Nutritional TRIGLYCERIDES Reduction: Fasting Blood Lipid Profile

Nutritional Triglyceride Reduction: Fasting Blood Lipid Profile

The purpose of this website is to present, to all who want the knowledge, a safe and dependable method through which individuals can lower their elevated blood triglyceride levels. You can achieve astonishing results - if you put your mind to it.

The blood tests make available to the physician a great amount of information about a patient's physical condition at the time of the testing. After review and interpretation, the blood test results play an important part in an overall medical diagnosis.

A blood test, though important, is only a part of the final diagnosis of a health problem.

Most reference ranges - often referred to as 'normal' ranges - are typically defined as the range of values of the median 95 percent of the healthy population; therefore, it is unlikely that a given blood sample, even from a healthy patient, will show "normal" values for every blood test taken.

For this reason, caution should be exercised by examining physicians to prevent overreaction to mild abnormalities without the interpretation of those test results.

Blood lipid test, mainly cholesterol and triglycerides, is a screening test which is used to try to detect a disease when there is little or no evidence that a person has a suspected disease.

Therefore, measuring lipid levels helps to identify one of the risks of heart disease in those who may show no symptoms of heart disease. Blood lipid test then is a tool for the physician to detect a potentially harmful and evolving condition.

However, sometimes a test result may be:

incorrectly abnormal in a person who does not have the suspected disease (a false-positive result) or
incorrectly normal in a person who has the disease (a false-negative result).

No blood test is completely accurate all of the time.

Because your physician cannot always be sure whether or not the reported result of a particular test from a particular person is false or true, a person with an abnormal result may often need to be re-tested or undergo a different type of testing.

"Normal" test result values, expressed as a reference range, vary somewhat among laboratories, due to methodology and even geography.

Also tests and testing vary widely in different parts of the world, and in different parts of most countries, mainly due to characteristics in the population, among other factors.

Standard Fasting Blood Lipid Profile

In assessing the risk of heart disease, standard medicine targets usually total cholesterol and LDL-"bad" cholesterol levels. However, people with high cholesterol often have high triglycerides, especially when there is no another disorder present.

Therefore, the type of standard treatment used to lower cholesterol

depends on whether triglycerides are high or normal, and

is usually directed toward lowering both cholesterol AND triglycerides.

HERE ARE YOUR RESULTS

Check these various components in your fasting blood lipid profile.They are considered important indicators of your risk of having a heart disease. It is obviously best to be at the high end of the "good" HDL cholesterol range (> 80 mg/dL), and the low end of the "bad" LDL cholesterol (< 100 mg/dL) and triglycerides range (< 100 mg/dL is IDEAL).

LIPID

LEVEL

SHOULD BE . . ..

Total Cholesterol (TC)

DESIRABLE
Under < 200 mg/dL

BORDERLINE-HIGH
(Depending on your HDL)
200 mg/dL -239 mg/dL

HIGH
240 mg/dL and Above

Under < 200 mg/dL (depending on your HDL level)
DESIRED: Not more than 4 times your HDL level.
Examples: 4 X 40 mg/dL HDL = 160 mg/dL total cholesterol (TC)
4 X 50 mg/dL HDL = 200 mg/dL total cholesterol (TC)

HDL Cholesterol (High Density Lipoprotein -"Good" Cholesterol)

DESIRABLE
Men - 65 mg/dL
Women - 75 mg/dL
or Higher

ACCEPTABLE
Men - 55 mg/dL
Women - 65 mg/dL

LOW
Men - <50 mg/dL
Women - <60 mg/dL

Above > 60 - 70 mg/dL
The lower your HDL, the lower your total cholesterol (TC) should be!

HDL/TC Ratio:
HDL divided by Total Cholesterol (TC)

IDEAL
0.30 or Higher

LOW
Under < 0.24

VERY DANGEROUS
Less than < 0.10

Above > 0.24
Example: 80 HD:190 TC = 0.42
The higher the number (HDL:TC ratio), the better - the lower your risk of heart attack.

Triglycerides (TRG)

BORDERLINE-HIGH
150 mg/dL - 199 mg/dL

HIGH
200 mg/dL - 499 mg/dL

VERY HIGH
Over >500 mg/dL

Under < 150 mg/dL
IDEAL: Under <100m/dL
When triglycerides are "severly high" (greater than < 1000 mg/dL), there is a risk of developing pancreatitis.

