Triglycerides

When high

Supplements:

• Omega-3 (EPA/DHA) -- 2-3g/day (most effective for triglycerides)
• Berberine -- 500mg 2-3x/day (before meals)
• Dihydroberberine -- 100-200mg 2x/day, an alternative to berberine rather than an addition. It absorbs far better: 100mg reached roughly nine times the peak plasma berberine of a 500mg berberine dose (Moon et al., 2021). Two honest caveats. That trial ran five participants over a single day, and it measured no significant difference in glucose or insulin between any condition, so the absorption advantage is established while the glycaemic benefit is not. Better tolerability is the reason dihydroberberine was developed rather than something that trial tested

Lifestyle:

• Reduce refined carbohydrates and sugar
• Increase fibre intake
• Regular cardio exercise
• If on GH, consider dose reduction if persistently elevated

Pharmacological options (when triglycerides remain elevated despite supplements):

• Fenofibrate -- 145-200mg/day; PPAR-alpha agonist; reduces triglycerides 30-50%; first-line prescription for triglycerides >5 mmol/L; monitor liver enzymes and CK
• Icosapent ethyl (Vascepa) -- 2g 2x/day; purified EPA; REDUCE-IT trial showed 25% MACE reduction; preferred over standard fish oil for athletes with persistent elevation
• Semaglutide / Tirzepatide -- 0.25-2.4mg or 2.5-15mg subQ weekly; GLP-1 (or GLP-1/GIP) agonist; reduces triglycerides 20-30% via insulin sensitisation and weight loss; ideal for GH/MK-677 users with concurrent insulin resistance
• Niacin -- 1-2g/day; raises HDL and lowers triglycerides but causes flushing and can worsen glucose control (limit in GH/insulin users)
• Pemafibrate -- 0.2mg 2x/day where available; selective PPAR-alpha modulator with cleaner safety profile than fenofibrate
• All require physician oversight and baseline liver/CK panel

Every on-cycle support supplement mapped to the marker it protects, with doses: On-cycle support protocol: every supplement mapped to your bloodwork.