Triglycerides are fat: the fats you eat are mostly triglycerides, and many of the fats in your body are triglycerides. Your liver turns some of this fat into cholesterol. Having a high level of triglycerides in your bloodstream can translate to higher cholesterol levels, which can increase your risk of heart disease. Your doctor may prescribe medication to lower your cholesterol and triglyceride levels. Cholesterol-lowering drugs work in different ways, but like all medications, they can have side effects, some of which can affect the liver.
Statins
One class of drugs doctors prescribe to lower LDL cholesterol and triglycerides is statins. Your liver uses an enzyme known as HMG-CoA reductase to manufacture cholesterol. Statins suppress the production of this enzyme. Especially at higher doses, statins can cause liver damage, so as part of your statin therapy, your doctor may require that you have regular blood tests to check the health of your liver.
Niacin
Another popular medication used to lower triglycerides and increase HDL cholesterol is niacin. Prescription niacin contains a much higher dosage of the vitamin than do over-the-counter supplements, but you should take niacin only under a doctor's supervision. About 3 to 5 percent of people who take niacin to lower cholesterol have liver problems. The first sign of this may be in abnormal results on liver function tests. Some people experience jaundice, or a yellowing of the skin, caused by the liver's failure to remove adequate waste products from the blood. If you stop taking niacin, your liver function should return to normal, however.
Fibrates and Other Therapies
Fibrates are drugs that work by breaking down triglycerides in the blood. They don't appear to affect the liver, although they can increase your chances of developing gallstones. Another treatment for high cholesterol may be omega-3 fatty acids, often from fish oil. Prescription-strength omega-3, sold under the brand name Lovaza, is one choice for treating high cholesterol and triglycerides. Columbia University Medical Center reports that compounds in fish can help lower triglycerides, and the most widely reported side effect is a fishy taste in your mouth. This therapy does not cause liver damage.
Cholesterol absorption inhibitors are sometimes prescribed in conjunction with another cholesterol-lowering drug, such as a statin drug. These drugs prevent your body from absorbing cholesterol in food, but they carry a risk of liver damage, and you should not take them if you have a history of liver problems.
Blood Tests
Your doctor may order a liver function test to check the health of your liver before or after you begin taking cholesterol-lowering drugs. This test measures the level of various compounds related to liver health. Among the compounds tested are bilirubin, alkaline phosphatase, albumin, aminotransferases, alanine transamanase, aspartate transamanase, mitochondrial antibodies, 5'-nucleotidase, lactic dehydrogenase and gamma-glutamyl transpeptidase. Abnormalities in the levels of these substances could indicate a problem with your liver. In most cases, discontinuing the drug will allow your liver to return to normal function.
References
- The Harvard Medical School Family Health Guide: Should You Worry About High Triglycerides?
- U.S. Food and Drug Administration: High Cholesterol---Medicines to Help You
- Columbia University Medical Center: Triglycerides
- University of Maryland Medical Center: Cholesterol---Medications
- The Ohio State University Medical Center: Common Liver Function Tests
