Hello mwann,
The way the system works, if you receive a reply that is not satisfactory to you, it is fairly likely that another expert will take up the challenge. I will do my best.
Assuming that your blood test was taken after a 12 hour fast, let me begin by saying that a triglyceride value of 752, whether it is an initial reading, or subsequent measurement taken after medication and lifestyle changes have been initiated, is a serious matter. I'm certain that you already know this, I am simply confirming it and emphasizing it.
Furthermore, it's safe to say that a value this high is going to have a significant genetic component. That means that it may have been going on for quite some time and may require more aggressive therapy than, say, for someone who had borderline normal levels for years but then gained some weight and fell into bad eating habits and had their triglycerides shoot up to 200 or 300. By aggressive therapy I mean a regimen that may need to include more than one medication and an even more severe diet and exercise program. I'm sure your doctor is aware of this. Nevertheless, he took the prudent and standard course of starting you on a single medication to see how you would respond. (You're probably aware that the pill you're taking is actually a combination of two ingredients. One of them is a synthetic medication in the sense that it does not occur naturally. The other ingredient is nicotinic acid, which is a vitamin, but, which when taken at what are called "pharmacological doses", essentially doses much much higher than are needed to prevent a vitamin deficiency, can have a major impact on your lipid profile. Aggressive therapy might include even a third oral component, but I believe most physicians would be watching and waiting for at least a few months before taking this step.)
To some extent, the bottom-line seriousness of this rather high triglyceride level depends upon the remainder of your blood lipid profile.
If you have high HDL's and low LDL's then a 752 is not necessarily so scary. But if you have low HDL's and high LDL's with the 752 on top of it, and especially if you should have even other risk factors such as a positive family history for dyslipidemia or coronary disease, you've really got to get on top of this with seriously aggressive lifestyle changes that will result in some weight loss, and to the extent that you include some aerobic conditioning, an increase in your HDL's.
It is reassuring that your blood pressure is normal. You seem to have educated yourself enough about blood lipid problems that I'm sure you would have mentioned it if you are diabetic,
and so it is also reassuring that you are not diabetic.
Improving one's blood lipid profile can be a long difficult struggle but the benefits in life expectancy and general health can be enormous. You must continue working closely with your physician and if you don't start making some progress in a few months, I would consult a cardiologist who specializes in cholesterol and triglyceride problems.
I hope this has been of some help. It would be helpful to me if you gave me some feedback as you did for the previous expert. I am rather new at this and would like to know how I'm doing.
If you should have further questions I would be glad to try and address them.
Good luck in the struggle,
Dr. Stepanek
Edited by Cognostrodamus on March 12 2006 at 6:13 PM
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