Everything you need to know about Lp(a) | ft. Dr. Tom Dayspring
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- Опубліковано 19 чер 2024
- Lipoprotein(a) or Lp(a) raises risk of heart disease in 1 out of 5 people, yet few have heard of it. We cover all you need to know about Lp(a).
Today we take a look at lp(a). Dr. Tom Dayspring goes over what is lp(a) and why it raises cardiovascular risk.
Cholesterol travels in lipoproteins. LDL and HDL. low density lipoprotein and HDL high density lipoprotein
LDLs carry ApoB, a protein that wraps around the LDL. we can measure ApoB, it equals number of lipoproteins in that family
We can measure the content of lipoproteins, lipid panel contains LDL-cholesterol=how much cholesterol is carried in LDL lipoproteins
lp(a) is a type of LDL. lp(a) is an exception. most ApoB-carrying lipoproteins are equally atherogenic. Small LDLs, large LDLs, VLDLs. lp(a) is an outlier
most of us have low lp(a). genetically determined. ~20% have high lp(a)
tests of lp(a). we can measure number of lp(a) lipoproteins (nmol/L) or mass (in mg/dL)
Everyone should measure lp(a) once. lp(a) raises cardiovascular risk
high lp(a): managing other risk factors: healthy diet, physical activity, body weight, not smoking, blood pressure, diabetes and apoB
70% lower risk in people with high lp(a) when lifestyle and risk factors under control
statins dont lower lp(a) but statins lower risk in people with high lp(a)
PCSK9 inhibitors lower lp(a) by 25-30%
New meds in development. Reduce lp(a) by 80%
saturated fat lowers lp(a) but raises ApoB. other studies show reduction of lp(a) on lower saturated fat diets
Trans fats increase lp(a) but most are banned from the market in the US
no diet demonstrated for lp(a) specifically but diet can help with risk factors like ApoB and BP
Summary: measure lp(a) once
References:
jamanetwork.com/journals/jama...
pubmed.ncbi.nlm.nih.gov/31147...
www.sciencedirect.com/science...
academic.oup.com/eurheartj/ar...
www.atherosclerosis-journal.c...
www.sciencedirect.com/science...
www.ncbi.nlm.nih.gov/pmc/arti...
Peter Attia´s podcast: • 210 - Lp(a) and its im...
Disclaimer: The contents of this video are for informational purposes only and are not intended to be medical advice, diagnosis, or treatment, nor to replace medical care. The information presented herein is accurate and conforms to the available scientific evidence to the best of the author's knowledge as of the time of posting. Always seek the advice of your physician or other qualified health provider with any questions regarding any medical condition. Never disregard professional medical advice or delay seeking it because of information contained in Nutrition Made Simple!.
#NutritionMadeSimple #GilCarvalho
0:00 Introduction
1:51 Overview. Lipoproteins & lp(a)
3:10 What is lp(a)
4:26 lp(a) raises cardiovascular risk
6:41 How to measure lp(a)
11:17 Other risks
12:45 Management
20:02 Nutrition
21:40 Summary and resources
I've heard several doctors now say that lp(a) is genetic and you can't change lp(a) but I tested my 3 times and got 3 different numbers. I was able to lower it from 104 to 70 through diet changes. I think more studies should be done comparing diet and lifestyle changes instead of always jumping to a pill.
AMEN!
What diet changes did you make?
I got mine down from 53 to 34 with diet as well.
I’ve had mine tested the last three years and the number has been different each time. I have not done anything to lower it in the past but right now I planned to eat more healthy with a few natural supplements to see if I can lower mine below30 mg/dl.
Mine just tested few days ago. The information on you tube is confusing. Anyway, i will try to see if there is any change in 3 months. I am taking lots of supplements daily, so perhaps will take more niacin - doc best sustainable release type, omega 3, EPA, Nac, grapes seed extract...
Of course I am on keto with no sugar except those in cooking outside
Fantastically clear from both of you, and SO important. 👏
Thanks to the both of you amazing individuals for teaching us so much invaluable information in such a digestable manner. No pun intended lol
When I asked my cardiologist for the LPa test he looked at me like I was a Martian! Surprised that I was even aware of the test.
Fantastic content! You and Tom Dayspring are the best!
Outstanding video and wonderful expert guest !!
Thanks Gil and Dr. Dayspring! Such helpful information and easy to understand. Keep up the great work and I am looking forward to future clips from this talk.
Thank you! Very good interview!
Great video. Complex topic with a great presentation -- thanks!
