| | | | Other Names | | | Triglyceride Levels, Triglycerides, Triglyceride, Hypertriglyceridemia.
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| | | Triglycerides (TGs) are a group of fatty compounds that circulate in the
bloodstream and are stored in the fat tissue. Individuals who have
elevated blood levels of TGs (known as hypertriglyceridemia) appear to be
at increased risk of developing heart disease. People with diabetes often
have elevated TG levels. Successfully controlling diabetes will, in some
cases, lead to normalization of TG levels.
What are the symptoms
of high triglycerides? Very high triglycerides can cause pancreatitis,
an enlarged liver and spleen, and fatty deposits in the skin called
xanthomas. Otherwise, high triglycerides may not cause symptoms until and
unless heart disease or other diseases of blood vessels
develop.
Conventional Treatment Options: People with high
triglycerides are typically advised to reduce their weight and limit the
consumption of processed foods, simple sugars, alcohol, and saturated fats
(found predominantly in animal products, [e.g., meat, eggs, and dairy
products], and tropical oils [e.g., palm and coconut oils]). In some
cases, conventional treatment includes niacin supplementation and the
prescription medication gemfibrozil (Lopid, Gemcor).
Dietary
changes that may be helpful: While consuming moderate amounts of
alcohol does not appear to affect TG levels, heavy drinking is believed to
be an important cause of hypertriglyceridemia.1 Alcoholics with elevated
TG levels should deal with the disease of alcoholism
first.
Ingesting refined sugar increases TG levels, as well.2 3
People with elevated TGs should therefore reduce their intake of sugar,
sweets, and other sugar-containing foods. There is also evidence that
ingesting fructose in amounts that are found in a typical Western diet can
raise TG levels, although not all studies agree on that point.4 It should
be noted that most studies of fructose investigated the refined form, not
the fructose that occurs naturally in some fruits.
In a study of
heavy caffeine users (individuals who were consuming an average of 560 mg
of caffeine per day from coffee and tea), changing to decaffeinated coffee
and eliminating all other caffeinated products for two weeks resulted in a
statistically significant 25% reduction in TG levels.5
Diets high
in fiber have reduced TG levels in several clinical trials,6 but have had
no effect in other clinical trials.7 Water-soluble fibers, such as pectin
found in fruit, guar gum and other gums found in beans, and beta-glucan
found in oats, may be particularly helpful in lowering
triglycerides.
Consumption of a low-fat, high-carbohydrate diet
reduced TGs in one study.8 However, in another study, populations that
consumed a low-fat, high-carbohydrate diet had higher TG levels, compared
with populations that consumed lower amounts of carbohydrates.9 Suddenly
switching to a high-carbohydrate, low-fat diet will generally increase TGs
temporarily, but making the switch gradually protects against this
short-term problem.10
The blood level of TGs following a meal may
be a more important indicator of coronary heart disease risk than the
fasting level.11 12 However, a low-fat diet (55% carbohydrates, 23% fats,
22% proteins) that succeeded in normalizing other blood lipids, including
fasting TG levels, failed to normalize post-meal TG levels in a group of
people with hypertriglyceridemia.13 These results suggest that dietary
reduction of fasting TGs, even if the diet controls other blood lipids,
may not be enough to provide optimal protection against coronary heart
disease. Many doctors recommend a diet low in saturated fat (meaning
avoidance of red meat and all dairy except nonfat dairy) to reduce TGs and
the risk of heart disease.14
Some,15 16 but not all,17 studies have
found that increasing consumption of fish is associated with a lower risk
of heart disease. Significant amounts of TG-lowering omega-3 fatty acids
(EPA and DHA) can be found in the fish oil of salmon, herring, mackerel,
sardines, anchovies, albacore tuna, and black cod. Many doctors recommend
that people with elevated TGs increase their intake of these fatty
fish.
Lifestyle changes that may be helpful: Exercise lowers
TG levels.18 People who have diabetes, heart disease, or are over the age
of 40, should talk with a doctor before beginning an exercise
program.
Smoking has been linked to elevated TG levels.19 As
always, it makes sense for smokers to quit.
Obesity increases TG
levels.20 Maintaining ideal body weight helps protect against elevated TG
levels. Many doctors encourage people who have elevated TGs and who are
overweight to lose the extra weight.
Nutritional supplements
that may be helpful: Many double-blind trials have demonstrated that
fish oils (also called fish-oil concentrates) containing EPA and DHA
(mentioned above) lower TG levels.21 The amount of fish oil used in much
of the research was an amount that provided 3,000 mg per day of omega-3
fatty acids. To calculate how much omega-3 fatty acid is contained in a
fish-oil supplement, add together the amounts of EPA and DHA. For example,
a typical 1,000-mg capsule of fish oil provides 180 mg of EPA and 120 mg
of DHA (total omega-3 fatty acids = 300 mg). Ten of these capsules would
contain 3,000 mg of omega-3 fatty acids. Other sources of omega-3 fatty
acids, such as flaxseed oil, do not lower TGs. While flaxseed oil has
other benefits, it should not be used for the purpose of reducing
TGs.
