What is LP(a)? Does It Cause Heart Disease?  

Wow! This was the detoxing that I needed after watching Peter Attias LP a talk

These past two years of watching various online doctors presenting information has horrified me at how *evil* the pharma industry and the captured government agencies are.

I absolutely love this man - his teachings AND his humor! He’s definitely worth listening to…

This is exactly what I needed at the exact right time. Excellent job Dr. Nadir!

You’re my absolute favorite low-carb centric influencer., and at the very top of my list. Your talks help us to deepen our understandings of our metabolism, and are at the same time very understandable. Keep it up!

After a lipid panel with low triglycerides, high HDL (1:1) and 'high' LDL in which my doctor immediately suggested statins, I have been on a three day deep-dive of lipids and heart disease including articles, youtube videos and Malcolm Kendrick's latest book (excellent), I had one last question that was proving difficult to find an answer for amidst the tangle of lipid discussions - 'could I have high LP(a) and do I care?' This excellent video has cleared this up thoroughly and efficiently and with zero impulses to choose a higher speed :-) Thanks!!!

This is tremendously good analysis. Finally someone who is willing to see through the bullshit and form a hypothesis that actually fits the data. Kudos! Excellent information!

Good in depth analysis. I wish all doctors had research this to this level.

Wonderful presentation by Dr Ali. Watched it for the third time. In fact I watch all his videos repeatedly and every time I get amazed at the foolishness of mainstream medicine. Dr Ali, pl keep educating the public, you are doing the job of God.

Doctor 🧑‍⚕️ i hope you reads this The way you started from ground zero assuming we dont know much about LP (a) shows you are willing to explore the truth and start again. Thanks and continue the critical work

I was diagnosed through the Boston Heart program with high Lp(a), and put on a statin and a Vegan, no oil diet. I GAINED weight and my Lp(a) went up and my doctor was unable to explain it. Thank you for explaining it.

Stay “Nerdy” doctor…we really need more critical thinking in the medical field, instead of all resources on new drug development (to get rich on!). Thank you for your good work and trying to spread knowledge to the masses!

My internist, PCP, thinks I'm killing myself on the carnivore diet because I'm not taking a statin and my LP(a) is 48. She has such a closed mind to anything other than what corporate medicine has to say. It is so sad that we have to get the truth from RU-vid. Thank you Dr. Ali.

love your nerdiness!! 10 min ago I thought I was doomed! After listening to you I am very encouraged!! Yes my high CRP and high lipoprotein A are probably correlated. thank you for this info!!!

Nerdiness is necessary for me. If I understand why, it makes sense and helps me remember the process. Also, I am a visual learner with a slow processor and the slides really help! I listened first, then watched, and took notes. A definite nerd!

Your presentation reminds me that Linus Pauling (Nobel prize winner in chemistry) and a Dr. Rath from Germany, received a US Patent 5,278,189 for treating blocked arteries in the 1990s which is apparently not well known today. Their theory was that arteries are subject to high pressure due to the force of the heart ejecting blood into the circulatory system, which could cause lesions/inflammation to the artery walls. To heal the lesions, the body must create collagen to patch up the "hole". Satisfactory levels of Vitamin C and certain amino acids such as l-Lycine and l-Proline were suggested as necessary to patch the lesions. As you point out in the video, the great apes are seemingly alone in creating lipoprotein (a). Interesting, we are also seeming alone (except for guinea pigs) in being unable to self-manufacture Vitamin C which is required for the manufacture of collagen. They postulated that lipoprotein (a) was a "work around" to compensate for low levels of vitamin C, especially in the 6 months of the year that vitamin C was low in the diet (outside of the equator), to ensure our survival as a species. (Think of the Ice Ages when the human race almost became extinct due to famine, malnutrition, exposure etc.) Lipoprotein (a) was postulated as a "band aid" to patch the lesion pending true healing with collagen mediated by Vitamin C, and to prevent death by way of subclinical(?) scurvy. Just a few years ago in 2018 Dr Rath, who is based in Germany, used genetically modified mice which produce lipoprotein (a), and which can not produce vitamin C (unlike normal mice) to successfully demonstrate the proposed mechanism in the lab. (See: www.drrathresearch.org/research/projects/heart-disease) Presentations were made in the Netherlands. I don't think this attracted much attention in the US, where we are apparently more preoccupied with reducing cholesterol levels rather than than solving the underlying problem of arterial injury and inflammation!? So yes, perhaps lipoprotein (a) may have ensured the survival of our species. Your thoughts as a true subject matter expert would be welcomed!!

