Does Lp(a) cause Heart Disease? Are there Solutions? [Study 251-265 Analysis]

[@Physionic]

*1 AMENDMENT (SEE BELOW NOTE)* NOTE: About 4 months of work for this analysis. I hope it proves useful. The one take-away I would strongly encourage is that you get your lp(a) levels checked once in your life (that's all you need), because if 1000 people watch this video, 200 will be at elevated risk (and may not know it, unless they check), so get it checked at some point. Cheers. *AMENDMENT:* It was pointed out that at the 53:00 mark, I did not point out the change in the units (nmol/L) vs the more common (mg/dL) in this analysis. At the 53:00 mark, the Lp(a) is quite low (nmol/L). Here is the original critique for full context: "You are looking at some studies that measure Lp(a) in mg/dl and correctly concluding that the risk does not begin to elevate until around 40. Later in the presentation at 53:00, you are noting that the participants had Lp(a) of 23 nmol/L and saying that risk doesn’t elevate until around 40. When you are measuring with nmol/L risk does not begin to elevate until around 150. 10-50 is very low." - thank you to @davidzip8841 for the correction.

[@orthotron]

Same at 1:36:20

[@chrisgiles5653]

Lp(a): When and how to measure it: PMID: 33040574

[@aesalenmassage]

I did and it's 35.5; thank you!

[@numberthree267]

Research scientist here. I have high Lp(a)----300 nmol. Yet at nearly 80 years of age, I have no other CHD risk factors. My coronary calcium score is only 29. My parents lived into their 90s with no CHD. Clearly, there must be mitigating factors that are protective against this factor. I think it's important to not freak out if your Lp(a) is high. I'm convinced lifestyle is still the major factor for the prevention of CHD and stroke.

[@sheddkkhan6758]

but few days ago you said that you do not have cac

[@mybjj9643]

Again, thanks for this. Your analysis of the studies is probably the most current one out there and I love how you dig into the details. Been a subscriber now for about 2 months. Keep up the great work!

[@donnamelcher7978]

Love the information that you share, also the way you displayed it🎉🎉🎉

[@Formula1-Dave]

I wish you a very very long life and much more youtube content for us as you grow older. Don't ditch us after your studies 😂 thanks man

[@manumitx]

I have family history of heart issues, got my Lp(a) tested and it was around 256 (very high). I have since had a CAC score (came back 1), CT Angio (no issues) other lipid blood work done and and everything is in the very healthy range. I'm 42 / male

[@Physionic]

I'm glad you're doing well so far. I'm glad you checked.

[@plants_and_wellness1574]

May I ask what your LDL is or usually is? I also have high Lp(a) (330 nmol/L as of December) and every one in my family died in their early to mid sixties. My mom is the only one who has made it to 70 and despite having high Lp(a) (167 nmol/L) and having smoked for the past 55 years, she is pretty healthy. She has zero heart issues and just had an EKG last month that the doctor said was “perfect”. She has always had an LDL under 100. I believe that is what has helped her stay healthy because her parents and four siblings died from heart disease and they all had high cholesterol and ate a lot of red meat and dairy and butter. She has always stayed away from those things, instead she only eats chicken or fish with veggies.

[@manumitx]

@@plants_and_wellness1574 LDL between 70 and 90 with high HDL and lower triglycerides. I have a feeling that Lp(a) may have factors to it that we don’t totally understand yet that may not all be negative

[@plants_and_wellness1574]

@@manumitx that’s fascinating that you both have high Lp(a) and low LDL and both of you are fine. She’s never exercised and has always been on the heavy side. I think as long as I keep my LDL low that I’ll be fine. I’ve always been a health fanatic due to family history. Thanks so much for replying 🙏

[@sheddkkhan6758]

@@manumitxhi

[@Jeffs60]

Low levels of Lp(a) could be bad news for longevity. The Lp(a) levels were inversely correlated with the CIMT in this population, suggesting that subjects with a low Lp(a) level may have a predisposition to carotid atherosclerosis. This finding was preliminary and should be investigated further in larger studies and in additional settings. 2012 article title, CIMT thickness in asymptomatic subjects with low Lipoprotein(a) levels. 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

[@ukispargitus970]

However a more up-to-date study concludes differently: 'In a large, contemporary, general population cohort, apart from the well-established association with cardiovascular disease, low levels of lipoprotein(a) and corresponding LPA genotypes did not concordantly associate with any major disease groups including cancers and infections. There is no safety signal from our results to indicate that low levels of lipoprotein(a) are harmful.' 2021 article title: Low lipoprotein(a) levels and risk of disease in a large, contemporary, general population study

[@Jeffs60]

@@ukispargitus970 Your up to date study has conflict of interest funding by many drug companies so of course the lower the better. The 2012 study I provided was from Japan which is a no profit healthcare system so no need to sell anything since they are already the country with the highest life expectancy and they want it to stay that way. So no, never tamper or try to change your Lp(a) levels as they are in your genetics for a reason to make you live a long healthy life.