Thank you so much for this video! Really interesting
Thanks Dr Gil., another awesome story from Dthe awesome Dr. Tom
WOW, thank the both of you for explaining this subject soooo well! I believe that I now know the reason behind my huge CAC score. I was completely perplexed as to my score and can only assume at this point that I must be a unlucky carrier of this gene. I have never been overweight, always had a physically demanding job, been very active, and most of my blood work numbers are good, slightly elevated hdl, ldl, good trigs., and ratios, never smoked, metabolically flexible and zero symptoms of heart issues. But the calcium tells a different story. Thanks 🙏
Thank you. What a great detailed video.
You two doctors are utterly brilliant. You work harmoniously and cooperatively together. I'm so grateful for you sharing the information with us.
THANK YOU very much for another useful video.
Excellent helpful video!!!
Thank you so much for this! Really, really helpful.
Great explanation!!!!
Brilliant. Thank you Dr Gil.
Thank you both! This is the best video I've seen on Lp(a). This was very direct & understandable for the patient. I hit the genetic jackpot (not!) of high Lp(a), with many of my relatives (father included) requiring aortic valve replacement by age 60 or so. Know I know why! Now I start the long/painful process of finding an MD who understands any of this. That may prove rougher than carrying the Lp(a) gene mutation. 😆Keep up the great work!
What was your dads diet prior to having heart problems? I also have high Lp(a), 380 nmol, and found out that my grandma had three strokes and died of heart disease in a nursing home at 70 and my grandpa, her husband had a heart attack at 55 and was dead by 63. My mom said her dad wanted red meat at the very meal.
@@plants_and_wellness1574 Funny you mention this! As I await the results of a CIMT test (self pay, $199 with CardioRisk btw) - I think about lifestyle/diet/genetic roles. My father has eaten a VERY UNHEALTHY diet his entire life - nothing but carbs & sugar, meats, no veges to speak of. 😲He's now 83 & minus the heart valve replacement, he's doing great. By contrast, I've consumed a VERY HEALTHY diet after age 20 or so (now 53). So my CIMT test will confirm that whole theory of 'genes loading the gun, but lifestyle/diet pulling the trigger'. Will report back after the CIMT results drop any day now...
@@wendylpa please do! That’s amazing that your dad is now 83. My husbands family eats whatever they want and one grandma is 91 and the other 89. Now, they’re not in the best of health but they must have really good genes to live that long. My side is the complete opposite 😄
@@wendylpadid u get the CIMT test done?
Great Video!!
Great episode, as always. So strange, the genetic variability. I have a genetic disposition to very high LDL-C and low LDL(a) and my wife is the polar opposite.
That was so interesting !
Thanks for recommending Dr. Attia's podcast. He did an extended series of episodes with Dr. Dayspring and went very in depth on all things lipid. Not as beginner friendly as this video, though :)
I really enjoyed that video!
Maybe I'm a mutant but I went on a low carb diet and my lp(a) went from 34 to 3 in 7 months along with a loss of 45lbs. Got off the diet went back up so now I am permanently on low carb and lp(a) stays under 7.
Got my lp(a) tested a few months ago at 17 nmol/L… I’m glad I checked, nice to know it’s low.
Absolutely terrific survey of what I wanted to hear. My only remaining question is, how do I get my doctor to watch this video? 🤔
Very neat, thanks!
Love your shirt, your friend and the genius level explanation of fats. I knew there was a reason I didn’t study medicine. My HDL is off the charts. My endocrinologist said it’s fine, heart protective. Is high HDL ever bad? Thanks so much for all the stellar content. X
According to Dr. Dayspring, HDL over 60 can indicate that too much cholesterol is being carried in your lipoproteins. Hardly anyone knows this, unless they have been watching Dr. Dayspring's interviews on YT.
Great video👍♥️🌱
Thank you.👏👏
great video as usual...thank you...it would have been nice if dr dayspring had explained in detail what he thought was a heart healthy diet
Yes!! I really wanted him to explain what he considers to be a healthy diet.
My father's lp(a) went through the roof on statins. I wanted to know if statins can raise lp(a) and you answered this in the video, thanks!
Same happened to me!
What did his docs do?
@@debbielaurune6506 he gets a PCKS9 ihibitor, but lp(a) is still high. But with very low LDL, maybe the harm is minimal.
There is also a possibility that the analysis method gives the wrong number if LDL is altered that drastically. I have to look Into that. Don't know if I will find an answer, since I'm a chemist, not a biochemist. I just know that there is a flaw in the analysis of lpa, because the size of the protein varies.