Thank you so very much for explaining Lp(a)! You may be nerdy but you did a completely understandable lecture.

Thank you, Dr. Ali. This presentation is marvelous. Your verbal skills are clear and precise, and I appreciate your speaking slowly and deliberately when discussing these complex topics. By the way, you look very good and youthful. The diet and biking are serving you well. All the best.

This was so timely 🙏🏽 god bless you doc :)👍

Dr. Nadir it is a pleasure to listen you. You put into words what I have believed for long time. Critical thinking in medicine is dead. Everything is protocol. I can’t wait to purchase your book. Ginge Brien, M.D.

Wow! I always wondered why nature would make Lp(a) to cause harm and Dr. Nadir Ali's nerdy talk explained a new perspective wonderfully. Keep such educative talks coming Dr. Ali - there are enough nerds out there who love to learn from your talks!

Thanks to your detailed view of LP(a), with mine elevated, you are helping me to believe that it is not necessarily my death sentence. A year ago, since diagnosed with ACVD, thanks to a requested CAC test, I have lost 85 lbs.(235 down to150), BP down below normal, and only eating clean foods, those from the ground-and animals that eat the food from the ground...basically clean as possible. CRP and every other bio marker (apart from LP(a)) are down to better than normal levels. But, until now, I believed my elevated LP(a) was a sure immediate death sentence. Your excellent presentation (firefighter vs arsonist), gave me encouragement to continue the new path I've chosen. That is, I now have a better chance to affect health span as well as Lifespan! Thank you!

Excellent information. I am a 55 fit female who’s recent labwork shows elevated LPa at 74. Remaining lipid profile normal with cholesterol tipping toward higher end of normal. I was started on niacin to bring down LPa. The studies you share are mind blowing as to what mainstream Healthcare is sharing. Thanks so much.

If you look at comments from people here it will be difficult to not get some critical thinking about how bad LP (a) realy is(if bad at all) . The root problem can't be the colesterol, but what makes the colesterol bad,(inflamation) it's certanly not the colesterol itself. So Dr.Nasir it's great listening to you!

Another excellent presentation. Be it known that I have stolen your line . “Is cholesterol the arson or the fighter fighter. And I give you the credit! 😁

ThIs PRESENTATION was ABSOLUTELY INCREDIBLE!

So the bottom line is to protect the vascular system. No injury to vessels, no thrombosis, regardless of LPa levels. However if there is a little vessel injury with high levels LPa then thrombi can propagate more intensely. Perhaps for these patients with high CAD risk they would benefit from anti platelets or prescribed anti coagulant. Or perhaps one in supplement form such as Omega 3 or Nattokinase. Who knows. Excellent presentation 🎉

This was fascinating, thanks! My LP(a) was 121 at my last lab test, and really had me scared. Thanks for this information!

We might have got away from using blood letting as a means of curing disease, but we certainly havent got away from the knee jerk reaction without understanding what we are doing. I have to admit I struggle to follow some of your videos, but its slowly sinking in, I'll get there eventually, please keep up the good work, its definitely appreciated ❤

What a great doctor and researcher you are, bravo

Hope there will be a debate for us to balance and know the truth. We want Dr. Ali for challenging the status quo.

Very interesting. A reminder that we are in the early days of understanding Lp(a). The idea that it might be more friend than foe is worth examining.

Wow.. great presentation of all of the data on Lp(a) not just what big pharma wants us to see. Thank you.. I find it interesting b/c I kept thinking of those points after I was told I have a high Lp (a)-why does the body make it? It’s gotta have a purpose..🤔 All my other markers are completely normal except for the amount of small particle sized cholesterol-hope you have another video on that.. I will look ..🤓

This is so good for me to hear as I have high levels of LPa

Dr. Ali i appreciate your out of the box thinking. Keep the lectures coming.

Thank you for sharing your knowledge ; sharing is caring . Bless you Dr & I am grateful .

Highly informative! Everything you said makes so much sense. Thank you, sir.

I am a big fan of Dr. Ali, but I have to criticize him for referring to hazard ratios as odds ratios. There are similarities in how they can be interpreted, but they are different. Odds ratios, relative risks, and hazard ratios come from different types of analyses and they are not interchangeable. Hazard ratios come from proportional hazards regression of time-to-event data. Odds ratios, generally derived from logistic regression, are appropriate for very different types of study design, such as case-control studies.

