I am so thankful for this information. I got a lipid panel with a wholistic MD a couple years ago as part of a wellness check and was told that all of my numbers were great, but I noticed the LP(a) number was off the chart (105 mg/dl)... When I asked my doctor about it he said it wasn’t anything to be concerned with because it was just something I inherited and couldn’t do anything about. So I never thought about it again until reading Outlive. I’m 35 years old and am so grateful to have read this book. Before reading it I was under the impression my risk for cardiovascular disease was was very low. Now that I know what I’m up against, I can pay special attention to mitigating other CVD risk factors…and stay on top of any new developments that come about
"Off the chart" is relative. I continue to see people who overthink TH-cam video's. At some point folks you have to ask yourself if just maybe....you are a bit of a hyppchondriac? Why the need to report your own personal numbers? No one knows you here, the Dr's are not going to reach out to you...What attention are you truly seeking? Mental health is just as important.
Thank you for sharing your experience. This is a scary journey with most docs ignoring LP(a) or blanketly prescribing a statin. My LP(a) was 173. Yikes
@@kate-lq3xgListening to the discussion would give you a better answer than asking a random person who most likely does not have secret knowledge about lp(a) lowering methods that neither of the MDs in this discussion have. It is currently still subject of research how lp(a) can be lowered and if that will have measurable impact.
Mine was 246 nmol/L. If you can get your ApoB and LDL lower, it can help. I did read one study that showed a plant based diet was able to lower LPa and we know it lowers ApoB and LDL, so maybe try that. I’ve been 100% plant based since getting my results.
@@plants_and_wellness1574 Interesting :)from what i understand nothing change's it not even plant's hardly ever eat meat or plant based food's and my score is 9 nMol/L also normal LDL normal HDL range just saying.my Dr still want's me on statin's.
@@markplaton84 LPa is based on genetics, so if yours isn’t high then you probably don’t have the gene that causes it to be. Mine was 312 before going plant based and as of July it’s 246. I’m getting it checked again soon. Why does your doc want to put you on a statin?
@@plants_and_wellness1574 My LPa is 9 first he used family history my age 65 i smoke like 6 a day for years maybe 10 pounds over weight 150 LDL 40 HDL CAC score 237 all my other blood work and liver work is normal which he never seen until after telling me i need a stain :)
@@markplaton84 did he check your ApoB? Your LDL is quite high, it’s supposed to be under 100 but many doctors say it needs to be closer to 70. APOb is what really matters and if your LDL is high, then most like your ApoB is high.
Wonderful discussion, thank you for addressing this big issue that the vast majority of cardiologists and GPs do not care to look into and when you ask them to do those tests mentioned they do not really want you to do. This will include the Lipid Subfractions
So proud to see all this research from Quebec. Also studied engineering at Laval University, but this fascinating discussion is way above my understanding. Really grateful you do them. I'm definitely going to ask for my LPa and apoB tested. Been WFPB for 7 years and high level endurance athlete and never tested since, but all previous tests I had high LDL, so does my family.
@@plants_and_wellness1574 Should not be related and should not change either. Maybe it's a test sensitivity issue. Will get tested in the following month, lost my family doctor and process to get tested can be long here.
@@purpleblueunicorn if you’re in the states then you can order your own lab work online and go to any Quest and get your blood drawn. That is what I have always done. I’ve also used the exact same lab for all of my blood work so I don’t know why my LPa keeps going up. Up over 100 just from June.
@@plants_and_wellness1574 I don't know about the change, but since Lp(a) do have an apoB marker, the apoB (count) test should encompass the Lp(a) result and if your apoB count is low, you should be fine. But it seems important to know the count, not the mass, because that's what causes trouble with Lp(a) being even more dangerous if I understand correctly. What units are your Lp(a) and did you get an apoB result? I'm in Canada, so have to deal with long wait times, but I should be able to get those tests for free if I can convince a doctor to give me the tests.
@@plants_and_wellness1574 Also seems to be some reliability issues with Lp(a) measurement, I would contact your assay provider and let them explain the results, because it should not change. Here's a good article on the subject if you can access it: pubmed.ncbi.nlm.nih.gov/33040574/
I've listened to over 50 talks on this matter, not to mention addicted to Dr Attia's talks and it's this talk that's convinced me to subscribe to membership 🙌🏻 I must also say that I had to describe what LPa and APOb was to my doctor!!
How dare you bring us back to reality?! I had to listen twice to get to the understandable level. I just want to be able to intelligently discuss this with my dr. next visit, and perhaps run the particular tests next blood test.@@dinomiles7999
I have elevated lipo protein A .. found out after having stents for 80+ occlusion in multiple coronary arteries. Found out after being blown off by my physicians. I’m fit thin. Ride my bike. My brother/ mother died of SCD so I pushed the issue. Now post stent am refractory to statins and on Repatha
I've got extremely high LP(a), about 100 points above the reference as stated by Quest Diagnostics. From what I understand there's not much I can do about it (because it is almost completely genetic) except try to lower my LDL cholesterol as much as possible.
Mine is 246 nmol/L as of July. I switched to a plant based diet since there was one study that showed it was able to lower it, that and it lowers ApoB and LDL.
Either (V)LF-(oil free) plant based or its apparent opposite, (V)LC-(V)HF, seem like they can be effectively implemented as part of a strategy with potential to do a very great deal - much can be done. Be wary of what are misleadingly described LF-HC or LC-HF which are often, in actuality, far from being low in anything, just muddying the waters.
I thought part of the lack of benefit from the Niacin(Niaspan) test was due to the addition of chem that reduced flushing. Either way..if something reduces LPA, and LP(a) and increases HDL yet provides no benefit one must question whether the numbers mean much of anything (at least in terms of reducing risk)
These discussions always seem to miss anything about the inflammatory nature of seed oils and the benefits of reducing or eliminating them from our diets. There are only a couple of people on TH-cam that talks about them; notably one being Tucker Goodrich and the other is Dr Chris Knobbe. Here are two good videos, one with each of them. th-cam.com/video/hFfRils4-YA/w-d-xo.html th-cam.com/video/bh5eTi9jTPw/w-d-xo.html . Seed Oils are the #1 Problem in Your Diet / Chris Knobbe, MD | Peak Human Podcast th-cam.com/video/jYQ1bMec3GM/w-d-xo.html Omega-6 oils in our body fat, the half-life is 680 days. I found that at about the 48:00ish minute mark of th-cam.com/video/dwBQG0Ea6_I/w-d-xo.html
omg I'm 58 and have been waiting for a treatment for 2 decades now :( I've tried getting in the trails but there is not one near me :( I'm the oldest living male in my family by 10 years with high lpa. I guess I'm lucky to live this long... but I'm waiting for a treatment still.
pubmed.ncbi.nlm.nih.gov/30014498/ this study shows that a plant based diet can reduce LPa. A plant based diet will also lower ApoB and LDL. Maybe give it a try. My LPa came back at 246nmol/L and I immediately went on a plant based diet. My ldl dropped just a few weeks in but I haven’t retested ApoB or LPa yet. Will do that soon to see if it’s helped at all
Statins definitely lower, LDL and APO B.. PSK9 inhibitors obviously do the same thing, but even more pronounced! So riddle me this, why is cardiovascular disease still the leading cause of death. It makes tjis last pandemic look like child’s play. I think it’s much more complicated. I believe clotting, Blood pressure, metabolic disease, pre-diabetes. And constantly high insulin levels played in a bigger role. When I used to do heart anesthesia, I would say 60% of my patients for coronary artery bypass graft surgery had normal LDL’s. However, they were metabolically broken. So I don’t think we have all the answers. However, not sure driving LDL down to the 30’s is a good idea. It might be. However, I don’t think it’s that simple.
You need to learn about independent risk variables. Obviously someone who is diabetic is at increased risk of cardiovascular disease. But if they have elevated ApoB they are also at risk irrespective of their insulin levels. These are independent risk variables, and both should be addressed.
The Niacin is very confusing. How can it do all those positive things and not reduce outcomes? How can Don Layman sit here and say saturated fat and cholesterol intake dont matter if you are healthy? Layne Norton said it is “energy toxicity” …. For the love of God I have no idea what I am supposed to eat. There is so much evidence saying what you eat doesnt matter. So is it just as simple as people that eat fish and fiber tend not to be obese and over eat and therefore they have fewer events across an entire population? Is it just all about over consuming calories? Being overweight? I wish I had more knowledge.
Checked my Lp(a) just recently, after hearing about it a lot. My levels were undetectable- below the threshold of the lab, at any rate. I found that quite pleasing and reassuring, ngl. I didn't even realise a "you have so little our lab equipment just throws up a zero" result was a possibility.
@@patriot20000 Lol, idk. Turns out, Lp(a) has a use in the human body. People over 60 with high levels live longer, are more resistant to infections and heal better. But it also gives you early atherosclerosis. The human body makes no sense sometimes.
Most cardiologists ( nevermind other specialties) are so inadequate that it is truly embarrasing. Medical decision making over a lifetime is the leading cause of mortality and morbidity.. There is no getting around it, if you value your life and health, make properly informed choices. Ira Goodman MD
Wonderful sentiment DocGoodman but you know it's a minefield out here. The dogma in MDs is stunning... who never ask one single question about diet or stressor as factors. No healing only amelioration.
1:07:20 - as one who’s both parents had normal Lp(a) but mine very high, I’m totally aligned. Check before 18, and in light of the potential that estrogen may mitigate (mask/lower) levels, before first menses in girls.
@ good Q. I’ve been testing Lp(a) for 20 years. My mentor Michael Doyle (MD MPH) was a top lipidologist before there were lipidologists. I tested my parents decades ago.
My Mayo Clinic cardio doc will not allow me ask about particle size or receive tests for inflamm. He is is obsessed with Total Choles and generic LDL and mega-doses of statins. The Clinic has him under their thumb like ""The Firm"".
i don't get it, why do americans (apologies if assumption is wrong) have to go through their doctor to get blood tests. can't you just do them on your own?
@@chuckbecker8735 couldn’t agree more! It’s too bad Institutions and insurance companies dictate what physicians (and ultimately patients) can and cannot do
Very informative podcast... For info, here in the UK the experience of me and people I know is that on average GPs are extremely reluctant to offer either ApoB or LP(a), unless you get lucky with a GP who is either really open minded or up to date on the research.