[@jaymehatfield9540]

I am literally in tears of gratitude for this Nick. Thanks, (sniff), thankyou.😢

[@armanrasouli2779]

Amazing content man, appreciate it

[@Physionic]

Thanks, Arman

[@rileykonara]

Great video Nic, thanks for putting it together!

[@demonfedor3748]

Great analysis! It so happened that I already read one of those studies specifically the one with 10,75, and 225 mg drug every 12 or 24 weeks. Yes, I was mad impressed too even though I didn't dive as deep as you into it.( I believe that was phase 2 olpasiran trial). I can't wait to see the results for phase 3 with massive sample sizes long duration and actual outcomes. Gonna measure my apoB and Lp(a) in a few days. I hope for the best,but if not drugs are already on standby.

[@plants_and_wellness1574]

I found out that I had high Lp(a) 5 years ago and got my mom tested and hers came back at 167 nmol/L. Mine is 330 nmol/L currently. Mine actually changes every time I get tested. It was 243, then 293, then 380, and now it’s 330 nmol/L. No one in my family had made it past 70 until my mom. Her dad had his first heart attack at 55 and was dead by 63 in 1976. My grandma had 3 strokes and died in a nursing home at 69 in 1990. Both my moms brothers died early 60’s from heart disease. Two sisters as well. I’d bet they all had high Lp(a). My mom is 70 and is pretty healthy despite having high Lp(a) and smoking for the past 55 years. She still smokes half a pack a day. The only thing she has done differently from her parents and siblings is she never got into butter or dairy or red meat. Her family ate a high red meat diet with lots of butter or lard. She says that she had a feeling that that was unhealthy and that’s why she didn’t eat that way. Her LDL has always been under 100. She had an EKG a month ago and the doctor said it was “perfect”. So, she’s the first to make it to 70 and has never had heart problems. Her diet is what is different from the rest of the family. Since finding out about my high Lp(a) I now eat a mostly plant based diet with wild caught seafood 3-4 times a week and chicken about once a week. My LDL was 194 when I was consuming butter and a lot of red meat, back then I thought it was healthy 😅 but now my LDL is 115. So, if you have high Lp(a) I think the secret is to keep your LDL and ApoB low. It’s worked out for my mom.

[@mikafoxx2717]

Very interesting, I wonder how the results of the LMHR study will go in relation to LP(a) of the participants. See how much being lean is a protective factor. I seemingly got extremely lucky on my side, even my great grandma still drives at 92. I suspect LP(a) is quite low..

[@plants_and_wellness1574]

@@mikafoxx2717 and I forgot to mention that my mom has always been heavier and never worked out or been health conscious. She just always ate chicken and vegetables for like every meal because that’s what hat she liked lol. I feel like I’ll live to 100 with my lifestyle 😄. She’s managed to stay pretty healthy despite smoking and being heavy. She has never drank alcohol and I don’t drink either. I’ve always been thin and very health conscious except for a time period where I thought butter and red meat and raw milk was really healthy, that was until I saw my cardiac markers. Now I absolutely no longer believe that and see that as a probable factor in why my family died so young.

[@mikafoxx2717]

@@plants_and_wellness1574 That's a good darn start to a diet. Getting enough protein to retain muscle and bone tissue as well as getting veg in. My gramps just helped me rip up my old deck today and he's 74 and in better physical shape than many teens these days, and it's down to mostly meat + veg/real food, keeping lean, plus physical exercise.

[@plants_and_wellness1574]

@@mikafoxx2717that’s amazing! I think our genetics play a huge role because my grandparents would eat bacon and eggs cooked in lard for breakfast and always went to the farmers market for veggies and covered them in tons of butter and ate a lot of meat and yet got heart disease and died really young. Maybe those with low LPa can get away with eating that way but those with high Lp(a) cannot 😢

[@mikafoxx2717]

@@plants_and_wellness1574 Certainly, yeah. I think there may be different risk factors to different aspects of heart disease. Some might be more sensitive to smoking, others more to being overweight, and others still to cholesterol or saturated fat intake. At least, that's a small hypothesis. Those doing well have always stayed very lean, though. That's probably a good aspect of it.

[@charlesdowning5899]

My LP(a) went up from 96 to 128 in 3 months when I cut out all saturated fats.

[@basic-decaf]

As mentioned in the comments, check your units when you get tested. Lp(a) of 19 nmol/L is approximately 7.5 mg/dL. (Divide nmol/L by 2.5 to get mg/dL).

