Dear Mr XXXXXXX
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
I have come across high values of triglycerides not uncommon in Indians.
If we review medical literature, high triglycerides (values above 500 mg%) are seen in:

Obesity.
Poorly controlled diabetes (which the enclosed other report excludes)
An under active thyroid (hypothyroidism).
Kidney disease.
Regularly eating more calories than you burn.
Drinking a lot of alcohol.
Certain medicines may also raise triglycerides(not above 500 per se, unless you have preexisting high value) . These medicines include:
Tamoxifen (an anti cancer drug)
Steroids.
Beta-blockers.
Diuretics.
Estrogen.
If it is confirmed by reports from two different laboratories than there is no reason to suspect the value. You would need to keep this as reference value for seeing the efficacy of treatment. Treatment includes Diet, Drugs & Exercise:
Diet (Avoid ready sugars and saturated fats like ghee, coconut oil, excessive calories and alcohol), Exercise (equivalent to brisk walk of 40 minutes at the speed of 5 KM/hour) and Drugs which include a combination of Rosuvastatin(5-10 mg) + Fenofibrate (145 mg), you will have to liver function test after one month of therapy (so as to ascertain there is no liver toxicity). Above all maintain ideal body weight for your height. Let a doctor guide you further on therapy. You have done well to exclude diabetes but also look for other risk factors (as cholesterol is one) for coronary artery disease. Good Luck.
If you have any more query I will be most happy to answer it.
Regards
Dr Anil Grover,
Cardiologist & Internist
M.B.;B.S, M.D. (Internal Medicine) D.M(Cardiology)
http://www/ WWW.WWWW.WW

---

Thanks for writing back.
Your other report which is of relevance to Cholesterol is normal HbA1C which rules out Diabetes. WWW.WWWW.WW does not prescribe medicines for legal reasons. We can, however suggest the drug but your doctor needs to prescribe it, as it is not over the counter medicine. The suggestion is take one tablet at Dinner time (either before or after dinner) a combined tablet of
Rosuvastatin 10 mg + Fenofibrate 145 mg (one example is ROSULIP F 10)

Best of Luck.

Dr Anil Grover

---

Thanks for writing back. Please start walking at slow speed and gradually increase the speed to what is tolerable for you. Also, I had written "equivalent". You can exercise upper limbs by shadow boxing or using a dummy (use pillow cover or gunny bag, fill it with old clothes and sand) hang it and use upper limbs and gloved hands to punch it. Idea is to burn calories. How you do it really does not matter. It should not cause you pain that is not the idea. Good Luck.

Regards

Dr Anil Grover

---