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When Picture Perfect Health Takes a Detour



In early 2017, Bob Harper, a trainer for the hit show The Biggest Loser, had a heart attack at the gym in the middle of his workout. He was only 52 years old, and one of the biggest names in the fitness industry. His heart attack shocked many people, since he outwardly seemed like the perfect picture of health. 


What could possibly cause seemingly healthy individuals to experience sudden heart attacks or strokes like his? The answer? A sneaky lipoprotein called Lp(a). Lipoprotein(a) is a specific type of LDL, it is increasingly recognized as a significant risk factor for cardiovascular disease. Sadly, its importance often goes unnoticed until its consequences are felt. Elevated levels of Lp(a) typically don't show specific signs or symptoms, so unless it is tested for, it goes undetected and is often overlooked. 


Unfortunately, getting your Lp(a) tested is quite rare and not part of any regular lipid panel that your doctor normally tests for.  Most lipid blood draws done by clinicians report lipid levels, NOT lipoprotein concentrations, and hence Lp(a) measure is not provided. Even cardiologists may overlook Lp(a) in part because it is not as well-understood as other risk factors and treatment options are still very limited.


The levels of elevated Lp(a) are predominantly dictated by our inherited genes, particularly the Lp(a) gene. Nearly 70% to 90% of Lp(a) levels are genetically determined. Elevated levels increase the risk of inflammation, blood clotting and clogging, or plaque buildup, inside your blood vessels, which can block the flow of blood and oxygen to your heart or brain. Regrettably, lifestyle modifications like diet and exercise don't typically lower Lp(a) levels, and many commonly employed preventive approaches for individuals with cardiovascular disease risk factors are not effective. However, individuals with high Lp(a) levels should still adopt healthy habits in collaboration with our healthcare providers to decrease their overall risk of heart disease. 


Is there a natural remedy to lower Lp(a)?


Niacin, also known as vitamin B3, has historically been considered a potential treatment to lower Lp(a) levels. However, recent studies have indicated that niacin might not significantly reduce Lp(a) levels compared to other medications specifically designed to target Lp(a).

While niacin can effectively modify other lipid parameters such as LDL cholesterol and triglycerides, its impact on reducing Lp(a) appears to be rather modest or inconsistent in various individuals. As a result, healthcare providers often consider other medications or strategies for managing high Lp(a) levels, especially for individuals with a strong familial predisposition to elevated Lp(a) and cardiovascular risk.


Every medication aimed at reducing Lp(a) levels will necessitate extensive cardiovascular outcome studies to demonstrate its ability to effectively decrease the risk of heart attacks, strokes, and other critical events. A study utilizing genetic data suggests that a substantial reduction in Lp(a) might be essential to bring about a significant decrease in risk.

Fortunately, recent advancements in research offer hope by introducing potential treatments in development that might assist individuals with elevated Lp(a) levels.


Know your Lp(a) number!


Understanding your Lp(a) level provides deeper insights into the risk of heart disease, stroke, and other vascular conditions compared to a standard cholesterol test solely measuring total LDL cholesterol levels. Should a significant portion of your LDL cholesterol be transported by Lp(a) particles, your susceptibility to heart disease and stroke might surpass the estimations from routine cholesterol assessments.


At Body Tonic, we test for critical scores like these.  Are you a part of one of our wellness programs? Let’s uncover these silent causes of early heart disease together. 

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