Congratulations on your son's wedding!!

Thank you Doctor! LPa is so villianized, yet we know the human body always has reason for its design. Your critical thinking is so appreciated and needed with the current standard of care in medicine. I believe CRP as a measure of inflammation is the most telling marker of cardiac health even with high levels of “bad” cholesterol. Brilliant video.

Thank you so much for sharing this info. Very useful. I really liked how you presented it.

Brilliant presentation, as usual!

Excellent content! Very helpful thank you!!

You mentioned the Quest test which utilizes Immunoturbidimetric methodology, curious what you think of the ion mobilization methodology for arriving at the LP (a) particle count, which Quest uses in their 'Cardio IQ' advanced lipid panel, which includes the LP (a) number... And also the NMR Nuclear Magnetic Resonance methodology.

THAT WAS REALLY GREAT! Very thorough and enlightening :D Thank you!

First encouraging message for people with high LpA. Thanks for the detailed analysis Doctor. I was never convinced how it is ok for statins to be considered ok for someone with LpA even as it raises it. Unrelated, I have seen it go down wity diet, so in my view more studies are needed before they conclude that it is invariant all life. Thanks again.

Thanks Dr Ali for wonderful explanation making me so happy because I had a history of constantly Lp(a) 150 and 3 MIs with Stent.

Fantastic video. Thank you!

In the French study at 22:39 into the video, Dr. Ali has it backwards. He states that the centarians are the hatched bars with the higher lp(a) levels. The label to the left says that the centarians are the dark bars -- which have the lower lp(a) levels as might be expected.

Hi I'm 61 years old and have gene determined high Lp(a). It was 403mg/l in 2012 and 400mg/l this summer. Yesterday I had a scan and feared a dead sentence. However the outcome was quite positive. I have very litle to no plaque. Only 3% at my age have less plaque I was told. My cardio age was judged to 34-39 years! I'm quite healthy and my triglyceride have been low the few times measured, which should hint I'm metabolic healthy. Maybe that's what matters? Not the level of cholesterol or Lp(a) ?

Thank you for this video as it makes me more hopeful. Much appreciated.

I'm a little late finding this, but I just want to say that i think Dr. Ali is just the right amount of nerdy!

Thank you for sharing this worthful information. It gives me hope for longevity with high Lp (a).

As a research scientist, I'm afraid the figure for Lp(a) values in centenarians (minute 22 in the video), as presented, is meaningless. Each black bar is the mean (average) Lp(a) concentration, but the number of individuals in each black bar is not specified. To illustrate, suppose there were 200 centenarians in the study population. The five tall bars taken together, which seemingly represent individuals with high levels of Lp(a), might only account for, say, 30 of the 200 centenarians (15%), whereas the remaining (smaller) 14 bars would represent the much larger remainder (170) of the study subjects. In that scenario, the conclusion would be that 85% of the centenarians had low levels of Lp(a). In short, we need to know the relative proportion of centenarians with high Lp(a) levels in order to make a reasonable conclusion. Hopefully this is explained clearly in the original publication.

22:40 I don’t think this is what you are saying. The controls have higher levels of lpa for a given genetic kringle size, than centenarians. So the centenarians have lower lpa levels than controls even for same genetics. So far it seems all we know is that the lpa number needs to be standardized by your kringle factor to be meaningful. The previous slide also didn’t say longevity was linear in lpa, but that there was a sweet spot. I would conclude from that that in very old people, having low lpa is beneficial because by that age they would have severe arteriosclerosis (not because of lpa, but because they are old), so wound repair is not as important as reduced chance of persistent clots, which outweighs the risk of hemmorrhagic stroke at that point. 32:40 lpa can’t be high in the higher CVD event patients to protect them from CVD, since it didn’t protect them. These values were measured before the cardio event, not during. Looks like lpa has nothing to do with cvd progression, but might be helpful to lower levels to reduce blood clots and thereby reduce events in cvd. Just another blood thinner. And statins as usual do squat, in this case increase lpa.

Great presentation on LP(a)!! At about min 36 you talk about "oxidized LP(a)" ... and i think you got something mixed up. What is shown on that chart on the right are "Oxidized phospholipids" which are actually carried by LP(a) and could be the main reason for the atherogenicity of LP(a)...

22:23 "centanarians represented in hatches" -but the graph labeling seems to indicate the controls are the hatches???

Excellent talk like always. Is there any benefit of checking Lpa level then??

