Elevated Lipoprotein “little a”. What's the best treatment for Lp(a)?
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- Опубліковано 15 чер 2024
- #afib #healthspanmd #CardiologyNearMe
Lipoprotein(a) - or Lp(a) - (pronounced L-P-little a) is arguably the most important genetic cause of heart disease. Yet, despite its importance, it is a risk factor that most people - and many physicians - know little about. If you have an elevated Lp(a), this video will explain what it is, what it means, and what to do about it.
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[00:00 - 02:20] Introduction: Dr. Hurst introduces the podcast and the topic of discussion - lipoprotein little a (Lp(a)).
[02:21 - 07:46] Understanding Lipoprotein Little A: Dr. Hurst explains what Lp(a) is, its impact on heart health, its prevalence, and why it's gaining attention in the medical community.
[07:47 - 12:28] Detection and Diagnosis: Learn how Lp(a) is detected, including through advanced lipid tests and genetic testing.
[12:29 - 15:47] Definition of Elevated Lp(a): Dr. Hurst discusses what constitutes elevated Lp(a) levels and its predominantly genetic nature.
[15:48 - 24:58] Principles for Addressing Elevated Lp(a): Dr. Hurst outlines four principles for managing elevated Lp(a), emphasizing the importance of optimizing heart health and aggressive LDL level reduction.
[24:59 - 35:28] Lowering Lp(a) Levels: Explore current and emerging therapies for lowering Lp(a) levels, including niacin, LDL apheresis, and promising new medications.
[35:29 - 39:36] Addressing Blood Clot Risks: Dr. Hurst discusses the relationship between Lp(a) and blood clotting, potential interventions, and the role of aspirin.
[39:37 - 43:42] Conclusion and Practice Overview: Summarizing the discussion, Dr. Hurst emphasizes Healthspan MD's approach to comprehensive care for high-risk patients.
[43:43 - 46:30] Closing Remarks: Dr. Hurst thanks listeners, reminds them to seek medical advice, and invites them to learn more about Healthspan MD.
[46:31 - 47:15] Disclaimer and Call to Action: A reminder that the podcast is for educational purposes only and encourages viewers to like, share, and subscribe for more content.
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![ApoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease [AMA 43 sneak peek]](/img/n.gif)
My LP(a) is 173 and all my inflammation markers are very low. My glucose levels are excellent and so are my triglycerides and HDL. I have type A pattern level. I think having high Lp(a) alone, without looking at all the other parameters might be misguided. Am i incorrect?
The Linus Pauling protocol lowers LP(a) you are welcome
Thank you
Thank you so much. I've watched several videos by other presenters and they are all so negative. You present this in a very positive well. Is there a transcript of this so I can take it to my own doctor and have a good discussion on a doctor-patient relationship.
Thank you thank you for a wonderful video learned so much right now my wife is taking a MHI gooseberry, probiotic and coupled with coq10 400 mg per day and we’re hoping that will make a difference in lower and what are your thoughts I know you don’t give advice but I was just curious on those two elements super food coupled with the Co q10
Where can I find your personal and HealthSpanMD conflict of interests statement? Thanks
If lowering LP(a) with niacin didn’t positively impact outcomes, why would lowering LP(a) with some new and likely expensive drug lead to better outcomes?
That's a good question. A couple reasons why it might help are that the siRNA therapy lowers lp(a) a lot better than niacin, and because the siRNA approach is extremely targeted, there should be little or no off-target effects. High dose Niacin, on the other hand, could have a lot of systemic effects, not all of which are guaranteed to be good.
How do I sign up for a study of the RNA drug as a volunteer?
I had my Lp(a) measured and it was below detectability (which was according to the lab,
Niaspan has lowered mine below 30mg/dl
but the studies at the time Lpa was not measured
Doc at what level is an aphoresis needed?
Thanks for this. I'm one of those small percentage of people with Familial Hypercholesterolemia. My LP (a) was 121 at my last blood test. I have to admit it's had me scared. I am doing things to minimize risk like you mention here in your 10 points.
Same here I'm scared
Mine is double yours
I have just learnt mine is 401. Doctors want me to double my atorvastatin even though I read this can increase LP(a). I have no heart symptoms so far...
