July 30, 2018


#07 – Deep Dive: Lp(a) — what every doctor, and the 10-20% of the population at risk, needs to know

"Elevated Lp(a) may have conferred a survival advantage for most of human history: a better ability to deal with acute trauma, but possibly at the expense of poor handling of chronic damage. In today's environment, for many people, that's not an advantage." —Peter Attia

Read Time 11 minutes

This is our first “deep dive” episode that goes into detail on one topic. Pronounced, el-pee-little-a, this lipoprotein is simply described as a low-density lipoprotein (LDL) that has an apoprotein “a” attached to it…but Lp(a) goes far beyond its description in terms of its structure, function, and the role that it plays in cardiovascular health and disease. Affecting about 1-in-5 people, and not on the radar of many doctors, this is a deep dive into a very important subject for people to understand.


* If you would like us to do a deep dive on a particular topic, please submit your request to the comments section of this post. Please look at the existing comments before posting, and “upvote” the topic (or topics) you want us to cover. *

Note: this podcast gets technical at times. The figures in the show notes are your friends. They truly speak more than a 1,000 words apiece. I can’t emphasize enough how helpful it is to look at the figures before, during, and/or after I try verbally walk you through things like kringle repeats, molecular weight isoforms, lysine-binding domains, and plasminogen homology, as a few examples. If you stick with it, I think you will be rewarded.

We discuss:

  • A quick primer on lipoproteins [7:30];
  • Intro to Lp(a) [11:00];
  • Lab tests for Lp(a) and reference ranges [20:00];
  • The physiologic functions of Lp(a) [31:00];
  • The problems associated with high Lp(a) [34:15];
  • Lipid-lowering therapies of Lp(a) [44:45];
  • Lp(a) modification through lifestyle intervention [1:00:45];
  • High LDL-P on a ketogenic/low-carb-high-fat diet [1:05:30]; and
  • More



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Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
  1. In the show notes you mention the 2 Lp(a) SNPs but in the podcast, I didn’t hear mention of those. Can you please feature these SNPs?

  2. Please deep dive dietary ketosis especially talking about risks/benefits of short term, intermittent, and life-long adherence.

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