Lowering Triglycerides Is
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At optimal heart health our primary concern is not merely avoiding heart disease. You and I would like to go beyond that. We want the best heart health we can have. It is important to us. It is important to those who love us.
So let’s consider the topic of lowering triglycerides for a moment. To do this we will cover the following points:
- Are High Triglycerides Really a Problem?
- When Should I Be Concerned About Lowering Triglycerides?
- What Causes My Triglycerides To Rise?
- What Are The Most Common High Triglyceride Treatments?
- What Can I Do To Lower Triglycerides?
As we begin it is important to ask the question…
Are High Triglycerides Really a Problem?
It is a fair question. Why? Because medical researchers have debated the issue for some time. Why would there be disagreement on the subject? High triglycerides usually do not happen alone.
If you or I have high triglycerides it is likely that we have other problems as well. For example, my high triglycerides will probably be accompanied by low HDL (the good cholesterol) and high LDL (the bad cholesterol). Therefore it is difficult to isolate triglycerides as an independent risk factor for heart disease.
I have received emails from people wondering why their doctor will not treat their elevated triglycerides. Now you know. Some doctors still are not convinced that high triglycerides alone are a problem.
However, the NCEP (National Cholesterol Education Program) guidelines...
... recommend aggressive treatment of hypertriglyceridemia.
These are the people who dedicate their lives to studying the effects of cholesterol and triglycerides. That is reason enough for me to take high triglycerides seriously.
By the way, if you are concerned about your cholesterol there are several natural products that can help you manage it.
Natural cholesterol care supplement.
Doctors who will not treat high triglycerides are increasingly in the minority. High triglycerides are considered by most to be a dangerous independent heart health risk.
When Should I Be Concerned About Lowering Triglycerides?
Some doctors will not consider triglycerides a problem until they exceed 200 mg/dL. However, this attitude has changed among most. It is now commonly considered that triglyceride levels should not exceed 150 mg/dL. Why the change?
Research has shown that triglyceride levels between 150 and 200 mg/dL may predict the presence of certain LDL particles. These particles belong to two families.
Pattern A is characterized by large particles and normal apolipoprotein B-100 levels. (Apolipoproteins are proteins on the surface of the lipoprotein complex that bind to specific enzymes or transport proteins across the cell membrane.)
Pattern B, however, is characterized by small, dense LDL particles and high apolipoprotein B-100 levels. This latter type (Pattern B) has been shown by the Quebec Cardiovascular Study to be associated with an increased risk of developing coronary heart disease (CHD).
It is believed that the small LDL particles are more susceptible to oxidation making them more active in the process of atherosclerosis (clogging the arteries.)
So why is this important?
Triglyceride levels in excess of 160 mg/dL predict Pattern B particles (the bad ones) over 50% of the time. Triglycerides over 200 mg/dL predict Pattern B particles about 80% of the time. All this means that 50% of the time triglyceride levels higher than 160 mg/dL indicate an agent that promotes atherosclerosis.
So the current thresholds for triglycerides are as follows:
- under 150 mg/dL (normal)
- 150-199 mg/dL (borderline-high)
- 200-499 mg/dL (high)
- 500 mg/dL (very high)
Alright, my triglycerides are high. So…
What Are The Most Common High Triglyceride Treatments?
If I go to my doctor what will he or she do? You will be told that there are certain things you can do yourself. We will look at those in a moment. But if you are given medication it will probably be one of the following.
Keep in mind triglycerides are not treated in isolation. So the following treatments affect serum cholesterol as well.
Niacin
Actually niacin is not a drug. It is a derivative of vitamin B. It has been used for years to lower cholesterol and has been shown to lower triglycerides as well.
The Coronary Drug Project tested men with a history of myocardial infarction. This is a term used to describe irreversible injury to heart muscle. It is used as a synonym for heart attack. The men were treated with 3 grams of niacin daily. The trial lasted six years demonstrating no mortality benefit during that time.
However, nonfatal myocardial infarction was decreased by 27% in the niacin group compared with the placebo group. Surprisingly though at the 15 year follow-up mark mortality was reduced 11% in the niacin group. This was accompanied by a 10% reduction in cholesterol and 25% reduction in triglyceride levels.
Niacin has long been available in supplement form and taken by many on a daily basis for general health purposes. Niacin decreases the production of VLDL (very low density lipoprotein) which can lead to a decrease in LDL (bad cholesterol) particles.
It also has the effect of raising HDL (good) cholesterol. Both total cholesterol and triglyceride levels are positively affected. But there is a downside. Cholesterol and triglyceride reduction is dose related. That is, the more one takes the greater the benefit. Usually dosages in excess of 1,500 mg per day are required to have a significant effect.
Niacin can have intolerable side effects, especially in high dosages, including…
- nausea
- diarrhea
- increased liver enzymes
- heartburn
- flushing
- liver toxicity
And for diabetics there is a possibility of worsening hyperglycemia.
Niacin comes in both immediate release and extended release formulas. The immediate release variety is more potent in causing the flushing and skin irritation. However, the time-release version is much more likely to cause liver problems.
Fibric Acid Derivatives
Next on the list of aids for lowering triglycerides are the fibric acid derivatives. There are a number of these including…
- fenofibrate (Tricor)
- gemfibrozil (Lopid)
- clofibrate (Atromid-S
- bezafibrate
They work by speeding up the chemical breakdown of triglyceride rich lipoproteins. Fibrates are known for their ability to lower triglycerides but do little to lower cholesterol. Therefore they are often used in conjunction with other drugs such as statins.
However, it is believed that the use of fibrates and statins together can increase one’s likelihood of suffering from
rhabdomyolysis
- a rare condition resulting in the destruction of skeletal muscle cells.
A few studies have been done to test the effectiveness of fibrates in lowering triglycerides. Two primary prevention trials come to mind. The first was the World Health Organization Cooperative Trial (using clofibrate). The second was the Helsinki Heart Study (using gemfibrozil). Both demonstrated a decrease in incidence of nonfatal myocardial infarction. They also showed an increase in non-cardiac deaths.
Another study was the Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial (VA-HIT). It tested 2,500 men with gemfibrozil. The results demonstrated HDL increases of 6% and decreased triglyceride levels by 31% compared to the placebo group. LDL levels remained relatively unchanged. The increased HDL levels are attributed with the 22% decrease in relative risk of cardiac event in the gemfibrozil group.
Statins
Statins are common for lowering triglycerides and cholesterol. Statins such as…
- atorvastatin (Lipitor)
- simvastatin (Zocor)
- pravastatin (Pravachol)
- lower LDL cholesterol
- increase modestly HDL cholesterol
- lower triglyceride levels up to 40%
There are some drawbacks to statins. One drawback that we can control is they tend to lower a person’s CoQ10 levels. CoQ10 (Coenzyme Q10) is a coenzyme essential to the proper functioning of enzymes in the body. It is a necessary component in energy production. This is especially important in large muscles like the heart.
It also is a powerful antioxidant. It especially targets LDL cholesterol. The oxidation of LDL cholesterol is believed to be one of the main causes of atherosclerosis. It has been demonstrated a powerful treatment for cardiovascular disease in both animal studies and human trials. Biopsies have shown that CoQ10 deficiency occurs in 50-75% of patients with heart disease.
When we are young our bodies produce all the CoQ10 we need. However, as we age this is no longer true. By the time we are in our mid-30s it is likely that we need CoQ10 supplementation. As CoQ10 levels fall off heart muscle energy also falls off. Further, oxidation of LDL becomes more rapid contributing to the building up of plaque in our arteries.
If you are taking statins these risks are greatly increased. CoQ10 supplementing should be a part of our daily routine as we approach our forties and go beyond. If you are taking statins this becomes even more critical.
Here is a great CoQ10 supplement at a very good price.
What Can I Do To Lower Triglycerides?
As mentioned your doctor is going to tell you there are certain things you can do to lower your triglycerides. These are mostly consistent with the things we can do to balance our cholesterol. The first two are to quit smoking and get some exercise. (I never feel popular when I say that.) Never the less, these steps are of extreme importance. If we are going to have optimal heart health we must take these things seriously.
The biggest effect we can have on our triglycerides is our diet. (Now there is a popular topic.) I have dedicated a page to diet and triglycerides. You can access it from the main triglycerides page.
Let’s look briefly at diet right now.
Alcohol is a problem for triglycerides. It may help with cholesterol but not triglycerides. Sorry.
Simple carbohydrates are also a big problem. By this I mean mainly sugars. Our diets are full of sugar. Read the labels on many of the foods you have in your pantry. They are loaded with sugar.
Carbohydrates are easily converted to triglycerides. The simpler the carbohydrate the easier it is converted into triglycerides. For lowering triglycerides we need to avoid sugars and other simple carbohydrates.
Triglycerides are fats. Foods high in fat contain a boat load of triglycerides. There is, however, a great exception to this. You want to eat lots of fats. Great. Eat more fish.
Cold-water fatty fish is very high in omega-3 fatty acids. I know a couple who eats salmon for breakfast every day. That truly is the breakfast of champions.
Omega-3 is well known throughout the world for its potency in lowering triglycerides.
The science backing this statement is incontrovertible. We get omega-3 from several vegetative sources. The strongest of which is flax seed.
But the strongest triglyceride lowering omega-3 is found in fish like salmon, mackerel and tuna. It is recommended that we get 2 to 4 grams of omega-3 (EPA and DHA) per day when trying to lower triglycerides.
That is a whole bunch of fish eating. That is why fish oil supplements have become so important in lowering triglycerides and balancing cholesterol. They provide the goodness of omega-3 without the risk of mercury poison. They are also a good alternative for people – like me – who do not eat salmon for breakfast every day.
It is important to get fish oil supplements from a quality source. You don’t want any mercury included.
Potent Omega-3 supplement at a very good price.
O.K. Here goes my reminder again. We don’t want to avoid heart disease. That goal is too short-sighted. Our goal is higher. We want to achieve optimal heart health. To do that we need to take action. You are reading this material. That means you are on the right path. Now let’s encourage each other to take action every day to achieve optimal heart health.
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