The Dilemma of Hypertriglyceridemia

‘An investment in knowledge pays the best Interest’
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BY FIZAH HAMID

Above mentioned quote truly defines that we are never too old and never too late to gain knowledge. We should always try to learn, as something is better than nothing.

Very famous old proverb says ‘Prevention is better than cure’, and for that we all should know about the most common diseases present in our nation and its basic Preventions.

We all must have come across a word- ‘Hypertriglyceridemia or High TG levels’, which is one of the most common disorders found in our nation, in our society.

Hypertriglyceridemia is characterized by elevated fasting TGs. Individuals with this phenotype generally have reduced lipolysis of TRL(Triglyceride Rich Lipoprotein), even overproduction of VLDL by the liver also contribute in most of the cases, that’s why we often see high VLDL levels along with High TG.

High TG levels are caused by a lot of things, which are heavily affected by our daily lifestyle. It includes Increased intake of Carbohydrates(which are found in a wide variety of our foods), Obesity, Insulin Resistance, Alcohol Intake, Hypothyroidism even certain medications. We should know that Liver Disorders may also play a role in Lipid Disorders.

We must understand that Triglycerides are all together different from Cholesterol, even people might have High TGs but normal serum cholesterol, and it doesn’t mean having high TG indicates high cholesterol.

A very important thing which is most commonly misunderstood is the fact that Hypertriglyceridemia is not generally associated with significantly increased risk of Coronary Heart Disease(CHD), however Severely High TG levels are risk factors of Acute Pancreatitis (as per latest edition of Harrison’s Internal Medicine). We must understand that the treatment of High TG levels differs to that of having High Cholesterol or High LDL level.

In our valley, most of the people usually go for self treatment, almost all Pharmacists usually recommend Statin Therapy(eg Atorvastatin, Rosuvastatin etc), but we should know that people who are otherwise not at high risk of Heart Disease already, these lipid lowering medications can frequently be avoided , and high TG levels(upto 500mg/dL) can be treated by appropriate dietary and lifestyle changes only, we must note it down that Plasma TG levels >500mg/dL afterwards can be treated by a class of drugs known as Fibrates(fenofibrate) or Fish Oil commonly known as Omega-3 fatty acids (as per Harrison’s Internal Medicine, NEJM.org, Mayoclinic etc).

Modifying lifestyle often is associated with a significant reduction in Plasma TG level. Dietary fat intake should be restricted, excessive intake of simple carbohydrates should be discouraged, Exercise can have a positive effect in reducing TG levels, persons who are overweight, weight loss can help to reduce TG Levels.

We must have the knowledge regarding these issues, and should appropriately manage the condition. We must not take self medications but to consult a Doctor should be encouraged. We usually prefer self medication in earlier stages which is usually followed by worsening of the disease before even consulting a Doctor. It’s better to modify our lifestyle habits or dietary habits which are harmful for us,in order to live a healthy life.

‘DON’T LOSE YOUR HEALTH, LOSE CIGARETTES, LOSE JUNK FOOD, LOSE WEIGHT, LOSE EXCESS FAT AND CARBOHYDRATES’.

Let us live a healthier life together.

References- 20th Edition of Harrison’s Internal Medicine, The New England Journal of Medicine(NEJM.org) , American Heart Association(AHA), Mayoclinic.in, Heart.org).

The Author is 5th Year Medical Student

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.

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