DEAR DR. DONOHUE: My 31-year-old son-in-law is 6 feet tall, weighs 185 pounds and is in good physical condition. His concern is triglycerides. His measure more than 600. His cholesterol is just a bit high. He eats very healthily, with little fast food. He drinks only diet soda and skim milk. He uses sugar substitutes in his coffee. He eats much Indian food. Any help is appreciated. — B.W.
ANSWER: Total cholesterol, LDL cholesterol (the bad kind) and HDL cholesterol (the good kind) have star billing when it comes to artery hardening and heart disease. The spotlight has begun to shine on triglycerides, and now they are sharing billing with cholesterol.
Triglycerides are fats. The whitish, yellowish stuff you see in a cut of meat is triglycerides. Guidelines tell us that a triglyceride level below 150 mg/dL (1.7 mmol/L) is ideal; levels between 150 and 199 (1.7-2.2) are borderline bad; levels from 200 to 499 (2.2-5.6) are bad, and anything over 500 (5.6) is very bad. Your son-in-law is in the “very bad” category.
For overweight people, weight loss is the first step in bringing down triglycerides. This doesn’t apply to your son-in-law. He should severely limit rapidly absorbed carbohydrates, like sugar. They raise triglycerides. He also should cut back on red meat and full-fat dairy products. He has to steer clear of trans fats, found in some commercially prepared foods, particularly baked goods and many fast-food deep-fried items. He has to limit alcohol. Your son-in-law is doing all this, but his levels still are too high.
Three hours of weekly exercise can lower triglycerides. If this doesn’t get the job done, then he should consider the medicine route. Niacin and gemfibrozil can bring down the triglyceride reading.
Diabetes, a low output of thyroid hormone, kidney disease and some medicines like beta blockers and thiazide diuretics raise triglyceride levels.
Very high triglyceride levels can inflame the pancreas — pancreatitis. Your son-in-law is at the threshold of that complication.
The cholesterol booklet explains triglycerides and their link to heart disease. Readers can obtain a copy by writing: Dr. Donohue — No. 201W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I need to know what is considered normal when it comes to menstrual cycles. Please tell me. — R.K.
ANSWER: Most women have cycles that last from 21 to 35 days. For 90 percent of menstruating women, bleeding lasts seven days.
A little more than 1 ounce of blood (30 to 35 ml) is lost with each cycle. That amount of bleeding requires three to five pads a day.
DEAR DR. DONOHUE: I have diabetes, and a while back lost 25 pounds almost overnight. I cannot gain it back. What can I do? — Anon.
ANSWER: A sudden, unintended loss of 25 pounds demands an explanation. If your diabetes was out of control, that might explain it. All the same, you must report this to your doctor right away so a search for a cause can begin.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
© 2009 North America Synd., Inc. All Rights Reserved