high triglycerides

[pinkadam]

Hello friends. I have been on medication for a 19 months. Iam on sustiva and truvada. When i checked my previous labs , i noticed high triglycerides.
I have been undetectable and my T cell is 230 (i started meds when my T cells are 50)

My ID thinks its not a big deal but when i reseached online , it might cause heart attack.

Iam 39 years 5"10 and i weight 160pounds and i jogg 5 times a week. According to my ID iam in very good shape and he says its not a big deal about high triglycerides.
I insisted that he need to do something about it. So he prescribed me card liver oil tablets. Now iam trying to figure out if my ID is doing his job.

What you guys think. I thank you ahead for all your valuble opinions.

Pink

[sharkdiver]

I have high triglycerides due to the meds. I am very active and have a good diet, etc.
With high triglycerides comes the risk of pancreatitus. I have had it 3 times over the past 2 years, each time requiring hospitalization. It is very painful and I wouldn't wish it upon anyone.

[Miss Philicia]

Many HIV patients have high triglycerides, and for long periods of time.  The key is HOW high.

Normal is 149 or less; mine are 226 (down from 269 a few months ago).  I take 2000mg omega 3 fish oil each day, per my doctor's recommendation.

[sharkdiver]

Sorry, Philly is right

I didn't mean to scare you or cause you anxiety. I left out important information. My triglycerides are currently at 2200 (down from 3100) that is extremely high which puts me at risk of pancreatitus. And yes I do the fish oil and cholesterol meds

[Miss Philicia]

Damn sharkie, that IS high.  Can we assume that you're on some type of prescription medication for this as well?  I'd question how much a mere supplement can do with that number.

[BT65]

I have high triglycerides, though I can't remember the number right now.  They're not a high as Sharkie's though.  Wow.  I don't know if there's a medication specifically targeted for high triglycerides, besides fish oil.  Is there?

[Miss Philicia]

If you take a med for cholesterol it should also lower your triglycerides number, correct?  It's all connected.  I know Gemfibrozil does this.

Anyway, before OP pinkadam returns for more discussion I would add that I see that he's not on any protease inhibitor, and that's generally the HIV class of med connected with rising lipid panel issues, so I'm still wondering how high his number is and how connected this issue (for him specifically) is connected to HIV/meds or is just something that would be happening otherwise, due to dietary intake of saturated fats.

It's also known that HIV infection itself causes higher triglyceride numbers:

http://www.aidsmeds.com/articles/aids_triglycerides_lipodystrophy_1667_14380.shtml

(also, according to this article my own high triglyceride numbers are most likely due to my daily intake of Norvir)

[Assurbanipal]

I read through all the lessons on here about 5 or 6 months ago as I was meditating joining in and I seem to recall .. .  Ah, here it is

http://www.aidsmeds.com/articles/Hyperlipidemia_4815.shtml

Hmmm . . . looks like it may need to be updated wrt to Zetia not being shown to be very effective at reducing heart attack risk, but the main point for this discussion was that there are some cholesterol lowering drugs that work mainly on LDL cholesterol, some that work mainly on triglycerides (incluiding fibrates like Gemfibrizol -- note to Philly that they don't seem to be very keen on Gemfibrizol for people on PI's and NNRTI's) and some that work on both.

Hey Pinkadam -- My triglycerides are somewhat higher than Philly's (289) but nowhere near Sharkie's.  My docs aren't obsessing, although I expect they will move me from Pravachol to Lipitor to see if we can do better.

A

[sharkdiver]

Yeah Mine are scary high and yes I am on lopid/Gemfibizil as well as the cod liver oil. All of my lipids (you don't want to know what my cholesterol numbers are) are going down rather slowly.  i will probably have to make the major dietary changes that were suggested a few months ago (45 gm carbs, 45 gm good fats and the rest protein)
The other option is switching meds, but I'm kinda coming towards the end of my "shopping list" of meds. But anyways... didn't mean to hijack and ... I hope I didn't scare pinkadam off.

Sharkie

[Tempeboy]

You should check with your doc, but Efavirenz can cause elevated triglycerides, and other adverse blood lipids.