TRG/HDL Ratio:
Triglycerides divided by HDL

IDEAL
2 or Less

HIGH
4

MUCH TOO HIGH
6

Under < 2
Example:
110 TRG:60 HDL = < 2
The lower the number (TRG:HDL ratio), the better - the lower your risk of heart attack.

LDL Cholesterol (Low Density Lipoprotein - "Bad" Cholesterol)

NEAR OPTIMAL OR ABOVE OPTIMAL
100 mg/dL - 129 mg/dL

BORDERLINE-HIGH
130 mg/dL - 159 mg/dL

HIGH
160 mg/dL - 189 mg/dL

OPTIMAL: Under < 100 mg/dL
VERY HIGH: 190 mg/dL and above

LDL Cholesterol FOR HEART PATIENTS

MUST BE UNDER
< 80 mg/dL
The lower, the better

HIGH
110 mg/dL

DANGEROUSLY HIGH
140 mg/dL

IDEAL: Under < 70 mg/dL
(If you are a heart patient, LDL MUST be under < 70 mg/dL)
SEE YOUR DOCTOR, IF
NOT UNDER < 80 mg/dL.

Glucose (GLU):
6-Hour Fasting Blood Sugar

NORMAL
Under < 87

HIGH
110 - 125

VERY HIGH
126 and Above

Under < 90
SEE YOUR DOCTOR, if 110 or above

PLEASE NOTE: These numbers are based on a fasting lipid profile: 12 to 14 hours before the test (alcohol should NOT be consumed for the 24 hours). IF YOU DON'T FAST, your Triglycerides, LDL and Glucose will be higher.
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Measurement Units: Mg/dL Vs. Mmol/L

American blood laboratories use a different version of the metric system than does most of the rest of the world, which uses the SI or Systeme Internationale d’Units.

The SI is an international standard recognized around the world – except by the United States of America, Liberia, and Myanmar (Burma) who will probably adopt it in due time.

In some cases translation between the two systems is easy, but the difference between the two is most pronounced in the measurement of chemical concentration.

The American System: mg/dL
The American system generally uses mass per unit volume (milligrams per deciliter of blood). By considering the weight of a substance in the blood, it is less accurate.

The term "mg/dL" then is the abbreviation for milligrams (mg) per deciliter (dL) and describes how much lipid is present in a specific amount of blood.

A deciliter is 1/10 of a liter or about 1/4 of a pint.

The SI System: mmol/L
The SI system (Systeme Internationale) - in Canada, Australia, Europe, and other countries - uses moles per unit volume (millimoles per liter of blood). By considering the number of molecules of a substance in the blood, it is more accurate then.

The term "mmol/L" is the abbreviation for millimoles (mmol) per liter/litre (L) and describes how much lipid is present in a specific amount of blood.

A millimole is 1/1,000 of a mole. A mole is an amount of a substance (in this case, triglyceride or cholesterol) that contains a certain number of molecules or atoms.

Since mass per mole varies with the molecular weight of the substance being analyzed, conversion between the American and SI units requires many different conversion factors.

Triglycerides Conversion:

from mg/dL to mmol/L: multiply by (x) 0.01129
from mmol/L to mg/dL: multiply by (x) 88.6

Cholesterol Conversion:

from mg/dL to mmol/L: multiply by (x) 0.02586
mmol/L to mg/dL: multiply by (x) 38.7.

Glucose (GLU) Conversion:
For diabetics wishing to converse in American sugar lingo, the conversion is 18. For example, a blood sugar reading of 7.5 mmol/L multiplied by 18 yields 135 mg/dL.

The Ideal Triglyceride/Cholesterol Ratio

The published evidence is quite clear in documenting that the actual cholesterol level itself is not the most important risk factor of cardiovascular disease. It is the ratio between the level of HDL-good cholesterol and total cholesterol.

HDL-"good" cholesterol/total cholesterol ratio:

in adults, it should be higher than 0.24 per cent (just divide your HDL level by your cholesterol). And, generally speaking, the higher the ratio, the better.

Triglyceride/HDL-"good" cholesterol ratio:

in adults, it should be below 2 (just divide your triglycerides level by your HDL). And, generally speaking, the lower the ratio, the better.

Calculating LDL-Cholesterol: The Friedewald Equation

Routine screening consists of measurement of total cholesterol and HDL. Blood drawn after an overnight fast will allow accurate measurement of VLDL and triglycerides in addition to the total cholesterol and HDL.

