Lipoprotein(a)

Recent research suggests that blood levels of Lipoprotein(a) or Lp(a) may be an important marker for the risk developing of heart disease. However, measurements of Lp(a) are not widely available and are seldom used in routine clinical practice.

Measurements of lipids levels are frequently used to assess the risk of future coronary heart disease or stroke. These two disease conditions are commonly termed cardiovascular disease (CVD).

Lipoprotein a

Blood levels of total cholesterol, triglycerides and high-density lipoprotein cholesterol (HDL-C) are measured when assessing a standard lipid panel. These numbers are then used to calculate low-density lipoprotein cholesterol (LDL-C), which has been found to be strongly correlated with the risk of CVD.

Recently measures of lipoprotein particles involved in atherosclerosis, which is the leading underlying cause of CVD, have been found to be very useful to assess risk. Examples of such measurements are LDL particle number (LDL-P), apolipoprotein B and lipoprotein(a).

Lp(a) is a strong risk factor for CVD. However, the lack of clinical trial data has resulted in Lp(a) being largely ignored by clinical guidelines assessing the prevention of CVD.

In 2010, the European Atherosclerosis Society (EAS) consensus panel recommended screening for elevated Lp(a), in people with moderate to high risk of cardiovascular disease. Desirable Lp(a) levels < 50 mg/dL were considered a treatment priority, after therapeutic management of LDL-C.


According to a statement from the EAS;

the evidence clearly supports Lp(a) as a priority for reducing cardiovascular risk, beyond that associated with LDL-C. Clinicians should consider screening statin-treated patients with recurrent heart disease, in addition to those considered at moderate to high risk of heart disease. 

What Is Lp(a)?

Lipoproteins are the particles that transport cholesterol and triglycerides in the blood stream.

Lipoproteins are composed of proteins (apolipoproteins), phospholipids, triglycerides and cholesterol.

The lipoproteins vary in the major lipoprotein present and the relative contents of the different lipid components.

Lp(a) is a lipoprotein rich in cholesterol. It differs from LDL as it contains an additional protein, apolipoprotein (a). Similar to LDL, a Lp(a) particle also contains one molecule of apolipoprotein B.

What Is the Normal Range For Blood Levels of Lp(a)?

It as assumed that Lp(a) is produced by liver cells. However, the pathways for the clearance of this substance are not clearly understood.

Plasma levels of Lp(a) rise shortly after birth and the levels appear to become consistent within a few months.

In adults, plasma levels of Lp(a) vary widely, ranging from 0.2 – 250 mg/dL. The levels are similar in men and women.

Studies indicate that about one in five individuals have plasma levels above 50 mg/dL (80th percentile), and about one in four have plasma levels above 32 mg/dL (75th percentile). Lp(a) levels less than 30 mg/dL are considered normal.

Here’s how Lp(a) lelevls are looked at in terms of risk:

Desirable: < 14 mg/dL (< 35 nmol/l)
Borderline risk: 14 – 30 mg/dL (35 – 75 nmol/l)
High risk: 31 – 50 mg/dL (75 – 125 nmol/l)
Very high risk: > 50 mg/dL (> 125 nmol/l)

According to the Framingham Heart Study, the 90th percentile of Lp(a) levels is 39 mg/dL (1.39 micromo/L) in men and 39.5 mg/dL (1.41 micromo/L) in women (units of mass)

The EAS Consensus Panel recommends that Lp(a) should be measured in high-risk individuals such as those with premature CVD, familial hypercholesterolemia, family history of premature CVD and elevated Lp(a), and people with recurrent CVD despite statin therapy.

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Lp(a) and Risk for Heart Disease

Epidemiological evidence indicates that Lp(a) is associated with the risk of CVD.

The Copenhagen City Heart Study found that individuals with plasma Lp(a) levels above 50 mg/L had 2 to 3 – fold increase risk for heart attack (myocardial infarction).

A meta-analysis of prospective studies provided evidence of a link between Lp(a) and coronary artery disease.

Studies on patients with familial hypercholesterolemia have provided additional evidence.

Studies have indicated that the association between Lp(a) and CVD is without a threshold, and does not depend on high levels of LDL or non-HDL cholesterol, or the presence of other cardiovascular risk factors. However, some authors have suggested that the risk of elevated Lp(a) is small if LDL-cholesterol is not elevated.

How Is Lp(a) Involved in Atherosclerosis and Heart Disease?

Lp(a) and LDL penetrate the inner layer of the arterial wall and accumulate together at sites for atherosclerotic plaque formation.

