4 high triglycerides treatment options

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 triglyceride treatment and prevention options—from statins to supplements.

High cholesterol (total blood cholesterol of 200 mg/dL or more) affects nearly 2 in 5 American adults. 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 lipid panel 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 levels of 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 the 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, D.C. She adds that a high fasting triglyceride level should prompt additional testing, including 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.

What causes high triglycerides? 

Aside from consuming a diet high in sugar and saturated fats, 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, antipsychotic medications, and corticosteroids.

How to lower triglycerides

There are several natural remedies for high triglycerides—like diet and lifestyle changes—that your healthcare provider may recommend trying first before prescriptions.

Diet 

Triglycerides come from the food we eat and occur naturally in the liver. Eating a low-sugar, lower-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. You can also consult a registered dietitian for help creating a healthy eating plan that works with your lifestyle. What’s more, many insurances cover this service.

Alcohol consumption

Some recommend completely giving up alcohol to lower high triglyceride levels. Reducing consumption can help if your cholesterol is borderline.

Exercise

Losing weight can help eliminate triglycerides stored in fat. Even losing 5% to 10% of your starting body weight (for example, 10 to 20 pounds if your starting weight is 200 pounds) can help. Increasing physical activity is a great way to start. Exercise can also boost your levels of HDL cholesterol, the “good” cholesterol which may help reduce triglycerides and help you achieve a healthy weight. Aim for 150 minutes per week (you can break it up into five, 30-minute sessions) of moderate-intensity exercise like walking—and add two days of strength training. Consult your healthcare provider before starting a new exercise program.  

High triglycerides treatment options

If lifestyle modifications fail to lower triglyceride levels, your healthcare provider 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 higher doses, can decrease triglyceride levels by 50%. “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 far 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 have been shown to decrease triglyceride levels by up to 30%, 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 dietary supplements. 

4. Fibrates 

These medications, such as fenofibrate or 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 these medicines should not be prescribed for patients with severe kidney or liver disease.

Prescription discount card

The bottom line

High triglyceride treatment can reduce cardiovascular risk by preventing conditions such as coronary heart disease and heart attack. There are several treatment options to help reduce LDL cholesterol, including diet, exercise, decreased alcohol consumption, statins, and supplements. If you are worried about your triglyceride levels or those of a loved one, the first step is to schedule a blood test with your healthcare provider. Heart health and decreasing the risk of heart disease should always be top of mind.