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

@alana924 You're welcome. Glad this gave you some insight.

@tommy901
Thanks for your explanation!

Thank you, but I am still in a panic.

Lipoprotein(a), or Lp(a), is almost entirely determined by your genes.
About 90% of a person’s Lp(a) level is inherited. Unlike LDL cholesterol—which is strongly influenced by diet, lifestyle, thyroid function, exercise, and medications—Lp(a) is produced in the liver according to a genetic “instruction set” you were born with.

Main Causes:

1. Genetics (dominant inheritance).

If you have one parent with high Lp(a), there’s a high chance you will also have elevated levels.

Levels stay relatively constant throughout life.

2. Family history of early heart disease.

High Lp(a) often clusters in families where people have premature coronary artery disease or strokes.

3. Certain conditions can raise Lp(a) further (but aren’t the primary cause):

Kidney disease.

Uncontrolled hypothyroidism.

Inflammation / acute illness.

Menopause (levels naturally rise).

What's known to control Lp(a)?

Very few things—Lp(a) is stubborn.

Effective options:

1. PCSK9 inhibitors (Repatha, Praluent) has reduced Lp(a) by 20–30% on average.

2. Apheresis (in severe cases)
Can drop Lp(a) by 50–70% but requires repeated treatments.

3. The upcoming Lp(a) antisense drugs:

(Pelacarsen and Olpasiran):

Currently in phase-3 trials, shown to lower Lp(a) by 80–95%. Expected to be approved in a few years, possibly sooner.

What does not lower Lp(a):

Diet

Exercise

Statins

(Studies show that statin therapy can lead to an average increase in Lp(a) levels of approximately 10–20%).

Niacin (lowers it mildly but doesn’t improve outcomes, so no longer recommended).

Vitamin C, lysine and proline (no proven effect on Lp(a) levels).

Vitamin C doesn’t lower Lp(a), but studies show it supports vessel health, which may indirectly reduce plaque formation.

Vitamin C improves endothelial function by acting as an antioxidant to protect blood vessels from oxidative stress and by boosting nitric oxide production, which leads to vasodilation. It is also a cofactor for enzymes involved in collagen synthesis, which is essential for blood vessel integrity. Research shows that vitamin C supplementation can improve endothelial function in patients with conditions like heart failure, hypertension, and hypercholesterolemia.

The above information is based solely on valid Epidemiological studies over the past few years.

Hopefully, this will clarify some of the aspects of LP(a).

I live in New Zealand and am 75 yrs old[ but not ready to die yet] I have LPO levels of 225 and a strong familial history of heart disease. I am terrified- which is probably pushing up my blood pressure. My sister has it too[ lpo 135] and is in a clinical trial, but she lives in Australia. There is nothing similar here.Is this death sentence ?

I just had a heart attack 6 weeks ago and in the hospital they ran the LPa test and mine was 229. I had had a calcium ct score done also and that was 220. I knew hear issues ran in my family but thought it was because of cholesterol. Now my children need to be tested because LPa is not affected by diet or exercise…and you can also have a good cholesterol score and still have blockages. I had 5 blockages and they stented two but left a 50-70% on the RCA. I have angina several times a day…my question is how do I know when my angina is an emergency situation….my doctor told me if I have another heart attack it will feel just like my last one…and this feels different. Anyone else dealing with this?

@charlie36 That is a very high number I think. I believe lp(a) is associated with atherosclerosis. You may already know this. If you haven't discussed your score with someone knowledgeable in this area, you should. Here's a site (among many) with more on lp(a) https://familyheart.org.

It's genetic so others in your family may be interested to have theirs checked. Good luck!!

Hi, i know your post was a few years ago, I just found out that my level is also extremely High at 305. I hope this finds you well!

Hi @gerhardus. I see this is your first post on Mayo Clinic Connect. Welcome! I am so glad you are around after your severe heart attack, able to join this discussion about elevated LP(a). You have found a good place to share experiences.

If you haven’t already, you may want to check out discussions related to your carnivore eating style. I am so glad it is working for you. I typed “carnivore diet” into the search box on the home screen and found several conversations.
- carnivore diet discussions: https://connect.mayoclinic.org/search/discussions/

Also, Mayo Clinic promotes long-term evidence based eating and provides good related information. Their perspective comes from what is proven to lower risk factors for heart disease, such as high cholesterol and high blood pressure. These are all positives for folks dealing with the additional risk associated with elevated lipoprotein (a).
- Examining meat-only diets: https://mcpress.mayoclinic.org/nutrition-fitness/a-meat-only-diet-is-not-the-answer-examining-the-carnivore-and-lion-diets/
- Mediterranean eating lifestyle: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801

What are your LP(a) levels?

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