However, the ultracentrifugal measurement of LDL-cholesterol is time consuming and expensive, and requires specialist equipment. For this reason, LDL-cholesterol is most commonly estimated from quantitative measurements of total and HDL-cholesterol and plasma triglycerides (TG) using the empirical relationship of Friedewald et al.(1972):

[LDL-cholesterol] = [Total cholesterol] - [HDL-cholesterol] - ([TG]/2.2) where all concentrations are given in mmol/L>.

PLEASE NOTE: If LDL-cholesterol is calculated using all concentrations in mg/dL then the equation is as follows:

[LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/5))

The quotient ([TG]/5) is used as an estimate of VLDL-cholesterol concentration. It assumes,

first, that virtually all of the plasma TG is carried on VLDL, and
second, that the TG:cholesterol ratio of VLDL is constant at about 5:1 (Friedewald et al. 1972).

Neither assumption is strictly true.

Limitations of the Friedewald Equation

The Friedewald equation for calculating LDL-cholesterol is generally unreliable (and should not be used) under the following circumstances: when

(1) chylomicrons are present
(2) blood triglycerides are elevated: over 400 mg/dL (4.52 mmol/L)
(3) remnant lipoproteins associated with Type III hyperlipoproteinemia are present (in patients with dysbetalipoproteinemia)

PLEASE NOTE: In situations (1) and (2), a reliable LDL-cholesterol may be obtained using the direct LDL-cholesterol test. In situation (3), ultracentrifugation is required to confirm the atherogenic and distinctly treatable Type III disorder and to obtain a reliable LDL-cholesterol.

The Bowling Green Study

William E. Feeman Jr. MD, a family practitioner, Bowling Green, Ohio, United States, conducted the long-term, observational Bowling Green Study, which has followed 2,818 family-medicine patients since 1974.

The effort of this investigator-initiated and self-funded study was to determine what components of lipid profiles have the greatest impact on risk of atherosclerotic events.

In his scientific poster, Dr. Freeman presented data on 1,339 men and 1,479 women ages less than 29 to greater than age 80 who were seen in his practice between 1974 and 2001.

According to Dr. Freeman's findings, the earliest onset of atherosclerosis have people with abnormal values for

decreased HDL-"good" cholesterol (39 mg/dL, or 1.0 mmol/L or less)
increased LDL-"bad" cholesterol (170 mg/dL, or 4.4 mmol/L or higher) and
increased triglycerides (150 mg/dL, or 1.7 mmol/L or higher).

This group does require aggressive lipid therapy.

The most typical lipid disorder, however, represent people with

normal HDL-"good" cholesterol (> 39mg/dL, or > 1.0 mmol/L) but
abnormal LDL (> 170 mg/dL, or 4.4 mmol/L) and triglycerides (> 150 mg/dL, or 1.7 mmol/L)

The definition of metabolic syndrome X or insulin resistance represent people with

normal LDL-"bad" cholesterol (< 170 mg/dL, or < 4.4 mmol/L)
abnormal HDL-"good" cholesterol (> 39 mg/dL, or > 1.0 mmol/L) and
abnormal triglycerides (> 150 mg/dL, or > 1.7 mmol/L).

All these people require lipid therapy as - according to Dr. Freeman - dyslipidemia, after smoking, is the next most important risk factor for atherosclerosis.

However, lipid therapy is not required in people with

normal HDL-"good" cholesterol (> 39 mg/dL, > 1.0 mmol/L)
LDL-"bad" cholesterol (< 170 mg/dL. 4.4 mmol/L), but
elevated triglycerides (> 150 mg/dL, or > 1.7 mmol/L).

In other words, these people can bring blood triglycerides down to normal by other than pharmacological means.

Source: 17th World Conference of Family Doctors 2004, Orlando, Florida.

Standard Medical Treatment Options: Patient's Risk Profile

The first important step in choosing medical treatment for hypertriglyceridemia is to consider a patient's risk profile. Usually, the major cardiovascular risk factors are associated with:

insulin resistance, also known as metabolic syndrome X

diabetes

high triglycerides

low HDL-"good" cholesterol

obesity

smoking, and

hypertension.

Here are standard treatment options offered at a typical doctor's office:

1. High Triglycerides and Low HDL-"Good" Cholesterol:
If your triglycerides are high (over 200 mg/dL, or 2.3 mmol/L) your doctor will check first whether your HDL-"good" cholesterol is low (however, less than 35 mg/dL, or 0.04 mmol/L in men and 45 mg/dL, or 0.5 mmol/L in women are considered very low!).