Evidence suggests that Lp(a) may be more firmly retained in the arterial wall than LDL. Furthermore, Lp(a) transports oxidized phospholipids whose plasma levels are strongly correlated with the severity of coronary artery disease. Interestingly, these Lp(a) associated oxidized phospholipids possess pro-inflammatory activity. This might be one of the links between lipids and inflammation in atherosclerosis.

There is also some experimental data suggesting that Lp(a) may promote clot formation in arteries burdened by atherosclerotic plaque. This may be one of the mechanisms behind the involvement of Lp(a) in heart attack and stroke.

How Can Lp(a) Be Modulated?

Lp(a) is mainly genetically determined and therefore refractory to lifestyle intervention.

At present, serum Lp(a) concentration does not appear to be significantly altered by realistic dietary changes. Standard dietary intervention such as a low-fat diet has little effect on serum Lp(a) levels.

Currently available data suggests that fat consumption does not raise Lp(a). One study documented a lowering of plasma Lp(a) levels in individuals placed on diets rich in saturated fat (a palm oil-enriched diet). In keeping with this, other investigators have reported an increase in Lp(a) levels in individuals after they reduced their saturated fat intake. Monounsaturated fats also seem to reduce Lp(a) levels, as shown by a study that reported a significant decrease in Lp(a) levels in individuals whose diets were supplemented with almonds.

The data on the effects of statins on Lp(a) are conflicting, and the same goes for fibrates. Oestrogen replacement therapy in women has been shown to lower Lp(a), although by less than 10 percent. Other agents that have been reported to slightly lower Lp(a) are aspirin, l-carnitine, ascorbic acid/L-lysine, angiotensin converting enzyme inhibitors, calcium antagonists, androgens, and anti-estrogens.

Consistent with treatment guidelines, reduction of elevated Lp(a) levels should be a secondary treatment priority, after maximal lowering of LDL-C.

Niacin lowers Lp(a) by approximately 30 percent. Therefore, the EAS Consensus Panel has recommended niacin as the primary treatment for lowering elevated Lp(a) levels. However, these recommendations may have to be reevaluated in light of the results from the recent AIM-HIGH and HPS2-THRIVE trials. These trials did not show any clinical benefits of adding niacin to statin therapy.

Evidence indicates that the new PCSK9 inhibitors that have recently been tested in clinical trials may significantly lower Lp(a).



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Jeffry N. Gerber, M.D.
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LDL with and attitude!

Axel F Sigurdsson
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Axel F Sigurdsson

That´s right Jeff. A good description 🙂

Bill
Guest
Bill

Is it your opinion that Lp(a) is atherogenic? I have heard two opinions. 1. that it is primarily atherogenic & 2. that it is primarily thrombotic. I do have high Lp(a) and am working on reducing mine in the hopes it will mitigate my CVD. Thanks for your discussion on ‘modulating’ Lp(a). I am doing some of what you mentioned and trying a couple of others suggested by my doctor. I was told that it can also he reduced a bit, maybe 10%, by taking DHEA. Have you any input on that possibility. Also I was told high dose EPA/DHA… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Bill. There is still much we don´t know about the exact role of Lp(a) in the pathogenesis of atherosclerosis and heart disease.Studies have indicated that it may be involved in the atherosclerotic process, where it may possibly play a causative role. Other studies have indicated that Lp(a) also plays a role in thrombosis formation, possibly by inhibiting fibrinolysis. I am not aware of any studies showing that omega 3 (EPA or DHA) lower levels of Lp(a). However I still believe that omega 3 may have positive effects when it comes to preventing heart disease. If Lp(a) is high, the… Read more »

Someone
Guest
Someone

Thanks again for the interesting article. I just recently read another article(written by Chris MasterJohn) which was maybe more focused to oxidized LDL and how it contributes to atherosclerosis. Anyways from there I understood that Lp(a) may also play a role in making the LDL particles small and dense. And as I have understood earlier that small and dense LDL particles might be more atherogenic than large LDL particles. https://www.cholesterol-and-health.com/Does-Cholesterol-Cause-Heart-Disease-Myth.html Article also considers the role of PUFA in oxidized LDL. I would be curious to hear Mie’s and Dave’s opinion on the article since they have been battling on the… Read more »

Mie
Guest
Mie

Someone, when you adjust for confounding factors, sdLDL isn’t really that much more atherogenic than larger LDL. The idea that larger LDL is “neutral” is – simply put – nonsense. What comes to oxidized etc etc. LDL; yes, the current view is that harmful modifications of LDL are relevant to CVD, but in clinical sense the benefit can and should still be achieved via reduction in LDL levels, should they be way too high. The higher the LDL level, the more vulnerable your arteries are. It’s not LDL per se, but abnormal levels of it. And about pufa: I’ve said… Read more »

