High Triglycerides

  I have been on a practically no-fat, low sugar, high protein diet for months. I am an avid bodybuilder, hence I exercise every day. I primarily train with weights but mix 10 to 20 minutes of high intensity aerobic exercise at least 5 days a week. I have supplemented my diet for several months with high protein, no-fat shakes and I use creatine on a regular basis. I feel that I am in excellent health, yet when I had some routine blood work done my triglyceride level was over 800. Feeling that the test must have been in error, I asked my doctor to take another sample and do the test again. This time the level was 760. I'm doing everything right, but my level is still way too high. What gives?
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Dear James:
You have asked an important question.  Elevated triglycerides if severely elevated (>1000 mg/dl) can cause serious medical problems such as pancreatitis (inflammation of the pancreas gland).  Less severe degrees of elevation of triglycerides have been linked to development of coronary artery disease in some, but not all, epidemiological studies.  The blood test for triglycerides should generally be drawn after an overnight fast, as a meal will transiently increase the amount of triglycerides in the blood.  Actually, a full lipid profile (including total, "good," and "bad" cholesterol) should be checked, as well as a blood glucose (to screen for diabetes, which can cause elevated triglycerides). Certain other medical causes of elevated triglycerides are kidney problems, such as nephrotic syndrome or chronic renal failure.  Medications, such as estrogen replacement therapy, can  cause elevated triglycerides.  Large amounts of alcohol intake can elevate triglycerides.    If  someone has an isolated elevation of triglycerides with no other abnormality, a genetic deficiency can be the cause.  While there are effective medications to reduce triglyceride levels, the first step is always dietary modification (and eliminating alcohol intake).  In particular, reducing fat intake (especially saturated fat) is important.  Reducing carbohydrate intake (rapidly absorbed carbohydrates are the worst) can also decrease triglyceride levels.  
Lipid specialists or preventive cardiologists specialize in treating disorders such as elevated triglycerides.  It would be reasonable to see one of these specialists to determine the cause of the elevated triglycerides and to treat it safely.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a preventive cardiologist.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.