The feedback from high triglycerides this is a worrying fact, which must be corrected as soon as possible to avoid the onset of cadiovascular and metabolic diseases. THE triglycerides I'm fatty substances used as an energy source and in cell metabolism. The main ones causes of high triglycerides I'm the kind of diet and lifestyle habits, even if part of the hypertriglyceridemia is genetic based. THE symptoms of high triglycerides they manifest themselves directly only if the values are really high.
High triglycerides: what they are
What are triglycerides? Triglycerides are, with the cholesterol, the main fats of our body. Chemically, i triglycerides they are also called triacylglycerols, i.e. neutral esters of glycerol. Simply put, triglycerides are formed from one molecule of glycerol to which the chains of three are joined long-chain fatty acids. Triglycerides are part of the glyceride family together with monoglycerides and diglycerides. They are an important constituent of vegetable oil and animal fats.
THE triglycerides they come from two main sources: they are introduced with food and to a lesser extent produced in our liver. As for the triglycerides introduced with the diet, the digestion of lipids in the intestine breaks down the triglycerides into the fatty acids that compose them. And after being absorbed by the intestinal mucosa, they are recombined back into their initial form. Since blood has a watery composition, triglycerides are hardly soluble in it. Then, in order to be conveyed to all cells, they are "wrapped" in water-soluble protein shells called chylomicromes.
As for the triglycerides produced by the liver, these are synthesized from simple sugars. Even these other triglycerides in order to be transported by the blood must be incorporated in water-soluble proteins known as VLDL (very low density lipoprotein). VLDL and chylomicrons together form the total concentration of circulating triglycerides.
The presence of high triglycerides (hypertriglyceridemia) is a very important cardiovascular risk factor, as an increase in triglycerides, together with high cholesterol, can damage the arteries and strain the heart. High triglycerides therefore put you at risk of diseases such as heart attack, stroke, metabolic syndrome.
High triglycerides - Hypertriglyceridemia
What are the triglyceride values considered too high? Here are the normal and elevated values of triglycerides, expressed in mg / dL (milligrams per deciliter)
- Normal triglycerides: less than 150 mg / dL
- Borderline high triglycerides: 150-199 mg / dL
- High triglycerides: 200-499 mg / dL
- Very high triglycerides: 500 mg / dL or higher
High Triglyceride Causes - Causes of hypertriglyceridemia
The increase in blood triglycerides can be primary or secondary.
Primary high triglycerides: the primary increase in triglycerides is usually of a genetic type, and occurs when the finding of high triglycerides in the context of the so-called familial hypertriglyceridemia : in these cases the risk of heart, kidney and pancreas disease also increases.
Secondary high triglycerides: the increase in secondary triglycerides is instead due not to genetic causes, but to an incorrect lifestyle, an unbalanced diet too rich in fats and carbohydrates, and is often found in obese or overweight patients.
What are the causes of high triglycerides?
Here's what the main causes high triglycerides:
- Unbalanced power supply: often people with high triglycerides eat few meals, but very abundant and rich in fats and sugars (understood as carbohydrates, therefore also contained in pasta, bread, pizza). Main meals such as lunch and dinner are preferred, compared to what many nutritionists recommend, ie to have small and numerous meals. This type of diet represents an eating behavior that places the body in front of a moment of great caloric and carbohydrate intake, alternating with moments of fasting with a drastic drop in circulating sugars. This means that in moments of great glycemic load (hyperglycemia) our pancreas produces a lot of insulin to try to lower the high concentrations of sugars in the blood, which are then partly stored in the liver in the form of glycogen, partly transformed into fat and stored in the adipose deposits, especially subcutaneous (the so-called "ciccia").
- Alcohol abuse: our body reacts to the ingestion of alcoholic beverages in a very similar way to the reaction that occurs in the event of a glycemic peak. Therefore, even by drinking wine, beer or spirits, the secretion of insulin is stimulated, which, as already mentioned, involves the formation of fats and an increase in the concentrations of circulating triglycerides (triglyceridemia). triggering the mechanism of hyperglycemia - insulin spike, resulting in a rise in triglycerides at the end of digestion.
- Difficult to control diabetes mellitus: the presence of glycemic peaks in the blood and the correction with high doses of insulin do nothing but trigger the exaggerated glycogenosynthesis and liponeogenesis process described above.
- Medicines: such as birth control pills, diuretic drugs and steroids (cortisone);
- Kidney failure: reduced kidney function may favor the increase of circulating triglycerides.
- Hypothyroidism: the body's metabolism is reduced in the presence of hypothyroidism, and therefore less fat is burned, causing an increase in circulating triglycerides.
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High Triglycerides Symptoms - Hypertriglyceridemia Symptoms
What are the symptoms of high triglycerides? A condition of elevated triglycerides or hypertriglyceridemia can have symptoms directly caused by the increased blood density linked to the higher concentration of circulating triglycerides, or indirect symptoms related to the effects that an increased concentration of lipids in the blood have had on arteries and tissues.
