Hello. Thank you for your question.

I would recommend some lifestyle changes. You should be on a low-salt, fibre-rich (green vegetables and fruit), low-alcohol (up to 30 g ethanol a day, e.g. one glass of wine or maximum two beers a day) diet. If you are under 45 years of age, these changes suffice for the moment and you will measure your cholesterol and triglyceride levels after three months. If you are over 45 years of age, a lipid-lowering agent should be started as treatment, I would say atorvastatin 20 mg x 1 tb/d. This is a class that also acts on triglyceride levels. You should measure your cholesterol and triglyceride levels after three months. If you do not get good results on triglycerides, then we could consider further treatment for that lipid fraction. Furthermore, tobacco should be ceased.

I hope I was helpful. Feel free to ask again. Best regards

Hello and welcome to HCM. Let me tell you,kind sir, that consuming alcohol is detrimental to the problem of elevated triglycerides and also I have seen the dilated blood vessels that you speak of in many of my nutrition clients who consume more than the recommended amount of alcohol.

To lower triglycerides, the alcohol must be conquered. It is better to change lifestyle as relying on medications is not the answer. As far as medications go, sir, your doctor will probably want to place you on a statin drug. He will go over all your risk factors and make that decision. Please follow your doctors advice.

To further lower triglycerides, omega-3 fatty acid supplementation is very helpful. In fact, for triglycerides over 500 a drug is available based on high levels of omega-3 fatty acids to treat these super high levels.

Other recommendations for lowering cholesterol below 200 mg/dl are as follows:
`1. Exercise 250 minutes per week. Start out with brisk walking. Clear all exercise with a doctor before embarking.
2. Lose weight if overweight.
3.Cut down on saturated fat (7% of calories)
4.Eliminate trans fat (read labels)
5.No sugar(increases triglycerides not necessarily cholesterol)
6.Limit cholesterol if your blood sugar is also high as you absorb more cholesterol if prediabetic or diabetic
7. Increase gradually soluble fibers, vegetables
8.No juice. Limit fresh fruit or fruit canned in its own juice to two servings per day (affects triglycerides, not cholesterol)
9.Avoid all alcohol
10. Cigarette smoking increases risk for heart disease above and beyond the risk caused by hyperlipidemia. And, 250 mg/dl is much more than "some" cholesterol. In fact, it is quite high.Please take this seriously, especially since you take in tobacco as well.

Please have your rash physically evaluated as it is causing you pain.I sincerely hope I have given you some direction. Be Well. Kathryn Shattler, MS,RDN