I am definitely not a doctor but I, like others here, have heard that high lipoprotein (a) is genetic. I have read that niacin is the only thing that can reduce it. You may look into that and ask your doctor about it. It has to be the nicotinic acid that causes the flush. Niacinamide does not help with that so make sure to do your research and get the right kind of niacin and the right dosage.