Using Repatha. Hoping it will help. Has lowered my ApoB and everything else across the board. My LP(a) is 198. 😕
Get a coronary calcium test ASAP
Schedule an appointment today: app.nexhealth.com/appt/healthspanMD
I have a LP(a) of 399. What can I do?
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'm looking over my shoulder every day thinking a stroke or heart attack is coming for me.
I heard psk9 inhibitors work
There's studies now going on
I found my LPa is elevated and I have aortic stenosis
How old are you? Did mom or dad have heart issues?
Risky. Give a listen to Dr. Nadir Ali
@@a.g.hustlegarland4197
I don't understand, it says apoA is 13. Must be less that 100.
ApoB is 1.05. I dont understand. Please can someone convert these numbers? What's a healthy result?
Hello - great update here. Back 10+ yrs ago couple studies showed L-carnitine supplement and flax seeds can lower LPa by ~ 5 to 30%. Please any new studies or just your scientific thinking on any benefits of this two compounds>. Thank you
Just had a heart attack and a stent placement within 90 minutes. Thank you so much for this…I got out of it with seemingly no underlying cardiac damage…but my levels of this are high…
It’s 119…guess that isn’t super super high…genetic, fascinating…
it seems Asprin reduces Lpa
119 mg/dl and how old are you, sir?
@@vrb340 mid 40s
@@JBActors what is prescribed to reduce LPa?
My lp a is 190. I am so worried.
What is the units that your Lp-a measurement is in?
Is it mg/dl or mg/L ???
I believe the risk from Lp(a) is from its interference with the natural ability to dissolve blood clots in arteries. If true, blood thinners and preventing clots from forming should be the treatment. Insulin resistance must be prevented or reversed. Very strict low carb diet is the intervention of choice.
Absolutely right. Under circumstances of chronic inflammation, between the inner layer(tunica intima) & the middle layer of the blood vessel(tunica media) becomes inflamed and "sticky" for the cholesterol that is normally going through the artery & subsequently will illicit an immune response and clot formation. The emphasis is to reduce your inflammation wherever it's coming from. Not a fan of dropping the LDL to as low as possible for it's not changing much if inflammation persists.
I use Earthing to lower to raise my bloods electrical Zeta potential. Grounding the body substantially increases it to the point of flowing like wine instead of clumping like ketchup and no side effects that blood thinners have.
Reversing my CAC Score using Linus Paulings Heart Protocol.
Sir, asian diets are carb heavy. Although for me personally i can cut processed sugar, trans fat. But rice and wheat are a big part of the diet. Any comments on that? Are we here talking about carbs from whole food also?
@prateekpawanpaharia8687 No one answered you... I have heart disease, but I am reversing mine with the Linus Pauling Heart Protocol. It involves High dose vitamin C to bowel tolerance myself. I'm at 30 grams per day in divided doses with Lysine and Proline 8 grams per day each.
A separate enhancement is magnesium glycinate 800mg per day do drive calcium out of the body.
I have reversed my coronary artery calcium score from 660 to 458 in 20 months.
@@SET12DSPlook into K2 to help drop your calcium score
Is this the smalldense LDL partical.?
It’s an LDL-like particle with a specific protein wrapped around it. familyheart.org/media/2023/11/Lpa_FAQ_20230221.pdf
Thanks for the video. Are Apoliprotein a, Apoliprotein a1 and Lipoprotein (a) the same things?
No. lipoprotein A1 is the principle lipoprotein on HDL. Lipoprotein (a) is an extra protein on LDL. Whoever dreamt up the lipidology nomenclature gets a D- for clarity
@@nanduthalange7736 Thank you for your reply. I just had my Lipoprotein (a) tested and it was 44. A good result. Just the rest of my lipid breakdowns don't look quite as good.
@@nanduthalange7736No Apo(a1) is on the HDL. Lp(a) is it’s own thing
LP(a) is a LDL molecule combined with 2 other molecules ApoA and ApoB.
HDL molecule has ApoA1.
So ApoA and ApoB are bad.
ApoA1 is good.
