Too high triglycerides, how to lower them

When you’re monitoring your blood pressure and cholesterol levels, there’s something else you need to keep an eye on: your triglycerides.
High levels of triglycerides in the blood can increase the risk of heart disease. But a lifestyle that promotes overall health can also help lower triglyceride levels.

What are triglycerides?

Triglycerides are a type of fat (lipid) found in your blood.

When you eat, your body converts calories into triglycerides, which it doesn’t need to use right away. Triglycerides are stored in your fat cells. Later, hormones release triglycerides to provide energy between meals. If you regularly consume more calories than you expend, especially high-carbohydrate foods, you may have high triglyceride levels (hypertriglyceridemia).

What is considered normal?

A simple blood test can show if your triglycerides are in a healthy range:

Normal: Less than 150 milligrams per deciliter (mg/dL) or less than 1.7 millimoles per liter (mmol/L).
Upper limit: 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
High: 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
Very high: 500 mg/dL or more (5.7 mmol/L or more)

Your doctor will usually check for high triglycerides with a cholesterol test, sometimes called a lipid panel or lipid profile. For an accurate triglyceride measurement, you must be fasting before blood is drawn.

What is the difference between triglycerides and cholesterol?

Triglycerides and cholesterol are different types of lipids that circulate in your blood:

– Triglycerides store unused calories and fuel your body.
– Cholesterol is used to build cells and some hormones.

Why is it important to monitor high triglycerides?

High triglycerides can contribute to hardening of the arteries or thickening of their walls (atherosclerosis), which increases the risk of stroke, heart attack and heart disease. Extremely high triglycerides can also cause acute inflammation of the pancreas (pancreatitis). High triglycerides are often a sign of other conditions that increase your risk of heart disease and stroke, including obesity and metabolic syndrome: a range of conditions that include excess fat around the waist, high blood pressure, high triglycerides, high blood sugar, and abnormal cholesterol levels .

High triglycerides can also be a sign of:

– Type 2 diabetes or prediabetes.
– a metabolic syndrome, ie a combination of high blood pressure, obesity and hyperglycemia, which increases the risk of heart disease.
low thyroid hormone levels (hypothyroidism)
– Certain rare genetic diseases that affect the way the body converts fat into energy.

Sometimes high triglycerides are a side effect of taking certain medications, such as:

– diuretics
– Estrogens and progestins
– retinoids
– steroids
– Beta blockers
– Certain immunosuppressants
– Certain HIV medications

What’s the Best Way to Lower Triglycerides?

A healthy lifestyle is important:

– Do sports regularly

Aim for at least 30 minutes of physical activity most, if not all, days of the week. Regular exercise can lower triglycerides and increase “good” cholesterol. Try to incorporate more physical activity into your daily chores – like climbing stairs at work or going for walks during breaks.

– Avoid sugar and refined carbohydrates

Simple carbohydrates like sugar and foods made from white flour or fructose can increase triglycerides.

– Lose weight

If you have mild to moderate hypertriglyceridemia, try cutting calories. The extra calories are converted to triglycerides and stored as fat. By reducing your calories, you reduce triglycerides.

– Choose healthier fats

Replace saturated fats from meat with healthier fats from plants like olive and canola oil. Instead of red meat, try fish rich in omega-3 fatty acids, like mackerel or salmon. Avoid trans fats or foods that contain hydrogenated oils or fats.

There is strong evidence that the unsaturated fats in fish oil can lower triglyceride levels by up to 30%.

– Limit your alcohol consumption

Alcohol is high in calories and sugar and has a particularly strong effect on triglycerides. If you have severe hypertriglyceridemia, avoid drinking alcohol.

And the drugs?

If lifestyle changes aren’t enough to control high triglycerides, your doctor may recommend the following:

statins. These cholesterol-lowering drugs may be recommended if you also have bad cholesterol or a history of clogged arteries or diabetes.

fibrates. Fibrates can lower your triglyceride levels. Fibrates are not used if you have severe kidney or liver disease.

Niacin. Niacin, sometimes called nicotinic acid, can lower triglycerides and low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol. Consult your doctor before taking over-the-counter niacin, as it can interact with other medications and cause significant side effects.

If your doctor prescribes medication to lower your triglycerides, take it as directed. And don’t forget the importance of the changes you’ve made to your lifestyle. Medications can help, but lifestyle also plays a role.

Sources

High blood triglycerides. National Heart, Lung and Blood Institute.

Bonow RO, et al., eds. Risk markers and primary prevention of cardiovascular disease. In: Heart disease Braunwald: A textbook of cardiovascular medicine. 11th ed. Philadelphia, Pennsylvania: Saunders Elsevier; 2019

* Presse Santé strives to convey health knowledge in a language accessible to all. In NO CASE can the information given replace the advice of a doctor.

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