If you have been diagnosed with high triglyceride levels, you need to get those levels back to normal. Triglycerides are fats that circulate in your blood and get stored in your fat cells. High levels of these fats increase your risk for heart disease, stroke, and a dangerous swelling of your pancreas called pancreatitis. Selecting the best treatment for your high triglycerides depends on what your fasting triglyceride numbers are. Triglycerides are measured in milligrams per deciliter (mg/dL). Here are the possibilities: Less than 150 means you are in the normal range. Between 150 and 199 means you are borderline high. Between 200 and 499 means you are too high. 500 or higher means you have very high triglycerides. Treatment Options for Triglycerides From 150 to 199 If you are in this borderline area, your doctor may do tests to see if you have metabolic syndrome. Metabolic syndrome is a combination of conditions that increase your risk for heart disease and type 2 diabetes. This condition can include high triglycerides, high blood pressure, increased belly fat, low HDL (good cholesterol), and high fasting blood sugar. Your treatment plan might include: Counseling to help you improve your diet, lose weight, stop smoking, and start exercising Better management of your diabetes, if you have diabetes Losing 5 percent of your body weight Having your risk for heart disease evaluated Lowering your bad (LDL) cholesterol You may need to take a statin drug, such as Lipitor or Crestor, to lower your bad cholesterol if you have a high risk for heart disease or you have diabetes. Studies show that taking a statin drug can also lower your triglycerides by about 20 to 40 percent. To evaluate your 10-year risk for heart disease, your doctor may use the Framingham risk calculator. To do this risk study your doctor will take into consideration factors such as your age, smoking history, diabetes history, blood pressure, total cholesterol, and bad cholesterol. Treatment Options for Triglycerides Between 200 and 499 For high triglycerides you may be given all the same counseling, evaluations, and treatment options as for borderline triglycerides. Additional options may be needed if your LDL cholesterol goals have not been met or if your doctor feels you are at high risk for heart disease. These options may include: Switching to a statin drug with better triglyceride lowering properties Combining a statin drug with a fibrate drug Combining a statin with niacin Combining a statin with fish oil Fibrate drugs can lower triglyceride levels by 40 to 60 percent. Fibrate drugs include Tricor and Lopid. Niacin is a B vitamin that has been shown to lower triglyceride levels by 30 to 50 percent. Fish oil capsules contain omega-3 fatty acids, which are healthy fats that can reduce triglycerides by 30 percent. However, a number of studies have not shown clinical benefit (e.g., prevention of heart attacks) when combining statins with other drugs despite some improvement in cholesterol and triglycerides levels. As a result, some doctors feel the risk of drug side effects outweighs any potential benefits. Treatment Options for Very High Triglycerides Above 500 If your triglyceride level is above 500 you will probably need to take a fibrate or niacin along with all the other options for high triglycerides. Here are some other options: A very low-fat diet to decrease your risk for pancreatitis if triglycerides are above 1,000 Significant weight loss A combination of fibrate, niacin, and fish oil to get triglyceride level down below 500 If your triglycerides are above 500, your doctor will direct therapy towards this first and then target your LDL once triglycerides drop. If you don't know your triglyceride level you should have a complete lipid profile done–it's a simple blood test. The National Cholesterol Education Program advises that everyone have a lipid profile done every five years starting at age 20. A complete profile includes triglycerides along with your cholesterol levels. If you have borderline or high triglycerides, work with your doctor to start getting your triglycerides under control. Key Takeaways High triglycerides are dangerous for your health and need to be treated. All treatment begins with counseling on diet, weight loss, and exercise. If you have diabetes, you will need to get your diabetes under good control. Taking a statin drug to lower your bad cholesterol is an important part of treatment. Statins can lower high triglycerides by up to 40 percent. If you have very high triglycerides, you may need to add fibrate, niacin, or fish oil to lower triglycerides.