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Very high LPA
Posted on 1/7/26 at 8:18 am
Posted on 1/7/26 at 8:18 am
Just got bloodwork back and I have very high LPA, as in 90th percentile. I haven’t yet had a calcium test, I assume that’s coming g, to see if there is any plaque buildup. It’s really got me concerned and depressed. I workout hard 5 times a week, eat healthy, and to find this out it a real gut punch. Anyone else score very high, and how are you dealing with that risk?
3
Posted on 1/7/26 at 11:55 am to warm
By LPA, are you meaning LPa? Mine is sky high also (136 mg/dl) and from what I understand is hereditary. Sucks that you can't really do anything to lower this but good news is that there are trials being done for meds to help drop these numbers. Eli Lilly is running a trial that I tried to get in but minimum age was 40 so I missed it by a couple years.
Posted on 1/7/26 at 12:36 pm to Petey8
Yes that is what I mean. Mine was 219 ngdl or around 90mg
Posted on 1/7/26 at 7:36 pm to warm
Because meds do nothing for LPa, my doc put me on rosuvastatin to help bring LDL and ApoB down. LDL wasn’t very high and was in good ratio with HDL but because of the LPa number, she wanted to lower any risk of the two compounding.
Posted on 1/7/26 at 8:04 pm to warm
Wow, hate to hear that.
Here are a couple of things to look into:
LINK
LINK
Here are a couple of things to look into:
quote:
Lipoprotein Apheresis
Lipoprotein apheresis is currently the only therapy approved by the Food and Drug Administration (FDA) for lowering Lp(a) in the United States. It is only approved for people with all three of the following:
Heterozygous familial hypercholesterolemia (FH)
LDL cholesterol higher than 100 mg/dL andLp(a) higher than 60 mg/dL
Either coronary artery disease or peripheral artery disease.
Estrogen, niacin, and PCSK9 inhibitors are known to lower Lp(a) levels. However, estrogen and niacin have not been shown to protect you against developing heart disease if you have high Lp(a). Preliminary evidence suggests that the cardiac benefit seen with PCSK9 inhibitors is because of both LDL and Lp(a) reduction, but more evidence is needed at this time. Studies specifically looking at PCSK9 inhibitors and Lp(a) are underway.
LINK
quote:
Therapies to lower Lp(a)
Most of the drugs in development for lowering Lp(a) work by interfering with RNA, the molecule that copies and transfers genetic instructions from DNA, the cell's genetic blueprint. Currently, there are four RNA-based drugs that effectively silence the gene that makes Lp(a) in liver cells: lepodisiran, olpasiran, pelacarsen, and zerlasiran. All are administered by injection every one to six months and have been shown to lower Lp(a) levels 80% and 100%. The side effects appear to be limited to mild, short-lived pain at the injection site. Larger, longer trials looking at whether these drugs will help prevent heart-related problems are currently under way, with results expected within the next one to two years, says Dr. O'Donoghue, who is a lead investigator on the clinical trials of olpasiran.
Preliminary results also look promising for another experimental drug called muvalapin, which works by preventing the assembly of the Lp(a) particle. Like the RNA-based drugs, muvalapin also leads to dramatic drops in Lp(a), but it is taken as a daily pill. Side effects include headache, back pain, and fatigue. While some people prefer pills over shots, injectable drugs have the advantage of much less frequent dosing, Dr. O'Donoghue notes.
LINK
Posted on 1/7/26 at 8:19 pm to Reubaltaich
I can't find LPa in my labs, I guess I can ask about it. Is it calculated from other stats?
Posted on 1/7/26 at 8:46 pm to calcotron
quote:
I can't find LPa in my labs, I guess I can ask about it. Is it calculated from other stats?
From what I can tell, the LPa is a separate test from the standard lipid panel.
You will have to request a separate LPa blood test.
Get one from your Dr or you can get it done through an independent testing center like Labcorp.
Posted on 1/8/26 at 12:38 pm to calcotron
quote:
I can't find LPa in my labs, I guess I can ask about it. Is it calculated from other stats?
They don't test for it on a regular lipids panel. I found out mine was high (150mg) when I asked my doctor to do an expanded panel.
Apparently, about 15-25% of the population has this genetic predisposition to high LP(a) and it increases the baseline risk of CVD. The current best method is to reduce your ApoB because that is what carries the protein.
There are several significant therapies currently undergoing Level Three testing. They absolutely obliterate LP(a) - like reductions of 90-95% - but the Level Three testing is looking to determine whether that reduction actually corresponds with a reduction in CVD.
If so, they should be to market in 2027-2028.
Posted on 1/9/26 at 7:01 pm to warm
Lp(a) rides on LDL particles, making the particles more atherogenic. You can lower the number of ldl particles (apo b) for risk reduction. PCSK9 inhibitors are the most potent (if insurance will approve) and have been shown to reduce lp(a), or the more traditional statin/ezetimibe route
Posted on 1/10/26 at 2:49 pm to NewOrleansBlend
As i've gone down this rabbit hole of LPa, the PCSK9 inhibitors do indeed lower LPa about 30% on average; however, since mine is about 300% higher than high, it doesn't really do anything. I suppose now the course of action is to start Statins for the rest of my life to lower Apo B as low as possible. It's just a real crappy situation, I workout and eat healthy my whole life and then this genetics thing happens and I have no control over it.
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