[@sheddkkhan6758]

Hello bro how much ldl

[@mybjj9643]

Great presentation! Thank you for helping to increase Lp(a) awareness through your platform. One thing that I don't believe that you made clear is the two therapies discussed, antisense and olpasiran, have not yet been approved by the FDA. The antisense trial is in phase 3 currently, with FDA approval expected in late 2025, assuming all goes well. Olpasiran is also in phase 3. They are behind the antisense trial with FDA approval expected in a few years.

[@SrenelyDiscord]

I would appreciate you covering this conversation," Increase Nitric Oxide: Fix Blood Pressure & Inflammation Naturally (Dr. Nathan Bryan)." In this conversation, sodium nitrate is stated to be beneficial. So why are we not taking sodium nitrate with our other salts?

[@mikeroll9868]

Great content. Thanks for your amazing hard work. The more I look at the mechanism’s of plaque the more I think it resembles the body healing itself. The plaque ing is like a scab on the skin, but t you can’t do that inside injured arteries. One of the tertiary benefits of statins is that they are anti inflammatory. Another is hemolytic. Wouldn’t it be ironic that reducing LDL would be inhibiting repair, but the other effects of statins are countering that. The muscle cell s moving to surround the plaque are one indication of repair the other is calcification. It is known that calcified plaque is “stable” and not likely to rupture antibodies into the blood stream. You mentioned the inflammatory response of the Endothelio cells to the proteins and attraction. Seems to resemble a natural response to some causation. That sickle cell anemia it is the sharp shaped red blood cells damage ing the artery walls that is causing the plaque’s. Again the plaque’s are a repair response. And now there is water to early info on Lean Mass Hyper responders with high LDL and no plaque. Interesting times. Please keep up the great work.

[@jimking6484]

Love your video. I’m currently reading Malcom Kendrick’s “The Clot Thickens”. He does a deep dive on the endothelial wreckage from thrombosis and the culprit has little to do with cholesterol and LDL but the devastating impact of LPa and APOB.

[@KoiRun50]

Hi Nick. As usual outstanding illustrations. Would you please do illustrations of how cataracts and/or arcus senillis are formed. How about the mechanism of action for ivermectin.

[@RedPilled100]

Wonderful.👏Continue with what you do

[@Physionic]

Thank you, I will

[@whobdis77]

your correct that it doesn't change much. Mine was around 240 when tested 10 years ago. Recent test came back about the same. I got it down to 195 at one point about 9 years ago with high dose Niacin but didn't really know if that change was worth staying on the Niacin.

[@ryanvegntech]

@1:36:22 I've been part of a test group on familial hypercholesterolemia since I was a child, my LP(a) is pretty darn high and multiples higher than even those, it's actually so high one of the private testing clients had to change their reporting software as their chart axis didn't go up far enough. Back then the only option was statins, and I've been on statins since a child, but it never made a difference to that score. Nor fasting, exercise, or diet, that I tried anyway. But somehow Im still around anyway. My last calcium artery score was last year and still zero. I don't notice the condition, but I feel it will catch up with me eventually, I hope PCSK9 inhibitors will be approved in my country and/or better more advanced mitigations become available before long. I think because it's not tested often by GPs or understood, probably there are more people who could benefit and at the same time a larger customer base than the industry expects. Maybe that incentive will encourage better understanding of the mysteries of the michevious little a 😊

[@zlmdragon.]

so if cholesterol doesn't kill you, make sure stressing about it does kill you🤣

[@Always-xl9db]

How high is your cholesterol? LDL and VLDL?

[@elizabethfletcher1487]

Well, I cracked up when I found that the study’s idea of high Lp(a) was in the 500s. Mine is 1844 nm/L. Yep, I found a good heart doc who checked everything and at, 74 (female), no plaque, aortic valve is fine, heart structure fine, and no treatment was offered. I was fine with that. Something is protecting me since my total cholesterol runs about 220, LDL at around 135, low triglycerides, even on a vegan diet.

[@sheddkkhan6758]

Do a angiogram

[@sheddkkhan6758]

Do a angiogram

[@sheddkkhan6758]

Do a angiogram

[@sheddkkhan6758]

Ct angiogram

[@sheddkkhan6758]

are you busy

[@mybjj9643]

Also, in your amendment, yes there was some confusion between nmol/L and mg/dl, but the comment was made that when using nmol/l that elevated risk is not seen until 150nmol/L. I think if you look into the data you will find that elevated risk begins significantly lower than that. When measured in mg/dl, Lp(a) is considered elevated, and at elevated risk, when over 30mg/dl. When measured in nmol/L, the reference range for elevated Lp(a) is 75nmol/L with increased risk found at >75nmol/L.

