Lp(a)
Lp(a) is a fat combined with a blood clotting stimulant. Everyone has some in the blood but high levels are linked to increased risk of heart disease. Elevated levels of Lp(a) are often found in people with a strong family history of heart disease.
Is Lp(a) measured in the usual cholesterol tests?
Elevated levels of Lp(a) can not be detected with routine tests for cholesterol. High levels can be found even in people with completely “normal” cholesterol levels as measured by the routine tests most commonly performed.
What causes high levels to build up in the blood?
High levels usually are inherited. Unlike other fats, Lp(a) is not affected much by diet.
What should the Lp(a) level be?
Values under 30 are desirable.
What are the options for treatment?
Individuals with mildly elevated levels may not require treatment, depending on whether other risk factors are present. In situations where levels are very high or when several risk factors exist, treatment may be recommended.
Lowering the level of Lp(a) can be difficult. The most common cholesterol medicines, “statins”, do not lower Lp(a). The vitamin niacin (either over the counter or in the prescription Niaspan) is the best treatment to directly lower Lp(a). Niacin taken for this purpose usually requires high doses and should only be done under a doctor’s supervision. The supplement, L-Carnitine can also be helpful although it is generally less effective than niacin.
Since Lp(a) needs to team up with other fats to cause damage, another approach to treatment is to aggressively lower the overall fat level without targeting Lp(a) directly. In this approach, a statin type of medication (ie. Zocor, Lipitor, Pravachol, Mevacor, Crestor) is used. The best treatment option is determined by assessment of your individual risk profile.