Mine is 272 and I am a mom, three girls and a wife I am very worried to where I don’t even want to eat. The only thing they put me on was cholesterol pill and baby aspirin low dose . which I don’t like taking baby aspirin
I’ve noticed they can do more harm than help.
hi sir, your videos and thumbnail can be edited better and can be improved, do you need editor?
let me know, so i can share portfolio
your videos are actually helpful to me, just subscribed your channel.
so.. my recent result was 1282 mg/L ......hmmm
Have heard there is a benefit of taking high levels of vitamin c. Out of a study in Canada. I will try anything holistic first
The Pauling Method. Linus Pauling. Friend used supplement that lowered her LPa a lot
Niacin immediate release flush version, vitamin C, nattokinase, lumbrokinase, coq10, omega3, proline, lysine.
Yes, I am lowering my CAC with the Linus Pauling Heart Protocol so far by 30%.
@@SET12DSP any particular dosage you are using?
@marcrabbat Yes, I use the Pauling supplements all in powder form from BulkSupplemets off of Amazon currently at a substantial savings as I use a lot.
I use 25 grams of Vitamin C in divided doses per day. I take 5 grams morning and 5 grams afternoon with 15 grams evening with no issues.
Lysine 3 grams 2x per day
Proline 4 grams 2x per day.
My Lp-a level is 20mg/dl
My coronary artery calcium score appeared to be reversed by 30% as of a year ago. I am planning on another scan to verify further.
My LP(a) is 253. Was on niacin for years and years and it went down to 243 😭😭
LP(a) levels are mostly genetic, imo the best way to optimize your risk profile as of now is to focus on inflammation and clotting.
@@dr.proteomix1257 thank you!
@@sherrio5629 np👍
If my LPA (a) is 266, A1 2.08 and B-100 1.08 what are the risk factors? How do these tests compare. LDL has come down from 6.6 to 3.8 since March through changing diet and exercise and alcohol. No Statins as of today.
I've used Niacin and it lowered mine by more than 30% with just 500mg per day. Are you using the no flush niacin by any chance? That will have no effect on Lpa
No mention of statins. What, if any, role should statins play in all of this?
Some statins raise it slightly. Lipitor is supposed to drop it a bit but they don't know if the reduction improves health outcomes or if the benefits are just due to lowering LDL.
he said to keep LDL lowered. but what I have read is that LPa binds to LDL and blocks the apoB receptor binding site for the liver. so that would just be clearing out the unbound to LPa portion . so that wouldn't affect LPa bound stuff
Most of the doctors I have encountered brush off elevated LP(a). My current Dr is slightly better. My LP (a) is 85 dl and I have had 3 mild strokes , so a relatively low LP(a) level does not lessen the risk of stroke, at least for me. Being placed on a statin did lower my LDL to 77 from 104 which hopefully should reduce my risk of another stroke a little better. I am also eating a strict vegan diet with next to no saturated fat.
NO saturated fats absent in diet can be the culprit,
I just got tested at age 66 for LPa and its 486. no strokes or HA so far. I quit my statin after 4 years due to knee pain and neuropathy. I'm on low carb but that has increased my LDL to 255 (from like 180 pre-statin level). LDL on statin was 89 but couldn't tolerate that pain.
Does Repatha lower LPa?
Yes. That is its purpose. PCSK9 inhibitors lower Lp(a), Repatha is one. Praluent is another.
No. Absolutely not. Can't believe the level of ignorance and misinformation out there. Pcsk9 inhibitors primarily affect LDL, triglycerides. Zero affect on Lipo A. However, there is one drug in U.S. currently in trial stage.
I used niacin 2000 mg for six weeks and lowered Lp a from 145 to 45. I proceeded to 1000mg per day and will test after six to determine optimal daily dose
I was told you cant lower it by two heart surgeons as it is genetic mine over 1500!
Just try niacin, inexpensive and worked on me- almost 60% . I’m on 1000 mg ( 500 in the morning and 500 at night). I will have next Lp a test in two weeks and will post the results. Some surgeons are correct and some?
@@edwrobel Heart that niacin can cause more heart probs.
Beneficial definitely in my case. I should have new lipoprotein a test results this week.
@@charlesfuchs what heart problems?
My lipoprotein a is169nmol/l..iam just 33 years old female..i have kids in my hands..iam so worried😢..how to overcome this?
Work on the factors you can control. Drop saturated fats, eat more plants/fiber. Get exercise. In the long run we will have drugs to control it. They are being tested right now and are very effective at lowering it. But more testing is needed and when they eventually come out insurance is not likely to pay for them for primary prevention. But costs will drop over time and coverage will expand.