[@hypnotiqpits13]

Mine ranges about 450! I had a massive heart attack at 39, the lab said my LPA was about 25 if I remember correctly 20 months later another coronary artery blocked 20 months after that another, months later, Another, about 30 months later in the hospital with four blocked arteries. Now at almost the 13 year point I have four vessels plugging up again and they’re waiting for insurance approval to do quadruple bypass. Wanted to try eating meat and vegetables only to see what happens but was always afraid to since a week ago when I got the news about the bypassing I’ve been doing Caldwell Esselstyn whole plant food diet hoping that I am OK until the surgery wishing I didn’t have to go to the surgery.

[@sheddkkhan6758]

How are you

[@susanpusateri2129]

I thought you said your LPa is 450... But then you said 25. What's causing your plaque buildup? I'm so sorry...

[@sheddkkhan6758]

@@susanpusateri2129how much lip (a) you have

[@shauna996]

Your LPa is low so that’s not a factor in your coronary artery disease. A more likely culprit is insulin resistance or even high stress.

[@shauna996]

Misread your statement. If it’s 450 that is high but if it’s 25 that’s low. Which is it?

[@stevemc2626]

Thanks so much for this discussion. There may be a slight error and if it’s my mistake I apologise but when talking about the Olparisan trial you mentioned very high levels in the 250 -300 compared to the earlier 50 but I think there was a change of units from ng/dl for the ‘50’ and nmol/l for the 250+.

[@darylfortney8081]

Super clear explanation of the mechanism of Lp(a) and disease... thanks!

[@htnam123]

Wonderful study break down! Thank you

[@maestroharmony343]

I am confused. Is apoA found in HDL the same as apoA in LP(a), or is it just the same name?

[@MiniaturesAndVintage]

I had my first LPa test in January of this year and it was 354! 😬 I have been trying different things with my diet and then retesting it. (4 times - 354, 393, 372 and 437) It has big fluctuations but so far not downward and I cannot see a correlation with my diet. In my N=1 experiments, it doesn’t change like my ldl does directly with carbs and fats. As a side note, I’m also LMHR when on keto, and when my LDL was the highest, the LPa was the lowest. I’m 57 years, and I had a CAC and CCTA done last August and thankfully had 0 calcium and no detectable plaques. No family history of heart disease either. My parents are in their mid 80’s and fine so far. This is scary to know about and not be able to do anything to lower it. Kinda wish I didn’t know.

[@hypnotiqpits13]

Like you mine ranges in the 400s normally sometimes the 300s as low as 317 as high as 577. I don’t know what changes it. I eat a pretty clean diet just started plant-based recently but I’ve had tons of plaques in the heart arteries. I have eight stands and currently need four more. I’m in the hospital today awaiting the procedure tomorrow.

[@sheddkkhan6758]

Hi please

[@sheddkkhan6758]

Hi

[@sheddkkhan6758]

Hi

[@sheddkkhan6758]

Hi

[@jeffwilliams4108]

What else can be drawn through the endothelium? Why do the endothelium cells shrink to allow this? What other particles have a different charge and is there a size limit to what can be drawn in? Lastly why would the endothelium cells draw anything in just to eject it?

[@carlloeber]

this was fantastic .. thank you .. I just had this test with the VA .. it came back

[@rodenwald]

I am 48. My Lp(a) was tested for 115nmol during a routine checkup. Further examinations were then carried out and an incipient calcification of the aortic valve and 1 mm of plaque were found in the cerebral artery. I was prescribed statins (also to stabilize the plaque) which lowered my LDL from 120 to 60, but increased my Lp(a) to 137. Now the question is: What is worse: 120 LDL or 137 Lp(a)? Should I stop taking statins or reduce them? I am also tryiung to lower Lp(a) with low dose of red wine an 200mg Niacin. Hope this works.

[@danieljrgensen133]

120-137?? That's nothing, in my family lp(a) is above 500 nmol/L and the male members, first start to get symptoms in their mid to late 50's. The accuracy/tolerance of the blood test is also needed to be taken into account, when you compare results. You'll never get the excact same number....even if tested twice the same day! Lot's of people don't seem to know this! 😉 My lpa was raised +25% on 10mg of rosuvastatin....so I think your safe! 😉

[@michaelhimes8778]

After listening to dozens of hours of frontline researchers on this, they seem to all agree the risk in modest rise of Lp(a) with statins is offset by the benefits of lowering LDL. Regarding niacin, with very high Lp(a) levels, it doesn’t lower it enough to make a clinical improvement. You can try to do LP Apherisis or wait for the drug trials to finish.

[@charlesfuchs]

Get on a PCSK9 Repatha!!

[@jp7357]

This will be interesting .. I’ve pondered how much lp(a) contributed to ASCVD as opposed to ldlc level. I.e: is high ldlc/apoB in the absence of elevated ( 100 was ONLY 1.2 increased risk, literally ALL of my buddies that have high lp(a) (>100) have had stents (some multiple) by age 60. Edit2 as always … a truly excellent presentation… need to relisten to the part about low ldlc and low apoB and high lp(a) .. how is that possible ? how did they subtract lp(a) from the apoB measurement ?

