Are There Any Symptoms Associated With A High Level Of Triglycerides
Usually, most people with high triglyceride levels have no symptoms and the only means of discovering a high level is with blood tests. However, in rare cases, a person may have an extremely high level of triglycerides sustained over time and the individual may experience repeated bouts of acute pancreatitis. Some of the signs and symptoms include pain in the upper half of the stomach area that develops suddenly and then gradually gets worse, fever, nausea, vomiting, and sometimes jaundice. A person with severely high levels may also develop lesions on the skin called xanthomas. These typically appear as several small, round, solid, yellow bumps mostly on the back, chest, buttocks, shoulders and thighs.
Possible New Treatment For High Triglycerides
In the report in The New England Journal of Medicine, an international team of researchers describe a new therapy for high triglycerides. It involves a weekly injection of “antisense oligonucleotides” , pieces of DNA that short-circuit the livers production of triglycerides. The new report shows that ASOs can reduce triglyceride levels by as much as 70%.
Keep in mind that this was a phase 2 trial, which is designed to test whether a drug does what it is supposed to do . Larger, longer-term studies will be needed to see whether ASOs actually reduce the risk of heart disease, and what sorts of side effects they cause.
Many experimental medications that sparkle in early testing never become FDA-approved drugs. We wont know for several years whether ASOs will become available for individuals with high triglycerides.
Signs And Symptoms Of Hypertriglyceridemia
Hypertriglyceridemia is usually asymptomatic until triglycerides are greater than 1000-2000 mg/dL. Signs and symptoms may include the following:
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GI: Pain in the mid-epigastric, chest, or back regions nausea, vomiting
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Respiratory: Dyspnea
References
Alexopoulos AS, Qamar A, Hutchins K, Crowley MJ, Batch BC, Guyton JR. Triglycerides: Emerging Targets in Diabetes Care? Review of Moderate Hypertriglyceridemia in Diabetes. Curr Diab Rep. 2019 Feb 26. 19 :13. . .
Wu CW, Lin PY, Liu YF, Liu TC, Lin MW, Chen WM, et al. Central corneal mosaic opacities in Schnyder’s crystalline dystrophy. Ophthalmology. 2005 Apr. 112:650-3. .
FREDRICKSON DS, LEES RS. A SYSTEM FOR PHENOTYPING HYPERLIPOPROTEINEMIA. Circulation. 1965 Mar. 31:321-7. .
Mahley RW, Rall SC Jr. Type III hyperlipoproteinemia : the role of apolipoprotein E in normal and abnormal metabolism. Scriver CR, Beaudet AR, Sly WS, Valle D, eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. New York: McGraw-Hill 2001. 2835-62.
Kane JP. Structure and function of the plasma lipoproteins and their receptors. Fuster V, Ross R, Topol EJ, eds. Atherosclerosis and Coronary Artery Disease. Philadelphia, Pa: Lippincott-Raven 89-103. 1996: .
Mahley RW, Huang Y, Rall SC Jr. Pathogenesis of type III hyperlipoproteinemia . Questions, quandaries, and paradoxes. J Lipid Res. 1999 Nov. 40:1933-49. .
Feussner G, Piesch S, Dobmeyer J, Fischer C. Genetics of type III hyperlipoproteinemia. Genet Epidemiol. 1997. 14:283-97. .
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What Can I Do To Lower Triglycerides
High triglycerides put you at increased risk of heart attack and stroke. It is especially important to work towards lowering triglycerides if you have other risk factors for cardiovascular diseases, such as high blood pressure, diabetes, heart disease, or smoking.
Many of the steps that can help bring down triglyceride levels are also steps that can protect your heart and improve your overall health. These include:
- Losing weight if you’re overweight .
- Getting regular aerobic exercise .
- Eating a healthy diet with plenty of fresh fruits, vegetables, whole grains, low-fat or fat-free dairy products, healthy oils like olive oil, and lean meats, including poultry.
- Limiting the amount of saturated fat and trans fat in your diet.
- Keeping alcohol intake to none or moderate.
- Stopping smoking.
My Approach To Triglyceride Levels In Specific Patient Scenarios
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What Strategies Can Be Used To Lower Triglyceride Levels
For many people, high triglycerides are caused by another disorder, such as diabetes, obesity, renal failure, or alcoholism. With these conditions, the strategy is to treat the primary cause. When high triglycerides are not caused by another disorder, they are often seen together with high cholesterol and treatment is directed toward lowering both cholesterol and triglycerides. Lifestyle changes, such as a healthy diet and increased exercise, are usually the primary strategy for lowering levels. If these fail, lipid-lowering medications such as statins are generally recommended. For more on this, visit the American Heart Associationâs webpage on Healthy Living.
What You Can Do
Many of the steps you should take to lower triglycerides are the same ones you should take to protect your heart and health overall.
