What Is The Best Medication For Triglycerides

What Causes High Triglycerides

Aside from consuming a high-fat and/or high-carb diet, other lifestyle factors can contribute to high triglycerides, specifically excess weight, lack of exercise, drinking too much alcohol and smoking. Dr. Malaney adds that it can also be a side effect of certain medications, such as some birth control pills, beta blockers, antipsychotics medications, and corticosteroids.

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.

What Are Triglycerides And What Is Considered A Healthy Level

Triglycerides are sort of like cholesterol: Both are types of fat found in your blood. But while cholesterol is used to make cells and certain hormones, the job of triglycerides is to store unused calories to give your body energy between meals.

Triglycerides get stored after you eat. If you take in any calories that arent needed for energy right away, theyre converted into triglycerides and transferred to your fat cells for later use.

Eating more calories than you need on the reg can lead to high triglycerides over time, which can up your risk for heart disease. Triglycerides are usually measured along with cholesterol, and numbers over 150 mg/dL are usually considered high.

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Effect Of Niacin On Atherosclerosis

Many of the initial niacin therapy imaging studies combined niacin with other drugs and compared these combinations vs. placebo. These studies showed that niacin in combination with other drugs reduced the progression and/or increased the regression of atherosclerosis. However, because of the use of other drugs it is impossible to determine if niacin therapy per se was beneficial .

How Are Fats And Cholesterol Connected In Cats

Fats, including cholesterol, are carried in the blood in complex compounds that also contain protein: so-called lipoproteins.

These include triglycerides, cholesterol and phospholipid linked to apopproteins, which are manufactured in cells of the liver and intestines. Apolipoproteins are synthesized in the liver or in intestinal cells.

There are four major lipoprotein classes in cats, as follows:

Chylomicrons and Very low density lipoproteins carry triglycerides in the blood

Low density lipoproteins and High density lipoproteins carry cholesterol in the blood. In cats, HDL outnumbers LDL by 5:1, while in humans, LDL is the main carrier of cholesterol.

Many humans are aware of these abbreviations from their own blood test results, but its important to remember that the significance of abnormal levels is very different in humans compared to cats.

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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.

Treatment Of High Triglycerides

The goal of treatment for individuals with hypertriglyceridemia is to protect the heart and reduce the risk of pancreatitis.

The best treatment approach for managing high triglycerides will vary for each patient. For mild cases, lifestyle modifications such as dietary changes and incorporating regular exercise may be enough to get triglycerides down to a healthy level. Your doctor may recommend special dietary modifications, such as lowering your carbohydrate intake and increasing fiber. Exercising regularly can also help to burn fat and lower triglyceride levels.

If lifestyle modifications alone arent enough to lower triglyceride levels, your doctor may recommend that you take medications. Common medications for hypertriglyceridemia include statins, fibrates, niacin and fish oil.

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Lifestyle Factors To Maintain Heart Health

Taking steps to improve your cardiac health is an action that you will never regret. The heart serves as a vital role in the overall function of the body. When it comes to learning how to strengthen your heart and maintaining heart health, you can talk with your doctor about recommended methods or try any of the following:

• Practice regular cardiovascular exercise such as walking, running or using an elliptical.
• Swap out the potato chips for heart-healthy snacks like fresh fruit, nuts or whole grain crackers.
• Maintain a healthy weight and work to lose any excess weight.
• Practice proper stress management and self care.
• Avoid smoking and excessive alcohol usage.
• Maintain a healthy blood pressure.
• Keep cholesterol levels under control.
• Visit your cardiologist regularly to have blood levels checked and heart health monitored.

Unfortunately, heart disease of all kinds is on the rise in todays society, so taking steps to maintain your heart health is more important now than ever before.

Uses For Tricor Tablets1

• TriCor should only be used when other measures, such as diet and exercise, have not been enough.
• TriCor is a prescription medicine used along with diet in adults to lower triglycerides, total cholesterol, and LDL cholesterol, and to increase HDL cholesterol.
• TriCor is also used along with diet in adults to lower severely high triglycerides. Improving blood sugar control in certain people with diabetes may prevent the need for cholesterol drug therapy.
• TriCor was not shown to reduce the risk of having heart problems in patients with type 2 diabetes.

