Everything you need to know about Lp(a) | ft. Dr. Tom Dayspring

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:

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

[matchseason]

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.

[Hanover-ekjy]

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.

[Viva-Longevity]

Fantastically clear from both of you, and SO important. 👏

[Virtualis-hzks]

Thank you so much for this. Two years on from your video, cardiologist in Australia still don’t look beyond standard lipid testing. I literally looked at a senior cardiologist in the eyes who was oblivious as to why this may be useful. I had to argue for lipo a and b testing, which I have only recently had run. Apologies if you have already done this, but what is missing from most lay person YouTube content, is a holistic view of the interaction between all the testing and what it means. This sort of content would be good to provide to our drs. After all, and without wanting to sound dramatic, this is about people’s lives. Once again, thank you.

[michaelshilby]

You two doctors are utterly brilliant. You work harmoniously and cooperatively together. I'm so grateful for you sharing the information with us.

[wendylpa]

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!

[lenakohl]

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!

[ndaair]

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 🙏

[jmw]

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…

[tekkeewang]

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.

[AdamIsMyNameO]

Got my lp(a) tested a few months ago at 17 nmol/L… I’m glad I checked, nice to know it’s low.

[edwrobel]

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.

[davidmay]

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.

[dontworrybehappy]

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.

[RobertOsborne]

Fantastic content! You and Tom Dayspring are the best!

[mpoharper]

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.

[MichaelToub]

Outstanding video and wonderful expert guest !!

[willbrink]

Measure once, say elevated, yet what can we do about it? Vid is 2 years old, I know there's meds in testing that may lower Lp(a), but what's the status on that? Lowering LDL-c/ApoB will at least lower overall/residual risk, but that's not enough! Finally, PCSK9 drugs are very expensive and insurance usually not covering it in favor of cheaper statins, etc.

[amadorar]

Thank you so much for this video! Really interesting

[bigswolletx]

My LpA 8.4 results that came back today, Dr., said that was phenomenal