How to manage severe hypertriglyceridemia?

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How to manage severe hypertriglyceridemia (how to lower severe hypertriglyceridemia)?

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Alton Banks 3 months 1 Answer 35 views 0

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  1. Once diagnosed, other blood tests are usually required to determine whether hypertriglyceridemia is caused by other underlying disorders (secondary hypertriglyceridemia) or whether no such underlying causes exist (primary hypertriglyceridaemia). Common diagnostic blood tests include: a TSH test, the thyroxine test (T4 test), testosterone blood test, SHBG hormone blood test, and liver function tests (ALT and AST).

    Treatment guidelines for hypertriglyceridemia, triglycerides between 200–499 mg/dL (2.3–5.6 mmol/L)

    1- Fish oil – omega 3 fatty acids (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) – 2 to 4 g of total EPA/DHA daily can lower triglyceride levels by 30 to 50% (Omacor 1-g capsules that contain 840 mg EPA/DHA)
    2- Low fat diet (15% of caloric intake)

    Treatment guidelines for severe hypertriglyceridemia, triglycerides > 500 mg/dL (5.6 mmol/L)

    Option #1

    1-High doses of a strong statin (simvastatin 80 mg daily for 12 weeks) also lower triglycerides by 25 to 50%

    2- Low fat diet (15% of caloric intake)

    3- Omacor 1-g capsules (840 mg EPA/DHA)

    Option #2

    Fibrates, such as fenofibrate (Tricor) raise HDL; however, use cautiously as they may increase LDL, especially if the triglyceride level is greater than 400 mg/dL

    Option #3 (Statin and Fibrate Combinations)

    Fenofibrate/statin therapy.

    Patients with severe hypertriglyceridemia may benefit from combination statin and fibrate therapy. However, combining Fibrates and Statins, such as simvastatin fenofibrate may increase the risk of rhabdomyolysis. The measurement of CK (serum creatine kinase) must be performed regularly for patients receiving fenofibrate/statin therapy, especially if they have symptoms like muscle pain, and brown urine (symptoms of muscle tissue damage).

    Option #4

    Low dose niacin therapy, for non diabetics, use of aspirin taken 30 minutes before niacin is recommended to prevent side effects. Common side effects of niacin therapy include: hepatotoxicity (elevation of liver enzyme levels) and vasomotor symptoms (hot flushes and night sweats)

     

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