Great stuff. Hope you guys cover using K2 MK7 to prevent calcification.
You have to have an advanced cardio panel to determine apo(a) and apo(b). It is worth it to get a good profile. My values are good; nice and low.
This is my prob...which I discovered thanks to a response you gave me on a comment...so you taught me more about my calcified aorta than any cardiologist ever has and I am so grateful.
Our gratitude! Hoping that well be educated bout CAD..,causes,test,angiography, CT angiography,blockages, what to do,is it reversible, is bypass on 3 arteries needed if blocked,what extent and why..my brother is confused and so do i, since he was recently diagnosed with CAD but asymptomatic.. 'lookin forward. Thank you once again!
My Lp a was 147. After six of 2000mg per day Niacin treatment my Lp a was 45. Currently I’m taking 1000 mg and will check Lp a after six weeks.
After six of what?
After weeks of 1000mg niacine per day, 117 nmol/L. I’m going back to 2000mg per day.
thank you for your information, I just ordered LP (a) test.
Does insulin resistance have anything to do with lpa or ApoB?
The Life Extension site that offers an Lp(a) test says to avoid taking niacin, aspirin and estrogen supplements before taking this test. I read in the NY Times that niacin can reduce Lp(a) levels, but I didn't know that aspirin and estrogen did too--but then again, maybe the reason some doctors recommend taking a baby aspirin and phytoestrogen supplements for heart health are onto something?
this is great my particle number is high and my Doctor is either too ignorant about the issue or don't see the need to help me hell! they did an NMR and didn't say a thing about the high particle number my total is 155, triglycerides 86, and LDL a lil high at102 HDL is low at 37 now I know how to handle these people I have a cardiologist now I just saw him before this video the guy is very helpful and knowledgeable i'm going to bring this to his attention I may have the gene because my IDL is high.
What’s a more important market lp(a) or AopB?
I am 47 years old and from India (South Asian origin) and have 66 mg /DL due to genetics. Calcium score of more than 1000
Left coronary artery:
70% stenosis of prox. RIVA, 50% stenosis of prox. RIM.
70% stenosis of LCX - Proximal. 70% stenosis of Mid.LCX
both my tibialis anterior arteries are 100% blocked
Dr. Carvalho, recently I came across a hypothesis by Dr. Matthias Rath and Dr. Linus Pauling about the roles of Vitamin C and Lipoprotein(a) with regards to CVD. The theory was postulated in the early 1990s. The theory was very interesting, in my opinion. I was wondering what became of it, and why it did not make it to mainstream science. Perhaps, you can dig more into it and do a video on it.
I lowered my LP(a) by almost half with the Pauling protocol.
@@commentoriawhat did the protocol consist of like what supplements did you take?
@@shanes.9089 6 grams Vitamin C, 5 grams Lysine, 1 gram Proline. Spread throughout the day.
Hi. Brilliant set up, with Dayspring holding forth, rapid-fire, and you injecting graphics and summaries along the way. Counter-intuitive shock: saturated fat LOWERS apo a! I eat some cheese each morn (yes, guiltily). Have apo a of 79 mg. 80 yr old. On Repatha (PCSK INHIB). But why can't we approach the prob from the wrong end? Apo a spikes plaque buildup, how about putting high apo a pts. on a reg. dietary intake of nattokinase? From what I've read, a powerful fibrinolytic. It could perhaps scavenge/scrub the apo a-induced fibrin plaque. Natto is a dietary staple in Japan…for centuries. And Japan is the longest lived country (not just one local 'Blue Zone')
It seems that lp(a) can be lowered by Niacin, Cysteine and Vit C which was studied by L. Pauling already. Any newer studies on this topic? Some people seem to confirm a reduction on lp(a) after taking those things over months.
10 years ago I see that my LpA was 34 (Over 4 points over the normal max range) but my ApoB 1 point below the normal range, LDL was normal. So is LpA still dangerous if ApoB is low? From what he said it sounds like I'm not as at risk as I thought? Recently got both checked again so awaiting results. But I know that I have very high cholesterol when checked a few months ago so have been making lifestyle changes.
Awesome video. Thanks
Im clearly screwed my Lp (a) is 233.8 NMOL/L
I'm in my late 50's and just had these tests done for the first time. ApoB = 159, Lp(a) = 103, Apo A1 = 156 yet my cac score is zero. Had my carotid arteries scanned and no buildup. Still going to see a cardiologist about getting on a pcsk9.
