Anyone else out there with extremely high lipoprotein (a)?

Posted by csage1010 (Sue) @csage1010, Feb 21, 2022

Hi! I just found out that I have an extremely high lipoprotein (a) of 515 nmol/L. I'm terrified; it's that high. I'm 58 years old and my total cholesterol is 212. My LDL is 141, and my HDL is just 40. My cholesterol/HDL ratio is 5.3. Of course it's a long weekend and I may not be able to reach my doctor tomorrow. I have watched a couple of informational sessions online from various doctors discussing elevated LP(a), but no one mentions anything close to how high mine is. Is there anyone else out there with severely elevated Lp(a)? Thanking you in advance. Sue M.

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@sueinmn

@csage1010, @glennose, @whineboy, @hopeful33250, and all in this great discussion -
I have always believed that the best healthy diet is one that can work for you, not just for a week or two, but as a permanent life change. Anything extreme is likely to be discarded because it seen becomes burdensome. And the best changes are usually made incrementally, one or two things at a time. If we had "thrown out the cookbooks" and tried to be radical, I doubt it would have worked.
For example, hypertension is a big deal in both my husband's family & mine, so we use very little, and season our food with onions, garlic, herbs and spices. Ditto with diabetes - so sweets are small, select and a special treat. Over the past few years, we have gradually cut back the frequency and portion of meats, and added beans for a protein boost. My husband has even learned to like tofu, and I have learned to like oven roasted vegetables like brussels sprouts... We travel a lot, and pack our own "road food" - carrots, grapes, nuts (portioned), select snack bars, healthy lunches, even homemade smoothies - fast food is a rare big deal, then we find it meh!

How have you made diet changes that you can stick to long term?
Sue

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Hi Sue - thanks for your excellent observations. I agree with you 101% that compliance is key to a healthy diet (and other lifestyle changes).

Until late 2018 I ate unwisely, no junk food, but while I tried to make lowfat choices (chicken breast, sandwiches, breads and cakes, lots of pasta, rice, steel-cut oats for breakfast), my health was declining, I was obese and prediabetic. At the end of 2018 I 'got religion' and vowed to change. I asked my cardiologist whether he recommended low carb or low fat, he said go with low carb. I did some reading about low carb vs. low fat and concluded the Ornish/Esselsteyn regimes were too strict for me and I'd never be able to stay on them. I realize they work for many and people swear by them. I decided to give lower carb a try.

I immediately eliminated any foods with added sugar, and did a lot of reading about LCHF (I started with Dr. Lustig's "Fat Chance" and several books by Gary Taubes, and Nina Teicholz' "Big Fat Surprise"). By mid-March 2019 I was eating low carb, and by the end of 2019 I was eating very low carb (any carbs came from green leafy veggies, full-fat dairy, and once every day or two a buttered mini-pita). I can't say I eat keto because I don't measure macros, I just eat what I want until I'm full. I try not to snack. I don't eat bread/pasta/rice/potatoes. I eat lots of eggs, cheese, full fat dairy, salmon and sardines. I do try to limit beef to 1x a week. Since I've maintained a 50 lb weight loss since spring 2019, and my lipids are vastly improved since late 2018 (now - HbA1C 5.1, then 5.8; now - HDL ~ 75, then, HDL ~ 40; now TGs < 85, then TGs > 200; now, LDL is large fluffy pattern A, then, I don't know but expect it was pattern B; morning blood sugar is 85-90), I'm fairly confident that this is a manageable lifestyle for me. I spend a lot of time reading nutrition books to keep reinforcing the importance of what I'm doing. I feel like it has done much more for me than rosuvastatin.

Edit - I've added a lot of fermented foods to my diet - besides yogurt I eat at least one of kimchi, natto, sauerkraut and pickles each day. Despite these salty foods my BP is 115/75 (I do take 5 mg amlodipine), I think salt is not a problem for me because I'm very insulin sensitive (fasting insulin is 3 uIU/mL and my Quest insulin resistance score is 5, more than a bit below the sensitive/impaired cutoff of 33).

