send a signal to release insulin into the bloodstream. Insulin is then responsible for transporting sugar to your cells to be used for energy.

If you have too much insulin in your blood, your body can become resistant to it, making it difficult for your body to use insulin effectively. This can lead to a buildup of both sugar and triglycerides in the blood.

Fortunately, setting a regular eating pattern can help prevent insulin resistance and high triglycerides. For instance, research shows that not eating breakfast can lead to decreased insulin sensitivity .

An American Heart Association statement suggested that irregular eating patterns seemed less likely to achieve healthy cardiometabolic levels. They recommended intentional eating at regular times .

However, the evidence is mixed when it comes to meal frequency.

A 2013 study demonstrated that eating three meals per day significantly decreased triglycerides compared with eating six meals per day (

36 ).

Regardless of how many meals youre eating daily, eating regular meals can improve insulin sensitivity and lower blood triglyceride levels.

Summary

While studies are mixed on how meal frequency affects blood triglyceride levels, research suggests that sticking to a regular meal pattern can decrease many heart disease risk factors and prevent insulin resistance.

What Are Normal And High Triglyceride Levels

The National Cholesterol Education Program sets guidelines for triglyceride levels:

  • Normal levels: Less than 150 milligrams per deciliter
  • Borderline high:150 to 199
  • High: 200 to 499
  • Very high: 500 or more

Elevated levels may lead to heart disease, especially in people with low levels of “good” cholesterol and high levels of “bad” cholesterol. The same is true if you have type 2 diabetes.

Experts once debated how important triglycerides are, but it now seems clear that higher levels are linked to problems such as heart disease.

One thing is clear, though: A good diet and exercise plan can lower triglyceride levels, improve cholesterol, and decrease the chance of heart disease.

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Supplements And Medications To Lower Triglycerides

  • Fish oil, in doses of 3.5 grams of omega-3 fatty acids per day, can effectively lower triglycerides. Lower doses are ineffective,” explains says Scott Shurmur, MD, cardiologist and professor of medicine at Texas Tech University Health Science Center School of Medicine in Lubbock. When prescription medication is needed, lowering triglycerides usually starts with medication that lowers LDL cholesterol levels many of the same medications used to lower cholesterol will also lower triglycerides.
  • Statins are usually effective and well tolerated, and are the most commonly prescribed drugs to lower cholesterol. Examples include Lipitor , Crestor , Zocor , Lescol , Pravachol , and Mevacor . Severe side effects that last are rare, but side effects may include forgetfulness, abdominal pain, constipation, and muscle aches. You shouldn’t take one of these medications if you are pregnant or have active liver disease. Statins may interact with other drugs, including antibiotics and antivirals, so be sure to discuss all your medications with your doctor.
  • Fibrates like Tricor are used specifically to lower triglyceride levels. Side effects include stomach upset, gallstones, and muscle aches. You should not take fibrates if you have kidney disease or severe liver disease.
  • Some diabetes medications, Actos , for example, will also lower triglycerides, says Shurmur. However, this drug may cause or worsen congestive heart failure, warns the FDA.

    Cut Back On Sugar And Refined Carbs

    5 Home Remedies for High Triglyceride Levels

    Different carbohydrate-loaded foods also contain very different nutritional levels.

    Dr. Nissen recommends scaling back or eliminating:

    Dr. Nissen advises that increasing your fiber intake may lower triglyceride levels. If you have high triglyceride levels, theres a good chance you dont ingest close to the recommended 25 to 30 grams of fiber a day, he says.

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    What Qualifies As High Triglycerides

    According to MedlinePlus , blood levels less than 150 mg/dL fall under the triglycerides normal range, while anything higherknown as hypertriglyceridemiacan increase risk for heart disease. Elevated triglycerides can also be a very early sign of diabetes, states Kristin Thomas, MD, a board-certified internist and co-founder of Foxhall Medicine in Washington, DC.

    Extremely high triglyceridesblood levels over 500 mg/dLmay be due to a genetic disorder and can increase the risk of pancreatitis, along with heart disease, including atherosclerosis , Dr. Thomas, co-author of You Can Prevent A Stroke, explains. It can be seen alone or in association with many other conditions, as well, such as metabolic syndrome, hypothyroidism, fatty liver disease and kidney disease, Dr. Malaney says.

    Ask Your Doctor About Natural Supplements

    Several natural supplements could have the potential to lower blood triglycerides. Always speak with your doctor before starting any supplements, as they can interact with other medications.

    Note especially that the Food and Drug Administration does not regulate supplements in the same way as it regulates pharmaceuticals, and supplement quality can vary widely.

