What should my partner avoid for high triglycerides at 41?

Question

Hello, Doctor,

My 41 year old husband just got blood work results, and his triglycerides are over 800. The doctor says normal is under 150. He has been having chest pain on and off for weeks, and we were terrified that he was going to have a heart attack. He has always been overweight, but he gained another 40 pounds this past year while working from home. His diet is terrible, with lots of fast food and sugary drinks, because he is always too busy to cook.

He also drinks beer every night to relax after work. The doctor prescribed some medication, but he's worried about side effects and wants to try diet changes first. We have tried low-fat diets before, but he always goes back to his old eating habits. His father died of a heart attack at 50, and his grandfather had diabetes. He has been getting dizzy spells lately, and his legs cramp up when he walks. The doctor mentioned something about pancreatitis risk, which scared us even more. He is supposed to go back for more tests, but keeps putting it off because he is afraid of what they will find. His work stress is through the roof, and he says eating is his only comfort.

What foods should he avoid?
How quickly can triglycerides come down?
Is he at immediate risk of a heart attack?
Should he start medication right away?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

It sounds like your husband is at a critical juncture, and your concern is completely understandable. Very high triglyceride levels, greater than 800 mg/dL, can result in serious complications such as pancreatitis and cardiovascular disease. For reference, normal triglyceride levels are less than 150 mg/dL.

High levels are between 200 and 499 mg/dL, and very high levels are above 500 mg/dL and are associated with a higher risk of pancreatitis. Even greater is the risk when the levels are above 800 mg/dL. At this level, your husband could be in danger of acute pancreatitis, which is a life-threatening condition.

He may also be at increased risk of cardiovascular events, such as a heart attack or stroke. In addition, very high triglyceride levels are associated with insulin resistance, diabetes, and other metabolic disorders. But his symptoms and medical history raise other concerns. He has had occasional chest pains, dizzy spells, and leg cramping.

These could be signs of an underlying cardiovascular or circulatory problem. His family history is also important, as his father died of a myocardial infarction at the age of 50. Rapid weight gain, an unhealthy diet, stress, and alcohol use can further increase the risk of cardiovascular disease. Because of these, a thorough cardiac workup is strongly recommended.

This may include an electrocardiogram, echocardiogram, stress testing, and, if his physician says it is needed, advanced imaging such as coronary CT angiography. Timely assessment might identify issues before a critical incident. He should speak with his doctor about medication as soon as possible. Changes in diet are important, but triglycerides over 800 mg/dL usually require medication in addition to lifestyle changes.

Usual treatments are fibrates, such as fenofibrate or gemfibrozil, high-dose omega-3 fatty acids, statins if cholesterol is also high, and, in selected cases, niacin. Medications can have side effects, but these are usually manageable and reversible. However, untreated severe hypertriglyceridemia can result in pancreatitis and cardiovascular complications, which are potentially much more serious.

Dietary changes are very important during this phase. He should avoid alcohol, sugary drinks, sweets, desserts, refined carbohydrates, and fatty processed foods until his triglyceride levels have improved. With a structured diet plan and medical supervision, you can significantly lower triglyceride levels and reduce future health risks.

I hope this information helps you.

Feel free to ask further questions.

Thank you.