Taking Medications To Lower Triglycerides
Summary
However, most medications and even supplements can come with significant side effects. Always ask your doctor before starting any new supplements or medications.
In addition to supplements, several studies show certain medications may reduce triglycerides. Recommendations to take medications focus on reducing the risk of pancreatitis as well as heart disease.
The evidence to support the idea that lowering triglycerides with medications can provide cardiac protection is mixed. Many isolated studies show no benefits, but a meta-analysis of multiple studies suggests minor benefits.42
Ask your doctor if any of these medications may be right for you:
Statins The most commonly prescribed class of cholesterol-lowering drugs has a mild triglyceride-lowering effect ranging from 10% reduction at low doses to 30% at higher doses.43
Fibrates Drugs such as gemfibrozil can lower triglycerides by 30-50%.44 These drugs should be used with caution when taken along with statins or warfarin due to drug interactions. Those with a history of gallstone disease should not take fibrates.
Although fibrates do lower triglycerides, it is not clear that they reduce cardiac events or the risk of death.
Prescription niacin Niacin can reduce triglycerides by up to 30%.45 Niacin may cause liver disease, and may worsen insulin resistance or blood sugar control in those with type 2 diabetes. Those with peptic ulcer disease should not take niacin.
Dos And Donts In Managing High Triglycerides:
- DO exercise regularly.
- DO eat more fruits and vegetables and high-fiber foods such as oat bran. Cook with monounsaturated fatsolive, peanut, and canola oils.
- DO stop smoking.
- DO lose weight by changing your diet and doing aerobic exercise, such as walking, jogging, bicycling, or swimming. Exercise at least 30 minutes daily.
- DONT forget to treat other medical conditions such as diabetes and underactive thyroid.
- DONT drink more than two alcoholic drinks per day.
- DONT change your diet or medicines without your doctors approval.
Medications Can Lower Ldl And Triglycerides
To get cholesterol and triglycerides into the target zone, many people with diabetes need to add medications to their healthy eating and exercise plans. Reducing elevated LDL cholesterol is typically the top priority. To achieve the target goals, many people need to take a medication in the statin category.
The American Diabetes Association recommends that statin therapy be added for people who have:
- a lower risk of cardiovascular disease and whose LDL cholesterol doesn’t hit the target of 100 mg/dl or less with healthy lifestyle change.
- cardiovascular disease and who don’t reach the LDL cholesterol target of 70 mg/dl or less.
Statin medications are most effective at lowering LDL cholesterol. All medications should be prescribed and monitored by a health care provider.
Common statins include:
Other medications that lower both LDL cholesterol and triglycerides:
- Prescription-strength niacin
Other medications prescribed to lower LDL cholesterol:
- Bile acid sequestrants, such as Questran or Colestid
- Welchol , a bile acid sequestrant that can also lower blood glucose
Other medications prescribed to lower triglycerides:
- Prescription-strength fish-oil pills
Other medications to lower cholesterol and blood pressure:
Medications that have been found to increase triglycerides:
- Birth-control pills
- Tamoxifen, a breast cancer drug
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Are High Triglycerides A Common Problem
Experts recommend you keep your triglycerides below 150 milligrams per deciliter. About one-quarter of the people in the United States have high triglycerides. These numbers have declined since 2001, probably because more people take statin drugs and fewer people smoke cigarettes.
The U.S. FDA’s ban on trans fats in food could be another reason triglyceride levels have dropped among Americans. Trans fats increase the levels of not only LDL cholesterol also called the “bad” cholesterol but also triglycerides.
Even though trans fats may be banned by the FDA, you should choose unsaturated fats over saturated ones.
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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Health Conditions Related To Triglycerides And Cholesterol
High blood lipid levels may increase your risk for plaques to develop in your arteries or thicken the walls of your arteries .
Other health conditions related to high triglycerides or cholesterol include:
- High blood sugar levels or diabetes
- Metabolic syndromea cluster of conditions that increase your risk for heart disease
- Genetic conditions
Eat More Protein & Unsaturated Fats
Compared to a diet high in carbs, diets rich in protein and unsaturated fat reduced triglycerides by about 10 mg/dL in a study of 164 people with high blood pressure .
Diets high in monounsaturated fats, found in olive oil and avocados, decreased triglyceride levels better than a high-carb diet over 7-weeks in 85 people with an increased risk of heart disease. An olive-oil-rich diet also decreased the buildup of triglycerides in the liver .
A diet high in monounsaturated fats and omega-3s decreased triglyceride levels in 17 men with moderately increased triglycerides .
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What Foods Can Help Lower Triglycerides
Now that you know which foods to avoid, what foods can you add into your diet that can help support healthy triglyceride levels? “Foods to emphasize are high fiber vegetables with lower sugar content, such as cruciferous vegetables,” Archibald says. “Including legumes, canned or cooked from their dried versions, will add both fiber and satiety to the plate.”