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Effect Of Low Dose Omega

Initial studies of the effect of fish oil administration on cardiovascular outcomes were favorable, demonstrating a reduction in events including all-cause mortality. However, more recent studies have failed to confirm these favorable results. In these more recent studies the use of other drugs, such as statins, that reduce cardiovascular disease were more intensively utilized. The outcomes studies that will be described below were carried out with doses of EPA and DHA that are lower than the doses used to lower plasma TGs. We will limit our discussion to the administration of fish oil as a drug and not discuss diet studies, such as DART, which had patients increase fatty fish intake .

The above results indicate that low dose fish oil do not significantly and consistently reduce the risk of cardiovascular disease.

Garlic And Lemon Juice

2016 study , garlic and lemon juice may be effective at lowering cholesterol.

The study looked at people with moderately high cholesterol levels. It found that people who consumed 20 grams of garlic with 1 tablespoon of lemon juice per day experienced a significant decrease in their LDL and total cholesterol levels compared with those who did not have garlic and lemon juice.

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Acute Pancreatitis Associated With Significant Hypertriglyceridemia: A Special Situation

Treatment of acute pancreatitis in patients with massive hypertriglyceridemia comprises strict fasting and intravenous fluid replacement as basic measures. Whether plasmapheresis is indicated has to be decided on a case-by-case basis. With this approach TG levels can be lowered rapidly, which may interrupt the underlying pathomechanism so that the pancreatitis takes a milder course . However, there are no randomized studies on this topic . Moreover, a recent analysis showed that TG levels decline quickly without plasmapheresis . Furthermore, patients with acute pancreatitis frequently present with various triggering factors , making it difficult to distinguish the role played by hypertriglyceridemia from those of other factors. In addition, plasmapheresis is not suitable as a long-term treatment in patients with hypertriglyceridemia because TG levels quickly rebound after hemofiltration.

Patients with FCS in whom hypertriglyceridemia is apparently a key factor in the pathogenesis of acute pancreatitis should immediately be treated with plasmapheresis. In the long term, a diet change from standard fats to medium-chain TG may be beneficial, as MCTs are metabolized independent of chylomicrons and do not result in an increase in TG levels after a meal . This is all the more relevant when women with hereditary disorders such as FCS become pregnant, as estrogens can trigger a significant increase in TG levels .

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How Do Fibrate Drugs Work

Fibrates reduce the amount of very-low-density lipoprotein your liver makes. VLDL particles carry triglycerides to other parts of your body. By limiting how much VLDL your body makes, these medicines lower your triglyceride levels.

Fibrate drugs also increase the amount of apolipoproteins A-I and A-II your liver makes. These two proteins help create HDL cholesterol. Creating more of these proteins increases your HDL cholesterol levels.

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How Quickly Can I Lower My Cholesterol

Your cholesterol levels may lower as quickly as a few weeks to a few months, depending on your treatment plan.

If your levels are very high, your healthcare provider may recommend taking medications at the start of your treatment plan. This may help lower your cholesterol levels more quickly. The sooner you can lower your bad cholesterol levels, the sooner you can lower your risk for plaques to form.

You can also lower your cholesterol through lifestyle and diet changes alone, but it may take three to six months to see results. Talk with your healthcare provider to figure out the best treatment plan for you.

How Can I Prevent Hypertriglyceridemia

Some causes are out of your control . But theres still a lot you can do in your daily life to prevent hypertriglyceridemia. Here are some steps you can take to help keep your numbers in the healthy range:

• Reduce sugar and refined carbohydrates.

Ask your healthcare provider for resources to help you manage your triglycerides.

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Do I Need Cholesterol Medication

• Moving your body for 30 minutes each day. Exercise can help raise HDL cholesterol and lower LDL cholesterol, especially for anyone who is overweight.
• Quitting smoking. Smoking raises LDL cholesterol and lowers HDL cholesterol, especially in women.

When lifestyle changes arent enough to control your cholesterol, medication can be an option.

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What Is The Best Treatment For Hypertriglyceridemia

Hypertriglyceridemia treatment includes:

• Managing underlying causes of your high triglycerides.

You may need one or more of these approaches. Your provider will recommend the best treatment plan for you.

Lifestyle changes to lower your triglycerides

In general, treatment begins with lifestyle changes. Guidelines include:

Managing underlying causes of hypertriglyceridemia

Your healthcare provider will work with you to manage underlying causes. The goal is to make adjustments thatll help your triglycerides return to a normal level. You may need new medications to manage a medical condition. Or you may need changes to your current drug regimen. Ask your provider if you have questions or concerns about your treatment plan.

