Plaque is the stuff of coronary heart disease. It is CONTROLLABLE, it is STOPPABLE, it is REVERSIBLE.
But you must be equipped with the right information on diet, nutritional supplements, and hopefully the avoidance of medication.
This is the blog that accompanies the 
Lipoprotein(a), or Lp(a), is the combined product of a low-density lipoprotein (LDL) particle joined with the liver-produced protein, apoprotein(a).
Apoprotein(a)’s characteristics are genetically-determined: If your Mom gave the gene to you, you will have the same type of apoprotein(a) as she did. You will also share her risk for heart disease and stroke.
When apoprotein(a) joins with LDL, the combined Lp(a) particle is among the most aggressive known causes for coronary and carotid plaque. If apoprotein(a) joins with a small LDL, the Lp(a) particle that results is especially aggressive. This is the pattern I see, for instance, in people who have heart attacks or have high heart scan scores in their 40s or 50s.
Lp(a) is not rare. Estimates of incidence vary from population to population. In the population I see, who often come to me because they have positive heart scan scores or existing coronary disease (in other words, a “skewed” or “selected” population), approximately 30% express substantial blood levels of Lp(a).
Then why haven’t you heard about Lp(a)? If it is an aggressive, perhaps the MOST aggressive known cause for heart disease and stroke, why isn’t Lp(a)featured in news reports, Oprah, or The Health Channel?
Easy: Because the treatments are nutritional and inexpensive.
The expression of Lp(a), despite being a genetically-programmed characteristic, can be modified; it can be reduced. In fact, of the five people who have reduced their coronary calcium (heart scan) score the most in the Track Your Plaque program, four have Lp(a). While sometimes difficult to gain control over, people with Lp(a) represent some of the biggest success stories in the Track Your Plaque program.
Treatments for Lp(a) include (in order of my current preference):
1) High-dose fish oil–We currently use 6000 mg EPA + DHA per day
2) Niacin
3) DHEA
4) Thyroid normalization–especially T3
Hormonal strategies beyond DHEA can exert a small Lp(a)-reducing effect: testosterone for men, estrogens (human, no horse!) for women.
In other words, there is no high-ticket pharmaceutical treatment for Lp(a). All the treatments are either nutritional, like high-dose fish oil, or low-cost generic drugs, like liothyronine (T3) or Armour thyroid.
That is the sad state of affairs in healthcare today: If there is no money to be made by the pharmaceutical industry, then there are no sexy sales representatives to promote a new drug to the gullible practicing physician. Because most education for physicians is provided by the drug industry today, no drug marketing means no awareness of this aggressive cause for heart disease and stroke called Lp(a). (When a drug manufacturer finally releases a prescription agent effective for reducing Lp(a), such as eprotirome, then you’ll see TV ads, magazine stories, and TV talk show discussions about the importance of Lp(a). That’s how the world works.)
Now you know better.
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Hi, I recently had a VAP test done via LEF — I seem to have some very good numbers and some bad LDL ones. Any comments would be appreciated.
all values in mg/dl
LDL 105
HDL 71
VLDL 14
Total Cholesterol 190
Triglycerides 51
LP(a) 4.0
IDL 3
HDL2 18
HDL3 53
VLDL3 8
LDL1 PatternA 5.4
LDL2 PatterA 7.5
LDL3 PatternB 61.6
LDL4 PatternB 22.4
LDL Density pattern = B, flagged abnormal
Vit D 65.4 ng/ml
Homocysteine 6.2
C-Reactive Protein 0.2
I am 55 yr of age, 6'0", 165 lbs, exercise regularly.
Heart disease in family, mother's father died of heart attack at 66, other 3 grandparents lived into 90s. father died leukemia cancer 53, mother living at 80 in good health. Thanks, Jim
I use Lugols solution 2% and I have absolutely no idea what dosage I should be using. I have been using one drop about twice a week, but I would like to have a better idea of proper dosage. Can you help?
My cardiologist is treating my high Lp(a) with Niaspan, but even with high doses, it has not had much effect. What do you mean by items 3 and 4 on DHEA and T3? Please be more specific. Thanks.
Could you give some dose for T3 and DHEA that you are recommending?
Thanks!
"If your Mom gave the gene to you, you will have the same type of apoprotein(a) as she did. "
Does that mean that high levels of Lp(a) is not inherited from the father?
Thanks
Dear Dr. Davis,
I’m a 44 yr old female. I recently had a consultation w/ a cardiologist here in Canada. I was sent for the consultation because of some strange left jaw and low chest tightness I’d experienced at work the week prior (had been seen then in the ER, normal ECG x 2, normal CXR, normal bloodwork). Prior to the appt I was told I needed to have fasting bloodwork (so that results were available for the cardiologist to review at my appt).
HDL good, LDL good (though at the higher end of the normal range). Lipoprotein A was 0.55 g/L (which i guess works out to 55 mg/dl which is what the usual unit of measurement is for this one in the U.S.). The cardiologist told me that all of my bloodwork was normal and that I was very low risk for a heart attack but I requested a copy of my results just to have on file. I am surprised she didn’t mention the elevated Lipoprotein A (normal range for this lab is: 0.00 to 0.33 g/L). So that got my on my search for info on what exactly Lipoprotein A is, and what it indicates.
My question is: I was only told to fast for 12 hours prior to my bloodwork, nothing was said about ensuring I didn’t smoke. Well I did smoke over the 12 hours up until the blood was drawn (even about 30 minutes prior to). Now I’m reading online that one should not smoke prior to blood being drawn for Lipoprotein A, HDL and LDL, etc. So could my smoking right up to the time bloodwork done have negatively impacted the results? Could smoking have made my LDL and Lipoprotein A higher? Should I have these redone but ensure I don’t smoke for 12 hrs prior to blood draw? (I have a ‘quit date’ set for next Saturday, so don’t worry, I will be quitting).
Thanks so much,
Lisa