Adding healthy omega-3 fats can be helpful as well. “Among fats, seek out foods rich in omega-3 fats, which not only act as natural anti-inflammatories in the body but can also prevent the production of triglycerides and cholesterol in the liver,” says Archibald.
Here are 20 foods that can lower triglycerides.
Eat Fatty Fish Twice Weekly
Fatty fish is well known for its benefits on heart health and ability to lower blood triglycerides.
This is mostly due to its content of omega-3 fatty acids, a type of polyunsaturated fatty acid that is considered essential, meaning you need to get it through your diet.
Both the Dietary Guidelines for Americans and American Heart Association recommend eating two servings of fatty fish per week to reduce the risk of heart disease and stroke .
Whats more, one study showed that eating salmon twice a week significantly decreased blood triglyceride concentration .
Salmon, herring, sardines, tuna, and mackerel are a few types of fish that are especially high in omega-3 fatty acids.
Summary
Fatty fish is high in omega-3 fatty acids. Eating two servings per week may lower triglyceride levels and decrease the risk of heart disease.
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Foods That Can Help Lower Triglycerides
The way you prepare food can also have an impact on triglycerides. One approach to lower triglycerides naturally is choosing healthy fats, like extra virgin olive oil, instead of saturated fats, like butter and lard, when its time to fry or saute something to eat.
Adding foods rich in omega 3 fatty acids, like salmon, flax seeds, and chia seeds, can also help. The American Heart Association currently recommends at least 1 gram of omega-3 fatty acids per day.
What Are The Causes And Symptoms Of High Triglycerides
Causes include obesity, eating too much unhealthy food, genetics, certain illnesses including poorly controlled diabetes, kidney disease, and underactive thyroid . Some drugs, such as steroids and birth control pills, and drinking a lot of alcohol can also cause it.
Most people have no symptoms. Very high levels can cause small fat deposits under the skin and a painful inflammation of the pancreas called pancreatitis.
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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.
How To Lower Your Triglycerides Level
Typically, there aren’t any symptoms of high triglycerides. That’s why doctors do a blood test also called a lipid panel or lipid blood test to check your triglyceride levels, along with your cholesterol. The Centers for Disease Control and Prevention recommends that adults have this test done every four to six years, and more frequently if you have a family history of heart disease.
- Less than 150 milligrams per deciliter is a normal level of triglycerides
- Between 150 to 199 mg/dL is considered borderline high
- Between 200 to 499 mg/dL is considered high
- Above 500 mg/dL is considered very high
Obesity, type 2 diabetes, and smoking cigarettes are associated with higher triglycerides, according to the US National Library of Medicine.
Unless a person has very high triglycerides or a history of heart problems, lifestyle changes are the first option to lower triglycerides, says Patel. These include exercising, drinking less alcohol, managing your weight, and dietary changes. For instance, losing 5% to 10% of your weight can lead to a 40 mg/dL reduction in triglycerides, according to a July 2011 study in Diabetes Care.
Medications, such as statins, fibrates, and niacin, can also help lower triglycerides by either preventing your body from making more triglycerides or decreasing the absorption of fat from food, Patel says. If your triglycerides are over 500, then medication is typically prescribed, due to the risk of pancreatitis, according to the Cleveland Clinic.
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Eating Foods With A Low Gi
The glycemic index indicates how much a specific food is likely to increase your blood sugar levels.
For example, oats have a low GI, but white bread has a high GI and is more likely to lead to a big spike in your blood sugar.
Research suggests that eating a low glycemic diet is associated with lower triglycerides.
Increased Risk Of Heart Disease
Medical science consistently demonstrates that people with higher triglycerides have a higher risk of heart disease. That is not surprising since high triglycerides are also correlated with other cardiac risk factors such as insulin resistance, metabolic syndrome, and more atherogenic small LDL particles.49
Observational studies demonstrate the risk of a heart attack triples for those with triglycerides above 265 mg/dL compared to those with lower levels.50
Another study reports an increased risk for statin-treated patients when their triglycerides were above 175 mg/dL .51
Studies comparing the impact of elevated triglycerides on cardiovascular risk suggest it may be equally or more important than high LDL cholesterol.
One study shows genetic mutations that lower triglycerides have an equal benefit for reducing heart disease risk as those that lower LDL.52
Other studies report elevated triglycerides and triglyceride-to-high-density lipoprotein cholesterol ratio are associated with smaller LDL particles and a more advanced coronary disease, whereas elevated LDL cholesterol show no significant correlation.53
Most recently, an evaluation of the PREDIMED trial demonstrates that triglycerides above 150 mg/dL and remnant cholesterol ) have greater predictive power for heart disease risk than does LDL.54
In fact, many trials show no improvement in the risk of heart disease or death.
