Lipoprotein (a)

[David76]

Does anyone know how to reduce lipoprotein (a)? I just had my A1c and lipid profile taken, and I was really happy with everything except that my Lp (a) was high. Fortunately, it came down from 3 months ago, and whether that is due to more exercise or less carbs (or something else), I'm not sure. Anyway, if someone has found a strategy that works well, I'd love to hear it (I tried niacin, but it made my blood sugars more difficult than I thought worthwhile given that my LDL is in the 85-115 range).
Thanks,
David

[JasonSmithMT]

David -

It is my understanding that Lp(a) levels are fairly constant throughout one's life. Its determined by genetics and there isn't much as far as diet, exercise, or drugs that one can do to significantly change the value. Most of the times the test is only done once during an initial lipid profile workup and usually not ever repeated. Was the change that you saw in your Lp(a) level a significant change?

Jason

[David76]

Hi Jason,
Thanks for the reply. I believe the change was significant. Over the past three tests (about 1.25 years) it has gone from 98 to 76. I guess it's supposed to be < 30, but not much is known about it other than it can be back if it coincides with high LDL's. Fortunately, my LDL is pretty good right now (101, and HDL of 62), but I figure if I can reduce the Lp(a) without too much trouble, I'd rather have it in the normal range.
Thanks again for your response,
David

[rzrbks]

David76,
One of the short and direct articles



Lipoprotein (little) a - Lp(a)

What is Lp-a? It is a lipoprotein particle found in the bloodstream. The structure of the Lp-a particle is very similar to an LDL particle linked to a plasminogen molecule. Plasminogen is involved in dissolving blood clots. The function of Lp(a) is unknown.

How is Lp-a related to atherosclerosis? Lp-a is a marker for the development of atherosclerotic vascular disease. Individuals with elevated Lp-a are definitely at an elevated risk of developing atherosclerosis. Whether Lp-a is directly involved in the atherogenic process has not been determined. The concentration of Lp-a is race specific.

How is Lp-a treated ? Treatments of Lp-a are very few. Nicotinic acid has been shown to lower concentration of Lp-a to a small degree as well as estrogen supplementation.

Is it beneficial to treat Lp-a? Whether direct treatment to lower Lp-a is helpful in preventing atherosclerotic vascular events has yet to be demonstrated. Thus, it is unknown whether treatment of Lp-a is beneficial.

How should therapy change if Lp-a is elevated? It is clear that Lp-a is a marker for development of atherosclerotic events. It is felt that in individuals with elevated Lp-a the LDL cholesterol is more toxic. Current use of Lp-a revolves around determining the intensity of therapy of the LDL cholesterol. In the presence of elevated Lp(a) there is evidence that the LDL cholesterol should be treated more aggressively and to lower targets. Global risk factor modification should be more intense.

[David76]

Thanks for the info rzr. Given that the niacin was tricky, I guess that just leaves estrogen supplementation...what are the side effects of that :D