Effect of Rapamycin on Lp(a)?

I have taken 8mg Rapamycin, cycling for nearly 3 years. With a FH of ischaemic heart disease and watching my lipids for years, only recently with Dayspring and Attia discussing it did I have my Lp(a) checked (not part of the usual lipid panel in the UK).
I am in the mod-high risk group (190). Dont qualify for PCSK9i as only given to very high risk groups in the UK.
This useful review of non-genetic influences Lp(a) made me wonder what effect (if any) Rapamycin might have.
Does anyone know?

PIIS0021915022001836.pdf (1.8 MB)

While this paper (below) didn’t call out Lp(a) directly, it states that low density lipoproteins (Lp(a) is a low density lipoprotein) decreased by 38%. The transplant patients in this study were taking a daily dose of 10 mg.

Though I do not have data prior to starting Rapa, I did tests on day 7 after dosing 7 mg, and had Lp(a) about 12% higher (193 nmol/L) compared to only 4 days after (170 nmol/L). Endurance exercise may also increase Lp(a) by 10-15%, and I had done more running prior to my day 7 test compared to my day 4 test, so that may have something to do with it. Either way, mine is elevated like yours, and I’m now working with a cardiologist and hope to convince him to put me on a statin so that I can shoot for ApoB in the ~30 mg/dl range. My ApoB was about 27% higher on day 4 compared to day 7 after dosing.

During sirolimus administration, mean total plasma cholesterol increased from 214 to 322 mg/dL (+50%); low density lipoprotein-cholesterol levels changed in a similar pattern. Mean triglyceride level rose from 227 to 432 mg/dL (+95%). ApoB-100 concentration rose from 124 to 160 mg/dL (+28%). ApoC-III level increased from 28.9 to 55.5 mg/dL (+92%). These lipid and apoprotein changes were found to be repeatable, reversible, and dose dependent. [13C4]-palmitate metabolic studies in four patients with hypertriglyceridemia indicated that the free fatty acid pool was expanded by sirolimus treatment (mean = 42.3%). Incorporation of [13C4]-palmitate into triglycerides of very low density lipoprotien, intermediate density lipoprotein, low density lipoproteins was decreased 38.3%, 42.1%, and 38.4%, respectively, by sirolimus treatment of these patients.

Thanks for that.
Like you Im aiming to flatten my ApoB and LDL to as low as possible. Ive increased my Atorvastatin to 80mg and thinking of adding Ezetimibe 10mg.
However saturated fat reduces Lp(a) so do I change my macro intake to more SFAs?
Seems risky in part but might lower my Lp(a).

It doesn’t look like increasing saturated fat decreases Lp(a) that much, only about 6-12%. Personally, I’m not going to increase saturated fat intake for this effect, I’d be more likely to try pantethine or tocotrienol supplements.

Thanks. Useful find that paper. Yes, will check out the supplements

I read this last night and was trying to figure out where to put it. It is a way to lower lp(a) that involves eating saturated fat or going low carb:


It can apparently be affected by diet. Most on here have said it is genetic, so try the new drug or give up.