Management First Steps

How is sHTG treated?

Many possible causes of severe hypertriglyceridemia (sHTG) exist. And each person may have a different mix of causes. 1

As a result, a treatment that works for someone else may not work for you. Still, many ways of reducing triglyceride levels work for most people. 1

First steps

Have thorough, honest conversations with your doctor and other members of your healthcare team. Try to identify possible causes of sHTG, such as the ones below.

Medications you are taking

Tell your doctor about any prescription medications, over-the-counter medications, supplements, herbal remedies, or other remedies you use. You may need to change medications or adjust your dosage.

Medical conditions

As listed on the Causes page, some medical conditions may increase triglyceride levels. You and your healthcare team should explore whether you have any of them.

Many people with sHTG have diabetes, excess weight, high cholesterol, metabolic syndrome, or insulin resistance. Often, better control of these conditions reduces triglyceride levels.

Familial chylomicronemia
syndrome (FCS) requires a different approach

In people with FCS, medications to lower triglyceride levels often have little to no effect on triglyceride levels. Some medications may even raise their triglyceride levels due to their genetics. It is important for people with FCS to follow a specific diet to prevent triglyceride levels from becoming dangerously high. 8

Lifestyle changes

Often, changes to lifestyle can reduce triglyceride levels. 1,9,11

  • Reducing alcohol. Drinking alcohol may cause large increases in triglyceride levels. For some people who drink a lot of alcohol, triglyceride levels drop by as much as 80% (for example, from 500 mg/dL to 100 mg/dL) when they stop drinking alcohol.
  • Weight loss. Losing 10 pounds (~4.5 kg) of body weight reduces triglyceride levels by about 36 mg/dL, on average.
  • Changing the foods you eat. Reducing saturated fats, sugars, and excess calories from your diet may lead to reductions in triglyceride levels. Stricter limitations on fat consumption are needed if:
    • Your triglyceride levels are above about 500 mg/dL.
    • You have FCS.
  • Physical exercise. Getting enough physical exercise may reduce triglyceride levels by 10 to 20%.

Exercise provides numerous other health benefits including improved control of
diabetes, weight loss, lower risk of cardiovascular disease, and possibly lower risk of dementia as you
get older. 23,24

Support from a registered dietitian, exercise specialist, or counselor may improve your chances of making lifestyle changes. Talk to your doctor about adding some of these specialists to your healthcare team.

For more information, see Working with your healthcare team.

Show References
 
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