Recently, I gifted a female friend the cost of CT scan of her heart ($250) to check for calcium buildup. It's non-invasive and pretty accurate. She suffers from unusually high cholesterol at 55 y/o and the scan showed zero calcification. Depending on where you live go to a place that does them frequently. Insurance won't pay for this, but this will give you some idea where you stand.
@@bearclaw5115the American medical journal has concluded that increasing saturated fats lowers lp (a), eating more poly or monounsaturated fats increases lp (a). Sorry but you are 100% wrong. A quick google search of ‘does saturated fat raise lipoprotein (a)?’ will lead you to the info you need. Not sure where your getting your info
@@user-mq6yt3qq8jif you are on a low carb, keto diet Dave Feldmans lipid energy model with lean mass hyper responders showed that 100 people with an average of 345 LDL, 93 had zero calcification and 7 had under 10%. Saturated fats raise LDL but lower lipoprotein (a)
Talk to your doctor about using a combination of PCSK9 inhibitors which can reduce it 30%… also, extended release niacin 500mg to 2g daily can reduce levels 18-40 %
My LPa is 31 nmol. I've been low carb/ no added sugar, since 2018. I'm a 63 y/o female, no meds other than hormone replacement therapy.
My triglycerides are 93, HDL 71, LDL 166. All ratios excellent. Doctor anointed me "Superiorly healthy."
My CAC score was zero. My carotid arteries were checked via CIMT which were all clear. I had a heart MRI all great. I eat all animal products, minimal vegetables.
IT'S THE SUGAR, CARBS, FOLKS. 🤸
LDL 166 is not good at all and thats mainly from saturated fatty acids (animal fats). Your triglycerides are good - because you eat only little sugar and refined carbs. I would also suggest you to check your ApoB, especially with your unusual High HDL/LDL.
@MarcoMeile Heart mri excellent. CIMT all clear. CAC zero
Dr anointed me "superiorly healthy"
LPa has nothing to do with diet and all about how much Lpa your liver produces (since the time you are 6 weeks old).
Asprin can cause heart palpitations which can progress to atrial fibralation
Future therapy’s, you mean one thing that the pharmaceutical industry can jump on and make a drug and tell everyone that lp(a) is bad. Do you have any studies that show causation vs association? Do share. Let’s see some studies that show absolute risk vs relative risk. This is another huge blockbuster opportunity for big pharmaceutical companies to cash in.
My lipo a is 69 I am worried 😟
Don't worry, that is only slightly high. There are people with lp(a) more than ten times as high as yours.
Niacin works
Yes Niacin works but he is not pushing Niacin ,there is more money in pharmaceutical drugs
How much per day to lower ApoB?
@@wildcsgotacticsat least 500 mg per day of the flush form. Start low if you can’t tolerate the flush. You will get used to it then increase.
Explain to me good cardiologist the following fact. If you have low Lpa you have a higher all cause mortality. If it’s low your more likely to die from cancer and if it’s important in wound care snd it’s goes up as a result of injury. Do maybe you need to go back and learn more. Dr. Ginge
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
@@beepbeepnj2658 oh on this I would agree. Lpa has been labeled as bad like LDL. I believe Lpa is a necessary molecule that is elevated as part of the repair mechanism. I believe using PSK9 inhibitors & statins is insane. 😁
@@gingebrien2408 "Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.
Beekeeper you are spot on with your thinking. 😁
We are in 2024. Anything current?@@beepbeepnj2658
We should start looking at Vitamin C Liposomal and then we would not to talk about Lpa
Healthy cholesterol levels...completely outdated knowledge
What do you mean?
@@yellowgames7 He has likely been listening to the peddler's of Keto and carnivore diets. They like to discredit the importance of low LDL in particular because their diet raises it so profoundly.
💯🫡
@@bearclaw5115I assume you haven’t research the lipid energy model for LMHR. Where are you getting your info? Is it possible you are wrong?
Good god, not more RNA medication! F that
You are mistaken. Someone lied to you. siRNA therapies are completely different than RNA vaccines.
@@incognitotorpedo42 I think not confused troll. You seem like part of the leftie movement that's been spewing disinformation and lying to humanity
@1:07. LP(a) i a type of cholesterol ??? A protein attached to a cholesterol molecule? i would call this,...not just undifferentiated, it is simply wrong. it just continues, n and on... even laymen can talk better about that subject