The Symptom Reduction Series:

 

Charlie Smigelski, RD,

Fenway Health Center

Boston, Massachussetts

 

 

MANAGING HIGH TRIGLYCERIDES

 

 

High triglycerides (TG) means you have extra fat (grease) in your blood stream. If this happens for a while, you could develop an inflamed pancreas, known as pancreatitis. This can be deadly, because it can cause you to get infections and kidney failure.

 

Also, with that much grease in your blood, you feel tired. It is most likely the result of some medicine you are taking, (especially some protease inhibitors) but eating too much fat and sugar can also contribute to the problem. Here are some steps to take to reduce your triglycerides.

 

If your TG level is above 500, start doing something about the situation.

 

1. Aerobic exercise is a great treatment. A 45-60 min. power walk or a treadmill session is effective. Bicycling or roller blading for 45 minutes is good, too. Try to do it all at one time though, a 30 minute walk twice a day isn’t the same thing.

 

2. Lower the grease level in your diet. Ease up on fatty foods like ice cream and cheese and French fries. Eat some good fiber foods, like more vegetables and fruits, and bran cereals. Olive oil is the best choice for cooking oil and salad dressing.

 

3. Take 3 grams of Fish Oils each day. Also known as Omega 3 fatty acids or EPA or DHA. These can be good for immunity too. DON'T take fish oils if you have low blood platelets. You might raise your risk of bleeding too easily. (Ask your expert HIV nutritionist about taking N-acetylcysteine (2 grams a day) to raise your platelets. Take this for a month or two. Ground flax seeds (1-2 Tblsp/day) or flax seed oil pills (2 gm/day) may be used instead of fish oils later on, but start with fish oils. By the way, ground flax seeds have a great nutty taste

 

4. Take 2 grams Evening Primrose oil each day. This is an omega-6 essential

fat. I can help prevent heart disease. Particularly, it raises HDL cholesterol

levels. It also solves dry skin problems that people get when taking some

protease inhibitors.

 

5. Take 2 grams L-Carnitine each day. This helps the body increase fat-burning in cells. It can lower cytokine (stress hormone) levels as well. Carnitine comes in prescription form as “Carnitor”; ask your doctor about it if you find it helpful.  You may hear about acetyl L-carnitine, it's not quite the same for burning fat, but it may be helpful for preventing neuropathy when taking ‘d’ drugs, like ddI, ddC , and d4T.

 

The prescription drug Lopid can be very useful too. Ask your doctor about prescribing this if your exercise and nutrition supplement efforts aren’t working well enough.

 

Selenium and antioxidants seem to reduce risk of pancreatitis. These should all be a part of your vitamin supplements when HIV+ anyway.

 

High triglycerides are sometimes a suggestion that your HAART drugs are increasing your blood sugar, and have you pointed in the diabetes direction.

 

You can reduce diabetes risk.  Glucose is managed by insulin. Insulin works with glucose tolerance factor (GTF). GTF is composed of Glutathione (which is made from N-Acetyl Cysteine and Glutamine), Niacin, & Chromium. Over time, we can expect chromium levels to be low due to malabsorption. Take 400 mcg chromium/day for 1 month. All B-vits are needed in higher quantity. We know that glutathione is at risk as well. The 1-2 gm NAC/day you take help maintain good glutathione levels. Insulin receptor status on muscles is a function of “in-shape” level of muscles, and repair status. Do some resistance-training exercise, this means weight-lifting. Alpha Lipoic Acid (100-200mg/day) can also help sugar pass through muscles better, and reduce neuropathy potential thanks to its antioxidant effects on nerve cells. It is a common treatment for diabetic neuropathy in Europe. Testosterone levels also impact sugar processing and storage in liver. Have your total and free testosterone levels checked every 3-4 months once AIDS diagnosis has occurred.