Seeking Advice on High LP(a) Levels: Any Insights or Personal Experiences?

Dr Greger is focused in plantbased interventions. Therefore he might have this focus as a bias. but when that said I think he come up with healthy advice. He has made som short videos about LP(a) and amla and diet. At the moment I take amla and grounded black cumin seeds. I will check my biomarkers in a few weeks so then we see if this approach has had any effect on my LDL and ApoB.

How to Lower Lp(a) with Diet (nutritionfacts.org)

Amla vs. Drugs for Cholesterol, Inflammation, & Blood-Thinning (nutritionfacts.org)

Amla (dried Indian gooseberry) vs. Lipitor for Lowering Cholesterol (nutritionfacts.org)

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I know about the bias. I only take what is useful; discard what I don’t like. I read Gundry as well, for the nuggets I can pick up, and disregard the part about lectins. I watch Dr. Annette Bosworth’s vids, also for the nuggets of good info, though I am not into keto.

I read on this site and other fora for the wealth of info and experiential data. It helps me winnow the chaff from the grain.

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Obicetrapib sounds super interesting

https://twitter.com/lpa_doc/status/1664288295197745152?s=51&t=zJMJ1xVdRJYEDYz-DHipTw

https://twitter.com/lpa_doc/status/1664288296518979584?s=51&t=zJMJ1xVdRJYEDYz-DHipTw

https://twitter.com/lpa_doc/status/1664288298771292160?s=42&t=zJMJ1xVdRJYEDYz-DHipTw

https://twitter.com/lpa_doc/status/1664288300268662784?s=51&t=zJMJ1xVdRJYEDYz-DHipTw

Hi @RapAdmin - can you help me figure how to ensure the kinks I posted above show the summary views of each link?

You know… twitter being the mess that it is right now, seems to have changed something so that the twitter links no longer do the “white boxing” that they used to do. Let me dig into it a bit and see if there is anything we can do to fix it… but I think its a twitter issue.

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Hi @DMac , any update on how your Lp(a) journey has gone / is going?

Hi @Neo - it’s currently ‘on pause’ atm. Went to a cardiologist a few months ago and I don’t meet the criteria for the subsidised PCKS9 inhibitor in Australia.
I’ve purchased a 5mg statin and intend on starting this when I’m back from an o/s holiday. I know this won’t impact the LP(a) level but it’ll cut my LDL. I’ll look at the inhibitor again in a few years (hopefully the price will be a bit lower).

Got it, sorry to hear @DMac . Did you ever try any of the other things? Eg Niacin? I’m considering trying that.

My LP (a) is very low, much lower than most ppl have. It’s 9nml/l which corresponds to 0.12 mg/dl. I don’t know what to think about it. There were no comments from my cardiologist.

Should be great now in modern times to not have that extra cardiovascular risk factor

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I would rejoice and stop thinking about it. 9 nmol/L is great. Mine is 193 nmol/L and there’s nothing I can do about it.

2 or 3 grams of vitamin C throughout the day with Lysine? This is what Linus Pauling said would work. Very low cost experiment and no down side at all.

Perhaps push to get

Lipoprotein Apheresis - Family Heart Foundation.

Considered niacin @Neo but decided not to go down that path yet…

Would be interested to hear if you have success with this though :+1:t3:

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I’m suspicious that something is wrong bc my apo b is 109 (high), and my CAC is almost 300. How can it be with lp (a) so low?

Seems like aphereis is only recommended for people with very high LDL-c AND high Lp(a):

Personally, I only have high Lp(a) and relatively low LDL-c, in the range of 70 mg/dL, which has risen since I started rapa from about 53-58 mg/dL. I started taking nexlizet (bempedoic acid + ezetimibe) and 5 mg of rosuvastatin every other day to see if I can reduce my LDL-c into the 40 or below range.

The cardiologist I saw about this wasn’t very helpful. He refused to let me do a calcium score test due to my age (37) citing radiation. Instead, he wanted to have me do a stress echo-cardiogram test, but I read that the test is really only good for severe blockages. I’m in good physical shape at the moment, running 100+ miles weekly with a 20 mile long run each week, averaging in the range of 6:40-6:50 min/mile pace, so I felt like the stress test would be a waste of money as it would have cost me $1000 for the test and probably another $300 for the followup appointment (original appointment was like $600) only to be told that there isn’t an issue. I think I will try to manage my LDL-c with bempa+ez+statins over the next three years and push for a CAC after I turn 40. I’ll also see a PCP in February so he may have a different opinion.

I also wonder if the high Lp(a) is a result of my long distance training. There is some evidence for elevated Lp(a) in endurance athletes, but there aren’t many studies on it. Some of them state that the increase shouldn’t be more than a 10-15% increase. You’d think someone like Peter Attia would have mentioned this at some point, but I haven’t really heard about it anywhere else.

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Are you talking about apo A-1 or Lp(a)?

@Radiata thx for color and sharing the exercise hypothesis (I have not noticed anything around that personally)

I think that may be similar in cost to a PCSK9i - perhaps consider that instead as it can lower Lp(a) by up to more than 1/3rd.

Talking about Lp (a) which is 9nmol/l (0.12 mg/dl).