[@gordonv.cormack3216]

It is important to note that "not statistically significant result" (often unfortunately stated as "no significant effect" or "no significant difference") does NOT mean "no effect" or "small effect." It simply means the study lacks the power to be considered slam-dunk evidence. The estimated difference (or ratio) gives the maximum-likelihood estimate, and if it is positive (or above 1) that's evidence of a positive effect. To draw a legal analogy, the estimate gives probable cause or balance-of-probability evidence, but significance gives "beyond reasonable doubt." As in a trial, you can draw together a body of evidence is all balance-of-probability, to reach an overall conclusion beyond reasonable doubt. I could see you were trying to be careful not to imply that "not significant" meant "no effect" but you slippped up several times.

[@IlIKRATOSIlI]

Why would risk decrease with age? That is something you missed in the video.

[@Marc_de_Car]

Thank you

[@maestroharmony343]

I tested lp(a) 5 times in 15 months. The results were (in nmol/L) from 106 to 199 and in the between. So, it's definitely not "test once in a life." Statins did not affect it much, but I think Niacin did lower it a lot.

[@plants_and_wellness1574]

Mine has been different every time I tested. In 2019 it was 125 mg/dl and in 2021 it was 243 nmol/L, in 2022 it was 293 nmol/L and in 2023 it was 380 nmol/L and then recently it was 330 nmol/L. Either way it’s always high and will probably always be high. My mom has high Lp(a), hers was 167 nmol/l and she is 70, has smoked for 55 years, still smokes half a pack a day and has never ever had any heart problems and just had an EKG last month that was “perfect”. I should add that she has always had an LDL under 100 and never consumed butter, dairy, or red meat. She’s the first in our family to make it to 70. Her dad died at 63, mom at 69, and siblings in their early 60’s, all from diet related diseases. They were all heavy red meat eaters, ate lard or butter, and drank a lot of milk. She’s the only one who didn’t. And she’s the only one still here.

[@bradbaker4679]

@@plants_and_wellness1574I would expect a comment like this from someone with your KZbin name

[@plants_and_wellness1574]

@@bradbaker4679 lol. Before having a cardiac panel done and finding out I had high Lp(a) among high everything else my diet was a ton of raw milk every day, homemade butter on everything and grass fed beef almost daily. Once I changed my diet I brought all of those numbers down including my CrP. The diet I had prior is the diet that my family had and all of them died in their early 60’s. My mom is 70 and is healthy and has always stayed away from red meat and dairy. Different strokes for different folks.

[@sheddkkhan6758]

@@plants_and_wellness1574how are you

[@ML-yf2dl]

What about PCSK9 inhibitors? And are these injections mRNA ”vaccinations” like the covid vaccines? Thinking of side effects.

[@vw3610]

Would you know if you have ‘normal’ LP(a) SNPs (LPA SNP rs3798220 rs10455872 ), and have very high levels of LP(a), are you at less risk than someone who has polymorphisms on these two SNPs? Also, if your levels of LP-Pla2 are in the ‘good’ range, does that mean that the LPa is not doing damage to your vessels?

[@RHt09]

No, that's a different factor and not the reason that Lp(a) does "damage" to the blood vessels

[@land0oo]

I have 126 nmol/l lp (a) with rs3798220 T/T and rs10455872 A/G also have MTHFR rs1801133 A/A 80% reduction and Fast COMT. Good HDL/Trig obv high Total cholesterol and LDL due to keto?. but I suspect inflammation pathways at play due to MTHFR, also have a few markers in the inflammation pathways according to the genetics. Love geneticlifehacks.. 39 fit healthy mostly keto just had a full blockage/rupture of the right Conary from up top. Reevaluating everything as you would, still no wiser with a conclusion yet on what to do next :/, docs just doing the usual shotgun approach pump with 40mg of statin and thinners. But I would rather be smarter about it. Awaiting specific genetic testing and more advanced lipid panel to see ApoB and subtractions size of LDL etc. Tests I ordered my self lol.

[@darylfortney8081]

Lp(a) of 50 as high in the study? Hold my beer... 350... I'm praying for the day Olpasiran is actually approved for use and doesn't cost your entire life savings.

[@plants_and_wellness1574]

In the mean time keep your LDL as low as you can. My recent LPa came back at 330 nmol/L but last year it was 380 nmol/L. My mom also has high LPa but at 70, and despite smoking for the past 55 years and still smokes half a pack a day, she has no heart issues at all. Her EKG last month was “perfect”, but she has always had an LDL less than 100. Her parents and four siblings died really young and they all ate a heavy red meat, butter or lard and lots of milk type diet and she has done the opposite and she’s still here and quite healthy despite the high LPa and smoking.

