Triglycerides [posted 7/17/98]
Question: A co-worker and friend had by-pass surgery last year. He is using Lipitor, Accupril, and Trovan. The Trovan For the last 4 weeks. At his last check up his LDL's shot from 200 something to over 700 and something. Is the new drug Trovan driving his triglycerides up?

Answer: I am not familiar with Trovan. Do you have a generic name? In any case, the only way to know is to stop it and see what happens to triglycerides post Trovan. It�s certainly suspicious.

Triglycerides
Question: Having been tested at 3400 for triglycerides, my physician put me on lopid over two years ago. With the lopid and a somewhat restricted diet, I now range in the 800-1200 range. My question is two fold. Is the lopid doing any damage to my liver? And would the addition of lipitor be of any benefit. All testing is done with a minimum 12 hour fast. They keep telling me that they can't read my cholesterol because of the high triglycerides. So I don't have a clue as to the good or bad types. Also, has there ever been any connection found between high triglycerides and impotence? Everything seems to work much better when I watch my diet and get the triglycerides down below say 900. Is that just in my head or is there anything to it?

Answer: Both lopid and lipitor will lower triglycerides, you'd have to see which one has the greater effect. I'm not aware of head on head studies. Both medications can have liver toxicity, but monitoring will reduce this risk (which is fairly low to begin with). Long term use necessitates occasional liver tests. As to the impotence, it�s hard to say, although there certainly could be a connection. This isn't a common complaint though.

Triglycerides
Question: I am a 34 year old man living in Kuwait. I am very thin and about 55 KG. Recently, I had a full blood test and everything was normal except Triglycerides. I have high Triglycerides in my blood, although I do not eat much fatty food. Where did I get the Triglycerides? The reports reads as : Triglycerides 3.78 MMOL/L where 0.0 - 1.8 is the expected value. I don't know what to eat and what to not as I already do not eat a lot of fatty food. I would appreciate if you could advise me to keep the Triglycerides either reduced or controlled.

Answer: First, was the sample fasting? Triglycerides are very sensitive to calorie intake and will rise rapidly after eating. A 12 hour fast is necessary for accurate testing. Having said this, I wouldn't worry too much about this. Triglycerides are a minimal risk factor for coronary disease and some would say not a risk factor at all. They are a risk factor to eventually develop diabetes mellitus and I'd check your sugar every other year or so. Keep your weight down and don't worry if the cholesterol is OK.

Triglyceride
Question: What are the major contributing factors to a high level of triglyceride?

Answer: It seems to be fairly genetic and seems to pertain to the levels of insulin in your body and how your body uses insulin. However, high triglyceride levels are only a minor risk factor for coronary disease. Some authors cite that they are unrelated. They are related to the eventual development of diabetes mellitus and DM is a risk factor for heart disease. Very high levels will increase the risk of pancreatitis(usually over 10,000 or so). Weight loss and exercise are the best treatment options. Focus more on your cholesterol and start exercising to head off any risk of diabetes mellitus.

Triglycerides / Premarin
Question: I have been on premarin for a year now and I am 53. My cholesterol and triglycerides increased substantially. I was put on zocor and I feel I have familiar hypertriglyceremia. I am wondering if it is safe to take premarin or if there is an alternative medication that is available? Also, my blood pressure occasionally rises in times of stress. I exercise for 30 minutes every day.

Answer: While it is true that some patients do have an elevation of triglycerides with estrogen this is not thought to increase risk of strokes and heart attacks. This is because elevated triglycerides by themselves have a very low to non-existent risk for heart disease. Triglycerides do increase the risk of Diabetes Mellitus and Diabetes does have a risk for heart disease. Incidentally, there only one drug that substantially decreases the risk for coronary disease and that is estrogen. Blood pressure needs to be watched with estrogen, but in general the overall risk of coronary disease with estrogen is about 10-15% as without it.

Triglycerides
Question: Do you have any information on combination cholesterol lowering agents for use in a patient presently on Mevacor with a Cholesterol level of 238, but a Triglcerides level of 920. Are there any better choices?

Answer: A recent addition is Lipitor which is the first HMG, Co A to be approved for lowering triglycerides. I'd try this first. If the triglycerides are still too high, addition of niacin or lopid can be tried. However, they tend to have additive liver toxicity and must be watched very closely.

Triglycrides
Question: What are triglycrides? How do they enter the body, and in what foods? What is the best way to lower their levels? My triglyceride level is 320 and my cholesterol is at 173. Where can I obtain additional information on them? How much is really know about their effect?

Answer: Triglycerides are manufactured by your body in the liver. They are also absorbed with almost any ingested fat as long chain triglycerides. Consequently, a low fat, high fiber diet will reduce the amount entering your body. There is much medical debate concerning triglycerides. Finding a direct correlation between high levels and vascular disease has been difficult. Extremely high levels (5000 or higher) can cause pancreatitis. There is also a good correlation between a high triglyceride level and the eventual development of diabetes mellitus (a known cause of vascular disease). Three hundred is not especially high, but can be reduced by weight loss and a low fat diet. There are lipid lowering agents, especially niacin, lopid and the newer lipitor which lower triglycerides. I would focus more on cholesterol. Also, this is one test that is very influenced by food. Accurate levels can only be obtained after a 10 to 12 hour fast.
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