[aztecan]

Hey Sharkie,

Not to hijack the thread, but are you taking fish oil or cod liver oil? They are different and do different things.

Hey Pink, same question. Cod liver oil is different from fish oil. While it does contain Omega 3 fatty acids, it also contains high levels of Vitamins A and D.

Overdoing Vitamin A can cause problems.

http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/index.html#safety

So, check with your doc. Does he want you to take cod liver oil or fish oil?

The amount of fish oil I take (6,000 milligrams or 6 grams, whichever you prefer) is the maximum recommended daily dosage, according to my doctor.

Just wondering what type of fish oil you're taking.

HUGS,

Mark

[sharkdiver]

Hey Sharkie,

Not to hijack the thread, but are you taking fish oil or cod liver oil? They are different and do different things.

Hey Pink, same question. Cod liver oil is different from fish oil. While it does contain Omega 3 fatty acids, it also contains high levels of Vitamins A and D.

Overdoing Vitamin A can cause problems.

http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/index.html#safety

So, check with your doc. Does he want you to take cod liver oil or fish oil?

The amount of fish oil I take (6,000 milligrams or 6 grams, whichever you prefer) is the maximum recommended daily dosage, according to my doctor.

Just wondering what type of fish oil you're taking.

HUGS,

Mark

oops

I meant the fish oill not the nasty cod liver oill. Once again I'm taking away from this guys thread.  i'll start another one.

[BobF]

HI ... I, too, take Gemfibrozil along with Crestor and Niaspan.   The #'s are going up (except for the "good" cholesterol) since I started Atripla last year.   I agree that cholesterol and triglycerides are something to definitely keep an eye on, with your Doc.

Good luck!
Bob

[pinkadam]

Hi Mark

I have been assuming both fish oil and cad lever oil are same. i need to checj my prescription to find out the medication he prescribed me.

My triglycerides is 275. Iam in any danger ?

thx
Pink

Hey Sharkie,

Not to hijack the thread, but are you taking fish oil or cod liver oil? They are different and do different things.

Hey Pink, same question. Cod liver oil is different from fish oil. While it does contain Omega 3 fatty acids, it also contains high levels of Vitamins A and D.

Overdoing Vitamin A can cause problems.

http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/index.html#safety

So, check with your doc. Does he want you to take cod liver oil or fish oil?

The amount of fish oil I take (6,000 milligrams or 6 grams, whichever you prefer) is the maximum recommended daily dosage, according to my doctor.

Just wondering what type of fish oil you're taking.

HUGS,

Mark

[aztecan]

Hey Pink,

My triglycerides were at 261 last time I had them checked. The doc wasn't too concerned about it. Mine have hovered between 350 and 225 for years.

Are you at risk? I would ask your doc, but in the short term I think you are doing OK. Sharkie ended up with pancreatitis from his high triglycerides, but remember his were in the thousands (2,200), not the hundreds like ours 261 or 275).

So, I would check with your doctor about the fish oil and ask him/her about taking some exercise. It really can help sometimes. At the very least, it will probably make you feel better.

HUGS,

Mark

[Jeff G]

 I just got my lipids results back this week and my triglycerides are 686 .
 My cholesterol is 227 .
 These numbers are despite medication  , proper diet , and exercise and are half of what they
  were a year ago .
  I am at a loss as how to bring them down to a normal level .

[BT65]

I just got my lipids results back this week and my triglycerides are 686 .
 My cholesterol is 227 .
 These numbers are despite medication  , proper diet , and exercise and are half of what they
  were a year ago .
  I am at a loss as how to bring them down to a normal level .

Wow.  What medication are you on?  My triglycerides are always elevated, but my doctor said that's because of the diabetes.  Aren't you diabetic as well, Jg?

[Jeff G]

Hey Betty...Yeah I'm a type 2 diabetic . I take lovastatin and fish oil .