Congrats on your thru-hike, that's quite an accomplishment. I have read and listened to everything I can find on little a since I have the gene and a hgh number. It Sounds like you do not have the gene. Because I have not read of anyone lowering it greatly, much less undetectable. And everything I have read (there's not a lot) says it can not be budged much except by an expensive drug that is not out yet. In the latest YT talk I heard a doc/researcher who said fish oil was shown to be effective for a group (in Africa? not sure) who lived by the sea and ate fish with every meal, and they had the gene. Were you tested for it?
Gee, must be nice to know more about Lp(a) than all the scientists and researchers who've studied it for the last 60 years! You obviously don't have the genetic profile that causes high Lp(a), so you can stop giving yourself credit for lowering it to an undetectable level........that's easy to do when it clearly wasn't high in the first place. What you claim to have done isn't possible when it comes to Lp(a). Those of us who DO have the gene and maintain pristinely clean lifestyles, yet still face serious residual risk for cardiovascular events, don't appreciate being righteously advised by someone who's not even in the club. According to the American Heart Association, the Ketogenic diet ranks far lower than the Mediterranean Diet or the DASH Diet (among others!) for cardiovascular health benefits. While you may have seen some benefits to your metabolic biomarkers (excluding Lp(a)) in the short-term, the longer-term health consequences of a Ketogenic diet may not be so positive. I hope for your sake that they remain so. In the meantime, stop making claims about Lp(a) that have no basis in science and that blame people for genetic factors over which they have no control. I, for one, am eternally grateful for the researchers, scientists, and yes, pharmaceutical companies, who are working toward finding a treatment for high Lp(a). When the new drugs come out, they will no doubt spare untold numbers of people around the world from the aftermath of heart attacks, strokes and other disabling conditions that result from high levels of Lp(a). While not perfect, the pharmaceutical industry has developed medications that are life-sparing and life-changing for people who suffer from a broad spectrum of diseases. I have personally benefitted from 2 such drugs, and when the new Lp(a) drugs come out, they'll most likely benefit me greatly as well. Your cynical attitude toward all things pharma seems as misguided as your false claim that Lp(a) can be managed with diet and exercise.
Why do atherogenic plaques build up only in pressure aortas? why dont the plaques form on non pressure sides? why lipids are considered the culprit since if they are running fine unoxidezed the body should eflux them normally .. the idea that cholesterol is the marker for cvd starts to become really stupid when there are clearly other markers for metabolic disorders that are really raising enormously
Type 2 diabetes has a hazard ratio of 10.2. Insulin resistance 6.4. Obesity 4.3. Smoking 3.9. LDL 1.6. Why focus on cholesterol when blood sugar is much more of a risk? He explained it near the end when he mentioned his conflict of interest. He's a vegan so he must demonize fat and praise carbs. BTW, smoking spikes cortisol. Chronic high cortisol results in cortisol induced insulin resistance. Which is why smoking is a risk factor.
Diabetics get similar damage to the capillaries in their eyes. Resulting in various eye diseases. You can even watch drug commercials which admit that high blood sugar caused the damage. Yet they refuse to make the same connection to arterial damage. Instead they resort to blaming the firefighter(cholesterol) for starting the fire.
Excellent discussion! good to know the relationship between LPa and risk, but there is always that lingering sense of a piece of the puzzle is missing, the genetic would of been around for thousands of years, why wasn’t CVD a prevalent cause of death throughout human history? I do think like Apoe4 , context of environment and diet plays more of a deciding role in the outcomes……just a thought
This is an interesting thought... my two cents is that heart disease takes years to develop (a strong genetic cause would still see early heart attacks in 40's and 50s), so for thousands of years, humans didn't often live past 30 years old.. they died before heart disease could manifest with visible symptoms. It was probably there but just didn't have time to be the ultimate cause of death as so many other things ended human lives quicker than heart disease.
@@megan_kal I have slightly elevated LPa but only my great grandfather died from heart attack at 73. All my other relatives died at 80 or older. My father died from cancer early but it’s probably related to Chernobyl as he lived in Ukraine.
Evidence from ancient mummified Egyptians demonstrates CVD, arteriosclerosis, etc. Death from heart disease mostly occurs after reproduction so hasn’t been eliminated from the gene pool.
Maybe low levels of Lp(a) are not that good? The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. 2012 article: CIMT in asymptomatic subjects with low Lipoprotein(a) levels.
@@hypnotiqpits13 "Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.
If the blood work shows Apo B is high, but Lipoprotein a is extremely low, how does that rank as cardiovascular risk for a person on low glycemic index nutrition??
- Lp(a) is a large lipoprotein made by the liver. - Since it is naturally made by the body, is there a biological purpose for it? Why did we evolve to produce Lp(a)? - Does attempting to significantly / aggressively reduce it, potentially cause a risk for an adult ... by not having enough Lp(a) available to assist in the repair process? - Lastly, does Lp(a) in a person with very low inflammatory markers and an optimal metabolism ... pose the same risk cardiac risk? You always say that everyons eventually gets atherosclerosis no matter what ... what is the differnece in the ones that pass away from it and the ones that don't?
From what I’ve read LDL kind of came in to take the place of vitamin C and some humans, however many thousand years ago. And it does help the repair process. The only downside is it apparently it helps the repair process and the vascular system so aggressively. It causes the blockage.😢 and that kills us. I died on the table once in the Cath Lab already.
LPa is associated with CV, but it's not the cause. And for anyone to say it is a genetic marker that can't be lowered is absurd. In addition, please do explain how 25% of centenarians studied had an LP(a) level of over 30 mg/dL
Thank you for covering LP(a) this thoroughly. It’s good to know we only need to take this 1 test 1 time to determine our levels and they are pretty constant throughout our lives. #KickAss100YrOld
@@dinomiles7999 my point is LPa is not like HDL or triglycerides or even LDL which change annually depending on diet. Everyone gets or should get annual bloodwork. It’s part of your physical. An LPa test has to be paid for outside of regular bloodwork. If you are monitoring your bloodwork regularly you only have to pay for 1 LPa test to know that it will basically be the same 10 years from now. I thought you would have to test it annually in an Ion test like ApoB or CRp. Basically it’s pointless to pay for more than 1 LPa test in your lifetime.
@@kevinjones7505 wow. My Gp won’t even do an LPa test. I have to go to a functional med doctor and it’s expensive. How often to you test your LPa. I get once a year blood tests but my functional med doc said it’s not like APOb or triglycerides that change enough month to month. LPa is more of a genetic predisposition. Do you have a disease?
@@jimking6484 I just went into a Quest Diagnostics lab near me to get it done - $60 bucks. Didn’t even go through my physician at all. For something like this, it was so important for me to get a sense of where I stand-and as soon as possible-that I just felt comfortable taking things into my own hands. If results come back suggesting I’m elevated, I’m prepared to absolutely obliterate ApoB!
what do you mean that measurement of LP(a) is stable over time, I've measured it 2 times in a span of 23 days, it increased by 17.9 from 68.5 mg/dl its stable 26% alright :) while LDL-C measured directly decreased by 4.4 from 168.6, HDL-C increased by 1.5 from 42.6, and TG decreased by 44.3 from 127.5, tests were done by the same lab. since I cannot measure my LDL-P, could it be if LP(a) is stable, then my LDL particle size should drop and its count should increase in order to accomodate this 26% LP(a) increase?
Had an LP(a) of 144 nmol/l and high LDL (4.2 mmol/l). Had a sudden heart attack age 53. Extensive ASCVD and stenting. After lifestyle changes, intensive statin therapy and more recently Inclisiran my LDL is 1.2. Having my LP(a) tested again in 4 months time, hoping that Inclisiran reduces it by 25% to reduce residual risk. Fingers crossed.
QUESTION: So really, we don’t have a conclusive answer on lifelong treatment with niacin for the reduction of Lp(a)? It may provide a benefit, just not one that would identified in the outcomes trial?
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
Can anyone answer this question? My LPA is 220 mmo/l and my total Cholesterol is 6.26 mmo/l but my HDL, APO B and inflammation markers etc etc is all good--also 0 Calc score...My Lipid Cardiologist says my Cholesterol has to be 2 mmo/l, which is VERY low...I have got my Cholesterol down before going Plant Based and Mediterranean, so I now do this strictly and will not be able to retest for my Cholesterol for a few months...I am 55, post meno, non smoker, drink on occasion, do weights and walk daily, low BMI and on no other medication...but recent MRI showed small Meningioma and Cerebral Small Vessel Disease beginning? Wondering if I take the low dose Crestor ? I am worried about the CSVD and statins increasing risk of cognitive decline.
👍 This is a huge treat on Lp(a) pathology, soo informative and beneficial, reealy enjoyed it, thank you so much Peter and the guest 👍 Unsolved: the conversion between mg/dl and nmol/l - Lp(a) has a molecular wt of 300k-700k Da. So the conversion factor = mg/dl x 10 dl/l x 1000k ng/mg / 500k ng/nmol = mg/dl x 20 (nmol/l) as compared to 2.5 as said here. What is wrong ??
My LP(a) is less than 8.4 nmol/L. I didn't ever hear anyone having a heart attack on both sides of my family. There were stroke due to hypertension on my dad's side.
Hello @peterattiamd I did a test recently and the numbers are as follows: HB1AC: 6.0 %; Lp-a: 45 mg/dl; Total Chol:148 mg/dl; TGL: 120; mg/dl HDL:42; mg/dl LDL: 82; mg/dl VLDL: 24 mg/dl; APO-B: 102.2 mg/dl; HS-CRP: 0.58 mg/l; Homocysteine: 8.9 umol/l; How high is my risk of CVD and what can be done about it?
Is LP(a) not mainly the best marker for oxidised LDL? And the oxidation of the LDL the real arterogenic causal factor? Which doesn’t mean that I think the influence on fibrinogen/clotting has no role.
Yes ... concur ... I guess that you may already be aware of LP(a), and small oxidised LDL also being able to be joined by ratio of triglycerides to HDL, emphasised by Robert Lustig among others as a more meaningful measure - a good so called poor man's indicator for damage ... and fibrinogen ... yea give us a break please Peter, and to throw the phrase back at him: appropriate in this context - necessary but not sufficient ... a phrase which Peter has been known to use rather inappropriately, when talking with Dave Feldman.
My thoughts too. Have you ever seen a source that documents the process of phospholipid oxidating? For example, at what blood sugar level does it occur? Is there the potential to control blood sugar so that it does not occur? So many questions but I'm hoping that blood sugar control can pre-empt the pressure towards using statins.
