Familial Hypertriglyceridemia

Familial hypertriglyceridemia is a common disorder passed down through families in which the levels of triglycerides in a person’s blood are higher than normal. This condition is not associated with a significant increase in cholesterol levels. Recently I had the opportunity to assist in the treatment of a patient who suffered from familial hypertriglyceridemia. I’m glad I had the opportunity to take part in this case because I really learned a lot from this patient, his conditions, and how all of the components in life can affect the rest of your life and health.

The patient was a male, 39 years of age, and was suffering from hypertriglyceridemia. His condition was also exacerbated by his weight, insulin resistance, and alcohol consumption. The patient’s peripheral vascular disease raised suspicion for familial dysbetalipoproteinema. The gentleman was a non-traditional student at a nearby college, majoring in mechanical engineering. He was also married with two daughters. The patient was the main food preparer in the household and was open and willing to learn new ways of cooking (low-fat) for his family.

Here were the patient’s labs values:
Cholesterol: 254 mg/dl (160-200: normal)
TGs: 1029 mg/dl (35-160: normal)
Glucose: 127 mg/dl (70-109: normal)
HDL: 36.3 mg/dl (40-60: normal)

I’ve noticed it’s always important to put the normal range for each lab value because different facilities/healthcare agencies could have different normal ranges, depending on their measuring tools.

The patient’s typical diet consisted of:
Breakfast:
– Once a week
– Breakfast sandwich
– Danish (sometimes)
– Coffee
Lunch:
– 12p-1pm
– Leftovers- dinner
– Salad- chicken, shredded cheese, Ranch/Italian dressing)
– Sandwich- turkey/ham, wheat/rye bread –or- Chicken hoagie with mustard
Dinner:
– Lean chicken breast (grilled/baked)
– Olive oil
– Bread crumbs
– Vegetables (variety)
– Shredded cheese (Mozzarella or cheddar)
Bedtime Snack:
– Pretzels

So after speaking with the patient, learning his diet habits, and hearing about his lifestyle factors, as well as other miscellaneous habits, we developed a few goals for him to strive for.
Goal 1: The patient mentioned that he drinks 2-3 cans of soda a week. So, we asked if he can cut that out of his diet. And he said he could.
Goal 2: The patient mentioned that he’s very tech savvy so we asked if he could keep a food log on through a Smart phone application. And he said he could.

We also gave the patient education materials on:
– Dean Ornish program
– Nutrition Therapy for high TG levels
– High TG Meal Tips
– Fat-Restricted Diet

It was clear to me that the patient was at risk for developing pancreatitis from the amount of pressure that his pancreas was experiencing from the fat in his diet. So, to avoid this, we recommended that the patient restrict his fat intake to 15% of his daily energy intake. This is a good starting point for this patient. This way we can work together to get his fat (and protein) levels down and take those important baby steps towards decreasing his fat intake even more, hopefully, in the future.
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