If you’re overweight, shed a few pounds. Get regular aerobic exercise . Limit the saturated fats in meat and dairy products. Watch your alcohol intake, even moderate drinking ramps up triglyceride levels. And diet? High-carb/low-fat eating will increase your triglycerides and lower your HDL.
If you’re taking a statin to lower your LDL, one side benefit may be reduced triglyceride levels. Depending on the dose, statins can lower triglycerides by 20%40%.
The omega-3 fats in fish and capsules are another triglyceride-lowering option. For a very high triglyceride level, your doctor can prescribe a high-dose omega-3 medication.
Image: udra/Getty Images
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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
What Are The Symptoms Of High Triglyceride Levels
High triglycerides do not typically cause any symptoms. They are usually diagnosed by a blood test. Symptoms often appear after the increased triglycerides have caused significant damage. For instance, a person may develop heart disease due to high triglycerides and suffer symptoms like angina , shortness of breath, dizziness, sweating, nausea, and fatigue.
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When Is It Ordered
Adults
A lipid profile, which includes triglycerides, is recommended every 4 to 6 years to evaluate risk of heart disease in healthy adults. Children should have a lipid profile screening at least once between the ages of 9 and 11 and once again between the ages of 17 and 21.
Testing may be ordered more frequently when people have identified risk factors for heart disease. Some risk factors for heart disease include:
- Cigarette smoking
- Acceptable: Less than 90 mg/dL
- Borderline high: 90-129 mg/dL
- High: Greater than 130 mg/dL
For young adults older than 19
- Acceptable: Less than 115 mg/dL
- Borderline high: 115-149 mg/dL
- High: Greater than 150 mg/dL
Note: These values are based on fasting triglyceride levels.
When triglycerides are very high ), there is a risk of developing pancreatitis in children and adults. Treatment to lower triglycerides should be started as soon as possible.
Patients With Very High Triglycerides And Treatment With Omega
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The prevalence of hypertriglyceridemia has increased several-fold over the past few decades, mostly as a result of the concomitant obesity epidemic.1,2 The categorization of hypertriglyceridemia as endorsed by the 2013 American College of Cardiology /American Heart Association cholesterol guidelines3 and the AHA scientific statement on triglycerides and cardiovascular disease4 is summarized in Table 1. Approximately 40 million adults in the United States have hypertriglyceridemia, and ~4 million have very high triglycerides .5 Indeed, VHTG is more common than numerically analogous increases in total cholesterol levels.6
Table 1: Categorization of Hypertriglyceridemia
|
Triglyceride Range |
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Very high |
The most alarming untoward effect of VHTG is hypertriglyceridemia-associated pancreatitis.7 Risk of hypertriglyceridemia-associated pancreatitis is more clearly defined at higher TG levels, and is approximately 5 percent with TG > 1,000 mg/dL and 10 to 20 percent with TG > 2,000 m/dL. TG-lowering therapy is recommended in patients with VHTG based on the observation that hypertriglyceridemia-associated pancreatitis tends to be more severe than other etiologies of pancreatitis.8-10 At least three different studies have demonstrated the cost effectiveness of such an approach.11-13
Table 2: Prescription Omega-3 Fatty Acid Formulations
|
Formulation |
|
|
Contains EPA and DHA free fatty acids |
55% EPA, 20% DHA |
References
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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.
When To Contact A Doctor
While high triglyceride levels typically do not cause symptoms, anyone concerned they may have high triglyceride or cholesterol levels should contact their doctor.
A doctor would usually measure triglyceride and cholesterol levels at the same time as high levels of either may contribute to heart conditions.
Doctors may recommend drug therapies in some cases. This may happen if a person has dangerously high triglyceride levels that need to come down quickly or if their levels do not respond to lifestyle and dietary changes.
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What To Do If Your Triglycerides Are Over 1000
Hello Anon
Thank you for writing!
Triglycerides are a type of lipid in your blood that is created from food you eat. If the calories arent needed right away, they are converted into triglycerides and stored in your fat cells to be used as energy at a later time.
There are no symptoms of high triglycerides , so its important to get blood levels checked periodically to make sure your levels are in the healthy range. Unchecked, high triglycerides can contribute to clogging of the arteries , and heart problems such as stroke, heart attack, and heart disease.
Talk with your doctor to learn positive ways to control high triglyceride levels. Some things you may talk about with your doctor might include:
1.How is my triglyceride level determined?When your doctor checks your blood as part of a physical examination, he or she likely will check your cholesterol levels. There are a few different types of cholesterol that are checked, HDL cholesterol, LDL cholesterol, triglycerides, and total cholesterol levels. You may have normal cholesterol levels, and still have a high triglyceride level.
2.How is a triglyceride problem treated?Initially, your doctor will instruct you to try and make lifestyle changes such as improving your diet and exercise activity to try and bring the triglyceride level down to a more normal level.