The CIMT is a good test that is a good indicator of CVD. If it is normal, I would keep doing what you’re doing. But I’m no doctor ha ha.
The Journal of Clinical Lipidology, July 2014, has an article on using nicotinic acid ( extended release niacin) to lower Lp(a) as much as 25%. Docs don't seem to like niacin because of its side effects, but it has a decades long history of use in treating lipid pathologies.
Extended release has more side effects i think. Exception is the skin flushing.
I just got my results back today for lp(a), ApoB and ApoA1 testing. lp(a) is 17nmol/l, ApoB is 85mg/dl, ApoA1 is 141mg/dl and Apob/ApoA1 is .60. Not bad but looks like i can still work on getting the ApoB down. It is often said that lp(a) is genetic and diet cannot change this, but according to the notes above saturated fat lowers lp(a).....so which is correct?
Hello - couple studies back 10 to 15 yrs found L-carnitine and flax seeds can lower some 5 to 20%. So both safe and think if lpa high why not take as maybe some help. Any thoughts on these two compounds or newer studies for these compounds?
still need a discussion on the units of measure for Lp(a)
-- nmol/L , or mg/dL
If you have a genome set and you don't have one of the 2 polymorphisms associated with elevated risk should you still get the blood test?
We need a vid on GERD and how to differentiate from low HCL in the stomach
thank you for all your videos
(i am a biochemist and currently a fresh new
student of dietitian and nutrition in Greece)
14:54-It's my understanding the the PCSK9 inhibitors currently on the market do have an indication as an adjunctive treatment for both primary and familial hyperlipidemia. Did I misunderstand something?
Hey so I have a question- I have significant family history. I just got a referral for a cardiologist in Boston. I’m 33. Been very active and eat well because I’m aware of history. My results are: total-190 HDL-49 LDL-135 but I’m concerned with my 383 nmol/l lp(a) and my apoB was 104. I started statins last week, so you recommend anything else? Planning to get a CAC also. I’m basically running the show myself until I get a cardiologist my primary care I had to push for a lot of this. Should I be concerned about lp(a) raising on statins or just control what k can and lower the other values?
Why are you taking statins for those numbers which don't look bad. Was it prescribed by a doctor?
Crazy question, can Apo(a) drive higher Apo(B)? If you have a genetic disposition to high Apo(a), and it is always a small part of the overall Apo(B) content, then how do you overcome the genetic obstacle?
I am in my late 40s. I dropped my lpa level from 93 to 46 (norm
How’s your LDL so low?
I have an lp(a) of 138, so according to what I’ve heard on the video, I’m screwed! Looks like the treatment is to live for today and keep your will updated…
see a specialist if possible. approach will be managing other risk factors until specific therapy for lp(a) is available
"Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.
@@NutritionMadeSimplehow scared should we be of this? Seriously. Assuming we have no other risk factors. I’m at 69mg ?
Mine is over 400 - I am a ticking time bomb.
@@terribrooks9041yep mine is 1500! Wish i didn't know - live for today
What is your opinion of Dr. Sten Ekberg?
He seems to have a very high opinion of keto and meat. I started watching him on advice from my naturopath ( who us vegan) and have gone vegam keto since. Lost over 60 lbs in 4 months and have been been maintaining the weight.
Just wondered about your opinion if you ever watched his channel.
haven't watched but we have a lot of requests to comment, may do a react video at some point
My Lp(a ) initially was 151 nmol/L
I eliminated all dairy from my veg diet &
did not add EVOO to my food. Went down to 101.
Added EVOO back thinking maybe it would be a non issue & it went up to 181. EVOO out of my diet again & it is currently 135 nmol/L
In my case the #'s fluctuate in regards to what I ingest.
Are you still eating meat or not at all
I am confused. I got a Quest Cardiac IQ with Advanced Lipid panel. Among other results it has Apolipoprotein A1 and Apolipoprotien B.
So, is Apolipoprotein A1 the same as AP(a)?
What about the use of Niacin?
He linked a video under the description to Peter Attias podcast where he had an expert on LPa on and he talked about that.
I watched this video about 10 days ago. My mom has 7 siblings, 5 of them didn't make to 50, all had heart attacks out of the blue and died, her father died at 45 too. I'm about to turn 41 and after watching this video, I immediately scheduled an Lp(a) test. The results came back today at 93 nmol/dl, the test says the risk is moderate but Dr. Dayspring said it's high. Now I need to figure out what to do. Thank you for this insight. It may have saved my life.
hi, please see the Family Heart Foundation familyheart.org (nonprofit) for more info and guidance
and please share this info with your family as it is likely at least some of them also have high lp(a)
thank you for your interest
Nmol/dl or nmol/L?
