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diabetes triglycerides and fish oil supplements.
Apr 4, 2007

Dear Doc, I just read in AIDS MEDS newsletter that Fish Oil lowers triglycides in people with HIV. My t-cells are around 347 and I am undecticable. I am a 52 year old male living with HIV for 11 years now on meds, Atripla, Glucophage 500 2x a day,Fosinopril 10mg 1 x a day . My cholesterol is 160 my a1c is 5.8 my glucose fasting varies from 105 -147 my triglycides are 195, I am on a low GI high fiber diet and I exercise regularly. Can you tell me if a fish oil supplement would be good in lowering my triglycides? And if so how much can I take daily and what are the side effects as well as it effecting my glucose levels? Can you recommend a fish oil supplement? Thanks in advance for any info you can shed on this. CS

Response from Dr. Wohl

It sounds like you are taking excellent care of yourself. While the 'target' triglyceride goal is 150 or below, 195 is pretty darn close and I, even as one of the people who conducted the studies of fish oil in HIV, would not feel strongly at all that you start anything to lower your triglycerides.

Triglycerides are generally not as big a contributor to cardiovascular disease as high LDL cholesterol and/or low HDL cholesterol. There is also some variability in the triglyceride tests so that your number one day could be 195 and the next 145.

There may be benefits of fish oil beyond its effects on triglycerides. In studies outside of HIV, it has been associated with reduction in inflammation and survival benefits among those with cardiac disease. There is some support that it may improve survival in general.

Doses of 2 to 6 grams of fish oil a day have been studied in HIV. The ingredients that count are called EPA and DHA. These are what you add up when counting the grams. You can buy fish oil over the counter. There is also a prescription formulation. All of these can lead to fishy burps. Too much fish oil can suppress the immune system (bad) and make blood harder to clot (also bad).

I treat people with 3 to 4 grams a day when the triglycerides are over 500. There should be no effect on glucose. You will read some things about mercury in fish oil supplements. Check out the brand if you do decide to take this as a supplement.

DW



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