Lifestyle Changes to Manage Elevated Triglycerides

Q:  I read with interest your reply to the person who was having difficulty managing his/her elevated triglycerides.

I am a health care professional (non-MD) with familial hypertriglyceridemia, so I have followed the literature closely and incorporated a variety of modalities quite successfully. While I appreciate that you have a limited amount of space for your response, it seemed there were more non-drug interventions that could have been reviewed.

First, I understand that for many individuals, an exercise period of 45 minutes can produce much greater reduction in plasma triglycerides than the shorter period reported by your reader. Second, omega-3 fatty acids as a daily supplement at 2.5 to 3.0 grams is a well-documented dietary adjunct for this condition (while less clearly beneficial for other lipid disorders) without the side effects of the pharmaceutical options you discussed.

Finally, while the reader did not specify the problem with niacin, one suspects that he or she may have tried time-release niacin and experienced the well-known hepatotoxicity associated with time-release but not regular crystalline niacin. Most individuals can gradually increase dosage of regular niacin and eliminate or reduce the flushing to acceptable levels. I'm always in favor of trying dietary and other lifestyle modification before turning to pharmaceutical strategies.

A:  Amen to everything you said. It's great to have readers who also provide answers.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.