Could triglyceride-lowering lifestyles have a greater impact than medications?
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What Vitamins And Supplements Help Lower Triglyceride Levels
Fish oil lowers triglycerides. The dose needed to reduce triglycerides is 1 to 4 grams of EPA/DHA per day. Four grams per day has been shown to reduce triglycerides by 25% to 30%. People with the highest triglycerides benefit most. It is worth noting that non-marine omega 3 fatty acids do not appear to lower triglycerides in the same way. The prescription form of synthetic omega-3 fatty acids, Lovasa, Vascepa, or Epanova is approved by the US Food and Drug Administration for people with triglycerides over 500 mg/dL.
Niacin is another supplement for lowering triglycerides. Both regular and extended-release nicotinic acid has been shown to reduce triglycerides by up to 40% . Niacin has the added benefit of increasing HDL and lowering LDL. The high doses of niacin needed to lower triglycerides can cause uncomfortable flushing in some people. To avoid this, niacin can be taken with baby aspirin, with food, or with an extended-release form of niacin/nicotinic acid . Inositol-hexanicotinate, marketed as no-flush niacin, is NOT the same thing and contains very little nicotinic acid.
Fibers, such as chia, flax, psyllium, or bran, help lower triglycerides. Fibrates, a class of cholesterol-lowering drugs that have been used for decades, also have a triglyceride-lowering effect through the same general mechanisms.
There are other supplements with limited research supporting their benefit in hypertriglyceridemia.
Address Underlying Health Issues
Remember, although triglycerides can be high due to bad lifestyle and dietary choices, they can also be high due to an underlying health condition. The most important thing is to work with your doctor to find out whats causing your high triglyceride levels and to treat any underlying conditions!
For example, triglycerides can be high due to liver disease, infections, underactive thyroid , autoimmune disease, or some genetic disorders just to name a few .
In these cases, simply changing your diet or lifestyle wont help address the underlying issue and may actually be harmful!
In addition, high triglyceride levels can be dangerous for your body. If necessary, your doctor will prescribe triglyceride-lowering medication.
Thats why, if your triglycerides are elevated, you should discuss the lifestyle and dietary changes listed below with your doctor. None of these strategies should ever be done in place of what your doctor recommends or prescribes!
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Change Your Diet To Reduce Triglycerides
Follow these dietary guidelines to reduce your triglycerides:
- Choose unsaturated fats Reduce your intake of saturated fats by eating less red meat and less full-fat dairy.
- Reduce total fat intake Get no more than 30 percent of your calories from fat.
- Eat less sugar Cut down on table sugar, syrup, sweets, and sugary drinks.
- Go for complex carbohydrates Substitute whole grains for refined grains like white bread and white rice.
- Cut back on alcohol If you drink, talk to your doctor about safe amounts.
Fishes Rich In Omega 3 Fatty Acids
Omega 3 fatty acids are a blessing to the body to reduce triglyceride and LDL and enhance HDL levels. It is responsible for stabilizing heart health. Several fishes contain omega 3 fatty acids and can lower the triglyceride in the blood. It is advisable to add at least 8 ounces of omega3 fatty acids to the diet thrice a week to stay healthy and lower the triglycerides. The fishes rich in triglycerides are-
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Cut Back On Sugar And Refined Carbs
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.
Increased Risk Of Pancreatitis
Severely elevated triglycerides is the third most common risk factor for pancreatitis but causes only around 4% of all cases. Gallstones and alcoholism are much more common, comprising approximately 70% of all cases.56
Individuals with triglycerides above 1,000 mg/dL have a 5% chance of developing pancreatitis, and that increases to 10 to 20% for levels above 2,000 mg/dL . For reference, the general population risk of pancreatitis is just 0.5%.57
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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.
What Are Triglycerides And Why Are They Important
“Triglycerides are a type of blood lipid and they’re made up of free fatty acids. They’re stored in your body fat, but you’ll also find them in your blood,” says nutritionist Jessica Ash, CNC, HHC, FDN-P and founder of Jessica Ash Wellness. “And because your liver makes them, they’re also found in your liver and then your tissues. Our body gets triglycerides either from the food that you eat or from the body it manufactures triglycerides in the liver.”
“It’s important to know that triglycerides, like cholesterol, are normally protective . But triglycerides are used for energy, whereas cholesterol is used for steroid hormone production,” Ash explains. “And our muscles are specifically what like to uptake fatty acids or triglycerides. So they’re fatty acids that the body usually uses for energy.”
Your body needs energy from food to function. But excess energy, especially from sources like simple carbohydrates, can be stored as triglycerides, which can create issues if your triglyceride levels are elevated above the normal range. According to the Mayo Clinic, if your triglycerides are over 150 mg/dL, then you’re at a greater risk for developing heart disease.
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