Excellent content. Surprised no discussion re ezetimibe. Can mitigate statin side effects allowing lower, even intermittent dosing (eg as little as once weekly 20 mg rosuvastatin), which is important when discussing commitment to lifelong primary prevention and someone as young as Ben.
I would love to read a study of significance this. Etizimbe and rosvastatin ok that's my boat but I don't want to get in. are you saying medicos don't know how to heal this, only ameliorate?
32:00 minute mark. But statins accelerate the calcification of your arteries. I know this as I have had 4 CAC scores before and on statins. Before statins I had a 25% annual increase in my CAC score. On a statin I had a 45% annual increase. So if someone has a high LPa and have a CAC Score of say.. 400 should they take a statin? Sounds like Repatha would be better but insurance probably wont cover it.
This is only true for some people. A statin can exacerbate hypercalcemia in a patient with underlying hyperparathyroidism and maybe other reasons. But it does not appear to be universally true. "A study performed by Hernández et al. in 2012 compared 478 statin users to 1837 non-statin users, with 84% of statin users having been on the medication for more than one year. Contrary to our observation, they showed no significant difference in the blood levels of calcium, 25-OH vitamin D, and PTH when comparing the two groups." www.ncbi.nlm.nih.gov/pmc/articles/PMC10905201/#:~:text=The%20drug%20has%20known%20adverse,additional%20rise%20in%20calcium%20levels.
If someone has elevated LPa they can certainly get BASELINE Cardiac Cath. If clear - every 5 years. If ASCVD can get stents, meds, etc. or just decisions made about low dose contrast repeat Cardiac Caths. If no ASCVD with elevated LPa on heart arteries, maybe less risk in brain arteries as well.
Exercise, stay lean, no junk food, get sleep, reduce stress, fast and eat low carb/0 carb to drive insulin down to baseline, get outside as much as possible. Our body doesn’t make all the millions of processes to kill us! Inflammation causes all these blood markers to make us ill.
@@plants_and_wellness1574 Mine and 1 sister's is over 300. We both have Von Willebrands disease.Other sister doesn't have it. I'm 68 years old, parents survived to 83 and 91. No heart disease. My other numbers are normal. Doctors conflicted about whether to put us on statins. Looking forward to advanced treatments coming soon.
@@navirose9133Hi, my genetic Lp(a) value is 216 nmol/l (=90 mg/dl), which is very high. My LDL is 130 mg/dl. I am 40 years old, fit and healthy. No buildups in the arteries. My father passed with 68 and had diabetes, but no cardiovascular issues. Mother 65 years old, alive, healthy with Lp(a) 6 mg/dl which is nothing. My other variable risk values are fine. Shall I take medicines? Statine or pcsk9? What is my life expectancy? Greets from Budapest
Look at TRPV4 that causes the break in the endothelial monolayer and causes monocytes to become M1 inflammatory macrophages that produce ROS that oxidized LDL and phagocytizes the LDL. TRPV4 does this in response to stress from hypoosmolarity such as in hyponatremia. TRPV4 does this in osteoblasts that lead to osteoclasts that go into the RANKL and bone breakdown.
Have you received any answers from your doctors? I have a similar profile, low APOB and moderately elevated LP(a), and two cardiologists have turned me down for PCSK9 inhibitors.
What a shambles when it comes to lipoproteins. One misunderstood and maligned particle category after another ... I say this on account of a related video in the suggestions pane - "Professor Steven Nissen - Lipoprotein (a): a new target for therapeutic intervention" Ever new heights of ludicrous absurdity ... let's take a physiologically significant particle with key functions across the human's organism and try really hard to ignore any sense of curiosity with regard to their ultimate relevance, instead try to figure out how to 'treat' it - all the while relying on obfuscatory technical explanation-like chatter to distract the hapless 'audience' from the fumbling fingers hidden in pretentious gloves. My goodness. Siobhan Huggins at least makes an effort to resist the collective mind numbing codswallop that we are all inviting to our door with our collective lack of curiosity.
Acronyms are a curse of our trending communication style. I feel your frustration. On paoer, in texts, in emails, in person, people cannot say the words. Everything in life is now abbreviated.
I relocated to France from the US a couple of years ago. I have very high LDL and asked my cardiologist for ApoB test to confirm and he said it wasn't necessary. Today I took his script for a generic lipid and fasting glucose test on orders to retest after 6 months of tweaking an already good mediterranean diet. I also took with me a list of my own - ApoA, ApoB, lp(a) and A1C - and paid for those myself. Well worth the 50€ it cost me. In the states I'm sure it would have been triple that.
Why aren't blood thinners prescribed for elevated LPa when a person has a stroke? This happened to me but only because I went to an electrophysiologist after having an ischemic cerebral stroke. He found that I had a very mild A-fib which is why he put me on the blood thinner at age 80. I feel the blood thinner is protective for future strokes. I requested a low dose (10mg) statin to bring my elevated LDL of 104 down to 77 plus I'm a whole food plant based eater and stay strictly away from saturated fat. I only discovered a low level elevated (85 out of 50 norm) LPa when I did research and requested the test for LPa. No doctor ever suggested I be tested for it even after I had the stroke. No arterial plaque was noted in my workup following the stroke and no stenosis. US medical care mostly sucks at least based on my ´experience unless you find an unusually astute doctor which I think I have now found.
Is Lp(a) not associated with clotting factor of blood? which may have some past benefit? I personally heal quickly from wounds. Pcsk9 inhibitor seem to drop lo(a) +/- 30% Notable, I have been taking zedia as a monotherapy , which achieved a 41% drop in apo b, lp(a) also dropped ( 30%) to 195nmol/l (still very high)in my case. As for increasing calcification, I have a zero cac at 57.
Im looking into Zetia, thank you for the info. Do you still take Zetia and Do you take Pcsk9? I take Lipitor but not happy because I feel its not enough. Im 50 ys old and my Lpa was 248 then doctor put me on Lipitor and it raised up to 300😭 Thank you🥹Christy
I’m confused at the end why Benoit put himself on a statin because his high LPa if they established that statins actually increase LPa. What is the benefit then?
Hi, my genetic Lp(a) value is 216 nmol/l (=90 mg/dl), which is very high. My LDL is 130 mg/dl. I am 40 years old, fit and healthy. No buildups in the arteries. My father passed with 68 and had diabetes, but no cardiovascular issues. Mother 65 years old, alive, healthy with Lp(a) 6 mg/dl which is nothing. My other variable risk values are fine. Shall I take medicines? Statine or pcsk9? What is my life expectancy? Greets from Budapest
Anybody else find it strange that any over the counter treatment is always useless. Niacin reduces LPa 20 to 30% and increases HDL and it is not recommended???
Unfortunately, niacin did not reduce mortality. This means it “cleans” the test results, makes it look pretty, but patients taking it did not have much benefit when compared to those not taking it.
23&me and Ancestry DNA has LPa snps rs3798220 (T/T) and rs10455872 (A/A). I have both typical snps and my LP(a) was less than 8.4nmol/L, and my husband has the same typical snps and his LP(a) was 20.1nmol/L.
two children with high Lpa and Von Willebrand diease type 1, I was told the second disorder could mitigate the effects of Lpa. We are hoping this is true.
Statins a good medication!!!! Statins block the production of mevalonate in every cell, every intermediate molecule between mevalonate and cholesterol is blocked! Examples, important CoQ10 needed for the production of ATP, Insulin Resistance problems .. etc. Statins give you a higher risk for heart problems!
I've been on the carnivore sights asking about promoting such a diet, for those who don't know they have LP(a). Also asked if they know what that diet would do to them. Waiting for responses...
@@Patricia-lz2zo I hate dietary cults of any sorts. And I am Vegan. However, it is for me purely ethical thing and I don’t claim it is the healthiest diet. So while I am a devoted vegan I hate “plant based” cherry picking and quackery. But carnivores are absolute champions of cherry picking (vegans at least cherry pick human studies, carnivores cherry pick rodent mechanisms), quackery and cultism. They are extremely agressive and while some vegans promote malnutrition (frutarians,…), carnivores promote inevitable ASCVD for most of long term followers. I told my carnivore friend that my apoB is 61 and he told me that no human being should walk around with such low amounts of cholesterol 😂
You are referring to people in Amsterdam like John Castelijn, probably Jonas Castelijn and Eric Strews. I can’t find Eric Strews could you please give his correct name. I am in Holland. LPa pateint, and would love to consult with him. Normal physicians here do not know about LPa and reject my telling them this is an urgent problem.
I think they are getting too focused on this and cholesterol in general. How they are saying some that have high lpa don’t get it and others with low lpa do. I think the body is just trying to repair damage caused to the epithelial cells due to high pressure environment and certain conditions that cause damage to glycocalax and these molecules repair them in the arteries but these plaques are just places that are repeatedly damaged and repaired and the process is overwhelmed. Instead of trying to control these intensely complicated processes and molecules that are so important to other bodily functions that messing with them can cause more issues we should worry about not damaging the epithelial glycocalax
No clinical studies on it. Statins turn off the ability for K2 to work. So if you are on a statin don't bother taking K2. You would be wasting your money. Statins can accelerate the calcification of your arteries. Some believe this is called "stabilizing plaque".
Well Maybe some good news. I read that a study showed that an increase in fish oil helped in lowering little a. There wasn't much more than that except I believe it was about a 3 to 1.5 or 2 ratio of DHA to EPA . I upped my cod liver oil from one teaspoon every morning to add one more in the evening. IDK. It's all hopeful guesswork.I will test my number again in a month. I've read you can't change it but others have said they were able to lower theirs so... fingers crossed. The drug they have is expensive and worrisome. So I hope this works. Good luck all.
What do you say to people who lower their Lp(a) by almost 80% using Pauling Protocol? Anecdotal even with lab reference evidence? Is it fair to say that it isn't understood enough to call it dangerous? Why statins? Why are you recommending poison?
Peter, loved the podcast and all the information but PLEASE stop interrupting and talking over your guests. It’s an immediate turn off and I usually will turn off whatever I’m listening to based on that because it drives me crazy and is so disrespectful . Please let your guest finish what they are saying 🙏
Nope, I have to interrupt you... There is no point in one person pursuing a subject any further if there needs to be clarification for greater benefit. If we are ever speaking in person, please ask your question right away. You'll be on your second question instead of your first one and after a few minutes you may know what you need to know. This is science. If Benoit doesn't like Peter's manners he doesn't need to participate again. He's an adult judging by his facial hair. Just revel in the fact that Peter is human, sometimes when he interrupts he's wrong. But then the conversation goes down a different road for a few minutes and I get to learn more...talk about a win win!