[randym431]

Just came across this thread from May 08.
It looks like my triglycerides are going up too.
This lab they were at 300. Before triglycerides were not an issue
or anything the doc talked about.
One thing, on these latest labs, I did not fast. Usually they ask me if I did
or tell me to, but not this time so I didn’t.
I told the doc I did not fast and could that maybe cause higher triglycerides?
He, like usual in his own evasive way, replied “well... maybe”.
Not a very firm answer.
I do take one fish oil a day, pretty low dosage.
I'm also on sustiva and epizcom, which are not triglycerides friendly
from what I hear.

[aztecan]

I am facing the issues right now. I have just had to stop taking my cholesterol meds (Pravastatin, Zetia) because they are causing a rather nasty side effect that could lead to serious consequences.

I know that high sugar intake can increase a person's triglycerides. So, I am going to start using Splenda in my coffee and tea.

I won't go nuts over this, like cutting out all sugar or something, but a little harm reduction couldn't hurt.

There is a medication for high triglycerides called Tricor. I know several people taking it. I don't because, while a bit high, my triglycerides were never that high.

Hey Pink, did you ever ask your doctor about the fish oil, etc.?

Just checking.

HUGS,

Mark

[minismom]

Mini's triglycerides and cholesterol are high and have been for a long time.  What prompted her PID to check was when the lab sent her a note that said Mini's blood was "cloudy"..YIKES!  She sees a cardiologist / lipid doc every 3mths for a fasting panel.  She's on 1000mg of fish oil / day, cut off all sugar (she's a walking Splenda ad), and diagnosed diabetic, and she takes 2 doses of FiberSure / day (the powder stuff) and eats double fiber bread.  Even with all of this, and being off of Susteva, she's still elevated. 

Her docs are less worried about her high triglycerides as they are the fact her LDL is nearly twice her HDL.  But, all her echos have come out normal, so they are mored worried about the long-term effects and the fact that we can't get them under control.

Mum (who has decided that high tris are just par for the course)

[newt]

Hello

High tris are not reason enough to change meds and/or add some kind of other agent to lower triglycerides.

High triglycerides are linked to increasing the risk of heart disease. For each increase of 1.1 mmols/L the 10-year risk of a heart attack increases by about 25% in men and 60% in women. This is over your baseline risk, which will vary from person to person.

Although there is a lot of individual variability target fasted levels of under 2.2 mmol/L are considered normal and of 2.2-4.4 mmol/L are borderline. Above this, the risk of heart disease increases. Levels above 11 mmol/L are considered very high. (soz, these is European units, for USA multiply by 100 to giv ml/dL).

You need to take other factors into account.

The alternatives may not deliver a better picture. Most PIs raise some kind of cholesterol, although Reyataz and perhaps Prezista are better in this respect. Abacavir use doubles the risk of heart attack according to recent analysis from the D:A:AD study. If your baseline risk of heart attack over the next 10 years is low, like 1-2% this may not be important, but if its higher it may be.

Bottom line:

1. you need to look at all risk factors (family history, body mass index, diet, age, gender, smoking, exercise etc)

2. If high tris still concern you, diet/supplements/additional meds/a change of combo are perfectly reasonable things to do

- matt

[panda]

wheat grass !!!! this will help u so  much ...
I also handle the high levels of lipids, the problem with the wheat grass is the taste.. its not pills u actually have to drik it but boy it worth it... u should get it every morning on empty stomach, I take like 3/4 glass... i did it for like a full month and then went to take my blood test and the results were much much better... so now I am starting it all over again, i am about a week with this weath grass... i will continue for another week and then I will go for the blood test..

[YaKaMein]

Think Matt hit it clearly on the head. Our ability to modify our trig levels (and cholesterol) may involve lifestyle changes even if the cause is not genetic but med effects. This is no easy task, speaking for myself - I've added supplements, changed my diet, take Lipitor. With the increased energy levels and waning fatigue, maybe I'll make time and effort to incorporate some exercise, which has plenty of benefits.

[Pippet]

My triglycerides got as high as 540 but I got back down to "normal" by cutting back on the hard liquor and watching my fat and sugar intake.   I have to be vigilant about it or they shoot back up again.

Be well, Pip