I am wondering if there is any treatment for patients with high triglycerides (typically 300-500) that do not respond to traditional medicines. I have been under the care of a specialist who has advised me that there’s nothing else he can do for me. I have seen ads for over the counter treatments like Nialor that are touted to be effective in lowering triglycerides and wonder what the view is of such remedies. I am 52, 20% overweight, my cholesterol is typically 200-250 and my liver enzymes are typically 10-20% above normal range. I swim laps for 40 minutes at least 300 days each year and have cut cholesterol, fat, sugar and alcohol intake significantly in recent years.
None of these measures have reduced my readings although I feel much healthier. I have tried a range of statins, fibrates and bile sequestrants over the past few years, including Gemfibrozil, Tricor, Zocor, Niaspan, Zetia, Crestor, Colestid and even Policosanol. None of these have brought my triglycerides into the normal range, and I’ve had adverse reactions such as muscle weakness to the statins. I note that to my doctor’s amazement, Niaspan actually lowered my liver enzymes into the normal range, but didn’t bring my triglycerides under 300.
Are there any other treatments or medications I should try?
Answered by: Maria/MDHealthForum.com Team
Since you experienced muscle weakness while on statin therapy, then you should definitely ask your doctor whether he or she thinks it’s a statin side effect and whether it is the right lipid-lowering medicine for you. The muscle weakness could be a sign of either of these conditions: myalgia, myopathy or rhabdomyolysis. Rhabdomyolysis is a dangerous side effect of statins. In this condition the skeletal muscles break down, as a result there will be a leakage of substances such as creatinine kinase and myoglobin into the circulation. Myoglobin is very harmful to the kidneys. This may cause an obstruction in the renal tubes and lead to serious damage to the kidneys. If not treated promptly, this may even cause kidney failure. Muscle pain and voiding of dark-colored urine are also symptoms of rhabdomyolysis. If your doctor suspects statin-related side effect, tests to measure creatinine kinase level may be ordered A creatinine kinase level 10 times greater than the normal upper limit indicates myopathy. In patients with rhabdomyolysis the creatinine kinase level is also within that range, additionally manifestations of renal impairment are also evident.
Elevated triglyceride levels could be genetic in nature, but it could also be caused by quite a number of factors such as obesity, alcohol consumption, diabetes mellitus, hypothyroidism or the use of certain medications that increase triglyceride production. Women who are on hormonal replacement therapy may also have high triglycerides. Considering that there are many causes, a visit to the doctor is therefore necessary. Sedentary lifestyle and unhealthy eating habits may also affect triglyceride levels. I commend you for exerting efforts to lower you triglycerides. You have already made modifications in your food intake and it was a remarkable step. Avoiding alcohol plus limiting carbohydrates and fat in the diet are known measures in managing triglyceride levels. When you visit your doctor, remember to ask him about his recommendations regarding diet-related measures to further decrease your triglycerides. Regular exercise is also important, in addition to your swimming routine, your doctor may also recommend other activities that will be beneficial to your condition.
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