I hope this helps-
Inflammation Infection And Autoimmunity
In some cases, high triglycerides may be caused by inflammation and infection.
People with infections and chronic inflammatory and autoimmune diseases such as rheumatoid arthritis, lupus, and psoriasis often have high triglycerides and low HDL. These disease-triggered changes initially serve to dampen inflammation or fight infection, but they increase the risk of heart disease in the long run .
For example, untreated gum disease increases blood triglycerides. People with chronic gum inflammation are continually exposed to bacteria, which disrupt immune and lipid balance in the body .
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Is Any Test Preparation Needed To Ensure The Quality Of The Sample
Current standards recommend that testing be done when you are fasting. For 9 to 12 hours before the test, only water is permitted. Your health care practitioner may decide that you may be tested without fasting. Follow any instructions you are given and tell the person drawing your blood whether or not you have fasted. In addition, alcohol should not be consumed for 24 hours just before the test.
What Are The Health Risks Of Having High Triglyceride Levels
High triglycerides are one of the signs of metabolic syndrome, a collection of conditions that significantly increase the risk of heart attack and stroke. Other conditions that are also signs of metabolic syndrome in addition to high triglycerides are high blood pressure, high blood sugar, low HDL cholesterol levels, and abdominal obesity.
Extremely high levels of triglycerides can cause acute pancreatitis.
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Look At Your Prescription Meds
A bunch of different drugs can potentially raise triglyceride levels, including oral estrogen, corticosteroids, and antipsychotic drugs.
If your numbers recently measured high, be sure to review any prescription drugs you might be taking with your doctor. If one of your meds is the culprit, you can talk figure out a plan for protecting your heart health.
Controlling High Triglycerides: Medical Treatment
People with heart disease and high triglycerides may need medication to bring down their levels.
- Fibrates can lower triglycerides. They modestly improve cholesterol levels, too.
- Fish oilwith omega-3 fatty acids can help keep triglycerides under control. Ask your doctor whether you should use prescription fish oil. Omega-3 acids from plant sources like flaxseed may help.
- Niacin can lower triglycerides by up to 50%. It’s available as a non-prescription supplement and as a prescription drug.
Remember that to stay healthy and keep your triglycerides down, you still have to focus on improving your lifestyle.
When you talk to your doctor, discuss all of the medicines, supplements, and vitamins you take. Some common drugs — like beta-blockers, birth control pills, and diuretics — can cause high triglycerides as a side effect. It’s possible that one of them could be causing your problem.
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Parameters To Be Tested
Besides total cholesterol, TG, HDL-cholesterol, and LDL-cholesterol, the lipid profile should include the calculated non-HDL-cholesterol concentration . In addition to elevated TG, patients with hypertriglyceridemia typically have increased total cholesterol, decreased HDL-cholesterol, and normal to low LDL-cholesterol levels. The increase in total cholesterol is explained by the fact that all triglyceride-rich lipoproteins also contain cholesterol, which then raises the total cholesterol level. The parameter non-HDL-cholesterol specifies the amount of cholesterol associated with triglyceride-rich lipoproteins . The advantage of determining non-HDL-cholesterol is that the concentration of all atherogenic lipoproteins can be estimated by measuring one single parameter. The level of non-HDL-cholesterol is more closely correlated with adverse cardiovascular events than that of TG as it also includes LDL-cholesterol. Furthermore, atherogenicity increases with rising TG levels only if more lipoproteins are present, not when existing lipoproteins are loaded with additional TG . Here, the concentration of remnant cholesterol islike the concentration of apolipoprotein Bsuperior to TG concentration as a marker for the amount of abnormal lipoproteins .
How Often Should My Triglycerides Be Tested
If youâre a healthy adult, you should get a lipid profile every 4-6 years. Children should have it done at least once between the ages of 9 and 11, and one more time between 17 and 21. If youâre making changes to your diet or taking medication for high cholesterol or triglycerides, experts advise you to get a lipid profile afterward.
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What Are Normal Triglyceride Levels
Normal levels of triglycerides are as follows:
- Optimal: Under 90 mg/dL
- Normal: Under 150 mg/dL
- Borderline High: 150 to 200 mg/dL
- High: 200 to 500 mg/dL
- Very High: 500 mg/dL or higher
White people tend to have higher triglyceride levels than Black people. Men tend to have higher triglyceride levels than women.
Eat Less To Lose Weight
High triglycerides come from regularly eating more calories than your body burns, so eating less overall is one of the best ways to start reining them in.
How much less, exactly? You may want to cut back by 500 to 1,000 calories a day, depending on how many calories youre consuming. Thats enough to help you lose weight, which is key.
Dropping 5 to 10 percent of your body weight is enough to reduce your triglycerides significantly. But definitely get the OK from your doctor before making any major changes to your diet.
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