@@NutritionMadeSimple mine came up high, my PCP had to get me referred to a cardiologist to approve the Repatha prescription. All other tests came up good, LDL stays a tad above 130. LpA test, not sure the scale used, but it came up high. Re Testing in a few months to see how Repatha is doing. (Been on Crestor for a few years)
My Lp(a) went from 155 nmol/L in 2018 to 38 nmol/L in 2021. Is that likely a testing error? During that time I was taking low dose Lipitor as well as low dose aspirin and high dose niacin. I was puzzled but my Dr didn’t seem to think the results were noteworthy.
Maybe the Niacin? What MG and how often? I'd get it tested again.
Mine is through the stratosphere! It varies from 375 to 575
Yes, I really had a heart attack. Yes, I’m only 52 years old and I have coronary artery stents
Where do I get a hold of the people doing these trials
Thank you for digging into the background of Lp(a). I am 61 and the youngest of 8, 4 of my older siblings all passed from sudden cardiac arrest. One brother was 31 and the other was 40. My sisters were 78 and 71. Fortunately my cardiologist tested me for Lp(a) because of my family history. One other brother had a heart attack in his early fifties, my surviving sister (78) and brother (64) are both on statins. Fortunately my cardiologist tested me for Lp(a) and unfortunately it's 188 and my APOLIPOPROTEIN B is 61; which is the magic numbers Dr. Dayspring mentioned as needing the PCSK9 Inhibitors. My question is, will my cardiologist be able to administer them or do I need to see another kind of cardiologist specialist? I know it's not covered by insurance, but I feel it's worth the cost. Thanks in advance, Anne M.
Could we possibly get some help for Anne?
How much is the inhibitor Anne?
I have been able to reverse. My coronary artery calcium score or CAC as it's called using the Linus Pauling Heart Protocol. This involves High dose vitamin C with Lysine and Proline. The Lysine and Proline are binders to Lp-a which I take 6 grams of Lysine and 8 grams of Proline per day. Vitamin C 5 grams morning 5 grams afternoon and 15 grams at night.
My CAC Score went from 660 to 458 in 20 months.
Lysine and Proline neutralize Lp-a. Vitamin C rebuilds the artery.
Lp-a is used as a substitute for vitamin C
The RDA is not enough for vitamin C. Dr. Thomas Levy has many u-tube videos.
@@SET12DSPThanks. That's very interesting. I've been taking Niacin, vitamin C (ascorbic acid 2 to 3 g a day) and organic plant based protein for my workouts and this contains the amino acids chain including proline and lysine, which I never thought could help but now that you mention it, my last test showed a lower Lpa although I haven't increased the Niacin dose. So it could be the added proline and lysine in protein powder. I'll keep an eye on that. Thanks for sharing.
Great info. My Lp(a) is 334nmol, otherwise total cholesterol 160.5 mg/dl, TG 77.1 mg/dl, HDL 70 mg/dl, LDL 75,8mg/dl, A1c 6.1%
On low statins for the last 14 years. Dr wants to increase statins and I don’t want to.
I am 78 working to decrease my A1c, have decreased carbs and lost 20 lbs the last 12 months, all thanks to info here on the channels- not from my Dr.
Is it better to say eat a can of sardines for the omega 3s, vitamin D, & B12 to help lower cholesterol & triglycerides, or is there a way to get these vitamins purely from plants. Much thanks & side note I am half Portuguese and love the culture.
Statins can raise LP(a) particularly in people with low molecular weight APO A. I have high LP(a) and somewhat high LDL. Very low triglycerides and very high HDL-C. I started Rosuvastatin but then added PCSK9 (Repatha). I am wondering whether to stop the Statin and just take the PCSK9. Would love to have guidance on this.
hi, iirc this Q is explicitly covered in this video
Great video thanks. I’m 56 always kept myself fit and eaten relatively well, more so now and my LPa level is over 700 nmol. Struggling to even see a cardiologist because I’ve had no ‘events’ all I want is a calcium scan or some other test to see what my arteries are like. I’m in the UK, all I’ve had is an ECG which said sinus bradycardia and possible left atrial enlargement but was told that was ok. Is it unreasonable to want a calcium scan rather that wait until something happens especially when my grandfather who was supposedly fit and healthy died age 60 with no warning of a heart attack and my father had triple bypass 3 weeks after his first symptom. Any advice much appreciated.