@@alexanderohanlon8825 my mom has high Lp(a) and turns 70 next month. She didn’t even know until I paid to get her tested. She has smoked almost a pack a day for 50 years and has never had heart problems at all. She also didn’t have the best diet but she does eat better now. She has a low LDL though, like it’s 80. I think that has something to do with it.
I am a 73 yr old male and had a heart attack 2 yrs ago. Always been in very good shape--handball, hiking,etc. No weight issue either. My cardiologist prescribed 40mg of atorvastatin. In addition he has me on two 500 mg of niacin- am and pm. Told me right away that I was an LP little a patient. Is niacin an often prescribed med?? And thanks, Dr Attia, for your informative programs!!
Niacin is vitamin b3. In high dosage it can be therapeutic. You and your doctor have to monitor your liver. It helps with lowering cholesterol and lp(a). Eating oat bran along with taking niacin is helpful. The book, The Cholesterol Cure by kalwaski (sp) is good resource. With all due respect You have to do your own research and not rely so much on medical professional.
I think that guest often says “lpa” when thinking “lp little a” 🙄, almost impossible to follow and comprehend…😏 yet such a wonderful and eye opening pod…guest is fantastic!
Such a wonderful and informative video. But if you look at the comment section, it is full of so much misinformation one has to wonder whether anyone actually watched the video. If you have high Lp(a) you need to address every other risk factor for cardiovascular disease. One of those is reducing your ApoB as low as possible (I.e., below 50). Unless you are very lucky genetically, that will likely involve more than one pharmacological intervention starting with a statin in most cases. Hopefully, in another five years we will have drugs that can target Lp(a).
I just don’t agree when he says it’s not worth re-checking any more in life. There’s studies show you things that you can do to reduce it there’s one or they did a vegetarian diet that reduced it however, when you look at the specifics, they also reduce drain consumption by almost 100% at the same time along with dairy. So maybe you can eliminate one thing at a time and see what works for you so far I am able to figure out do you know mine swings 200 points with the same lab every few months
An individual's Lp(a) level is 80-90% genetically determined in an autosomal codominant inheritance pattern with full expression by 1-2 years of age and adult-like levels achieved by approximately 5 years of age. Outside of acute inflammatory states, the Lp(a) level remains stable through an individual's lifetime regardless of lifestyle. From American College of Cardiology.
Oh, yeah. I order my own blood tests and decided this year I would check for APO-B. There was a mysterious Lp(a) result. Had no clue what that was so searched and was rather stunned. I take vaccines but I do not do drugs (ok, I take aspirin or acetaminophen a couple of times a year) so I had turned down my doctor’s advice to take statins for my high total cholesterol (270) back when I was still going to the doctor, like 5 years ago. Anyway, my current total cholesterol, after 7 years of being a vegan, made it down to 220. Yahoo! But Bummer, my APO-B was 1844 nmol/L (the “very high” bar is 2000!). Then this mystery Lp(a) was 312 nmol/L (the reference level was should be 125! That extremely high APO-B particles (1844 nmol/L) and very low triglycerides😂 (77 mg/dL) means my LDL cholesterol of 148 mg/dL + the triglycerides are distributed over quite a number of small LDL particles, 576 nmol/L, which shows on the test report as being at the larger end of the small particle size range AND at the 50% point of the population. my large LDL particles are at the smaller end of the large particle range. In short, at 50 lbs overweight and old (73), I am a ticking time bomb for a heart attack. I do exercise an hour a day on my treadmill, set at 4% incline, at a particular heart rate, 110 BPM, and once a week I take it up to my max of 148 for 1 minute. And I do some weight work. Have I done anything to fix my cholesterol level other than staying on my low fat vegan diet? Not yet. I am trying to lose weight but in the dead of winter, that is like slogging thru mud. When a healthy vegan diet of only soy milk and tofu as processed foods does not keep you thin, then weight loss requires eating fewer carbs…it is difficult. Oh, like find a doctor….I might do that. I would like to know how my aortic valve is doing; calcified valves do not work very well. Anyway, you should listen to these good Canadian doctors and find out your numbers. The buzz on the other good sources on the internet is that your children should be checked for Lp(a) once at age 2.
Your so called healthy vegan diet is not working if you’re pre-diabetic. You need to get your HbA1c down to 5.5 or lower. You’re clearly consuming way too many carbohydrates and probably a bit of processed food, and seed oils. Good luck.
For someone wanting help pronouncing Kåre: Hard K. Å is like the o in "core". The R has no equivalent in english, but imagine the R in speeches by Hitler. The E is like the eh in "meh". For the lazy: "core" is better than "carey".
“The results on plasma lipid is pretty good with niacin”…. Lol and attia hates it because of 2 large trials… penguin hole. Side effects of flushing is a joke. These guys seems to move pharma drugs. Niacin is cheap and has proven not to harm
Then you have the people who eat very low fat plant based....they have the same rate of high Lp(a)yet no heart disease. Studies looking at LP(a) are not done on people eating a very low fat plant based diet with less than 10% of calories coming from fat.
I eat very low fat plant based and still have heart disease. . I have some coronary arteries that are 50% to 80% clogged with plaque. Lp(a) is the cause.
What we’re you eating before your heart attack? I just got back my Lp(a) results two days ago and it’s 380 now, it was 246 in June 🙄 I eat a strict plant based diet 🤷🏼♀️
@@plants_and_wellness1574 diet doesn't matter, I'm in phase 3 trials with anti - sense drug. Should be available in a couple years. Lowers lpa by 90% . Not sure if I'm getting actual drug or placebo but I guess it doesn't matter if I can help my fellow lpa's! 👍
@@darwinhughey3861 so you’re telling me your LP(a) alone caused you to have stents? What was your LDL prior to having all these heart problems? I absolutely believe what you eat matters, maybe not for your Lp(a) but definitely for your ApoB and LDL.
@@darwinhughey3861 my strict plant based diet brought my LDL from 194 to 112 and my ApoB from 118 to 94. Believe what you want but my my plant based diet is working 😆 and I also reversed my Hashimotos which is an incurable thyroid disease since switching to a plant based diet but you keep on being delusional thinking diet doesn’t matter 😆 #blessyourheart
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
![ApoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease [AMA 43 sneak peek]](http://i.ytimg.com/vi/MAw4KMoBTPo/mqdefault.jpg)
![ApoB, LDL-C, Lp(a), and insulin as risk factors for cardiovascular disease [AMA 43 sneak peek]](/img/tr.png)
![Does Lp(a) cause Heart Disease? Are there Solutions? [Study 251-265 Analysis]](/img/n.gif)
I am so thankful for this information. I got a lipid panel with a wholistic MD a couple years ago as part of a wellness check and was told that all of my numbers were great, but I noticed the LP(a) number was off the chart (105 mg/dl)... When I asked my doctor about it he said it wasn’t anything to be concerned with because it was just something I inherited and couldn’t do anything about. So I never thought about it again until reading Outlive. I’m 35 years old and am so grateful to have read this book. Before reading it I was under the impression my risk for cardiovascular disease was was very low. Now that I know what I’m up against, I can pay special attention to mitigating other CVD risk factors…and stay on top of any new developments that come about
"Off the chart" is relative. I continue to see people who overthink TH-cam video's. At some point folks you have to ask yourself if just maybe....you are a bit of a hyppchondriac? Why the need to report your own personal numbers? No one knows you here, the Dr's are not going to reach out to you...What attention are you truly seeking? Mental health is just as important.
Ironically you make a good point.. alot of this shyt is mental control, mental bandage
Thank you for sharing your experience. This is a scary journey with most docs ignoring LP(a) or blanketly prescribing a statin. My LP(a) was 173. Yikes
What are you doing for your lpa mine is 143
@@kate-lq3xgListening to the discussion would give you a better answer than asking a random person who most likely does not have secret knowledge about lp(a) lowering methods that neither of the MDs in this discussion have. It is currently still subject of research how lp(a) can be lowered and if that will have measurable impact.
good discussion
I worked in Cardiology research for 20 yrs and am glad, that Peter makes these interviews public
Well, as someone who just got LPa tested at 234 nMol/L, I can say this is a much appreciated but very discouraging conversation.
Mine was 246 nmol/L. If you can get your ApoB and LDL lower, it can help. I did read one study that showed a plant based diet was able to lower LPa and we know it lowers ApoB and LDL, so maybe try that. I’ve been 100% plant based since getting my results.
@@plants_and_wellness1574 Interesting :)from what i understand nothing change's it not even plant's hardly ever eat meat or plant based food's and my score is 9 nMol/L also normal LDL normal HDL range just saying.my Dr still want's me on statin's.
@@markplaton84 LPa is based on genetics, so if yours isn’t high then you probably don’t have the gene that causes it to be. Mine was 312 before going plant based and as of July it’s 246. I’m getting it checked again soon. Why does your doc want to put you on a statin?
@@plants_and_wellness1574 My LPa is 9 first he used family history my age 65 i smoke like 6 a day for years maybe 10 pounds over weight 150 LDL 40 HDL CAC score 237 all my other blood work and liver work is normal which he never seen until after telling me i need a stain :)
@@markplaton84 did he check your ApoB? Your LDL is quite high, it’s supposed to be under 100 but many doctors say it needs to be closer to 70. APOb is what really matters and if your LDL is high, then most like your ApoB is high.
Wonderful discussion, thank you for addressing this big issue that the vast majority of cardiologists and GPs do not care to look into and when you ask them to do those tests mentioned they do not really want you to do. This will include the Lipid Subfractions
So proud to see all this research from Quebec. Also studied engineering at Laval University, but this fascinating discussion is way above my understanding. Really grateful you do them. I'm definitely going to ask for my LPa and apoB tested. Been WFPB for 7 years and high level endurance athlete and never tested since, but all previous tests I had high LDL, so does my family.
Did you ever get tested? My LDL went down since going PB but my Lp(a) is not NT from 246 last June to now 380 😮 so it went way up since going PB 😢
@@plants_and_wellness1574 Should not be related and should not change either. Maybe it's a test sensitivity issue. Will get tested in the following month, lost my family doctor and process to get tested can be long here.