Someone
Guest
Someone

Mie, thanks for giving your view on this matter. By the way, have you read MastJohn’s arcticle related to Rho ? (https://www.cholesterol-and-health.com/Rho-Activation.html). In the article he points out that statins lower cholesterol and inhibits Rho activation through the same mechanism. Rho on the other hand inhibits Nitric Oxide Synthesis. I remember earlier having discussion with you about statins and you mentioned that statin’s way to reduce CVD is mainly due it’s ability to lower cholesterol. Your most relevant point was that the more cholesterol is lowered by the statins the better are the results. Now based on MasterJohn’s view, statins… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

A number of studies indicate that the anti-inflammatory effects of statins may contribute to their clinical efficacy. The potential mechanisms for these effects are reviewed in this excellent overview; for those who want to dig deeper.

Mie
Guest
Mie

Someone, the pleiotropic effects of statins do indeed have some added value, but in no way is this comparable to their main effect (HMG-CoA reductase inhibition). Data shows that the clinical value of statins is chiefly related to their LDL-lowering effect: https://www.ncbi.nlm.nih.gov/pubmed/16214597 To answer your first question briefly: no, I don’t think it’s totally irrelevant. However, there’s no data to suggest that the treatment goal should be changed. About the second question: care to define “partially” in terms of %? 🙂 Bear in mind that statins lower LDL more efficiently than fibrates, niacing etc. etc. See https://www.health.harvard.edu/newsweek/Help_for_your_cholesterol_when_the_statins_wont_do.htm Concerning Masterjohn’s article… Read more »

Paul Harris
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Paul Harris

The idea that larger LDL is “neutral” is – simply put – nonsense? This statement is incorrect. Also, simply LDL is not and should not be a precursor to anything wrong, but your total Cholesterol to HDL ratio is important. If your Cholesterol is 300 but your HDL is 95, you are well within normal ranges. As for ApoA, ApoA and B are both apolipoproteins. Usually, ApoA is associated with HDL (the so-called “good” cholesterol) and ApoB is associated with LDL (the so-called “bad” cholesterol). In actuality they’re both “good.” Lp(a) is an odd fellow that’s kind of a hybrid… Read more »

Someone
Guest
Someone

Mie, but isn’t HMG-CoA reductase inhibition just same mechanism that affects to the Rho activation as well ? So let’s assume(just for fun;) that the Rho would be the one to blame, so wouldn’t the LDL level reduction still correlate with the CVD(because LDL level gets down trough same mechanism) ? Anyways, I believe that even if the Rho would be important factor here, LDL level would also contribute to CVD because the more LDL you have in the blood the more likely you probably have more oxLDL as well. About MasterJohns comment: “the idea that the primary cause of… Read more »

Someone
Guest
Someone

Hi Doc’s opinion

My dad underwent CABG 4 months back now we tested the LPA level, it is 40.7 mg/dl. Is it normal ? Also CVD seem to be familial. Any advice/tips Doctor ?

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Lp(A) above 30 mg/dL is generally associated with increased risk. It is important to also look at other lipid parameters as well as other risk factors. CVD has a tendency to run in families. Therefore, if you have a parent or a sibling with CVD, your risk is increased and therefore important to work with the modifiable risk factors.

Ed Thomas
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Ed Thomas

I know this site is geared more to health care pros, but I am grappling with a decision and thought I would take a shot at “Doc’s Opinion”. My recent VAP test results: total ldl-c 122, total hdl-c 62, total vdl-c17, total chol 201, triglycerides 71, total apob100 91, lp(a) 23, idl-c 9, real ldl-c 90, real ldl size pattern A, remnant lipo 19, hdl-2 17, hdl-3 45, vldl-3 10. I have had a coronary calcium scan with a reading of 2. I am a 65 yr. old white male, with no other CVD risk factors. Out of what seems… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the post Ed. The site is geared for everyone, not only healthcare pros.
Of course I can´t give you any personal advice. What I can say is that statins are not particularly useful when it comes to lowering Lp(a). When giving recommendations on statin therapy I always look at the whole risk profile including family history, smoking, blood pressure etc. If a patient of your age has no such risk factors, a coronary calcium of 2, an LDL-C of 120 and apob less than 100, I would generally not recommend statin therapy.

