My LP a came in at 283. I had already shifted to a mostly plant based diet based on Dr. Esselstyn's book since July 2023. I have an article from another source that if you are eating a diet as you mention above, stay active and get exercise, the extremely high Lp a risks are relatively minor. The other key seems to be to check you "high Sensitivity C-Reactive Protein" and if it is low, again, the risks seem much less if not very low. I am still researching to learn more that I can do and will try to share any information I find with you. I too am looking for help. My cardiologist was of little help since their is no pharma treatment yet approved that is practical for me, so far. Several clinical trials are in progress but not expected to be approved until 2025 or later.

I too have a high Lp a of 283 nmol/L and already have low overall cholestrol using statins. My wife and I have shifted to a mostly plant based diet with some salmon/shrimp/tuna occasionally. After a short time my cholesterol went down some more and I lost 10 pounds without trying. Given that LP a is genetic there is little one can do except embrace a more healthy lifestyle (be active and exercise) and a very careful diet. I am contacting family members and recommending they get checked as well. We avoid sugar, seed oils, most meats and dairy products and only a small amount of good fats. We eat only whole grains with a low fat content. Eating out and traveling is a huge challenge. My wife has chronic kidney disease and the diet increased her eGFR almost 50% in just a few weeks on the diet. For us, Fast Food is poison. Often, even the vegan foods have lots of added seed oil. However, We found the diet to be easier that we thought possible. Hopefully, the clinical trials to lower Lp a will soon be sucessful and approved.