@@purpleblueunicorn if you’re in the states then you can order your own lab work online and go to any Quest and get your blood drawn. That is what I have always done. I’ve also used the exact same lab for all of my blood work so I don’t know why my LPa keeps going up. Up over 100 just from June.
@@plants_and_wellness1574 I don't know about the change, but since Lp(a) do have an apoB marker, the apoB (count) test should encompass the Lp(a) result and if your apoB count is low, you should be fine. But it seems important to know the count, not the mass, because that's what causes trouble with Lp(a) being even more dangerous if I understand correctly. What units are your Lp(a) and did you get an apoB result?
I'm in Canada, so have to deal with long wait times, but I should be able to get those tests for free if I can convince a doctor to give me the tests.
@@plants_and_wellness1574 Also seems to be some reliability issues with Lp(a) measurement, I would contact your assay provider and let them explain the results, because it should not change.
Here's a good article on the subject if you can access it: pubmed.ncbi.nlm.nih.gov/33040574/
I've listened to over 50 talks on this matter, not to mention addicted to Dr Attia's talks and it's this talk that's convinced me to subscribe to membership 🙌🏻 I must also say that I had to describe what LPa and APOb was to my doctor!!
One of your best yet. Masterfully brought the complexities of the subject to a very understandable level. Even at 1.2x speed :-)
And how did it change your behavior ? NOT !
How dare you bring us back to reality?! I had to listen twice to get to the understandable level. I just want to be able to intelligently discuss this with my dr. next visit, and perhaps run the particular tests next blood test.@@dinomiles7999
This is a gift! Thank you for sharing your immense knowledge.
I have elevated lipo protein A .. found out after having stents for 80+ occlusion in multiple coronary arteries. Found out after being blown off by my physicians. I’m fit thin. Ride my bike. My brother/ mother died of SCD so I pushed the issue. Now post stent am refractory to statins and on Repatha
I've got extremely high LP(a), about 100 points above the reference as stated by Quest Diagnostics. From what I understand there's not much I can do about it (because it is almost completely genetic) except try to lower my LDL cholesterol as much as possible.
What's your number in noml/l?
@@a.g.hustlegarland4197 191 nmol/L. They say the normal level is < 75 n
Niacin effective. Book: Cholesterol, Cure. Must monitor liver.
Mine is 246 nmol/L as of July. I switched to a plant based diet since there was one study that showed it was able to lower it, that and it lowers ApoB and LDL.
Either (V)LF-(oil free) plant based or its apparent opposite, (V)LC-(V)HF, seem like they can be effectively implemented as part of a strategy with potential to do a very great deal - much can be done. Be wary of what are misleadingly described LF-HC or LC-HF which are often, in actuality, far from being low in anything, just muddying the waters.
I thought part of the lack of benefit from the Niacin(Niaspan) test was due to the addition of chem that reduced flushing. Either way..if something reduces LPA, and LP(a) and increases HDL yet provides no benefit one must question whether the numbers mean much of anything (at least in terms of reducing risk)
I heard the same through Dr Ford Brewer, niacin seems to be one of his favorites
These discussions always seem to miss anything about the inflammatory nature of seed oils and the benefits of reducing or eliminating them from our diets. There are only a couple of people on TH-cam that talks about them; notably one being Tucker Goodrich and the other is Dr Chris Knobbe. Here are two good videos, one with each of them.
th-cam.com/video/hFfRils4-YA/w-d-xo.html
th-cam.com/video/bh5eTi9jTPw/w-d-xo.html
.
Seed Oils are the #1 Problem in Your Diet / Chris Knobbe, MD | Peak Human Podcast
th-cam.com/video/jYQ1bMec3GM/w-d-xo.html
Omega-6 oils in our body fat, the half-life is 680 days. I found that at about the 48:00ish minute mark of th-cam.com/video/dwBQG0Ea6_I/w-d-xo.html
omg I'm 58 and have been waiting for a treatment for 2 decades now :( I've tried getting in the trails but there is not one near me :( I'm the oldest living male in my family by 10 years with high lpa. I guess I'm lucky to live this long... but I'm waiting for a treatment still.
pubmed.ncbi.nlm.nih.gov/30014498/ this study shows that a plant based diet can reduce LPa. A plant based diet will also lower ApoB and LDL. Maybe give it a try. My LPa came back at 246nmol/L and I immediately went on a plant based diet. My ldl dropped just a few weeks in but I haven’t retested ApoB or LPa yet. Will do that soon to see if it’s helped at all
May I ask how you knew about it 2 decades ago? I'm surprised.
@patriot20000 scientists have known about lipoprotein a since the 1960s
Statins definitely lower, LDL and APO B.. PSK9 inhibitors obviously do the same thing, but even more pronounced! So riddle me this, why is cardiovascular disease still the leading cause of death. It makes tjis last pandemic look like child’s play. I think it’s much more complicated. I believe clotting, Blood pressure, metabolic disease, pre-diabetes. And constantly high insulin levels played in a bigger role. When I used to do heart anesthesia, I would say 60% of my patients for coronary artery bypass graft surgery had normal LDL’s. However, they were metabolically broken. So I don’t think we have all the answers. However, not sure driving LDL down to the 30’s is a good idea. It might be. However, I don’t think it’s that simple.
You need to learn about independent risk variables. Obviously someone who is diabetic is at increased risk of cardiovascular disease. But if they have elevated ApoB they are also at risk irrespective of their insulin levels. These are independent risk variables, and both should be addressed.
@@davidzip8841wrong
The Niacin is very confusing. How can it do all those positive things and not reduce outcomes? How can Don Layman sit here and say saturated fat and cholesterol intake dont matter if you are healthy? Layne Norton said it is “energy toxicity” …. For the love of God I have no idea what I am supposed to eat. There is so much evidence saying what you eat doesnt matter. So is it just as simple as people that eat fish and fiber tend not to be obese and over eat and therefore they have fewer events across an entire population? Is it just all about over consuming calories? Being overweight? I wish I had more knowledge.
Checked my Lp(a) just recently, after hearing about it a lot. My levels were undetectable- below the threshold of the lab, at any rate. I found that quite pleasing and reassuring, ngl. I didn't even realise a "you have so little our lab equipment just throws up a zero" result was a possibility.
Good for you!
@@patriot20000 Lol, idk. Turns out, Lp(a) has a use in the human body. People over 60 with high levels live longer, are more resistant to infections and heal better.
But it also gives you early atherosclerosis. The human body makes no sense sometimes.
Most cardiologists ( nevermind other specialties) are so inadequate that it is truly embarrasing. Medical decision making over a lifetime is the leading cause of mortality and morbidity.. There is no getting around it, if you value your life and health, make properly informed choices.
Ira Goodman MD
Wonderful sentiment DocGoodman but you know it's a minefield out here. The dogma in MDs is stunning... who never ask one single question about diet or stressor as factors. No healing only amelioration.
1:07:20 - as one who’s both parents had normal Lp(a) but mine very high, I’m totally aligned. Check before 18, and in light of the potential that estrogen may mitigate (mask/lower) levels, before first menses in girls.
May I ask how you know your parents had low little a when most docs now don't even know about it or test for it without being asked.
@ good Q. I’ve been testing Lp(a) for 20 years. My mentor Michael Doyle (MD MPH) was a top lipidologist before there were lipidologists. I tested my parents decades ago.
Thank you so much for this informative episode, under appreciated topic indeed.
My Mayo Clinic cardio doc will not allow me ask about particle size or receive tests for inflamm. He is is obsessed with Total Choles and generic LDL and mega-doses of statins. The Clinic has him under their thumb like ""The Firm"".
i don't get it, why do americans (apologies if assumption is wrong) have to go through their doctor to get blood tests. can't you just do them on your own?
Order your own labs! There’s plenty of online places you can do this like Marek Health etc and have some freedom over your health
@@DrAdamHotchkiss Thank you. I shall because I now need to be swiftly proactive rather than merely trying to be more persuasive... [ thus passive ] .
@@chuckbecker8735 couldn’t agree more! It’s too bad Institutions and insurance companies dictate what physicians (and ultimately patients) can and cannot do
Mayo is awesome for using outdated snd ineffective treatment protocols to exacerbate CVD.
Really helpful - thank you for posting this
I wish someone would speak about the major LP(a)SNPs and their variants. If the SNPs are ‘normal’ ( no variants) is LP(a)
still as dangerous ?
I don't have the variant and my lpa is less than 8.4nmol/L on low carb
Very informative podcast... For info, here in the UK the experience of me and people I know is that on average GPs are extremely reluctant to offer either ApoB or LP(a), unless you get lucky with a GP who is either really open minded or up to date on the research.
Tell them to say a parent had it. :)
My Lp(a) is non-detect,
You seem in very good shape, keep on trucking!!!
Congrats on your thru-hike, that's quite an accomplishment. I have read and listened to everything I can find on little a since I have the gene and a hgh number. It Sounds like you do not have the gene. Because I have not read of anyone lowering it greatly, much less undetectable. And everything I have read (there's not a lot) says it can not be budged much except by an expensive drug that is not out yet. In the latest YT talk I heard a doc/researcher who said fish oil was shown to be effective for a group (in Africa? not sure) who lived by the sea and ate fish with every meal, and they had the gene. Were you tested for it?
Gee, must be nice to know more about Lp(a) than all the scientists and researchers who've studied it for the last 60 years! You obviously don't have the genetic profile that causes high Lp(a), so you can stop giving yourself credit for lowering it to an undetectable level........that's easy to do when it clearly wasn't high in the first place. What you claim to have done isn't possible when it comes to Lp(a). Those of us who DO have the gene and maintain pristinely clean lifestyles, yet still face serious residual risk for cardiovascular events, don't appreciate being righteously advised by someone who's not even in the club.
According to the American Heart Association, the Ketogenic diet ranks far lower than the Mediterranean Diet or the DASH Diet (among others!) for cardiovascular health benefits. While you may have seen some benefits to your metabolic biomarkers (excluding Lp(a)) in the short-term, the longer-term health consequences of a Ketogenic diet may not be so positive. I hope for your sake that they remain so. In the meantime, stop making claims about Lp(a) that have no basis in science and that blame people for genetic factors over which they have no control.
