Hypertriglyceridemia · Pancreatitis risk · Metabolic health
High triglycerides, brought down for good.
Triglycerides are the fat your body stores and ships for energy. Levels above 150 mg/dL usually signal insulin resistance, excess refined carbohydrate or alcohol, and they add to heart risk. Levels above 500, and especially above 1,000, risk acute pancreatitis and need prompt treatment. Dr. Hasan is experienced in managing mild to severe hypertriglyceridemia and the metabolic conditions behind it.
What raises triglycerides
Unlike LDL, triglycerides swing with what you ate, drank and did in the past few days, which is why they are the most changeable number on the lipid panel. The common drivers are insulin resistance and type 2 diabetes, central weight gain, alcohol, sugary drinks and refined starch, hypothyroidism, kidney disease, pregnancy, and medications such as estrogen pills, retinoids, steroids, some antipsychotics and beta-blockers. Very high levels usually combine a genetic tendency with one of these triggers.
Fasting is no longer required for a routine panel, but triglycerides above 400 are rechecked fasting.
Treatment
- Food and drink first: cutting added sugar, sweet drinks, refined grains and alcohol lowers triglycerides 20 to 50 percent within weeks. For severe elevation, total fat is restricted to under 10 to 15 percent of calories until levels fall.
- Treat insulin resistance: weight loss of 5 to 10 percent, regular activity and, when appropriate, GLP-1 therapy or metformin lower triglycerides substantially.
- Fix secondary causes: uncontrolled diabetes, hypothyroidism and problem medications are corrected before adding lipid drugs.
- Statins lower triglycerides modestly and remain first-line for cardiovascular protection when LDL or overall risk warrants.
- Icosapent ethyl (purified EPA, 4 g/day) reduces cardiovascular events in people with triglycerides 150 to 499 on a statin with diabetes or heart disease.
- Fibrates (fenofibrate) and prescription omega-3 are used for levels above 500 to prevent pancreatitis.
Dr. Hasan is experienced in treating moderate and severe hypertriglyceridemia, including familial forms, triglyceride-induced pancreatitis prevention, and the insulin resistance, diabetes and thyroid disorders that drive triglycerides up.
Common questions
Do fish oil supplements work?
Over-the-counter fish oil at typical doses has little effect. Prescription-strength omega-3 (4 grams of EPA or EPA/DHA daily) lowers triglycerides 20 to 30 percent; only purified EPA has been shown to reduce heart events.
How fast can triglycerides come down?
Within 2 to 4 weeks of changing diet and alcohol, often dramatically. Medication effects appear over 4 to 8 weeks.
My triglycerides are high but my cholesterol is fine. Should I worry?
Moderate elevation is mainly a signal of insulin resistance and is worth acting on for that reason. It also raises the number of small, dense LDL particles, so ApoB or non-HDL cholesterol gives a truer picture of risk than LDL alone.
Can high triglycerides cause pancreatitis?
Yes, typically above 1,000 mg/dL. Severe abdominal pain with very high triglycerides is an emergency.
Related conditions
In Wexford or by telehealth in PA and OH