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High Triglycerides: What to Know

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DDiscussions about heart health often center around blood pressure and cholesterol, with factors such as poor sleep, smoking, family history of heart disease and chronic stress being involved. However, there is one variable that is often not covered, even though it may be an important indicator of cardiovascular risk: triglycerides.

“We really don’t talk about triglycerides a lot, especially compared to cholesterol, but they really are an essential part of understanding heart health,” says Dr. says Adriana Quinones-Camacho. “For someone with a condition that increases their heart risk, such as diabetes, knowing whether triglycerides are elevated can be an important part of maintaining their health overall.”

Whether you have diabetes or another potentially chronic medical problem, or are simply looking for a way to track any changes in your health status, here’s what triglycerides are and what can happen when you have too many.

What are triglycerides?

Triglycerides are a type of fat (or lipid) that is naturally made in your liver; Its production increases when you eat. Excess calories are converted to triglycerides and stored in fat cells in the bloodstream, so they can be used to increase energy and regulate temperature when needed.

This process is different from another well-known lipid, cholesterol – which builds cells and plays a role in making hormones. Triglycerides and cholesterol are both necessary for your body to function properly. For example, without enough triglycerides, you may struggle with fatigue, chills, dry skin and even possible malnutrition because lipids are necessary to absorb certain types of nutrients.

Triglyceride readings are divided into four categories: normal, borderline high, high, and severe. A normal reading is less than 150 milligrams per deciliter (in a lab report, this would be “150 mg/dL”) while a reading greater than 500 mg/dL is considered serious.

In a 2020 report, the National Institutes of Health estimated that 25% to 30% of the US population had abnormal triglyceride levels. When the number rises, even to the high borderline, it can indicate a problem with how lipids are being processed in the body. Since this poses serious health risks, it is essential to monitor how triglyceride numbers are changing, and if necessary, to implement treatment options – especially lifestyle changes.

Read more: What to know about high cholesterol in children

Possible Causes and Concerns

High triglycerides often occur with other risk factors for heart disease, such as high cholesterol, diabetes, and smoking. However, they can be elevated even without any of these factors, because genetics can play a role, says Dr. Antonio Giamo, assistant professor of cardiovascular medicine at Yale University School of Medicine. Triglyceride levels are often higher in men than in women, and they tend to rise with age. An elevated reading is often a clue that something is going wrong in the body, he says.

“When we see very high readings, it could be a sign of another problem, such as hypothyroidism, kidney disease, or poorly controlled diabetes,” he says. “At the very least, this number should be a starting point to figure out what’s going on, especially if it’s increasing other health risks.”

Some medications can also temporarily raise triglycerides, says Giaimo. These include antipsychotic drugs, beta blockers, corticosteroids, and oral estrogen, all of which are widely used. If triglycerides reach the “high” or “severe” ranges, you may need to switch medications to see if your levels return to normal.

According to the National Institutes of Health, untreated or uncontrolled high triglyceride levels—a condition called hypertriglyceridemia—can increase the risk of coronary heart disease and stroke, as well as acute pancreatitis. Typically, problems with the pancreas occur when triglyceride levels are high over a long period of time, and can lead to hospitalization if the inflammation becomes acute.

That said, seeing a high reading once doesn’t mean you need to pack your overnight bag for a hospital stay. Most notably, triglyceride levels are strongly affected by your carbohydrate consumption, says Dr. Yu-ming ni says.

“With food and drinks like bread, rice, pasta, and soda, these are converted to fat in your liver, and triglycerides are often affected by this,” he says. “That’s why it’s recommended to be in a fasted state when you’re getting blood work done to determine your cholesterol and triglyceride levels, since carb-rich foods can affect the numbers significantly.”

If you have a high reading and are seeing it for the first time—and especially if you don’t also have high cholesterol—it’s likely that your doctor will repeat the test at different times to make sure it’s working for you. An accurate reflection of triglyceride levels.

diabetes connection

Triglycerides are an important heart-health marker for everyone, but Dr. Elkin Nuñez, they are especially helpful for people with diabetes.