THE direct symptoms of hypertriglyceridemia they are usually present in case of concentrations higher than 800-1000 mg / dl, and are:
- Gastrointestinal symptoms: abdominal or epigastric pain, chest pain, pain in the back or in the posterior regions of the chest; nausea and / or vomiting
- Respiratory symptoms: dyspnea
- Dermatological symptoms and signs: xanthomas
- Eye symptoms and signs: corneal arcus, xanthelasma
The indirect symptoms of increased triglycerides are symptoms related to cardiovascular and metabolic diseases that emerge after a long time that persist high values of triglycerides and cholesterol in the blood, and are:
- Chest pain in case of angina or acute myocardial infarction
- Dyspnea (shortness of breath) in case of left heart failure or heart attack
- Edema slopes (swelling of the legs from fluid accumulation) in case of right heart failure
- Jugular turgor (swelling of the jugular veins of the neck) always in case of right heart failure
- Pain in the lower limbs when traveling a certain stretch of road. This problem is called intermittent claudication or "window disease", because those who have it pretend to stop and look at the windows but actually stop because they have pain in the legs, it is linked to atherosclerosis of the arteries of the legs, which they occlude more and more and give angina (pain) during an effort. With the passage of time the disease progresses and it is possible to travel less and less road before the pain sets in
- Overweight or obesity: the accumulation of triglycerides and / or cholesterol, especially if it occurs in the framework of a metabolic syndrome, occurs mainly in people with a certain degree of overweight, up to real obesity.
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High triglycerides consequences
The main consequences of high triglycerides are borne by the cardiovascular system, such as:
- Activation of the arteriosclerosis process: increase in the thickness of the artery walls caused by the accumulation of fats in the so-called "atherosclerotic plaques ", of the "encrustations" that reduce the diameter of the arteries and can give problems of ischemia or thrombo-embolism.
- Worsening of fibrinolysis: fibrinolysis is the process that, once a plug of fibrin and platelet has formed and therefore a clot on a damaged vessel, and that the vessel has been repaired, allows the plug to be removed and the vessel lumen released, which it becomes free to flow erythrocytes and other blood components. High triglycerides cause a reduced efficiency of the fibrinolysis process, increasing the risk of thrombosis and embolisms.
- Ischemic disease of the coronary arteries, which can give angina pectoris (chest pain without heart attack) up to real heart attack.
- Obesity or overweight: as already said before, the presence of high triglycerides favors the accumulation of fat on all tissues.
- Increase in abdominal circumference: Often people with high triglycerides also have a metabolic syndrome, and which among its criteria includes an excessively large waist.
- Hypercholesterolemia: high cholesterol, and in particular high LDL cholesterol (it is the so-called bad cholesterol), often with low HDL cholesterol.
- Hypertension: it can be primitive (that is, without a known cause) or secondary to atherosclerosis at renal vascular levels.
- Imbalance of thyroid hormones: there may be evidence of high TSH or low TSH, as well as alterations to thyroid hormones.
Fatty liver disease: accumulation of fat in the liver.
- Metabolic syndrome: metabolic syndrome is a syndrome which includes arterial hypertension, insulin resistance, increased triglycerides, increased circumference of the waist, reduced levels of HDl cholesterol (the so-called good cholesterol.
- Nephroparenchymal renal insufficiency: secondary to kidney damage mediated by the accumulation of fat in the small arteries of the kidney.
- Pancreatitis: in the case of very high triglycerides, the increased density of the blood and consequently of the biliary and pancreatic secretions can lead to the formation of stones or can directly occlude the biliary tract and Wirsung's duct causing pancreatitis.
- Biliary colic: as mentioned above, the increase in triglycerides and cholesterol can increase the density of the bile and transform it into biliary sludge or into real stones that can occlude the biliary tract, giving rise to biliary colic and cholestasis, with consequent finding of ALT high, high AST, high GGT, high ALP, high bilirubin.
High triglycerides - Hypertriglyceridemia what to do
How to lower triglycerides? When triglycerides rise above the level considered to be normal, i.e. they exceed the value of 150 milligrams per deciliter, you are in the condition of hypertriglyceridemia.
Hypertriglyceridemia should be addressed as soon as possible, to try to bring the triglyceride values as close as possible to normal values.
So what to do in case of high triglycerides:
- Get blood tests to better investigate the nature of the increase in triglycerides. The basic analyzes are blood count complete with hemoglobin, MCV, leukocyte and platelet counts, analysis of renal function (urea, creatinine, sodium, potassium), liver function (AST, ALT, GGT, ALP, total bilirubin and direct bilirubin and indirect bilirubin), total cholesterol, cholesterol HDL and LDL cholesterol, homocysteine, Lipoprotein a.
- Change your diet, preferring small, frequent meals. What to eat? It is better to have at least 5-6 snacks a day rich in fruit and vegetables, yogurt, rice, fish and white meats, instead of the usual 3 meals (breakfast, lunch and dinner).
- By increasing physical activity, carrying out at least three times a week aerobic physical activity, that is slow but constant, such as half an hour of swimming, 45 minutes of running or an hour of cycling or brisk walking.
- Pharmacological therapy: if the above measures do not work, it is possible to pass, under medical prescription, to a therapy with drugs aimed at reducing circulating fats. If in addition to high triglycerides there is also high cholesterol, it is often preferred to start with a treatment with statins, while if the main problem is only the increase in triglycerides, therapy is usually started with bundles. Often these drugs are added omega-3 fatty acids, which help regulate the absorption of fats in the intestine and their metabolism at the systemic level.
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