[@darylfortney8081]

@@plants_and_wellness1574 I’m also allergic to statins… they spike my CK and AST and ALT levels. The most I can tolerate is 5mg Crestor and that even seems to be raising my A1C to pre-diabetic levels.

[@ccamire]

You have to excuse me but but but…. First great detailed analysis is to be appreciated. Second, i kind of disagree with the explanation of lpa penetrating the endo cells. You did not mention that the glycocalyx is a membrane that protect the endothelial cells which is really tight. Not sure how all the ldl create an injury tomthe glycocalx. Also you did not mention why fibrinogen, platelets, rbc, wbc are all present where there are plaques and any ldl are a very small parts of the plaque. These studies are all conflicting from apob, ldl and lpa. Inwould recommend the thrombogensis theory who reall explain heart attacks more clearly. A good reference is dr gregory Sloop on research gate. Thanks again

[@Physionic]

Glycocalyx is not a membrane, but a polymer coming off the cell. Lp(a) is retained under the vessel wall - here are some studies directly testing this (PMID: 9531056, PMID: 9259586)

[@HobzyMcRuse]

What do you think of Malcolm Kendrick's lp(a) role in atherosclerosis?

[@jeffwilliams4108]

I to would like to hear more on Malcom s theory compared to this explanation

[@JMK-vo8pv]

You may want to take a look at Dr Nadir Ali's work in Lp(a). Dr. Nadir Ali opines that Lp(a) has ABSOLUTELY NOTHING TO DO WITH CAUSING atherosclerosis. Dr. Ali believes that the Lp(a) particles, just like LDL particles, are actually "firefighters" at the scene of inflamed coronary endothelium. 🧑‍🚒⛑👩‍🚒

[@Steve-nb9kg]

From reading the comments, seems outcomes of Lp(a) widely vary. Personally I have Lp(a) of 199, LDL 114, 62 yrs old, HDL 65, Tri 54, BP 110/65, non/never-smoker, BMI 22.5,, but CAC 3137! No heart attacks or strokes. Started statins (LDL now 61), diet 7% saturated fat, hoping for the best. Got appt with cardiologist next month, should go well as I have no symptoms and can exercise vigorously (HR 85% sustained) no pain. May need stronger/additional statin to lower LDL more though.

[@seascape35]

Is that LP(a) of 199 in mg/dl or nmol/l?

[@Steve-nb9kg]

@@seascape35 nmol/L

[@tajmeal]

@01:11:08 @01:28:55 @53:21 @35:34 & @17:47

[@andremarques6270]

One question: Why did Lp(a) levels change in some people of the placebo group @1:42:30 ? Wasn't it supposed to remain stable?

[@ukispargitus970]

@Physionic: Thank you for this deep Lp(a) analysis! However how to deal with extremely low Lp(a) level in the range of

[@anechoicmedia]

thank you for this!! :)

[@waaaaantube]

Thanks!

[@Physionic]

Thank you :)

[@waaaaantube]

@@Physionic insider package sounds like a good place to be. See you in there!

[@zombi3lif3]

You know those kringles look like tiny Santas. I believe we may be close to a hypothesis on why Santa is able to deliver all those packages in one night.

[@pennyt820]

I heard the dr called them kringles b/c they looked like the pastry from germany (like a bearclaw?)

[@flolou8496]

How do I get into a clinical trial for Olpasiran ?

[@hagancs]

My LPa is in the very high category at 278 nmol/L. The lab test listed anything less than 75 as optimal. You say anything over 30 is bad. Maybe I missed something, did the test in the study reference different units?

[@Physionic]

Some studies used nmol/L, some used mg/dL - the 30-40 is mg/dL

[@plants_and_wellness1574]

Mine just came back at 330 nmol/L, it was 380 nmol/L last year so thankfully it’s come down. The best thing you and I and anyone can do who has high Lp(a) is keep your LDL as low as possible. My mom is 70 and has high lp(a) and has never ever had heart problems but her LDL has always been under 100. She’s always stayed away from things like butter, dairy, and red meat. She watched her parents die super young from heart disease and she said they ate butter or lard on everything and a meal wasn’t a meal without red meat. All four siblings died early 60’s as well and kept the same diet.

[@stevemc2626]

@@plants_and_wellness1574 I’d like to see the evidence for ‘the best thing you can do’.

[@jackspintz5784]

Wow great video. I have lpa 250 is that drug Olpasiran available? I need to pop that pill quick!

[@Jeffs60]

@@davidzip8841 Lp(a) is the same thing as Lipoprotein(a) and it is in your genetics for a reason just like how many times you blink your eyes per minute so don't worry about Lp(a) levels or how many times you blink your eyes.