Thanks for the great video! I would like to see a study of people in cultures where coronary artery disease is nonexistent (rural China, Papua Highlands of New Guinea,etc) and look at their lp(a) levels.

Darn I was happy that I had low Lp(a),

I am a basic person with an environmental policy law degree. I have watched at least 50 of these videos and I'm finally understanding the language of cholesterol. My doctor says nothing and just prescribes medication without explanation. Another specialist in cholesterol insists that I take all kinds of meds and also get this new type of shot every two weeks that I give myself to get rid of my LDL-LP(a) cholesterol without explaining why I need to do that. I am 118 pounds, female, 61 years old, exercise seven days a week and I am 90% vegan for the last 25 years. Yet I have high cholesterol but I don't feel ill. When I take cholesterol medication, I feel bad. I have all kinds of issues. I want to change my lifestyle so I will take CO Q 10, K2 vitamin supplements, three different pure omega 3 supplements from garden of life like the rest of my vitamins,. I feel better already. And now that I am watching number 51 of my cholesterol videos, I also feel reassured if not vindicated. Can watching a cholesterol video be comforting?

Wonderful talk by Dr. Ali. My lp(a) was 52 mg/dl when i measured in the month of April 2021. After that i had recovered from Covid-19 with mild symptoms. And June 2021 the reading of lP(a) was 86mg/dl. A research on these lines is advised evaluating the effect of Covid infection on Lp(a) alone. I am 41 years old. I have two queries i) Will Lp(a) reading change or constant throughout the life time. ii) The rise in the level after infection is reversible or not?

Great video I would like to see you as a patient. Own very busy anesthesia practice. Tell me Easiest way to go about this. Thank you Doc

Interesting🤔 i had a heart attack with 2 stents a month ago. Took the blood test , it was confirmed the cause was elevated lpa. Im vegan, no oils no alcohol no smoking no dairy. Exercised daily and had a major heart attack 100% blockage . I was lifw flighted from one hospital to another. Im scared to death on what to believe

My lp iz 54.5 and my doctor really freaked me out. Like I would drop dead any time soon... this is really helpfull... thank you so much... you bring comfort with facts...

Can you please add the links you mention at the end into the description of this video? They are very difficult to find.

Excellent talk! Perhaps oversimplified but as I understand it.. LDL gets oxidized in the presence of cells that send out inflammatory signals. Those oxLDL then serves as a signaling of inflammation and bind with ApoA to form lp(a) so that it can assist in the healing process. People who have chronic high lp(a) may also simply have chronic elevated inflammation. As such it can be used as a proxy for CVD. In a healthy system however, high levels of LDL may actually be beneficial in cases of acute inflammation as it is an important source for the formation of lp(a).

absolutely great, enjoyed it much :) regarding L8a) in severe infections: I think it is actively downregulated, since everything the body is trying to improve flow = reducing viscosity at all costs. But surely, there is regulation, up and down, across a wide range

I am 23 years old having an Lp(a) of 50 mg/dl which should be below

Excellent! Thank you.

Interesting presentation, but the findings appear to be misleading based on the vast majority of literature in peer reviewed journals that clearly support the cardiac and health benefits of low levels of Lipoprotein (a). Posters would be wise to perform their due dilligence, review the peer reviewed literature, and related presentations on RU-vid presented by very reputable lipid researchers, to form your own opinions.

Thank you very much for extremely helpful lecture and insights!

Please have a video on the mechanism of action on how Vitamin K1 is converted to K2. Please verify if fermented meat, fermented fish and Fermented shrimp have Vitamin K2?

Thank you Doc. I thank God for doctors like you who take time to research understand and explain in layman’s terms the biology and functioning of the human body. Truly appreciate the time and effort you have put in to put our fears to rest 🙏🏼. God bless

Pls go on with your style of lecturing! It's much more informative than the widespread way of just using headlines and trigger words! At least I enjoy it, even when I have to use a few brain cells more than usual.

Thank you for this video.

Dr. Ali; Please revisit the subject of Lipoprotein a. I'll be interested in hearing any new thoughts/developments now that more information and research is available. Please and thanks!

Linus Pauling said that Lp(a) levels increase when a Vitamin C deficiency exists and that Lp(a) is an emergency repair molecule which stops bleeding in an arterial wall which is falling apart due to collagen breakdown. So, like Dr. Ali, he consideted it a beneficial molecule but only in an emergency setting;.if the Vitamin C deficiency is chronic then the repair mechanism of Lp(a) would ultimately result in atheroscletotic plaque buildup, he said. Dr. Pauling recommended supplemental Vitamin C, proline, and lysine to rebuild blood vessels.