Have you had your ApoB and other cholesterol numbers checked? Are you consuming eggs or red meat?
@@plants_and_wellness1574 hi, not had ApoB checked that I know of. My cholesterol was high (genetic) hence testing for LPa. I rarely eat red meat and never eat eggs. I will ask about checking ApoB but they seem reluctant to do much to be honest. Thanks for your reply.
Flaxseed, amla powder, statin will help a long way.
I was able to lower mine with just a plant based diet with no nut butters or avocados. Getting it checked again next week to see if it’s gone down even more.
@@stafjustice9899 thanks for that much appreciated.
Replaced my statin with 1/2 Tbs of Amla powder in my daily oatmeal a year ago...and never looked back. Thank you Dr. Greger!
And do your lab results show that it works equally good to lower LDL?
@@CharlieFader It is within the brackets and good to go!
@@Cedrus1952 what is within brackets? Numbers please.
@@Cedrus1952 Can you be specific?
Where do you get Amla please, and do you have a source for this info? Would like to add it to my repertoire.
I have read that niacin can lower LPa, specifically nicotinic acid that causes the flush.
i am 22 and have hypothyroidsm. On a regular blood work my lipoprotein a was checked. It was 245 which shocked me. Currently I have heart burns that feel like a radio tgat is not working and is making the rough sounds. Could tgat be from lipoprotein a?
One question - if your LDL is very good (aka very low), should of even worry about either apoA or ApoB at all? Are we guaranteed to have low apoA and or apoB in those cases?
Thank you for this thorough and informative presentation.
Great question, April
What is very low? Have you had your ApoB or LPa checked?
@@plants_and_wellness1574 My ldl was 80 at once point, and I have a goal of trying to bring it to 60. If I get there, what’s the possibility I need to do a apoA or apoB at all since both of these are subsets of LDL? (Hopefully I have understood this correctly; feel free to let me know if I have not).
I don’t know about you, but I’ve had trouble getting somethings checked in blood tests. I couldn’t even get my Omega-3 levels tested locally. *shakes head at local hospital system* So, if someone who cannot get these tested and are otherwise at a low level, how critical is it?
Of course, if LDL is at a high level, I would think getting it checked would be more important than ever.
Then again, I’m making the assumption that more apoA and more apoB would drive up LDL overall. Maybe I got that wrong too…
@@apriljohnson6191 I replied but it got deleted for some reason 🙄. I order my own test online since most doctors won’t order them.
LDL does have protective properties to low seems bad, this is a new research angle. In general the ldl particles are carriers of apob if they form artherosclerosis depends on macrophages mitochondrial health I think just ldl metrics can stop the mechanism but isn’t the end point. Important factors are insulin and blood pressure and blood viscosity people’s stress negatively impact blood pressure and viscosity and also mitochondrial health in general. This probably why even hyper responders on keto can do well. No medical advice. Insuline can be targeted with lower carb patters but Whole Foods will probably be a win for everyone.
due to genetics from my father (heart attacked at 50 years old) my Lp(a) is very high at 107 mg/dl, although i am 34 years old and training 4 times/week.
Who you telling 😮 I'm 47 workout 5 times a week and got a 78 was surprising but I'm optimistic
very frustrating to discover that the dietary inventions I used to lower my high LDL and ApoB numbers - replacing saturated fats primarily with PUFAs and keeping my carbs fairly low (though with added soluble fiber) - may also raise my LP(a). Certainly will test levels if I can...
I know this is outside of your preview and the topic, but what is the role of air pollution on our CVS? Pesticide? Antibiotics? Maybe we are missing the boat.
Nice informative video. Could you get your guest to comment on in a new video with Lp(a) and LDL-C reduction for people with hATTR using newly approved siRNA drugs such as inclisiran Novartis Leqvio and others
Is Apolipoprotein A-1 the same thing as APO(a)? Bc if so, why does that safe range on my test say 79 - 169 mg/dl? EDIT to add. nevermind I see you answered the same question below. It is not the same thing. This test I bought did not give me the apo(a) result I was looking for. They gave me apo-b , standard lipids and apolipo A-1.
ApoA1 is the protein on HDLs. lp(a) is a type of LDL. so totally different
After watching this video, I decided to get my Lpa checked. It measured
Isn't that a little too low? 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)
@@Jeffs60 From European Heart Journal, Jan. 2021 "We tested whether low levels of lipoprotein(a) and corresponding LPA genotypes associate with major disease groups including cancers and infectious disease. Conclusion.