Ed Thomas
Guest
Ed Thomas

Thank you very much for your reply. No family history, have not used tobacco of any kind since Feb. 1976, avg bp130/80, stable weight 163 @ 5’7″, 60 mins .aerobic exercise 3-4 x a week, moderate diet and alcohol intake. As I mentioned, my primary care(not a cardio) who I greatly respect and have been going to for 20+yrs.is very conservative, a self described belt and suspenders guy, is concerned about long term arterial inflammation, stroke factors etc. He dismisses my concerns as to statin side effects, but my concerns are real. At this point, I think I’m just going… Read more »

aerobic1
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aerobic1

The results from the AIM-HIGH and HPS2-THRIVE trials give rise to the question if elevated Lp(a) levels truly have a cause and effect relationship on the incidence of CVD or if it is just a correlation, and if Lp(a) is really a risk factor that needs to be treated. I have battled high Lp(a) for seven years and have tried every imaginable mainstream and alternative therapy and only high-dose niacin has any measurable positive impact on lowering Lp(a) despite treating lipids to ATP III guidelines. I tried high-dose EPA/DHA (6 grams per day) that Bill speaks of above and it… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

You´re absolutely right. There is no proof yet that lowering lipoprotein(a) will bring any clinical benefit. The new PCSK9 inhibitors appear to significantly lower lipoprotein(a) so maybe we will have some more information on this issue when the results of ongoing trials with these drugs have been published.

Bhaskar Raju
Guest
Bhaskar Raju

i have cvd dieses for 20 yrs presnt blood tst lippoprotien a 36.1mg /dl plz advis

JM100
Guest
JM100

Curious why you wouldn’t just take SAMe or at least add it to your methyl donors? Thanks.

Richard Shaffner
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Richard Shaffner

All — I found this study fascinating: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2678922/ . Using data from the large WHS, it found that women with a minor allele variant of Apo(a) had much higher Lp(a) levels and a much higher CVD risk. However, that increased risk was eliminated for those that took low-dose aspirin. (Interestingly, aspirin had no significant effect on non-carriers of the minor allele, over the 10 years of the study). For the individual with high Lp(a), it makes sense to take aspirin, or to get tested for the gene variation, if one is concerned about aspirin side effects. (Berkeley Heartlab has a… Read more »

aerobic1
Guest
aerobic1

The trials using low-dose aspirin showed inconsistent results. In one small trial group of 37 CVD patients, low-dose aspirin dropped Lp(a) by an average of 82% (https://lpi.oregonstate.edu/fw12/lipoprotein.html). That was impressive but other trials showed no effect. I believe a person should be tested for aspirin resistance using the AspirinWorks test as a great many people receive little therapeutic effect from aspirin https://aspirinworks.com/. The are no double blind RCT trials using aspirin as a therapy for reducing Lp(a) and won’t be either as there is no funding or profit potential for the least expensive therapy on earth. I used low-dose aspirin… Read more »

Richard Shaffner
Guest
Richard Shaffner

I understand, and I agree. It’s worth noting that in the study I referenced, aspirin helped lower Lp(a) in the minor allele “carriers,” but the benefit was greater than those lower numbers would suggest. In other words, aspirin seemed to have a beneficial effect, beyond just lowering the Lp(a) levels. For those subjects, it seemed to eliminate the incremental risk from high Lp(a), in spite of the numbers remaining relatively high. So…if one can tolerate aspirin and has those minor alleles, it could be that taking aspirin would reduce or eliminates one’s Lp(a) risk (so to speak). Anyway, that’s what… Read more »

Shannon
Guest
Shannon

Hi my dad passed away suddenly a few years ago whih they belu was heart related. I recently got tests done and found out that my lipoprotein a was 111 (not sure units) they put me on a strict diet and now moniter me every six months they said that if it rises ill have to be put on medication for life. While attempting to explain to me (now 15 years old) what lipoprotein a was, in a bunch of doctor jargon, they mentioned that it cannever be lowered -is that true? And are my lipoprotein a levels dangerous and… Read more »

Richard Shaffner
Guest
Richard Shaffner

Shannon, I am so sorry for your loss. I’m not a doctor. I’m a dad who has lost his wife (and the mother of my children) to cancer. I was very involved in my wife’s medical battle, and I have helped other family members (parents and children) deal with several serious medical issues. So I know a little about dealing with these things from a patient’s perspective. I was touched by your note, and if you don’t mind, I’d like to offer the following points and suggestions: (1) I applaud your taking responsibility for your own health. You’re getting tests… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Richard. Nobody could have said it better. I really appreciate your compassionate and rational response. Thanks. More here.