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@csage1010

Yes, I am having the most trouble finding a good salad dressing that is made with olive or avocado oil, and I will use it sparingly. You are correct about statins.

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Yuck to the stuff on the shelf! I always make my own. It is easy. Just mix olive oil and balsamic vinegar. SECRET => buy quality olive oil and vinegar.

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@csage1010

Fortunately, I am not a meat eater. I do like an occasional piece of salmon, but right now I want to see if I can get my cholesterol down with diet and exercise. I know it will not effect my Lp(a). If my numbers don't start coming down significantly in a month or so, I will have to go on the statin. I have an appointment with my primary care doctor Tuesday and will find out my calcium score (fingers crossed, but I'm not expecting good results). How do you do with adding beans and maintaining good blood sugars? Thank you, Sue McMahon

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Cooked beans and lentils have not had a noticeable effect on blood sugar, but they always combined with a wide variety of other vegetables, so they are only one part of the meal, much as a serving of meat would be. Even our pea soup is 1/3 green & yellow peas, 2/3 other vegetables like onions, carrots, celery & rutabaga.
Sue

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@sueinmn

@csage1010, @glennose, @whineboy, @hopeful33250, and all in this great discussion -
I have always believed that the best healthy diet is one that can work for you, not just for a week or two, but as a permanent life change. Anything extreme is likely to be discarded because it seen becomes burdensome. And the best changes are usually made incrementally, one or two things at a time. If we had "thrown out the cookbooks" and tried to be radical, I doubt it would have worked.
For example, hypertension is a big deal in both my husband's family & mine, so we use very little, and season our food with onions, garlic, herbs and spices. Ditto with diabetes - so sweets are small, select and a special treat. Over the past few years, we have gradually cut back the frequency and portion of meats, and added beans for a protein boost. My husband has even learned to like tofu, and I have learned to like oven roasted vegetables like brussels sprouts... We travel a lot, and pack our own "road food" - carrots, grapes, nuts (portioned), select snack bars, healthy lunches, even homemade smoothies - fast food is a rare big deal, then we find it meh!

How have you made diet changes that you can stick to long term?
Sue

Jump to this post

I have made many diet through the years. It was easy to go paleo about 10 years ago (and you probably realize that it is a vegetable heavy diet). Slowly moving away from carbs and towards keto. All organic food, grass fed/finished meats, wild caught salmon and sardines, pastured eggs and eventually got to a 16/8 eating window. I am now in cyclical ketosis, lean, muscular, high energy and consume no seed oils or soy except for nattokinase, occasional legumes & nuts. I do take supplements, no drugs. My lipid ratios and inflammation are stellar. Doing great for someone who is approaching 70.

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@sueinmn

Unless you are looking for a particular flavor, what about making your own? Very simple - oil of your choice, good quality vinegar of your choice plus seasonings of your choice, shake and refrigerate. Or even simpler, a small drizzle of oil on your salad, followed by a shake of seasonings and vinegar to taste. Here is just one example, but you can find thousands on line
Peeled garlic clove in a bottle, add 1/4 cup high quality oil, a grind of fresh pepper, a grind of sea salt, 1/4 - 1/2 teaspoon of dried herbs (I like rosemary, basil & oregano) and about 1/2 cup of good balsamic vinegar or red wine vinegar. Shake vigorously now, refrigerate, an shake vigorously before using.
Have you though about making your own dressings?
Sue

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I have thought about it. Those ideas all sound very good. I even like salsa on salad, with a tiny bit of plain non-fat yogurt mixed in. I can do mostly vegan/low-fat and play around with the spices and herbs, especially those that have anti-inflammatory properties. Thank you for all you good advice.