In a large, contemporary, general population cohort, apart from the well-established association with cardiovascular disease, low levels of lipoprotein(a) and corresponding LPA genotypes did not concordantly associate with any major disease groups including cancers and infections. There is no safety signal from our results to indicate that low levels of lipoprotein(a) are harmful."
I’m scared of dying because so many people count on me. My mg/dl is 45.10 and my HDL is 36 with LDL 126 and seems to fluctuate every year, low and high.
I’m googling everything and scared after hearing this video. Please direct me in the right direction as I feel doomed after this. I’m I going to die?
My Lipoprotein(a) was recently measured at 519nmol/L and ApolipoproteinB at 1,51 g/L.
Some stats: male 42, trains 3 times a week(cardio and lifting weights) and goes for small walks on the other days. Eat a balanced diet(about equal amounts from the 3 macro groups, but more recently prioritized fiber and protein over carbs) and am at 182cm/80kg.
How does my health prediction look like? Do I qualify for the trials I wonder? 🤔
I do suffer from anxiety and depression(started suddenly 8 years ago)...wonder if it could be related! 🤔
if those numbers are correct (150mg/dL ApoB, 500nmol/L lp(a)) they're very high. given the high lp(a) you very likely have indication for lipid-lowering medication. I recommend seeing a cardiologist for specialized following. also a good idea for family members to check theirs since lp(a) is genetic
Incorporate meditation into your routine. Anxiety plays a much bigger role in CVD than most people ever realize.
Thanks for this! I have high Lp(a), 121.7, and take a PCSK9 Inhibitor (Praluent). Only problem are the side effects. I have fatigue, muscle aches and weakness. I hate to stop the drug because it was my last hope, since I can't tolerate statins.
interesting. muscle symptoms are less common on PCSK9is. it will be a while before anything specific for lp(a) is out, a couple years at least... one possibility to look into is inclisiran (Leqvio), it's a PCSK9i with only 2 doses a year. not sure about availability where you are...
@@NutritionMadeSimple I am part of a research study on Leqvio. Just had my first injection. I will let you know how it goes.
Why Quest Lab have the Lipoprotein A normal lower than 75?
So what does it mean when you have high TC, high HDL, high LDL, high ApoB, but low trigs and low Lp(a)?
lp(a) is $48 via LifeLabs in BC...fyi folks
I'm still not sure. If LDL cholesterol is highly modifiable, why isn't Lp(a) too, since it's a component of LDL?
Great video. At the 21 min mark you say most trans fats are banned anyway, after saying they they can raise apoe a by 70%....what about trans fat that are naturally in red meat? Would keto/carnivore be a bad choice if you have high lp(a)?
My LPa is 413 NMol/L. I've had triple bypass and one stent. I've asked my cardiologist about any clinical studies and he doesn't seem interested in helping me. He wants my LDL as low as possible and says thet's the only thing I need to do aside from diet and exercise. How do I get in touch with someone for a study?
I'd cut sugar, limit carbs... this seems to be working for most folks..... my mom has high LP(a)... (and assuredly my siblings and I would as well, adopting the (a) gene)... but the cardiologist said her arteries were clean as a whistle!..... I believe it's about glucose and elevated insulin, being the bad guys at play.
My physician said that donating platelets (not whole blood) can help to lower lp(a). Has this been discussed in any studies? She is one of two lipidologists in our city.
The only FDA approved treatment is Lipoprotein Apherisis, which basically is a process that filters out your blood of LDL and Lp(a) and puts it back in. So it makes sense that removing platelets would also remove lipoproteins. I just don’t know how much. It would not be a lot.
Based on the information in this video, I had an lipoprotein (a) test done. The result was
17:04 how old are you? And are you pre or post menopausal. Major differences
This is really depressing. So if you’re like me and have a score of 104 mg/dl that’s “very concerning” but there’s literally no treatment for it???
Nope it's genetic i was told mine is 1500!
I'm 35.. just found out my LPa is 318Nmol/l.. I feel like genetically I'm doomed and has given me such anxiety. Trying to learn all I can, I have a toddler and baby to be here for.
I'm 97 mg/dl - very similar story. I'm 38, toddler & baby here myself (congrats!). I'm relatively thin, good B/P, A1C, workout frequently. But CRP/Homocysteine slightly elevated. I got a CAC through my primary & it was zero, but that's just a baseline.