Cod liver oil, another source of omega-3 fatty acids, has also
been found to lower TGs.22 Cod-liver oil is less expensive than the
fish-oil concentrates discussed previously. However, cod-liver oil also
contains relatively large amounts of vitamin A and vitamin D; too much of
either can cause side effects. In contrast, fish-oil concentrates have
little or none of these vitamins. Individuals wishing to use cod liver oil
as a substitute for a fish-oil concentrate should consult a
doctor.
Omega-3 fatty acids from fish oil and cod liver oil have
been reported to affect blood in many other ways that might lower the risk
of heart disease.23 However, these supplements sometimes increase LDL
cholesterol-the bad form of cholesterol. A doctor can check to see if fish
oil has this effect on an individual. Research shows that when 900 mg of
garlic extract is added to fish oil, the combination still dramatically
lowers TG levels but no longer increases LDL cholesterol.24 Therefore, it
appears that taking garlic supplements may be a way to avoid the increase
in LDL cholesterol sometimes associated with taking fish oil. People who
take fish oil may also need to take vitamin E to prevent the oil from
undergoing potentially damaging oxidation in the body.25 It is not known
how much vitamin E is needed to prevent such oxidation. The amount
required would presumably depend on the amount of fish oil used. In one
clinical trial, 300 IU of vitamin E per day prevented oxidation damage in
individuals taking 6 grams of fish oil per day.26
Pantethine is a
byproduct of pantothenic acid (vitamin B5). Several clinical trials have
shown that 300 mg of pantethine taken three times per day will lower TG
levels.27 28 29 Pantothenic acid, which is found in most B vitamins, does
not have this effect.
The niacin form of vitamin B3 is used by
doctors to lower cholesterol levels, but niacin also lowers TG levels.30
The amount of niacin needed to achieve worthwhile reductions in
cholesterol and TG levels is several grams per day. Such quantities can
cause side effects, including potential damage to the liver, and should
not be taken without the supervision of a doctor. Some doctors recommend
inositol hexaniacinate (a special form of vitamin B3) as an alternative to
niacin. A typical amount recommended is 500 mg three times per day.31 32
This form of vitamin B3 does not typically cause a skin flush and is said
to be safer for the liver than niacin. However, the alleged safety
advantage of inositol hexaniacinate needs to be confirmed by additional
clinical trials. Moreover, it is not clear whether inositol hexaniacinate
is as effective as niacin at lowering cholesterol and TG levels.
In
a preliminary trial, supplementation with 800 mg of calcium per day for
one year resulted in a statistically significant 35% reduction in the
average TG level among people with elevated cholesterol and
triglycerides.33 However, in another trial, calcium supplementation had no
effect on TG levels.34 One of the differences between these two trials was
that more people in the former trial had initially elevated TG
levels.
In a double-blind trial, 30 people with type 2
(non-insulin-dependent) diabetes received 200 mcg of chromium per day (as
chromium picolinate) for two months and a placebo for an additional two
months. The average TG level was significantly lower (by an average of
17.4%) during chromium supplementation than during the placebo period.35
Some,36 37 but not all, trials38 39 support these findings. It is not
clear whether chromium supplementation affects TG levels in non-diabetics,
but some evidence suggests that it does not.40 41 42 43
44
L-carnitine is another supplement that has lowered TGs in
several clinical trials.45 46 However, the effect of carnitine is
unpredictable, and some individuals have experienced an increase in
triglyceride levels after receiving this supplement.47 Some doctors
recommend 1-3 grams of carnitine per day, in the form known as
L-carnitine.
Several double-blind trials have evaluated the
efficacy of fructo-oligosaccharides (FOS) or inulin (a related compound)
for lowering blood cholesterol and triglyceride levels. These trials have
shown that in individuals with elevated total cholesterol or triglyceride
levels, including people with type 2 diabetes, FOS or inulin (in amounts
ranging from 8 to 20 grams daily) produced significant reductions in
triglyceride levels; however, the effect on cholesterol levels was
inconsistent.48 49 50 51 In people with normal or low cholesterol or
triglyceride levels, FOS or inulin produced little effect.52 53
54
A double-blind trial found that a supplement of 5 grams of
creatine plus 1 gram of glucose taken four times per day for five days
followed by twice a day for 51 days significantly lowered serum total
triglycerides in both men and women.55 However, another double-blind trial
found no change in any of these blood levels in trained athletes using
creatine during a 12-week strength training program.56 Creatine
supplementation in this negative trial was lower-only five grams per day
was taken for the last 11 weeks of the study.
Are there any side
effects or interactions? Refer to the individual supplement for
information about any side effects or interactions.