Research suggests that the combination of low HDL and high triglycerides indicates a generalized disorder of lipid (fat) metabolism, called metabolic syndrome X, which may place you at high cardiovascular risk.

In this case, before prescribing any medication, your doctor will recommend for three intial months basic lifestyle changes - suitable for all people with elevated triglycerides and other lipids - such as:

exercising

losing excess weight

quitting smoking

reducing alcohol, and

eating a diet low in carbohydrates and saturated fats.

Not Responding to Lifestyle Changes:
After 3 months, if despite the sincere lifestyle changes your triglycerides remain high and HDL-"good" cholesterol low, your doctor may consider adding a fibrate drug such as Lopid ^® (gemfibrozil) to your regimen.

From doctors' point of view, being on medication doesn’t mean you failed – just that you need a little more help that diet and exercise can provide. However, you would be astounded how many people would rather take a pill than consider changing anything else.

You need to take your medication for initially 3 months and then check your triglycerides level under medical supervision.

2. Familial Hyperlipidemia:
If you have a family history of lipid disorders your doctor may choose niacin.

Not Responding to Niacin:
If that doesn’t work, he will probably add to your regimen a fibrate (e.g., gemfibrozil, fenofibrate) - especially, if you suffer from familial hypertriglyceridemia - or a statin (e.g., simvastatin, lovastatin).

Without treatment you may eventually develop atherosclerosis leading to a heart attack. (Familial combined hyperlipidemia manifests as high cholesterol, high triglycerides, or both).

3. Triglycerides Over 500 mg/dL:
If your triglycerides are greater than 500 mg/dL, or > 5.65 mmol/L your doctor may prescribe fibrate therapy, either alone or in combination with niacin, a statin, or fish oil (taken in supplement form or as 30 percent of dietary calories).

If left untreated, triglycerides over 500 mg/dL can cause pancreatitis (the inflammation of pancreas).

4. Borderline-High Triglycerides and Normal LDL-"Bad" Cholesterol:
If your triglycerides are borderline-high (150 - 199 mg/dL, or 1.7–2.3 mmol/L) with normal LDL-"bad" cholesterol (less than 130 mg/dL, or 3.4 mmol/L) your doctor my consider using niacin or a fibrate.

Not all doctors would agree you should be treated medically, unless you have history of vascular disease. However, this line of treatment may be considered, if you

have not responded to lifestyle chagnes and

have other cardiovascular risk factors, such as smoking or a family history of heart disease.

5. High Triglycerides and High LDL-"Bad" Cholesterol:
If you have high triglycerides (over 200 mg/dL, or 2.3 mmol/L) in combination with high LDL-"bad" cholesterol (over 160 mg/dL, or 4.1 mmol/L), the LDL abnormality will be treated first - along with lifestyle changes, medication (usually statins), or both.

Not Responding to Statin Therapy:
If, however, your triglycerides remain high despite statin therapy, your doctor may consider adding niacin to bring them into the normal range (less than 150 mg/dL, or <1.7 mmol/L).

Once the underlying disorder is identified and treated, triglyceride levels often decrease.

6. High Triglycerides Due to an Underlying Disorder:
High triglycerides may be caused by other disorders, such as type 2 diabetes, alcoholism, hypothyroidism, Cushing’s syndrome, liver disease, uremia, dysglobulinemia, or nephrotic syndrome.

PLEASE NOTE: Because drinking can cause hypertriglyceridemia, you will be asked by your doctor about your drinking paterns, and suggested - if needed - to cut back or eliminate alcohol before exploring other treatment options.

Suggested Medications for Treating Hypertriglyceridemia*
Blood Triglyceride Level (mg/dL or mmol/L)		Suggested Medical Therapy
Over 500 mg/dL, or 5.6 mmol/L		Fibrate If unsuccessful, add niacin, fish oil, or statin
200-500 mg/dL, or 2.3-5.6 mmol/L and patient has familial combined hyperlipidemia		Niacin If unsuccessful, add statin or fibrate
200-500 mg/dL, or 2.3-5.6 mmol/L and patient has familial hypertriglyceridemia		Fibrate
200-500 mg/dL, or 2.3-5.6 mmol/L with normal LDL (under 130 mg/dL, or 3.4 mmol/L)		Niacin or fibrate If unsuccessful, add fish oil
150-200 mg/dL, or 1.7-2.3 mmol/L with normal LDL (under 130 mg/dL, or 3.4 mmol/L)		If at low cardiovascular risk: no drug therapy If at high risk: niacin or fibrate
150-500 mg/dL, or 1.7-5.6 mmol/L with elevated LDL (over 159 mg/dL, or 4.1 mmol/L)		Statin If unsuccessful, add niacin. If still unsuccessful, refer to a specialist
150-500 mg/dL, or 1.7-5.6 mmol/L with low HDL (less than 35 mg/dL, or 0.04 mmol/L in men and 45 mg/dL, or 0.5 mmol/L in women)		Fibrate or niacin

* Courtesy of Michael Schloss, MD, Associate Professor of Medicine, New York University Medical School

"TriCor Produced Side Effects So Badly..."