I'd recommend trying to find a lipidologst. Your "everyday" cardiologist may very well be suited for the job. But a cardiologist with a focus on clinical lipidology may be advised for folks in our shoes IMO. I just made my appt, but the guy is booked up until Sept. Trying to get in sooner, but I feel that their more focused approach may be helpful here.
@@mmostwill we do sound similar. All my numbers are great including CRP (under 1) and homocysteine was 8. A1C 5.3 could be better but could be worse. My LDL is slightly high(112) HDL/triglycerides ratio is excellent. Current doctor wants LDL under 70 but doesn't know about Lpa much. My plan was repatha and supplements continuing a healthy lifestyle(good weight, diet, stay active). Still likely the plan.
I have an appt end of the month with a well known doctor Dr Pradip jamanadas. He has a UA-cam channel.. has a private practice couple hours away. His information lists about Lpa and he has a more holistic approach and claims to be about prevention (unlike most cardiologists). I'm hoping he can help.
My CAC score is zero but I have 15-20% blockages in two arteries. All soft plaque that CAC won't find. Found this out at age 32. More digging recently is how I found the high Lpa.
I might look into lipidologists around me. I have seen 4 cardiologists in the last 3 years, I don't mind seeing more until I find the right one.
I'm hoping the new drug in phase III trials will be the answer for us. It's had very promising results all around. That can give us some hope for the future. Should be released in 2-3 years.
@@everydayhomelife8697 sounds like you're concerned by your original comment, but the good news here is you're actively addressing the potential issue & getting out in front of it as best as possible now! Repatha not an option for me due to $$, but if you can, seems to have great potential if you're a good candidate. Reason being I mentioned lipidologist is that they may have a tendency to dig a little deeper on things like synthesis/absorption levels & other factors. Only issue is, it's not always easy to find a cardiologist w/lipidology specialty. But any good cardiologist would listen to your concerns and take them into consideration IMHO. Via home testing, I see that I have elevated cholesterol absorption markers in addition to high Lp(a). So that could guide the doc's decision on whether to start only with ezetimibe which stunts absorption. A statin will likely increase absorption levels further, but in conjunction with ezetimibe, it could be a better big picture approach... So that's something that needs to be weighed. Essentially, the whole process seems it's a bit more nuanced than "high-ldl=take statin". I'm working with my doc to reduce the inflammation markers before they become an issue. Introduced B/folate complex, changing omega-3 supp first for the the 1.3 crp, 15μmol/L hcy. Best of luck on your journey!
im also in 30s with elevated lpa, curious to know which test you took to discover the 15-20% small blockages ? @@everydayhomelife8697
I have a friend who just showed me results of testing his lp@ tested and it was 154 nmol and about 11 months later had it tested again and it dropped to 105 nmol. Then 3 months later it went up to 126 nmol. I am asked him what could have attributed to the fall and rise in numbers, and he isn't sure. He is on a wholefood plant-based diet. Both his parents have the gene that makes lp@. Is this unusual that his numbers changed dramatically in a short period of time? He added that all his other lipid blood markers are in normal range. Except he hasn't been yet tested for LPOB.
With the interest of trying to see if there was a correlation with his lp@, my friend looked back at those dates using his Cronometer app. He noticed that prior to his 105 results in March 2022 he added taking psyllium husk and an OTC supplement of Niacin 250mg on a daily basis. His lp@ dropped 49 points since April 2021. However prior to June 2022 when it went up to 126, he sometimes took psyllium husk, however had discontinue his Niacin supplement. While this does not prove causation it seems probable that Niacin has a reduction effect on lp@ maybe with psyllium husk also. By the way Niacin in his food was approximately 300% but made no difference. In supplement his total Niacin was over 1200%. Thanks to the Cronometer app for its tracking ability. Any news about Niacin helping? THANK YOU FOR ALL YOU DO MAKING NUTRITION SIMPLE.
The screen shot made it look like this was about IPA 🍺. 😂
Im 38 male i recently went to cardiologist he said i have slight aortic stenosis and a LPa of 90noml
I had my own Lp(a) done 2 years ago. It was 45 , >75 being problematic.
lol Gil is just cloning Peter Attia at this point
but great video, same discussion from a slightly different perspective and to slightly different demographics, very important
hehe in practice these videos are planned long in advance. some overlap is inevitable with others in the health space and not a bad thing as you alluded to, since we have different audiences and different presentation styles. these topics are wildly under-discussed
@@NutritionMadeSimple Couldn't agree more, thank you for what you do!