If you have high triglycerides levels, you may be looking into medications and supplements that can help you lower serum triglycerides.
First intervention to address this health concern is to change your diet and lifestyle, but sometimes and especially with high (<200 mg/dL) and very high lab values, medicine and supplements may be indicated or may be a good addition for faster and better results.
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Best Supplements to lower triglycerides
There are a wide variety of supplements available on the market that promise to help lower your triglycerides levels, but not all of them have been proved effective. The following are the ones with real science backing up their claims.
Remember to always consult your physician before taking any supplement as they may have risks, side effects and may interact with drugs or may not be indicated according to your medical history.
Omega-3 Fatty acids (EPA and DHA)
Daily supplementation of omega-3 supplements can effectively reduce triglycerides levels. Different sources of omega-3 contain different ratios of EPA and DHA (two of the three omega-3 fatty acids, the other being ALA) although it is not yet clear which one may be the best ratio. Most supplements contain fish oil, cod liver oil, or krill oil with the latter appearing to have higher bioavailability than the previous two.
Dosage varies between 1 g/day and 5 g/day but supplementation of more than 1-2 g/day should be started only after talking to your GP or if advised by another specialist. High doses of omega-3 interfere with blood clotting.
Niacin: vitamin B3
Niacin is a water soluble vitamin that is capable of decreasing bad cholesterol (LDL) and increasing good cholesterol (HDL) while also lowering triglycerides by up to 50%. It is particularly effective at high doses, at 1,500 mg/day and above, for which a prescription is required. Risks of high dose supplementation include liver damage and hyperglycemia in diabetic patients.
Berberine
Berberine is a plant-derived chemical that appears to be effective at lowering both triglycerides and cholesterol as well as improving fasting glucose and glycated hemoglobin and reducing insulin resistance in type 2 diabetes patients. Recommended dosage is 500 mg to 1,500 mg /day and it may cause some gastrointestinal side effects.
Red Yeast Rice
Red yeast rice is a popular supplement that was originally used in traditional Chinese medicine. Red Yeast rice contains Monacolin K, a chemical which is identical to lovastatin, a serum lipids lowering prescription medication. For this reason, red yeast rice has been banned by the FDA in the USA, although it is still available as a supplement in many countries worldwide. The suggested dose is usually 10 mg/day, but it is important to note that it poses the same risks as taking a statin medication and for this reason you should consult your GP before using it.
Medications to lower triglycerides
Before starting to use prescription medications or prescription-grade/dose supplements, a risk benefit analysis should be done. Depending on your medical history and on your triglycerides levels, your GP may prescribe you one or more of the following drugs.
Statins
Statins are a class of drug used as first line treatment for high cholesterol, but they are also effective at lowering triglycerides. Commonly sold medication in this class are:
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol XL)
- Lovastatin (Altoprev)
- Pitavastatin (Livalo)
- Pravastatin (Pravachol)
- Rosuvastatin (Crestor)
- Simvastatin (Zocor)
Among the possible risks and side effects, statins may cause muscle pain (potentially rhabdomyolysis), constipation, nausea and elevation of liver enzymes.
Fibrates
Fibrates are a class of drugs that lower lipids in the bloodstream, both cholesterol and triglycerides. Commonly sold medications in this class are:
- Fenofibric acid (Trilipix)
- Fenofibrate (Antara, Fenoglide, Lipofen, TriCor, Triglide)
- Gemfibrozil (Lopid)
People with liver, kidney or gallbladder issues should not take this medication. Some other drugs may interact with fibrates: when taken in combination with statins there is an increased risk of rhabdomyolysis, a severe condition in which muscles break down causing pain and potentially leading to kidney failure.
Take-home message on supplements and medication for high triglycerides
Studies show that it is important to monitor lipid levels in blood: triglycerides, HDL and LDL cholesterol are important factors when it comes to cardiovascular health.
It is also important the way you decrease such levels when they are elevated: lowering your cholesterol or triglycerides without changing diet, exercising and modifying your lifestyle may not reduce your risk of heart disease and stroke; so while supplements and medications are an important tool in improving your health, they should not be seen as a shortcut or easy way to improve the lab results without making any effort.
Sources
- Omega-3 Fatty Acids – Fact Sheet for Health Professionals
US National Institute of Health – Office of Dietary Supplements
https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ - Triglyceride Lowering Drugs
KR Feingold – Endotext, 2020
https://www.ncbi.nlm.nih.gov/books/NBK425699/ - Management of Hypertriglyceridemia: Common Questions and Answers
RC Oh, ET Trivette – American Academy of Family Physicians, Sep 2020
https://pubmed.ncbi.nlm.nih.gov/32931217/ - Management of hypertriglyceridemia
V Simha – British Medical Journal, Oct 2020
https://doi.org/10.1136/bmj.m3109 - Fibrates
US National Library of Medicine – MedlinePlus
https://medlineplus.gov/ency/patientinstructions/000789.htm
