 Currently, patients having very High TG are treated with Fibric acids gemfibrozil, Tricor, Antara, and if hyperinsulinemic, with Glucophage. Lovaza 4gday has been shown to be effective and safe in lowering TG levels. There is no published data which indicates that Lovaza 8 or 12 g per day would have therapeutic effectiveness in further normalizing triglycerides in subjects on maximized triglyceride lowering and Lovaza 4 g per day. We hypothesize, based on our clinical experience that increasing Lovaza to 8 and then if necessary to 12 gday would safely optimize triglycerides in subjects with primary hypertriglyceridemia who failed to normalize their triglycerides on optimal therapy including Lovaza 4 gday. 