• Home
• Healthy Heart

• Choose text size:
• A
• A
• A

September 7, 2010 | Comments: 1

What to Do About High Triglycerides

If you have high cholesterol, there are clear steps you should take to lower it. But what should you do if your triglycerides are also elevated? 

Assembled by the liver, triglycerides are a type of fat that circulates in the blood. They are also found in the fats we eat, and blood levels rise temporarily after meals. A desirable blood level, measured after fasting, is below 150 mg/dl (milligrams per deciliter of blood). Many experts think this cutoff should be 100. A level between 150 and 200 is defined as borderline-high; 200 to 500 is high; above 500 is considered very high. Along with cholesterol, triglycerides tend to rise as people get older (and heavier); women, especially after menopause, tend to have higher levels than men.  

Whether a high triglyceride level by itself endangers the heart is controversial. But high levels tend to go hand-in-hand with a constellation of other risk factors for heart disease, including low HDL (“good”) cholesterol, increased levels of small dense particles of LDL (“bad”) cholesterol, insulin resistance or diabetes, abdominal obesity, and high blood pressure. Treating these conditions often brings triglycerides down, too. High triglycerides are also associated with kidney disease, hypo­thyroidism, and the use of some medications, including certain diuretics, birth control pills, and cortisone.

What it takes to lower them

If your triglycerides are high, your doctor should screen and treat you for any medical conditions that could be contributing. The good news is that triglycerides are relatively easy to lower. Your doctor may advise one or more of the following: 

• Lifestyle changes include losing weight if you’re overweight and limiting alcohol. Frequent moderate exercise helps with weight loss and may also have a modest effect on triglycerides.

• Dietary changes include cutting down on sugars and other refined carbohydrates, and eating less saturated and trans fats. The same foods that boost blood sugar most (such as sugars and some starchy foods) also boost triglycerides. You don’t need to go on a low-carb diet, but you should eat more “good” carbs, including those in whole grains, beans, and vegetables. Eating more unsaturated fats (in fish, nuts, seeds, and vegetable oils) in place of refined carbs may also help.

• Fish oil, consisting of the omega-3 fatty acids EPA and DHA, lowers triglycerides, at the recommended dose of 2 to 4 grams of EPA/DHA a day. Lovaza is a prescription high-dose fish oil supplement. Don’t take over-the-counter fish oil supplements without talking to your doctor first.

• Drugs that lower triglycerides include statins and fibrates. Thiazolidinediones may also have a triglyceride-lowering effect, especially in people with Type 2 diabetes. Niacin, at high drug-like doses (up to 3 grams daily), lowers triglycerides, too.

Bottom line: If your triglyceride level is high, dietary and lifestyle changes are usually the first steps to take. But if these are not sufficient, or if your level is very high, you will need medical treatment. 

Read more on this topic