U.S. doctors online nowAsk doctors free
Cerritos, CA
A 40-year-old female asked:

my ldl is 46 and triglycerides 540, i am taking simvastatin 40. do i need another chol med to target and fix my triglycerides.

3 doctor answers3 doctors weighed in
Dr. Jerome Zacks
Cardiology 51 years experience
It depends: Make sure your blood was drawn after fasting at least 12 hours. Nonfasting blood contains high triglyceride levels after a fatty meal. If triglycerides remain very high, your doctor might add a fibrate medication. If that is done, one must check your blood within the next few weeks to ensure you don't experience a rare adverse reaction called rhabdomyolysis, a muscle inflammation.
Dr. William Cromwell
Clinical Lipidology 34 years experience
Next Steps: First, identify the problem. Possible causes include; genetic (familial combined hyperlipidemia, familial hypertriglyceridemia, familial dysbetalipoproteinemia); non-genetic (insulin resistance, type ii diabetes, thyroid abnormalities, chronic kidney disease, alcohol) issues. Next, optimize diet / exercise and fix contributing factors. Prescription fish oil (vascepa, lovasa) should be considered.
Dr. William Haynes
Endocrinology 37 years experience
What is non-HDL?: Ldl is completely inaccurate (no matter how measured) when triglycerides are above 400 - and less accurate even when tg is above 200. The reason is that cholesterol moves from LDL to vldl particles where it can still cause damage. Best measure is total cholesterol minus HDL (called non-hdl), which if >160 needs extra treatment with a stronger statin or zetia (ezetimibe). Fish oil will help triglycerides.

90,000 U.S. doctors in 147 specialties are here to answer your questions or offer you advice, prescriptions, and more. Get help now:

Ask doctors free
Personalized answers
Free
Talk to a doctor
24/7 visits
$15 per month

90,000 U.S. doctors in 147 specialties are here to answer your questions or offer you advice, prescriptions, and more. Get help now:

Ask doctors free
Personalized answers
Free
Talk to a doctor
24/7 visits
$15 per month
Last updated Mar 18, 2017
Connect with a U.S. board-certified doctor by text or video anytime, anywhere.
24/7 visits
$15 per month

Disclaimer:

Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Never disregard or delay professional medical advice in person because of anything on HealthTap. Call your doctor or 911 if you think you may have a medical emergency.