Your tolks are clear i helpfull. Thank you.

At time 22:29, it was said that the centenarians were represent by hatches, and the controls represented by dark bars. This description however does not align with the legend provided on the graph indicating the opposite.

Maybe since statins increase Lpa, that’s part of how they extend life

Can you use a fibrinolytic enzyme while on Plavix? If not, how long after discontinuing Plavix could you start using Natokinase, Serrapeptase etc? Also, can you use fibrinolytic enzymes while on Statins?

My dad's family all developed heart disease or died of MIs in their 60s. I was just tested for lipo-a, which is 319. I started aspirin as it's the only thing that is recommended to reduce MI risk. I also has a coronary artery calcium test and a carotid ultrasound. I naturally expected bad news. My CACS was zero and the carotid US showed mild plaque, same as 15 years ago. I was stunned.

What about the study "Effects of a Low Carbohydrate diet on insulin resistant dyslipoproteinemia, in the American Journal of Nutrition, Jan 2022? They claim lowering lp(a) with low carb diet with a sample size of 147. What are your thoughts on low-carb?

My understanding is that an association in not a fact; is not directly proven to be causal. I prefer to know for sure that if I am going to ignore abnormal labs results and refuse therapies, based on recommendations made by experts, specialist, physicians - cardiologists etc that the information provided is based on fact. Not on "possible" alternative theories that are not based on fact. I like the proposal of alternative theories, but it is important to STRONGLY emphasize when one provides information that they are just providing hypothesis but there are not clinical trials or studies that thus far have proven a causal outcome or relationship or finding. So, are there proven clinical trials or studies that refute Lp (a) as not being atherogenic and actually benefit one to a level that we should ignore therapies that may be available to us in the next few years?

Stay nerdy my friend :)

I’m 50 my LPa is low on a carnivore ketogenic diet. I thought that was good. Even though high LPa It’s not so bad being high what does that mean for the people with low numbers. My LDL is 250. My total cholesterol 300. I’m in great shape I don’t worry about those numbers with my LPa It’s always 10 or lower

Thanks doc for giving us (with high LP(a)) hope! I’m 59, have extremely high LP(a) but my CAC score is zero.

Thank you! For sharing your immense knowledge that we too can learn I hope you find God in Jesus Christ. He loves you very much! I know!

I was told I have high LP(a) at 138 nmol/L in the UK - trying to compare with the units in studies here but computer says no! Can you shed light on this? Btw recently had a CT angio with calcium score 0 and clean arteries. Doc desperately wanted to give me statins for the lp(a) but refused

has anybody seen dr. peter attia the drive podcast 210?

My LP(a) result was 1371mg/l. The range says

Good doctors seem to understand the body isn’t producing excess anything for no purpose. Every molecule produced has a purpose - the body does not waste resources…

What is considered “really high” Lp(a)? I just got my results back and my Lp(a) is 246 😳 ApoB 93, LDL particle count 1867. I ordered all my test online, I don’t have a doctor. I’ve googled everything and apparently this is really bad?

My Lipo(a) is 198 mg/dL, but my hs-CRP is low. If Lipo(a) is a fireman, what fire is it working on??

Thxs for this excellent presentation..my lp(a) is > 170 ...I ll try taking Vit C, Niacin and Cysteine

My LpA is 8.4 Dr. Just took the test

Dr. Ali's bottom line research analysis: Statins elevate the risk of CVD, This is the smoking gun. Brilliant!

My LP(a) is 1025 mg/L. This seems off the scale. So does this mean I have nothing to worry about, according to your video here? I hope so! I genuinely am rather frightened by mainstream doctors telling me I have this high level, but there's nothing I can do about it. As well as this, doctors are not interested in treating me because I don't want to take a statin, am not old enough to be ill (apparently - am 36) and as I've not had a heart attack yet, they do not want to know. I can't even have a heart scan to check everything is okay.

Would it be possibly helpful to raise Lpa by using a statin since your data showed better results (small amounts) for some conditions? Recall a website that was started by people who had high Lpa and had heart attacks... but it said need to test right way (forget if by mass or weight). Also read article by a Dr with Lpa, that were trying some nutrients and also some diet changes did effect amount Lpa. read Dr Rath had article also and said vitamin C can be helpful (said Lpa was used by body when not enough vite C I think).