Triglycerides: The Forgotten Nemesis to a Healthy Heart

According to conventional medicine, cholesterol is the cause of our heart disease epidemic. I have heard of some cardiologists telling patients that if it were possible they would lower their patient’s cholesterol levels to zero. This type of comment shows how the most advanced medical system in the world is based on antiquated ideas and philosophies. If we develop a drug tomorrow that would lower people’s cholesterol to zero and administered that drug to 100,000 people in a clinical study, we would have 100,000 dead people on our hands. Cholesterol is an important compound in the body, we need it to make important hormones and compounds such as vitamin D. When cholesterol is elevated, it is because the body is out of balance and is producing excessive levels of cholesterol. As with most things in life it is the dose that makes the poison and cholesterol is no different.

An important question to ask, however, is at what dose does something become a poison? We have discussed cholesterol in other articles…Today’s article is not about cholesterol, rather we are going to discuss cholesterol’s nasty little brother called triglyceride. Just as cholesterol plays an important role in the body, triglycerides also are important and necessary for survival. Triglycerides are your body’s way of transporting fat to the organs and tissues to be used for energy. Triglycerides are also stored in the body so that when energy is needed there is an abundant supply. Like cholesterol, the majority of triglycerides that are floating through the blood are produced by the liver. When your lifestyle is out of balance, the liver loses the ability to sense that the body no longer needs to produce triglycerides and these levels begin to rise in the blood stream. Once the triglycerides in the blood reach a level greater than 100 mg per deciliter then health begins to suffer.

A study that was published in the journal Circulation discovered that high triglycerides cause more damage to the blood vessels than having an elevated LDL (bad cholesterol). Another study that followed showed that patients with a high triglycerides level (over 200 mg per deciliter) had three times the risk of heart attack compared to patients with normal triglyceride levels. In that same study scientists found that people with the highest ratio of triglycerides to HDL cholesterol suffered a 16 time higher risk of heart attack compared to people with the lowest ratio of triglycerides to HDL. This ratio is calculated by dividing your triglyceride number by your HDL number, this ratio determines if you are suffering from a condition called metabolic syndrome. For more on this condition see the article on FirstLine therapy.

Metabolic syndrome occurs when the body produces too much insulin in response to a diet that is high in carbohydrates. This elevated insulin causes many problems for the body such as elevated cholesterol, triglycerides and blood pressure. Elevated triglycerides can also be a sign of an omega-3 fatty acid deficiency.

So what do you do if your triglyceride levels are elevated?

Occasionally, triglycerides are extremely high which can place the patient at risk of a painful and dangerous condition called pancreatitis. In these people, who can have triglycerides in excess of 1,000, medications are likely needed to prevent complications. With that said, medications are not the answer for 99% of the population. They simply cover up the real problem, which is poor diet and lack of exercise. The first step is to look at your diet. As with many other conditions and diseases, carbohydrates are the most common culprit. If your triglycerides are elevated it is likely that you are eating too many refined carbohydrates such as bread, pasta, cereal, sugars and sweets. Exercise is also very important because exercise burns excessive fat and sensitizes the body to insulin.

The next step is to optimize your omega-3 fatty acid intake. People who have elevated triglycerides can often drop their levels in half simply by adding omega-3 fatty acids from fish oil to their supplement program. It is important that you take enough fish oil to provide 1800 mg of EPA and 1200 mg of DHA per day. Recently, the FDA approved fish oil as a drug. This drug form of fish oil is ridiculously expensive and no better than the less expensive, non-prescription fish oils available. I will caution you to be very picky with your brand choice to assure that it is free of heavy metals and other contaminants. In our practice we use the Your Prescription for Health brand of fish oil for those who prefer capsules (3 capsules twice daily) or Carlson Labs Finest Fish Oil for those who prefer liquid (1 tablespoon daily).

It is my preference that you start with these two changes and give them a good 2-3 months before you retest. If after this period your triglycerides are still elevated above 100 then I would recommend that you try a special form of a B vitamin called pantethine. This is an effective tool for normalizing triglycerides and cholesterol. The recommended dosage is 450 mg two to three times daily. Niacin is also an effective tool against elevated triglycerides, however, given the possibility of severe side effects I would recommend that you reserve this as a last defense. To lower triglycerides, doses in excess of 2,000 mg may be necessary and regular blood tests to assess liver function will be needed on a fairly regular basis.

Although triglycerides appear to be an independent risk factor for premature heart disease, we must not lose sight that elevated triglycerides are an indicator of a more serious condition called insulin resistance or metabolic syndrome. IF you correct the insulin resistance, the triglycerides usually correct themselves. In addition, by correcting insulin resistance, you will also enjoy healthier cholesterol and blood pressure levels.

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