aerobic1
Guest
aerobic1

Shannon: Very sorry to learn of your Dad’s passing. I find Lp(a) to be a very finicky and unpredictable animal to deal with but you are smart and fortunate to have a doctor who monitors your health. By any lab standard in the US, 111 is a high level whether it be Lp(a) mass or Lp(a) cholesterol. While it is presumed to be an inherited risk factor, Lp(a) has never been clearly shown to cause heart disease. Say you have the flu with a fever. The fever is positively correlated with the flu but it did not cause flu. You… Read more »

SC Mishra
Guest
SC Mishra

Test was conducted in reference to back pain and levels are as under,
Apolipoprotein – A1, Serum 1.3 g/l

Apolipoprotein – B, Serum 0.81

LIPOPROTEIN (A) , SERUM 79.8

My TMT was positive and have undergone angeography in year 2010, no blocked detected. I am taking Atorvastatin 10 mg per day.

Kindly suggest,
Thanking You,
SC Mishra

Casie Williamson
Guest
Casie Williamson

I just read what was wrote. Here is whats going on over here. My 11 year old daughter had a TIA on Jan 16,2014 (4 days before her 12th birthday). Dallas Childrens Hospital did a bunch of tests on her and the only thing that came back abnormal were her Lp(a). She was showing 128. She was released from the hospital before we found out her levels. Right now they have her on 2 “baby” asprin a day. Her neurologist informed us that this type of protein was genetic. I went and had mine tested as when I was 19,… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for your comment Casie. Sorry to hear about your daughter and I sincerely hope that she will make a full recovery. I’m not a pediatrician and will therefore not be able to help much in your daughter’s case. Some studies have shown a correlation between Lp(a) and the risk of stroke. However, we still don’t know whether there is a causative relationship and whether lowering Lp(a) will reduce the risk of future events. As you say, our Lp(a) levels appear to be largely determined by our genes. Lifestyle and diet does not seem to influence Lp(a) very much. Although… Read more »

Casie Williamson
Guest
Casie Williamson

Thank you for your help with this. I’m going to look more into the clinical trials which you mentioned and see if anything there might be of assistance with a pediatric case.

R.Chandrasekhar
Guest
R.Chandrasekhar

R.Chandrasekhar, Bangalore India Dated: 15th March, 2014 I am Diebetic since 1998. Now as on date, I take Glycomet SR 500 and Becausules cap in the night Diapride M 1, Ramitorva cap and ecosprin 75 in the morning after food. When I went for regular check this day, the findings were…FBS 136 mg;PPBS 189 mg;Total Chlo 127 mg Triglycerides 82 mg;HDL 40 mg; LDL 79.7 mg;VLDL CHlo 7.3 mg;Total HDL ratio 3.18;LDL ratio 1.99;Apoliprotein A 1 124 mg;Apoliprotein B 62 mg; APO B APO A ratio 0,50;High sensitivity CRP 0,02 mg; LIPOPROTEIN (a) Immunoturbidometry 51.3 mg….This is the main cause… Read more »

srinivas trully
Guest
srinivas trully

Hi Chandrasekhar, Hope your Lipo protien (a) levels are normal now. I am having elevated level of Lipo protien(a) problem. Could you provide the medication you have used to lower it and the doctor you had approached please ?
please send the details to [email protected]
Satish, HYD

Margo
Guest
Margo

Hello, Could you please advise? I am a 51 yr old female, 5’9″, 155 lbs. I am VERY concerned about my LP(a). It is 237 nmol/L. My Apolipoproien B is 91mg. Total cholesterol is 195, HDL 61, Triglycerides 54, LDL 123. I have had chronic achy, heavy, throbbing leg pain for about 15 years now. I also have chronic fatique. My father passed away from a heart attack age 56. I do not know if he had high LP(a). My diet is fairly good, (I know I have to watch my sugar/carb intake!!) and I do exercise. Over the years,… Read more »

Mahesh shah
Guest
Mahesh shah

We have family history have heart deases like my brother has open heart surgery and other brother and sister has angio plast and my parent expired due to heart attack. My wife father also expired due to heart attack.i am 55 years old and I got angioplast and I am regular taking medicine as per DR, advice and my ldl n hdl in control and LIPOPROTEIN is 6.5 Recently my dr. Has suggest that as you have family history kindly check your kids body check up My son whose age is 22 Years old having slim body has lipid profile… Read more »

