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You probably know your total and LDL cholesterol, and perhaps even your HDL level. But do you know your triglyceride level?
Triglycerides dont get nearly as much attention as cholesterol, but evidence is accumulating that your triglycerides may be almost as important as your cholesterol levels when it comes to the health of your heart, particularly if you have other risk factors for coronary heart disease (such as diabetes, high blood pressure, obesity, or a family history of coronary heart disease).
The triglyceride debate
Like cholesterol, triglycerides are a form of fat transported in the bloodstream. Triglycerides can come from food, but they are also manufactured in the body. For years, experts have debated how important triglyceride levels are in predicting the risk of coronary heart disease (CHD). Some experts argue that triglycerides are not an independent risk factor for CHD, but are merely an indicator of a higher likelihood of developing CHD, because people with high triglyceride levels are more likely to have other health characteristics (such as obesity, high blood pressure, diabetes, high LDL cholesterol levels, or low HDL cholesterol levels) that put them more at risk for CHD. More recent studies, however, provide convincing evidence that high triglycerides are a significant, independent risk factor for CHD as well as a sign that you have other CHD risk factors. The bottom line: You cant afford to ignore your triglyceride level and what it may mean to your heart health.
Getting tested for triglycerides
When your physician orders a blood test called a lipid profile, it will include an analysis of your triglyceride level. To get an accurate reading, your doctor will ask you to fast overnight before the blood is drawn and sent to the laboratory. In a day or two, the lab will provide your physician with the results, which will also include your levels of total cholesterol, LDL cholesterol, and HDL cholesterol.
What should your triglyceride level be? Current guidelines from the National Cholesterol Education Program recommend a triglyceride value less than 150 mg/dL. If your triglycerides are in the 150199 mg/dL range, they are considered borderline high; if they are 200 mg/dL or more, you have high levels. Talk with your doctor about the optimal triglyceride target for you.
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I have had problems with triglycerides for years, with one blood test indicating a triglyceride level greater than 700. Before that result, I thought that the triglyceride level was associated and related somehow with cholesterol. However, I have also noticed that my triglyceride level has fluctuated independently of my cholesterol level (HDL and LDL). Then I read somewhere that the triglyceride level may in some people be a side product of the inability of the liver to metabolize efficiently high fructose corn syrup (a sweetener found in many, and I mean many, foods and soft drinks). I then went on a difficult campaign to reduce the consumption of foods containing high fructose corn syrup. I have felt better ever since, and while my triglycerides are still high, within normal range. I make this comment not from the point of view of an understanding of a relationship between triglycerides and high fructose corn syrup, but from the point of view that additional research is needed on the relationship, if any. The actions I have taken have helped me manage my health more effectively.
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Posted by: Cracking Neck | March 11, 2007
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The link you mention is gradually being established as more research is being done on "metabolic syndrome," a whole basket of symptoms which include elevated triglycerides, reduced sensitivity to insulin, weight issues, high blood pressure and more. It is considered by many doctors to be a precursor of diabetes, so if you want to learn more about metabolic syndrome, go to the Diabetes section of the site too.
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Posted by: Jo | May 31, 2007
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I also have had elevated triglycerides for the past 20 years starting at age 40 (when they went to 300 up from 60 the prior year). After being sent to a nutritionist by an AF flight surgeon, I was counseled to eat less fat and get more exercize with all the standard remedies recommended by the various heart organizations. Nothing I did seemed to lower them from a range of 190 up to a high of 557 in 1998, a period of 13 years. That high reading of 557 was reached after a summer of drinking lots of "healthy" fruit and vegetable drinks made in a blender that uses the whole fruit or vegetable, rather than a juicer. Then my physician recommended I read the book, "Protein Power" to understand the relationship between carbohydrates and triglycerides. While similar to the Atkins diet, it does not recommend eating high fat foods. Rather it emphasizes limiting one's carbohydrate intake, especially from refined sources. Results? Absolutely! Three months later, my triglycerides measured 176, a 68% drop. Eleven months later, my triglycerides were 109, 112, and 134 from three separate labs (done for a life insurance policy screening), a 78.8% drop on average from the high of 557. For the next three years, on a more "normal" diet my triglycerides rose back up to 195 to 211. Most recently, they have risen to 261, 294, 257, and 372. Niacin (up to 2 gms/daily) has had no measurable effect in the past. As for me, the only thing that has worked has been to limit my carbohydrate intake to less than 100 gms/daily to lower my triglycerides and a yet to be determined amount to maintain low triglyceride levels. The low carb diet had no significant effect on my fairly normal total cholesterol range of 190-200, LDL of 90-140, and HDL of 33-37. Hopefully, this will offer an alternative to the standard advice of limiting one's fat intake when that does not work. My fat intake has always been low and I have lived a fairly healthy lifestyle following my career as a military pilot.
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Posted by: male62 | August 3, 2007
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After I talked to my doctor about the high fructose corn syrup article I read, he said that my problem was that my liver was not breaking down my triglycerides. He seemed to think that the enzymes that do this were deficient or something. When I studied the physiology and biochemistry of the process, I learned that triglycerides are highly concentrated stores of metabolic energy that are accumulated in the cytoplasma of adipose (fat) cells of mammals. Similar to glycogen, triglycerides (or triacylglycerols) are produced when blood glucose levels are high, to store energy for future use. The initial event in utilizing triacylglycerols as a source of energy is hydrolysis by lipases. When glucose levels are high, the body uses this direct source of glucose as a source of energy. When blood glucose levels are low, the liver will produce the glucose by the pathway of gluconegenesis using amino acids, lactate and "glycerol derived from triglycerides". The overriding signal that triggers gluconeogenesis is a reduction in the insulin:glucagon ratio. Since blood glucose levels can be regulated by regulating food intake, it stands to reason that triglycerides can also be regulated similarly. If my analysis is correct, big eaters will have a triglyceride problem. We can talk about carbohydrates if we want, but I am not an obese person that has a triglyceride problem. I am sure things are more complicated for people who have diabetes (which is in my family, although I do not have diabetes).
I have been asked to take fish oil to reduce my triglycerides. My highest triglyceride readings occurred when taking fish oil, and I experienced heart arrythmias when taking the oil even at the 1.3 gm/day level. I have also been asked to take niacin to reduce my triglycerides. It only gave me headaches, tremors, and nights of lost sleep. Niacin is nicotinic acid that can stimulate the acetylcholine receptors of the nervous system as an agonist. My experience with these approaches to lower triglycerides is not productive.
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Posted by: Cracking Neck | August 3, 2007
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