Why It's Important to Know Your Lp(a) Levels

Disclaimer: Not Medical Advice. Opinions are my own.

In partnership with ​Function Health

Today's Newsletter at a Glance:

• What is Lp(a)?

• Measuring Lp(a): What range puts you at increased risk?

• What to do if you have elevated Lp(a)?

• Medications for lowering Lp(a)

  
  

Heart disease is the leading cause of death globally.

The primary motivation for my newsletter is to identify the leading risk factors that contribute to the development of heart disease.

I'm confident that many of you reading this newsletter are familiar with the standard lipid panel, which includes LDL-C, HDL-C, triglycerides, and total cholesterol. However, there is more to the story.

Apolipoprotein(a) or Lp(a) is typically not included on a standard lipid panel, but it is a causal risk factor for atherosclerosis.

In today's newsletter, we will uncover what Lp(a) is, what makes it dangerous and different, and ways to navigate elevated Lp(a) levels.

What is Lp(a)?

Again, you may be familiar with LDL (Low-Density Lipoprotein); Lp(a) is an LDL with an apolipoprotein (a) "tail".

The blessing or curse associated with Lp(a) is that it is 90% predetermined by genetics.

You can't run from your genes, and unfortunately, making lifestyle modifications typically won't alter your Lp(a) levels.

What's with the tail?

Though the verdict on the function of the tail is unknown, it's clear that the tail offers enhanced clot formation.

This feature may have contributed to survival from injuries throughout evolution; however, with our longer lifespans and reduced daily risk of fatal injuries, it now plays a role in the development of atherosclerosis.

Measuring Lp(a): What range puts you at increased risk?

If you haven't tested your Lp(a) levels yet, I would strongly suggest considering it.

Understanding your baseline is crucial in determining whether you have the genetic predisposition to elevated Lp(a), which provides a more comprehensive picture of your atherogenic risk.

Ranges & Risk for Lp(a):

• Lp(a) levels <30 mg/dL (<75 nmol/L) are considered low cardiovascular risk.

• Lp(a) levels between 30–50 mg/dL (75–125 nmol/L) are considered intermediate risk.

• Lp(a) ≥50 mg/dL (≥125 nmol/L) is considered high cardiovascular risk.

  
  

My wife recently used ​Function​ to test her Lp(a) since it's typically not included on a standard primary care panel, and she was distraught when the results came back.

Her Lp(a) was 152 nmol/L, which puts her in the high cardiovascular risk category.

So, how did she navigate these results?

What to do if you have elevated Lp(a) values?

First and foremost, you are not defined by a single biomarker - take a deep breath. Elevated Lp(a) is not a death sentence.

My wife underwent a Calcium CT Scoring test after receiving her Lp(a) results, and, despite elevated levels, her score was 0.

This provides her peace of mind about her risk profile. It also acts as a baseline for subsequent Calcium Scoring CT scans.

Remember, your genetics determine this lab value, so lifestyle changes won't significantly impact the result.

Worrying about a lab value won't solve the problem either.

What you can do is control the controllables.

Focusing on modifying your overall cardiovascular risk is the mindset my wife has adopted.

What do we know will move the needle in your favor?

1. Managing your LDL-C & ApoB levels

2. Regulating your blood pressure

3. Avoid smoking

4. Maintain low blood sugar levels

5. Lower your overall body inflammation

All of these are risk factors for total heart disease and stroke risk, and you have significant control over all of these pillars.

​In this study​, researchers found that individuals with elevated Lp(a) and high levels of hs-CRP (a marker of overall body inflammation) were at the highest risk of cardiovascular disease.

Reducing high-sensitivity C-reactive protein (hs-CRP) in individuals with elevated Lp(a) is optimistically associated with a lower risk of atherosclerotic cardiovascular disease (ASCVD); however, elevated Lp(a) remains an independent risk factor even when hs-CRP levels are reduced.

The good news is that hs-CRP is something you have control over and can be modulated with exercise, a clean diet, and prioritizing sleep.

Focus on the controllables and minimize your overall risk as much as possible.

Monitoring your lab values over time will help you evaluate your progress. Always consult a qualified healthcare professional if medications are necessary.

Medications for Lowering Lp(a)

Are there medications, such as statin therapy, to lower Lp(a)?

At the time of writing this newsletter, no medications are available to specifically lower Lp(a) levels yet.

However, multiple medications are in Phase 2 and 3 clinical trials that have successfully reduced Lp(a) levels by up to 80%.

To fully assess the impact of these medications, Phase 3 will help uncover definitive evidence of cardiovascular outcomes by lowering Lp(a) levels with medication.

In other words, are patients at less risk of heart disease and stroke with these medications?

Personally, I'm optimistic and eager to see the long-term impact these medications will have on individuals, such as my wife.

Stay tuned!

If You Don't Test, You Don't Know

True health ownership starts with knowledge.

Understanding which biomarkers are in range or, more importantly, out of range will help you personalize and create your own instruction manual.

​Function Health​ is an all-in-one health platform that starts with 100+ lab tests, including your Lp(a), heart, hormones, liver, kidneys, thyroid, autoimmunity, cancer signals, toxins, and overall nutrients.

Function provides five times more bloodwork testing than standard primary care labs, which would cost you thousands of dollars out of pocket.

Function makes scheduling at 2,000 locations across the USA convenient and straightforward, with lab visits averaging only 15 minutes.

Once your results are in, you will receive a comprehensive summary written by Function's Clinical Team. Clinicians call you promptly if any urgent results arise.

After seeing your biomarkers and Function's insightful recommendations, you will have the confidence to take action and retest in the future to track your progress.

Join hundreds of thousands, including me, who use Function to take control of their health. ​Click here to get a $100 credit when you sign up for Function.​

Only the best,

Jeremy London, MD

P.S. Don't forget to follow my podcast for free on ​Spotify​ or ​Apple Podcasts