I, for one, am eternally grateful for the researchers, scientists, and yes, pharmaceutical companies, who are working toward finding a treatment for high Lp(a). When the new drugs come out, they will no doubt spare untold numbers of people around the world from the aftermath of heart attacks, strokes and other disabling conditions that result from high levels of Lp(a). While not perfect, the pharmaceutical industry has developed medications that are life-sparing and life-changing for people who suffer from a broad spectrum of diseases. I have personally benefitted from 2 such drugs, and when the new Lp(a) drugs come out, they'll most likely benefit me greatly as well. Your cynical attitude toward all things pharma seems as misguided as your false claim that Lp(a) can be managed with diet and exercise.
I would love to see a study of all of these levels pre- and post-liver transplant.
what percent of all clinical atherosclerosis is caused by elevated lp(a)?
I don't know it that is known or knowable. But it can present as deposts on the mitral valve and That is a big problem.
Why do atherogenic plaques build up only in pressure aortas? why dont the plaques form on non pressure sides? why lipids are considered the culprit since if they are running fine unoxidezed the body should eflux them normally .. the idea that cholesterol is the marker for cvd starts to become really stupid when there are clearly other markers for metabolic disorders that are really raising enormously
Type 2 diabetes has a hazard ratio of 10.2. Insulin resistance 6.4. Obesity 4.3. Smoking 3.9. LDL 1.6. Why focus on cholesterol when blood sugar is much more of a risk? He explained it near the end when he mentioned his conflict of interest. He's a vegan so he must demonize fat and praise carbs.
BTW, smoking spikes cortisol. Chronic high cortisol results in cortisol induced insulin resistance. Which is why smoking is a risk factor.
Diabetics get similar damage to the capillaries in their eyes. Resulting in various eye diseases. You can even watch drug commercials which admit that high blood sugar caused the damage. Yet they refuse to make the same connection to arterial damage. Instead they resort to blaming the firefighter(cholesterol) for starting the fire.
@@PestisNonSapien_GMO_exHuman You are full of crap.
@@PestisNonSapien_GMO_exHuman yeah, I'm a low carber who eats mostly red meat 90% of the time and my LP(a) is less than 8.4nmol/L.
Excellent discussion! good to know the relationship between LPa and risk, but there is always that lingering sense of a piece of the puzzle is missing, the genetic would of been around for thousands of years, why wasn’t CVD a prevalent cause of death throughout human history? I do think like Apoe4 , context of environment and diet plays more of a deciding role in the outcomes……just a thought
So what can we do ?
This is an interesting thought... my two cents is that heart disease takes years to develop (a strong genetic cause would still see early heart attacks in 40's and 50s), so for thousands of years, humans didn't often live past 30 years old.. they died before heart disease could manifest with visible symptoms. It was probably there but just didn't have time to be the ultimate cause of death as so many other things ended human lives quicker than heart disease.
@@megan_kal, the 30-year-old-daying thing is a myth. The Life expectancy was low because half of the people died before they turned five.
@@megan_kal I have slightly elevated LPa but only my great grandfather died from heart attack at 73. All my other relatives died at 80 or older. My father died from cancer early but it’s probably related to Chernobyl as he lived in Ukraine.
Evidence from ancient mummified Egyptians demonstrates CVD, arteriosclerosis, etc. Death from heart disease mostly occurs after reproduction so hasn’t been eliminated from the gene pool.
Maybe low levels of Lp(a) are not that good?
The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. 2012 article: CIMT in asymptomatic subjects with low Lipoprotein(a) levels.
What is considered low?
@@Carlosconga Ask the doctor running this site.
I have extremely high Lpa
I have 8 coronary artery stents now over 11 years
First was massive heart attack
@@hypnotiqpits13 "Remarkably, one-quarter of the centenarians had high Lp(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.
If the blood work shows Apo B is high, but Lipoprotein a is extremely low, how does that rank as cardiovascular risk for a person on low glycemic index nutrition??
- Lp(a) is a large lipoprotein made by the liver.
- Since it is naturally made by the body, is there a biological purpose for it? Why did we evolve to produce Lp(a)?
- Does attempting to significantly / aggressively reduce it, potentially cause a risk for an adult ... by not having enough Lp(a) available to assist in the repair process?
- Lastly, does Lp(a) in a person with very low inflammatory markers and an optimal metabolism ... pose the same risk cardiac risk? You always say that everyons eventually gets atherosclerosis no matter what ... what is the differnece in the ones that pass away from it and the ones that don't?
From what I’ve read LDL kind of came in to take the place of vitamin C and some humans, however many thousand years ago. And it does help the repair process. The only downside is it apparently it helps the repair process and the vascular system so aggressively. It causes the blockage.😢 and that kills us. I died on the table once in the Cath Lab already.
Great questions! I was thinking in the same direction.
I literally feel like I am becoming an educated physician watching your videos and im just a pot grower lmao
Don’t delude yourself.
LPa is associated with CV, but it's not the cause. And for anyone to say it is a genetic marker that can't be lowered is absurd.
In addition, please do explain how 25% of centenarians studied had an LP(a) level of over 30 mg/dL
Thank you for covering LP(a) this thoroughly. It’s good to know we only need to take this 1 test 1 time to determine our levels and they are pretty constant throughout our lives. #KickAss100YrOld
So whats your point ?
@@dinomiles7999 my point is LPa is not like HDL or triglycerides or even LDL which change annually depending on diet. Everyone gets or should get annual bloodwork. It’s part of your physical. An LPa test has to be paid for outside of regular bloodwork. If you are monitoring your bloodwork regularly you only have to pay for 1 LPa test to know that it will basically be the same 10 years from now. I thought you would have to test it annually in an Ion test like ApoB or CRp. Basically it’s pointless to pay for more than 1 LPa test in your lifetime.
@@kevinjones7505 wow. My Gp won’t even do an LPa test. I have to go to a functional med doctor and it’s expensive. How often to you test your LPa. I get once a year blood tests but my functional med doc said it’s not like APOb or triglycerides that change enough month to month. LPa is more of a genetic predisposition. Do you have a disease?
@@jimking6484 I just went into a Quest Diagnostics lab near me to get it done - $60 bucks. Didn’t even go through my physician at all. For something like this, it was so important for me to get a sense of where I stand-and as soon as possible-that I just felt comfortable taking things into my own hands. If results come back suggesting I’m elevated, I’m prepared to absolutely obliterate ApoB!
@@bobbymath2813 I’m going to do it as well. Thank you for sharing. I’m going to check the prices on APOb, and CRP as well. Thanks!
what do you mean that measurement of LP(a) is stable over time, I've measured it 2 times in a span of 23 days, it increased by 17.9 from 68.5 mg/dl its stable 26% alright :) while LDL-C measured directly decreased by 4.4 from 168.6, HDL-C increased by 1.5 from 42.6, and TG decreased by 44.3 from 127.5, tests were done by the same lab. since I cannot measure my LDL-P, could it be if LP(a) is stable, then my LDL particle size should drop and its count should increase in order to accomodate this 26% LP(a) increase?
Had an LP(a) of 144 nmol/l and high LDL (4.2 mmol/l). Had a sudden heart attack age 53. Extensive ASCVD and stenting. After lifestyle changes, intensive statin therapy and more recently Inclisiran my LDL is 1.2. Having my LP(a) tested again in 4 months time, hoping that Inclisiran reduces it by 25% to reduce residual risk. Fingers crossed.
Good luck
QUESTION: So really, we don’t have a conclusive answer on lifelong treatment with niacin for the reduction of Lp(a)? It may provide a benefit, just not one that would identified in the outcomes trial?
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet
Can anyone answer this question? My LPA is 220 mmo/l and my total Cholesterol is 6.26 mmo/l but my HDL, APO B and inflammation markers etc etc is all good--also 0 Calc score...My Lipid Cardiologist says my Cholesterol has to be 2 mmo/l, which is VERY low...I have got my Cholesterol down before going Plant Based and Mediterranean, so I now do this strictly and will not be able to retest for my Cholesterol for a few months...I am 55, post meno, non smoker, drink on occasion, do weights and walk daily, low BMI and on no other medication...but recent MRI showed small Meningioma and Cerebral Small Vessel Disease beginning? Wondering if I take the low dose Crestor ? I am worried about the CSVD and statins increasing risk of cognitive decline.
blessed with a
👍 This is a huge treat on Lp(a) pathology, soo informative and beneficial, reealy enjoyed it, thank you so much Peter and the guest 👍
Unsolved: the conversion between mg/dl and nmol/l - Lp(a) has a molecular wt of 300k-700k Da. So the conversion factor = mg/dl x 10 dl/l x 1000k ng/mg / 500k ng/nmol = mg/dl x 20 (nmol/l) as compared to 2.5 as said here. What is wrong ??
Great discussion!
My LP(a) is less than 8.4 nmol/L. I didn't ever hear anyone having a heart attack on both sides of my family. There were stroke due to hypertension on my dad's side.
Quest diagnostics in Florida measures in nmol/L
Hello @peterattiamd I did a test recently and the numbers are as follows:
HB1AC: 6.0 %;
Lp-a: 45 mg/dl;
Total Chol:148 mg/dl;
TGL: 120; mg/dl
HDL:42; mg/dl
LDL: 82; mg/dl
VLDL: 24 mg/dl;
APO-B: 102.2 mg/dl;
HS-CRP: 0.58 mg/l;
Homocysteine: 8.9 umol/l;
How high is my risk of CVD and what can be done about it?
You’re pre-diabetic so you should work hard on lowering your HbA1c by consuming fewer carbohydrates/processed food and minimal seed oils.
Is LP(a) not mainly the best marker for oxidised LDL? And the oxidation of the LDL the real arterogenic causal factor? Which doesn’t mean that I think the influence on fibrinogen/clotting has no role.
Yes ... concur ... I guess that you may already be aware of LP(a), and small oxidised LDL also being able to be joined by ratio of triglycerides to HDL, emphasised by Robert Lustig among others as a more meaningful measure - a good so called poor man's indicator for damage ... and fibrinogen ... yea give us a break please Peter, and to throw the phrase back at him: appropriate in this context - necessary but not sufficient ... a phrase which Peter has been known to use rather inappropriately, when talking with Dave Feldman.
My thoughts too. Have you ever seen a source that documents the process of phospholipid oxidating? For example, at what blood sugar level does it occur? Is there the potential to control blood sugar so that it does not occur? So many questions but I'm hoping that blood sugar control can pre-empt the pressure towards using statins.
Excellent content. Surprised no discussion re ezetimibe. Can mitigate statin side effects allowing lower, even intermittent dosing (eg as little as once weekly 20 mg rosuvastatin), which is important when discussing commitment to lifelong primary prevention and someone as young as Ben.