Chad
Guest
Chad

I have elevated Lp (a) along with a strong family history of males passing from MI’s in their early to mid 40’s. I made the decision a few years ago to go 100 percent whole foods plant based and avoid all processed foods and oils. I’m following Dr. Esselstyn’s recommendations along with daily running. I began this at age 37 and am now 41. I saw that my Lp (a) did tick up a few points but everything else dropped so much I thought that I was OK. Now, I’m starting to question it from what I’ve seen from low-fat… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks for the comment Chad.
Generally, Lp(a) is very difficult to modify by diet.
I don’t believe you’ve done any damage by adopting a plant based diet. In fact such a diet usually affects blood lipids and heart disease risk in a positive way.
You should absolutely discuss your symptoms, “the squeezing sensation” in the chest with your doctor.

sue
Guest
sue

Chad, how much good fats are you eating? you should make sure to eat egg yolks, cocunuts oil, olive oil and avocado on a daily basis.

Paul Harris
Guest
Paul Harris

Stay away from the olive oils, stick with coconut oils that are medium chain tryglicerides, not long. And do NOT scramble your eggs, this will oxidize the yolk and fats, eat them sunny side up and pull from heat soon as the whites are white. Yolks should be look warm and well below their flash points. If not, don’t bother with the eggs. Keep it all organic brother 🙂

robert lipp
Guest
robert lipp

Hi Paul. Cooking eggs – interesting comments. Please can you explain the reasoning / what is happening a bit more. Is (soft) hard boiled OK? Appreciated

Dub
Guest
Dub

Chad, how you doing 5 years out? I’m in a similar position and curious about the effects of low fat plant based diet. Last checked my Lp(a) was 260 🙁

Teri
Guest
Teri

Hi, I’m have been following Esselstyn’s advice that if you can get your LDL C down to 70 or below that you didn’t have to worry about your high Lp a. Is this not true? In addition, I just had NMR LipoPropfile done which showed LDL P 609 and HDL P 42. APO B 74. Lp a remains elevated at 43. I was very excited but now reading your blogs I’m back to feeling frustrated since I have worked so hard to get theses numbers down, albeit with the help of niacin, asa, l carnitine, almonds and Paulings Lysine/proline/Vit C… Read more »

amy e wadsworth
Guest
amy e wadsworth

I am apoe 3/4 and also have an lp a of 75 ..along with elevtaed ldl at 144,..which is no suprise as my apoe3/4 variant causes ovesabsorption of dietary fats and cholesterol. I have tried years of various plans and supplements with varied results. this is so consuming and stressful and still havent found a way to deal with it, the only time my chol and lp a profile was ideal was when i went overboard low fat low carb, lost 25 pounds) which brought me at 80lbs and ended up int the hospital in bad shape. one i reumed… Read more »

Richard
Guest
Richard

Amy, I’m not a doctor. However, at times I too have had high LDL and high Lp(a). I’d like to share some perspectives as a fellow patient that might help. First, let me say that I applaud your doing research and taking an active role in your health. That’s great. Second, I think it helps to remember that all the research you see deals with statistics about groups of other people, and at best those statistics can only show correlations. From those correlations, researchers will draw inferences about general tendencies and sometimes even about causality. But when using those findings,… Read more »

robert lipp
Guest
robert lipp

Hi Richard. A fascinating analysis of the concept of risk which do not get to grips with. You state “For example, I saw a recent study that compared three different diets: ” please can you post the url as I would like to read the detail. Appreciated

robert lipp
Guest
robert lipp

Sorry … which many do not..

Richard Shaffner
Guest
Richard Shaffner

Robert —

Thanks. Here’s a link to the article:
https://jama.jamanetwork.com/article.aspx?articleid=1199154 .
Note the charts (also attached) that show how each subject did on the three different diets. The individual variations are the real lesson from this study (for us as individuals). It would be absurd to tell everyone to follow the one diet that produced the best average result for all subjects. Clearly the right answer for each subject is a series of individual tests (n=1) to and learn what works best for him or her.

Here’s another article that makes a similar point: https://ajcn.nutrition.org/content/95/2/506.short
Richard

Richard
Guest
Richard

Sorry! Somehow two charts got combined and added (no clue how I did that). Please ignore the top part of the chart.

robert lipp
Guest
robert lipp

Thanks Richard

robert lipp
Guest
robert lipp

Hi Richard
Different subject. Same general topic nutritional research.
You seem to have been around these sites have good knowledge. I would love to see / look through a table (Excel perhaps?) That lists all the relevant LCHF research on Fats, Sat Fats, Cholesterol and all its sub fractions, and Statins. With columns for the research type (animal, RCT etc) date, who, trial name, number of participants, duration, reference, findings summary etc etc etc. Any ideas that such exists, where found??????
Thanks Robert

Richard
Guest
Richard

Robert, I don’t have a Excel list, but I’ve read books and visited websites that refer to many studies. The following might help. I think the “Keto Clarity” book by Moore and Westman has a long list of studies, by topic. “Cholesterol Clarity” does too, from a different approach. The books by Phinney and Volek are great resources — they refer to many studies and link the findings with their own observations. The book by Gary Taubes are good too. Peter Attia’s blog ( https://eatingacademy.com/ ) probably saved my life, or at least made me much healthier. My story is… Read more »

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Hi Richard

Thanks for this sensible and thoughtful comment.
I appreciate your input.

