How to Fix Lp(a)

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Lp(a) is a real problem! In fact, Bob Harper (Biggest Loser trainer) attributes his “widow maker” heart attack to Lp(a). If you have elevated levels then you have a significantly increased risk of having a heart attack.

Part of the problem is that most doctors aren’t even measuring it. But, if they do measure it then very few know how to address it.

Lp(a) is largely genetic and probably not due to anything you are doing (or not doing). It is also very difficult to lower. So what do you do about it?

How to fix Lp(a)

LIFESTYLE RECOMMENDATIONS

  1. Exercise: Gradual increase over 2 months to 60 minutes 6 d/wk. 40 minutes resistance and 20 minutes interval aerobics.  Use the ABCT exercise program in Dr Houston’s What your Doctor Won’t Tell You About Heart Disease book (available on Amazon).
  2. Ideal body weight and composition: Men 16% body fat or less.  Women 22 % body fat or less. BMI between 18.5 and 24.9.  Waist circumference:  Men < 36 inches.  Women < 30 inches.
  3. Sleep: 8 hours per night with good sleep habits.
  4. Avoid all tobacco products. Limit alcohol (1-2 servings/day for men, 1 for women)
  5. Mediation prayer, religion, spirituality and faith.
  6. Caffeine: If you are a slow metabolizer, then avoid it completely.  If you are fast metabolizer, it is OK to drink. You’ll learn if you are a fast or slow metabolizer on the CardiaX test. I believe that EVERYONE should have this test done. It is a one time since since your genetics will never change!
  7. Avoid all artificial sweeteners. Use only Erythrytol (Swerve), Allulose, or Stevia.

NUTRITION RECOMMENDATIONS: (See Diana, Lifestyle Coach, for consultation) Read my post on my general nutrition recommendations here.

  1. Water: 50% of body weight (pounds) in ounces of filtered or distilled water per day. If you weigh 150 pounds that is 75 ounces of water, herbal teas, broths daily. No plastic.
  2. Tea: 16 ounces of decaffeinated green tea per day and 8 oz of white tea per day
  3. Pomegranate: ¼ cup of pomegranate seeds or 6 oz of pomegranate juice per day
  4. Omega 3 fatty acids (get Omega-3 Index >8%) and extra virgin olive oil (4 tablespoons per day)
  5. Detox + elimination diet, then anti-inflammatory, blood sugar regulating protocol with high-fiber foods and cruciferous vegetables: broccoli, cauliflower, Brussels sprouts, and cabbage

Treatment

There are no level 1 evidence trials which demonstrate that lowering Lp(a) will reduce cardiovascular events. Reduction of LDL to 30 mg/dl did not reduce risk from Lp(a).

  1. Niacin – the effect is dose related. Niacin (Sustained Release) 500 mg tab once daily. Over time, work up to 2 grams per day (21%-40% decrease).
  2. NAC (N-acetyl cysteine) 500-1000 mg twice daily
  3. Aronia (Chokeberry) 900 mg twice daily and possibly elderberry. Order from Amazon or get at health food store.
  4. Carnitine 2 grams (8-21% decrease) – CarniteX 2 capsules twice daily.
  5. Vitamin C 10 grams per day Buffered powder (27% decrease) (Designs for Health)
  6. Proline (500 mg) with L-Lysine (1000 mg) + Vitamin C 10,000 mg.
  7. Berberine: Berberine is a natural PCSK9 inhibitor with benefits on blood sugar, lipids (cholesterol), as well as gastrointestinal health. Take 500 mg bid and possibly curcumin, quercetin and Citrus Bergamot. Berbemycin 2 capsules twice daily.
  8. Gamma delta tocotrienols Delta Gold: 300 mg hs (DFH)
  9. Flax seed: One cup per day (decrease 14 %) (health food store)
  10. CoQ10 – We want serum levels >3. I recommend CoQmax Omega 2 capsules daily.
  11. Ginkgo biloba: 120 mg bid
  12. Omega 3
  13. Aspirin 81 mg (81% decrease), reduce IL-6 and inflammation.
  14. Sex hormones: estrogen and testosterone. Postmenopausal women have 30 % increase Lp(a)
  15. Thyromimetics and thyroid hormone
  16. Antisense Oligonucleotides
  17. Apheresis in a Russian study reduced coronary atheroma volume over 20 % compared to control

Even aggressive reduction of LDL to very low levels below 50 mg/dL in Jupiter trial with statins still left residual CHD risk due to Lp(a). Risk was 89% higher in those in the 4th vs 1st quartile.