Our customers write to us:

Thanks! I have been trying to reduce my triglycerides for several years now. I was placed on (...) Tricor which produced side effects so badly that I could not take it.

I started taking your Triglycerides Reduction Formula and following the Diet just under two months ago.

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* The testimonial above has been presented as a true story. However, it has not been reviewed by Full of Health and is the opinion of the listed individual.

Statins and Coenzyme Q10 (CoQ10)

A study in the Archives of Neurology published unsettling new information: "Atorvastatin decreases the Coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke" (Arch Neurol, Jun 2004; 61: 889 - 89).

Atorvastatin is the chemical name for Lipitor ^®, the world’s best selling cholesterol-lowering prescription drug.

This new study, however, is simply confirmation of what scientists have known for some time: “miracle” but potentially harmful statin drugs may lower levels of Coenzyme Q10 (CoQ10) - a superior antioxidant, essential for the production of energy in every cell of the body.

Isn’t it a little ironic? Millions of heart patients are taking a drug that depletes CoQ10 which - through many years of research - has been shown to be effective in protecting the cardiovascular system and helping to prevent heart disease.

Meanwhile, the United Kingdom has decided to reclassify Zocor (another best selling statin drug) as over-the-counter (OTC), in spite of the fact that Zocor may cause muscle pain or weakness, as well as liver problems (according to the Zocor website).

PLEASE NOTE: If you are on statins, taking 100 mg of CoQ10 daily will help you replenish depleted CoQ10 stores as you work with your doctor in weaning yourself off these drugs.

Coenzyme Q10 is one of the most valuable investments you can make for your heart - and one of the most important nutrients you can take for your health. In fact, if you can only take one or two supplements a day - CoQ10 should absolutely be one of them!

Nuclear Magnetic Resonance (NMR)

Lipid measurement may show normal total cholesterol, with a low HDL-“good” cholesterol and a moderately elevated triglyceride level; for example, total cholesterol of 197 mg/dL, an LDL-“bad” of 120 mg/dL, an HDL of 35 mg/dL, and a triglyceride of 210 mg/dL. That pattern is not unusual; in fact, it is seen in about 20 percent to 30 percent of people who have had a myocardial infarction (heart attack).

However, an important issue is how to best manage these people.

In those cases, doctors may now use a new commercially available test. This procedure uses nuclear magnetic resonance (NMR) spectroscopy to fractionate VLDL, LDL, and HDL concentrations into 15 different subfractions. It is completely automated and takes only about one minute to perform, since it measures all subfractions simultaneously.

For example, two people may have similar lipid levels, but if NMR spectroscopy shows that one has a much higher proportion of small, dense lipoprotein particles, that might tip the balance toward treatment, especially if there is a family history of cardiovascular artery disease (CAD) or other risk factors.

Test and Re-test Triglycerides from Home

Even when your triglycerides are way up - off the chart at 800 mg/dL, or >9.0 mmol/L - you can't tell. There's no symptom. And that's what makes it so scary. Because no one feels badly with high triglycerides, a lot of people simply have no clue!

The only way you know you might have a problem that needs to be attended to is to get the blood test. As a matter of fact, triglyceride count test is the test everybody gotta have at least once a year.

But there's even more to it. You should absolutely know your triglyceride level, if you have symptoms of the metabolic syndrome X, in other words, if you

are overweight
eat too many refined or simple carbohydrates (white bread, pasta, cakes, etc.),
have a history of heart disease or high blood pressure, or
have a genetic predisposition to cardiovascular health problems.

Don't have your better lipid health prompted just by panic!

Home Collected Triglycerides Testis a simple, FDA-approved, clinical laboratory analysis that measures the amount of the following lipids in your blood:

triglycerides

total cholesterol

HDL-"good" cholesterol, and

calculated LDL-"bad" cholesterol.