My Lp(a) is SKY HIGH.... ridiculously so. I'm on a statin because of sky-high triglycerides, and my Lp(a) has meandered from 150 mg/dl (2020) to 354 mg/dl (!!) in 2022 to around 133 mg/dl again in 2023. I've managed to get my BMI and weight to my lowest level in my adult life with exercise, diet, and GLP1's + statins. Hoping that this helps. I keep waiting for Pelacarsen or other drugs to come out. My late grandfather likely died of a heart attack in his early 60s when he suddenly drowned (probably atherosclerosis, but we don't know). Thank you for this tip! Any other tips for people with RIDICULOUSLY sky high levels in spite of very good BMI, RPR, BP, etc, etc. I've gotten my a1c down to 4.8. Thank you so much for all your great writing and info!
My Lp(a) is 125. Just had it taken for the first time last week. I do have plaque in all coronary arteries, some mild, some moderate and in the Right Coronary Artery, severe. Scary. I've had a healthy diet, exercised most of my life. I am now 74. I have off and on in the last 4 years used a Vegan no oil diet. Now I am on it in a serious way and eating greens throughout the day as the nitrates in them when chewed well and reportedly able to become nitric oxide in the blood and act as a vasodilator in the arteries. both my parents died from heart diease at age 76.
I should add, I read the article (and LOVED it).... I meant are there any newer items on the horizon besides Pelacarsen and other novel treatments designed to lower Lp(a)? Loved this article! Thank you Dr. Barrett!
Catching up on all the Lp(a) articles! These are great! As mentioned in a previous article I got mine checked in Switzerland 796mg/dl, cholesterol level /LDL level also high, fit and generally health 38 year old. Have a lipidologist who has put me on 10mg of Rosuvastatin, just started in the last month. Had a CAC scan and CT angiogram (requested after reading content from Dr Peter Attia) and both of those were clear. However what bothers me is the chest pain on left hand side comes and goes and has done throughout my life. All tests come back fine with the exception of elevated Lp(a) and so not sure if I should worry or not..
I think pretty much all diets that keep visceral fat levels and lipids in check are a million times better than the Standard American Diet (SAD) but as for the differences between them I dont have any strong opinions. In my view you have to choose the vehicle that works for you. Far too much dogma in the nutrition space.
Great content as always Dr Barrett. I’ve been healthy plant based for over fifteen years and am a former amateur endurance athlete. I went from a zero calcium score in 2015 to one of 57 in late 2021.
It turned out my lp(a) was 118 mg/dl. As all my other blood markers (LDL/HDL/apo B) were in the normal range the conclusion was elevated lp(a) is the cause. I’m now on repatha and niacin which has lowered the lp(a) to between 50-60 mg/dl. I’m hoping that the new therapies being tested at the moment come to the market soon.
I recommend that everyone should get their lp(a) tested at least once. I never imagined I would have mild heart disease at the age of 52. Dr Barrett, what age meets the early onset of heart disease criteria?
Good work. Sounds like you are on the right track. Early heart disease is a moving target. The easiest was is to think about when you go from a 0 CAC score to >0 score. That varies for males and females but in general it is about 56 for males and 66 for females.
Thanks. I’ve also been listening to a lot of Thomas Dayspring on this subject and it seems your views align. The goal is to get my LDL below 1.3 all the time (it’s consistently between 1.3 and 1.7 - noting that lab measurements in Australia vary about 20%) and my Apo B around .35 (currently .55). To that end I’m going to begin a very low dose statin of 5 mg. Thanks for all your content.
It sounds like niacin is beneficial for you.. If you feel comfortable answering this, Did you have side effects? I have not heard of repatha....but I am in the US, which may have different options.
I am glad you enjoyed the article. I’m not convinced of the niacin data. For now the focus should be on controlling all your traditional risk factors as much as possible with your cardiologist.
Got my Lp(a) measured, thankfully normal at 12mg/dL (30 nmol/L).
Agree up everyone should measure if nothing but motivation for lifestyle changes to improve health.