Herbs that
may be helpful: Guggul, a mixture of ketonic steroids from the gum
oleoresin of Commiphora mukul, is an approved treatment of hyperlipidemia
in India and has been a mainstay of Ayurvedic herbal approaches to
preventing atherosclerosis. Clinical trials indicate that guggul is
effective in the treatment of high TGs; in one trial, serum TGs fell by
30.3%.57
However, these results have not been confirmed by large,
controlled trials. The recommended daily intake of guggul is typically
based on the amount of guggulsterones in the extract. The recommended
amount of guggulsterones is 25 mg three times per day. Most extracts
contain 5-10% guggulsterones. Guggul's effect on TGs should be monitored
for three to four months, and guggul may be taken long term if successful
in lowering TGs.
Reports on many clinical trials of garlic
performed until 1998 suggested that triglycerides were lowered by an
average of 8-27% and cholesterol by 9-12% over a one- to four-month
period.58 59 60 Most of these trials used 600-900 mg per day of a garlic
supplement standardized to alliin content and allicin potential. More
recently, however, three double-blind clinical trials have found garlic to
have minimal success in lowering triglycerides and cholesterol.61 62 63
One negative trial has been criticized for using a steam distilled garlic
"oil" that has no track record for this purpose,64 while the others used
the same standardized garlic products as the previous positive clinical
trials. Based on these findings, the use of garlic should not be
considered a primary approach to lowering high triglycerides and
cholesterol.65
Odor-controlled, enteric-coated garlic tablets
standardized for allicin content can be taken in the amount of 900 mg
daily (providing 5,000-6,000 mcg of allicin), divided into two or three
daily portions.
In a double-blind trial, people with moderately
high triglycerides took a tincture of Achillea wilhelmsii, an herb used in
traditional Persian medicine.66 Participants in the trial used 15-20 drops
of the tincture twice daily for six months. At the end of the trial,
participants experienced significant reductions in triglycerides compared
to those who took placebo. No adverse effects were
reported.
Fenugreek has been shown to lower total and LDL
cholesterol and triglyceride levels in people with high lipid levels in
preliminary trials.67 Bread made with 50 grams defatted fenugreek powder
was used twice daily in the trial. Similar results have been seen at half
that amount in people with diabetes and elevated blood levels of various
lipids.68 A small randomized trial found similar results using 100 grams
fenugreek seeds daily.69 One small clinical trial found that either 25
grams or 50 grams per day of defatted fenugreek seed powder were effective
in reducing triglycerides over a 20-day period.70 Mild diarrhea and gas
can accompany the first few days of fenugreek use, though it almost always
fades as the person taking it adapts.
Psyllium seeds and husks have
shown a modest ability to lower blood triglyceride levels in some,71 72
but not all,73 clinical trials. Further research is needed to assess the
effect of psyllium on triglyceride levels more closely, as much of the
study so far has focused on lowering cholesterol levels.
Intake of
three cups or less of green tea daily has been shown not to affect blood
triglyceride levels.74 Intake of four or more cups per day has been
correlated with lower triglyceride levels.75 Overall, the evidence is
unclear on how much of an effect high levels of intake of green tea has on
triglyceride levels.
Although primarily used to lower high serum
cholesterol, red yeast rice extract, high in monacolins, has been found to
significantly lower serum triglyceride levels.76 People in the trial took
1.2 grams (approximately 13.5 mg total monacolins) of a concentrated red
yeast rice extract per day for two months.
Animal studies suggest
the mushroom maitake may lower fat levels in the blood.77 However, this
research is still preliminary and requires confirmation by controlled
human trials.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or
interactions.
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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High Triglycerides - Health - Artichoke Leaf Tea
50 tea bags
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High Triglycerides - Health - Artichoke Leaf Tea
25 tea bags
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High Triglycerides - Health - Artichoke Leaf Tea (Loose)
4 oz / 114 g
10.35 US
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High Triglycerides - Health - Artichoke Leaf Tea (Loose)
8 oz / 227 g
13.48 US
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High Triglycerides - Health - Chromium Chelate - 200 mcg
60 tablets
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High Triglycerides - Health - Flaxseed Oil, Cold Pressed - 1000 mg
60 softgels
7.77 US
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High Triglycerides - Health - Flaxseed Oil, Cold Pressed - 1000 mg
180 softgels
Looking For a Natural Way to Lower Your Blood Pressure?
14.99 US
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High Triglycerides - Health - Salmon and Fish Oil - 1000 mg (180:120)
60 softgels
6.83 US
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High Triglycerides - Health - Salmon and Fish Oil - 1000 mg (180:120)
180 softgels
14.84 US
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High Triglycerides - Health - Vitamin E - Pure - Research Quality - 400 IU
60 softgels
11.73 US
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High Triglycerides - Health - Vitamin E - Succinate (Dry) - 400 IU
60 capsules
13.43 US
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High Triglycerides - Health - Vitamin E - Natural Source - 400 IU
90 softgels
11.97 US
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