    Below are a few of the main supplements that have been studied:

    • Fish oil. Well known for its potent effects on heart health, fish oil is rich in omega-3 fatty acids, which have been shown to decrease triglycerides and several other risk factors for heart disease (

    Summary

    Several supplements have been studied for their ability to lower triglyceride levels, including fish oil, fenugreek, garlic extract, guggul, and curcumin.

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    Prescription Drugs For Cholesterol And Triglycerides

    From statins like Lipitor to PCSK9 inhibitors like Repatha to niacin and beyond, several kinds of medications are regularly prescribed to treat high cholesterol and triglyceride levels.

    Which is most appropriate for you depends on several factors, but its likely your healthcare provider will want you to begin taking prescription medication if diet and exercise are not enough to lower your levels, or if your risk for cardiovascular disease is particularly elevated.

    Keeping your lipidcholesterol and triglyceridelevels from getting too high is an important part of preventing atherosclerosis, coronary artery disease , stroke, and peripheral artery disease.

    This article will help you learn about the possible prescription options your healthcare provider might suggest so you can take an active role in your treatment discussions and decisions.

    Treatment Of High Triglycerides

    BP Meds That Raise Cholesterol & Triglycerides

    In most cases, high triglycerides are managed by making lifestyle changes. You may be advised to:

    • Exercise for at least 30 minutes every day.
    • Eat less, particularly high fat foods.
    • Increase the amount of fibre in your diet.
    • Avoid high sugar foods such as lollies. Choose foods with a low glycaemic index such as legumes and wholegrain products.
    • Eat more fish. Choose fish rich in omega-3 fatty acids such as salmon, mackerel, tuna and trout. Omega-3 in high doses can reduce triglyceride levels.
    • Cut back on alcohol. The kilojoules and sugar in alcoholic drinks can raise triglyceride levels.
    • Lose excess body fat using a combination of healthy eating and regular exercise.
    • Manage coexisting health conditions such as diabetes or hypertension effectively.

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    Increase Your Intake Of Unsaturated Fats

    Studies show that monounsaturated and polyunsaturated fats can reduce blood triglyceride levels, especially when theyre replacing carbs in your diet .

    Monounsaturated fats are found in foods like olive oil, nuts, and avocados. Polyunsaturated fats are present in vegetable oils and fatty fish, as well as nuts and seeds such as walnuts, flaxseeds, and chia seeds.

    A 2019 review of 27 studies reported that while olive oil consumption does decrease triglycerides levels, it does so significantly less than other types of plant oil .

    One older study analyzed the diets of 452 adults in a specific population of Indigenous people in Alaska over the previous 24 hours.

    It found that saturated fat intake was associated with increased blood triglycerides, while polyunsaturated fat intake was associated with lower triglyceride levels .

    To maximize the triglyceride-lowering benefits of unsaturated fats, pick a heart-healthy fat like olive oil and use it to replace other types of fat in your diet, such as trans fats or highly processed vegetable oils .

    Summary

    Monounsaturated and polyunsaturated fats can decrease blood triglyceride levels, especially when theyre consumed in place of other fats.

    Causes Of High Triglycerides

    In many cases, habitual overeating causes high triglycerides. Occasionally, the trigger is an underlying condition such as:

    • Excessive alcohol consumption
    • Some types of liver disease
    • Some types of kidney disease
    • Some genetic disorders, including the inherited disease familial hypertriglyceridemia and familial combined hyperlipidemia .

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    What Can You Do At Home To Treat High Triglycerides

    The main way to deal with high triglycerides is to eat better and get more exercise. Here are some guidelines to help you manage your level:

    Moderate exercise: Try to exercise 5 or more days each week. Lack of movement makes it hard for your body to process blood sugar and triglycerides as it normally does. So itâs important for you to get up and get moving more each day. Skip the escalator or elevator and climb stairs. Get off the bus or subway one stop early and walk. Find activities you enjoy: Walk, swim, or ride a bike. Join a gym. Talk to your doctor before you begin any exercise plan.

    Watch your weight: If youâre carrying extra pounds, losing 5% to 10% of your weight can lower triglycerides. People with a healthy weight are more likely to have normal levels. Belly fat is associated with higher numbers.

    Eat less bad fat and carbs: Try to lower the saturated fat, trans fat, and cholesterol in your diet. Cutting back on carbohydrates will help, too. Foods high in saturated fat, such as red meat, boost levels. Butter and cheese contain these same triglyceride-boosting fats. Choose lean meats or protein alternatives, such as chicken and unprocessed turkey, that are lower in saturated fat.

    Another healthy option: Make meatless meals. Vegetarian pastas, chilis, and stir-fries are a delicious alternative to meat dishes. Avoid dishes loaded with cream or cheese in favor of recipes that use vegetable or olive oil and feature plenty of vegetables.

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