Best wishes
Axel

Richard Shaffner
Guest
Richard Shaffner

Well, thank you for providing such a good, informative website and letting us comment on it!

crystal
Guest
crystal

My daugther is 11 and has hyperlipid disorder her lipoprotein a level is 62. What can i dod to help her

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Crystal
I think the best thing you can do at the moment is to teach her the importance of healthy lifestyle. Not smoking, regular exercise and a healthy diet are key issues. Hopefully, in a few years time drugs will be available that can lower Lp(a). This article might be helpful.

amy
Guest
amy

thank you so much for taking time to really encourage me not to panic and make the worst conclusion! i really will take your advice to heart. i need to focus less on these issues and enjoy life more. im thinking everything in moderation is the best recipe !

a.wadsworth@comcast.net
Guest

i hv consistenly come across info pointing to pufas and carbs raising lpa mufa (almond flax ) lowering lpa and ldl sat fats lowering lpa. Except the stearic acid component of sat fat ..which is chocolate 🙁 coconut palm and dairy fat always touted as bad sat fat for ldl. but apparently good for lpa and stearic acid touted as cholesterol neutral is bad for lpa so.. whats recommeded for non lpa population is actually opposite of whats rec for lpa population my question is : with lpa. is it more important to have low ldl ( with still high… Read more »

Richard Shaffner
Guest
Richard Shaffner

Amy, There are many good questions for which there is no simple answer (or not one that you should believe and take to heart.) I believe that is one of them. I suspect the best answer would be, “It depends.” It would depend on many other factors, including how high or low those LDL and Lp (a) levels are, and what one’s other risk factors were. And if you were asking for your own health, it would depend a lot on how you respond to the foods you eat. (Who cares how various foods might affect others? You’re not eating… Read more »

Sandra Tremulis
Guest

For those patients interested in a non-profit, patient advocacy organization for high Lp(a) please see http://www.lipoproteinafoundation.org. For physicians who would like to help the organization please contact us through our web site, we would love to have your support for more research into Lp(a)! We have some of the world’s leading experts on Lp(a) on our SAB board.

Axel F Sigurdsson
Admin
Axel F Sigurdsson

Thanks Sandra
Appreciate the link.
Best regards.
Axel F

Dr Samir lodh
Guest
Dr Samir lodh

Very very very noteworthy as in a short span of discussion like complicated matter happening inside the cellof the liver & blood stream relating to this topic, only individual liking along with moderate life style based on diet & daily combustion is to be maintained by the side of normal parameter watching that is activity control as well as healthy choice of behavior according to the available data herein Doc’opinion. So nice to see the interaction from all classes of readers is welcome.

ik
Guest
ik

Dear All I am a 37 Yr Old Male who just got the Results of the Blood Test package I had taken Just as Routine. All the Results came out “WITHIN LIMITS”: Total cholesterol, LDL, HDL, Alpo proteins, Triglycerides, Etc EXCEPT Lipoprotein (a) which came out to be 99 !!!! I have Normal BP, And Underwent a comprehensive Health Check up in April 14 (9 months ago) which included ECG, Doppler Heart, NCV, MRI Head, CT Scan Head, Cartoid Doppler and Full Ultrasound of Abdomen….All of which came out normal Only I was SEVERLY Deficient in Vitamin D and Moderately… Read more »

amy
Guest
amy

hi
your lp a reading is on the high side as mine is. but taking into account your low ldl and normal readings for all else makes the lp a factor less of an issue. lp a really causes problems coupled with high ldl and other genetic variants such as apoe 4
i wouldnt worry to much about it.
possibl reduce carb intake. up the saturated fats ( coconut palm dairy) reduce pufas. increase fish almond flax intake
i wd speak to your dr about slowly titrate up too 1000 mg niacin and add a baby asprirn

ik
Guest
ik

Thanks Amy for the Reply Its calmed me down a little Bit, I Re Read my reports carefully again and my HDL Value is 42 (Normal should be 35+ as per Report) and my LDL is 130 (Anything less than 130 is Normal, But 130 is Right on Edge)…Rest Everything is More or less NOT at extreme ends of Normal Range I will be seeking advice from a Cardiologist tomorrow. Is there any Non Invasive Tests which I can Take to make sure my arteries are Healthy and Fine. PS: I am naturally quite hyper and get stressed out /… Read more »

amy
Guest
amy

one question for us lp a people ! there seems to be correlation btw high endurance athletes and elevated lp a. theory is due to high carb endurance diet and or. appropriate response to constant minor tissue damage

any thoughts?

