- Scientists say 4 grams daily of prescription omega-3 medication can significantly reduce triglyceride levels.
- High triglyceride levels can narrow arteries and increase heart disease risk.
- Experts say lifestyle changes and medications such as statins and omega-3s can lower triglyceride levels.
Prescription omega-3 fatty acids can reduce high levels of triglycerides, but experts say consumers should avoid supplements that are unregulated.
A recent scientific advisory from the American Heart Association (AHA) found 4 grams daily of prescription omega-3 reduce triglyceride levels by 30 percent or more in most people who need treatment for high triglycerides.
“From our review of the evidence from 17 randomized, controlled clinical trials on high triglyceride levels, we concluded that treatment with 4 grams daily of any of the available prescription choices is effective and can be used safely in conjunction with statin medicines that lower cholesterol,” said Ann Skulas-Ray, PhD, an author of the advisory published in the American Heart Association journal Circulation.
Trigylcerides are a kind of fat that circulates in the bloodstream.
A healthy level of triglycerides is less than 150 mg/dL. Elevated levels are considered those with a triglyceride level of 200 mg/dL or above.
High triglyceride levels can cause narrowing of the arteries and an increased risk of heart attack or stroke.
For those with triglyceride levels greater than 500 mg/dL, complications also arise in the pancreas.
“When triglycerides accumulate in very high concentrations in the blood it can cause a very serious condition where the pancreas gets inflamed called pancreatitis. This is actually a very dangerous situation and in some cases can be fatal if it’s not recognized early on,” Dr. Michael Shapiro, a member of the Prevention Section and Leadership Council at the American College of Cardiology, told Healthline.
When a person eats, the body converts calories it doesn’t need right away into triglycerides.
These are stored in fat cells and later are released to provide energy between meals.
Those who eat more calories than they burn may have high triglycerides. A common cause of elevated or high levels of triglycerides is lifestyle factors.
“The Western lifestyle; being overweight or obese, being sedentary, having a poor diet, particularly one that is enriched in simple sugars and carbs and high in saturated fat, drinking too much alcohol. This is absolutely related to the epidemics of obesity and diabetes. It’s almost a certainty that is what is the cause of elevated triglycerides. We need to do much more to combat this epidemic of obesity,” Shapiro told Healthline.
Lifestyle interventions such as regular exercising, avoiding foods high in refined sugar or carbohydrates, and limiting alcohol intake can help reduce triglycerides.
But in some people, medical therapy is also needed.
“In those that have never had a heart attack or stroke, if the triglyceride levels are elevated over 150 mg/dl, they are a risk factor for heart disease over the long term and it is advisable to take steps to lower triglyceride levels, including diet, exercise, weight loss and sometimes medications,” Dr. Joshua Knowles, an assistant professor of cardiovascular medicine at the Stanford University Medical Center in California, told Healthline.
“In those with a prior heart attack or stroke, recent data suggests we should really try much harder to lower triglycerides, potentially using medications such as omega-3 fatty acids along with statins,” he said.
The AHA advisory suggests the effective dose of prescription omega-3 fatty acids is 4 grams daily with food.
This was found to be effective in lowering triglyceride levels regardless of whether the patient was on statins, a type of drug used to lower cholesterol in the blood.
Although omega-3 can be found in fatty fish such as salmon, most people would not eat enough fish daily to receive the same benefit as prescription omega-3.
“Prescription omega-3 fatty acids are highly concentrated forms of the omega-3 fatty acids EPA and DHA. Like dietary supplements, they are derived from fish oil, but they are subject to more oversight as FDA-regulated medications. Taking omega-3 fatty acids affects multiple risk pathways in the body, including how fat and cholesterol is transported is the blood. They help this process work more efficiently and decrease the amount of fat (triglyceride) in the blood,” Skulas-Ray told Healthline.
Although prescription omega-3 is effective, experts advise against using similar non-prescription supplements.
“Because non-prescription fish oils do not undergo the same rigorous testing and do not all have the same active and inactive ingredients we cannot know for certain if they will lead to the same outcomes, so for people with very high triglycerides we only recommend the prescription forms,” Karol Watson, PhD, a professor of cardiology and co-director of the UCLA Program in Preventive Cardiology, told Healthline.
The reason why omega-3 fatty acids work at lowering triglycerides is not yet fully understood, but experts say the drug has a number of benefits.
“What’s happening in the body is anyone’s guess. We do know that at least in a test tube… it lowers markers of inflammation, it makes platelets less sticky, so less likely to clot, it stabilizes cell membranes, it makes them less excitable so there’s less arrhythmogenic potential. There’s a whole host of things, anti-inflammatory, anti-thrombotic, anti-arrhythmic and, of course, they have this triglyceride effect,” Shapiro said.
He advises that those concerned about their heart health should see their doctor.
He argues that for most people, lifestyle interventions are a good starting point to lower triglycerides.
“For the vast majority, between 200 mg/dl and 500 mg/dl, we definitely want to give lifestyle a go before we move on to the addition of medical therapies. In people who really give it a good effort we can see very significant lowering of triglycerides,” he said.
“When you look at the three major lipid fractions on the standard lipid panel which are the LDL cholesterol; the bad cholesterol, the HDL cholesterol; the healthy cholesterol and triglycerides, the fraction that’s most amenable to lifestyle changes is triglycerides, they can simply melt away with good behavior,” he added.