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@sueinmn

@csage1010, @glennose, @whineboy, @hopeful33250, and all in this great discussion -
I have always believed that the best healthy diet is one that can work for you, not just for a week or two, but as a permanent life change. Anything extreme is likely to be discarded because it seen becomes burdensome. And the best changes are usually made incrementally, one or two things at a time. If we had "thrown out the cookbooks" and tried to be radical, I doubt it would have worked.
For example, hypertension is a big deal in both my husband's family & mine, so we use very little, and season our food with onions, garlic, herbs and spices. Ditto with diabetes - so sweets are small, select and a special treat. Over the past few years, we have gradually cut back the frequency and portion of meats, and added beans for a protein boost. My husband has even learned to like tofu, and I have learned to like oven roasted vegetables like brussels sprouts... We travel a lot, and pack our own "road food" - carrots, grapes, nuts (portioned), select snack bars, healthy lunches, even homemade smoothies - fast food is a rare big deal, then we find it meh!

How have you made diet changes that you can stick to long term?
Sue

Jump to this post

Fortunately, I am not a meat eater. I do like an occasional piece of salmon, but right now I want to see if I can get my cholesterol down with diet and exercise. I know it will not effect my Lp(a). If my numbers don't start coming down significantly in a month or so, I will have to go on the statin. I have an appointment with my primary care doctor Tuesday and will find out my calcium score (fingers crossed, but I'm not expecting good results). How do you do with adding beans and maintaining good blood sugars? Thank you, Sue McMahon

REPLY

@csage1010, @glennose, @whineboy, @hopeful33250, and all in this great discussion -
I have always believed that the best healthy diet is one that can work for you, not just for a week or two, but as a permanent life change. Anything extreme is likely to be discarded because it seen becomes burdensome. And the best changes are usually made incrementally, one or two things at a time. If we had "thrown out the cookbooks" and tried to be radical, I doubt it would have worked.
For example, hypertension is a big deal in both my husband's family & mine, so we use very little, and season our food with onions, garlic, herbs and spices. Ditto with diabetes - so sweets are small, select and a special treat. Over the past few years, we have gradually cut back the frequency and portion of meats, and added beans for a protein boost. My husband has even learned to like tofu, and I have learned to like oven roasted vegetables like brussels sprouts... We travel a lot, and pack our own "road food" - carrots, grapes, nuts (portioned), select snack bars, healthy lunches, even homemade smoothies - fast food is a rare big deal, then we find it meh!

How have you made diet changes that you can stick to long term?
Sue

REPLY
@csage1010

Yes, I am having the most trouble finding a good salad dressing that is made with olive or avocado oil, and I will use it sparingly. You are correct about statins.

Jump to this post

Unless you are looking for a particular flavor, what about making your own? Very simple - oil of your choice, good quality vinegar of your choice plus seasonings of your choice, shake and refrigerate. Or even simpler, a small drizzle of oil on your salad, followed by a shake of seasonings and vinegar to taste. Here is just one example, but you can find thousands on line
Peeled garlic clove in a bottle, add 1/4 cup high quality oil, a grind of fresh pepper, a grind of sea salt, 1/4 - 1/2 teaspoon of dried herbs (I like rosemary, basil & oregano) and about 1/2 cup of good balsamic vinegar or red wine vinegar. Shake vigorously now, refrigerate, an shake vigorously before using.
Have you though about making your own dressings?
Sue

REPLY
@glennose

Statins have been shown to increase LP(a). Things that reduce it are: keto or very low carb eating and eating only 8 hours a day and fasting 16 hours a day, high dose niacin, high dose vitamin c and absolutely no seed oils.

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Yes, I am having the most trouble finding a good salad dressing that is made with olive or avocado oil, and I will use it sparingly. You are correct about statins.

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@whineboy

I don’t believe statins can do anything to reduce Lp(a); given your low HDL, you also might want to make lifesyle changes. I shifted to a low-carb healthy fat diet 3 years ago, my Lp(a) dropped from 92 to 66. Took a year.
Lifestyle changes can improve a range of things, including blood lipid profiles, blood sugar, and weight. I lost 50 lbs. and no longer am prediabetic.
Good luck!

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I am thinking of doing a vegan, low fructose, very low fat diet. There are a few well known (and one really reputable ) doctors that advocate for this. One is Dean Ornish, the others are Caldwell Esselstyn and Neal Barnard. I think I feel more comfortable with that, but I meet with the lipid specialist in one month. You are correct, statins do nothing for Lp(a), except reduce your other risk factors. Appreciate your sharing your success story!

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