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4 high triglycerides treatment options

Amy Capetta writer headshot By | September 27, 2019
Medically reviewed by Lindsey Hudson, APRN, NP-C

Cardiovascular disease is the leading cause of death for men and women in the United States. Almost half of all Americans (47%) have one of the three risk factors for heart disease: high blood pressure, high cholesterol, or smoking, according to the CDC. It’s such a common—and dangerous— problem that many organizations exist only to promote heart-healthy living, from the American Heart Association to the World Heart Federation. They encourage people to protect their own hearts and inspire others (family, friends, colleagues) to do the same. The good news is that one health threat is highly treatable. There are  many high triglycerides treatment options (and preventions)—from statins to supplements.

High cholesterol affects more than 102 million Americans. While there are no symptoms associated with this condition, it’s tracked regularly in your annual physical. A complete blood cholesterol test (otherwise referred to as a lipoprotein or lipid profile) provides the various types of cholesterol levels measured in milligrams per deciliter of blood (mg/dL). One cholesterol it tracks is triglyceride levels. 

What are triglycerides?

“Triglycerides are a type of fat and the most common type of fat in your body,” states Roshini Malaney, DO, a board certified cardiologist with Manhattan Cardiology in New York City. Similar to cholesterol, triglycerides are made in the liver and exist in certain foods, including butter, margarine and oils, as well as other high fat or high carbohydrate foods. “When we consume extra calories, the body converts the calories it doesn’t need to use right away into triglycerides, which are then stored in fat cells,” she adds. 

What qualifies as high triglycerides?

According to MedlinePlus (the website powered by the United States National Library of Medicine), blood levels less than 150 mg/dL fall under the triglycerides normal range, while anything higher—known as hypertriglyceridemia—can 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. (She adds that a high-fasting triglyceride level should prompt additional testing, including a fasting blood sugar and hemoglobin A1c.)

Extremely high triglycerides—blood levels over 500 mg/dL—may be due to a genetic disorder and can increase the risk of pancreatitis, along with heart disease, including atherosclerosis (hardening of the arteries), 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.

Triglycerides level chart

Are your triglyceride levels in the normal range? Refer to this triglycerides level chart.

Risk level Triglyceride level 
Normal Less than 150 milligrams per deciliter (mg/dL)
Borderline high 150 to 199 mg/dL 
High 200 to 499 mg/dL
Very high 500 mg/dL or higher

 

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.

How to lower triglycerides

There are several natural high triglycerides treatment options—like diet and lifestyle changes—that your physician may recommend trying first, before prescriptions.

Diet 

Triglycerides come from the food we eat, and occur naturally in the liver. Eating a low sugar, low carbohydrate diet, with lots of high fiber foods rich in omega-3s can help. 

What are the best foods to eat to lower triglycerides?

Use the Mediterranean diet as a guide. Look for foods like:

  • omega-3 rich fish (e.g., salmon, sardines, tuna, halibut)
  • oatmeal
  • beans
  • nuts
  • vegetables
  • fruit
  • legumes
  • whole grains

Substitute olive oil for butter or lard, when possible. Choose complex over simple carbs, like brown rice instead of white. Limit your sugar intake. Avoid trans and saturated fats.

Alcohol consumption

Some  recommend completely giving up alcohol to lower triglycerides, especially if your levels are very high. Reducing consumption can help if your cholesterol is borderline.

Exercise

Losing weight can help eliminate triglycerides stored in fat. Increasing physical activity is a great way to start.

High triglycerides treatment options

If lifestyle modifications fail to lower triglyceride levels, your physician may give you one of the following four prescriptions: 

1. Statins

“Statins, such as Atorvastatin or Rosuvastatin, are medications typically used to treat high cholesterol levels, as well as other risks for cardiovascular disease,” Dr. Malaney says. She further explains that these drugs work by decreasing the liver’s production of cholesterol, and at certain doses can decrease triglyceride levels by 50 percent. “And with these newer, more potent statins, both LDL (“bad” cholesterol) targets and triglyceride targets can be reached,” Dr. Thomas adds. 

Even more encouraging: According to a December 2018 scientific statement released by the American Heart Association, side effects from statins tend to be rare, and their benefits outweigh any possible risks. 

RELATED: Read more about the side effects of statins

2. Niacin

Also known as vitamin B3, niacin can decrease triglycerides by blocking the release of free fatty acids from fat while increasing the clearance of triglycerides from the blood, Dr. Malaney explains. “In addition, it can boost levels of HDL (“good”) cholesterol and lower levels of LDL (“bad”) cholesterol, so it’s commonly used for adults who have both heart disease and high cholesterol,” she says. 

Dr. Thomas states that patients tend to prefer statins over niacin since statins are more tolerable. “And niacin has no demonstrable benefit over a statin,” she says. 

3. Omega-3 fatty acids

Fish oil tablets—2 grams per day—have been shown to decrease triglyceride levels by up to 30 percent, Dr. Malaney says. “These pills work by inhibiting the release of triglycerides from the liver and by stimulating the enzyme that clears triglycerides from the blood,” she continues. Dr. Malaney further adds that prescription fish oil preparations, such as Lovaza, contain more active fatty acids than most non-prescription supplements. 

4. Fibrates 

Medications, such as such as Fenofibrate and Gemfibrozil, can lower triglyceride levels similarly to fish oil tablets. “Fibrates reduce the liver’s production of VLDL (the particle that circulates in the blood carrying triglycerides) while speeding up the removal of triglycerides from the blood,” Dr. Malaney explains. However, she warns that this medicine should not be prescribed for patients with severe kidney or liver disease.