I would love to read a study of significance this. Etizimbe and rosvastatin ok that's my boat but I don't want to get in. are you saying medicos don't know how to heal this, only ameliorate?
32:00 minute mark. But statins accelerate the calcification of your arteries. I know this as I have had 4 CAC scores before and on statins. Before statins I had a 25% annual increase in my CAC score. On a statin I had a 45% annual increase. So if someone has a high LPa and have a CAC Score of say.. 400 should they take a statin? Sounds like Repatha would be better but insurance probably wont cover it.
This is only true for some people. A statin can exacerbate hypercalcemia in a patient with underlying hyperparathyroidism and maybe other reasons. But it does not appear to be universally true. "A study performed by Hernández et al. in 2012 compared 478 statin users to 1837 non-statin users, with 84% of statin users having been on the medication for more than one year. Contrary to our observation, they showed no significant difference in the blood levels of calcium, 25-OH vitamin D, and PTH when comparing the two groups." www.ncbi.nlm.nih.gov/pmc/articles/PMC10905201/#:~:text=The%20drug%20has%20known%20adverse,additional%20rise%20in%20calcium%20levels.
If someone has elevated LPa they can certainly get BASELINE Cardiac Cath. If clear - every 5 years. If ASCVD can get stents, meds, etc. or just decisions made about low dose contrast repeat Cardiac Caths. If no ASCVD with elevated LPa on heart arteries, maybe less risk in brain arteries as well.
Stents. Mere amelioration. Collectors. good for 3 or 4 years
Very illogical considering the risk of cardiac caths every 5 years
Exercise, stay lean, no junk food, get sleep, reduce stress, fast and eat low carb/0 carb to drive insulin down to baseline, get outside as much as possible. Our body doesn’t make all the millions of processes to kill us! Inflammation causes all these blood markers to make us ill.
I have very high LPa age 60 but zero CVD.
Do you remember your number? I just got my labs back and it shows 246 nmol/L. Also, do you have high LDL or ApoB?
@@plants_and_wellness1574 Mine and 1 sister's is over 300. We both have Von Willebrands disease.Other sister doesn't have it. I'm 68 years old, parents survived to 83 and 91. No heart disease. My other numbers are normal. Doctors conflicted about whether to put us on statins. Looking forward to advanced treatments coming soon.
@@navirose9133Hi, my genetic Lp(a) value is 216 nmol/l (=90 mg/dl), which is very high. My LDL is 130 mg/dl. I am 40 years old, fit and healthy. No buildups in the arteries. My father passed with 68 and had diabetes, but no cardiovascular issues. Mother 65 years old, alive, healthy with Lp(a) 6 mg/dl which is nothing. My other variable risk values are fine. Shall I take medicines? Statine or pcsk9? What is my life expectancy?
Greets from Budapest
Look at TRPV4 that causes the break in the endothelial monolayer and causes monocytes to become M1 inflammatory macrophages that produce ROS that oxidized LDL and phagocytizes the LDL.
TRPV4 does this in response to stress from hypoosmolarity such as in hyponatremia.
TRPV4 does this in osteoblasts that lead to osteoclasts that go into the RANKL and bone breakdown.
I am new to this. Thank you!
🙏👍🙏
Lpa 124.5 nmo/l and Apob 70 - should I ask my MD for PCSK9i ?
Have you received any answers from your doctors? I have a similar profile, low APOB and moderately elevated LP(a), and two cardiologists have turned me down for PCSK9 inhibitors.
amazing. they are real deals with researches \studies\ with caring mind for patients
What a shambles when it comes to lipoproteins. One misunderstood and maligned particle category after another ... I say this on account of a related video in the suggestions pane - "Professor Steven Nissen - Lipoprotein (a): a new target for therapeutic intervention"
Ever new heights of ludicrous absurdity ... let's take a physiologically significant particle with key functions across the human's organism and try really hard to ignore any sense of curiosity with regard to their ultimate relevance, instead try to figure out how to 'treat' it - all the while relying on obfuscatory technical explanation-like chatter to distract the hapless 'audience' from the fumbling fingers hidden in pretentious gloves.
My goodness. Siobhan Huggins at least makes an effort to resist the collective mind numbing codswallop that we are all inviting to our door with our collective lack of curiosity.
The fuck are you talking about
Repatha have any effect on particle size???
I'm unable to keep up with this one. 😥 My brain fries with so many acronyms. Can't process all this info. Will have to do some digging on my own.
I understood this 50% more second time through and am with you 100% on the acronyms.
Acronyms are a curse of our trending communication style. I feel your frustration. On paoer, in texts, in emails, in person, people cannot say the words. Everything in life is now abbreviated.
In France too we still use LDL as a metric instead of Apo-B, I think nobody in my family had apoB or LPa tested
They still use LDL in Canada as well , you have to request the Apo-B or LPa test specifically and some doctors don’t even know what it is.
I relocated to France from the US a couple of years ago. I have very high LDL and asked my cardiologist for ApoB test to confirm and he said it wasn't necessary. Today I took his script for a generic lipid and fasting glucose test on orders to retest after 6 months of tweaking an already good mediterranean diet. I also took with me a list of my own - ApoA, ApoB, lp(a) and A1C - and paid for those myself. Well worth the 50€ it cost me. In the states I'm sure it would have been triple that.
Why aren't blood thinners prescribed for elevated LPa when a person has a stroke? This happened to me but only because I went to an electrophysiologist after having an ischemic cerebral stroke. He found that I had a very mild A-fib which is why he put me on the blood thinner at age 80. I feel the blood thinner is protective for future strokes. I requested a low dose (10mg) statin to bring my elevated LDL of 104 down to 77 plus I'm a whole food plant based eater and stay strictly away from saturated fat. I only discovered a low level elevated (85 out of 50 norm) LPa when I did research and requested the test for LPa. No doctor ever suggested I be tested for it even after I had the stroke. No arterial plaque was noted in my workup following the stroke and no stenosis. US medical care mostly sucks at least based on my ´experience unless you find an unusually astute doctor which I think I have now found.
which takes precedence, apoB or LPa? Confusing. Update: guess that was answered. wondering at what age is LPa begin to stay consistent
Roche are already manufacturing gen 2 Lp(a) assay (nmol/L) for clinical blood sciences labs here in U.K.
Is Lp(a) not associated with clotting factor of blood?
which may have some past benefit? I personally heal quickly from wounds.
Pcsk9 inhibitor seem to drop lo(a) +/- 30%
Notable, I have been taking zedia as a monotherapy , which achieved a 41% drop in apo b, lp(a) also dropped ( 30%) to 195nmol/l (still very high)in my case.
As for increasing calcification, I have a zero cac at 57.
Im looking into Zetia, thank you for the info. Do you still take Zetia and Do you take Pcsk9? I take Lipitor but not happy because I feel its not enough. Im 50 ys old and my Lpa was 248 then doctor put me on Lipitor and it raised up to 300😭
Thank you🥹Christy
LPa is covered by Medicare/insurance?
Usually not
My cardiologist at UCLA ran the Lp(a) test on me recently and it was covered by my PPO insurance. My result was low normal:
I’m confused at the end why Benoit put himself on a statin because his high LPa if they established that statins actually increase LPa. What is the benefit then?
Reduces LDL which LPA rides on. Also stabilises plaque and mortality.
They also covered why statins are still beneficial even though it raises LPa. It might just be a measurement effect.
I have high LPa. How can I find out about getting involved in new clinical trials or studies?
Hi, my genetic Lp(a) value is 216 nmol/l (=90 mg/dl), which is very high. My LDL is 130 mg/dl. I am 40 years old, fit and healthy. No buildups in the arteries. My father passed with 68 and had diabetes, but no cardiovascular issues. Mother 65 years old, alive, healthy with Lp(a) 6 mg/dl which is nothing. My other variable risk values are fine. Shall I take medicines? Statine or pcsk9? What is my life expectancy?
Greets from Budapest
Do u have any symptoms like chestpain or other parts
Anybody else find it strange that any over the counter treatment is always useless. Niacin reduces LPa 20 to 30% and increases HDL and it is not recommended???
Unfortunately, niacin did not reduce mortality. This means it “cleans” the test results, makes it look pretty, but patients taking it did not have much benefit when compared to those not taking it.
Is there a direct consumer company to have an Lp(a) genotype done through that someone is familiar with ?
23&me and Ancestry DNA has LPa snps rs3798220 (T/T) and rs10455872 (A/A). I have both typical snps and my LP(a) was less than 8.4nmol/L, and my husband has the same typical snps and his LP(a) was 20.1nmol/L.
two children with high Lpa and Von Willebrand diease type 1, I was told the second disorder could mitigate the effects of Lpa. We are hoping this is true.
Statins a good medication!!!! Statins block the production of mevalonate in every cell, every intermediate molecule between mevalonate and cholesterol is blocked! Examples, important CoQ10 needed for the production of ATP, Insulin Resistance problems .. etc. Statins give you a higher risk for heart problems!
You are full of crap. Stop spreading misinformation.
Wow, you must have 5000iq
I would like to see Paul “celebrate your high LDL” Saladino’s response to this
I've been on the carnivore sights asking about promoting such a diet, for those who don't know they have LP(a). Also asked if they know what that diet would do to them. Waiting for responses...
@@Patricia-lz2zo I hate dietary cults of any sorts. And I am Vegan. However, it is for me purely ethical thing and I don’t claim it is the healthiest diet. So while I am a devoted vegan I hate “plant based” cherry picking and quackery. But carnivores are absolute champions of cherry picking (vegans at least cherry pick human studies, carnivores cherry pick rodent mechanisms), quackery and cultism. They are extremely agressive and while some vegans promote malnutrition (frutarians,…), carnivores promote inevitable ASCVD for most of long term followers. I told my carnivore friend that my apoB is 61 and he told me that no human being should walk around with such low amounts of cholesterol 😂
You are referring to people in Amsterdam like John Castelijn, probably Jonas Castelijn and Eric Strews. I can’t find Eric Strews could you please give his correct name. I am in Holland. LPa pateint, and would love to consult with him. Normal physicians here do not know about LPa and reject my telling them this is an urgent problem.