With diabetes, the body handles food differently, especially carbohydrates and sugars, and this can lead to higher triglycerides. In fact, for some people who do not yet have diabetes but are on the verge of developing the condition, a high triglyceride number may indicate pre-diabetes and insulin resistance. For people with diabetes, it can be a headache that the condition is not being effectively controlled. This can set off a ripple effect across many systems in the body, especially the cardiovascular system.

The American Heart Association (AHA) notes that high triglycerides are becoming increasingly prevalent in the US and other countries, due in large part to the rise in cases of type 2 diabetes.

Lipid abnormalities are common in people with diabetes, and may contribute to overall atherosclerotic heart disease, or ASCVD, Nuñez says. That condition can increase the risk of heart attack, stroke and peripheral artery disease. ASCVD is the leading cause of morbidity and mortality in people with diabetes, especially those over the age of 50.

“Although numbers related to A1C, blood pressure and cholesterol are essential in determining whether to provide care, triglyceride levels may pose an additional risk and are not always talked about or addressed , “Nunez says.

The most common lipid-profile abnormality in patients with diabetes is referred to as the “lipid triad,” he said. This means that elevated LDL cholesterol — often referred to as the “bad kind” — and HDL (“good”) cholesterol, as well as elevated triglyceride levels, are decreased. Even if someone with diabetes only has high triglycerides, that can raise heart attack risk, Giamao says, and the effects can be profound.

“People with diabetes who have a heart attack usually have more serious outcomes and are at higher risk of death than people without diabetes,” he says. “Prevention of the first event is important, because once you have had a stroke, it can alter the quality of the rest of your life and require more aggressive treatment. It can also put you at higher risk of a second heart attack or stroke. could.”

Lowering your triglyceride levels isn’t enough to completely eliminate the risk, but Giaimo says it’s part of a larger strategy that can be important in improving heart health and controlling diabetes.

Read more: how to lower your cholesterol naturally

treatment options

Addressing high triglycerides depends on several factors, especially if cholesterol is also an issue. For example, Nunez says that if you’re experiencing the lipid triad your doctor will most likely recommend a statin first. However, if only your triglycerides are elevated and your cholesterol is normal, you’ll likely be advised to wait and see if lifestyle changes can help improve those numbers. This can happen even if your cholesterol is only slightly higher than normal.

Whether you have diabetes or not, lifestyle habits are the first-line treatment for high triglycerides, he says. This includes getting regular physical activity, reducing alcohol intake, quitting smoking, losing weight if necessary, cutting down on carbs and sugars, and improving sleep habits.

One step shown to lower triglycerides naturally is eating a diet high in omega-3 fatty acids—especially fatty fish such as salmon and albacore tuna—or taking a supplement high in that compound. For example, a 2019 study by the AHA published in the journal Spreading There are reports that the use of these fatty acids can reduce triglyceride levels by about 30%.

The AHA said that using omega-3s as a complement to other healthy habits like exercise and avoiding sugar could potentially yield even better results. (One note to keep in mind if you’re thinking of putting supplements on your shopping list: Research from the AHA suggests that prescription-level omega-3s seem to be most effective compared to what’s available over the counter. )

Another benefit of omega-3 treatment is that you usually see a change within two weeks, Quinone-Camacho says. However, if triglyceride levels are still too high after two months, your doctor will recommend prescription alternatives such as fibrates. This type of drug, also called fibric acid, lowers triglycerides by reducing their production in the liver. They are also helpful in the rapid removal of triglycerides from the blood. Because fibrates do not affect high cholesterol, they are usually used only in people with severe triglyceride levels who are at particular risk for developing pancreatitis.

If lifestyle changes and fibrates are not working, a person with high triglycerides may be switched to a drug such as a statin. According to the American Academy of Family Physicians, these drugs work by reducing the amount of cholesterol produced by the liver and can reduce triglycerides by up to 40%. As with any treatment, what is effective will depend on your specific conditions, health risks, medical history, and current medication use.

When should you get tested?

Having slightly elevated triglycerides without any other health problems is usually not a cause for concern, says Quinones-Camacho. But if you have diabetes, heart disease, or a family history of heart issues — or if your triglyceride levels are considered too high and stay that way — it’s worth taking steps to bring that number down.

“Like high cholesterol and high blood pressure, high triglycerides don’t come with symptoms,” she continues. “That’s why knowing your numbers through annual checkups is essential to staying on track and reducing your health risks.”

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