Good news. Agree should be tested at least once for everyone
My Lp(a) is SKY HIGH.... ridiculously so. I'm on a statin because of sky-high triglycerides, and my Lp(a) has meandered from 150 mg/dl (2020) to 354 mg/dl (!!) in 2022 to around 133 mg/dl again in 2023. I've managed to get my BMI and weight to my lowest level in my adult life with exercise, diet, and GLP1's + statins. Hoping that this helps. I keep waiting for Pelacarsen or other drugs to come out. My late grandfather likely died of a heart attack in his early 60s when he suddenly drowned (probably atherosclerosis, but we don't know). Thank you for this tip! Any other tips for people with RIDICULOUSLY sky high levels in spite of very good BMI, RPR, BP, etc, etc. I've gotten my a1c down to 4.8. Thank you so much for all your great writing and info!
My Lp(a) is 125. Just had it taken for the first time last week. I do have plaque in all coronary arteries, some mild, some moderate and in the Right Coronary Artery, severe. Scary. I've had a healthy diet, exercised most of my life. I am now 74. I have off and on in the last 4 years used a Vegan no oil diet. Now I am on it in a serious way and eating greens throughout the day as the nitrates in them when chewed well and reportedly able to become nitric oxide in the blood and act as a vasodilator in the arteries. both my parents died from heart diease at age 76.
I will also add that I loved the article. I have heard different things about Niacin. Is it successful for anyone?
I should add, I read the article (and LOVED it).... I meant are there any newer items on the horizon besides Pelacarsen and other novel treatments designed to lower Lp(a)? Loved this article! Thank you Dr. Barrett!
It sounds like you are doing a great job and covering all your bases. It should keep the odds on your side. In terms of future therapies there are loads in the pipeline. Have a look here: https://paddybarrett.substack.com/p/future-lpa-treatment-options
Catching up on all the Lp(a) articles! These are great! As mentioned in a previous article I got mine checked in Switzerland 796mg/dl, cholesterol level /LDL level also high, fit and generally health 38 year old. Have a lipidologist who has put me on 10mg of Rosuvastatin, just started in the last month. Had a CAC scan and CT angiogram (requested after reading content from Dr Peter Attia) and both of those were clear. However what bothers me is the chest pain on left hand side comes and goes and has done throughout my life. All tests come back fine with the exception of elevated Lp(a) and so not sure if I should worry or not..
That sounds like a great conversation to have with your cardiologist. I can’t give personal medical advice here I’m afraid.
Thanks very much, great content!. If possible, what do you think about Esselstyn diet?
I think pretty much all diets that keep visceral fat levels and lipids in check are a million times better than the Standard American Diet (SAD) but as for the differences between them I dont have any strong opinions. In my view you have to choose the vehicle that works for you. Far too much dogma in the nutrition space.
Understood, thanks again.
Great content as always Dr Barrett. I’ve been healthy plant based for over fifteen years and am a former amateur endurance athlete. I went from a zero calcium score in 2015 to one of 57 in late 2021.
It turned out my lp(a) was 118 mg/dl. As all my other blood markers (LDL/HDL/apo B) were in the normal range the conclusion was elevated lp(a) is the cause. I’m now on repatha and niacin which has lowered the lp(a) to between 50-60 mg/dl. I’m hoping that the new therapies being tested at the moment come to the market soon.
I recommend that everyone should get their lp(a) tested at least once. I never imagined I would have mild heart disease at the age of 52. Dr Barrett, what age meets the early onset of heart disease criteria?
Good work. Sounds like you are on the right track. Early heart disease is a moving target. The easiest was is to think about when you go from a 0 CAC score to >0 score. That varies for males and females but in general it is about 56 for males and 66 for females.
Thanks. I’ve also been listening to a lot of Thomas Dayspring on this subject and it seems your views align. The goal is to get my LDL below 1.3 all the time (it’s consistently between 1.3 and 1.7 - noting that lab measurements in Australia vary about 20%) and my Apo B around .35 (currently .55). To that end I’m going to begin a very low dose statin of 5 mg. Thanks for all your content.
It sounds like niacin is beneficial for you.. If you feel comfortable answering this, Did you have side effects? I have not heard of repatha....but I am in the US, which may have different options.
I am glad you enjoyed the article. I’m not convinced of the niacin data. For now the focus should be on controlling all your traditional risk factors as much as possible with your cardiologist.