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What You Need to Know About LP(a)

Updated: Sep 6, 2023


Hey everybody, Dr. Julie McLaughlin here. Happy Functional Medicine Friday. Today, we're going to be talking about Lp(a). And I know many of you've had blood tests done here in our office at McLaughlin Care and so I want to go through this and dive a little bit deeper because sometimes when we go over and we talk about things, we're talking about so much that it can be overwhelming. So we're going to talk about just this one marker.

So it has to do with heart disease, and when you come in, we usually look at your personal risk assessment with McLaughlin care. Your personal history, your family history, medications, supplements that you may be taking and your blood tests. And when you look at the blood tests, we look at something called lipids, which is really your cholesterol.

Now, traditional blood test is going to have a lipid panel, which has your total cholesterol, your LDL, which is your bad cholesterol, your HDL, which is your good cholesterol and your triglycerides. That is a 50 year old panel. If you've had your blood done with us before we use an advanced lipid panel where we look a little bit deeper, we take a deeper dive under the hood.

So we look at things like ApoB, small dense LDL, VLDL, and LP(a), which we're going to be talking about today, and ApoA-1. Now these tests are more advanced and you think gee, why isn't my doctor doing these tests? And that's a really good question. And we all should be asking for these tests to be done because a couple of years ago, the American heart association and the American cholesterol association just came out and recommended that everyone along with the standard lipid panel have this LP(a) run and the small dense LDL at minimum.

We've been running this big panel for years and years, so many of you have had this done. And so let's take a deeper dive. What that LP(a) looks like. So it's something that can cause a heart attack and is not linked to necessarily just high cholesterol in lifestyle. And it appears to strike people who are perfectly healthy. For example, Bob Harper, on the biggest loser, he had a heart attack. He's their trainer, super healthy guy, had a heart attack because of this LP(a). And, there's little known about this molecule, but it is part of our LDL or bad cholesterol.

So when you look at this little diagram, this is like your LDL, your bad cholesterol. The ApoB is how sticky it is. And the LP(a) is the whole component that goes around it. So when we have this LP(a) going around here, it makes it much more dangerous to us and risk of having a heart attack. So the levels that we look for, anything above 50 milligrams per deciliter, or 125 nanomoles per liter carry a higher risk. So all you have to know is on your lab test. If it's in the red, or if it's marked with an "H" in high, then you're at higher risk of having this marker.

Currently, there's no approved medications to get rid of the LP(a). None at all, there are supplements that will help us reduce the risk and lower it, but it never really brings it back into the normal range. One of them is niacin. The other thing that we can do to minimize our risk with the LP(a) is continue to have a healthy lifestyle and do other things that can lower overall cholesterol like, fish oils and curcumin,

Green tea extract, resveratrol different things that we do specifically to help lower our cholesterol, but it doesn't lower that LP(a), so we have to know what we can do with it. Now, there are a few people that have LP(a) but their LDL cholesterol is low, which is crazy. You think, How can that be? But there are some people with that. And if you are one of those people, you are actually very lucky because that gives you less of a risk of having a heart attack or a stroke.

So LP(a) is a genetic marker for heart disease and it's associated both with atherogenesis like plaque building up in your arteries or promotion of a blood clot, which would cause a stroke. So in essence, this LP(a) is a plaque building clot making machine, which no one wants to have that. This number, if it's elevated 1.5 to 3 times, it can cause that much extra heart disease. So we really want to be cognizant if we have this, because we have to do everything else we can to lower our risks.

We call it the "you can never stop marker". And that means you can never stop being healthy, eating healthy foods, exercising, having a healthy lifestyle because the elevated levels of just the LP(a) is an independent risk, regardless of anything else you have going on for a heart attack or coronary artery disease. Your genes control how much of this LP(a) that you make. So it causes premature heart disease, recurrent heart disease.

Familial history. So if you have this, you most likely got it from either your mom or your dad and your siblings, your children can have it as well. It causes familial hypercholesterolemia. Maybe everybody in your family has high cholesterol and it is because his darn LP(a). It gives you a 5% or greater risk of having an event within 10 years when it's really highly elevated.

So it's something that we want to work on. They're doing lots of research with it now, but the best thing that I can do to help you is be aware that you have it and control all the other risks that are around it. We usually use niacin, which is really helpful. So if you have LP(a) or someone you know has LP(a) and you need some more help and guidance with the rest of your profile, just let me know and we'll be happy to help you @ or


That's it for this Friday.

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