[@Jeffs60]

@@davidzip8841 Do you really want to lower Lp(a) and if so why? Low levels of Lp(a) could be bad news for longevity. 2012 article title: Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

[@Jeffs60]

@@davidzip8841 There are many more than one. "Remarkably, one-quarter of the centenarians had high Lipoprotein(a) serum levels even though they never suffered from atherosclerosis-related diseases." 1998 G. Baggio.

[@Jeffs60]

@@davidzip8841 "Nonetheless, the apo(a) size distribution in centenarians did not entirely explain the high Lp(a) levels observed in this population. Factors other than apo(a) size, and which may be either genetic or environmental in nature, appear to contribute to the elevated plasma Lp(a) levels of our centenarian population. We conclude therefore that high plasma Lp(a) levels are compatible with longevity." 1998 article by J Thillet

[@Jeffs60]

@@davidzip8841 They claim about 1.5 billion people have elevated levels and it means nothing unless their levels are super high like over 300 mg/dL and what % do you think have that? On a closer look that woman Jeanne Calment only smoked 1 or 2 cigarettes per day and it does not say if she inhaled it. She also had a good diet and was super fit and still riding her bike outside at age 100 for free Vitamin D. She drank port wine but was never drunk, she lived in a wealthy area in France. Her favorite food was braised beef which is the most nutrient dense and least allergenic food but at 5 feet tall and 100 pounds the portion size was moderate.

[@robsmith5405]

Is there any advantage in measuring the ratio between apo a and apo b in one’s blood analysis ?

[@Caleb635]

Is it worth it to get Lp(a) checked even if my ldl is 49, triglycerides are 42 and hdl is 61?

[@RHt09]

Yes, it has nothing to do with those numbers and is purely a genetic factor. It's a once in a lifetime test if it's normal.

[@mikerudd4943]

Is it true that LP can go up when on carnivore diet for some time? I have heard it can, and then settle down but still be high? I see a number of markers be "different " from the population as a whole , when on carnivore

[@Mikolas649]

My LP a is 1.9 nmol or 5.2 mg/dl. I have high TC, between 240 to 350,Hdl, is higher than LDL, TG in 40s.Have stenosis in LAD. DOCTORS, never checked my LP a, I do regular CbC, on my own accord. THEY only throw statins and ask my to double dose... Switch I found never helped. I'm not to worried about high TC, but now surprised with below normal LP .Should I be worried and do other tests?

[@sheddkkhan6758]

How much ldl

[@Youtubedisco]

31 nmol ❤, 63 years old, low carb no sugar

[@sharonillenye8036]

lowering LPa with the siRNA treatment, does that lower major events?

[@danieljrgensen133]

Nicolas, I'm a bit disappointed I didn't see/learn about any new actionable advice/tips, to help people with lp(a) in the +500 nmol/L range, to normalize their risk to same level as people who are within the normal range(0-85 nmol/L)? 😔😉 If lowering ldl does not really affect outcome(as you suggest in the video), then people like me seems doomed....at least, according to this video. Nothing, except the mRNA drugs, seems to lower lp(a) in any significant way....and those drugs are not available. And because of price, won't be available for a very long time and people like me will be either dead or seriously ill before(perhaps) getting the drug offered. Non of the non-pharmaceutical options offers any significant lowering of lpa, if you have got very high levels! Sad conclusion! 😕

[@michaelhimes8778]

Lipoprotein Apherisis is the only current FDA approved method to lower and does 30-60%.

[@sharonillenye8036]

I have 486nmol/L LPa at 66 with no events so far. I just started taking nattokinase to make LPa less sticky and to break up any fibrin clots. and I also take lysine to bind to the LPa lysine binding site so that the LPa can't bind to epithelium.

[@Meadows191]

Contact Joel Kahn, Cardiologist. He takes patients all over US. He deals with lpa management and has written a book on it.

[@shauna996]

A baby aspirin seems to reduce clotting risk dramatically in those with high LPa. Also for that population bleeding risk is not increased because they already clot easier than others. Talk to your doctor.

[@sheddkkhan6758]

@@sharonillenye8036how much ldl you have

[@hypnotiqpits13]

Are These drugs available now?????

[@theshadow8008]

Florian Kronenberg?

[@theshadow8008]

Proteoglycans are positively charged while lipoproteins are negatively charged....

[@hypnotiqpits13]

Could someone have an unknown infection to cause Lpa to stay high?

[@jaymehatfield9540]

Ooh ooh ME TOO. a brutal root analysis extraction where I believe the ligament was left in. I have record of 13 antibiotic scripts issued at various ER, my provider, urgent cares, with 10pass ozone therapy 2 years, plus throwing ever possible therapeutic grade aromatic botanical and antioxidant at jaw infection for 6 YEARS. I am afraid that "standard of care" is going to killed me. Anyone have suggestions, please help, don't hesitate.