i am an endurance athlete::

amy
Guest
amy

hi again. i completly get where you are coming from. i get very overly anxious about health concern i do everything i can to keep healthy. eat clean exercise dont drink smoke go to bed early when i found out about lpa i went over the edge and my extreme response of .. now i really need to reign it in. resulted in huge unhealthy weight loss over exercise and more anxiety and stress on body and bones:: those things were more unhealthy than lpa. and some things we cant completly control. no matter how healthy and extreme i am… Read more »

ik
Guest
ik

Thanks Once again for the Positive Reply. As i have been reading everywhere that LPa Levels are “Genetic” and are not effected by Medicines as such But as you rightly pointed out…If Other parameters are in place…its negativity is reduced to a Good extent and worrying will create other issues Just for peace of mind, I will consult a cardiologist tomorrow and as per his recommendations take tests to Check the Health of Arteries Also I would like to ask you Amy…Do High Values of LPa have any Symptoms ? Spl like in your case…Inspite of being Fit and Healthy..the… Read more »

amy
Guest
amy

hi no symptoms. ive always had high ldl. since teenage years. my hdl remains high btw 80-100 bc i exercise a lot i only found out abour lpa six years ago. at times i wish i had never found out as theres not a lot to do for it! the only symptoms i get are anxiety and panic when i think about it! control what you can. exercise diet some supplements and be in the moment not living in :: why me:: or fear of what if:: its destructive mentally and physically you could get a calcium score to see… Read more »

ik
Guest
ik

Thanks My All Apolipoprotein levels are also well within limits HScrp is also 2.9 (Moderate Risk) Calcium 9.2 (Normal) All other Ratios of Ld, Vldl, hdl etc all within normal limits Basically I had a 75 Point / Parameters Blood Test done as Routine and LPa was a part of it, ALL the 74 Values are Within Normal ranges Except This One !!!!! and when I Googled it….It simply Scared me badly….but your posts have been encouraging I am planning to get the LPa Retested from another Lab to Rule out any Errors and will be talking to a Cardiologist… Read more »

ik
Guest
ik

Dear All I retested the LPa levels with another Lab and Result was 120 (2 days back from a Different Lab was 99) As per the Lab technician, such variation could be because of Method used and diff. type of Lab Machinery Can anyone shed a Light on this ? I am putting down my Cardiac Profile Values: Apolipoprotein A1 – 126 (Normal) APO B – 87 (Normal) APOB /A1 Ratio: 0.7 (Normal) HSCrp – 2.97 (Average Risk, but on Higher Side) Total Cholestrol – 178 (Normal) HDL Direct – 42 (Normal) LDL Direct – 131 (Almost Normal-On Edge of… Read more »

amy
Guest
amy

they have different ways to measure some labs use nmol some so use mg i believe i would just concentrate on normal range the lab provides you with and go from there see if both labs use same measurement parameters.. your overall provide is stellar!!! lp a is a problem mainly when coupled with other issue such as high LDL small particle size his tri’s etc you could boost your HDL a bit with fish oil and niacin (not without direction from dr) as fish oil thins blood and theraputic doses of niacin need to be monitored for liver function… Read more »

ik
Guest
ik

Hello All (Spl. Amy) This is the Update, I managed to get appointment from a Experienced Cardiologist When I showed him my Reports (Which were All within Normal Range, Except Lipoprotein A….which Showed a Value of 127 in a Repeat Test with a Diff. Lab and Initially was 99)…..He looked at me with a Smile and Asked me….Why Have you come here ??? Do you have any symptoms Like Shortness of Breath, Pain in Chest, Inability to Climb up stairs, Fatigue, etc To which I replied …No He asked me “Do you know the No.1 cause of Heart Ailments ?… Read more »

Jaymal Oboules
Guest
Jaymal Oboules

My oh my ,this is shaman recipe !
A full load of worn out motherhood statements and a good measure of utter crap 3) and 4). …..what’s missing is rhino horn powder.

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