Lipoprotein(a) (Lp(a))

TL;DR

If you're interested in or concerned about your heart health (particularly as you age) and can afford it, I'd highly recommend getting a Lipoprotein(a) (Lp(a)) blood test (this is different to a standard cholesterol blood test). This will reveal if you have Lp(a) levels that indicate a higher risk of atherosclerosis, cardiovascular disease (CVD), coronary heart disease (CHD) and thrombosis. If you find you are at higher risk you can then take appropriate action.

Lipoprotein(a) (often abbreviated to Lp(a)) is a type of low-density lipoprotein (LDL). LDL is one of five significant groups of lipoproteins, whose function is to move lipids (fats) around the body within extracellular fluid. One type of lipid: cholesterol when carried in the bloodstream by any LDL, but particularly Lp(a) can cause damage to your arteries, leading to a higher risk of many serious cardiovascular conditions (detailed shortly).

The concentration of Lp(a) in blood plasma is highly heritable; in other words, your genetics play a major part in determining how much of this lipoprotein is produced in your body and present in your bloodstream. This is mostly controlled by the LPA gene.

A high concentration of Lp(a) in the blood (high risk: 75-125 nmol/L and very high risk: above 125 nmol/L) is associated with a higher risk of;

premature atherosclerosis
cardiovascular disease (CVD)
coronary heart disease (CHD)
thrombosis

These risks exist even if your standard cholesterol levels are within the normal, healthy range.

Treatments

Unfortunately statins (drugs designed to lower cholesterol) are ineffective in reducing Lp(a) levels. Research suggests these may be effective;

testosterone/testosterone replacement therapy (TRT) ¹
hormone replacement therapy (HRT) in post menopausal women ², especially if take orally ³
L-carnitine ⁴
Coenzyme Q10 (CoQ10) ⁵

These may indirectly help reduce the impact of high levels of Lp(a); - garlic for atherosclerosis ⁶

Outside of maintaining hormone levels and taking supplements, its vital you maintain a high standard of cardiovascular fitness and ensure you also maintain a healthy lifestyle;

exercise - ideally a combination of;
- dynamic resistance training (weight lifting, push ups)
- static resistance training (isometrics (e.g. yoga, pilates, planks etc.))
- cardio
a (mostly) healthy, wholefood and ideally homemade diet - specifically consuming fruit and vegetables (which contain potassium and magnesium (electrolytes), as well as other essential micronutrients such as vitamins) - milk and yoghurts also contain potassium
adequate sleep and rest
meaningful and fulfilling social, familial and romantic relationships
avoiding or minimising alcohol, nicotine and recreational drug use, as well as your exposure to contaminates & toxins

Lipoprotein(a) (Lp(a))

Treatments

References