How can I lower my triglycerides and prevent pancreatitis?

Question

Hello doctor,

My triglycerides are over 1000, and I just had pancreatitis from it. I had terrible stomach pain that sent me to the emergency room, I could not eat for days, I was hospitalized, and now my doctor says my triglycerides are so high that they are dangerous and could cause another attack.

What are triglycerides? Why are mine so high?
Is this genetic? What causes it?
Why did it cause pancreatitis?
What can I do to lower them?
Should I avoid all the fat?
Should I cut out alcohol completely?
What medicines lower triglycerides?
How often do I check my levels?
What number should I aim for?
Am I at risk for heart disease or stroke?
Will I have diabetes?
Do I need a heart doctor or an endocrinologist?
Can I prevent another pancreatitis attack?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Triglycerides are a type of fat (lipid) in your blood used for energy. Very high levels (greater than 500 milligrams per deciliter) are dangerous, and over 1000 milligrams per deciliter significantly increases the risk of pancreatitis.

Extremely high triglycerides make your blood thick and sludgy. This can block the small blood vessels in the pancreas, inflaming it and causing the severe pain you experienced.

This is often a combination of genetics (a condition called familial hypertriglyceridemia) and lifestyle factors (diet, weight, lack of exercise). Other causes can include uncontrolled diabetes, high alcohol intake, and certain medications. Your primary goal is to prevent another attack

The immediate and most important goal is to get your triglycerides below 500 milligrams per deciliter to prevent another pancreatitis attack. So, according to me,

Eliminate alcohol: Alcohol is a major trigger for high triglycerides and pancreatitis. It is essential to stop all alcohol consumption.
Drastically reduce sugars and refined carbohydrates: This is critical. Your liver converts excess sugar and refined carbohydrates (white bread, pasta, white rice, and pastries) into triglycerides. Avoid sugary sodas, fruit juices, candy, desserts, and processed foods with added sugar.
Manage fats wisely: You do not need to avoid all fats. You need to choose the right ones. Avoid saturated and trans fats (fried foods, red meat, full-fat dairy, and processed snacks). Choose healthy fats like those in avocados, nuts, seeds, and olive oil.
Increase fiber intake by eating plenty of vegetables, whole grains (like oats and quinoa), and legumes.
Exercise regularly; aim for at least thirty minutes of moderate-intensity exercise (brisk walking, cycling) most days. This helps your body use triglycerides for energy.

So now,

1. Lifestyle changes are vital, but with levels over one thousand, medication is non-negotiable to get them down quickly and safely.

2. Fenofibrate: This is a first-line treatment for very high triglycerides. It works very effectively to lower them and is commonly prescribed after an episode of pancreatitis.

3. Prescription omega-3 fatty acids (Icosapent ethyl, Omega-3-acid ethyl esters): These are high-dose, purified fish oils.

4. Icosapent ethyl is specifically approved to reduce the risk of heart events in people with high triglycerides.

5. They are very effective and are often used alongside a fibrate like Fenofibrate.

6. Do not use over-the-counter fish oil for this; the dose is too low. Your doctor will prescribe the correct therapeutic dose (often four grams per day).

7. Statins primarily lower low-density lipoprotein cholesterol (bad cholesterol) but can also moderately lower triglycerides. You will likely be on one to protect your overall heart health.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.