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High Cholesterol Message Board

High Cholesterol Board Index


I have been reading your thread for a couple of days now. Even though I am preparing to bolt out of here to spend some time in France, I wanted to give you a little information on what I think is going on with you, and what you can expect.

Let's go back to your first post. Your TG levels point you in the category of severe hypertriglyceridemia. The highest reported level I have seen is 21,300 mg/dL; however, you are in the top 5%. Having said that, you should console your son that it is not really as bad as he thinks. You said you were referred to a cardiologist. That is a good first step; however, my cardiologist sent me to an endocrinologist, and ultimately, that might be the better choice for someone to treat you. Lopid is normally the starting med for individuals with extremely high TG levels, and if that doesn't work, the next one to try (normally) is TriCor. If that does not work still, then a combination of the fibrate plus fish oil is tried--the omega 3 oils inhibit liver VLDL production and inhibit the movement of TG into HDL, which decreases liver catobolism of HDL. After this, niacin is sometimes added, perhaps even a statin, e.g. simvastin.

You mentioned blockage, but quite often, when you reach extremely high TG levels, the risk of CHD starts to decrease. There are various hypotheses out there about the size of the particles (and TG carried) being too large to be taken in such that there isn't a direct correlation between TG concentration and CHD incidence when people reach high levels.

Quite often, there are other reasons for such high TG levels, as you are experiencing. Sometimes it is heriditary... The thing that you need to watch out for is pancreatitis, not the heart attack at this point. Any chance that you have noticed xanthomas on your skin? (Diabetics are more susceptible, so perhaps you don't have any observable...)

I understand what you are saying about how you watch your diet. Poor diet and poor lifestyle will only take most normal people down so far towards a level of high TG (often in the 300-600 mg/dL range) but coupled moreso with impaired glucose tolerance/diabetes, low HDL particle numbers, and small dense LDL, HDL and VLDL particle sizes. This is what Rick was pointing out.

Going back to carbs. Reduction in carbs can take some individuals far, others down a bit, and some won't really benefit at all. I believe you are in the latter category. Telling you to reduce your carb intake is like telling someone that just cut off their hand to put a band-aid on it to stop blood flow. It just won't do enough to fix the problem.

As Rick mentioned his TG went from 350 to 97, I took mine from 648 mg/dL to 37 mg/dL based on weight loss and exercise. Unfortunately, you are not like me, and not like Rick, so what worked for us is not going to work for you. What will hold true for you, as it does for Rick and me is that as your TG levels decrease, your HDL (protective) will increase. However, it won't do so to the extent as a person who has metabolic syndrome.

If you want to start somewhere, try doing a search on severe hypertriglyceridemia and focus on type IV dyslipidemia. However, you actually go beyond that with your reported TG plasma levels.

Finally, since you have severe hypertriglyceridemia, there could be a liver condition resulting in your TG levels. If you have not already had this done, your cardiologist or endocrinologist will probably have your SPGT and SGOT (AST) measured to assess that possibility.

Good Luck ;)

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