Why do high triglycerides matter?
Although it's unclear how, high triglycerides may contribute to hardening of the arteries or thickening of the artery walls (atherosclerosis) — which increases the risk of stroke, heart attack and heart disease.
High triglycerides are often a sign of other conditions that increase the risk of heart disease and stroke as well, including obesity and metabolic syndrome — a cluster of conditions that includes too much fat around the waist, high blood pressure, high triglycerides, high blood sugar and abnormal cholesterol levels.
Sometimes high triglycerides are a sign of poorly controlled type 2 diabetes, low levels of thyroid hormones (hypothyroidism), liver or kidney disease, or rare genetic conditions that affect how your body converts fat to energy. High triglycerides could also be a side effect of taking medications such as beta blockers, birth control pills, diuretics, steroids or the breast cancer drug tamoxifen.
What's the best way to lower triglycerides?
Healthy lifestyle choices are key.
- Lose weight. If you're overweight, losing 5 to 10 pounds can help lower your triglycerides. Motivate yourself by focusing on the benefits of losing weight, such as more energy and improved health.
- Cut back on calories. Remember that extra calories are converted to triglycerides and stored as fat. Reducing your calories will reduce triglycerides.
- Avoid sugary and refined foods. Simple carbohydrates, such as sugar and foods made with white flour, can increase triglycerides.
- Limit the cholesterol in your diet. Aim for no more than 300 milligrams (mg) of cholesterol a day — or less than 200 mg if you have heart disease. Avoid the most concentrated sources of cholesterol, including meats high in saturated fat, egg yolks and whole milk products.
- Choose healthier fats. Trade saturated fat found in meats for healthier monounsaturated fat found in plants, such as olive, peanut and canola oils. Substitute fish high in omega-3 fatty acids — such as mackerel and salmon — for red meat.
- Eliminate trans fat. Trans fat can be found in some fried foods and commercial baked products, such as cookies, crackers and snack cakes. But don't rely on packages that label their foods as free of trans fat. In the United States, if a food contains less than 0.5 grams of trans fat a serving, it can be labeled trans fat-free. Even though those amounts seem small, they can add up quickly if you eat a lot of foods containing small amounts of trans fat. Instead, read the ingredients list. You can tell that a food has trans fat in it if it contains partially hydrogenated oil.
- Limit how much alcohol you drink. Alcohol is high in calories and sugar and has a particularly potent effect on triglycerides. Even small amounts of alcohol can raise triglyceride levels.
- Exercise regularly. Aim for at least 30 minutes of physical activity on most or all days of the week. Regular exercise can boost "good" cholesterol while lowering "bad" cholesterol and triglycerides. Take a brisk daily walk, swim laps or join an exercise group. If you don't have time to exercise for 30 minutes, try squeezing it in 10 minutes at a time. Take a short walk, climb the stairs at work, or try some situps or pushups as you watch television.
It's also important to control diabetes and high blood pressure if you have high triglycerides and one of these conditions.
What about medication?
If healthy lifestyle changes aren't enough to control high triglycerides, your doctor may recommend medications that can help further lower your triglycerides. Usually, the focus of therapy is to lower high levels of the "bad" cholesterol (LDL cholesterol), before addressing high triglyceride levels. Medications to treat high cholesterol include:
- Niacin. Niacin, sometimes called nicotinic acid, can lower your triglycerides and your "bad" cholesterol (low-density lipoprotein, or LDL, cholesterol). Your doctor may prescribe a niacin supplement, such as Niaspan. Don't take over-the-counter niacin without talking to your doctor first. Niacin can interact with other medications and can cause dangerous side effects if you overdose.
- Fibrates. Fibrate medications, such as fenofibrate (Lofibra, TriCor) and gemfibrozil (Lopid), also can lower your triglyceride levels.
- Statins. If you also have low high-density lipoprotein (HDL, or "good") cholesterol or high low-density lipoprotein (LDL, or "bad") cholesterol, your doctor may prescribe cholesterol-lowering statins or a combination of a statin and niacin or fibrates. Because of the risk of side effects from statins, be sure to tell your doctor if you experience any muscle pain, nausea, diarrhea or constipation.
- Omega-3 fatty acid supplements. Omega-3 fatty acid supplements can help lower your cholesterol. You can take over-the-counter supplements, or your doctor may prescribe a prescription omega-3 fatty acid supplement (Lovaza, Vascepa), as a way to lower your triglycerides. These prescription supplements may be taken with another cholesterol-lowering medication, such as a statin. If you choose to take over-the-counter supplements, get your doctor's OK first. Omega-3 fatty acid supplements could affect other medications you're taking.
If your doctor prescribes medication to lower your triglycerides, take the medication as prescribed. And remember the significance of the healthy lifestyle changes you've made. Medications can help — but lifestyle matters, too.
Sept. 28, 2012
See more In-depth
- Triglycerides. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Triglycerides_UCM_306029_Article.jsp. Accessed July 26, 2012.
- Facts about triglyceride. Institute on Clinical Systems Improvement (ICSI). http://www.icsi.org/cardiovascular_8490/facts_about_triglyceride_.html. Accessed July 26, 2012.
- Third report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): Executive summary. National Cholesterol Education Program. http://www.nhlbi.nih.gov/guidelines/cholesterol/atp_iii.htm. Accessed July 26, 2012.
- Arsenault BJ, et al. Beyond low-density lipoprotein cholesterol: Respective contributions of non-high-density lipoprotein cholesterol levels, triglycerides, and the total cholesterol/high-density lipoprotein cholesterol ratio to coronary heart disease risk in apparently healthy men and women. Journal of the American College of Cardiology. 2009;55:35.
- Faergeman O, et al. Plasma triglycerides and cardiovascular events in the treating to new targets and incremental decrease in end-points through aggressive lipid lowering trials of statins in patients with coronary artery disease. American Journal of Cardiology. 2009;104:459.
- Koski RR. Omega-3-acid ethyl esters (Lovaza) for severe hypertriglyceridemia. Pharmacy and Therapeutics. 2008;33:271.
- Welsh JA, et al. Caloric sweetener consumption and dyslipidemia among US adults. Journal of the American Medical Association. 2010;303:1490.
- Miller M, et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2011;123:2292.
- Vascepa (prescribing information). Dublin, Ireland: Amarin Corp., 2012. http://www.vascepa.com/. Accessed Aug. 22, 2012.