Are your triglycerides high? This is how your doctor chooses the right medication for you.

It's normal to feel a little scared when your doctor tells you that your triglycerides are high in your blood. When you can't lower them even after controlling your diet and exercising, you may be wondering what to do next. Sometimes our bodies need a little help to control them, which means medication. So how does your doctor choose the right medication for you? Let's talk about it simply.

Do I need to start taking medication?

Not everyone is given medication when their triglycerides are slightly elevated. The first step is to try to control these levels by making lifestyle changes, such as eating a healthy diet and exercising. However, your doctor is more likely to prescribe medication in the following cases:

• If your triglyceride levels are very high: that is, much higher than 500 mg/dL. This can cause damage to the pancreas, so it is important to get it under control quickly.
• If you have high levels of "bad" cholesterol (LDL) along with triglycerides: The combination of these two conditions increases your risk of heart disease and stroke.

Before choosing a medication for you, your doctor will consider several factors. For example, are you currently taking any other medications? What is your overall health status? All of this will help determine the most appropriate and safest medication for you.

Main types of medications used to lower triglycerides

There are several main classes of drugs used to lower triglycerides. Let's look at each of them separately.

1. Fibrates

These medications primarily lower triglyceride levels. In addition, they help reduce cholesterol levels and a protein called ApoB, which is found in bad cholesterol (LDL).

People who should not take this medicine:

Fibrates are not recommended if you have liver , kidney , or gallbladder disease.

Possible interactions with other medications:

Before starting fibrates, tell your doctor about all other medications and vitamins you are taking, especially:

• Blood thinners (Anticoagulants) - e.g. Warfarin
• Medication for diabetes
• Other cholesterol-lowering medications - e.g. Atorvastatin (Lipitor), Simvastatin (Zocor)
• Insulin

2. Niacin

This is also a drug that improves cholesterol levels while lowering triglycerides. Niacin reduces bad cholesterol (LDL) and ApoB levels, and increases "good" cholesterol (HDL) levels.

• Drug name: Niaspan (niacin)

People who should not take this medicine:

• If you have an allergy to aspirin, niacin, or tartrazine (a yellow dye used in some medicines and foods)
• If you have bleeding problems
• If you have diabetes
• Gallbladder disease
• Heart disease
• Liver disease or jaundice
• Stomach ulcer
• If you are preparing for any surgery, including a tooth extraction

Possible interactions with other things:

Before taking niacin, tell your doctor if you are taking/doing any of the following:

• If you are taking blood-thinning medication (e.g. Warfarin).
• If you take insulin or oral diabetes medication (niacin may increase blood sugar levels, so your doctor may need to adjust the dosage of your diabetes medication).
• If you drink too much alcohol.

3. Prescription-Strength Omega-3 Fatty Acids

These medications lower triglyceride levels and can sometimes increase good cholesterol (HDL) levels.

• Names of the medications: Epanova, Lovaza, Vascepa

People who should not take this medicine:

• If you have allergies to fish or shellfish
• If you drink more than two glasses of alcohol a day
• If you have diabetes, liver, pancreas, or thyroid disease

Possible interactions with other medications:

Tell your doctor if you are taking these medications:

• Medicines containing aspirin
• Blood thinners (e.g. Warfarin, Clopidogrel)
• Birth control pills containing estrogen
• Estrogen hormone therapy (Estrogen replacement therapy)
• Some medications for high blood pressure or heart disease (e.g. Beta-blockers, Diuretics)

What if cholesterol is high?

Often, when triglycerides are high, cholesterol levels also increase. If you have both of these conditions, your doctor may also recommend that you start taking cholesterol-lowering medications. These medications can also help lower triglyceride levels to some extent.

What happens after starting the medication?

After you are prescribed medication, you will probably need to see your doctor every six weeks until your triglyceride levels have decreased. During these appointments, be sure to discuss any discomfort or side effects you are having from the medication.

Be sure to tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. You may need to change your medication or stop taking some medications.

Your doctor may adjust your medication dosage as your blood levels improve. If you are taking fibrates or niacin, you may also have blood tests to check your liver and kidney function at these appointments.

Once your triglyceride levels are within target levels, you will need to see your doctor every 6 to 12 months . They will also do blood tests at that time to make sure your levels are under control.