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Microscopic Testing Of Feces

Microscopic testing for fats is performed to identify the amount of fat present in feces. Using a microscopic exam, the laboratory professional is able to determine the number and size of fat droplets present in feces, as well as the type of fats present. The types of fats in feces include triglycerides, fatty acids, and fatty acid salts. The presence of fat in the stool is called steatorrhea, a possible sign or symptom of serious malabsorption syndromes and diseases such as celiac sprue and cystic fibrosis. Triglycerides 1-5 Fatty acids 5-15

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Mechanism Accounting For The Lomitapide Induced Lipid Effects

Lomitapide is a selective inhibitor of microsomal triglyceride transfer protein . MTP is located in the endoplasmic reticulum of hepatocytes and enterocytes where it plays a key role in transferring triglycerides onto newly synthesized apolipoprotein B leading to the formation of VLDL and chylomicrons . Loss of function mutations in both alleles of MTP results in abetalipoproteinemia, which is characterized by the virtual absence of apolipoprotein B, VLDL, chylomicrons, and LDL in the plasma due to the failure of the liver and intestine to produce VLDL and chylomicrons . Lomitapide by inhibiting MTP activity reduces the secretion of chylomicrons by the intestine and VLDL by the liver leading to a decrease in LDL, apolipoprotein B, triglycerides, non-HDL-C, and Lp .

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Effect Of Pcsk Inhibitors On Lipid And Lipoprotein Levels

There are a large number of studies that have examined the effect of PCSK9 inhibitors on lipid and lipoprotein levels. A meta-analysis of 24 studies comprising 10,159 patients reported a reduction in LDL-C levels of approximately 50% and in an increase in HDL of 5-8% . Notably, in 12 RCTs with 6,566 patients, Lp levels were reduced by 25-30% . The higher the baseline Lp the greater the reduction with treatment . It should be recognized that most LDL-C lowering drugs do not lower Lp levels. PCSK9 inhibitors have not been shown to decrease hs-CRP levels .

MONOTHERAPY

Both alirocumab and evolocumab have been studied as monotherapy vs. ezetimibe. In the Mendel-2 study patients were randomly assigned to evolocumab, placebo, or ezetimibe . In the evolocumab group, LDL-C levels decreased by 57% while in the ezetimibe group LDL-C levels decreased by 18% compared to placebo. Additionally, non-HDL-C was decreased by 49%, apolipoprotein B by 47%, triglycerides by 5.3% , and Lp by 18.5% while HDL levels increased by 5.5% in the evolocumab treated subjects. In a study of alirocumab vs. ezetimibe, LDL-C levels were reduced by 47% in the alirocumab group and 16% in the ezetimibe group . In addition, alirocumab decreased non-HDL-C by 41%, apolipoprotein B by 37%, triglycerides by 12%, and Lp by 17% and increased HDL by 6%. Thus, PCSK9 monoclonal antibodies are very effective in lowering pro-atherogenic lipoproteins when used in monotherapy and have a more robust effect than ezetimibe.

What Causes Levels To Fluctuate

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.

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Drugs To Lower Triglycerides In Type 1 Diabetes

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When And Why Triglyceride Levels Should Be Treated

Triglyceride levels are only part of the picture of cardiovascular disease risk, and whats normal can depend on your individual health factors. That said, according to the U.S. National Library of Medicine, triglyceride guidelines are defined as:

• Normal: Less than 150 mg/dL
• Borderline high: 150 mg/dL to 199 mg/dL
• High: 200 to 499 mg/dL
• Very high: 500 mg/dL and above

If you are in a category above normal, your doctor will likely recommend lifestyle changes and possibly discuss medications to normalize your levels and reduce your risk of cardiovascular disease. High triglycerides seem to create some increased levels of cardiovascular risk similar to LDL cholesterol, says Andrew Freeman, MD, a cardiologist at National Jewish Health in Denver. Triglycerides can play a role in the development of atherosclerosis, or the buildup of plaque in arteries that restricts blood flow and is associated with coronary heart disease, angina, and peripheral artery disease, says the AHA.

According to Mayo Clinic, high triglycerides can often be a sign of other conditions that raise your cardiovascular disease risk, such as obesity and metabolic syndrome, which is defined as having at least three out of a group of conditions: excess abdominal fat, high blood pressure, elevated blood sugar, reduced HDL cholesterol, and, of course, high triglycerides. Extremely high triglycerides can lead to pancreatitis, or inflammation of the pancreas.

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