Thursday, May 19, 2011

What if my triglycerides are high?

Clogged artery. Source: Wikimedia

Triglycerides are often measured alongside cholesterol on lipid panels. Like cholesterol, triglycerides are a type of lipid stored in the body and circulated in the blood in the form of lipoproteins. “Bad” diets high in calories or containing too many carbohydrates or fats increase triglyceride levels. 

Triglycerides in the body

Extra calories that are not used right away for energy are converted to triglycerides, which are stored in fat cells. “Bad” diets high in calories or containing too many carbohydrates or fats increase triglyceride levels. The normal level of triglycerides in the blood is currently accepted to be less than 150 mg/dL in the United States, equivalent to 1.7 mmol/L in Canada and Europe, but the exact range may vary by age and sex. A higher than normal triglyceride level is not a disorder on its own, but it is a risk factor that should be addressed to avoid health issues.

High triglyceride levels

Triglyceride levels up to 200 mg/dL are considered borderline high, and more than 200 mg/dL are high. As explained by the American Heart Association, individuals with heart disease or diabetes tend to have higher than normal triglyceride levels, as well as individuals who are overweight or obese, physically inactive, smoke cigarettes, excessively consume alcohol, and eat a diet consisting of 60 percent or more carbohydrates. When combined with high cholesterol, the triglyceride levels can speed up the development of atherosclerosis, which increases a person’s risk for heart attack and stroke. Even borderline high levels are a risk factor for metabolic syndrome, which increases the risk of heart disease and diabetes. Peripheral artery disease is also a concern.

High triglycerides are considered a lifestyle-related risk factor and can be manipulated by diet and exercise, as well as abstaining from tobacco use and limiting alcohol consumption. Avoiding high-sugar foods is also recommended by the AHA. Lowering cholesterol and avoiding foods high in cholesterol can also aid in reducing triglyceride levels. Omega-3 fatty acids (found in fish) can help reduce total lipids.

Very high triglyceride levels

Triglyceride levels higher than 500 mg/dL are considered very high. In addition to the problems associated with high levels, very high levels may lead to complications such as accumulation of fat in the liver (fatty liver disease) and inflammation of the pancreas (pancreatitis). Medication may be used to lower the triglyceride levels when lifestyle changes are not enough. Common medications include fibrates, nicotinic acid (niacin), and high doses of omega-3.

Genetic hypertriglyceridemia

Individuals with genetic abnormalities that lead to triglyceride accumulation may hit levels as high as 1000 mg/dL. Some individuals who suffer from diabetes, severe obesity, or alcoholism may also have levels this high. Familial hypertriglyceridemia affects 1 in 500 people in the United States and is caused by an autosomal dominant mutation. The condition is generally not associated with increased cholesterol levels, but the individuals are at risk for hyperglycemia and diabetes, very high VLDL levels, obesity, hyperinsulinemia, pancreatitis, and coronary artery disease. These individuals often are counseled to avoid alcohol and to follow a strict diet. Medications may be used when addressing lifestyle factors and underlying problems (obesity, diabetes, hypothyroidism) does not reduce levels.


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