[@mikespector2]

Is "Apolipoprotein in A1" the same as Apo little a?

[@hypnotiqpits13]

What are the other ways to decrease it so looks like an anti-drug which there’s two types?

[@levprotter1231]

Endothelial cells allowing the particles through sounds like an immune system function, kind of like an ambulance siren.

[@everydayhomelife8697]

My LPa is 318nmol. Im age 35 and wondering how hormones from pregnancy or breastfeeding may effect the number as I am postpartum and nursing. I plan to retest when baby weans. I suppose regardless, it'll still be quite high 😔 apob 90, ldl 113, triglycerides 34, inflammation under 1 and no IR.

[@sheddkkhan6758]

Hi

[@sheddkkhan6758]

Hi

[@sheddkkhan6758]

Hi

[@okamsug]

I need a 15 min summary.

[@Physionic]

Skip to the 30 second summary, then

[@da504ever]

I'm just so confused because my doctor says i have risky levels at 82 nmol/L and flagged anything over 75 as risky. But I see 150 is the level you state. She went so far as to retest me and told me I needed to see a cardiologist. The weirdest part is my HDL is 97 and my LDL is 80. Tryglycerides is 51. I was never concerned about my cholesterol until now. Am I at risk?!?!

[@sanepeter2034]

PLEASE do a health risk analysis comparing Ethanol conpsumption with a benign mixer ( water, grape juice ) compared to Spirits, Wine and Beer, etc. I am of the opinion it is not the alcohol in pure form, but rather added ingredients that pose the greatest health risk. I believe such an analysis will make it one of your most popular Videos. Thank you in advance.

[@wolfrahmphosphoros5808]

interesting request, but why exactly do You think this, if I may ask? regards.

[@sanepeter2034]

@@wolfrahmphosphoros5808 Whiskey for example aged in charred wooden barrels, also drinking pure alcohol does not result in a hangover. Chemical reactions go on between alcohol and added ingredients.

[@wolfrahmphosphoros5808]

@@sanepeter2034 thank You for sharing this, but ethanol is still a poison. regards.

[@basiltiffani8850]

I'm certain this man is British without an accent.

[@Physionic]

How certain?

[@tomgoff7887]

I'm British and I'd say that he has an American accent.

[@ThingsYoudontwanttohear]

The family name Verhoeven does not sound very British or American to me. Maybe Scandinavian, Dutch or German?

[@ycc9369]

@@ThingsYoudontwanttohear Popular Dutch last name.

[@themekfrommars]

Oh Behave!

[@hayd9785]

Do you have dutch ancestry?

[@manikkucka2840]

Why don't doctors test for LPA? So why have most people never even heard of Lp(a)? For starters, Lp(a) isn't picked up by a standard cholesterol test. You can get a separate Lp(a) blood test, but doctors haven't routinely recommended it because currently there aren't any FDA-approved drugs to lower elevated Lp(a).Feb 1, 2023

[@manikkucka2840]

Yes, I know about it. There is no cure, only a test. That's why the doctor prescribed me medicines such as Simvastatin. This will only fix the number.

[@bigswolletx]

my score was 8.4 on this test very low

[@hamxa_xhan]

Bro what is your height?

[@mikafoxx2717]

Tall

[@superspeederbooster]

just say lipoprotein 'a" not LP little "a"

[@michaelhimes8778]

I think the nomenclature is to not confuse it with Apolipoprotein A

[@whatthefunction9140]

Next vid go shirtless. For science

[@pennyt820]

🤣

[@frankenz66]

Am about 80% carnivore eating. My LP(a) came back

[@donwinston]

You are ridiculous. Whistling in the dark is not going to keep the bogey man away.

[@Maxim.Teleguz]

We started the same. How did you get around histamine issues.

80% carnivore? So you eat a omnivore diet with mostly meat. It's like saying I'm using 30% carnivore diet about a balanced diet xD

[@felixcat9455]

Thank genetics for your low lp(a). It’s not from carnivore diet.

[@frankenz66]

@@felixcat9455 Didn't help my Dad and Bro though. Both passed at 59 and 49 respectively from first Heart attacks.

[@darylfortney8081]

Content is excellent as always but you still could use to remove a good percentage of pork and just get to the point and skip the often wandering talks in between. Cutting your video time in half would be a great goal imho. I need to put your videos on 2x just to get through them.

[@Physionic]

I think you're going to have to keep playing it at 2x 😋

[@wolfrahmphosphoros5808]

Some of Us thrive on pork, the more pork, the better the meal. regards.

[@michelangelobuonarroti916]

I appreciate the in-depth presentation.

[@karsten600]

Dude, what an entitled thing to say lol

[@darylfortney8081]

@@karsten600 you’ll get over it