I think they are getting too focused on this and cholesterol in general. How they are saying some that have high lpa don’t get it and others with low lpa do. I think the body is just trying to repair damage caused to the epithelial cells due to high pressure environment and certain conditions that cause damage to glycocalax and these molecules repair them in the arteries but these plaques are just places that are repeatedly damaged and repaired and the process is overwhelmed. Instead of trying to control these intensely complicated processes and molecules that are so important to other bodily functions that messing with them can cause more issues we should worry about not damaging the epithelial glycocalax
What a great informative video!! Thank you!
Based on solid research you are looking at the wrong end. You need to look at your vitamin C dose, for when you take enough C, Lpa is not a problem.
Can you not stop or slow calcification with D3/K2 supplements??
No clinical studies on it. Statins turn off the ability for K2 to work. So if you are on a statin don't bother taking K2. You would be wasting your money. Statins can accelerate the calcification of your arteries. Some believe this is called "stabilizing plaque".
No good proof of this. But it's cheap with low side effects, so take it
Well Maybe some good news. I read that a study showed that an increase in fish oil helped in lowering little a. There wasn't much more than that except I believe it was about a 3 to 1.5 or 2 ratio of DHA to EPA . I upped my cod liver oil from one teaspoon every morning to add one more in the evening. IDK. It's all hopeful guesswork.I will test my number again in a month. I've read you can't change it but others have said they were able to lower theirs so... fingers crossed. The drug they have is expensive and worrisome. So I hope this works. Good luck all.
What do you say to people who lower their Lp(a) by almost 80% using Pauling Protocol? Anecdotal even with lab reference evidence? Is it fair to say that it isn't understood enough to call it dangerous? Why statins? Why are you recommending poison?
Peter, loved the podcast and all the information but PLEASE stop interrupting and talking over your guests. It’s an immediate turn off and I usually will turn off whatever I’m listening to based on that because it drives me crazy and is so disrespectful . Please let your guest finish what they are saying 🙏
Nope, I have to interrupt you...
There is no point in one person pursuing a subject any further if there needs to be clarification for greater benefit.
If we are ever speaking in person, please ask your question right away. You'll be on your second question instead of your first one and after a few minutes you may know what you need to know.
This is science.
If Benoit doesn't like Peter's manners he doesn't need to participate again. He's an adult judging by his facial hair.
Just revel in the fact that Peter is human, sometimes when he interrupts he's wrong. But then the conversation goes down a different road for a few minutes and I get to learn more...talk about a win win!
And no one hits on oxidised ldl/ldl-a for why those with high level may be fine/no disease.
@@alexanderohanlon8825 my mom has high Lp(a) and turns 70 next month. She didn’t even know until I paid to get her tested. She has smoked almost a pack a day for 50 years and has never had heart problems at all. She also didn’t have the best diet but she does eat better now. She has a low LDL though, like it’s 80. I think that has something to do with it.
If it bother you just don't listen or get your own podcast
I,m French Canadian. I’m sure Benoit doesn’t even pay attention to the interruption. It’s just the way people speak.. no offence
I am a 73 yr old male and had a heart attack 2 yrs ago. Always been in very good shape--handball, hiking,etc. No weight issue either. My cardiologist prescribed 40mg of atorvastatin. In addition he has me on two 500 mg of niacin- am and pm. Told me right away that I was an LP little a patient. Is niacin an often prescribed med?? And thanks, Dr Attia, for your informative programs!!
Apparently you were not in good shape or health you missed it good luck
Hey Dan, do you remember what your LPa number was? Mine just came back at 246 nmol/L.
Niacin is vitamin b3. In high dosage it can be therapeutic. You and your doctor have to monitor your liver. It helps with lowering cholesterol and lp(a).
Eating oat bran along with taking niacin is helpful. The book, The Cholesterol Cure by kalwaski (sp) is good resource. With all due respect You have to do your own research and not rely so much on medical professional.
Stop eating JUNK !!! Eyes mind heart and SOUL wide open.... NO FEAR !!!!
I read that niacin lowers it, but does not change mortality rate
Same with psk9
Quest Diagnostics just did my LP(a) in nmol/l - it was 242 nmol/l
how is your health
You said almost vegetarian diet- would you consider a low fat vegan diet? Dr Gregor speaks of a study where it was found to help.
Great info, but the camera angle (with Peter’s out of focus head in the foreground) makes the interview seem strange.
Anyone know if Lp(a) is Apolipoprotein A1 or is that something different?
Those are two different things. ApoA1 is one of the proteins that sit on HDL particles. It serves as marker of HDL particle count.
Lipoprotein (a) = Lp(a)
I think that guest often says “lpa” when thinking “lp little a” 🙄, almost impossible to follow and comprehend…😏 yet such a wonderful and eye opening pod…guest is fantastic!
Is plasma pharesis indicated?
Such a wonderful and informative video. But if you look at the comment section, it is full of so much misinformation one has to wonder whether anyone actually watched the video. If you have high Lp(a) you need to address every other risk factor for cardiovascular disease. One of those is reducing your ApoB as low as possible (I.e., below 50). Unless you are very lucky genetically, that will likely involve more than one pharmacological intervention starting with a statin in most cases. Hopefully, in another five years we will have drugs that can target Lp(a).
I just don’t agree when he says it’s not worth re-checking any more in life. There’s studies show you things that you can do to reduce it there’s one or they did a vegetarian diet that reduced it however, when you look at the specifics, they also reduce drain consumption by almost 100% at the same time along with dairy. So maybe you can eliminate one thing at a time and see what works for you so far I am able to figure out do you know mine swings 200 points with the same lab every few months
An individual's Lp(a) level is 80-90% genetically determined in an autosomal codominant inheritance pattern with full expression by 1-2 years of age and adult-like levels achieved by approximately 5 years of age. Outside of acute inflammatory states, the Lp(a) level remains stable through an individual's lifetime regardless of lifestyle. From American College of Cardiology.
Oh, yeah. I order my own blood tests and decided this year I would check for APO-B. There was a mysterious Lp(a) result. Had no clue what that was so searched and was rather stunned. I take vaccines but I do not do drugs (ok, I take aspirin or acetaminophen a couple of times a year) so I had turned down my doctor’s advice to take statins for my high total cholesterol (270) back when I was still going to the doctor, like 5 years ago. Anyway, my current total cholesterol, after 7 years of being a vegan, made it down to 220. Yahoo! But Bummer, my APO-B was 1844 nmol/L (the “very high” bar is 2000!). Then this mystery Lp(a) was 312 nmol/L (the reference level was should be 125! That extremely high APO-B particles (1844 nmol/L) and very low triglycerides😂 (77 mg/dL) means my LDL cholesterol of 148 mg/dL + the triglycerides are distributed over quite a number of small LDL particles, 576 nmol/L, which shows on the test report as being at the larger end of the small particle size range AND at the 50% point of the population. my large LDL particles are at the smaller end of the large particle range. In short, at 50 lbs overweight and old (73), I am a ticking time bomb for a heart attack. I do exercise an hour a day on my treadmill, set at 4% incline, at a particular heart rate, 110 BPM, and once a week I take it up to my max of 148 for 1 minute. And I do some weight work. Have I done anything to fix my cholesterol level other than staying on my low fat vegan diet? Not yet. I am trying to lose weight but in the dead of winter, that is like slogging thru mud. When a healthy vegan diet of only soy milk and tofu as processed foods does not keep you thin, then weight loss requires eating fewer carbs…it is difficult. Oh, like find a doctor….I might do that. I would like to know how my aortic valve is doing; calcified valves do not work very well. Anyway, you should listen to these good Canadian doctors and find out your numbers. The buzz on the other good sources on the internet is that your children should be checked for Lp(a) once at age 2.
Your so called healthy vegan diet is not working if you’re pre-diabetic. You need to get your HbA1c down to 5.5 or lower. You’re clearly consuming way too many carbohydrates and probably a bit of processed food, and seed oils. Good luck.
For someone wanting help pronouncing Kåre: Hard K. Å is like the o in "core". The R has no equivalent in english, but imagine the R in speeches by Hitler. The E is like the eh in "meh".
For the lazy: "core" is better than "carey".
The camera positioning is really bad shoing the head of Peter while the speaker is shown
best informative interview
I have it at 50.5 mg/dL :(
“The results on plasma lipid is pretty good with niacin”…. Lol and attia hates it because of 2 large trials… penguin hole. Side effects of flushing is a joke. These guys seems to move pharma drugs. Niacin is cheap and has proven not to harm
There was no benefit found in lowering in lp(a) with niacin.
Peter, how can I get Pelacarsen..????????
Got to wait until it is on the market!! At least 4 years before the trial will end.
Maybe see if it works and does not put people on the liver transplant waiting list?
This man kept being interrupted. :(
Then you have the people who eat very low fat plant based....they have the same rate of high Lp(a)yet no heart disease. Studies looking at LP(a) are not done on people eating a very low fat plant based diet with less than 10% of calories coming from fat.
I eat very low fat plant based and still have heart disease. . I have some coronary arteries that are 50% to 80% clogged with plaque. Lp(a) is the cause.
I have a high LPa and my doctor won’t prescribe Repatha
Have your doctor refer you for a CAC Scan. If your calcium score is high and you have a high LPa then maybe insurance will cover it.
My doc said you had to not be able to tolerate 3 statins to get it.
My lpa 267, 3 way bypass 5 stents, 63 years old , weight 165, been in clinical trials for 2.5 years.😇
What we’re you eating before your heart attack? I just got back my Lp(a) results two days ago and it’s 380 now, it was 246 in June 🙄 I eat a strict plant based diet 🤷🏼♀️
@@plants_and_wellness1574 diet doesn't matter, I'm in phase 3 trials with anti - sense drug. Should be available in a couple years. Lowers lpa by 90% . Not sure if I'm getting actual drug or placebo but I guess it doesn't matter if I can help my fellow lpa's! 👍
@@darwinhughey3861 so you’re telling me your LP(a) alone caused you to have stents? What was your LDL prior to having all these heart problems? I absolutely believe what you eat matters, maybe not for your Lp(a) but definitely for your ApoB and LDL.
@@plants_and_wellness1574 believe what you want....but your STRICT plant based diet obviously isn't working for you! Good luck!! 👍
@@darwinhughey3861 my strict plant based diet brought my LDL from 194 to 112 and my ApoB from 118 to 94. Believe what you want but my my plant based diet is working 😆 and I also reversed my Hashimotos which is an incurable thyroid disease since switching to a plant based diet but you keep on being delusional thinking diet doesn’t matter 😆 #blessyourheart
1:02
Association and correlation… are not CAUSATION! Another push for statins?
Yep.
"Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet