RCJ, Some suggestions for you and your wife to increase the effectiveness of Vascepa. Take your Vascepa on a full stomach with some fat. The fat helps to absorb the EPA into the bloodstream. Make sure your on a statin as well.
With regard to other things you can do you can consider taking Turmeric (1 gram a day with some black pepper) also to be taken with some fat. (Nuts will do.) Turmeric is also an anti-inflammatory and reduces Triglyceride levels.
Welcome to the board...Trig levels reflect SI levels...SI levels are determined principally by EPA/AA levels..Most likely in your wife's situation her AA/EPA level is too high...This could be related to a diet too high in Arachidonic Acid (AA)...You can get this checked at Quest Diagnostic which will do an AA/EPA ratio..
A diet high corn fed animal meat might..Walnuts are also very high in AA...
Chronic inflammatory disease could also account for increased SI levels..
Flax seed oil is touted for its N-3 effects but unfortunately it actually raises AA levels...
https://omegaquant.com/omega-3-index-plus/ Learn more from your cells with the Omega-3 Index Plus Test: Your Omega-3 Index Trans Fat Index Omega-6:Omega-3 Ratio AA:EPA Ratio All in one drop of blood. Only: $74.95
Robert, you can find a lot of information on the subject of n6/n3 levels. The post 20th century western diet is "very" high in n6/n3 levels. For thousands of years, man had a far more equal ratio, and it wasn't until the 20 Century that the ratio became so imbalanced. The Western Diet has been described as having a 15:1 ratio, HIGHLY INFLAMMATORY. Man went from a 1:1 to a 15:1 !!
A recent study (link below) wanted to see if a dietary change in young obese adults could reduce their levels of "fatty liver." The participants came into the study on diets that were high in n6/n3. After 12 weeks, the study showed fatty liver was reduced by switching to a diet with higher levels of n3/n6.
In the Japanese Jelis study, they used a daily dose of 1.8 grams. Vascapa's 4 gram formulation overcomes the Western Diet inbalances, to achieve the levels we see among the Japanese. Amarin's 4 grams of EPA is no small feat. It would take 40 OTC pills to provide the equivilance. Given all the data, it shouldn't take a mathematician to believe everyone would benefit from Vascepa. I wasn't @ risk, but I started Vascepa in 2013 for "anti-aging", since infammation is at the heart of premature-aging as well as causing other inflammation related disease states.